Undisturbed Birth? Yes please!
Birth plan following a Sarah J. Buckley, MD study day, Edinburgh 2013.

After attending Sarah Buckley’s study day on undisturbed birth I was asked to write a report for it. A way of sharing with others what I had got from the day.
Now, I’ve pondered over this for a couple of weeks and have decided to write it from the perspective of a woman about to give birth soon. I have previously read Sarah’s book ‘Gentle birth, gentle mothering’ and I can tell you that you can learn more from reading her book than you can from a little review/report that I write up… and I do highly recommend everyone reads her book!
So, I shall share from the angle of how I am going to put into practice what I gathered on that day.

Dr Sarah Buckley & Jay Kelly

Just a little background info: the baby I am carrying at present is my friends’ baby. So this plan is even more important, as having the two midwives, my doula, the mum, the dad (who is obviously someone else’s husband, and not mine, and has thankfully never seen my bottom before) all present, can risk labour from progressing. There also won’t be the usual desired skin to skin to increase the hormones needed to deliver the placenta, as this long time, longed for baby will be in the arms of mummy and daddy.
But who says that we still can’t all come together to give this baby the most gentle and kind birth that we can, and for me, a most empowering and happy birth… and all live happily ever after.

Back to the basics of what Sarah stresses utterly importantly. To birth, as they should, women need to feel safe. This seems such an obvious statement, but sadly the typical hospital birth environment doesn’t cover this too well.
Let me go a little further into my understanding of what safe means to me, and more importantly why.
Human’s have mammalian behaviours in lots of situations, and especially when it comes birthing. We are designed to give birth in the wilds (houses, hospitals and the like haven’t been around that long really!) So in the wild, in order to safeguard our newborns, smelling of fresh food for the animals lurking around looking for their next meal, it was helpful to postpone labour if we felt unsafe at all. Fight, flight or freeze instincts kick in.

How does our body react if we don’t instinctively feel safe? Hormones change.
A crucial one in the hormonal dance of birth is oxytocin. Oxytocin is also known as the hormone of love. You can bring about this amazing hormone by simply closing your eyes and imagining a loved ones arms around you, you feel at peace, loving, loved and totally relaxed.
And then try imagining that saber-toothed cat is about to pounce, and the adrenaline kicks in (the enemy of oxytocin) which in this case is good, as the adrenaline will cause certain aspects of your body and mind to shut down, to enable you to run or fight for your life.

Now, I know some of you may be pointing out that we don’t have Saber-toothed cats in hospitals anymore (whereas some others may suggest there are more than ever!) but we have never totally left behind our instinctive behaviours.

So let me describe it another way. The hormones of love are the hormones that created the baby in the first place. I’d like to check in, how many women can reach a climax during love making, if they know a healthcare professional is about to walk in… or was observing them in the act… or asking questions just as you are about to orgasm. Personally, I’d find it off putting, and the mood would be gone.

This is what happens repeatedly in most modern birth environments. So it’s not just feeling safe that is important, we need privacy and a safe space.

How many times have you heard the tale from a new mum “It was all go at home, then we got our bags, got in the car, drove to the hospital, and once in the observation room everything stopped.”
“Failure to progress” “slow dilation” “gave me something to speed me up” “baby went into distress”
These are comments I hear so so often, and they make me sad, disappointed, and even angry.
What do these professionals expect?
We’ve taken what is an instinctive and intimate act, and turned it into a medical procedure.

There are many men who have no problem ejaculating for pleasure… yet put him in an IVF clinic to give a sample, and it just doesn’t work the same for most guys.
You cannot expect a woman to release the hormones that she needs to, for her AND the baby, and expect a straightforward (nevermind ecstatic) result. Add in some fear, and Bob’s your uncle… traumatic birth for mum and baby. But it’s ok, because your baby is alive yeah? No, it’s not ok. I think the reasons why require a whole new article, so I’ll get back to my original point.

Back to the hormones. It’s not just oxytocin we require (which, by the way is naturally produced oxytocin, not the fake synthetic one that doesn’t even enter the brain, and do the multitude of real stuff the natural hormone is designed to do), the hormonal dance of birth includes prolactin (the mothering hormone), beta endorphin (the body’s natural painkiller), and the fight-or-flight hormones adrenaline and noradrenaline (epinephrine and norepinephrine), and these play such crucial roles in the different stages of birthing and the few hours after birth. These are the ones that we know about, and I’m sure there are many more that scientists haven’t discovered in our amazing bodies.

In a normal natural physiological birth, the woman, like the cat, creates her nest where she feels warm, safe, protected and nurtured. She has eaten enough and has snacks on hand (hunger causes the fight or flight reaction too you know) and is usually snuggled away birthing in the dim light of night time.

So, my birthing intention… is to create that safe space. The difference is that the team of midwives on hand (who do their part to make me feel safe, and since I know who these two amazing ladies are, I also know they will not make me feel observed and monitored. They will do what they need to do, yet be mindful of my need for privacy.
The parents of the baby, well they want the obvious involvement. I know how much they care for and love me, and will do whatever it takes to help with a peaceful undisturbed birth. Whether at the time it is pouring water over my back, or just snuggling up on the sofa together sending loving opening vibes. I know they totally have their best interests for all of us at heart and in mind, and so I know they will be guided by the moment. Dad is a great one for nodding off on the sofa at times of waiting!
And last but by no means least, I have my doula. She is a crucial and important part. She is the person who is there just for me. The person who will know when I stick my tongue out and make a little grunt, to pass me my water. The person who can gauge if I need a hug or if I need no touch at all. The person who will remind me that I really am doing this, when at transition I tell the world I’m giving up. In this case, she’s also the one to remind mum and dad all is well if they wobble at all.
She’s the one that will ensure that I am warm, feel safe, loved and nurtured, and protect my space.

I love my doula; every woman should have one!

And once the baby has been birthed and is snuggled in mummy and daddy’s arms, the birthing of the placenta will happen, and this is something that will be new to me. Not birthing a placenta, as I’ve done that before. But birthing without a baby snuggled in my bosom… but can you imagine how much love will be in our cosy environment as mum and dad meet their so longed for baby for the first time.
All of the people in our environment, at home, know that we need these crucial hormones to deliver the placenta, and love, warmth and time will be given to allow for this to happen. No stark lights, no whisking off the baby to a cold table to check that everything looks fine. It will be a moment of closeness as the baby gets it’s much needed cuddle with mum, whilst the cord pumps the final third of the baby’s blood supply (which was backing up in the placenta when there was pressure on the cord during the second stage of birth) This blood belongs in the baby, and only takes a matter of minutes for this final transfusion to happen. Which by great default makes the placenta lighter and smaller, and starts the process of detaching and also lowers the risk of PPH (post partum haemorrhage), and it’s giving the natural hormones time to do what nature intended… reducing blood flow to the placenta after birth. We don’t want to draw attention to the Saber-toothed cat now, do we!