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The 20 Things I Learned About Birth

I'm not an expert, just a husband and father who's been through an emergency-caesar birth followed 2+1/2 yrs later by a homebirth, so these are just my thoughts - mostly about the months before birth -I hope at least they are some help as you make your way through the VBAC maze!!

Top 20 things I have learned about Birth (well, Ok - the top 17...)
By Hugh

  1. In the right frame of mind, the birthing woman can achieve ANYTHING

  2. The right frame of mind is 90% of the journey, and crucial on the day

  3. Surrounding the birthing woman with people and places that love and support her, gives her that frame of mind and the strength to achieve - everyone who's there has a crucial role.

  4. Flipside - if, as a support person, you come across anyone who's sceptical or cynical about this woman's ability to do this, get rid of them out of your life - preferably for months before. If anyone's giving you that feeling on the day, challenge them.

  5. The hospital environment is right for medical emergencies. Most births are a natural miracle, not a medical emergency.

  6. Awful fact is that birth is one of those rare natural events where pain is meant to happen. Because this is a scary thought for most people, you need to specifically TRAIN TO MANAGE PAIN if you want to do this without drugs. Do a course!! (eg Embracing the Pain)

  7. VBACs are safer than a second Caesar, for most people!!! (Do your research!!)

  8. In Australia at least, any medical professional who backs you in your decision to birth at home - especially a VBAC - is coming from the right place - love and concern, knowing that birth the way YOU want it is the most important thing. They are putting their needs second to yours. In the current pro-drug, pro-hospital environment they are true believers and also taking a significant Ôprofessional riskÕ (note

  9. Do a bit of training + practice - without it you are vulnerable, (which currently means you're VERY likely to end up having a birth you didn't want). With it you are nearer to being IN CHARGE!

  10. Pro-homebirth midwives and doctors are mad, loving, alive, wonderful, life-changing people - get one today!

  11. If you talk to ANYONE employed by or working in a hospital, they will almost always give you HOSPITAL POLICY not their own opinion. That's the rules. However, THEY WILL NOT TELL YOU THIS CRUCIAL FACT.

  12. Hospitals manage pain through drugs - their rules, and conditioning of their people mostly do not allow them to see they can do it any other way. Therefore if you're trying to manage pain without drugs, you have a whole hospital full of 'experts' trying to talk you out of it.

  13. If a medical person tells you something and it doesn't feel right in your heart - it probably isn't!!!! Trust your heart, your feel for people - get a second (third) opinion.

  14. this applies no matter what their reputation or hourly rate.

  15. If family + friends are trying to work against your plans for a homebirth/drug-free birth, try to educate them on the real risks. If you all listen, you'll all grow. If they won't listen to you, do your best not to listen to them either. Listen to your Self.

  16. Once more with feeling - DO YOUR RESEARCH above -that gives you power!

  17. Being part of a homebirth means witnessing a miracle!

The 5 worst moments on the way to a homebirth VBAC:

  1. Being told by the obstetrician from Alice's birth that he would recommend a second Caesar, (implication: you are'irresponsible parents and you're risking your new baby's life) - and because the Freedom of Information Act didnÕt apply to medical records at the time of Alice's birth, he wouldn't give them to us. Getting this 6-line letter took 4 months. He also started the letter 'Dear Stephanie', and my wife's name is Sarah... thanks for your input, Dr Len.

  2. Visiting Monash hospital to book in for a homebirth backup, and being told by a 'midwife of 15 years, mother of 3' that 'we donÕt do trial-of scar or homebirth backup - itÕs too risky' (actually other hospitals WILL do this, it was just her unit that didn't - see above re quoting hospital policy) ...and being told about a recent uterine rupture she'd seen where the baby died. (Implication - you should listen to me, you irresponsible fools - I know what I'm talking about). When I rang her back and questioned her (while my wife cried in the other room) she admitted:
    - That it was a FIRST BIRTH - ie a tragic accident, could happen to anyone, in 0.03% of births - but NOT RELATED to the mother having had a previous caesar
    - that she couldn't remember when it happened
    - that she wasn't there, in fact it wasn't at her hospitalÉ

  3. Reading that some hospitals' funding, not to mention reputation, is affected by their neonatal (within 28 days of birth) death rate, of mothers and babies. Often when a Caesar goes tragically wrong, the mother will be moved to a non-birth ward, and/or the baby, if tragically brain-dead, may be kept alive on a respirator 'for a few weeks to see what happens'. If the mother dies on another ward, or the baby 'dies' (is turned off) at 29 days, neither will count as a neonatal death, thus helping caesars to be measured as 'safer' than they really are.

  4. Being told (from love, I know) by my mother that she wasn't happy with what we were planning. This from a woman who had a classical (vertical-cut) Caesar, then went on to have 3 VBACs! (She came around and was fantastic)

  5. Realising that, when it comes down to it, medicos are human - and not trained in things like breech births any more! Some obstetricians appear to be motivated not by what's best for the patient but by what I call the Porsche Protection Scheme
    - rule 1 - don't get sued
    - rule 2 - have as many patients as possible, = make more money (eg always have an overfull clinic, opening at 8.30 precisely...)
    - rule 3 - when 'managing a labour' (note - not 'assisting a labouring woman'), don't forget rules 1 and 2 (eg ask how many caesars happen around 7-8am).

Amazing bits of preggy trivia I have learned

- the prone (on your back) position was invented by a French doctor for the convenience of Louis XIV of France, who wanted to watch his favourite mistress give birth, hidden behind a curtain. It caught on from there because of course it was fashionable, once he'd done it! The fact that it's the worst possible position for the labouring woman is of course incidental...

- labour wards are always fuller at the full moon

- In some countries they will ask women their shoe size, because apparently there's some correlation between foot size + pelvic opening

- Labouring women will cease labouring if there is a threat to their baby (tested during bombing in Lebanon!) + resume when it's safe...

- Normal gestation in France is 41 weeks... makes you think about what's 'normal'..!

The Stella Story

"Have one Caesar, you have to have another".

"A VBAC is much riskier than a second Caesar".

"Your father and I are worried about this idea of a homebirth - you're so much safer in a hospital."

"But your first baby was 10lbs 12 - the second one'll be bigger, you just won't be able to deliver it vaginally"

These were the types of things we had to cope with as we went into our second pregnancy, 2yrs after Alice was born.
You have to do your own reading + make your minds up yourselves. But we came to the conclusion that all of the above are untrue, and ultimately we had a fantastic, life-changing and entirely positive homebirth, the best outcome we could have hoped for... Along the way we grew a bit as people, we learned a lot of interesting facts about the dangers of Caesars vs VBACs, we lost some trust in mainstream medicine, and we met some inspiring and wonderful homebirth professionals.

Our beautiful first girl was brought to us via a prostaglandin induction, 14hrs labour, then emergency Caesar at Freemason's Private in MLB (otherwise known, we found out later, as Caesar's Palace). This was due to brow presentation.

The journey began almost immediately thereafter - Sarah particularly felt cheated, felt that the delivery left her unfulfilled, felt that she hadn't bonded with Alice. She had some tough times at home with Alice because of these mental issues and the huge physical trauma of the Caesar and being a new mum. (This is a VBAC site, so I guess you don't need reminding). Alice was also a lousy sleeper. Sarah may have suffered a little PND, certainly she was a shadow of her former sparky self. (Chinese herbalists turned that one around bigtime - firstly they acknowledged that something was not right, and treated it. All the GP would say was - "well youÕre a working mum with young baby - of course youÕre tired" Thanks...)

Anyway, as we got around to thinking about a second Sarah turned the anger to positive energy and got educated, and took me along with her, getting me more and more energised about the issues as we went. Thank God she did, is all I can say.

You can see in this site all the great books out there, and they're a great place to start. If I'm honest I barely skimmed just a few of them, but the themes were clear. We're becoming a drug-dependent, knife-happy, pro-litigation birth culture, and basically if you don't want to be part of that, get smart and get a bit assertive (and get the RIGHT health professionals early - we found ours through this site, so this is by way of giving back a tiny amount of what we got).

So - I could go on forever but, briefly - do some reading! FACTS helped us feel stronger and combat some of the absolute crap we were told. Try Silent Knife, some of the Kitzinger books, etc. VBAC and Natural Birth info nights were the next step - a big hassle to get to (wrong side of Melbourne, babysitters, etc etc) but they really moved us on, gave us more information about what natural birth really meant, (lots of great discussions about managing pain!) what the real risks were, and meant we met childbirth educators, midwives, and other couples trying to do what we were. I was always struck by the wonderful warm energy of these professionals, and the frustration they clearly felt at a system that channelled people away from the natural. They did a very good job of containing it I felt, given their real, hands-on knowledge of how it could be (could have been) so different for so many people. They were also practical, funny, experienced people who were great to talk to. Through these we refined our choice of midwife, found out about pro-homebirth obstetricians (I think there's sadly only 1 in Melb), and had some great chats with other couples who were on the same journey.

From nights like that, and talking to people, getting on mailing lists for things like the Maternity Coalition, we slowly gained knowledge and confidence to start challenging crap we were told by people who, first time around, we would not have dared to question because '15 yearsÕ experience must mean they know what theyÕre on about, right'? First lesson - not necessarily! Are they up with the latest research? Do they actually still have an open mind about it? What really motivates them - patient care or the Porsche Protection Scheme.

We also learned about basic contradictions - if homebirths are so risky, how come 60% of births in Holland are at home? If going more than 10 days/2 weeks overdue means an induction is a 'must', how come it's anything up to 3 _ weeks in the UK? How come 'norma'Õ gestation is 41 weeks in France??

Through all this we formed our personal plan for a homebirth. We made a backup booking at a public hospital, found out to our joy that our private health cover would cover a homebirth (via a broker (Concorde in Adelaide) to QBE/Mercantile - theyÕd never been asked before, but when we told them how much money theyÕd save they said yes!!), and started regular checkups with the very wonderful Jan Ireland, and often with the gorgeous Peter Lucas, both of whom we warmed to instantly. We booked up our birth pool via Jenni Teskie, and did a birth debrief on Alice's birth with Rhea Dempsey (great!). We also did her Embrace the Pain course, which happened to be 1wk before due date - great timing. These gave us great mental support - understanding what our mental models are about pain + how it's innately 'bad' + can be dealt with only with drugs. About the power of the mind and of mental support throught delivery, and about how important it is to rid yourself of people who won't support you. Also about hospitals and how they innately go against natural birth - since their forte is medical emergencies, and intervening to 'fix' them, that's how they treat births! We also learned some communication skills, some tips to use during labour, and made them more usable through physically trying them out + finding what worked.

Jan and Peter looked after us right through, and were realistic about the things which might still mean we started in a hospital. Even with all this education we were both not letting ourselves believe we would really have a homebirth - we still statistics against us - Sarah dilated only to 9cm last time - would she make 10? What if the baby was breech? Alice was 10lbs 12 - we were looking at a big baby here! (Incidentally another example of the power of science - we had a 37week scan partly to check for size - 'we can get it accurate to within 5% at 37 weeks. If itÕs on due date, this baby will be 10lbs 4' he said confidently.)

And so to the Big Finish - Stella Rose was born at home, on her due date, in about 7 hours. She also weighed 11lbs 5!!! (so much for science - again). Jan, Peter and Jenni were all there and were brilliant. Each had their distinctive styles, but they've done this hundreds of times before and it showed.

I will remember the labour for the rest of my life - being at home was so wonderful, empowering and 'normalising', we only had people there who believed 110% we could do this, we were all involved, and the team were thoughtful, loving and caring throughout. Watching the video still makes me cry and brings back massive emotions. The biggest lesson was the power of a labouring woman who's mentally prepared for the labour at home. I'm sure it hurt like nothing before or since, but Sarah's story will tell you how she got through it - we just gave her the support we'd agreed on and that she asked for on the day.

I can only tell you my perspective - I felt so incredibly happy, useful, in control and supported.! And inspired by the sight of my gorgeous wife finally doing what she was born to do, the way she was born to do it... visibly healing old scars before my eyes. And while it was a serious business and the medicos were totally professional and focused, we laughed quite often (well, the support team did, quietly...) and I felt like we were part of a huge celebration! I think being at home for it made the following big differences:

- Alice was part of it from the beginning (she wasn't at home for the birth, but came home within 2hrs), she didn't need to be separated from Sarah at a traumatic time -

- Sarah recovered much better for being in her own bed + home environment (eg all she took was Panadol for 2-3 days, despite some fairly extensive stitching due to the shoulders sticking at the last minute - the only hitch in an otherwise textbook birth)

- Sarah was treated at home and NEVER had to leave the house for a checkup till 6wks postpartum!! (How's THAT for service!!)

- Our house feels different. We claimed it, big time.

- The whole community was involved!

I'd be pretty confident that the no-drug outcome would not have been achieved in a hospital - they make the drug choices too easy + available.

The first birth I was trying to be supportive, but I was nervous, entirely disempowered by the environment, unsupported by the staff and by my total lack of preparation - sure we'd been to ante-natal classes, etc but...all I can say is, do reading and things like the Embracing the Pain course!! It gave us the mental strength, the communication skills for this unique situation (how to talk to your wife mid-contraction...) and so many real, tested solutions that worked. It also explained why hospital environments influence so many births negatively.


PS - There are lots of other great professionals out there in the homebirth fraternity - our choices of courses, midwives, etc may well not suit you - your journey is your own, so drive it yourself! But if you want to talk to us about them, drop us an email - hugh.massam@shell.com

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