Accepting that I took a risk

Often I’ll read something and it will point out the downsides of decisions I’ve made as a parent.

This use to really upset me.

Just yesterday I was ready about co-sleeping, SIDS and breastfeeding. Now one of the benefits of breastfeeding is a lower rate of SIDS. This isn’t a benefit. Breastfeeding is the biological norm, so the lower rate of SIDS should in fact be the baseline and formula feeding would increase the risk. So by formula feeding my first baby I increased the risk of SIDS.

Now if someone had told me this when she was a baby I would have heard it as a personal attack. I was doing the best I could, I couldn’t change the fact that she was formula fed once I started, how dare someone insinuate I was risking my baby’s life.

It was when she was around 8 months old and we were thinking about a second baby it dawned on me. Statistics are not about making mothers feel bad. Not in the slightest. They’re a warning to those who are making decisions about feeding methods.

Perhaps if on the can of formula it had said that by giving my infant a bottle I was risking – SIDS, obesity, diabetes, allergies, childhood cancers etc. Perhaps if it had said that babies who were formula fed were hospitalized more then the breast fed counterparts. If I had of been told the real risks I would have fought harder to breastfeed. I really truly believed that formula was just as good.

Now we got lucky and my daughter was never sick as a baby and so far so good. But studying naturopathy and beginning with nutrition, I’ve once again had to accept that the decisions I made when she was a baby could have long lasting impacts and I have to accept that and own those choices. I don’t feel guilt, or anger, or sadness anymore, but I do accept my choices.

I read this article yesterday. My son was born at 35 weeks. It was life or death. If I haemoraged for an 8th time we may not have survived. But I still worry for his future. I don’t feel guilty about making the choice to deliver, however I accept the risks and going forward I watch for signs that he is struggling and will find him help if he needs it. So far so good.

It’s important to talk about risks vs benefits when we are making decisions, not to make anyone feel bad but to make sure their decisions are informed.

Because knowledge is power, and if we all have as much information about a choice as we can possibly get then ultimately the decision we make will be the absolute best for ourselves, our children and our situation. Sometimes that means doing what we need to do instead of what we want to do like waiting instead of inducing or cutting out caffeine instead of switching to formula.

But with all the information your decision will be one that is informed.

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Defining Natural

It is safe to say that csections are not natural birth. They’re surgical births. And I’ve never heard anyone argue to the contrary.

However the definition of what is natural birth can cause some pretty stirring debate.

Some will argue that vaginal birth no matter what is natural birth. Even if it is induced, medicated and riddled with intervention.

Some would argue that only true unhindered birth without any intervention is natural childbirth and that natural childbirth can never be achieved in hospital because it’s an unnatural setting to birth in.

I’m somewhere in the middle.

To start I believe that a birth does not have to be natural to be empowering. Even csections can be positive and as long as the mother has a chance to make an informed choice then she should be proud of her labour and birth.

I do not believe that birth that is medicated is natural childbirth the same way I don’t believe that taking paracetamol to relieve a headache is natural.

I do not believe that birth using forceps or vacuum is natural childbirth. You may have labored naturally but an instrumental delivery is an assisted delivery. Same as walking the last 100m of a running race doesn’t equate to running the whole way. It’s still a huge effort that you should be extremely proud of, finishing is finishing and birthing unmedicated is birthing unmediated but forceps and vacuums are not natural.

I believe a natural birth means without unwanted intervention. I know some women get offended if you say their birth wasn’t natural because of xyz. That’s not my intention. I believe all women should feel empowered by the births of their children. But I don’t believe vaginal birth automatically means natural birth.

That being said I do believe a natural birth is possible in hospital but I do believe it’s difficult to achieve.

If you want a natural birth you are more likely to get it at home, and if you’re in Australia the Joyous Birth is the perfect Homebirth community for you.

BellyBelly has a great article on planning a natural birth.

I’ve never had a natural birth. I’ve had an empowering medicated vaginal birth and a traumatic planned csection.

You can’t write about THAT!

Birth trauma. It’s a dirty phrase. To some women it’s empowering, freeing, validating, it relieves some of the guilt surrounding their birth experience and opens the discussion.

To other women it’s like spitting venom. You say birth trauma they hear “weren’t open to the unpredictable mature of birth.”

Or you’re expectations were too high. Or you were too prepared. Or you weren’t realistic. Or at least you have a healthy baby.

I mean just read Dr Maimy’s Horror Story Homebirth blog with all them dead baybeez aren’t ya glad that’s not you?

Right.

The top 10 Birth Trauma myths

1. Birth trauma is just being disappointed that something didn’t go ‘quite right.’
Women aren’t traumatized if the wrong Enya CD is playing while she labors or if the birth pool is missing an inch of water. Birth trauma isn’t about hippy mums being disappointed. Birth trauma is about really bad shit going down during labour and delivery. One is traumatized when they believe either themselves or their baby are in danger of death or serious injury. Still believe trauma is a farce?

2. Birth trauma only happens if you’ve had your expectations too high.
Doctors are busy/stressed/just doing their job/know best blah blah blah. This gives them permission to cut episiotomies while women scream “no don’t cut me” or to perform internals while women scream “get your hand out of me”? It might sound like I’m being dramatic but every hospital I’ve been to gives you a pamphlet stating your rights as a patient, one of those rights is to refuse treatment. I’d say screaming no is refusing, so why is that right to refuse treatment removed when you’re in labour? Are my expectations too high if I expect my basic rights to be respected? I also believe in a first world country women shouldn’t be experiencing permanent birth injury. Prolapsed bladders, uterus, anal fissures needing surgical repair… This is happening in Australian hospitals!

3. Birth trauma only happens to mothers wanting natural birth.
No. I have a good friend who labored for many many hours begging for an epidural, and was told time and time again to suck it up and get over it it’s just childbirth from several different midwives. She then birthed a large baby who got stuck in the birth canal and the OB manually moved her. The whole thing lasted 40 hours and she developed kidney issues afterwards for an untreated UTI. She wanted a hospital birth and trusted her doctors and staff. And was very disspointed as a result.

4. Birth trauma only happens if you end up with a Caesar you didn’t want.
Vaginal births can be equally as traumatic. Some vaginal births are so traumatic that women go on to have elective Caesars for subsequent births as a result.

5. The trauma ends in the delivery room.
Not always. It can follow you up to the antenatal ward or go with your baby to NICU, or both.

6. Those who talk about birth trauma really just hate doctors and midwives.
Not always true. I loved the OB present at my first birth, the midwives who cared for us were lovely, kind and compassionate. There were several midwives who cared for me on bed rest who were great value. The OB who delivered him was wonderful, he really knew his stuff, and the anethesist was kind and accommodating. This isn’t about demonizing anyone, it’s about giving voice to our pain, our trauma and it’s about saying “I’m not okay with how this all went down.”

7. Doctors are just doing their job.
And some doctors are doing poorly at it. Take your car to a mechanic and he screws it up, the basic service is done but he’s tracked footprints on the bonnet, there are cigeratte butts in the glove box and his dirty smelly mechanic smell all over the backseat… But he did his job and the car still runs. So why recommend piss poor OBs and under performing hospitals?

8. Birth trauma happens when you micro manage birth and your plan is too detailed?
I believe it’s essential to have a plan, it’s important to research and have expectations. This isn’t about the wrong CD or wrong oils being burnt. See true natural birth is primal and instinctive, and while it’s important to be open to change or the unexpected in birth, the unnecessary can wait. Routine OBs may need to be on the dot for say a patient on the general ward, but a woman in labour needs space and freedom to move. Strapping a laboring woman down for say a half hour for fetal monitoring can be like torture.

9. Doctors know best.
Really? Always? I have a friend who was screaming during second stage of labour “he’s stuck” over and over. No one listened. He was born with a broken colar bone. Let’s face it they’re not gods, they’re just people who went to school a little longer. They make mistakes. They forget to read charts before they walk into patients rooms (cheers resident who came into my room while my baby was in NICU and shrieked “where’s your baby!”) Australian hospitals are understaffed, doctors work long hours. I get it. You make mistakes. However doctors go home probably never think about it again. Women are reminded of that day over and over. Everytime they’re carrying their newborn and someone asks about the birth, everytime they look at newborn photos and then every single year on the date.

10. Talking about birth trauma is offensive to women with still horns and premature babies.
Not at all. I think it’s important to pick your audience carefully. I wouldn’t tell my birth story to a woman who had just lost a baby, I would tell our NICU story to a mum of a prem so she could see you can get out of there and breastfeed. I am offended for the women who are told to shut up and suck it up because there are women and babies like us who have it ‘worse.’. What is traumatic to one may not be to another. It’s all relative.

Birth trauma is not an invention of the Natural Childbirth Community. It’s not about making anyone the ‘bad guy.’

It’s about standing up, saying that our experience was shit and demanding better care for all women. Not just homebirthers.

All women deserve top quality obstetric care. And in a system where women are left with permanart birth injuries like catheters and vaginal prolapse, it’s obvious that the system needs to have a good hard look at itself.

It’s not about blame or shame. It’s about highlighting what’s not working. Because we can see the beautiful babies, but if no one speaks up about what’s going wrong then it will never be fixed.

Fed up with cyber bullying

I have never joined a parenting community to mock or to vilify another mother or group of parents.

I have never directly quoted another mother in a negative way to prove my point or to bully.

I have never intended to hurt other mothers no matter their view on parenting or childbirth.

I usually allude to but don’t link to websites or forums I feel are bullying or trolling.

Until now.
This blog post was written with no other intentions other then to flame, bully and troll. It has taken posts completely out of context simply to mock and humiliate.

And the writer is a doula! How unprofessional!

Why am I writing this? Why am I getting so upset about it? Because it is yet another example of someone demanding respect for their opinions and choices without returning the favour.

You want respect? Then give it. I wouldn’t have cared if it had of been a post about how some women chose cesareans and how it is still a birth and should be recognized as such. My son was born via the ‘sunroof’ as some like to call it. It was still a birth, he was born, he didn’t just appear. Now it wasn’t a natural birth by any stretch of the imagination but he was born, we certainly won’t be celebrating his surgery day or Caesar day, it’s his birthday.

But why get personal? Why bully?

And why join a website just to troll or for the lulz as this doula has said.

I personally wouldn’t want to be hiring a doula who trolled homebirth forums for the lulz.

If you don’t like a community don’t join. If you don’t want to actively contribute to a healthy discussion about birth, don’t sign up.

And if you think you’re being clever accusing loving and supportive women of being cruel and nasty, well you’re not.

Flame me all you want, I know what sort of a person I am. I give friends planning births all the facts at my disposal but at the end of the day the choices are theirs not mine and if they chose a Caesar then I will be cheering them on all the way and hoping they have a wonderful experience.

I don’t love surgical births, but I believe all women should be entitled to birth how they want to, not how someone tells them to. Not me, not websites, not doulas, not midwives, not OBs. The decisions should rest with the mother and she should be informed and supported in her choices.

Birth in the Movies – Myth or Legend

Birth in film has a lot to answer for. Women flat on their back,usually in stirups, they’ve usually been rushed to the hospital after their waters break in some unusual location, and it’s all a big hullabalu. I’m calling bullshit on the myths of birth.

Myth 1 – Labour begins when your waters break.

Not always the case, and your waters don’t need to break in order for your labour to progress either.  Many women have their labours artificially broken as a routine part of induction, however it isn’t always necessary.  In the book A Labour of Love, the author describes the birth of one of her children and at that particular birth her waters did not break until just before the baby was born.  In antenatal classes while pregnant with my first, the midwife described a birth to us where the baby was born in it’s sac of fluid, perfect and healthy.  Your care provider may tell you that you cannot labour in water after your waters have broken because of infection, however this isn’t true, water is a great form of pain relief in labour and your risk of infection is incredibly minimal.

Myth 2 – You need to give birth on your back

I hate how a woman is always shown on her back when giving birth.  For many women this position is incredibly unnatural and almost impossible to effectively push in.  Birthing is more effective in other positions such as all fours, squatting, leaning forward, or semi-reclined.  The book Birth Skills by Juju Sundin has plenty of great advice on position for birth.

Myth 3 – All women scream in labour, especially when pushing

Wrong!  Now I’m not saying all women are silent in labour either.  What I am saying is you have no idea what sounds you may make until you begin your labour.  I made some noise while labouring with my daughter but I certainly didn’t scream.  And when pushing I focussed all my energy into the act of pushing, and made no outward noise.  Screaming while pushing uses energy, and I didn’t want to waste my precious energy reserves.  Deep, low, groaning sounds are more helpful.  But even if you do scream, who cares, your midwife will have heard it all before.

Myth 4 – Birth will ruin your sex life

This isn’t so much from the movies, but something I read quite often from women writing about birth.  This morning I read a blog post that said whether you birth in hospital or at home the outcome is the same, and then basically likened birth to a car accident.  It’s not true.  Not all vaginas come out mangled messes after birth.  I had one vaginal birth and one caesar, and the vaginal birth certainly did less physical damage to me.  I had some slight tearing which required either 2 or 3 stitches, that is all.  My surgical birth has ruined my abdominal muscles and left me numb from my belly button to my pubic bone.  Gee, wonder which one did less damage?  Many women actually think sex is better after vaginal birth.  And the big kicker is, HOW DO YOU THINK PEOPLE HAVE MORE KIDS IF THEIR SEX LIFE IS RUINED?  They don’t just drop out of the trees!

Myth 5 – You’ll need all the drugs

Not true.  Many women every day have drug free births, many of them at home.  In Juju Sundin’s book Birth Skills she describes many alternatives to medical pain relief.  Read more about natural birth here at Joyous Birth.  Before women began going to hospital to give birth, women gave birth at home without epidurals, without gas, without inductions, without synthetic hormones.  Before doctors began routinely washing their hands more women died in hospital births then at home!  Many medical interventions can lead to maternal and fetal health problems and complications.  Remember thousands of babies died in hospital between 06-07 and only 3 died at home.

Myth 6 – Birth just happens, it’s nothing special

Birth is the beginning of everything!  Every bio you ever read begins he/she was born…. It’s the first chapter in the story of your life!  Birth can be so inspiring.  For some couples who have struggled with fertility it is the end of a long journey to become a family, to other women it is the beginning of their journey into motherhood.  Birth moves us, it inspires.  Every birth is important.  Every birth has a story.  Here is an inspiring birth story about twins born 33 hours apart!

Birth doesn’t have to be like in the movies, bright lights, up in stirups, baby coming out the size of a 3 month old… except for that one woman in Texas earlier last week, probably best she did have a csection.  Birth can be gentle, peaceful, beautiful, natural, and normal.  We are mammals after all, and this is what our bodies were designed to do.

Healthy mother healthy baby

“I value birth, but as long as the baby is born safely then that’s all that matters.” “I know natural birth is best but my doctor knows best so I’ll follow his advice and book my surgery.” “Healthy mother, healthy baby, that’s all that matters.”

Dismissive. Insulting. Bullshit.

Let’s be real, no woman is getting pregnant for the candles, insence and Enya that comes along with having a natural birth. No one is birthing so they can brag about how much tougher they are. There’s no international scoring system when it comes to birth, you don’t get extra points for twins or homebirths or length of labour.

Every single pregnant woman has one goal, to give birth to a normal healthy baby with no complications and no detriment to her own health.

The birth experience is also important, to some women. Now some women may chose to have an elective caesarean, or pain relief, or an induction, and as long as she is well informed of the risks then I respect her choice. The risks of surgical, instrumental, and medicated births are well documented and as long as a woman is informed and empowered in her choice then I hope she has a positive birth experience.

However if I had a dollar for every time a woman was told she was too fat, too thin, hips too small, baby too big, baby too small, too overdue, not allowed a VBAC, or must have certain conditions on her labour then I’d be a very rich woman. We don’t have to accept an unnecaeserean at the doctors convenience. Because let’s face it, an elective csection is easier for an OB and a hospital to book. It’s during the day, no coming in at stupid o’clock, it’s during the week, no pesky weekend call in, you can make all the arrangements ahead of time and it goes for a couple of hours, a natural birth could take days.

Many mothers know a natural birth is best for babies, normal natural birth is less risky for babies and for mothers. For many mothers birth can be a rite of passage into motherhood. And let’s face it, a birth is one of the few events (that and a wedding day) that is celebrated and relived over and over and over again on the anniversary every year. If a birth is disappointing or even traumatic, that woman will relive those memories every year.

When talking to a woman about her traumatic birth refrain from making sweeping statements about the importance of her baby being born healthy. It doesn’t serve to make her feel better but it can make her feel guilty about her feelings and it suggests that she isn’t grateful that her baby is well. It is not anyone’s job to tell anyone how to feel and good friends don’t dismiss each others feelings. How about just listening and if you have to say something just say “I’m sorry that happened to you.”

After all she doesnt have to snap out of it and it’s not your job to make her see how ‘lucky’she is. It’s not a pissing contest of who had it worst. Birth matters, and we don’t have to resign ourselves to at least we survived

Down The Garden Path

Ive never had a home birth, I’ve never had a natural birth. I have had two children, one was a stock standard private hospital induction and the other a caesarean under general in the public system. The second I intended to have a waterbirth, but it wasn’t to be as I had grade 4 placenta previa, a serious pregnancy complication.

Now despite having never had an unmedicated birth I know it’s best for babies and best for mothers too. Pain medication during labour is not without risk, and there are some pretty serious risks.

Take epidurals for example, it can paralyze a mother if not inserted correctly, that’s permanent disability. Now it’s not common but it does happen.

I think it’s important to talk about the cascade of intervention. That one intervention during labour usually leads to another and generally leads women down the garden path to surgical or instrumental delivery.

It starts with fetal monitoring and pelvic exams. Pelvic exams are painful, uncomfortable, distracting and completely unnecessary. A skilled midwife knows how a labour is going just by quietly observing. Unwanted pelvic exams cancause a woman to tense up and labour to stall. Never forget that it is your body, you do not have to consent to a pelvic exam, if an OB or midwife suggests it and you don’t want it just say no and make it clear. If you say no and they do it anyway that is assault. Report it.

Induction with syntocin or synthetic hormones is another way to start the cascade of intervention, at least it was for me. The contractions are not naturally and they ate intense from the very start. Have an induction and your chances of having an epidural increase dramatically along with your chance of having a instrumental or surgical delivery.

If you are told that the risks are very small and it won’t happen to you and you aren’t happy with the answer day no or seek a second opinion.

Many reasons are given for inducing. Baby too big, baby too small, too far overdue. The 10 days overdue rule is not evidence based, in fact the stillbirth rate is higher at 38 weeks then it is at 42, and there are more risks associated with being induced then going overdue. It’s better to wait and let nature take it’s course, even if that is 13 or 14 days after your EDD. Remember your ‘due date’ can be off, ultrasound is not a perfect technology so you may actually think you’re 2 weeks overdue when it may in fact be your actual due date. The 40 week pregnancy assumes every woman has a 28 day menstural cycle, when in fact even healthy women have variances.

What can you do to avoid a csection?

1. Stay home! Home birth is safe, even in high risk situations like previous surgery, multiples and very overdue babies.
2. Hire a doula, studies show your chance of needing intervention decreases dramatically when you have a doula present at the birth. Find one here – http://www.australiandoulacollege.com.au
3. Be informed! Know the facts about birth and intervention and the real risks.
4. Be empowered! Know your rights. It is always your right to refuse medical treatment.
5. Be supported. It is your birth partners responsibility to be your voice when you are in labour and cannot speak for yourself, your support person must know and respect your wishes.

Five reasons to avoid induction – http://pregnancy.about.com/od/induction/a/risksinduction.htm
Risk of stillbirth – http://www.ncbi.nlm.nih.gov/pmc/articles/PMC28178/
The Epidural Express – Reasons not to jump onboard – http://www.birthrites.org/Epidural.html
More information on intervention and the cascade of intervention – http://www.mybirth.com.au/intervention.html

What if I need a caesarean?

The World Health Organisation advises that the caesarean rate should be between 10-15%.  The rate in Australia varies from state to state with the lowest occurrence of csection being in Tasmania (28%) and the highest being in Queensland (over 30%). - http://m.brisbanetimes.com.au/lifestyle/one-in-three-queensland-babies-born-by-csection-20100623-yyyd.html

There is no doubting many caesarean births are happening unnecessarily.  Ultrasounds are overestimating babies size meaning women are encouraged to deliver ‘big’ babies surgically only to discover their baby was a lot smaller then anticipated.  False CTG readings are showing baby in ‘distress’ when in fact the baby is well.  There’s the belief that repeat caesareans are the only option, when in fact VBACs can have less risks then repeat surgery.

And then there are the unreasonable time limits placed on women.  Hospital births are timed and whether you are told or not you have a time limit of approximately 1-2 hours per centimeter of dilation.  Or 24 hours if your waters have broken.  Labour takes a long time, and for many women who have a natural delivery their bodies give them ‘breaks’ from the contractions to rest.

Breech babies CAN be delivered vaginally.  Babies DO turn before birth, sometimes in the last minutes.

I myself know a woman who when pregnant with her first baby was told she would need a caesarean but was allowed to attempt a vaginal birth, her baby hadn’t engaged.  Well he didn’t engage until she was fully dilated and pushing, she had a natural delivery.

Mutliples can be delivered vaginally.  Yes, even triplets.  They can even be born at home.  Twins may even be born hours or days apart!

There are, however, times when a surgical birth is necessary.  And could even be life saving.  I had complete placenta previa with my second child and a surgical birth saved our lives.  But I was still devastated that he was to be born that way.  And it was okay and natural for me to feel that way.

What if you need a caesarean?
Firstly, a surgical birth does not make you a bad mother.  It does not mean you have failed.  It is what it is.  You don’t have to be okay with it, you don’t have to be happy with it.  And you don’t have to buy that healthy mother healthy baby crap either.

What happens before a caesarean?
It is still an operation, despite it also being a birth.  So you will need to sign a consent form.  Unless it is an emergency you will have time to read it, make sure you do and ask lots of questions.

Talk with the anaesthetist and ask plenty of questions.  You will go through a full health questionnaire.  He may be able to forfill any special requests you have.  Make sure you ask for skin to skin immediately.

You will remove jewelry, make-up Abe underwear.  A wedding band may be taped over.  You will most likely be shaved, shaving of the pubic hair can help prevent infections

An IV drip will be placed in your arm to administer fluids and medications.  You may be given a drink of sodium citrate to neutralize stomach acids to help prevent aspiration.  A urine catheter is routinely inserted to keep the bladder empty and out of the way during the operation.

You will be wheeled into the operating theatre and moved onto a high narrow bed and a triangular sponge is places under your right side to prevent aorto-caval compression.  Then you will be prepped, your anaethestist will administer an epidural/spinal/general.

Once you are numb the incision will be made, and the baby delivered quickly and shown to you.  They will then be checked over and usually passed to your partner or support person.  The surgeon will then deliver the placenta by gently pulling on the cord.  Your uterus will then be inspected and will close your incision in layers.  This can take up to 30 minutes or more.

Once the stitching is complete you will be moved back onto a bed and taken to recovery.  If your baby cannot be with you, make sure your partner is aware to do skin to skin during this time.

The first 24 hours will involve resting, sleeping and recuperating.  Make sure you have a partner or friend with you to help with your baby as the midwives are generally very busy.  Drink plenty of fluids to keep yourself hydrated and take pain medication as you need it.

You may experience wind or gas pain during the early days and it can be quite painful, peppermint water or tea can help.

Try and get moving as soon as possible, even if it is just wiggling around in bed.  Drink nursing tea and eat lactation cookies to help your milk come in.

Have plenty of skin to skin contact with your baby.  Your body warmth will help keep her warm.

Write a plan and include all your wishes for during and after the birth.  Request your own music be played, only your own voices during the surgery.

Lotus births and maternal assisted Caesars are possible, just ask.

You may like to take photos, again just ask.  You may also want your partner to announce the sex, make that very clear too.

Bring your own wrap for baby and sleep with it for a few nights beforehand so it has your smell on it.  Newborns have a very heightened sense of smell.

I would probably not have visitors on the first day or make the visits short. For a start you will probably be very tired, and wanting to bond with your baby, and learning to breastfeed.  Even if you are having an elective, keep the date secret so you can still make a big announcement.

And remember it is still a birth and you still have every right to celebrate that and to make it special for you.  Every woman has the right to chose how her baby is born, whether that be elective Caesar or homebirth or something in the middle.  Do not let anyone make you feel bad for your choices no matter what they may be.

Birth by Catherine Price and Sandra Robinson has a great chapter on caesarean birth.

Our bodies, our babies, our choices

Every woman’s preferences, wants and needs with regards to birth and caring for their baby are going to be completely different. And if a woman is presented with all the facts, her choices regarding what she does with her body should be hers and hers alone

See from the minute those two little lines appear on the pregnancy test in the eyes of the medical system your body is no longer your own and your choices seem to carry less value then they did before.

Many women will go to a GP to confirm a pregnancy, some women will then be asked if they want a referral for a termination (as some GPs like to assume young means your baby was an accident), others will assume you want the nearest public hospital, others will scoff at the mere suggestion of a birth centre, or that you could possibly afford a private OB, and I wouldn’t even mention a homebirth to a GP.

It’s from this moment assumptions begin being made, you’re too fat, hips too small, haven’t had a baby before, had too many babies before, once a csection always a csection, you’ve used IVF, etc etc etc all these assumptions meaning you’ll need to be induced/sectioned/monitored more ‘carefully’/not allowed to waterbirth, in other words the cascade of intervention is already beginning long before you set foot in the delivery room.

Look, I don’t really care if someone choses a surgical or medical delivery if that is truly their choice. If a health care professional has discussed all the risks and benefits HONESTLY with that mother and then their choice is still a surgical or medical delivery then that this is their choice. If in 20-25 years time (and not before ) my daunted comes to me and says “mum I’ve really thought about, done a stack of reading, spoken to a midwife/doctor/surgeon and I want to have a csection” here is what I’d do. I’d tell her my experience, tell her my vaginal birth (granted with pain relief) was much more pleasant and preferable then my surgical birth and if she still said she wanted a csection delivery then I would be the first person to support her choice, and I’d be there for whatever she needed. What I wouldn’t want for her is to decide that she wanted a natural birth only to be fed a whole load of crap about hips too small, baby not yet engaged, too far overdue, or whatever is the flavor of the month, only to realize afterwards that it was a complete lie and her baby could have been born the way she wanted.

So, what can we do to ensure we get the best possible chance of the birth we need.
1. Stay home, home births give women the best possible chance of acheiving a natural labour and birth.
2. Hire a doula or birth attendant. Even if you are going to hospital or having an elective csection a birth attendant can work with you before, during and after the birth to help you get out of it whatever you need.
3. Read, read, read. Knowledge is power. Read books, web sites, pamphlets.
4. Go to independent birth classes. There are so many our there including calm birth, hypnobirth and Juju Sundin’s birth skills, just to name a few. By all means go to a hospital class but they are very much focused on the medical side of birth and pain relief as to be expected of a hospital.
5. Remember your right to refuse, its your body and if someone touches you in a way you do not like then that is not okay. If you refuse an internal and they continue anyway report it, on the street that would be sexual assault.
6. Write a clear, concise birth plan. Outline in a very clear very simple way exactly what you want.

There are situations where an ideal birth is not possible. I planned a free birth in water for my son, he was born via a csection under a general due to a grade 4 placenta previa. It couldn’t be avoided and a csection saved our lives. But a birth attendant salvaged what good I could find in the birth, good support safeguarded our breastfeeding relationship and open, honest discussion I am moving forward.

No woman should suffer birth trauma or birth rape simply because she was misled by a health care professional. It’s not unreasonable to expect that doctors and midwives would and should respect our legal right to refuse a medical procedure. It’s not unreasonable to expect that the risks of procedures not be glossed over with a “but that won’t happen to you.” All birth choices should be respected, all birthing women should be informed.

Further reading – Birth by Catherine Price and Sandra Robinson
Birth Skills by Juju Sundin
Birthing from Within by Pam England and Rob Horowitz

Find a doula and more information on doulas -
Australian Doula College – http://www.australiandoulacollege.com.au

Homebirth community and support – http://www.joyousbirth.info