How many times have you come across information or stories that give suggestions on how to achieve a certain type of birth? In fact, women will actively search and ask for this information in the hope that they too can work towards that outcome. This searching is a normal and important part of the pregnancy journey. What concerns me is that there is a large amount of information and methods available which present themselves as The Answer to The Perfect Birth.
Many of us want to be told that if we follow a certain formula, we will achieve a certain outcome. Do we really believe that birth is that simple?
Birth is complex. Far, far more complex than just “Eat *THIS; exercise with THIS program; think positive; breath THIS way; use THIS position; see THIS health professional; birth in THIS setting” and you will have The Perfect Birth. Anyone who is has long term experience supporting birthing women will understand there is no one magic solution for every birthing woman that will guarantee an outcome.
Sometimes THIS diet can be helpful. For a specific woman, for that baby. But for her next pregnancy, something else may be required of her journey. Her next pregnancy may require a whole new way of eating and looking after herself. Eating healthy can have an influence on all sorts of pregnancy related conditions and also the rate of recovery after birth. It certainly shouldn't be discounted.
Sometimes THIS exercise program can be awesome. Perhaps for a majority of pregnant women. But not all. For some, it could be unhelpful or even harmful. A different type of exercise may be better for an individual.
What about THIS way of breathing/meditating/positive thinking? Surely a birthing woman can't go wrong with any of that? No, not at all! There’s nothing wrong with adding extra skills to draw on during one of the most intense experiences of your life. But what happens when THIS method only works for you for part of your labour? Or perhaps THIS method just doesn’t suit your birthing style (which you don’t know until you’re in labour).
Maybe a woman needs to vocalise, yell out profanities and share every feeling in the moment. She certainly isn’t doing anything wrong on the whole spectrum of a normal labour. But if she’s formed the belief that “good” birthing women birth in a controlled, calm manner – imagine the thoughts and stories running around in her head during labour when she instinctively needs to vocalise. That’s almost certainly going to have a negative impact on her labour!
What about birthing in THIS birth setting? With THIS health professional or support person? Just because a friend/family member/work colleague’s third cousin had an “awesome experience” has no bearing on another woman’s individual experience of labour.
THIS birth setting may offer water births, but what happens to the “awesome experience” when a combination of factors during labour means that the woman cannot use this tool? The personalities of the woman and a particular health professional or support person may not work together well.
None of these things can guarantee a birth outcome.
A few years ago there was a book that was published by a very enthusiastic, natural birthing mum. She was so thrilled with her (one!) experience that she wanted to share with everyone what she had discovered. Don’t get me wrong, I think it’s wonderful to hear about positive birth stories. It’s desperately needed in a fear based birth culture. But how many women will buy this book and follow the instructions, hoping to achieve the same outcome? What happens if they don't achieve that outcome?
More often than not, women will blame themselves, rather than realising that that particular TOOL did not suit their labour. Instead of saying “Wow, THIS breathing technique worked so well for 2 hours of my labour. I’m so glad I had that available to me” (and then had experienced support who could direct them into something else that works for their labouring style), they will often think that they failed to practice hard enough or the tool was a waste of money.
So what can influence the birth outcome? I see it more like a jigsaw puzzle. Each piece needs to come together to put the big picture together.
- The overall health of mother and baby
- Position of baby
- Positions of mother during labour
- The mother and birth partner’s understanding of the birth process, including realistic expectations of birthing in their chosen birth space
- Knowing lots of options that apply to the individual labour on the day and that suits the mother’s labouring style
- The length of the birth
- Policies and procedures
- Each and every person that walks into your birth space
- Health professionals on the day and each shift
- The interaction of the mother’s/birth partner’s/health professional personalities.
- Support people attitudes, words and pheromones (yes, dad’s excrete pheromones)
- Unexpected visitors
- Random extras who might “pop their head in the door to collect keys/ask an OB a question/ask for help in another room” etc
- Cultural influences and expectations - including movies; TV and friend & family stories
- Medical tests and procedures during pregnancy and birth
- Subconscious belief systems and unconscious thoughts
- The mothers, and fathers, personal birth experience
- Sexual abuse history
And I'm sure there are more.
Of course I have to mention that a Doula’s role is to help women explore and find resources to address all of the above during their journey. This is why when someone asks “What Does a Doula Do?”, it can be hard to answer. Our role can be different for everyone, depending on their individual journey.
Perhaps we need to stop focusing on an ideal, method or outcome. Instead, preparation for birth needs to be more holistic and realistic about the complexities of birth. Each woman needs to be given the opportunity to explore whatever areas her journey takes her on, without being given false hope of a guaranteed outcome or birthing ideal. An experienced Doula who can be their pregnancy and birth “tour guide” through that journey is invaluable and something that is missing in our maternity system and birthing culture.
Imagine a labour, where the woman and her birthing partner have a solid understanding of the birthing process. They have practiced coping strategies and ideas over pregnancy that they'd like to use. They have come to know their health professionals over pregnancy (and vice versa) and understand the policies and procedures that govern their practice and in that particular birth setting.
The birthing couple’s support people, their doula and the mother’s sister, are all aware of the mother’s goals and work their hardest to keep her on track. Not only do the support people encourage the techniques that have been practiced over pregnancy, the doula has additional experience and tools that can be utilised as things shift in labour.
This woman feels supported and informed in her choices leading up to and during labour. Though there may be some unexpected turns during labour, the positive relationships formed with her birth team means that the woman feels confident about her decisions at each step of the way. The outcome may not have been what is considered on the outside as “The Perfect Birth”, but the mother is confident that it was “The Perfect Birth” for her individual labour and baby.
The Perfect Birth is not an outcome. Every birth has the potential to become The Perfect Birth when a woman feels loved and supported during labour.