Author: Beth Owen

What does birth look like in your head? Reframing Birth

This week I was reflecting on conversations in antenatal classes. In Daisy Birthing and an Active Birth Workshop we talked about how birth looks to us. When we talk about positions for birth – for labour or for bearing down/pushing – I always ask what position everyone things is good for this stage.

By this stage they have usually learnt a few things from me and you can see some uncertainty. The image in their head is lying on your back on a hospital bed but they can already see that isn’t what I am going to suggest.

The science tells us that upright and forward leaning positions are going to be the best way for labour to progress. Gravity is your friend! UFO is what you need to remember – Upright Forward Open. If you want to know more get yourself booked onto a class with me!

So why is it that we all picture a hospital bed and someone in a semi reclined position, or maybe even with their feet in stirrups?

The simple answer is SCREENS! All of our screens. Whether you have seen birth in films, soap operas or documentaries the chances are pretty much every single one will show a medicalised birth with the woman on her back on the bed. Probably hooked up to various monitors and drugs with doctors and midwives saving the day as she screws up her face and pushes as hard as she can.

We see this from such a young age that it is how we learn about birth. Very few of us will be present at a birth before we have our own babies. Those days are gone, where we would have learnt about birth from mothers, aunts, cousins, sisters as they birthed their own babies. Now we have learnt about birth from something designed to capture our attention, to be dramatic enough to draw us in and leave us wondering and edited or imagined for ratings.

Yes many births do look like this. But why?

Because our expectations are there. Because we walk into a hospital room in pain, maybe already feeling like we are exhausted and struggling, and the first thing we see? A bed. So we climb on and lie down.

If you haven’t been able to access antenatal classes or had a chance to learn about birth, why would you do anything else. It’s how birth works, we’ve seen it on TV or in films.

When we start to prepare for birth we need to reframe. We need to see birth in a completely different light. One where the birthing person is in control, where they are in positions that are comfortable and help their labour progress. But if you’ve never seen someone labour on their hands and knees and leaning over a birthing ball or the end of the bed, why would you do it?

Instinct! Our instincts are good, our bodies can birth babies, but we’ve lost our confidence. We think we need help and guidance (sometimes we do, but I’m not talking medical intervention here) to get our babies out because we don’t know what to do and the people caring for us are the experts. And they absolutely are, although when it comes to YOUR body and YOUR baby it’s YOU who is the expert.

 

It’s not uncommon for someone in labour to want to be close to the ground, to feel safe and private. So being on all fours with your head down and eyes closed is perfect. Or to raise your arms as your baby’s head crowns – so holding on to the top of the bed as you lean forwards into the pillows comes naturally. Maybe it’s a need to rest and regroup in between contractions, so being on your knees leaning on a ball or the bed is perfect for you.

The important thing is having the freedom to move and not being restricted by the images in your head. Even with monitoring, drips, epidurals in place you can be helped to move into positions that work better for you. Maybe sitting beside your bed on a ball, standing leaning on the bed or lying on your side. There are so many benefits to not being on your back that a bit of creativity and help from your birth partner can go a long way.

Reframe your birth and find the positions that work for you and your baby.

 

 

Choose the classes for you and let’s get you ready for a positive and confident birth.

https://thedaisyfoundation.com/beth-owen/product/daisy-birthing/

https://thedaisyfoundation.com/beth-owen/product/daisy-active-birth-workshop/

https://thedaisyfoundation.com/beth-owen/product/daisy-parent/

It’s something I hear when people enquire about classes, when people join classes when plans around birth might change.

From when you find out you are pregnant you might have felt some worries or anxiety. For some the pregnancy is a worrying time, maybe you have experienced a previous loss or know someone who has. Maybe you can’t relax until you see your baby wriggling around on a scan or hear a heart beat or feel the kicks.

But for lots of pregnant people the worries are around birth. It’s totally normal to feel anxious about birth. You are probably really excited to meet your baby but a little trepidation about the journey is to be expected.

When it comes to birth there are so many unknowns. Even assuming you are all on course for waiting for labour to start naturally you might be looking out for any sign of labour and wondering if that was a bit of a twinge.

First worry is often how things will start and when. Will your waters go in the supermarket or will it just be some cramps niggling that turn into something more regular? Will you even know?

And then how long is this going to take? Everyone knows someone who was in labour for days. Maybe your worry is how you’ll cope if you miss a (few) night’s sleep.

The pain! How will I cope with the pain? I think we all acknowledge that, for most, labour comes with some rather intense, interesting feelings from contractions. It’s a huge unknown. Even if you’ve experienced broken bones or kidney stones or anything else equated to child birth this is different. Those intense contractions are a sign of your body working positively, not a sign of something going wrong or an illness and you have lots of things to help you through it. With your birth hormones and endorphins your body is working to birth your baby and with some tools and tricks you can work with your body to make it more effective and more comfortable.

One of the things I see regularly in classes is people moving from a place of anxiety to growing confidence in their ability to cope with whatever come their way.

 

In Daisy classes we want to empower you. We want you to feel confident and comfortable about your birth choices. By teaching you how birth works and helping you understand how your uterus contracts and your cervix dilates, and how oxytocin and adrenaline interact, with endorphins and relaxin doing their job too, you will be able to make your own choices about what your preferences for birth look like. You will also be prepared for anything that comes up on the day where you might need to be making decisions or changing plans. By understanding what is happening in your body you are well placed to say yes or no or make your own call on situations.

Coming to Daisy Birthing is a chance to spend 1.5 hours a week focusing on your baby and your birth. The whole class is so relaxing, with dim lighting, gentle music and breathing to help you flow through the movements until we finish cosied up with blankets and pillows for a blissful deep relaxation.

 

How is an antenatal class going to help with your anxiety?

Learning more about how birth works

Learning and practicing tools to help you in pregnancy and birth

Being confident about what is happening and knowing you can make decisions

Spending time each week learning how to relax and bonding with your baby

Meeting other local mums-to-be and sharing this journey

Helping feel more prepared and maybe even excited about birth

 

When you sign up to Daisy Birthing (or any of our Daisy classes) you don’t just come along to a weekly class for 6 weeks and disappear at the end of it. Your class will have a WhatsApp group so you can stay connected through the class and beyond – sometimes far beyond – with people who are expecting babies around the same time as you. You also have my support beyond the end of our classes. If you have questions when birth gets closer or even in labour or when you are home with your baby you can always send me a message.

One thing that is missing from antenatal care at the moment is continuity. Few people are seeing the same midwife for their antenatal appointments and that means you sometimes are repeating yourself or asking the same questions, getting different opinions or advice. Your antenatal classes might be the place you find that continuity. Whether you come to my classes or somewhere else in the country you are going to be taught by your local teacher. It will be someone with local knowledge who is passionate about supporting your journey and who cares about your and your baby. You can trust us to help you find the information you need to make the decisions you want to.

So what are you waiting for? Come and join our awesome Daisy community and get prepared to meet your baby!

 

 

https://thedaisyfoundation.com/beth-owen/  

https://thedaisyfoundation.com/beth-owen/product/daisy-birthing/

Every new parent wants to bond with their baby, wants to feel that connection. For some it’s a real worry in pregnancy. How will I feel? What if I don’t love my baby? What if I feel nothing?

When you first see your baby you absolutely might feel that overwhelming rush of love and connection as you gaze at them. Or you might not. You might feel like you are looking at a strange alien creature. You might feel exhausted, in pain or out of it on meds, maybe the overwhelm of seeing your baby born is taking over. Whatever you feel in that moment isn’t the defining moment of your parenting.

For lots of people it takes time for the bond to grow. Not everyone adores a newborn (I know, but it’s true!), for some parents it comes more naturally when their baby interacts – smiles, laughs, shakes a toy or even says ‘Mama’ or ‘Dada’.

You might be doing things in your pregnancy to help with bonding. Maybe you rub your bump or you talk to your baby or play music. Your partner might be doing the same, or maybe all your preparations – building a cot, washing clothes, buying a pram – are part of that bonding process.

Once you get home with your baby and start to settle into life together how do we grow those bonds and attachment?

It might be really simple. If you are the parent breast or chest feeding your baby you probably spend a lot of time holding your baby while you feed, maybe while they nap after a feed, through the night and through the day. The person breastfeeding often does develop an attachment and the baby will attach to them as a place of safety and security because, on a primitive level, they are essential for their survival.

But what about the other parent? If your partner is breast or chest feeding your baby 12 times a day and spends hours trapped under a feeding, sleeping baby how do you find your bond?

It can be a really hard time for partners to figure out their role here. If breast/chest feeding is important to your family then time skin to skin and time at the breast is crucial to make it work and this can lead to the other partner feeling a bit left out.

When I teach on feeding we talk about expressing and the million and one reasons someone might have for expressing. At the top of the list is often for partners to feed and bond with baby. It’s natural to see it that way breast/chest feeding is often seen as being all about bonding. Food is how we nurture, it’s how we show love. People are welcomed into our homes and we want to feed them. Culturally food = love.

So is the partner feeding the baby at huge advantage and should the other partner give some bottles of milk to bond?

Well maybe, but it’s natural for a baby to quickly bond with the parent breast/chest feeding because of erm, survival. Your baby won’t feel safe being far from their source of food. But it isn’t necessarily a disadvantage if your anatomy doesn’t work for feeding a baby.

In those early days and weeks it’s really important for baby to spend lots of time at the breast/chest to establish a milk supply. It’s important to feed on demand to get all the right signals in your body to produce milk as and when it’s needed. Expressing and bottle feeding early on needs to managed with so much care to make sure the feeding journey isn’t derailed.

So what can you do?

In the postnatal period your partner needs you. But needs you in a really practical way. They need food and drinks, snacks and more drinks, encouragement, reassurance, someone putting the washing machine on, someone to listen and someone to bring snacks. I know, I know. You’re excited and exhausted, you just had a baby, you want to do baby stuff not be refilling water bottles and popping out for more cake.

How do we make this work? Where does the bonding come in? Well, for some that support of their partner might be part of the bond. That caring for your partner equals caring for your baby. But equally, that might not make sense for you.

My advice to partners looking for ways to bond is to find your thing. It might be a special song you sing, maybe a little game when you change a nappy, a walk with baby in the sling, bath time (maybe sharing a bath together), skin to skin with you, a massage for baby, maybe you can help with winding or sleepy snuggles.

 

Whatever it is, you’ll find your own thing for you and your baby and it doesn’t need to involve a bottle if that isn’t what you, your partner and your baby want. And if it takes time, don’t panic. You are still the perfect parent for your baby, you will be caring for them brilliantly and one day you will realise that the bond, the love, is there.

Want to learn more? Book your Daisy Parent course or if you want some bump bonding time come to Daisy Birthing

Need postnatal support? Head to Nurtured Mums to see how I can work with your family

Whenever I talk about sleep with expectant or new parents there is often a discussion around bad habits and wanting babies to fall asleep by themselves or stay asleep longer at night/not need help to get back to sleep when they wake.

 

My conversations have followed a similar format until recently when I added some new reflections.

 

I usually talk about normal newborn behaviour. Babies have teeny tummies that empty and need refilling frequently. That means they need to wake through the night and although a new born sleeps lots it isn’t it consolidated stretches for quiet a while.

 

Babies also need to be close to their caregiver. All they know is being in mum’s tummy, being rocked, stroked, talked to, listening to her heartbeat and having every need met instantly. Waking up alone in a moses basket or cot that is still, cold and big is scary. Your baby needs you.

 

Lots of new parents notice their baby sleeps so much better curled up on their chest or after a feed. But lots are also anxious that contact naps and feeding to sleep can become habit and that baby becomes dependent on them for sleep. What we need to recognise is that these things are not bad habits, these things are the biological norm for our babies. They need to be close to you, they aren’t manipulating you they just need to be with you. Sucking is calming and hard work for babies. It’s normal for them to fall asleep with a full tummy after a feed (who hasn’t fallen asleep after a big meal?). If you are breastfeeding there are hormones in your milk that help baby to sleep, it’s what is meant to happen. Trying to stop a feed and put an awake (or even a drowsy but awake) baby down in a cot is hard, they instinctively want to feed to sleep.

 

Once we start to think about our expectations it might help parents to rethink what they want to do around sleep. But I also reassure parents that it’s fine to follow your instincts. It’s all good knowing what to expect but what about when the advice from friends, family, social media and anywhere else is going against your natural instincts. Despite the growing knowledge of normal behaviour we still want our babies to fit in with us rather than us adapting to them and there is still a temptation to ‘fix’ this behaviour because most of us don’t cope well with broken sleep night after night.

 

So if your baby is crying and you know feeding them will settle them – feed them.

If you know a cuddle will help – cuddle them.

If you don’t know what is wrong but you can hear your baby crying – go to them.

The majority of parents feel that leaving a baby to cry goes against their instincts. And we have those instincts for a reason – they protect us all.

 

When we start questioning whether it’s a bad habit to wake or to need to be close to a parent to sleep or to need a feed in the night it’s not uncommon to see it turned around. Do you sleep better next to your partner? Do you sometimes want a cuddle in the night? Does your partner (or someone else) comfort you when you are upset? Do you wake up for a drink?

 

And if you respond to those needs is it a bad habit? How would we view it if an adult was denied those things?

 

Recently I’ve been reflecting on this with regards my own children. The older two both slept through the night (as in from when they went to bed until morning) from around 13 months. Once they did that they rarely woke unless they were unwell or had a bad dream. My youngest was (and is!) a very different story. He has consistently woken in the night and as he turned two he was still waking every couple of hours and I fed him as it was the easiest way to get him (and me) back to sleep. Soon after his second birthday I stopped breastfeeding and then he would come into our bed and stay until morning. Eventually we reached a point where he would come in for a cuddle for a few minutes and go back to his own bed. And at age 5 we are still there. Not every night, we go through phases of waking and sleeping all night.

 

When he wakes he calls out ‘Mummy can I come in your bed?’. And I say ‘Yes’. Because you can’t really say no, can you? He needs a cuddle and then once he’s drifting off I take him back to his own bed.

 

If we wouldn’t deny our partner the comfort they needed, or a child who can verbalise their needs a cuddle, why do we think our babies don’t need us at night? Or need to learn not to need us at night.

 

When I’ve shared this with parents it’s been a bit of a lightbulb moment. If my 5 year old asks for a cuddle I respond so of course it isn’t bad to respond to their baby if that is what feels right.

 

I know it’s hard. The two hourly wake ups for 2 years was tough. The number of days I sat at my desk thinking how incredibly tired I was juggling a part time job, teaching classes, 3 children and everything that comes with them. But our little ones need us at night just as much as they need us in the day and we need them to learn that we are there for them. When they need us we are there. That is how they become confident, independent little people.  It’s the confidence that they have someone who is there for them. When they start to go off and explore they know they have a safe place to come back to.

 

All of this doesn’t mean you have to suffer a lack of sleep. If you need to, by all means make changes, just do them as and when you feel comfortable and be aware that your baby will still need you in some way so you may be swapping something for something else. When I stopped breastfeeding the swap was for him to sleep more in our bed. Then came a time where we could change that too.

 

Trust your instincts, cuddle your baby and parent in the way that makes you feel comfortable.

 

Once you are pregnant a whole new world opens up. Tests, checks, scans and appointments are all booked in and you will be hearing a whole new set of language.

You will find yourself navigating the maternity system, another unknown.

You might meet midwives, maternity support workers, maternity assistants and sonographers. You might see a Consultant or one of their team. Figuring out who is who and who does what can take a bit of research or asking some questions.

All of this can seem a bit overwhelming and if you are not familiar with the maternity system or with pregnancy and birth you might not be aware of the choices that are open to you. Because when it comes to it everything is your choice. You can say yes or no to any of those tests and appointments.

But for a lot of birthing people the concept of choice in their care, in their birth, in what happens to their body is a little alien.

We have become accustomed to being told what to do when we are pregnant. You are probably feeling a little less like yourself than usual and maybe even just a teensy bit hormonal. Plus this stuff matters.

You don’t want to make the wrong choices – it’s your incredibly precious baby, you do not want to mess up. You want to trust the people looking after you and be guided in the best way to be cared for, the best place to have your baby and the best way to do it.

So when someone says ‘We’ll just….’ or ‘At your next appointment I will….’ or maybe even ‘Then we’ll decide on your birth plan’. We just go along with it.

But what if you stopped and asked some questions.

Everything that happens needs to be with your informed consent. That means that you need a full understanding of the pros and cons so that YOU can make a decision. Yes, no, later, if xyz. It’s YOUR decision, your body, your baby, your choice.

Some of them you won’t give a second thought to – you might be 100% confident you want midwife care and regular checks but there are people who would prefer not to. Likewise you might be really excited for your first scan to see your baby and find out your due date. But there are people who choose not to have that scan.

The most important thing is that you are able to make an informed choice about your own care. Just take a moment to reflect on informed choice. What does that mean to you?

If you wanted to make an informed choice about something – let’s say you are thinking about buying a new car – you would want to make sure you had the information you needed to make a decision you felt comfortable with. You wouldn’t want to listen to a sales person telling you all the reasons you need the car. That’s just one side of the information. You might ask a few questions about the information you have been given, you might decide to go away and do some research of your own, maybe you look at what other options there are but what you are trying to find out will be what are the good and bad things about this car. You are weighing up the pros and cons, figuring out what will work for you and your situation and deciding for yourself if it’s right for you.

The decisions you make about your care and about your birth are important. You might be weighing up the safety of your baby or yourself (not something anyone wants to think about) and maybe you feel like you need the guidance of the professionals.

There are always risks and always what ifs. Informed consent means you understand and come to the decision you feel is right for you and your baby.

As you read through this you might be thinking it’s all about the big decisions, the ones where you are thinking about safety and interventions. But the reason I’m writing about this is something that isn’t quite on that scale. However it is something that is a huge deal for a lot of people and something that you might not give any thought to with regards informed consent.

So lets talk vaginal examinations.

This year alone I’ve taught several people who were anxious about vaginal examinations in labour. Very understandable!

What they didn’t know was that they could decline. I can’t imagine feeling so anxious about something but not realising I could say no.

If I say that no one can put their fingers in your vagina without your consent you would certainly be nodding in agreement. Sitting reading this I’m sure you would think that’s pretty clear. But something happens when we are in labour and somehow we just expect that examinations will be happening and we need to just go with it.

First things first. You can absolutely say yes or no to examinations. At any time.

Why are examinations offered?

It is usual to be offered an examination when you are being assessed in labour. Either when you arrive at hospital or when a midwife comes to you at home. This is to see how dilated you are and is often used to see whether you are in established labour or not. This may well be presented as a necessity before being admitted .

In established labour it is usual to be offered an examination every 4 hours to assess your progress. You might like the idea of knowing your progress or you might prefer not to know!

You might also be offered an examination if there are concerns labour is slow or to check your baby’s position.

Whatever the circumstance it is worth considering the reasons for the examination and what you would do with the information. Would it impact your decisions? Will it help you? It is important you understand the purpose of the examination and what will happen because of the outcome.

From the NICE Guidelines

Your midwife will offer vaginal examinations during labour. These are done to check how far your cervix (neck of the womb) has opened (dilated) and the position of your baby’s head. The midwife should always explain why an examination is being advised and what it will involve.

There is a common perception that the only way to assess labour is by vaginal examination and that without that knowledge you can be denied care such as pain relief or even admission to the hospital or birth centre.

If your preference is to decline examinations you might want to read a bit more about other methods of assessment and if you feel you need more support or information AIMS are a good place to go.

As ever my interest is not in whether you want examinations or not it is that you are aware of your options and supported to make your own decisions.

There are times when vaginal examinations are incredibly useful but it’s all about the informed consent so you know.

What is important to remember is that all a VE will tell you is what is happening at that moment in time. It won’t tell you anything about what has been happening or how long you still have to go in labour. Labour progress isn’t linear and plotting it on a graph doesn’t really tell you anything useful. We know that not everyone will dilate at the same rate, some are faster and some are slower but whether anyone needs interventions or help needs to be taken on an individual basis not just by looking at the numbers.

In 2013 the conclusion of the Cochrane Review into vaginal examinations stated

We identified no convincing evidence to support, or reject, the use of routine vaginal examinations in labour, yet this is common practice throughout the world. More research is needed to find out if vaginal examinations are a useful measure of both normal and abnormal labour progress.

It would seem we are still waiting for the research because, despite a lack of evidence, routine examinations are taking place every day in every maternity unit in the country and unless women are aware they can say no and that there are pros and cons, nothing will change.

If you want to read more about the history and science (including some of the risks associated with VEs) please read this article https://midwifethinking.com/2015/05/02/vaginal-examinations-a-symptom-of-a-cervix-centric-birth-culture/

 

References

Cochrane Review 2013 https://www.cochrane.org/CD010088/routine-vaginal-examinations-in-labour (accessed June 2021)

NICE guidelines https://www.nice.org.uk/guidance/cg190/ifp/chapter/care-during-labour (accessed June 2021)