Ten ways to get the birth you want
Most women should be able to deliver without medical help. Check our 10-point plan to make the birth of your baby go smoothly...
Are you worried that your birth will turn into a full-scale medical drama, or are you just crossing your fingers and hoping for the best?
Use this checklist to help you increase your chances of a problem-free birth:
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1. Don't miss any check-ups
2. Be honest
3. Consider a home birth
4. Boost your birth power
5. Get fit and ready
6. Study your subject
7. Research your local hospitals
8. Ask questions
9. Plan for action
10. What if it doesn't go to plan?
If you're a busy working mum-to-be, it can be tempting to give the odd check-up a miss. Don't! It's vital that you keep all your antenatal and scan appointments, and your employer is legally obliged to give you time off.
Guay Ong, regional officer for the Royal College of Midwives, points out that all sorts of problems can be spotted early at these check-ups. "Among other things, your midwife will check blood pressure and urine for protein, which could signal the potentially fatal condition pre-eclampsia."
Your midwife will need to know about anything in your medical history which might make your pregnancy high-risk, or cause problems during labour. You should mention any family history of diabetes and heart disease, for example. But it can be harder to talk about previous sexual infections, such as genital herpes, which may be worrying you. "Your midwife will understand your fears and she will be able to reassure and advise you," counsels Guay Ong.
If you are classed as low risk, you could talk to a community midwife and your GP about having a home birth. Belinda Phipps, chief executive of the National Childbirth Trust believes that "probably the single most important way to achieve a natural, problem-free birth, with one-to-one care, is to book for home birth."
But despite figures showing that planned home births are as safe as hospital births, only two per cent of UK women give birth at home. While midwives will support your choices, not all midwives are as confident as they would like to be. You will be referred to the most experienced midwife available on the team.
Eating well and giving up smoking during pregnancy are, of course, the two most significant ways to avoid a low birth weight baby. You should be eating a balanced diet of around 2000 calories, rising to 2200 in the last three months.
But to help your body cope with the physical demands of labour, nutritionist Amanda Ursell recommends a stamina boosting diet for the last couple of weeks of pregnancy. "Think of yourself as an athlete in training," says Amanda, "and base small, regular meals around starchy carbohydrates, which take longer to digest and so release energy at a constant rate. Keep fluid levels up too, and drink plenty of water during labour to maintain physical strength."
Taking regular exercise during pregnancy will strengthen your muscles and increase your stamina in preparation for labour. Experts recommend that pregnant women exercise three times a week for no more than 30 minutes at a time. Swimming and walking are good choices.
In the last three months of pregnancy, start massaging your perineum (the area of skin between vagina and anus) after every bath with almond, olive or wheatgerm oil to reduce the risk of tearing or needing to be cut during birth.
Knowing what to expect of labour and birth really helps you stay in control and fight fear. Your hospital will offer antenatal classes, or contact your local branch of the National Childbirth Trust for details of other classes. The NCT offers a series of regular in-depth classes to prepare women and their chosen birth partners. These place a strong emphasis on women achieving natural, straightforward labour and birth.
"Pressure on hospital midwives means, sadly, that labouring women are often left alone for long periods," says Belinda Phipps, chief executive of the NCT. "But having learnt what makes a difference - getting off the bed and moving around, having a warm bath, which position to adopt for maximum ease of labour, for example - helps women to stay in control."
7. Research your local hospitals
If you are fortunate enough to have several maternity units within easy driving distance, you may find that there are startling differences in provision and practice when you compare them. Comparing statistics for local maternity units has been made easier by using the Good Birth Guide, published by independent research organization Dr Foster, which lists statistics for all the maternity units in the UK and Ireland. Or visit them online at www.drfoster.co.uk.
While the statistics are useful, you will need to visit local units and ask midwives for more detail. Belinda Phipps of the NCT suggests the following key questions:
- What percentage of women have a straightforward labour and birth?
- Is it routine policy to attach a fetal monitor to all women, even low risk, on admission to the unit?
- What is hospital policy on induction, episiotomy and Caesarean sections?
- Do the rooms have enough space for a labouring woman to move off the bed and adopt different positions to ease giving birth?
- Will I have immediate access to water during labour when I want it?
- Will I have a midwife constantly with me during labour?
Then write it all down and discuss it with your partner and your midwife. "A clear, courteous birth plan expressing your wishes will be valued by midwives," insists Guay Ong. "It also helps clarify your mind, and it helps to envisage birth as a positive experience."
10. What if it doesn't go to plan?
Sometimes, even after all the best preparation, medical intervention is needed to deliver your baby safely. "While everyone respects a mother's choices, in the end you must be guided by the professionals," says Charles Cox, consultant obstetrician and advisor to Baby Lifeline.
NCT's Belinda Phipps advises taking a pragmatic view. "If you end up having a Caesarean section, when you were working towards a natural birth, just be grateful that there was someone there to save you and your baby's life, but never blame yourself."
Sarah Kilby
Where to next?
- Talk about your birth plans with other mums-to-be in the Labour and birth discussion forum
- For more advice on birth issues, visit the Birth channel
- Get any worries off your chest in the Labour and birth chatroom
- Stuck for a name? Use babyworld's Baby namer to help you pick