Sometimes, when you say the words, ‘Positive Birth’, it automatically sets off people’s mung-bean alarm. Oh c’mon we’ve all seen them – those birth pics where the woman looks all serene and mystical, the tender (but quite fit) looking dad has his top off and just the right amount of tattoos, they’re in a pool, at home, with pretty little tea lights and bunting and … pass me the sick bucket! This is not real life, right?! This is not BIRTH! Birth is horrible and painful and you have to leave your dignity firmly at the door, right?!
The trouble with birth is that the conversation has got really polarised. At one end of the spectrum you’ve got the serene mama who ‘believed she could so she did’, with all her affirmations, lotus blossoms and hypno-woo-woo. Then at the other end you’ve got the ‘hop up on the bed dear’, agonisingly painful, lie-back-and-think of England and get it over as quick as possible type of birth.
What happens with this polarised perspective is that women can end up firmly believing they are going to get one kind of birth or the other. If you’ve done all your prep and have got photocopies of goddesses pinned to your fridge, then you’re right on course for a dreamy, pea-shelling home birth, right? But if you believe that birth is completely out of your control and are pretty certain it’s going to be awful, you’re probably not even going to make a plan because it’s ‘pointless’, and ‘birth is unpredictable’.
Women at both ends of this spectrum are seriously setting themselves up for negative feelings to be part of their postnatal package. Either because they didn’t get the birth they expected, or because they did – and it was flipping awful.
(Picture from the book ‘Bump’ by Kate Evans)
Step forward ‘positive birth’.
For the past five years now I’ve been running an organisation called The Positive Birth Movement (PBM) which promotes the idea that every woman deserves to feel good when she looks back on her birth experience, no matter where that birth happened, no matter what choices she made, and no matter how it unfolded on the day. The PBM philosophy – which is supported by plenty of evidence – is that it’s not how you give birth that matters, it’s how you are treated. Women should be listened to in the birth room, they should be treated with respect and dignity, and they should have their human rights and bodily autonomy respected at all times.
The PBM outlook is a real pathway through the ‘middle ground’ or ‘grey areas’ between the two polarities of ‘text-book natural birth’ and ‘disempowering medicalised birth’. It’s a way to get all women thinking not only about the kind of birth they really want, but also about how they will feel if their birth surprises them in either positive or not so positive ways, and how they can plan for almost every eventuality, not just the expected or ideal scenario. It also gets women thinking and talking about CHOICE in childbirth (yes, you do have a choice!), and often discovering that there may be more options available to them than they had originally thought.
Having said all that, it seems like sometimes, when you say the words, ‘Positive Birth’, it automatically sets off people’s mung-bean alarm and they think you want them to give birth in a cabin in the woods and feed their placenta to the foxes. This is not true (why waste your placenta on a fox when you could eat it yourself #justkidding), but in case you’re still worried, here are my Top Myths about Positive Birth – Busted!
Positive Birth has to be at Home
Incorrect. You can have a positive birth in literally any setting, from your own sofa to the operating theatre. Positive Birth is about having freedom of choice, access to accurate information, and feeling in control, powerful and respected. If for you this means a planned caesarean, then this is your positive birth. Women themselves, as individuals, get to define what kind of birth feels positive to them.
Positive Birth has to be Natural
Many women want a natural birth and feel strong and healthy after such an experience. At the PBM, we want as many women as possible to feel great about what happened to them on the day they had their baby. But whether you actively choose certain interventions, or there are medical reasons why they are the best plan for you, this definitely doesn’t mean that your birth can’t be positive. All women who have babies deserve a standing ovation, a statue to their achievement in their town centre, and their own talk show. It doesn’t matter how they did it.
Positive Birth is for Hairy Hippies.
No. Positive Birth is for everyone, no matter their background, education, career path, lifestyle choices, bank balance or capitalist tendencies. This includes hairy hippies, of course.
Positive Birth has to be Vaginal
Many women want to give birth via the traditional exit route and often feel pretty chuffed with themselves for pulling off this seemingly impossible feat. However, if it’s not for you, either because you or the Fates decide it isn’t, then this absolutely doesn’t mean that you can’t have a birth that is moving and beautiful. Many women are choosing to find out more about their options for positive birth experiences in the operating theatre, with ‘woman centred’ or ‘natural’ caesareans becoming more popular. Theatre staff don’t chit-chat, music of choice can be played, delayed cord clamping can still happen, as can immediate skin to skin – and much more. All of these options make the experience feel more special and meaningful for the woman and her partner.
Positive Birth is Pain Free
Oh, this is a good one! It’s true that some women have births that they describe as ‘painless’, but this is usually because they’ve successfully ‘reframed’ the idea of pain for themselves, and think of the sensations of labour as ‘power’ or ‘surges’ etc. Whilst this is proof that the mind can play a vital role in how we experience childbirth, it’s true to say that not many of us (including me), feel that the experience was painless. Some people find that they can cope with the pain without drugs, and this is often about how they approach birth and how they are supported during labour. On the other hand, some people – especially if their baby is awkwardly positioned and / or labour is long and tough, or if they don’t feel safe and supported in labour – might find the pain overwhelming. In this case, great relief can come from epidural or opioids, and – if it feels right and good, then – of course! – it is a positive birth, too.
Positive Birth is Fear Free
The idea of ‘birth without fear’ is a strong one, and suggests that we should all be marching forwards towards the labour ward, in some kind of cosplay warrior woman outfit, shouting BRING IT! at the top of our feisty lungs. Of course, the reality is that most of us are pretty terrified of birth, and this is a lot to do with the attitudes we’ve been brought up with and the pretty scary images of birth most of us have seen on the telly. At the Positive Birth Movement, we try to encourage women to have a think about where their fear and pre-conceptions of birth might be coming from, and to try to bring some balance by watching some different birth films or reading stories from women who really loved the experience of labour. It’s not a positive experience for women if their fear of birth is overwhelming or prevents them from taking an active role in their care. However, it’s perfectly normal, and rational, to feel a bit scared as you approach arguably one of the biggest and most challenging days of your life. It’s also really normal to have moments of fear during labour – and these can often be part of the hormones of ‘transition’ – which means your fully dilated and getting ready to birth your baby. Yay!
Positive Birth is Calm and Quiet
The idea of ‘calm birth’ is quite prevalent, and yes, it’s a nice way to imagine yourself in labour – not making any noise, just breathing gently through each contraction and looking super-serene. It’s also easy to imagine why partners, husbands, and even midwives would prefer birth to be like this! But hello?! Birth is REAL LIFE. You might be calm and quiet at times, but you also might struggle, moan, grunt, roar, swear, thrash around, and yell at people. This does not mean that you are ‘not coping’. This might be precisely your way of coping. You do not have to be any particular kind of woman when you are having your baby. You just have to do your thing, your way. This is positive birth.
Positive Birth ends when the Obstetrician turns up
I loved talking to ob Liz Martindale when I wrote the Positive Birth Book. She’s performed several forceps deliveries with the woman in an upright or kneeling position. Another ob, Dr Andy Simm, requests that all staff stand at the woman’s head while she is catheterised before caesarean. Ok, so these obs – simply because they are thinking about the experience of birth for the woman as well as getting the baby out safely – are pioneers, but it goes to show that small touches can make a huge difference to how new mothers feel. Women who have had caesareans under General Anaesthetic have told me how wonderful it is if someone can take a pic of them holding their baby, even while they are still under GA – and these pics are treasured for a lifetime. There is literally not one single kind of birth experience that we cannot make more positive for women with a little thought.
Positive Birth Movement groups are free to attend, antenatal discussion groups with a set topic each month. There are 250 in the UK and another 200 all around the globe. To find out more and discover your nearest group, visit http://www.positivebirthmovement.org/find-a-positi…
The Positive Birth Book by Milli Hill was published in March 2017 by Pinter and Martin and is available from Amazon and all good book sellers.