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How to have a positive birth in unpredictable times

I am writing this because I know that if you are pregnant right now, the lack of information combined with the unpredictability what maternity care might look like when you give birth might be making you anxious.

I am seeing a lot of worried pregnant women and new mothers asking worried questions on social media at the moment.

So I am going to try and give you some ways to prepare.

I have already collated all the information produced by the royal college of obstetricians in this blog.

Here is a summary of what restrictions are in place right now (I will aim to update it as it changes):

  • No partners or visitors are allowed to accompany women at antenatal appointments (such as blood tests, scans etc).
  • No partners or visitors in antenatal or postnatal wards.
  • Only one partner during labour. This only includes established labour, so if you start labour at home you’ll be able to go with your birth partner of choice to the hospital (as long as you are both symptom free), if your labour is induced, because this is taking place in the antenatal ward, your partner will only be able to join you once you are in established labour and you transfer to the labour ward.
  • Your birth partner can only accompany you if they are well, i.e. free of COVID-19 symptoms (so it might be a good idea to plan for a backup person if you can).
  • Several trusts have suspended homebirth services due to ambulance services being stretches.
  • Because staffing levels are stretched, some trusts have also closed their birth centres.

Because of the above, it is likely that the only option available for the majority of mothers will be giving birth inside an obstetric unit, or to give birth at home unassisted (something known as freebirth-which is legal in the UK- see Birthright’s fact sheet on unassisted birth , and AIMS’s articles. If this is something you are considering, educating yourself deeply on the topic is paramount).

I’m aware that this may feel like a rock and hard place situation for many women.

Whilst I am seeing a lot of anxious mothers on social media groups, I am also reading a lot of positive birth stories, with women relating stories of incredibly supportive midwifes in the face of stretches circumstances, as well as being apologetic about the current restrictions.

As someone who has been supporting pregnant, birthing and new families for over 10 years, I am accustomed to the fact that birth in unpredictable, and that what makes a good birth experience isn’t what the birth looks like on paper, but rather how the parents were made to feel during the birth.

I encourage all the families I support antenatally to write 3 birth plans: Plan A which is your ideal scenario, plan B for curve balls such as when induction of labour is needed, and plan C for a caesarean. I wrote a blog about this here .

I have supported plenty of women who told me that they didn’t like the idea of writing a caesarean birth plan just in case, but that when it came to it made all the difference because it meant they still got some aspects of what was important to them (such as skin to skin in theatre). The situation we are facing now is similar.

I also encourage women to think about what is really important to them, i.e. I know that there will be plenty of things in their birth plans that they aren’t particularly bothered about, but to highlight in bold or red the stuff that really matters.

This doesn’t mean that losing your preferred birth options doesn’t matter. It does, and so does grieving the loss of said options. Your feelings matter, and I know this is a very unusual and stressful time.

Just like I encourage expectant parents to cover all possible scenarios ahead of the birth (because deciding whether you are happy for a major medical intervention to happen during birth is easier to ponder whilst you aren’t in the middle of labour), I know that by getting prepared as much as you can for all possible scenarios, you are more likely to have a positive experience, and to have put things in place that will allow you to retain some elements of control and decision making, regardless of how your birth circumstances unfold.

Since it is likely you might give birth in an hospital labour ward/obstetric unit, think about how you can make the space as private and homely as possible.

Here are some example of things you could bring to make the room as cosy as possible:

  • Dim the Lights/use fairy lights/LED candles. A great tip to darken a room without curtains is to bring a couple of rolls of foil: moisten the widows and you can stick the foil to them, making instant black out (make sure to have a torch in case staff doesn’t have one). Another option is to use a sleep mask.
  • Bring some pillows from home/some blankets (they’ll smell like home and be softer/nicer than hospital ones)
  • Bring something nice to smell, such as pregnancy safe essential oils, which you can put on a tissue.
  • Your own music/noise cancelling headphones, some people like to make a playlist.
  • Create a playlist of your favourite music, whether it’s calm or upbeat. Music can help reduce stress and the perception of pain during labour. Start working on that playlist while you are in birth preparations by finding what genres or artists are soothing/relaxing to you. Listen to those tracks or stations throughout your pregnancy; it’ll be familiar during labour and help promote relaxation.
  • Some pictures. I’ve seen couples putting up pictures and/or affirmations on the wall. Some included pictures of the scan, pictures of a favourite holiday place etc. You could make a collage to take with you and blue tack on the wall.
  • Move the furniture around! Here is a video showing how you can move things around inside a typical labour ward room and make use of the furniture to have an active birth

What if your labour is being induced:

  • First know your rights and options, and that being induced for “postdates” can be a bit of a grey area. I wrote a blog about this here .
  • All of the above, plus stuff to keep you entertained, like books and downloaded movies. Induction can take some time (sometimes several days) especially for first time mothers. Since you will be on your own in a ward, with several other women in the same bay, privacy can be an issue, so sleep mask, earplugs and noise cancelling headphones can be really helpful.

Regardless of how and where you hope/plan to give birth:

  • Write a multipart birth plan, the process of finding out about options is as important as ever. Remember that nothing should be done to you without your full and explicit consent, even simple medical procedures such as vaginal examinations.
  • The positive birth book has a great set of free icons to download if you’d like to make a visual birth plan-they are also great as a prompt if you aren’t sure about what topics to cover
  • Use the BRAIN  (Benefits, Risks, Alternatives, Instinct, Nothing) acronym to help you through decision making and asking the right questions.
  • In your birth plan, you might want to start with a paragraph introducing yourself to your caregivers, highlighting any really important aspects. The quicker they can get to know you and what you prefer, the easiest it will be for them to establish rapport and support you as best they can.
  • Practise ahead of time techniques to help you stay as relaxed as possible, such as meditation, breathing and relaxation techniques, or movement.
  • Consider hiring a doula. Whilst it’s unlikely a doula will be able to come with you due to the one partner only rule, most now offer remote services. Not only your doula will be invaluable in helping you prepare, she will provide a much needed friendly voice at the end of the phone or video call. I know it sounds odd that we can provide help remotely, but I have personally supported several couples through birth over the phone and I know how much of a difference it can make.

Ultimately whilst we can control certain things, I think what this extremely unusual circumstances have shown us is the we have the illusion of control of scenarios, when really we don’t have control over it.

I will leave you with this quote from Sara Wickham:

I am so heartened to hear about the generous and creative ways in which many people have responded to this crisis. I’m taking two thoughts into the weekend with me. The first is that there are still plenty of things that are within our control. And the second is that creativity and connection are key to getting us through this.”

If you have found this blog helpful and would like to support my work and help me continue provide valuable free information to birthworkers and expectant and newborn families, you can donate to my paypal account paypal.me/SophieMessager.

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