Positive childbirth: birthing a better story

When journalist Danielle Batist became pregnant, she was shocked by a cultural overdose of dramatic birth stories. A year after her own baby arrived, she explores efforts to create a more balanced picture of childbirth

“You’re not ill, you’re just pregnant”, was the response from Dutch friends and relatives when I broke the news to them. Everyone in my family was born at home and no one batted an eyelid when I explained my natural approach to birth.

But in the UK, where I live, things were different. I was surprised to encounter almost exclusively shocking, drama-filled stories about childbirth. From horror stories online and sensational accounts in the tabloids, to conversations in the pub (“My cousin’s auntie’s neighbour gave birth in a shopping centre”), it seemed as if no one had a ‘normal’ birth. I wasn’t even sure what that was.

I went along to pregnancy yoga sessions and classes held by the National Childbirth Trust where people often referred to the popular TV show One Born Every Minute. They said it made them nervous about what was ahead. I tried watching the programme myself and, despite having an idea of how TV editing works, all the screaming, panic and bright lights failed to put me at ease. Neither did it calm the nerves of my partner.

We weren’t alone in our reaction. A few months into my pregnancy, a campaigner for fear-free childbirth launched a petition urging Channel 4 to present a more balanced portrayal.

By the time I went on maternity leave, I found myself desperately googling ‘positive birth stories’. To my relief, there was much to read. Mum-of-three Milli Hill, who lives in Somerset, founded the Positive Birth Movement four years ago after spending much of her first pregnancy feeling “terrified” by negative narratives around childbirth. When her own baby was overdue, she delayed being induced. “Whenever I told people that, they would say: ‘Really? I didn’t know they let you do that!’ That used to really annoy me. Why are women made to feel that the choice isn’t in their hands?”

Positive information

The movement, despite being mocked by some for addressing ‘first world problems’, rapidly gained momentum. It has since sparked more than 400 ‘real life’ groups that meet regularly around the UK, as well as in 35 other countries including the US, Brazil, Indonesia, Turkey, Uganda, South Africa, Morocco and Poland. Hill, alongside the midwives, obstetricians and doulas [birth ‘mentors’] who run the groups, stresses that a positive birth does not necessarily mean ‘natural’ or drug-free – it simply means being informed from a place of positivity as opposed to fear and misinformation.

The definition resonated with Leah Neuhauser, who delivered her son by emergency caesarean. She moved from the US to the UK mid-pregnancy and found support at Positive Birth Movement meetings. “Birth in the States is very clinical. Not once was I told I had any choice about how my son was born. These are our babies, our birth experiences: shouldn’t we have the right to choose? The meetings provided a safe environment to talk about things they don’t tell you in the books. I felt much more at ease knowing I had options.”

Positive principles are even being applied on a clinical level. ‘Gentle caesarean’ refers to a method that incorporates more natural aspects of childbirth, from mothers being able to witness their deliveries to having skin-to-skin contact right away.

This is about how women are treated and the effect that has on the rest of their lives

NHS obstetrics consultant Andy Simm, based at Nottingham University Hospital, says: “The idea has been around for about eight years and is starting to take off around the country. It is about creating a soft environment and making the birth less clinical. And it doesn’t require any more staff than a regular caesarean – it just adds a few more minutes to the operation. For those needing a surgical delivery, it definitely softens the experience.”

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The UK charity Birthrights aims to improve women’s experience of pregnancy and childbirth through emphasising their human rights. Founded by a group of lawyers, it promotes respect for rights including dignity, autonomy, privacy and equality.

Human rights are particularly important around childbirth, they say, when women may be more exposed and vulnerable; physically and emotionally. More than 1,100 mothers responded to the charity’s 2013 Dignity in Childbirth study. Of those who had given birth naturally, 22 per cent reported that their experience of childbirth had a negative impact on their feelings about themselves, their relationship with their baby and their partner. For labours in which instruments such as forceps were used and in caesarean section deliveries, these figures rose to 77 and 73 per cent respectively.

But Hill believes a ‘quiet revolution’ is taking place, a shift in mindset toward more empowered, positively framed births. “We’re talking about human rights here, not about whether somebody wants music and tea lights while they are giving birth. It is about how women are treated and the effect that has on the rest of their lives.”

Improving expectations

While cultural and societal attitudes need to change, a more personal shift may also be required. “Some women respond by saying: ‘All that mattered was the healthy baby’. Admitting that your own experience matters too can be seen as somehow selfish. Of course a healthy baby is what we all want, but that should be the baseline of our expectations, not the pinnacle,” says Hill.

And problems may be being exacerbated by the strain being placed on midwives. Excessive workloads and inadequate staffing levels are causing many to leave the NHS. Some are reportedly looking after as many as 15 mothers and babies at a time. The Royal College of Midwives has warned of an imminent ‘midwife exodus’.

There are signs of progress however, even within the NHS. When I told my nearest hospital I wanted a home birth, they transferred me to a brilliant group of local NHS community midwives who support women wanting to give birth at home. It was a postcode lottery and I just happened to get lucky. My midwife Emily came to my house for all my check-ups and introduced my partner and me to her colleagues in person, so we knew whoever would be on call.

In the end, it was her colleague Vicky who attended my labour, in the middle of the night during Easter weekend. She was calm, supportive and let me get on with it, just as I had hoped. My other half was fully involved and helped with everything from making infinite cups of tea and filling the pool, to timing contractions.

In the end, I got what I always hoped for: a calm, safe and intimate home birth, and a healthy, beautiful baby. It was possible, it turned out, within the UK’s national health system, with a fantastic team of midwives.

In the end, I got what I always hoped for: a calm, safe and intimate home birth, and a healthy, beautiful baby

A labour of love

Midwife Vicky Guilor says: “Fear of labour and birth can have a physical effect. For a labour to progress, the ‘love hormone’ oxytocin needs to be produced and that only happens when women feel safe, calm, relaxed and loved.

“Fear and anxiety stimulate adrenaline and cortisol. These then block natural, pain-relieving endorphins. This can slow a labour down and make it more painful. I try to prepare women to let go of fears, give in to their body and let nature take its course. This may not guarantee a straightforward birth, but it will guarantee a positive one.”

This feature is from issue 88 of Positive News magazine

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Images: The Birth Lens, Amber Pembleton Photography