My Natural Birth Plan

I am now 37 weeks pregnant with our second baby and looking forward to my birth. Elise was 10 days 'late' which means she came 10 days after my estimated due date. I had a wonderful first birth - it was exactly as I had imagined it would be: calm, relaxed, short and enjoyable. Truly, it was enjoyable.

And with 3 weeks to go (give or take a week or two) I am really, really looking forward to my next delivery.

I learnt with my first pregnancy, when reading books or talking to people to were natural birthing advocates, that knowing what you want is really crucial. At the very least, you need to have a good understanding of what your options are when it comes to Delivery Day.

There are so many options available to you:

• Where you want to birth
• Who you want with you
• What birthing positions are best for you
• Whether you want medicated pain relief or not
• Whether you want to use natural pain relief methods or not
• How quickly - and how - you want to bond with your baby after birth
• Who will cut the cord
• What vaccinations (if any) you are prepared to give your newborn...

...the list is truly endless. And it is so important to have an opinion for each variable.

I decided to be explicit in my first birth plan (and I have hardly modified it for my second) which for me, meant being assertive and clear about what I wanted and what I did not want. 

I'm of the view that a labouring woman, with no pregnancy complications, is not ill. She is not sick. She is simply having a baby. That means she needs to have awareness of what her options are and to have clear opinions about those options. 

Yes, midwives and obstetricians might be more experienced in helping to birth more babies, but a labouring mum-to-be knows her body and her wishes better than anyone else. Her body is also perfectly capable of birthing a baby, just as her heart works without her thinking about it and her lungs inflate without her having to make them do so.  

Of course, complications can arise. And although you should have a clear Plan A that you are committed to in your birth plan, you should educate yourself as to what your options may be should special circumstances arise on the day. 

My Natural Birth Plan

My birth plan is logical and divided into the different stages of labour. I've been lucky and have had no complications during this pregnancy which means a 'natural water birth' is more possible. Women who have had complicated pregnancies/labours would potentially need to deviate from a natural birth plan but they could still use the principles of natural and/or hypnobirthing to help them through C-section deliveries. 

Here's a snapshot of my plan which I have adapted from different sources, namely my birthing bible, 'Hypnobirthing - The Mongan Method' (Marie F Mongan) and from Kathryn, my natural birthing tutor at Natural Birth Sydney. And of course, it takes into account my own birthing preferences too.

My plan is simply about setting out my wishes and politely requesting that they be followed, all being well. Here it is:

Overall

• I request the most calm, natural, gentle labour and birthing experience possible.
• I have chosen the Hypnobirthing method and intend to follow this practice throughout labour and birth.
• My preference is a water birth and to labour and birth in a birthing pool provided by the hospital.
• I do not want artificial induction; do not want artificial rupture of membranes; and do not want episiotomy.

Special Circumstances

• Should these arise, and mean I may need to deviate from my planned natural birth, I trust that our medical care providers will give me a clear verbal explanation of the special circumstance; the medical need for any procedure they might anticipate; and all of my options.
• In the absence of any special circumstance, I ask that my birth plan be followed by all medical care providers.

Arrival at Hospital

• To remain at home for as long as possible before coming into hospital (NB: this timeframe will vary depending on your health, baby's health, and whether this is your first or a subsequent baby).
• To decline routine IV drip on admission (NB: I prefer not to be attached to wires unnecessarily... it is highly unnatural and I can keep myself hydrated during labour.)
• To decline any internal examinations if I choose (NB: I believe internal exams are usually unnecessary so long as you're healthy and baby is doing fine. They also interrupt your state of calm and risk bringing on contractions before you, baby or your body are ready... what's the point in that?).
• To have a private birthing pool and room ready upon arrival.
• To play music if I choose to.

During Labour

•  I wish to labour naturally in my own time – however long that may take – and to be allowed to do so in peace and quiet
• Artificial inducement will only be considered if there is a medical emergency (NB: it is important to know what the options are here and what methods of inducement you'd be most willing to try and in what order. You may also have a view on methods you want to avoid).
• Caregivers, please do not mention ‘pain’; ‘pain tolerance’; ‘pain relief’; ‘pain levels’; ‘medication’; ‘failure to progress’.
• To decline discussion of ‘moving things along’ and to allow labour to take its natural course.
•  A natural, drug-free birth. Epidural is not wanted.

During 'Thinning and Opening' Stages

• The patience and understanding of all medical caregivers to refrain from any practice or procedure that could stand in the way of me having the most natural and calm birth possible.
•  Freedom to move, walk, sit or do none of these things during labour.
•  To change positions and assume labour positions of choice.
• To be fully consulted before the introduction of any medical procedure including gels; Pitocin; sweeping membranes; episiotomy; suction.

During Birthing

• To remain in the water and to allow natural birthing instincts to facilitate the birth of the baby. Caregivers please don’t be pushy; I ask for gentle encouragement.
• To assume birthing positions of choice to facilitate gravity and to avoid episiotomy.
• That episiotomy only be discussed if absolutely necessary and administered only after consultation and agreement.
• No forceps. Suctioning is preferable if there is medical urgency.

Post Birth

• I request that I receive baby onto my chest after birth to enable immediate skin to skin contact and to be allowed to stay in this position for as long as possible.  APGAR testing and weighing can wait please. Skin to skin contact is more important.
• Do not remove vernix from the baby; please let it be absorbed.
• Please allow umbilical cord to pulsate and wait until it has stopped before clamping the cord. Obstetrician to cut the cord with our agreement.

• Vaccinations: NB: have an opinion on which vaccinations you're willing for baby to have. These are country-dependent. Some countries advocate for BCG and Hepatitis B at birth. You can do this, or request to wait until baby is a little older - it is your choice as parents what you believe to be best for baby. Similarly Vitamin K is usually offered at birth - know in advance what your views are on that too. 

• Placenta: NB: there are lots of options here too about how you'd prefer the placenta to be expelled (naturally or with help of drugs).
• Cord blood: again, know your options. 
• Feeding: NB: make it clear whether you intend to feed baby with breastmilk or formula and whether you want the baby to remain with you throughout your hospital stay or to be taken to the maternity ward nursery.

There are so many variables with a birthing plan and with a birth. There are no right or wrong answers but there are opinions. Know your own opinions well in advance of Delivery Day and it will aid a smoother, more enjoyable birth.

If you want to read more about what info you might include in your birth plan, click here.

Happy birthing!

Rebecca x

Positions for Labour

With only 11 weeks until my due date (15 February 2016), I am starting to think about the birth itself. I'm not concerned about it - on the contrary, I am extremely excited about 'D Day'!

My 28 week bump!

I know so many mums who have had difficult births. By that I mean long labours. Painful labours and births. Disappointments.

Many say the most important thing is that the baby came out safe. And of course that is the most important aspect: that you and your newborn are both safe and well.

But there has to be more to it than that. One thing is always certain with birth: the baby will come out. But what I think a lot of people miss is that you have plenty of opportunity to determine how that baby will come out.

My Own Positive Experiences

I have never wanted to feel robbed by any birthing experience. I'm extremely fortunate to have had a very positive first birthing experience and I am determined to have the same sort of experience this time round.

Much of my own thinking about birth, I've realised, comes from my own mum's positive perspectives on birthing. My brother and I were both born naturally - my mum had a bit of gas and air and she focused on being as relaxed as she could until we were born. So much so, she was watching a film at home when she went into labour with my brother and refused to leave for hospital until her film had finished. Mum has only ever talked about the 'ease of birth' to me and as a result, I have only ever believed it to be a straight forward process.

This is why I always actively avoid women who want to share their horror stories with me. They add no value to me as a pregnant woman - who wants to hear about someone else's 65 hour labour or birthing agony when you are faced with your own birth in a few short months??

Birthing Preparation

Preparation is absolutely key to a pleasant birthing experience. I prefer to listen to my hypnobirthing CDs; practice my hypno breathing; research videos of women giving birth naturally and pleasantly; doing yoga that focuses on my pelvic area; and stretching.

It's also really valuable to have thought about what positions you might want to birth in when the day comes. Obviously you might be really lucky and have a really quick labour and birth, but the positions are really useful all the same.

Gravity is a really key aspect of birthing naturally - the more you move around and the more you are upright, the better. So standing, sitting and squatting are all really good upright positions that will help gravity help you bring your baby into the world.

Here's a fab article, with illustrations, on good natural birthing positions ... 

And here's another one!

Happy birthing ladies!
Rebecca x

Preparing Your Body for Labour

When it comes to birth preparation and natural birthing, a lot of attention is given to your mental state. In other words, preparing yourself mentally for the challenge ahead.

In my case, I read a lot (for both pregnancies) and was very interested in the whole hypnobirthing approach. It's very much about preparing your mind: getting yourself into a positive 'state'; being relaxed; and repeating various visualisations daily in the run up to your birth to keep you on track.

Not a lot of discussion is made of how to prepare yourself physically for labour.

I'm no expert and all I can share is my own experience. But when pregnant with my first child, I swam a few times a week, walked a lot and did prenatal yoga once a week. Inbetween classes, I would practice my yoga poses at home a few times a week and I felt physically 'right' and prepared for birth when it came.

With my second pregnancy, I am trying to replicate my first program but have had some issues with the swimming side of things (the haze in Singapore makes outdoor activity a loser at the moment) but I am doing prenatal yoga classes twice a week and a few times at home. And once the weather is better I will be swimming too.

I don't think you can do enough stretching throughout your pregnancy (whilst being mindful not to hold poses too long or to over stretch, which is easy to do during pregnancy due to relaxin coursing through your body).

In our yoga classes we focus a lot on stretching hamstring, calf and pelvic muscles which makes a lot of logical sense. I am told by my obstetrician (whom I trust) that the key is to find balance in your exercise, to make sure that your body is aligned and therefore baby is evenly supported during pregnancy (by your many muscles and ligaments) to aid a straight forward (pardon the pun) labour and birth.

When the body is physically imbalanced, it might tilt to one side which can make your birth canal literally not so straight forward!

He gave me a useful article, from his partner midwife, at Spinning Babies that I wanted to share:

To read more about Spinning Babies and their approach to preparing your body for a natural labour click here!

Birthing My Daughter Elise: A Natural, Drug Free Waterbirth

I wrote this blogpost in December 2011 (on my professional, company blog) as I was so in awe of my birthing experience and of my gorgeous little girl, Elise! She's now nearly four years old - where has that time gone? - but I still remember that day very clearly. It was without a doubt, the most incredible, positive, heart warming experience of my life to date. I hope you enjoy my account of a wonderful birth!

26 December 2011

It's now Boxing Day and I can't believe how quickly December has gone! Three weeks ago I encountered an entirely new experience: a natural, drug-free hypnobirthing birth. The result: our gorgeous little girl, Elise was born weighing in at 3.8kg!

Here's a pic of her at 2 weeks old:

Elise was 8 days 'late' but, despite talk from our midwives that they wanted to book me in for an artificial induction to 'get things moving', I was adamant that I wanted our baby to come spontaneously - when she was ready. After all, I had been lucky enough to have a straight forward pregnancy and Elise's heart beat was healthy and strong.

At 4am on 5th December I woke up with my first contractions. Having never been a mum before I wasn't sure what contractions would feel like. All I knew was that this was a different sort of feeling. I was so ready to have my baby that I was ecstatic to be feeling these pangs. I woke Ross to let him know that something was happening -and then, knowing all we could do was wait, we went back to bed.

In the morning, the spasms were still coming so I started listening to my hypnobirthing CDs, doing the specific breathing techniques through each contraction and staying as focused as possible on remaining calm and oxygenating my body.

By 10am it was time to go to hospital: the contractions were 5 minutes apart and strengthening. We left, got half way to hospital and I remembered I'd left a candle burning in the living room. There was no way I could relax and stay focused knowing our house could burn down at any minute (!) so we drove back home to blow it out! Back to hospital again... :)

Our delivery room was much more welcoming than I expected it would be. This would be our 'home' for the next few hours!

I was still comfortable enough chatting with Laura (our midwife) and as I didn't seem distressed she suggested we went home for another couple of hours. To be truthful I didn't fancy the car journey home twice again and anyway, my instinct told me to stay put.

I was linked up to a machine to monitor the contractions (or 'surges' if you want to use hypnobirthing speak) and the baby's heartbeat.

Within ten minutes the waves of contractions started to come more quickly and harder. They sort of punched down from my mid-stomach and across my lower abdomen.

I was glad I'd listened to my intuition and stayed put. An internal exam revealed that I was already 6cm dilated (you need to be roughly 10cm to birth your baby). I think Laura was surprised I was so far along and still so calm!

Throughout my pregnancy I had seen my acupuncturist, Olivia Shurdova (who is exceptionally gifted). Amongst other things Olivia had shown Ross and I key acupressure points on my legs, hands and shoulders that, when pressed, would offer natural pain relief. It was time to apply what we'd learnt! Ross began to apply pressure to these points each time a contraction washed across my belly and it made a significant difference.

By about 1pm the contractions had sort of taken over my body. Every 1 to 2 minutes this tightening would surge across my lower abdomen - from the hips into the centre of my belly. Some women describe it as a strong period pain. My experience was quite localised to the lower part of my belly but I know contractions can come from any angle: your sides, your back, your upper belly, lower belly, or all over. From my hypnobirthing classes I knew this feeling was the horizontal muscles at the base of my uterus being pulled open and up as a result of the vertical muscles contracting upwards.

I remembered the advice from our tutor: to imagine these muscles as ribbons (or anything flowing, limp and light... like running water or fabric blowing in the wind).

Any of my clients will know that I am a huge advocate of visualisation and mental preparation - I firmly believe in the power of the mind-body connect. Knowing how my body was naturally working to birth my baby, coupled with these visualisations, enabled me to stay totally focused and manage the situation more easily.

At this stage of labour some women like to stand, others to lie down. Many prefer to work through it hunched over an exercise ball. Quite frankly no position for me was comfortable at this point. The best option was standing with my hands on the end of the bed.

By 2pm I asked for the bath to be filled. "I think you've got another half hour before we do that," Laura said. "Nope," I said, "I need to get in the water!" I wanted the warm water around me to soothe the contractions. And I knew I had to listen to my intuition.

Here's a picture of what my birthing bath looked like (although you might birth in a regular bath too):

The warmth of the bath water was delicious. Not only did it ease the ache from each surge, it also helped me to feel weightless. Ross was an absolute godsend too at this point. He had also attended the hypno classes with me and knew what to say and when to say it.

In a hypno birth, the role of your birthing partner is vital. Well let's face it, in any birth it helps to have a birthing partner who is aware of your birthing preferences and to encourage you throughout!

Ross' voice became my main focus and enabled me to filter out all other voices and noise. He reminded me to breathe deeply to a count of ten and out for ten - not only did this saturate my body and uterus with oxygen (thereby keeping the muscles maleable as possible) it also brought calmness to my mind.

Every wave, he reminded me too, was bringing us closer to meeting our daughter.

Our baby was well and truly down in my birth canal when Laura suggested I stand up. Although gravity is a natural aid to birthing, standing up was the last thing I fancied attempting!

One of my friends had used 'active birthing' techniques, where you walk and stand as much as possible. It seemed logical - and it worked - as soon as I stood up, our baby started to be visible. Hooray - it was time!

In hypnobirthing terms, this is the point where you switch to 'J' curve breathing. This is where you inhale quickly and deeply and then exhale down hard whilst imagining baby is moving out in a sort of 'j' shape.

For me, this was a technique that went totally out of the window as my body's natural instincts took hold. All I wanted to do was push! I could feel the baby surging forwards each time, only to be sucked back in again! After that occuring twice, I twigged that I needed to make more of a concerted effort whilst still allowing time for my skin to stretch.

Within 20 minutes the baby's head was out. Her shoulders were soon to follow. It was only then that I really heard Laura's voice. "Mum, you can reach down and pull baby out if you want." What? I thought. I hadn't imagined I would be able to do that! How amazing!

I opened my eyes, looked down and saw this little head and body in the water. Our baby was almost born! I reached down and clasped her little body. It was truly magical. With the next contraction I delivered our baby girl and lifted her out of the water and onto my chest. I think I was in shock - she was finally here and she was absolutely perfect.

Here's another pic just after she was born:

Birthing Elise in a natural way was, as I say, a truly magical experience. It is true that I would have been desperately disappointed if I hadn't been able to bring Elise into the world drug free (I believe the combination of water and hypno birthing without drugs or intervention has resulted in an exceptionally calm and healthy baby).

But I was a very lucky mum and had no complications. So now she is here... the true challenge begins!

I hope you've enjoyed hearing about my experience. I would love to hear other parents' birth stories - feel free to post your comments below!

Love and hugs,

Rebecca x

Birth Plans and Natural Birthing

I'm currently 23 weeks pregnant which is wonderful. It has got me thinking about birth plans and birthing, breastfeeding and sleepless nights... and I am so looking forward to all of it!

Birthing is such a tricky subject because it is such a personal experience and often, opinions don't meet. Through my career, when I was pregnant with Elise, I heard about hypnobirthing and wanted to find out more.

Photo: iStockPhoto/Kryu

Hypnobirthing is focused on calm birthing and allowing your body to do what it does naturally. To do this, it is important to understand what actually happens when you go into labour - physiologically and emotionally - to help yourself help your body bring your baby into the world.

Hypnobirthing in the Western world is relatively unknown still which I find fascinating. I find this so interesting because natural birthing has been around since the beginning of time and is practiced in hundreds of countries around the world. There are women in Africa working in fields when they go into labour - when the time comes, they simply stop working and deliver their babies.

I remember being a 7 year old and being at my best friend's house. Her name was/is Amy. We watched fascinated as her dog gave birth to a litter of puppies and I remember thinking at the time what a peaceful experience it was. Puppy upon puppy appeared and yet the mother dog stayed calm and seemed at peace. She simply licked each one as it emerged and encouraged them to suckle straight away. Of course then, I wasn't thinking about human births, or what my own birthing experiences might be like... I was only 7... but that experience certainly stuck with me.

We human beings think too much. We overthink everything. And truly it is the only thing that differentiates us from every other mammal on the earth that gives birth using the same processes as us. Waters can break; contractions occur; a cervix opens; a baby (or babies) crown; and enter the world. So why are we the only mammals who seem fearful of birth?

Obviously complications arise and when they do, it is essential that they are met with the correct medical attention. But when everything is going well in your pregnancy and you and baby are doing just fine, a natural birth is the best option.

When I talk to other mums to be, I am always fascinated by how little they have researched the topic of their birth.

• Most don't know why contractions occur or how they actually help baby emerge. 
• Most do not know why birthing mums are taught to breathe. I'll do a separate post on this.
• Most do not have a clear understanding of what kind of birth they want and what they really want to avoid. 
• Many believe from their first trimester that their birthing experience will be agony and that 'D Day' will be a horror day, best forgotten quickly.

If you were planning a holiday, you would research it thoroughly. You'd find out what facilities were at the hotel; what the pool was like; whether the hotel was walking distance to any restaurants; read reviews; plan day trips; look into the exchange rate. The list is endless.

If you're married, think about how much preparation went into your wedding plans!

Having a baby is no different. Planning, researching and considering all your options (and the best option for you) is so important. You have so many choices and it is important to know what they are.

Love and hugs
Rebecca