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Approximately 1 in 3 women report their births as traumatic. The good news is that means that the majority of births are not traumatic. Unfortunately we don't have statistics about how many women find their births positive, empowering and brilliant. As a doula, I regularly witness beautiful births where the mother is powerful and in her element. This is not just about luck, or the personality of the person labouring. Often people come to me because of a previous traumatic birth and they want to know how to avoid it happening again. It basically comes down to education, planning and support. Obviously, it is never possible to predict the way a birth will go, but even if things don't go to plan and medical intervention is necessary, these tips can prevent an unpleasant experience becoming emotionally scaring. So here are my tips for avoiding a traumatic birth.

The modern cave-woman

The process of labour and child birth has evolved over millenia and is more suited to the stone-age than the brightly lit, sterile environment of the modern hospital care. The main hormone controlling labour and birth is oxytocin. Oxytocin is the hormone of love but it is incredibly shy and its mortal enemy is adrenaline. In the olden days, adrenaline would have kept us safe from predators, stalling labour, to allow us time to get to safety. Oxytocin, by comparison, requires security, comfort and loving feelings to really start flowing. It is also an important hormone for love-making and bonding with our baby, so the same conditions are required during all these scenarios. Low lighting, warmth, good food, the right company and privacy will help you get in the mood for loving, labouring and bonding.

It probably for this very reason, midwife led unit is considered safest for women with low risk pregnancies, particularly for first time mothers. They have all the comforts of home, with all the benefits of having someone else clean up all the mess. They often have birth pools, access to gas and air and are close to the hospital if you require some extra help or pain management. However, home birth are considered almost as safe as midwife led units and both give you an even higher chance of having a positive birth.

The great thing about a home birth is that you are already there, you don't have to lug your labouring body into a car and get yourself to the place you need to be, to give birth. Also, after your baby is born, you partner doesn't have to leave, so there is no interruption to all the lovely bonding. You can make your space cosy, with fairy lights, candles, incense, chocolate, maybe even a bit of sexy time. You can hire a birth pool in advance, or have a bath. Whatever you need to get you in the mood and get your oxytocin levels up.

Even if you fall into a high risk group due to your weight, age or some medical conditions, having your baby at home may still be a safe option. Consultants can have a rather one-sided view, since they spend their time dealing with birth when it all goes wrong, so it's worth getting more than one opinion. Community midwives have a much different experience of birth and a skill set which is more appropriate to a home setting. It's also worth remembering that hospitals have to managed risk over the entire ward, whereas at home you have the undivided attention of two midwives, who can give you the time you need to birth on your own terms in your own time.

If being in a hospital with all the drugs and the doctors is where you feel safest, then work out in advance how you can manage the hospital environment to make it as oxytocin-friendly as possible. Request a private room, ask for the lights to be dimmed, request that people only come into your space with your permission.

Its also worth bearing in mind that it is difficult to gain entrance to the hospital or birthing unit until you are well on your way to giving birth. If you find that you really, really want to be at the hospital, you can insist that they admit you. If they wont budge and keep trying to send you home, find a quiet corner of the hospital such as the chapel. Get out your fairy lights, turn off the main lights, and put on your tunes. Even a toilet can make a quiet safe haven. Ride that toilet like a horse, put a cushion on the cistern for your head. Relax knowing that your medical team aren't too far away. The toilet is actually a popular spot for accidental births, because we have already trained our bodies to open up when we sit on the loo.

Planning for the unexpected

So you think you know what to expect? You've read the books, you've done your pregnancy yoga, you've got this thing cracked. Or perhaps you've been watching 'One born every minute' and you are happy to hand yourself over the medical professionals and take all the drugs. Maybe you have a medical condition which means that you are having a obstetrician-led medical birth. This doesn't mean that you don't have options, its still beneficial to find out what these are and do some planning. Your baby may have very different ideas about how it's intending to come out and you need to be ready for more than just your perfect scenario.

In an ideal world, with all the planets aligned you may get to follow your birth plan to the letter. However, in most cases this isn't what happens. This doesn't mean you shouldn't make a birth plan, but think of it more as a list of preferences. Build in a plan B, and plan C. So you want a home birth? Okay, so what happens if you end up transferring to the hospital anyway? Think about this carefully. Pack a bag before hand, with everything you need to make the hospital homely.

Know that every intervention offered, from vaginal examinations to cesarean sections, have risks attached which need to be explained. All treatments and interventions require your complete, informed consent. Know also, that they are only one of a list of options, so make sure you are made aware of all the alternatives. It is your body, and if someone is making you feel uncomfortable, its your right to request that they leave, or get you a second opinion.

If you are planning to go to the hospital anyway, remember that you are going to spend a large part of your labour at home. The power of early labour can be intense and overwhelming, think about how you cope with stressful situations, this is probably what you will need to help you through this early part. You may want to be alone, you may want to take a hot bath, or you may want your partner to give you a foot rub, you may want amusing, distracting company. It's okay to call a good friend for support at this point. Anything you can do to calm yourself down, get that all important oxytocin flowing and keep adrenaline and cortisol levels down.

Self-hypnosis or hypnobirthing is an increasingly popular method used to handle the intensity of labour and birth. Whilst it does not make labour pain-free, it can take away some or all of your fear. This in itself can change the way you experience contractions, enabling you to focus deeply on your body, or keep you calm during a cesarean. This is a great way to get oxytocin flowing whilst keeping adrenaline at bay. This in turn can make labour seem less painful, more manageable and help you cope with whatever is going on.
Hypnobirthing practitioners may offer one to one courses or group sessions. It is becoming so popular that it is being taught at some hospitals. If neither of these are possible then there are online courses and CD's which allow you to teach yourself some tricks to help you stay calm and collected.

Continuous emotional support

Science shows that the key to a positive experience is less about the way that baby enters the world, and more to do with how we feel and how those around us make us feel. Continuity of care is also an important part of making sure we feel supported and cared for. Unfortunately in the UK only 8% of women have a midwife that they have met before, at their birth. Your midwife is very likely to be a complete stranger. So, if you can afford it, hiring an independent midwife or a doula is a great idea. People don't think twice about spending several hundred pounds on a new pram, but taking care of your emotional well-being, during one of the most intensely emotionally-charged experiences of your life, is priceless. 

Independent Midwives are the best for ensuring you have a medical attendant who really knows you, especially if you are planning a home birth. However, due to insurance restrictions, if you did have to transfer to hospital then she would have to hand your care over to an NHS midwife. However, she would still be able to accompany you as your doula or birth partner.  

A doula is a professional lay birth partner, trained to give you emotional and practical support during labour and birth. They are are much cheaper than independent midwifes but they still provide information, guidance and  emotional support whilst leaving all the medical stuff to the experts. You get to know your doula in pregnancy and she will stay with you throughout the entire experience. She will explain your options, and tell you what is happening every step of the way. She will also help you and your partner to stay calm and focused no matter what else is going on around you. She can do this whether you decide to give birth in at home or in a hospital, and she will support you in whatever decisions you make.

A doula can also be there for you in the early stages, before a midwife is prepared to come out. She can stay after the baby has been born to help you with the first feeds and nappy changes. She will even make you some food, walk your dog or clean up whilst you and your partner gaze blissfully at your new baby. She can also help you in the first few weeks as new parents, by doing a bit of light housework, lending a friendly ear while you get used to your new role, giving you an opportunity to talk and process your birthing experience, and keeping an eye out for postnatal depression and other issues.
The best way to find a doula is by word of mouth and through personal recommendation, but Doula UK have a list of registered doulas which can be searched for by area. Mentored doulas are cheaper than fully qualified doulas and you have added bonus of a very experienced doula in the background. Doula UK also have an access scheme where you can have the benefit of a doula for free if you are on a low income.

Research has shown that women have positive experiences of birth because they felt in control, listened to and respected. There is no right or wrong way to give birth so do what makes you feel safest and happiest. Bear in mind that things rarely go to plan so make sure you explore all of the options and plan for other possibilities. Find someone you can trust to support you in your decisions throughout the whole journey. This gives you the best chance of coming away with, not only a healthy baby, but also feeling empowered and ready to take on all parenting challenges.


NICE guidelines for birth place

Continuous support 

Benefits of Doulas 

Useful links

NICE guidelines for healthy mothers and babies

One to one midwives

Doula UK

Positive birth movement

Tell me a good birth story

PANDAS (Peri-Natal Depression)

Birth Trauma Association

Hypnobirthing association

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