My second birth was so enjoyable and beautiful but my first birth was anything but. Why? Because the second time around I attended a Birth Choices group where a Doula (professional birthing partner) gave me some simple yet labour-changing advice.
She said: “At any point in your pregnancy and birth you’re allowed to say no or question interventions and advice from family and health professionals.”
Like many I just assumed that what the doctors, midwives and nurses wanted me to do was what must be best for me. But it wasn’t.

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I found I could question their motives and I had a right to do what I wanted with my body and my baby. And that knowledge gave me the power to have a positive birth experience.
That Doula was Emma Ashworth who I am thrilled to have blogging with me once a month to share her advice, giving you a voice. Feel free to comment with questions as well.

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Why you DON’T “have to”! (Your Baby, Your Body, Your Choice)
By Emma Ashworth – Volunteer breastfeeding counsellor and birth doula

How often do we hear women saying, “I had to” when discussing their pregnancies and births?

“I had to be induced” is perhaps the most common one, but what about those less talked about things, things that perhaps we don’t even think about until we’ve actually had a baby.

Vaginal exams (e.g. to check dilation). Monitoring of the baby, with straps around our belly which mean we can’t move. Being told to lie on our back. Being told when to push. How many of these things are optional – offered to us as choices we can accept or reject? ALL of them. Every single one. And how about, “I wasn’t allowed”? What other area in our life would we accept being told that “I wasn’t allowed to be at home”, or “I wasn’t allowed to go into the bath/pool”.

You DON’T have to, and you ARE allowed!
But how can we work out which interventions have value to us, and which don’t?

Understanding in advance what may be offered is a great start (and no matter how it’s worded to you, it’s always an offer and you ALWAYS can decline the offer).

Attending NCT antenatal classes is really helpful but ask questions, read, go to your local Positive Birth group or homebirth group (even if you’re not planning a homebirth), or birth choices group if there is one.

Consider a doula.

Common interventions to consider before labour include vaginal examinations (VEs) (which absolutely do not have to happen unless you want them to!), foetal monitoring, especially continuous monitoring and positions for labour and birth (you don’t need to be on the bed, and you certainly don’t need to be on your back, unless you want to be). Key things to consider are, “what value has this intervention for me”. So for instance, looking at VEs, there’s no way that your cervical dilation will tell you how much longer your labour will be, because cervical dilation is not linear. You could go from 3cm to 10cm in ten minutes, ten hours or 4 weeks. Some women really want to know how they are “progressing” and in this case you may decide that a VE is a positive thing for you. But consider what you’ll feel if your dilation isn’t as much as you’d hoped, given that it doesn’t actually mean much anyway! Provided that there is some progression, given plenty of time, while mum is managing ok, and baby seems well, what’s the problem? VEs can also be useful for checking on the position of your baby if there is good reason to feel that his or her position isn’t optimal. However, again, what will you do with that information? Changing position by listening to what your body is saying to do can help a baby to move into a better position, and you don’t need to know where you baby is to do this if you are able to just move freely as you want to. Not On Your Back – unless your body clearly tells you that’s where you feel best!
At no other time in our lives would we accept that someone else has autonomy over our body. When we are giving birth, nothing changes. It is STILL our own body, still our own choice what happens to it and our own choice about what interventions, if any, are right for us.
Birth may not always be how we want it to be. We are incredibly lucky to live in a time and place where we have the ability to choose to accept obstetric interventions when needed. But don’t ever forget – we always have the right to choose or decline what is offered to us in birth. That is the part of our birth plans which can never be taken away from us.
“If I don’t know my options, I don’t have any.” ~ Diana Korte

Further reading on vaginal examinations:
http://aims.org.uk/Journal/Vol22No1/VEsDiagnostic.htm
http://www.biomedcentral.com/1471-2393/10/54

For more help and support:
AIMS (Association for Improvements in the Maternity Services) Helpline: 0300 365 0663, or [email protected] (aims.org.uk)
Birthrights: [email protected] (birthrights.org.uk)

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