I'm making an assumption here. I'm assuming the birth that you and everyone wants involves consent, choice, freedom, comfort, love and autonomy. Within that, there are so many options, Some people like to birth with music on, dancing, laughing, with lots of family support. Some people like dark and quiet, with calm and whispers, and just their partner. Some women prefer to be in a cave - or more likely the basement, or in a bathroom by themselves. But at all the births I have been at, women universally have wanted to be respected, safe, heard and reassured.
So how do you get that? Here are my 5 ways to have the birth you want.
1. Believe in your body's ability to birth your baby. Learn about your anatomy; about how your baby moves into the inlets of your pelvis, about how movement helps this process, and how the bones in your baby's head and your pelvic bones accommodate each other. Learn about your hormones and endorphins, which ones are at play during birth, and how to help them work. Learn about your parasympathetic nervous system - this is the rest and digest system, and how to get yourself in it so that you can relax and let your body do the work. Then when the time comes, get yourself out of your head, and into your body, and trust that you have done the work to allow your body to work for you.
2. Hire a great team. One that supports your views and asks for consent. Our birth culture still says things like 'deliver your baby', 'I'm not going to let you go past 41 weeks', 'we're going to induce you'. Sigh.
You are going to birth your baby. A doctor or midwife is not going to deliver you or your baby. This language takes the power away from women, and gives it to the care provider. Your baby is not a pizza to be delivered.
'I'm not going to let you...', this is language that is based in fear, and doesn't give options, information or consent. Women are frequently told by their primary care providers that what they can and can't do, when in fact there is so much consent and information left out. If you are being told that you need to do something or have something done to you, ask alllllll the questions. Specifically ask, "what happens if we do nothing?" Also, "if we do nothing, what are the risks?" Also consider the whole picture. What are the studies that were done to support what your health provider is suggesting, and is the person in the studies a reflection of you and your situation.
"We're going to induce you." Always with the we. Because no one wants to own it, so it becomes we instead of I. I am going to induce you. Here is how we see so many inductions go: Someone has high blood pressure, and they want to induce, so they go to the hospital and get a foley catheter put in. And then they are sent home and told that they will get a phone call. And then they don't get a phone call because the hospital gets busy with births, and so you wait and wait and wait. So which was it, was it an emergency that you needed to get induced or wasn't it?
A team that supports your views and asks for consent, looks like a doctor or midwife that puts information and choice above their own bias. Ideally this is how everyone would practice, but unfortunately we are all conditioned by what we see most often. Consider that if an obstetrician sees high risk births more often than not, because that is what they are trained for, then they might not be the best choice for a unmedicated, vaginal, upright birth. If that's what you wanted for instance. If you have already chosen an obstetrician for your birth, and are comfortable with them, simply keep in mind that their skill set is to be trained for high risk births. I was recently at a birth where the obstetrician on call, had never seen the squat bar used. The squat bar is a super helpful bar that can be placed over the bed in labour and pushing for the woman to pull on. To me, this suggests that often Obstetricians aren't witnessing spontaneous and self directed births. It also means that they are suggesting medical ways to advance labour rather than physiological ones.
Part of your team can include a doula, such as ourselves. We help to educate and support you during pregnancy, birth and postpartum. Having a doula present reduces the incidences of cesarean birth, complications and interventions. Women who hired a doula also report having felt safer during labour and birth and having felt more confident in their ability to birth their baby.
3. Design your birth space. Things that work against us in labour are things that don't make us or our bodies feel safe. Things like bright lights, strange voices, weird smells and machinery. This isn't to say that everyone should choose a homebirth, some people feel safer in a hospital, and you should always birth where you feel safest. However, keep in mind that even if you mentally and logically feel safer in a hospital, your body may not. This is simply because our bodies are primal, and need things to keep them in their parasympathetic nervous system like familiarity, touch, calm, privacy and kindness. The easiest way to do this is to have your baby in your home. It is difficult for any health provider to take away your power because of their own timeline or comfort, in your own home.
If you are choosing a hospital birth, here are some things that you can do. Labour at home for as long as possible. This is easiest with a doula, because they can help you to stay at home longer, and not arrive at the hospital at 3 cms dilated. At home you can pass the time by resting and sleeping, and bathing, and watching a movie, and baking a cake and walking and leaning on couches, and hanging on counter tops, and leaning on ottomans and siting on toilets and having a bed big enough that your partner can be in it with you. And maybe you can even giggle and make out and relax and play with your nipples - because what got the baby in, can help get the baby out as Ina May Gaskin, an amazing midwife, says.
When you go to the hospital, bring things that remind your mind and body of home. Clothes that smell like home, consider not changing into a hospital robe. A pillow that you love, essential oils that calm you, music playlists that sound like a spa. (At a birth I was at recently, the nurses who came in commented that the music made them relax, and feel sleepy and feel like they were at a spa!) This is an amazing state to have yourself in and your team. Bring battery operated candles so you don't have to use the overhead lights in the bathtub or shower.
4. Allow yourself time. If this is your first birth, consider that as much as you have seen quick births in movies, or heard about people having their babies in cars, or racing to the hospital and blowing through lights, that more than likely, it is going to take time. On average, for a first time mom, the early stages of labour where you are having contractions 6-8 times an hour, lasting under a minute, last about 6-10 hours. The active labour stage usually lasts about 3-6 hours, this is where contractions are every 4 mins and lasting for a minute. Then transition can last anywhere from 15 min-2 hours ish. Then pushing is anywhere from 1-3 hours. So all said and done 10-21 hours. Of course these are averages and we have seen first time moms have babies faster than this and take longer than this. But the point is, don't rush to the hospital or call your family to the waiting room of the hospital after 1 hour of cramping. Stay distracted and busy in early labour for as long as possible. Once you can no longer be distracted, wait some more, then call in the midwives or head to the hospital.
5. Set your intentions. This starts way before the day of your baby's arrival. I'm talking visualization, mantras, meditation and even listening to some hynobirthing! Even making some birth art or some quotes to put on the wall, so that when your eyes are open, you see things that remind you of your body's strength and ability. A picture of a powerful animal works. As well as a picture of visual representation of your cervix dilation size - like an image of a bagel or a 10 cm circle. Quotes such as, "I soften, I release, I open", "i am doing this, i am birthing my baby", and "i don't have to do that contraction again", or whatever speaks to you. There are some really great birth meditations that you can listen to on different apps before your birth and during early labour. As labour progresses some people don't want that in their ears and some people do. Hynobirthing is a really gentle and powerful way to help you combat fear and pain in birth.
Birth is a ride, and there are aspects of it that we don't have control over, like when it begins, and what position the baby may be in. And babies can truly dictate their own births. But we do have control over how we set the stage in our heads, our environment and with the support we choose. So definitely set yourself up for your best birth possible with everything that is within your power.