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How to have the birth you want
- 1 day ago
- 5 min read
Antenatal educator Megan Rossiter, author of Birth Power, tells Lisa Salmon how pregnant women can best take control of childbirth.
You can’t control birth, but you can have an influence over what happens.
That’s the promise of antenatal educator Megan Rossiter, who points out that while the “poor state of modern maternity care” is at the forefront of public conversation and things need to improve, that’s no comfort to women who are pregnant at the moment.
“Stepping into the system, crossing your fingers and hoping for the best simply won’t get you the kind of birth you’re hoping for,” she says.
“And while we can remain ever-hopeful that ongoing investigations lead to improvements in maternity services for the future, they’re not much help if you’re already pregnant.”
So she’s written the new book, Birth Power, in a bid to teach women how to take as much control as possible over their birth experience.
Rossiter, who’s also the founder of the Birth-ed Method, an inclusive antenatal course, says she wants to give pregnant women practical tools to take power back over the choices made about their care.
“Having autonomy and agency in the choices that are being made during your pregnancy, birth and postpartum is everything when it comes to care and feeling emotionally safe,” she says.
“We’re sold this message throughout pregnancy that ‘all that matters is a healthy baby’. But what about you? The way you give birth matters, because it impacts everything, and the weight of this experience ought to be mirrored in the weight that we give to its preparation.”
However, although she points out there are too many variables for anyone to offer guarantees when it comes to birth preparation, she stresses: “Don’t misinterpret this to mean we have no influence over how things unfold, that the choices we make don’t have a ripple effect, or that the power in the birth space should belong to anyone but you. “
She explains that when planning for birth, women need to differentiate between the things they can control and the things they can’t.
“Unfortunately, this isn’t always clear-cut,” she says. “We usually have control or influence over where we plan to give birth, the comfort measures, the interventions we accept, the environment, birth partners, the preparation, the screening and the interventions we plan for.
“We usually don’t have total control over what birth feels like, when we naturally go into labour, how long it lasts, the position of our baby, the sounds we make, the way we move, the positions we find comfortable, the staff on shift, some of the complexities that may occur, or the plans of Mother Nature herself.
“And so I encourage you strongly to take control of the aspects that you can, but to let go of the things you cannot.”
So what can you do to take as much control as possible of your birth experience? Here’s Rossiter’s advice…
Calm the nervous system
Rossiter explains that when someone’s stressed and their nervous system is on high alert – as a women is when she’s about to give birth – their brain prioritises survival over rationality, so they’re not in the best place to make decisions.
“So before we even explore how to make a choice, we need to consider how to calm your nervous system and get you back to a place where you can think clearly,” she says.
It’s important to step away from the clinical environment if possible to make decisions, and she suggests: “If a decision is being made in labour and you’re unable to leave the room, ask your clinician to step away so you can make the decision in your own time and way.”
Women need to take their time, and even sleep on big decisions if they can, she advises.
“Get some fresh air and see something green – this lowers stress hormones and calms your nervous system,” she points out.
Other ways to potentially calm the nervous system, she advises, are taking a stress-relieving shower, trying slow deep breathing – in through the nose and out through the mouth – or using grounding techniques like focusing on five things you can see, four things you can touch, three things you can hear, two things you can smell and one thing you can taste.
“Or try anything that makes you feel safe, from a big hug to a phone call with someone you trust,” she suggests.
Gather information before making decisions
Rossiter uses the acronym ‘I ADAPT’ as an information-gathering tool to help pregnant women make decisions, and here she outlines what it means…
Instinct – What does it feel like you should do?
Advantages – What are the upsides to both accepting and declining this choice?
Disadvantages – What are the downsides to both accepting and declining this choice?
Alternatives – If I didn’t do this, what else could I do?
Package of care – How does this choice impact other birth choices I have?
Time – What if I waited? For 30 minutes, three days, a week?
She advises: “Use your care provider’s expertise, but independent research can also be helpful. You may find reliable information in national guidance, research papers, through independent experts and charities, or through peer support.”
Advocacy and communicating choices
“Being informed and knowing what you want is pretty useless if you don’t know how to actually get your choices supported,” Rossiter points out. Her tips to advocate for yourself if you need to during pregnancy and childbirth are…
Take someone with you to appointments. “Ideally someone who won’t be emotionally swayed by the conversation, is good at communicating clearly and who understands what’s most important to you, and why,” says Rossiter.
Approach conversations from a place of curiosity, not accusation. Rossiter advises: “If you don’t feel confident in what you’re being told or have heard conflicting information, ask if they could point you in the direction of some further reading, and if they’ve considered another perspective.”
Make it clear that you’re happy for the midwife or doctor to take their time to gather information for you.
Write down questions and the key things you want to communicate before appointments. “Reading aloud is significantly easier than remembering everything in stressful conditions,” she points out.
Ask your care provider to write down everything they’ve suggested and why (or let them know you’ll write as they speak), so you remember everything once you get home, and to ensure information is presented in a balanced way.
Ask for a second opinion or another perspective. For example, if you’ve had recommendations from a consultant obstetrician, another consultant or senior midwife might offer a different point of view.
Write your plans down, ideally signed by the clinician involved in agreeing them so you don’t end up repeating the conversation on the big day.
Rossiter adds: “Pregnancy is the start of a lifetime advocating for these babies of ours, and the skills you’re learning now will serve you for years to come.
“I’m both excited and proud to see so many women in pregnancy waving goodbye to the people-pleasing tendencies of their past and stepping into a bold, brave and assured new version of themselves.”
Birth Power by Megan Rossiter is published by Bluebird, priced £16.99. Available now.
