Pregnancy and Birth Choice, Continuity and All That Stuff
By Corrinne Gamble RM
Independent Midwife – Sussex and Surrey Boarders
07592 933456
Passionate about choice http://birthwell.weebly.com
So, you’ve decided to be an active participant in your pregnancy and the birth of your child? You’re half way there then, to achieving a positive empowering experience. How are you going to go about achieving the rest? What can you do that will make your carers listen to you and support your choices?
If you are low risk, no medical conditions or previous difficult births then a midwifery led birthing unit may be your better choice. You will see only midwives during pregnancy, maybe several members of the same midwifery team. The birth itself will be low key, birthing units tend to have low lighting, maybe a comfy chair and less medical equipment than a consultant unit. There may also be a built in birthing pool which you can use to labour and/or birth in. Some units are very close to an obstetric unit so if you need to see a doctor or decide you want an epidural it’s a short hop down the corridor. Others, such as Crowborough are quite a distance from the main hospital and you would need to be taken by ambulance should you need any of these things. Midwives are the guardians of normal birth and have lots of training to facilitate their listening skills, they will do their best to help you achieve the birth you want.
Maybe home birth? At home you are in charge, anyone who comes to you in labour is your guest and should behave as such. You have total choice over position, location and how you birth. The midwife will be there to offer you the support you need and again do her best to facilitate a positive experience for you. Some areas have home birth teams, usually staffed by community midwives. The size of the teams vary from 6 to maybe as many as 26. They cover home births 24 hours a day but at night there may only be two midwives covering. As a home birther you have the luxury of two midwives attending you, so there may be issues if there is more than one home birth taking place. Women are sometimes ask to go to the hospital because there is no one to send to them at home. The home birth team may be the midwives who see you antenatally so there is a chance you may have already met the midwives who come to your birth, they may already know you and what you are hoping for.
Home birth with an independent midwife? Women who choose an independent midwife do so for many reasons, maybe they are high risk and are finding it difficult to get support within the NHS. Maybe they are planning to utilise some of the more unusual birth options such as lotus birth or consuming their placenta and feel an independent midwife may be more open to these choices. Some women simply just want to get to know the midwife during the antenatal period and know it will be she that walks through the door when she is in labour. The midwife will be on call for you, usually from 37 weeks and she will battle through hell and high water to get to you in labour. She will also call a second midwife who you may have also met before. They will know your wishes and as they have no employer to answer to (they have to abide by the midwives rules) they can assist you in the way you choose, in the safest way possible. The downside of course is cost. Most IMs will be happy to sort out a payment plan with you, maybe monthly payments. It may mean that you can’t afford to trade up your car this year or have that Mediterranean holiday, but the value of a birth that is empowering, life enhancing and proactive is beyond pounds and pence.
Free birth? Birthing at home with no midwife attending, basically DIY. Some women choose this because they know that birth is a normal everyday occurrence and needs no assistance other than the support of their partner. These women will have limited pain relief options and if things start to go wrong they may have difficulty accessing a midwife and may be sent paramedics only. They are aware of these issues and some attend infant resuscitation classes during pregnancy, they have assessed the risks and have managed those risks as best they can and have made their choice. This is not illegal in the UK as long as the woman does not have someone “acting” as midwife, but partners and doulas can offer support. There have been prosecutions of partners who the courts considered acted as midwife rather than support for their birthing partner.
Obstetric unit or planned Caesarean section? These are choice too and the woman who chooses a medicalised birth is making a valid choice as much as the home birther. Looking at risk, minimising that risk and then choosing is every woman’s right. We are lucky in the UK that women and midwives cannot be prosecuted for their choices like they can in many countries, including some states in the USA. Know that these are your rights, exercise them and have a positive birth.
Corrinne Gamble RM
Independent Midwife
07592 933456
Passionate about choice http://birthwell.weebly.com
