Navigating your birth with the right team. Planning your birth in and outside of the system

You should always feel in control of any decisions about your birth. This can include where, how and when you give birth, who will be with you and who your care provider will be.

You may be thinking about your birth and what it may look like from very early on in your pregnancy and start to research your options. It’s never too early to gather all of the information you will need to help enable you to make the best choices. Infact, I would always encourage everyone to do their research and look into every possible option available to them as early as they can.

This will give you enough time to explore all options and what they mean, how they may apply to you and looking at the alternatives if what is recommended is not what you envisage. It can be a minefield with so much conflicting information or out of date guidance.

How do you know what is accurate and up to date, what is the guidance based on and how do you begin to navigate care deemed “out of guidance” and to feel supported in doing so.

There is so much information out there, about home births, water births, birth in hospital, MLU’s, caesarean births, freebirth, induction of labour, interventions, pain relief and so on.

Imagine the birth you envisage then look at what is offered and available in your local area. Does your trust offer a home birth service, how is the staffing, are there any gaps in the service, are you likely to be denied a home birth for any reason at all? This *shouldn’t* happen, but all too often it does.

Have regular discussions with your midwife about what is important to you, what your preferences are and ask, will your preferences be supported?

For many reasons we hear so many women are being denied their birth preferences, being informed that due to staffing there is no available home birth service, they “can’t” use the pool because of BMI, fetal monitoring, being induced etc etc... (believe me the list is endless)... you can only have 1 birth partner (if birthing in hospital) or feeling coerced into going into hospital if your membranes rupture before labour, if you’re “post dates”, measuring big, measuring small, being old or very young, having pre existing medical conditions…..I could go on and on.

It happens every day, women being coerced and guilted into interventions or onto a pathway they don’t want and in a lot of cases, don’t need. In some instances, birth in hospital, induction or other intervention may be necessary and be the absolute right decision for you and your baby. However, being offered these just because it is standard practice or within hospital guidance or policy does NOT mean you have to accept, you can absolutely decline and ask for the evidence and the alternatives.

Ask questions and do your own research too to ensure the information you’re being offered isn’t biased. Be prepared well in advance so you can enter into the final few weeks of your pregnancy well informed and feeling in control.

Choosing the right team around you from the start of your pregnancy can help with this planning so it doesn’t feel too overwhelming to do alone. Choose the people you want to share your journey with and who you feel most aligned with, as potentially these people/or person will be with you during your most vulnerable moments.

Your team can be an Independent Midwife, a Doula, a supportive NHS Community Midwife, your family, friends and your partner too. You can have them all! It’s your pregnancy and birth experience, invite who you want in that space if you know they’re there to support you 100%, respect your birth choices and respect you as a person, someone who empowers you, who you trust and feel safe with, who listens to you and will advocate for you.

If your team doesn’t consist of any of those, look at alternatives to your care. Having the right support and especially continuity from a known and trusted health care professional can make a huge difference to your experience.

If your pregnancy is deemed to be complex or you are planning on a hospital or surgical birth, your birth can still be an empowering and calming experience with an individualised plan in place. These plans and preferences can be discussed with your health care professional or obstetric team, the HOM, matron or a PMA to ensure a tailored plan is shared with everyone caring for you.

You have a choice in how you want your care to look, you have choices around who will provide your care (more difficult in the NHS but care can be outside of the NHS) and you have choices about where and how you give birth.

I discuss all of this and more with my clients from very early in the pregnancy and review these discussions regularly. As I’m seeing my clients often throughout their pregnancy, this gives us adequate time to explore everything and formulate a holistic plan that they’re happy with, even a plan B and plan C!

If a home birth is their preference, I ensure I am available to be on call from around 37 weeks and until their baby is born, whatever gestation this may be. I will be there. If for whatever reason, baby is going to be born in hospital I will also be there to continue my support, in a non clinical role. This level of support and continuity is rarely available within the NHS unfortunately.  With an IM, you are guaranteed continuity of care, you WILL be in control of your pregnancy and birth and will always be supported with your choices.

IMs don’t have large caseloads so we have the time to dedicate to you, as much as you need. Accompanying you to scans or hospital appointments if you wish and providing information and evidence you may want to explore along the way. We will ensure your birth space is protected and provide you with the tools to help empower you.

Just because the local or national guidance may recommend a certain pathway of care for many scenarios or “risk factors” does not mean you must adhere to these. A lot of my previous clients who may have been deemed “out of guidance” by their NHS trust have gone on to have the most beautiful, empowering and healing birth experiences  which would’ve looked completely different if they were to have given in to the coercion and pressure to birth in hospital with medicalised care.

And whilst nobody can ever give you 100% assurance that you will have the most perfect birth at home without complications arising or plans changing along the way, sometimes we have to navigate the most unexpected curveballs, but you can be assured that you will still be part of any decision making and be informed of what is happening.

The possibility of things not going to plan and unexpected concerns arising and the plan for managing these should always be addressed during the antenatal period with you being at the centre of those nuanced conversations.

Understanding that sometimes even with the best planning and preparation, birth doesn’t always unfold as we’d like, the hope is that with the right team by your side, these scenarios and discussions aren’t as frightening as you’re still involved and educated on these potential deviations.

I am always happy to chat to anyone who wants to explore their options. If you’re thinking about hiring an Independent Midwife to work with you and want to know more about our role and our commitment to you, get in touch and we can have a chat. I’d love to be able to support you and work with you on your exciting journey!