I am a huge advocate of home birth and think it is fantastic. Both of my children were planned home births (neither were actually born at home though – that’s a whole other blog post!), but the more I work in the birth field, the more I am becoming convinced that it is not the actual place of birth that matters. It’s what and who is in your birthing space that has the strongest influence. Birthing in a hospital does pose some challenges to achieving a natural birth (if desired), but contrary to popular belief, it IS possible to have a good, enjoyable, and drug-free birth in a hospital setting.
The Birthing Space
In my opinion, the absolutely most important thing to consider is your birthing space. Feeling safe and comfortable plays such an important role in your body’s reaction to labour, and your environment has a lot to do with how you feel. So take the time to plan how you want to personalize your birthing room at the hospital. Always remember that you can control most environments and make them as birth friendly as possible. Whatever and wherever your original plans – it is always possible to retain some control over your birth environment.
Lighting is key! – Hardly any hospital rooms have oxytocin/melatonin friendly lighting. Bright lights are a huge inhibitor of labour progress, which is why most women prefer a dimly lit environment to birth in. In hospital rooms you are unable to light candles (compressed gas!) and so I am a huge fan of battery operated candles. So shut the blinds, dim the lights, and scattered some battery operated candles around the room to get that oxytocin flowing!
Play some tunes – My husband’s main job during labour was to be my DJ! I found music so relaxing. It helped me tune out all of the hospital hustle and bustle around me. Some mamas-to-be make a ‘labour playlist’ containing their favourite songs. They don’t all have to be relaxing, either. Play whatever music will help you feel comfortable. I have even had some doula clients who preferred to play sounds, such as rainfall or crickets.
Get rid of that ‘hospital smell’ – Our sense of smell is the sense most closely related to our memory. This can work either for or against us. The smell of medical equipment, antiseptic and latex gloves can bring up unpleasant feelings for us, most often triggering the release of adrenaline-- which in turn can slow labour and increase pain levels. Whereas the smell of plants, flowers, the ocean and the smell of our home can all encourage us to relax and feel good. Consider bringing some aromatherapy with you (but first make sure that you are not birthing in a ‘scent-free’ hospital).
Ask for the staff to respect your privacy – The feeling of safety and privacy is so important when you are in the birthing process. Consider asking for the staff to enter the room as minimally as possible, and to limit vaginal checks. I’m sure you can imagine that an unfamiliar doctor entering the room, turning on the lights, and sticking his/her hand up into your cervix is not particularly beneficial to the birth process!
Don’t confine yourself to the hospital bed. If you require an IV, or need to be monitored continuously, there are lots of positions that you can try! I have been to many births where the nurse tries to convince the labouring mom that she MUST stay in bed because of the monitors. This is simply not true. Sitting on a birth ball and leaning on bed, hands and knees on bed, or standing up and leaning on bed are all positions you can try while trying to stay close to the bed/monitor. Being in the hospital also doesn’t mean you need to birth on your back. Speak to your caregiver in advance about other positions that they may be comfortable with, including hands and knees on the bed and squatting using squat bar.
Don’t Arrive at the Hospital Too Early
Early labour often moves slowly, and also starts and stops. Being at the hospital before active labour is established might make it more likely that your labour is augmented. Induction agents are so commonly used today, even for women already in labour. If you want to avoid them, then you may want to get some of your dilation out of the way at home, where you can move freely and are not on the hospital's schedule.
Be an Informed Birth Consumer
Though it may not often seem so, birth is a consumer issue. When speaking about their experiences with labour and birth, it is very common to hear women say, “they won’t *let* me do that”. Some women seem to have forgotten that they are customers receiving a service, hiring a service provider, not a boss. YOU are the expert on your body, your labour, your birth, and your baby. The rest are paid consultants, not experts whose opinions, ideas, and preferences override your own. You might frequently feel comfortable with your doctor’s recommendation, but if you don’t, remember your right to informed CHOICE.
Tackle Perceptions, Concerns & Fears
You may have fears about going to the hospital and the routines that may come with that birth location. You may feel as though these are the very things that may get in the way of you having an enjoyable experience. I can empathize with that worry (as I was once in your shoes) but want to encourage you by saying that when you are well prepared and educated, you will be able to negotiate, avoid or adjust to many of these procedures. It is important that you talk through your concerns with your partner, doula and care provider before your birth.
Whether you are at home or in the hospital, being surrounded by those that allow you to feel comfortable and uninhibited during labour is key. Consider hiring a doula! Doulas are not for everybody, but they can really help both mom and dad have a better hospital birth. Even when you have prepared well for a birth class, a doula can help you remember what you have learned. If you want your partner to be your main source of comfort, you can always talk to the doula about helping him, help you. Labour can be long, and an extra pair of hands can be really helpful. If you don’t want a doula for one reason or another, consider asking your mom, sister or friend to be that extra support.
As a doula, I have had the privilege of witnessing so many beautiful moments during labour. From loving embraces, to funny (but appropriate) jokes to lighten the mood, a woman’s birth partner can most certainly be her rock during labour. But I have also observed those moments that people in the Twitterverse like to call #epicfails. Someone says the wrong thing, or eats the wrong food. It really doesn’t take much to anger or upset a labouring mama, so here are some tips to help you stay on her good side:
1) This first one is a biggie but it can be a tough one to master, especially for all you men out there (sorry, but it’s true). Try not to say anything stupid. In case you don’t know what would constitute a stupid thing to say, here are some examples: “does it hurt?”, “are you okay?”, “how long is this going to take?” or “I can’t believe I am missing the big game”. Do not say any of these things. And keep in mind that this this is far from extensive, so think before you speak.
2) General complaining is also a BIG faux pas. I do understand that it has been a long night/day/days. You have every right to be tired, hungry, sore and anxious. But for the love of bananas, act like you are perfectly fine! Your partner doesn’t need to hear you whine. Nothing you are experiencing is as uncomfortable as what the labouring mom is going through, so suck it up, buttercup!
3) A labouring woman (or women in general, really) can quickly tune into how others are feeling and acting, so if you think you aren’t coping well then don’t let her see it. If you can, leave the room until you feel more composed.
4) If you are having a hospital birth it may be hard to turn away from the super cool mountain drawing machine (AKA contraction monitor). Those things are borderline hypnotic, but ignore that pesky monitor! All of those beeps and buzzes mean nothing of consequence and distract you from mom. In fact, I feel like they give partners a false sense of understanding what the labouring woman is going through. Avoid comparing the monitor to her pain level, and steer clear of phrases such as “these contractions aren’t nearly as big as they were two hours ago” or “here comes a contraction”. Trust me, mama knows what’s going on with her body way better than the machine attached to her does.
5) Don’t interrupt a woman who is coping well with a technique or idea. Encourage what is working for her instead of trying to introduce new ideas or tips.
6) Sense of smell is heightened during labour and many women become nauseous. Avoid eating in front of her (unless she is okay with it) as the smell of food might be a big turn off. During the labour of my first son I became very agitated when the smell of cucumber wafted in my direction. If you step out for a bite to eat then brush your teeth before you return. And if mom has medical circumstances that do not allow her to eat food, then eating in front of her would constitute cruel and unusual punishment.
7) Try not to be preoccupied with other thoughts such as getting the car seat installed, getting to the coffee shop before it closes or calling your mom. Your partner is your main focus, and being overly concerned with anything else will earn you some evil stares.
8) As labour progresses, mom will likely want the chatter toned down a bit. Follow her lead. Be silent if she is being silent. Bring a book to read in the corner or nap if you can. Don’t ask open ended questions, especially late in labour. Stick to ‘yes’ or ‘no’ questions. And most certainly do not ask any questions during a contraction. I’ve witnessed this occurrence on several occasions and it is never pretty
9) Do not encourage mom to do things that do not fit into her birth plan. If mom desires to avoid pain medication do not suggest it because it is hard to see her in pain.
10) Don’t ask her what you can do to help. She is likely too exhausted to come up with an answer, or she simply just doesn’t know. Instead, just try things that you think might help. She’ll let you know if she doesn’t like it and if she does, don’t take it personally.
Disclaimer: Evey woman is unique. Reading this blog post does not guarantee that you will not say or do anything stupid. I do not take responsibility for any omissions that have gotten you into trouble.
Pregnancy, birth and parenthood are times when it is best to tap into your instincts and inner wisdom, but that can be hard to do in a world full of experts, advice and education about what you “should” be doing. So I sometimes find it insightful to turn to the animal world and discover how their instincts and inner wisdom drive them. In this tutorial, I will teach you how to birth like an elephant.
Step 1: Surround yourself with loving support. Female elephants in the wild huddle around a birthing mother and protect her within this circle. They have their bums pointed toward the birth and their faces looking out on the landscape. Facing outwards protects the mama elephant against predators, and also affords the mama some privacy. Just like elephants, birthing women tend to prefer privacy and don’t like to be watched. That is why it is important that you find a doula, a partner or family that will protect you, but also respect your birthing space.
your birthing space quiet and dark in order to keep your melatonin flowing. It has been shown that melatonin acts synergistically with oxytocin to increase the efficiency of contractions.
Step 3: Don’t disturb the amniotic sac. In most cases, the baby elephant drops to the ground inside the amniotic sac, which breaks when it hits the ground, releasing both the calf and a lot of fluid. I often hear from new moms “...my waters didn’t break on their own so the doctor had to break them”. But artificially rupturing the membranes is unnecessary. Just like in elephants, a baby can be born in it’s sac if it doesn’t break on its own before the moment of birth. And there are plenty of benefits to keeping the sac intact (if possible) during labour.
Step 4: Celebrate and rest.The herd that surrounded the mama elephant during birth proudly trumpets the arrival of its newest baby member, and also creates an impenetrable wall around the newborn until it is able to get to its feet. The herd pauses for a couple of days to give the newborn and new mom a chance to rally their strength. Much like elephants, mom and baby need a chance to pause and bond after birth. So try to take some time to recover and celebrate the birth. And surround yourself with a support network that will protect and take care of you while soak in those precious moments.
Step 5: Eat your placenta? The placenta may not be expelled for a few more hours after birth. But when it is, the elephant mother observes standard procedure for many wild animals -- she eats it in order to conceal the birth from predators. To leave it lying on the ground would be an announcement to all predators within miles that a newborn elephant was now within their territory. Maybe eating their placentas also has the added benefit for elephants of balancing their postpartum hormones, like it does in humans? After 22 months of pregnancy, I am sure that their hormones are going crazy! But for the record, a 22-month pregnancy is not an elephant trait that I suggest you mimic.
We all have instincts, but as humans we tend to value conscious thought over gut feelings and we are quick to ignore our intuition. So, when you are feeling overwhelmed, and your instincts are being pushed down by a barrage of information, try to ask yourself what an elephant mama would do! She would surround herself with loving females who create a sheltering circle around her and give her privacy. She would find a safe, comfortable, dark space in order to help keep her melatonin levels high. And above all else, she would enter labour full of strength, joy and respect for the power of birth.
Shame and guilt appear to be accepted aspects of motherhood. There is very little a mother can do that doesn’t make her susceptible to being shamed into feeling like a ‘bad mother’. If you formula-feed, you are denying your child a healthy start. If you breastfeed past one-year, you are a hippie attachment parent who can’t let their baby grow up. If you go back to work early, you are abandoning your child. If you stay home, you have no ambition (I have done ALL these things by the way). The list goes on…
Shaming also extends into the birthing world, and birth shame is personally something that I have carried with me for some time now. After attending an awesome lecture by Jodi Hall at this weekend’s Birth & Beyond conference, I was inspired to explore my birth shame a little deeper.
When I was pregnant with my first son I had planned the birth that many doulas dream of. I had the midwifery team, the doula, my home birth supply list, and even a spot in my backyard picked out for planting my placenta. It was going to be a peaceful, primitive and undisturbed birth experience, complete with rainbows and unicorns. Well, it turns out (in case you didn’t know) that things don’t always go as planned, and I ended up in the hospital at 36.5 weeks facing an induction.
Induction is a bad word in the birthing community. It should be avoided like the plague! And I was a doula, so shouldn’t I know better? Shouldn’t I be ‘informed’ enough to know the risks? Against what I was taught I went ahead with the induction. After 12 hours of labour my son was born, and was immediately whisked away to the NICU. Instead of making memories of our first gazes, or taking pictures of his tiny feet, I was left in the birthing room without a baby. Were my choices the reason that my baby was in a cold incubator all alone? Was I the reason that we missed out on those first precious moments together? My shame convinced me that our mother-child bond was compromised by my failures. All I could see was that I hadn’t been good enough, that I hadn’t tried enough, and that I hadn’t been smart enough. Maybe if I had refused Pitocin, the birthing process wouldn’t have been so hard for my son. All the things that I could have done differently swirled in my head.
As a doula, I felt somewhat like an imposter for not having the intervention-free birth that I had envisioned. I would share my birth story with other moms and doulas, but I felt the need to justify all of my actions and to explain all the medical reasons that led to an induction so that I wouldn’t be judged. Luckily, with time, the shame simply morphed into disappointment. I was soon pregnant with my second and I had convinced myself that I would do things entirely different this time around. But unfortunately many of the same problems that plagued my first pregnancy started creeping up again, and it looked like my rainbow-coloured home birth was just a fantasy.
After 37 weeks of a very emotional second pregnancy, I made the decision to be induced before my medically necessary 'deadline date' (cue audible gasps). I was exhausted and worn down by a difficult pregnancy. And I was sick of being treated like a ticking time bomb. I was done with the blood tests, the ultrasounds and the non-stress tests. I was just done. I knew it was the ‘wrong’ choice to make, and I carried a lot of shame over it. I didn't telI anyone about my choice (until now!) because I was afraid that I would be judged by other moms, and by other birth professionals. But after some self-reflection I have realized that it wasn’t the wrong choice to make, because it was the right choice for my family in that moment and it involved so much more than simply weighing the medical benefits and risks of an induction. My fears, my hopes, my past experiences, my knowledge, my insecurities, and the information I was given were all factors in my choice to be induced. And people can judge my birth choices all they want, but I am no longer going to let their judments cause me shame. I am proud of myself, and I am proud of my births.
Being a mom is the source so much guilt and feelings of failure. Let’s not make birth one more thing that we fail at as moms. Let’s support each other and the decisions that we make, even if they were ‘uninformed’, or based on fear or pain. Let’s watch our words and our thoughts, because they can have a big effect on how a woman remembers her birth experience. Let’s not project what we feel is an ideal birth onto someone else…it may not be what they consider ideal at all. And let’s focus all of our judgey energy on making maternity care system better, and not on shaming the woman within the system.
Kiss-ass doula, pretty okay-ish mom, spreadsheet enthusiast, punctuality freak, ice cream addict.