I recently did a Facebook LIVE! Yeah, I know! I actually did it... You can watch it HERE.
It was all about having a more homely birth in the hospital. Soo there are some obvious things to add here. It isn't going to feel like home, if you are birthing in hospital. BUT there are elements of home birth that you can draw on and bring into the medicalised environment, to make it feel that little bit more comfortable.
There are many occasions where home birth may not be the safest or preferred option for women, but that does not mean you must endure difficulties which often arise within the hospital. What I mean by this is that as soon as you walk through the hospital doors you are subjected to medicalised opinion and procedures, did you know you have a choice?
Just by starting your labour in an obstetric unit you have a higher chance of epidural and caesarean section, but why and why does this always have to be the case? Because you begin to hand over autonomy to staff and take the role of a patient when in hospital. You need to take back control and promote physiology as far as possible, to give you the best chance of the birth outcome which is idealistic for you.
Why birth in hospital?
Anyone can birth in the hospital, but you should consider this wisely. Maybe have a read of The Birthplace Study (2011), to support you in making an informed choice. Hospital is generally the recommendation for anyone with medical conditions or complications within their pregnancy. This is so that if any issues arise, you are able to get support from a range of professionals quickly. It may also be the best place for someone who is reassured by the medical environment. Lastly, you may be transferred from home or the midwifery led unit, in some cases. Hospital isn't the enemy, but you must know how to use the space to your advantage.
How does the body work?
Lets recap on physiology quickly. Your body needs to be as relaxed as possible, for labour to work. When you are relaxed, your body releases the lovely hormone called oxytocin. This allows your uterus muscle to have surges (contractions) and birth your baby. Wahooo. If oxytocin is produced, there will be good blood flow to your uterus and baby.
If you are stressed, you will produce adrenaline. We don't want this! You will enter the fight or flight state. All your blood will go to your limbs, ready to run away. This means it goes away from your uterus. If you aren't getting blood or oxygen to your uterus, it won't be able to work well. Your baby may also become stressed. Think - if you hold your arm in the air, the blood drains out and it begins to ache. Your uterus feels this too and it may be why we experience pain in labour if we are panicked.
You can't produce oxytocin and adrenaline at the same time. This is important.
What makes birth more difficult in the hospital and how can we help it?
1. The environment – not necessarily where you feel safest, smells, equipment, lots of people, bed set up in middle of room, we take the role of the patient and feel uncomfortable.
SO... make it your own. Take things with you that make it feel more like home. Put the bed in the corner, utilise the space. Cover up machines. E.g. smells – lavender, room spray you like, clary sage. Stuff – pillows, colours, positive affirmations, birth ball, dim lighting, clothes that are comfortable. Noises – ear plugs or headphones, relaxation MP3’s, playlist you love, limited talking and calming voices. Tastes – food, sweets, Lucozade, mints.
2. The people – very experienced professionals but they are everywhere, can burst in the door all the time, even cleaners. Midwives tend to watch over you, which can be disturbing to your natural physiology. Your cat wouldn't give birth being watched.
SO... have a birth partner who makes you feel safe, midwife who you get on with i.e. if you don’t get on/click with them, ask for someone else! Make sure people always knock before entering and think, do you need the midwife in there with you at all times?
3. Cascade of intervention – especially if you are ‘high risk’ you’ll be recommended continuous monitoring which most people do on their backs = no gravity, harder passage for baby, picks up every single change in heartrate, more pain on back = epidural = slower progress = quicker to jump in with medical intervention
SO... Do you need continuous monitoring, full stop? Is there the evidence? Doesn’t always improve outcomes for baby compared to intermittent auscultation, but does increase caesarean section rate. If it is needed, can you get off the bed? Wireless monitoring? Or adopt a better position? Can you use other methods of ensuring you are comfortable? E.g. pool, gas and air, breathing, tens, massage, aromatherapy instead of going straight for the epidural? If using epidural, how can you continue to promote physiology? It isn’t a case of no discomfort = do what you want. Think of your body! It is still in labour.
4. Loss of bodily autonomy, feel like you cant say no and that doctors know best, they only ever see emergencies or when things go ‘wrong’ so are less likely to promote physiological birth.
SO... Choices – using your BRAINS. What are the benefits, risks, alternatives, my instincts and doing nothing? Allow time. Before birth and during. Do your research. Birth preferences. Evaluate for all circumstances. Your body – should not be any coercion. Say no if you don’t want it, ask for evidence, what is best for you? WHY? Don't feel like you are being annoying!
5. MORE options? Yes, there are so many more options in hospital. So hard to work out what is best! Specifically for pain relief which is constantly offered, even expected! If you don’t have it you are ‘weird’ or ‘unusual’, feel like you have to have it or cant make those sorts of decisions whilst in labour. Labour isn't the time for making decisions, so do it beforehand and know your stuff.
6. If you know you’ll be birthing in hospital, you might think that you don’t need to educate yourself, so not prepared properly for your choices. If anything, choices are MORE important in the hospital!
7. Hospital policies and time limits, don’t want to go against the grain as it can cause difficulties in itself. Educate!
SO... Hypnobirthing classes – not only for home births. Useful for hospital too! My classes encorporate hypnobirthing techniques and theory, as well as birth preferences, what happens in labour, what is the evidence and how you can have the birth that you want. It is a mental shift, not a totally physical process. If you aren’t prepared, you cant expect for things to go how you imagine. Having worked in an obstetric unit, I know what goes on. I know my stuff guys...I'll tell you the truth, I'll teach you how to advocate for yourself and I will be your support until way after the birth. This isn't just hypnobirthing. It is continued support, guidance and showing you that you are incredible.
If you want to book a course, get in touch! There will be an option for you. I teach in East Sussex or via skype if you are hundreds of miles away from me. And I am offering 10% off all classes for the month of October! Don't miss out my lovelies xxx