My womb, my rules

Birth involves a lot of emotion but being in control of the experience will help you to relax and feel more confident, writes Siobhan Miller

Knowing that you are in charge when it comes to your birth, that all decisions are yours to make and that nothing can be done to you without your explicit consent should immediately help you to feel more confident, reassured and, importantly, relaxed.

First up let’s get a few things straight… I’m going to assume, if you’re growing a baby, you’re a woman.

A strong, intelligent woman, not only capable of making her own decisions, but with the freedom to do so.

A woman who, quite rightfully, would object to being told what to do.

And yet, for reasons I can only speculate over, the minute we set foot in a hospital setting, we have a tendency to relinquish all personal responsibility over ourselves, our bodies, our babies and, worryingly, our birth experience, willingly handing over full responsibility and control to the doctors and midwives, who we may never even have met before.

Informed consent

Despite being it being a legal requirement to give informed consent prior to anything being done to you, the reality on a busy labour ward, is that women frequently consent to a procedure, or an examination, or an intervention without fully understanding the implications or the pathway they are now heading down.

They simply say yes and comply.

‘Conveyor belt of care’

I call it ‘the conveyor belt of care’: You go through the doors of the hospital (or a birth centre) and are processed through the system conforming to the guidelines and a ‘one-size-fits-all’ approach.

Routinely examined for progress as though very woman progresses in the same way, unaffected by external influences or personal circumstances, cervixes dilating like clockwork.

It’s a conveyor belt of care, because certainly nobody is trying to cause any harm! I trust that everyone involved wishes to provide a good level of care and is committed to the safe arrival of a baby.

But the truth is doctors and midwives are having to adhere to strict guidelines with their hands are tied. They might not have the time to explore other options with you, or are too fearful to recommend trying something different.

That’s why it’s so important that you (yes, you reading this!) step off that conveyor belt – or, better still, avoid getting swept up onto it in the first place – and take control of your birth.

I want you to have the confidence to navigate your own birth, in the way that is best for you and your baby, because we are all individuals and one size does not fit all.

So why is it that so many strong, independent, intelligent women cross that threshold into a hospital and forget they can say ‘no’? What causes them to forget that it is their choice? That they have choices!

‘Respect’ and ‘comply’ 

We are so conditioned from an early age to respect authority and essentially ‘do what we are told’. Firstly, by our parents, then our teachers and, later in life, the law. We live in a society in which we are taught to respect those in a position of authority and comply.

This conditioning runs deep and when we feel vulnerable, as we do in labour and birth, we are less able to advocate for ourselves and therefore more compliant.

We also don’t wish to cause a fuss, ruffle any feathers, or be labelled a troublemaker, so we comply, even when we aren’t overly happy doing so.

We are also often inclined do what we are told because we are frightened about birth and we trust that the medical professionals know more – and better – than us. And in some respects they do, but certainly not all.

We don’t want to go against medical advice because the ‘what ifs’ plague us, so we defer the decision to others, going with what we are told is best, placing the responsibility for our body, our wellbeing, our baby and our birth experience in the hands of a stranger, albeit a qualified one.

We also often don’t feel confident to challenge the opinion of medical professionals, mistaking our inexperience with inability.

Professional help 

It’s worth remembering that what is offered by professionals within the HSE is a course of action that is deemed safe, but is also time-efficient, cost-efficient and uses the fewest resources.

Because, as we all know, the HSE is working to a budget. Which means what’s offered is not necessarily the best option available.

Which is why you should never hand complete control over your birth to anyone else. Not least because, when it comes to giving birth, you are the only person in that room who is feeling and experiencing the sensations. Nobody else. You know more than you might think.

And then there is the language used by medical professionals, which means recommendations and advice are often delivered as non-negotiable orders.

‘Hop up on the bed’

The amount of times I’ve heard grown women (myself included) being told to ‘hop up on the bed’ for an examination – with no explanation as to why or what is involved, no discussion as to whether or not the woman wants an invasive internal examination, or whether there are any risks.

Just a simple ‘hop up on the bed’, as though she is a child. It’s immediately disempowering and, because of the conditioning that I describe above, the majority of women will go along with it.

The medics don’t wish to cause harm with the words they use. I suspect it’s all said without much conscious consideration and more down to a lack of being mindful about the impact of language.

Life-changing occasion

Remember, this might be your first birth, your last birth, your only birth – a monumental and life-changing occasion in your life – but for the doctor or midwife looking after you, you could be the third, fourth, fifth, tenth pregnant woman they have dealt with today.

It might be very routine for them to carry out internal examinations, but for you, it could be a big deal. So, be mindful of language and always remember: it’s a recommendation, never an order.

A simple and polite ‘Thank you for your advice. I will have a think about what you’ve suggested and let you know what I decide’ works wonders as a reminder to those providing the care that you are in charge.

Of course, you may well agree to go with the recommended course of action. But do so because you made that decision and believe it to be best for you and your baby. Not because you were following an order.

Make your own decision 

Even though the outcome might seem the same from an outsider’s perspective, there is in fact a massive difference.

The act of making your own decision is empowering and enables you to embrace your choice feeling positive and in control.

These feelings contribute to a positive experience, the benefits of which are profound and long lasting; a positive birth experience significantly reduces the risk of you suffering from postnatal depression.

Always remember, you have the same basic human rights in labour as you do in life.

This includes the right to make your own decisions and choices. And you can always say no. You should never feel pressured or coerced into doing something you do not want to do.

You have the right for your wishes to be respected. Writing those wishes down, essentially outlining your birth preferences, can be a really helpful exercise and something I recommend you do. Handing over a written document ensures nothing important is lost in translation.

Above all, remember: it is your body, it is your baby, it is your birth and it is always your decision. You are in charge.

Siobhan Miller is founder of The Positive Birth Company and author of Hypnobirthing – Practical Ways to Make Your Birth Better (Piatkus).