02 Apr A Good Birth According to Hulda, from Annerley Midwives
“Ever since I came to Hong Kong, now 14 years ago, I have been helping women to go through the journey of pregnancy and birth in such a way that they, their partner and their baby may have the potential of the best possible outcome, physically and emotionally.” Says Hulda Thorey from Annerley the midwives clinic. “What has become obvious to me is that somehow the whole birth event – when preparing – is often something that people look at in a black-and-white way, so when it comes to actually going through the process, most are surprised and are not well prepared at all.”
So what is a good birth?
My opinion is that a good birth is a birth where you and your partner feel you have had your baby safely, where your wishes were treated genuinely well and you feel that you were supported to enjoy the experience in a respectful way. This is usually achieved when you are in charge of your own birth i.e. allowed to do what you want while you go through labor, whilst professional staff also ensure that you and your baby are safe. When I was at the very first birth in my midwifery training, my mentor at the time told me that my role in that room was to make sure that the woman and her baby were safe and they needed to be monitored and helped to continue to be so, but I was not allowed to order that woman to do anything. If she wanted to crawl on the floor, sit in the corner, leave the room, take a bath etc., she was allowed all that, but I just had to chase her with my equipment, should I need to do any medical tests or checks on her. I was not allowed to tell her to change whatever she was doing to make herself comfortable.
The reason for this is that when women go through labor, they gradually find ways to cope with it in a manageable way, as long as they are left to it and perhaps helped a little bit every now and again. Similar to animals, if disturbed, they will often feel scared and anxious and lose the focus to cope and help themselves to have an easier birth. Adrenaline takes over and the birth feels more painful and also is often described as “out of control” by the women.
Factors that may contribute to making the birth easier for women are things like: moving about, eating and drinking, changing the environment in any way that feels best (lights, setup of furniture, cushions, birth balls etc), using toilet and shower, having the people around you that you want, having privacy (believe it or not but in many hospitals, staff just wander in and out of the labor room as they wish, without even knocking – and often there is a half naked laboring woman in there). Many women also complain that they are treated as if they are expected to just “do as they are told” and “behave” – for example not to make any noise, or to lie down when it does not feel comfortable but the staff feels they should and so on, and this puts stress on them.
A good birth = natural birth?
Perhaps, but it depends on how you define natural. There is a common belief amongst women that a good birth is a natural birth only. Anything not natural means that the birth has gone wrong. Other women define a good birth as a pain-free one, and many define it as a birth where they feel in control. I would say that if your expectations for a good birth are as rigid as this, it may be hard to meet them.
A birth where you are mostly in control is usually the birth that is remembered afterwards as a good one. Control can mean so many different things, but in labor if it means that at all times, explanations are given to you, you are supported to make decisions on your own, within safe limits, and regardless of the TIME the labor and birth takes and the INTENSITIY of the labor, there is support available to you. Much effort has been put into researching this and it is generally the view of laboring mothers that non-support in labor equals non-control AND a less positive birth experience. Similarly, good support through labor and birth, equals control and a good birth experience. Take note that this is more or less regardless of pain, length of labor, or medical interventions.
Different types of labor
Many mothers are unaware of some factors in our modern world greatly affect the outcome of the birth. In Hong Kong, one of the biggest factors is how labor starts. A labor that starts at home, on its own, with contractions gradually building up, membranes intact and a normal, full length pregnancy and the woman can stay at home for most of her early labor, has a very good chance of a normal vaginal birth, with almost no medical intervention or unexpected surprises. It is likely to be similar to most of the births that preparation books and classes have portrayed. Where the onset of labor is more complicated, the rest of the labor is likely to be more complicated. So you are to conclude that this will mean that you will not be able to have a good birth, you are in trouble! Thinking out of the box is very necessary here and it is very important to focus on making the birth a good one – given the circumstances you are in. So you have to ask yourself, what is REALLY important to you, apart from a healthy baby?
Birth is a journey that can be long, rough and totally different to what you expected it to be. Still, it can be a very good one, as long as you have solutions and help available when you meet your challenges. And fewer challenges do not always mean a better trip.
Given this, I would suggest, before the birth to ask yourself the following:
1. What kind of birth do you want and WHY?
2. What are the circumstances that have been proven to maximize the chances of that kind of a birth?
3. What is your view of pregnancy and birth in general?
4. Why did you pick your doctor/midwife/hospital? Have they been supportive during the pregnancy?
5. Have you realized the difference between the labouring stage and birthing stage?
6. What about the subject of pain? Should it be there or not? How to avoid it? What are your opinions based on?
7. Control. How would you define this?
8. Your partner & support people. Will they be supportive? How do you know? Have you discussed your ideas?
9. If you want a totally natural, non-intervention birth, have you prepared this way? How?
Safety and Comfort
Birth is an event that happens very differently to different people. If you are going to have a good one, it is important to remember that doctors and midwives care very much about safety. If you have picked your doctor and hospital, trust that they will genuinely do the best for you in this regard. You are the one to take care of your comfort – and to make the birth a good one. This you do by self-exploring, preparing realistically and looking at all the different options you have regarding the birth, not only before, but also during the labor. This means that despite the length or strength of labor and the hard work, at all times you keep matters in your own hands, get help when needed and make sure that the team around you is one to be genuinely devoted to what you want.
Annerley the Midwives Clinic
Upcoming Flex Workshops with Hulda
How to Get the Birth you Want – A Physical Preparation
with Hulda Thorey, Annerley Midwives & Noriko Tojo-Egger
10 April | 3pm- 4.30pm
with Hulda Thorey, Annerley Midwives
16 April | 2.30pm- 3.30pm