Setting The Wheels In Motion

I am currently filled with exuberance! Each day is bringing me closer to my dreams of becoming a breastfeeding counselor and a pregnancy, birth and postpartum doula.

Last year I chose a doula course that spoke to me, and I save up to enroll and commence studying. But, as is often the way, life took a few twists and turns and before I knew it all those savings had gone into more areas of more immediate need. Talking to my partner today, though, I am reinvigorated. He noted that we don't have plans for this financial year's tax return, and so that pretty little sum will go straight to enrollment.

Until then I continue to read and to collect pieces of research, links, articles and books to wet my appetite.

I am making a little more progress on my journey toward breastfeeding counselor training. Before I can enroll into the course with The Australian Breastfeed Association, I need to have had six months first hand breastfeeding experience, which I am about two months and two weeks away from reaching. But in the meantime my local group leader is taking advantage of my enthusiasm and says I can get a lot of the paperwork out of the way while I wait.

I need to demonstrate active involvement in the ABA to qualify for the training program, and so my group leader offered me what I consider the ultimate dream job; librarian for our group. So I am waiting to receive the books our group already owns and an email from her with more information on what is involved with the paperwork.

Victorian Government Initiative To Boost Breastfeeding Rates

From The Hearld Sun newspaper From http://www.news.com.au/heraldsun/story/0,21985,23751149-2862,00.html:

Mums to get guides
Peter Rolfe

May 25, 2008 12:00am

BREASTFEEDING guides will be hired to encourage mothers to feed their babies naturally, under a Brumby Government plan.

In a bid to boost breastfeeding rates, the guides will work across the state.

Breastfeeding education classes are being developed, with more than $60,000 given to the Victorian branch of the Australian Breastfeeding Association to carry out the plan.

New figures reveal big variations in breastfeeding rates.

West Wimmera, Mansfield and Queenscliff have the highest breastfeeding rates in the state, according to a Department of Education and Early Childhood Development report.

But the City of Casey, which takes in Berwick, Cranbourne and Narre Warren, has by far the state's lowest rate.

Only 62 per cent of Casey mothers breastfed when they were discharged from hospital, compared with more than 93 per cent in West Wimmera and 90 per cent in Mansfield. The figure dropped to only 13.8 per cent after six months.

A department spokeswoman said culture, beliefs and a desire to return to work affected breastfeeding rates.

It's times like these I am filled with state pride. What great news for the babies to be and mothers living in Victoria, Australia! Better still is the fact that the government is working with the ABA to bring this initiative into being rather than trying to reinvent the wheel themselves.

Lactating Police Officer Responds to The Call of Duty

From CNN China http://edition.cnn.com/2008/WORLD/asiapcf/05/22/china.breastfeed/:

Officer Breast-feeds quake orphans
updated 7:32 p.m. EDT, Thu May 22, 2008

JIANGYOU, China (CNN) -- A Chinese police officer is being hailed as a hero after taking it upon herself to breast-feed several infants who were separated from their mothers or orphaned by China's devastating earthquake.

Officer Jiang Xiaojuan, 29, the mother of a 6-month-old boy, responded to the call of duty and the instincts of motherhood when the magnitude-7.9 quake struck on May 12.

"I am breast-feeding, so I can feed babies. I didn't think of it much," she said. "It is a mother's reaction and a basic duty as a police officer to help."

The death toll in the earthquake jumped Thursday to more than 51,000, and more than 29,000 are missing, according to government figures. Thousands of children have been orphaned; many others have mothers who simply can't feed them.

At one point, Jiang was feeding nine babies.

"Some of the moms were injured; their fathers were dead ... five of them were orphans. They've gone away to an orphanage now," she said.

She still feeds two babies, including Zhao Lyuyang, son of a woman who survived the quake but whose breast milk stopped flowing because of the traumatic conditions.

"We walked out of the mountains for a long time. I hadn't eaten in days when I got here, and my milk was not enough," said that mother, Zhao Zong Jun. "She saved my baby. I thank her so much. I can't express how I feel."

Liu Rong, another mother whose breast milk stopped in the trauma, was awed by Jiang's kindness.

"I am so touched because she has her own baby, but she fed the disaster babies first," Liu said. "If she hadn't fed my son, he wouldn't have had enough to eat."

Jiang has became a celebrity, followed by local media and proclaimed on a newspaper front page as "China's Mother No. 1."

She's embarrassed by the fuss.

"I think what I did was normal," she said. "In a quake zone, many people do things for others. This was a small thing, not worth mentioning."

There has been a huge outpouring of support from families who want to adopt babies orphaned by the quake. But that process takes time, and there are mouths to feed.

Jiang misses her own son, who's being cared for through the emergency by in-laws in another town, but she is aware of the new connections she's made.

"I feel about these kids I fed just like my own. I have a special feeling for them. They are babies in a disaster."

Obviously this is a story of compassion and sisterhood, but what I love most about it is Jiang's reaction to the media attention her actions have attracted. For her, what she did was what any breastfeeding mama would have done in her shoes. The ability to save little lives is an everyday miracle for women who breastfeed. We make milk, what's your superpower?

Breastfeeding Affirmations

• My breasts were made for feeding

• My breasts are perfect

• Breasts are life-sustaining

• Without breastfeeding there would be no human race

•  I can breastfeed

• Breastmilk is life

• Woman has maintained and saved lives with her breasts since the beginning of motherhood. I am woman.

• My breasts belong to me and my baby

• My breasts will be/are magnificent milk fountains

• My body knows how to make milk and nurse my baby and I will let it flow freely.

• One feed at a time!

• It's OK to need and ask for help learning to breastfeed.

• It gets better and easier each time I nurse.

• My new baby is learning to breastfeed with me.

• It will get much easier.

• I am creating a special bond with my nursling.

• I am providing my baby with the comfort and nutrition she/he needs.

• My breastmilk is protecting my child from disease
  
• My breastmilk is guarding my child's health

Some are originals, others from internet searches. The last six are from breastfeeding guru.

Childbirth - Your Options

Childbirth can be a profound experience. It is a very personal event for every woman. In our society many women are not aware of their options in childbirth until after they have had a baby. To have the birthing experience you want it is important to plan ahead. Know your options, and think about what suits you best. Remember, it’s your body, your birth.

Commonly Held Myths

There are a number of myths about childbirth in our society, these include:

• Birth is unsafe.
• Birth must be managed by a doctor or surgeon.
• Medical technology makes birth easier and safer.
• You can’t get the support you need during birth outside the hospital system.
• After one caesarean, all subsequent births must be via caesarean section.
• Caesareans are just as safe as vaginal births.
• You have to give birth in a hospital.

And The Reality…

• The vast majority of women do not require medical assistance during childbirth.
• Childbirth is a very personal experience for the birthing woman, and has the potential to be a very intimate and empowering experience for her if she has the right support.
• Your experiences of childbirth can impact how well you bond with your child.
• One medical intervention in childbirth usually leads to a series of interventions, this is known as the “cascade of intervention”.
• Home birth is safe.
• Vaginal birth is the safest way to birth.
• You can give birth wherever you like!

It is up to each individual woman to decide what model of care will best meet her and her baby's needs during childbirth (and for the immediate postpartum period), whether it be: homebirth with a midwife and/or birth servant, free birth (in the comfort of her home free from midwifery or medical assistance), a birthing centre with a team of nurses and midwives attending, or a hospital with an obstetrician as her primary carer.

No matter which model of care or place of birth you choose, you are in charge! Remember your obstetrician, or GP, or midwife, or birth servant, or nurse is working for you, so all decisions rest with you.

To help you consider your options here is a list of different places to birth explained at Ilithyia Inspired:

Homebirth with a Midwife

Homebirth without a Midwife (Freebirth)

At a Birth Centre

In a Hospital

After taking a look at your options consider writing a birth plan:

Having a Birth Plan

See Also:
Birth Trauma & PND
Pregnancy & Birth Websites
Pregnancy Articles
Birth Articles

Birth Stories That Inspire

Birth in a Hospital

Hospitals are a good place to give birth if you have a need for medical treatment that an independent midwife can't give you (remember that midwives are the normal birth specialists). Hospital births can be attended by GPs, obstetricians, nurses and/or a team of midwives (depending on which hospital you go to). Due to rosters, you may receive care from different members of staff at different times depending on how long you are in labour for. If you want continuity of care but require medical assistance during labour taking a doula or an independent midwife with you to hospital is a great option.

If you want a natural birth a hospital is not the best option, only a small minority of women (5%) who birth in hospitals manage to have normal intervention free births. Birthing in a hospital increases your risk of caeasarean by 50%. You will need to be highly motivated for a natural birth, and you will need strong and constant support throughout the labour. If you are fortunate enough to have an obstetrician who is happy for you to have a natural birth, be aware that your obstetrician is not with you for most of the labour, hospital midwives (as opposed to independent midwives) and nurses are. And if you are lucky enough to have midwives and nurses who are happy for you to have an intervention free birth when you arrive there is no gauruntee that when the shift changeover happens the next group of hospital staff will be as supportive.

Research shows that the most successful way of achieving a normal birth in a birthing institution such as a birth centre or hospital is to have continuity of care. You may feel highly motivated for a natural birth at the start of labour, but as time passes and you become tired and possibly face crises of confidence that are completely normal for birthing women in our culture, your resolve may weaken and you might end up submitting to something you may later regret. These are the times when a doula or independent midwife are supportive gold!

Before deciding to birth at a hospital:

• Think about the different models of care available to you and whether this suits you. Ask yourself why you require medical attention? Find out if an independent midwife can provide you with this medical care at home.

• If you have opted to have an obstetrician as your primary care provider be aware that he or she is foremost a surgeon and may not have seen a completely normal intervention free birth before.

• Find out what the hospital’s intervention rates are? (drugs for augmentation, drugs for pain relief, episiotomies, forceps, ventouse, managed third stage, caesareans etc.). This will give you an indication of what to expect at that hospital. If this information is hard to access, be suspicious, these are routine questions any care provider should expect to be asked.

• Find out if you are able to have your partner stay with you overnight.

• Find out what is the average length of stay?

• Ask who can be present at the birth (eg. your children? other family members? friends? a doula? an independent midwife?)

• Ask if there is a time limit out on how long you can push (second stage)?

• Ask to see some recent customer feedback surveys.

• Look into what kind of assistance you can get from the centre with breastfeeding.

• Find out if the hospital has implemented the baby friendly initiative.

• Talk to other women who have given birth there to find out what their experiences were like.

• Write a birth plan that clearly states your preferences, and go through it with the staff to see how they respond.

• Ask yourself (and discuss with others such as an independent midwife) what it is you want from a hospital birth experience that you don't think you will be able to get with a hiring an independent midwife for a homebirth?

• Write a birth plan that clearly your preferences, and go through it with your hospital care providers. But remember that hospitals, like many birth centres, will prioritise their standard procedures and protocols over your plan. Also be aware that individual staff members who may end up attending your birth may have their own agendas.

No matter where you decide to give birth the decision always rests with you, and you can change your mind at any time. Just as you are not obligated to stick with the one care provider or model of care you first chose, you are not obligated to stay at the place you initially thought you would like to give birth in.

Doulas
A doula is a trained birth attendant. She is not trained in providing medical care like a midwife or obstetrician, but in providing other forms of support. Her entire focus is you and your comfort. Each doula has a library of information about birth she can share with you. She is able to provide you with information to help you make informed choices, but she cannot make decisions for you, or offer medical advice.

Like a midwife, a doula provides continuity of care, she can help you with breastfeeding, and household maintenance after the birth. During birth she can be as hands on-or off- as you like, she is at your service. Having a doula present has been shown to lower rates of intervention and increase women’s satisfaction with the birth. You can hire a doula as your primary support, or as additional support to your midwife, or your obstetrician. Doulas are great support no matter where you decide to have your baby.

Doula Links:
More about doulas
Doulas and Birth Attendants in Victoria
Australian Doulas
Doula Direcory, Joyous Birth
Find a Doula, Optimum Birth

Helpful links:
Hospital & Birth Centre Birth
Informed Choice in Childbirth
Care in Normal Birth
Victorian Hospitals
Get Me to the Hospital (or Birth Centre) On Time

Related Ilithyia Inspired Pages:
Pregnancy & Birth Websites
Pregnancy Articles
Birth Articles
Birth Stories That Inspire
Doulas: Mortal Ilithyia

Return to Childbirth Choices Page

Birth Plan

Having a birth plan is a great way to prepare yourself, and your support team. It is also a good way to figure out exactly what you want out of the experience, and how you and your support team can achieve this. Joyous Birth has this to say about birth plans:

So why should you try to plan for your birth? After all, isn’t birth unpredictable and you don’t want to be tied to a plan that doesn’t fit the circumstances?
Well, first off, your careprovider has one so unless you want your labour to run totally to their plan (which will involve interventions more likely than not in a hospital) you need to tell them how it will run.
It will probably protect you from the things which go wrong as a result of managed labours such as the cascade of interventions which commonly results from induction or epidural.
It will probably ensure that if things do result in a caesarean, you have a plan for having your baby kept with you, immediate skin-on-skin and breastfeeding.
It will help you labour more effectively if you're not stressing about who might try to do what to you without your knowledge or consent.
It will mean that your baby will only have those tests or injections which you truly believe in and they won't be automatically poked, prodded or turned into a pin cushion without your consent and participation.
It means that you will know, no matter how your journey goes, that you made the best possible choices for you and your baby and they weren't choices made by staff you don't know based on their timetables and philosophy rather than yours.
It empowers you through knowledge to understand and respect your body a lot better and give you and your baby the best possible chance of achieving a peaceful
So who wouldn't want one?!
And if you hire a doula you have another person advocating for you, and able to help you make decisions based on your needs, not that of the hospital/BC.

But remember that just because you write it down doesn't ensure it will be respected by your attendants. You need supportive and trustworthy attendants who share your goals.

To start writing your plan, ask yourself:

• Where would you like to give birth? Where would you like the baby to be born?

• If the answer is not at your home; when would you like to go to your birth place?

• If the answer is at home, you may also like to prepare a second birth plan for the unlikely event of a hospital transfer.

• Would you like to be free to move around, eat, drink, and change positions at your leisure?

• What positions would you like to use when pushing?

• Would you like the baby to be monitored during labour, and if so; how?

• Would you like to have time limits on the length of your labour or pushing, or would you rather let your body take its own course?

• What procedures are you willing to go through? For example: induction or augmentation, episiotomy, electronic foetal monitoring, caesarean, etc.

• Are you willing to be separated from your support team at any time? Or are you willing to be separated from your child after birth for any length of time? If so, are you willing to allow your child to be separated from your partner during this time?

• Would you like your child to be given any injections or tests after birth? For example: vitamin K injection, vaccination against hepatitis B, hearing tests, and measurements and weight of the baby recorded, etc.

• Would you like to breastfeed your child immediately? What support would you like to best ensure a smooth transition into breastfeeding?

• Would you like to have skin-to-skin contact with your child immediately?

• Would you like someone to take pictures or record the birth?

• Will you have the umbilical cord cut, or have a lotus birth? If you would prefer to cut the cord, who will cut it, and when would you like them to do it?

Be sure to discuss your answers to these questions with your support team, whether that be your partner, friend, midwife, doula, nurse, or obstetrician. And don’t be afraid to ask your care provider lots of questions. Remember they are working for you, so if you are not satisfied with their answers find another care provider better suited to you.

You can find samples of birth plans online by searching “birth plan”, or check out templates and expamples: here and here.

More birth plan links:Birth plans
Trust birth, prepare for the staff
Discussion of "The Birth Plan Trap" 

For an inspiring birth plan idea see the end of this blog post.

Related Ilithyia Inspired Pages:

Pregnancy & Birth Websites

Pregnancy Articles

Birth Articles
Birth Stories That Inspire
Childbirth Choices Page

Birth Trauma & Postnatal Depression

Your birth experience can have a major impact on the way you feel about yourself, your baby, and the way your baby entered the world. If you have a traumatic birth you are not alone. There are women who you can talk to, who understand. It is important for all women to debrief about their birth experiences, and for those who have been left feeling disappointed, or hurt, or angry, or sad etc. it is vital that they have a listening ear and a safe place to process these emotions. No matter what the cause of your trauma, your feelings are valid, even if you have a healthy baby your feelings about the birth matter and should not be dismissed as "baby blues", oversensitivity, or having unreasonable expectations.

Birth trauma is not the same as postnatal depression. Birth trauma is post traumatic stress disorder brought about by a negative birth experience.

Birth Trauma Association UK

Birth Trauma Info, Articles & Links

Forms of Birthrape, Birth Abuse & Birth Trauma

Birthrites: healing from caesarean

Likewise, if you find the transition to new motherhood hard (whether it’s your first time, or your tenth!), less enjoyable than you expected, or depressing, there is help available to you. Many women have experiences like these, and with the right support you will make it through!

Post and Antenatal Depression Association

Related Pages:

Birth Trauma Awareness

You Were Raped, But Let's Talk About My Sex Life

Giving Birth at a Birth Centre

Birth centres are birthing institutes primarily staffed by midwives. They are available to low-risk women (risk is defined by the birth centre and any hospital that centre is affiliated with) and they have lower rates of intervention than hospitals. Birthing women are granted more freedom of movement and control over when they eat and drink than in a hospital. Birth centres also have natural pain relief options which hospitals don't. But if complications arise during the birth you are likely to be transfered to an associated or nearby hospital.

You are more likely to receive continuity of care at a birth centre than a hospital. Birth centres are mostly staffed by registered midwives (unlike independent midwives who attend homebirths, birth centre and hospital midwives are employed by the institution and are answerable to their employer. Independent midwives are also registered but they are employed directly by you). Due to roasters, you may receive care from different members of staff at different times in birth centres.

Before deciding to birth at a birth center:

• Find out what the centres’ transfer to hospital rate is? Sometimes a centre's intervention rates are low because they are quick to transfer women whose births don't fit the mould they've set.

• Find out how independent the birth centre stands from hospitals and obstetric led maternity centres, often birth centres’ are bound by the same protocols as hospitals and as such many women are transferred out of the birth centre to the hospital during pregnancy or birth.

• Find out if your partner is able to stay with you overnight.

• Find out what is the average length of stay?

• Ask if you will have one-to-one care from a midwife throughout labour? Find out how many members of staff you can expect to see during your birth.

• Ask who can be present at the birth (eg. your children? other family members? friends? a doula? an independent midwife?)

• Ask if they ever induce labour and what methods they use to speed labour up?

• As how they might monitor your baby?

• Ask what methods of pain relief they offer?

• Ask if there is a time limit out on how long you can push (second stage)?

• Find out what percentage of women are given an episiotomy?

• Ask to see some recent customer feedback surveys.

• Look into what kind of assistance you can get from the centre with breastfeeding.

• Find out if the centre has implemented the baby friendly initiative.

• Talk to other women who have given birth there to find out what their experiences were like.

• Write a birth plan that clearly states your preferences, and go through it with the staff to see how they respond.

• Ask yourself what it is you want from a birth centre birth experience that you don't think you will be able to get with a hiring an independent midwife for a homebirth?

Your ability to get the birth experience you want at a birth centre will depend greatly on which centre you choose and the staff working at the time of your labour. Due to different centre's procedures and protocols some birth choices will not be supported. For example some centres will not accept clients planning a vaginal birth after caesarean, or who have gestational diabetes or high blood pressure, leaving these women with homebirth or hospital birth as their only options. Some birth centres place restrictions on how long birthing women can labour and recover in the centres.

Doulas
A doula is a trained birth attendant. She is not trained in providing medical care like a midwife or obstetrician, but in providing other forms of support. Her entire focus is you and your comfort. Each doula has a library of information about birth she can share with you. She is able to provide you with information to help you make informed choices, but she cannot make decisions for you, or offer medical advice.

Like a midwife, a doula provides continuity of care, she can help you with breastfeeding, and household maintenance after the birth. During birth she can be as hands on-or off- as you like, she is at your service. Having a doula present has been shown to lower rates of intervention and increase women’s satisfaction with the birth. You can hire a doula as your primary support, or as additional support to your midwife, or your obstetrician. Doulas are great support no matter where you decide to have your baby.

Doula Links:
More about doulas
Doulas and Birth Attendants in Victoria
Australian Doulas
Doula Direcory, Joyous Birth
Find a Doula, Optimum Birth

A doula can be a great asset when researching what your options in birth are and in helping you find out about whichever birth centre or hospital you are considering. Just as she would in birth, a doula can help you know which questions to ask, when finding out about your centre or hospital. She may even have had experience at that centre or hospital.

Helpful links:
Hospital & Birth Centre Birth
All About Birth CentresBirth Centres in Victoria
Get Me to the Hospital (or Birth Centre) On Time

Related Ilithyia Inspired Pages:
Pregnancy & Birth Websites
Pregnancy Articles
Breastfeeding Websites
Birth Articles
Birth Stories That Inspire
Doulas: Mortal Ilithyia

Return to Birth Choices Page

Freebirth (homebirth without a midwife)

Freebirth involves not having a medically trained care provider; such as an obstetrician, GP, nurse, or midwife. It is similar to homebirth in terms of atmosphere, and avoiding medical interventions. In freebirth the birthing woman (and her partner) is responsible for informing and advising herself and any family or friends she might wish to have present. All decisions rest with her, she directs how the birth goes.

Some of the reasons a woman might opt to freebirth include:

• Privacy: some women find that they feel inhibited by the presence of hired birth care providers.

• Responsibility: freebirthing women have an understanding that no matter where they birth they are responsible for their bodies and their babies and they want to embrace this responsibility rather than fear it.

• Power: at a freebirth the birthing woman is the only expert in the room.

• Natural Birth: freebirthing women are highly motivated to have completely natural births, and for some this means birthing the same way that our ancient foremothers did.

• Empowerment: many women feel that freebirth is the best way to ensure they have an empowering childbirth experience.

• Intimacy: in the absence of care providers the birthing woman and her loved ones are better able to enjoy a very intimate birth experience.

• Instincts: some women feel that the only way they can truly tune into their own instincts, rather than rely on the suggestions of those attending the birth, is to freebirth.

• Because they can! Women who choose to freebirth are generally low-risk women who know, either from extensive research or first-hand experience, that they don't need a midwife to watch them labour.

Women who choose freebirth beleive that there is no need to monitor, chart or time childbirth, they treat birth as a simple and natural experience. Unassisted Pregnancy and Childbirth Australia states: “The woman simply labours and gives birth in whatever ways that she feels like, trusting and knowing her body, her baby and the safety of unhindered birth.”

Things to consider:

• If you require medical treatment during a freebirth it will be up to you to make that decision and arrange for a transfer to hospital

• Independent midwives are able to provide in-home medical treatment for a range of issues and as such can help prevent needing a transfer to hospital

• Partners, family and friends who may be supportive during pregnancy and the planning stages of freebirthing may change their tune while you are in labour and make trusting your instincts challenging.

• Some midwives may be willing to be on call to you on the off chance you require it during birth, ask around during pregnancy. Other midwives are happy to sit in another room of the house while you birth and only perform checks when you explicitly request.

• You may be able to find a doula who is willing to attend your homebirth without a midwife, but many won't. Those who do cannot provide you with any more support than a very respectful and wise friend or family member. A doula may help your partner and other family and friends present to relax and trust your judgment during birth.

• Registering your baby's birth can be frustrating and require jumping through beauracratic hoops. Look into birth registration protocols in your state before you choose freebirth.

• You will be responsible for your own care during pregnancy, birth and postpartum. Depending on how knowledgable and supportive your partner, friends and family are, this can increase your workload/stress during pregnancy, birth and during postpartum recovery.

• Be prepared for those common variations on normal birth. Some midwifery/childbirth and general first aid education is essential.

Some Places to Begin Your Journey:Born Free
Freebirth Australia

Related Ilithyia Inspired Pages:

Registering a Freebirth in Victoria, Australia
Pregnancy & Birth Websites
Pregnancy Articles
Birth Articles
Birth Stories That Inspire
Doulas: Mortal Ilithyiai

Return to Childbirth Choices Page

Homebirth with Midwifery Care

Homebirth is a safe and comfortable way for women to bring their children into the world. There are a number of reasons women choose to have a homebirth including:

• Continuity of care: homebirth women see the same midwife consistently throughout pregnancy, during labour and after birth. You will know in advance exactly who will be present for the birth, and you don’t have to worry about hospital or birthing centre staff timetables.

• Comfort: independent midwives can provide all antenatal and postnatal appointments in your home.

• To avoid medical interventions: hospitals have high rates of intervention, and birthing centers can have high rates of hospital transfers as well as interventions.

• Safety: interventions experienced in hospitals and birthing centers carry risks and have the potential to make birth a traumatic experience for women and their children. Some women find the easiest way to avoid these interventions is to birth at home.

• The Midwifery model of care: some women prefer this model of care which is based on the idea that pregnancy and birth are normal physiological experiences, not medical conditions.

• To have a free (or unassisted) birth: some women prefer to birth without the medical assistance of a midwife, nurse or obstetrician, but enjoy this care during pregnancy and after birth. In addition to providing care and support during pregnancy and after birth, independent midwives can assist families in registering their homeborn baby's birth with the state.

• Atmosphere: Some women prefer to give birth in their homes because it is comfortable and private, because they can have their family present. Some women who already have children like to include them in the birth of their newest sibling. While these women feel it is a nice environment for them to labour in, they also feel it is a nice environment for their babies to be welcomed into, and there are no awkward transitions from the hospital or birth centre to home.

• Privacy & Trust: Some women are able to trust their instincts and enjoy birth with a midwife in the room, others enjoy the knowledge that their midwife is in another room of the house should they need assistance.

To have a midwifery model homebirth in Victoria you need to find an independent midwife (a midwife who works in private practice, rather than the hospital system). Before making your decision you can interview the midwife, to make sure you will be comfortable with her. She will be able to help you learn more about pregnancy and childbirth by sharing her books, videos and experience with you.

It is also a good idea to contact your local homebirth support network, to acquire more resources and information, as well as discuss your options with women (and their families) who have homebirthed before.

Transfers

While it is not mandatory to make a hospital transfer booking, some women prefer to have this arranged, in order to be known to the hospital just in case they transfer. If you do make a transfer booking, you might like to go through your birth plan with the hospital staff prior to labour. But remember there is no guarantee that when the time comes those attending your birth will follow your plan, that will depend on who is present. Some midwives will require you to make a booking with the hospital and meet with hospital OBs, if this is not something you are comfortable with discuss it with her and/or find another midwife.

If at any point during your home birth you feel you need to go to hospital your midwife will transfer with you and continue to provide her support, though her power as a care provider will be diminished and she will instead be your doula because the hospital becomes your primary care provider in a transfer.

Questions for your midwife

• What care can you provide me at home during pregnancy, birth and postpartum?

• How many homebirths have you attended that have resulted in transfer to hospital?

• Will you continue to be my midwife and support me in homebirthing if we have multiples, the baby isn't head down at full-term or my pregnancy goes past 40 weeks? How long past 40 weeks are you willing to continue to provide me with homebirth care?

• What is non-negotiable for you? Eg. do you require all clients to meet with an obstetrician and/or make a hospital booking when planning to homebirth in your care?

• What kind of checks and interventions can I expect from you during my homebirth? Eg. do you monitor the baby's heartbeat and if so how often? Do you perform routine vaginal exams? 

• For what reasons would you suggest we transfer to hospital (during pregnancy, birth and postpartum)?

• Do you work with any other midwives/can I expect to be attended by another midwife despite hiring you? Can I meet with the midwives you work with during pregnancy so I know them before birth? Do your rates change if you are unable to attend my birth and/or another midwife attends? Do you have any other clients due around the same time as me?

• Are you willing to sit in another room while I birth unless I call you in? How do you feel about me choosing not to call you to attend the birth if I feel at the time I would prefer an unassisted birth?

• Can you put me in contact with women who have homebirthed with you before so I can ask them about their experiences?

Some Places to Begin your Journey:

Joyous Birth: homebirth website

Find a Midwife-Victoria

Midwives in Private Practice – Melbourne, Australia

Australian College of Midwifery Incorporated List
Who Homebirths?

Related Ilithyia Inspired Pages:

Pregnancy & Birth Websites

Pregnancy Articles

Breastfeeding Websites
Birth Articles
Birth Stories That Inspire

Return to Childbirth Choices Page

Birth "As Seen On TV"

It's little wonder that only 5 in every 100 birthing women in Australia achieve a normal physiological birth when one considers the social attitudes and messages disseminated to the public about birth. The majority of women go into birth expecting it to be a medical drama because this is what they have taken away from cultural representations of birth. One of the biggest communication mediums that pushes dangerous concepts of birth onto the public is film and television.

I have watched countless representations of birth on television and in film. Every single birth I have seen has been hyper-medicalised and overly dramatic. And while I understand that drama boosts ratings I am tired of the old cliche that birth is a medical fiasco in which a woman risks her life. Aside from it being factually incorrect, it's politically and morally sinister because it influences the attitudes of viewers and convinces women that when their own time comes to birth, the safest thing to do is hand their agency and power over to the heroic doctor figure.

What Happens in a Film or Television Birth?

• The onset of labour is usually characterised by dramatic and unexpected pain which causes the pregnant woman to clutch at her belly, wince, buckle forward, and everyone around her to begin frantically calling out for an ambulance or a doctor.

• Invariably the birthing woman is taken out of her own clothes and dressed in a hospital gown.

• For the majority of the labour the woman lies on her back in a hospital bed.

• We never see the birthing woman eat, she may drink water and be fed ice chips, but food is usually absent.

• Characters who are adamant that they will have a natural birth are often turned into foolish looking failures who are given drugs and quite often end up in surgery, and the message that they would have died if it weren't for the intervening hospital staff is loud and clear.

• Caesareans are represented as perfectly safe run-of-the-mill birth procedures. In every representation of caesarean delivery I have seen on television the caesarean is credited with saving the life of either mother or child, more often than not it saves both. And in these stories normal birth (meaning unhindered birth, not just vaginal or drug free birth) is presented as the danger.

• Drugs in labour (including epidurals) are represented as risk-free and often the birthing woman will request them prior to going into labour, demanding the maximum legal dosages (often this is meant to be funny, but personally I find it far from amusing).

And in Reality?

• Labour begins gradually, often with weeks of prelabour where the body prepares itself, and the pregnant woman, for what lies ahead. The discomfort of early labour is not usually felt across the front of the pregnant stomach, but more commonly in the lower back and legs, or feels similarly to menstrual cramps (Henci Goer Are You Really in Labor?).

• For those who do go to a hospital to birth where they are expected to labour wearing hospital gowns there are very political motivations behind this. Think about the meanings of uniforms, why do certain institutions (for example prisons and schools) make individuals wear uniforms? To create uniformity, and to send a message to the individual about where they are and what is expected of them; to behave, toe the line, and accept unquestioningly that the prison guard, teacher and hospital staff are the rightful authorities. Whenever I think about hospital gowns I remember a cartoon in Birthing From Within (p.87) which shows a pregnant woman in a gown that has "Property of County Hospital" printed across her chest.

• Lying on your back in bed increases pain for the labouring woman, demands more of her energy, and puts unnecessary stress on her body because she is unable to use gravity to aid her. It also prevents the naturally occurring foetal ejection reflex characteristic of second stage labour, puts pressure on the coccyx, and compresses the mothers main blood vessels thereby restricting blood flow and oxygen to the baby (See J.G Anema, A.F Morey, J.W. McAninch, L.A. Mario & H. Wessells Complications related to the high lithotomy position during urethral reconstruction). Maternal passivity is counterproductive in birth and increases the mother and baby's risk of unnecessary intervention, the only so-called benefit of the lithotomy position in childbirth is that it gives the hospital staff greater control over the birth and the woman's body (From Birth as an American Rite of Passage).

• Women absolutely must eat and drink during labour in order to maintain healthy energy levels and hydration. This is imperative to healthy active normal labour, just as it is for healthy active normal life! By restricting a birthing woman's food intake you prevent her from birthing at her full potential and increase the risk of her requiring interventions and medical assistance (much the same as starving an athlete or denying a marathon runner water during her run would have dangerous and unhealthy results!) (Pat Thomas Labouring With Food?).

• At least 80% of all women are capable of giving birth safely without any assistance or intervention whatsoever! (Marsden Wagner Fish Can't See Water)
  

• Caesarean sections are major abdominal surgery, they are not a natural birth option, and are in no way safer or even close to being as safe as normal physiological birth! (Sarah Buckley Gentle Birth Gentle Mothering, pp.220-228; Henci Goer Obstetric Myths Versus Research Realities See also Henci Goer's articles on Caesarean; pp.20-155;Sheila Kitzinger The Politics of Birth, chapter 9 ; Marsden Wagner Technology in Birth & Choosing Caesarean Section; Childbirth.org Caesarean Fact Sheet).
  

• The drugs routinely offered to women during childbirth carry significant risks and side-effects for both mother and baby and present more risks to the health and well-being of women and babies than normal birth! (See Sarah Buckley Ecstatic Birth; Pain in Labour and Leaving Well Alone; Henci Goer's Articles; Marsden Wager The Active Management of Labor and Technology in Birth; Beverley Lawrence Beech Drugs in Labour)

Thanks to these fictional representations of birth many women accept that birth is an unsafe and commonly surgical event before they've even conceived a child! From these cultural representations of birth they have already learned that even trying to have a normal physiological birth is unreasonable and will only make the experience worse in the end. And the message that doctor knows best and is the rightful authority of your birth has been well and truly sent home by the time a woman actually reaches the point in her life when she wants to have a baby.

The individuals working in film and television who perpetuate these myths about birth play a central role in pacifying birthing women and preventing women's empowerment in childbirth. It is irresponsible of film and television writers to continually represent many dangerous interventions in birth as safe. They are the most prominent vehicle through which attitudes and ideas about birth are transmitted and therefore should have a responsibility to the public to refrain from perpetuating dangerous myths.

People working within the mediums of film and television have the power to educate and influence the public on a massive scale, and with that comes responsibility. The challenge is how to go about making those power-holders accountable for their responsibility? In some respects it is a case of which came first; the chicken or the egg? because television writers and producers are not going to portray normal birth unless it is a ratings winner first, which means it needs to be popular amongst the viewing public first, but how can it become popular if the viewing public never see it? I am left concluding that the best we can do is bombard writers, producers, directors, actors etc. with information about the true nature and safety of birth. And pray that Angelina or one of her equally famous and desirable colleagues gets homebirthing!