Expert / 26 May, 2022 / Milli Hill
Milli Hill is the author of the bestselling The Positive Birth Book, and she drops by to celebrate the launch of her revised and updated book with the low-down on ten things nobody tells you about giving birth.
This is a big one, and in The Positive Birth Book, I call it one of the ‘two steel beams’ – the strong, important bits you really need to know and that hold up everything else. The other ‘steel beam’ of the book is that ‘you have choices’. It’s amazing how many women go towards childbirth not knowing that they have rights and choices in childbirth, just as they do in every other area of their lives. During pregnancy and birth, you still have bodily autonomy and the right to be the key decision-maker in everything that happens to you.
Birth plans get a really bad press and are often described as ‘pointless’ – but this couldn’t be further from the truth. Making a plan is first and foremost a way to learn about all your choices and think about what kind of birth you really want. I also recommend you think about ‘contingency plans’ – have a Plan A for your ideal birth but also think about a Plan B (or C or D!) so that you feel confident and prepared for any curveballs.
When I first wrote the Positive Birth Book, I was curious to work out just how much time of labour is spent between contractions. Yes, we all know contractions are painful, but when you are in labour, they are not constant – there is a lot of time between them. So, I did some maths, and was amazed by what I discovered! In a standard 8 hour labour, for example, you are only having contractions 23% of the time. The rest of the time, 77%, is pain-free! Nobody ever tells you about this pain-free time.
Vaginal exams happen as routine in labour, they come every 4 hours to check your dilation or ‘progress’. What many women don’t realise is that they are entirely optional. You don’t have to have them, and some women (and I was one) get through labour and birth without a single one. Of course, if you want them, that’s fine, but the important point is that – it’s up to you. Your body, your choice and if you don’t want one, nobody can make you.
Many people have seen plenty of TV and film births where the midwife (or even a group of people!) are telling the woman to “PUSH!”, but this is not necessary unless you have had an epidural, in which case, because you can’t feel the contraction, it’s useful to have this help. If you have not had an epidural, it’s better to tune into your own body and push as and when you feel you want or need to. In some births, you may even have a ‘foetal ejection reflex’ when the body completely takes over and you don’t have to consciously decide to do anything.
Again, we see this image of birth on TV and take it as read that to have a baby you need to be lying down on a bed! But you can have a baby standing up, kneeling, on all fours, squatting, lying on your side, in a birth pool, on the floor, on the sofa, or in your garden! In fact, lying on your back can make giving birth harder by narrowing your pelvic opening and meaning that you are working against gravity rather than making it work for you!
When it comes to place of birth, you have options. If you are told you don’t, ask more questions! Hospital may work perfectly for you but it’s just one choice – you might prefer to be in a birth centre or ‘midwife-led unit’, or even at home. If you look at the evidence around home birth, you might be surprised – have a look at the tables here from NICE. One option if you are not sure about home birth is to book one, then if you change your mind during labour and think, “I’d rather go to hospital” – just go in! You can always change your mind, how and where you have your baby is completely up to you.
Some people think all this talk about plans and choices only applies to women who want a natural birth or vaginal birth. But you still have choices, even if you have a caesarean birth. You can have skin to skin, watch the birth, have special music, delay cord clamping, and some doctors even specialise in this kind of birth – known as a ‘gentle’ or ‘woman centred’ caesarean. Even if you are not planning a caesarean, make a caesarean plan and talk to your care providers about your options and choices!
We tend to think about giving birth in purely physical terms, but it’s actually a major life event – not ‘just one day’, but an experience you will never forget. Allow yourself to treat it with real reverence and respect. Think about it as you would think about other ‘rites of passage’, like a wedding day for example. How can you bring this energy to the day you have your baby? It’s not really about spending money, it’s more about intention – the intention to celebrate and make things special. To honour the day and to honour your own role in it. Think about ways you can do this.
Rites of passage are usually about ‘crossing a threshold’, and as we give birth, we cross the threshold into motherhood. This changes us! It affects how we view the world, what we want from life, how we feel about ourselves. It influences our plans and our decisions – forever! It is daunting to think that a new phase of our lives is beginning, but it’s also true. And as with all other major life changes, some of it will be wonderful and other parts will be hard. There will be losses as well as gains. I’m not sure people talk about this enough, but it’s definitely part of the process of becoming a mother.
Article by Milli Hill, author of The Positive Birth Book, revised and updated for 2022, available to purchase at Book Depository.