Tag: home birth

Things For You To Try That Could Shorten Labour

If you’re pregnant, you may be wondering what you can do to shorten labour – because who wants to spend longer than necessary in labour rather than meeting your baby?! The good news is that there are several things you can do to help prepare your body for labour and potentially shorten the process, which can last between 14-21 hours depending on whether it’s your first baby or not. But of course, all bodies are different and there are lots of factors that affect how quickly a baby comes.

Stay Active In Pregnancy

Staying active throughout your pregnancy can help you prepare for labour and birth. Exercise strengthens your muscles, including your pelvic floor muscles, which can make pushing easier. Walking, swimming, and antenatal yoga are all great options for staying active. People who exercise 3 times a week in pregnancy can reduce the length of their labour by 50 minutes!

Antenatal Yoga

Yoga and other forms of stretching are excellent ways to help get your body for labour and birth. A lot of the movements help to keep you upright and open up your pelvis, as well as stretching and releasing the psoas muscle which supports the pelvic floor. If any of the muscles in your pelvic area are tight or imbalanced it can cause suboptimal positioning for baby, which in turn can cause labour to be longer. Yoga can also help turn your baby into an optimal position with their head down and chin tucked, and if baby’s in a great position then that can help reduce the amount of time it takes to meet them.

Antenatal Education

You wouldn’t head off to a job interview without doing some prep work first would you? Giving birth is exactly the same – birth preparation can help you prepare for your labour and birth. Knowing what your body does when giving birth, how you can optimise your birth physiology and what you might encounter if your birth throws you a curve ball can really help you reduce your stress hormones when the big day arrives. And we know stress hormones impact oxytocin and can slow your labour right down. The good news is we cover all of that and more in my classes – check out the store page to see what options suit you.

Eat Dates

Research tells us that eating dates can reduce the length of your labour as well as increasing your chances of going into spontaneous labour rather than being induced. Eating them also decreases the chance of having heave blood loss after birth. Around 7 dates a day from 36 weeks of pregnancy might mean you get a little bit bored of dates, but not bad for a humble fruit!

Raspberry Leaf Tea

Many women and birthing people swear to the power of raspberry leaf tea to tone the uterus and make contractions more effective, and in doing so making labour shorter. The evidence behind it isn’t robust but we do know it’s not going to cause any harm. Worth a shot, eh?

Oxytocin Boosters

Oxytocin stimulates contractions. Having a good healthy dose of oxytocin in your system will ensure your contractions are as effective and as efficient as possible leading to a shorter labour. Without enough oxytocin in the system, your contractions will slow and things will take longer. Find out ways you can encourage oxytocin here.

Breathe!

Breathing is a very powerful tool when giving birth. Not only does it help you relax which reduces physical tension and soreness, it trips your parasympathetic nervous system and reduces stress hormones – allowing oxytocin levels to rise and the wonderful positive feedback loop mentioned above to start. But that’s not all! A steady breathing pattern makes sure your body has plenty of oxygenated blood to carry to the birth muscles, and well oxygenated muscles work more effectively.

Continuous Support Partner

Whether this is from a birth partner, a doula, or both, research tells us that having a continuous support during birth can help improve outcomes. Having a non-medical person to help support you in different positions, with oxytocin boosters, to help you relax, and to make suggestions if things seem to be slowing down can help you optimise your birth.

Stay Home

We know that people who plan home births have fewer interventions because things aren’t progressing as quickly as expected as well as a whole heap of other benefits. Even if you’re not planning a home birth, staying at home for longer helps keep your oxytocin levels up which can reduce the amount of time you’re in labour (and hospital) for.

Try Different Birth Positions

Changing positions during labour can help ease pain and pressure and encourage your baby to move down. Some positions to try include squatting, kneeling, or standing and leaning forward. You can also try using a birthing stool or a birth sling. Positions that help you be upright and open are great ones to try. Being on a bed on your back generally slows things down as your body has to work against gravity and the pelvis doesn’t have space to open.

Use a Birthing Ball

Sitting on a birthing ball can help open up your pelvis and encourage your baby to move down. The gentle bouncing motion can also help ease pain and discomfort during contractions. If you don’t have a birthing ball, you can use a regular exercise ball or even a chair.

Eat, Drink and Be Merry

Staying hydrated and fuelled with calories is important during labour, as dehydration and not having enough calories can slow down the process. Make sure to drink to thirst (or have someone remind you) and snack on calorie dense food throughout labour.

Consider Medical Intervention

For some people, no matter what they try, labour will be slow progress. This might be due to lots of different factors such as baby’s position. If your labour isn’t progressing your midwife or doctor may suggest medical help such as an oxytocin drip or rupturing your membranes. When interventions are offered they must always discuss the benefits, risks and alternatives with you so you can give informed consent.

There are no guarantees when it comes to giving birth but we do know that lots of things can help – and hinder! – the process. Make sure the team around you know how they can help you with some of these things.

Where Can You Give Birth: Your Birth Place Options

Women and birthing people are supposed to be informed of their choices about where they can give birth and, crucially, are supposed to be supported in their choice. But we know this doesn’t always happen – according to the CQC Maternity Survey Results published in January 2023 a fifth of women said they were not offered any choices about where they can have their baby. Even if they are, the choices are often presented as a list rather than a proper discussion about them. How can you pick something as important as where to birth your baby if you don’t know what each option means?!

Read on for an overview of your choices of where you can give birth.

Home Birth

A home birth is exactly what it says – you give birth at home. Midwives come to you when you’re in labour and stay until you’ve given birth. They examine you post birth, help you with a shower, feeding, and tuck you into bed and go on their merry way. There is NOTHING like getting in to your own bed after giving birth and not sharing a postnatal ward with several other mums, partners and babies.  

You’re supposed to be told that home birth is a good choice for ‘low-risk’ women as there’s a lower intervention rate and the outcomes for mums and babies is no different to in a hospital setting – there’s lots of evidence for this. You’re also supposed to be supported in a home birth if you’re ‘high risk’. You can choose to birth at home whether you’re low or high risk.

To hear more about what I’ve got to say about home birth, click here or here.

Birth Centre / Midwife Led Unit

Midwife Led Units (MLUs) are generally called Birth Centres. They come in two variations:

Alongside Midwifery Unit (AMU) – these are alongside the obstetric unit, ie on the same hospital site. Because they’re on the same site if you need extra support such as certain types of pain relief or necessary interventions, it’s a short trip usually taking a matter of minutes in order to receive it (and doctors do also have legs and can come to you if it’s really necessary!).

Freestanding Midwifery Unit (FMU) – these are on a separate site to the obstetric unit. Because they’re not in the same place it will take more time to receive extra help. If you needed that support you would need to be transferred to the local obstetric unit.

Midwifery Led Units are, as the name suggests, led by midwives rather than care being shared between midwives and doctors. They tend to be a little bit more ‘home from home’ like than labour wards and often have birth pools, twinkly lights and pretty murals on the wall. If it’s a particularly well-equipped one you might even find birth ropes, birth stools and other exciting birth equipment.

You have the right to choose to give birth at a Birth Centre if you wish, however sometimes this may involve a negotiation as your trust literally hold the keys and may encourage you to believe that it’s ‘not allowed’.

Labour Ward / Delivery Suite / Obstetric Unit

On Labour Wards care is shared between doctors and midwives. This is generally where those who are expected to have a complicated birth are recommended to give birth, however sometimes your definition of “expected to” may differ from your caregiver’s definition! It’s also where caesarean births take place.

The environment tends to be more clinical looking and less oxytocin-promoting than at home or in Birth Centres, which is a bit silly because people having complicated births are arguably more in need of oxytocin promotion! There is access to more significant pharmacological pain relief such as opiates and epidurals if you want them. By definition, more interventions happen here – because they can’t take place at home or on the Birth Centre.

You have the right to choose to give birth in a Labour Ward either vaginally or by planned caesarean section if you want to. However, you should be advised that unnecessary intervention is more likely to happen on a Labour Ward than either at home or Birth Centres.

So there’s your whistle stop tour of where you can give birth. Where you choose to give birth to your baby is a really important decision because even planning to give birth in one place but actually giving birth in another can change your birth outcomes. So make sure you really consider it and don’t dismiss any of the places until you’ve thought about them properly. And remember, you can change your mind at any point before your baby arrives!

Positive Birth After Birth Trauma

Here we are, in the middle of birth trauma awareness week 2019 and I realised that as important as the subject is for people to recognise and talk about, it’s also pretty important for people to know that it can get better and it doesn’t have to affect you forever.

Now, I’ll preface all of this with I was a bit of a dick and went for the head in the sand approach to birth trauma management. Personally and professionally I recommend that you go for a slightly more structured approach that has better success rates! Although having written that I guess I need to be as compassionate to myself as I would to someone else telling me this story. I did try and get help after my first was born; I waved bright red flags at the Health Visitors but one ignored my sobbing and left the house, and others didn’t have the depth of understanding of me to know that I wasn’t fine (and I don’t blame them for that, I blame the system which doesn’t have the continuity of health care that means you’re not just a name on a list of visits or appointments that day). I specifically made an appointment to try and get support from a GP before getting pregnant again and was basically laughed at saying I need to get pregnant first and then I can be referred to the mental health midwife. I spoke about this in my birth trauma video at the beginning of the week but that’s not helpful. For some it would be the difference between having more children and not. The ignoring of people when they stick their hand up and say they’re struggling has to stop. During pregnancy number 3 I told my booking in midwife I was experiencing high levels of anxiety and she said “don’t worry, I won’t write it in your notes just in case”. Just in case what? Just in case I get help?!

Anyway, there I was. Other avenues could have been explored but I went full-blown ostrich instead. Got pregnant, tried to block out the fact I needed to actually give birth. In writing this blog post I’ve tried to remember being pregnant and I can’t. I can remember being pregnant with the first, remember the third but there’s not one single memory I have of me actually being pregnant with my middle child. I experienced panic attacks in the hospital during appointments because the NHS still hadn’t caught up to person-centred care, so I decided to have a home birth with a doula in attendance (for which I’ll forever be grateful to the friends who paid for it for me) and during my “if there aren’t enough midwives to come to you” talk I made it clear I flat out refused to go to that hospital if midwives couldn’t come to me or I needed to be transferred. And it was around that point that I’d got it clear in my head that I wouldn’t have to go to the source of my traumatic event no matter what – which I firmly believed, even if the midwifery staff didn’t – that my attitude to my pregnancy began to change. I could relax into it.

All of that is a fairly long contextual prelude to what came next. Knowing I had the safety blanket of someone to step in and advocate for what I wanted I was able to let go for labour. I was at peace that she’d arrive when she was ready to arrive and, although I’d known what I’d wanted and hadn’t wanted out of my birth the first time, I didn’t have an understanding of how I could help myself achieve that. I was told or read what interventions existed but never how to help avoid them, or even how they’d impact on my ability to give birth. I never knew how crucially important being calm was. We’re sold the idea that ‘what will be will be, accept what happens’ in labour and it couldn’t be further from the truth – things might happen that we hadn’t anticipated but arming yourself with the tools to decision-make through the unexpected puts control back into your hands.

And that’s the crux of it, for me. I felt in control this time. My house, my rules. I hadn’t devolved responsibility or authority to anyone else because I wasn’t on their turf. I hadn’t handed over my labour to people wearing an ‘hello my name is’ badge simply because they were the trained professionals. I was responsible for my decisions and my actions, in a way that never felt true for my first birth. I owned the house and they were my visitors and that had to be respected, and I was treated in a much more respectful way from those who attended me, unlike in the hospital where doctors felt that it was appropriate to walk into a labouring woman’s room without knocking, without introducing themselves, while she was trying to use a bedpan kneeling on a bed after taking opiates. Whether this was the beginnings of change away from paternalistic healthcare over the intervening years, striking lucky with who was on duty or a different dynamic from being at home I don’t know, but it definitely helped. I mean, I guess not owning a bedpan also helped!

As well as this shift in the dynamics of who was present, one of the other things that helped me was going in labour knowing I’d considered what would happen in different scenarios, something I’d not done for the first birth. I think this was likely the beginning of my birth flow chart theory! Instead of a black and white view of what I didn’t want with, crucially, no real understanding of what my alternatives were or how to find out, I knew what alternatives were available for different things that might crop up and I was reassured that I, my husband, and my doula were able to get that information if we got into a situation that needed it. Knowing that there were people positively primed to be the labour breakwater and stop a situation escalating was priceless.

Home birth isn’t for everyone, but for me staying at home and the extra support coming to me instead of me going to it meant that I didn’t have the huge break in oxytocin during the travel time which is where the fear was really allowed to set in during my first birth experience. It almost goes without saying that a calmer, less fearful labour is going to help not replicate the events of the first time round.

After a 7 hour labour during which I was described as “zen”, my daughter was calmly and quietly born in the water in a darkened room arriving en caul. A far cry from the screaming purple baby born under the strip lights of a huge labour ward suite observed by dozens. I immediately described her birth as healing. I still do. It made me realise that birth really is magical, that our bodies do know what to do and that we really, really need to listen to women. My emotional scars took 3 years to heal, but they healed the moment she came into this world (2nd degree tear and all!). So much so I opted to do it again 4 years later and, although this time it wasn’t a healing experience, it was even more beautiful and joyous than I’d experienced before.

Image adapted by Natalie Dean

National Homebirth Day

HOMEBIRTH SAFETY

The biggest question for most people when thinking about home birth is ‘is it safe’?

Generally birth is safe in this country, especially if you’re low-risk in pregnancy.

Up until now home birth was considered a safe option for low-risk pregnancies but with a statistically significant increase in risk for first time mothers. However, a very recent study, published in August 2019 by McMaster examines the risk of death either at birth or within the first 4 weeks after birth and has found no statistically significant difference between hospital or home. The study looked at over 500,000 intended home births to come to the conclusion.

Transfer rates for first-time mothers from home are around 45% which is a significant number, *however* the transfer rate from an along-side maternity unit (like the one at Stepping Hill) is 40% so really, the numbers are quite similar when looking at the right comparator. It’s worth mentioning that, again, we’re likely looking at a significant number of women who haven’t prepared for birth and perhaps might not understand the physiological changes the body goes through while giving birth which can affect the way a person births.

Transfer rates for women who already have a baby are much lower at 12%, which again is a similar figure to those from an AMU.

While producing very similar statistics for the most serious outcomes, birthing at home significantly reduces the need for an emergency caesarean, forceps or ventouse delivery, episiotomy or epidural – all of which have their own risk factors and health consequences.

ADVANTAGES OF BEING AT HOME

Apart from the different ways that being at home can affect the health and wellbeing of you and your baby there are other significant advantages to giving birth at home.

Your own space: Being in your own space is immeasurably beneficial. You’re not confined to one room or area of the hospital, you have everything you own on hand in case you need it (without dragging 3 suitcases to hospital with you in labour), you feel safe and secure which aids the labour process, you can dress the birthing area however you want to (laminated affirmations a-go-go!). There’s also a fundamental difference in attitude as well. When you walk over the threshold of the hospital you take on the role of patient, no matter how person-centred the unit tries to be. Your attitude changes as subconsciously you hand over some of the responsibility of your labour – and for some people that’s exactly what they need but for most people your subconscious needs to fully own that autocratic decision-making. When you welcome midwives into your home they’re on your turf not you on theirs, and it makes a difference.

You labour where you birth: It’s so common for contractions to drop off a bit during that journey to hospital and the settling in session when you get there. It’s no wonder, because your oxytocin vibe is disrupted. Without that journey you can stay inside your birth bubble doing your wondrous labouring. And there’s no need to worry about petrol in the car, change for the car park or accidentally giving birth on the A6!

You’re not in hospital: Well duh. But actually it’s a really huge one, this! Tokophobia is rising, birth anxiety is rising, birth trauma is rising as well as the non-birth related fear of hospitals and doctors that some people have. For some people being in a hospital is triggering, and removing the medical element can reduce anxiety levels which helps people give birth.

Childcare is sorted: Now some families won’t want to have their children at home while they give birth regardless, but for others it solves a childcare issue or means that the whole family is around ready to welcome its new member to the household.

Your own bed: I cannot emphasise enough just how amazing this is after giving birth. Your own shower. Your own toilet. Your own bed. With only the people you choose to be there; no noisy ward neighbours, midwives or babies (apart from your own). Literally worth a million pounds.

WHAT DO I NEED AT A HOMEBIRTH?

Really you need very little. A pregnant body and that’s about it. Realistically you’ll probably want to plan to have a little bit more than that!

  • Something to cover the floor, whether that’s old towels, cheap shower curtains or tarps
  • Something comfortable for the floor; old bedding or towels
  • Something easy to slip on and off if you get cold and hot, like a dressing gown
  • Something to keep baby warm, like a towel or blanket to go over you both
  • A birth pool if you want a water birth (and if you do, get a sieve)
  • A head lamp or torch (although there’s some controversy over this one! The idea is that the midwife may need extra lighting to check you over afterwards but in reality I know some midwives who have never needed a miner’s lamp to do post-birth checks so…)
  • Bin bags to clear up after.

The midwifery team will either bring a homebirth kit prior to you going into labour, or on the day itself, with everything they need.

And that’s pretty much it! Everything else you’ll have handy anyway, like food and drink, music, hypnobirthing tracks, more food… 

WHAT ABOUT THE MESS?

Genuinely one of the most frequent questions I get about home birth is about the mess.

IT’S FINE!

Honestly. What comes out is mostly contained to one area or the pool (the previously mentioned sieve serves its purpose here!) and because you’ve protected the area it can all be wrapped up and binned or washed.

By the time your own post-birth checks have been done and you’ve had a shower, got into clean PJs and into bed your house is back to its normal state. The only evidence that a birth has happened recently is that tiny mewling little human in your arms.

LOCAL HOMEBIRTH RESOURCES

There are regular home birth meetings across Greater Manchester run by Greater Manchester Homebirth​

To find out about their upcoming planned events follow this link.

They also run the Manchester Community Birth Pool Hire Scheme​ and the Cheshire Community Birth Pool Hire Scheme, as well as the group Greater Manchester Homebirth Support Group. You can find all of them on Facebook.

Edit: This blog post was updated followed the publication of the McMaster study August 2019

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