"I didn’t know I could say no," she exclaimed, turning her surprised face towards me. I can see the cogs literally whirring as she applies this new knowledge to her situation, as the possibility for a different way forward opens up.
I smile encouragingly, my own cogs working overtime as my mind is flooded with all that I desperately want her to know to ensure her birth goes as she dreams of… Where to even start?
I want her to know that her right to say no is enshrined in human rights law.
I want her to know that these human rights apply equally to her in pregnancy and birth just as they do at any other time.
I want her to know that these include the right to decline any treatment for any reason or even no reason at all.
I want her to know not to go in blindly trusting an overstretched system that is not women centred at its core, but to go in eyes wide open and ask for what she needs, expecting it to be given.
I want her to be aware of the limitations of this system with its overworked and understaffed workforce in supporting her so she is empowered to ask for more for herself.
I want her to know doctor doesn’t know best, she does.
I want her to know she has choices, more choices than she has been given so far.
I want her to know she is not just a passive passenger in this birth, an object of interest for obstetrician to tick off in their file but is the active agent.
I want her to know to ask for more information, with facts and evidence, to be able to make her choice and to expect this to be given with respect and dignity.
I want her to know she can request a new midwife, a different consultant, change hospital – whatever it takes until she is heard and respected.
I want her to know she deserves to raise the bar on her expectations for this birth and her treatment way, way higher.
I want her to know there is another world possible for her. A world where her birth isn’t all about managing risks, counting stages, measuring and charts.
I want her to know this world has her at the centre of her birth experience and that it is her opinions, desires and wishes that matter here.
I want her to know this is an everyday magical world where she, her baby and body will dance the birth dance in an organic flow of pulsing energy- maybe it is intense, maybe difficult at times but it is her dance no one elses.
I want her to know there is another version of her waiting on the other side. A strong, proud and confident woman and mother born with her baby.
I want her to know she is holding out her hand to invite her across the threshold and hold her hand throughout.
I want her to know to trust herself as the only real expert in her own birth, the only one who can really decide what’s best in each moment.
I want her to know and value her instincts that were telling her to say no and to have the courage to stand her ground.
I want her to know that when she really shows up and claims this space for herself in this way then she will see those supporting her change to reflect her newfound strength and conviction.
I want her to know there are people here who care and have her back.
I want so much for her.
I can feel the fire rising in me, burning through my silence and hesitation. I want this fire to touch her, to warm her heart so she knows she is loved and supported. I want this fire to light the fire in her own belly so she finds her courage to speak her deep desires. I want this fire to fan the flames of her own passion so she rises up to claim her desires. I want this fire to ignite her own passion for herself and her birth so she can make it happen her way. I want this fire to blaze a trail for us all to follow as we collectively transform the face of birth and the path to motherhood.
The fire is pulsing in my heart and flames flicker through my words as I repeat with as much emphasis and love as I can muster ..
“You absolutely have the right to say no. “
That day we did chat a little more and I know she has since given birth as she wished to a wonderful baby boy. This post today is dedicated to her and to all the women who didn’t or don’t know they can say no. For all the women who are hearing their soul whisper to them that they deserve more and better.
I hear your whispers too. I see you.
I love you.
Along with the passion and fire it’s good to get practical. Below is the grounded practical resource list you can draw on when you need to make a stand for what you believe in for your birth.
1 Knowing where you stand.
“Human rights require public bodies to treat you with dignity and respect, consult you about decisions and respect your choices.”
(From Birthrights fact sheet - Human Rights in Maternity Care
You don’t stop being a human being just because you are pregnant. You and your unborn child are not the property of the NHS. All your basic human rights apply in pregnancy and childbirth too. Along with dignity and respect you should be able to exercise your right to informed consent. Meaning that you cannot be made to do anything you don’t want to do and that you should be provided with all the information you need to make your own choice.
The human rights in childbirth charity - Birthrights -founded by Rebecca Schiller produce a number of excellent fact sheets. These include Human rights in maternity care, consenting to treatment, choice of place of birth, right to a c section, accessing your records and making a complaint.
(Currently the legal information is for the UK- Please check for your own country. Please message me if you have links to equivalent factsheets for other countries and I will add them.)
I recommend the Aims booklet ‘ Am I allowed' By Beverley a Lawrence Beech, which gives in detail all the information you need to make an informed decision. Aims stands for Association for improvement of maternity services and this and other booklets that go into great depth on specific subjects can be bought direct from the Aims website.
2 Getting the information you need.
Now you know you have the right to dignity, respect and informed consent you might be forgiven for thinking this will all just be handed to you effortlessly at every step of your pregnancy and birth. Sadly this is not the case or I would not be writing this post.
Given the shortcomings in the existing system you may need to ask and ask again to get all the information you need. The Acronym BRAINS is one of the best and most widely known ways to make sure you cover every angle. Here it is in detail:
Benefits: What are the benefits of X (the procedure that has just been offered to you) You may ask- How will this help me? What problem will it solve? You can also ask what undergoing this treatment option means for you – how is it carried out, how long will it take what else is involved?
Risks: What are the risks of procedure, protocol etc? You can also ask about potential side effects and knock on effects for the birth. In some cases you may wish to ask what effect a procedure has on future pregnancies and births
Also a missing piece here is to check in with absolute versus relative risks. In other words there is a big difference between a risk that doubles if the original risk is 25% or 0.1% Finding this out can really put risk into perspective. A consultant is used to seeing difficult births and is likely to stress the risks of not doing a procedure they recommend. By asking more questions you can get the information you need and a fuller picture to choose what is best for you.
Alternatives: What else is possible? What other options do I have? Remember to go through brain again with each alternative. This part can really open you up to the choice that is so often present and that you may have been unaware of.
Intuition: Intuition or gut instinct is an undervalued but powerful tool For me, whilst listening to medical advice and getting information is important, intuition trumps everything when it comes to the final decision. We are conditioned to rely on information we can measure, and monitor. Birth is not linear and predictable in this way and you are not a statistic. Different people respond differently to different procedures and only you know what is right for you. Tune in to your body and listen to your inner guidance. After receiving all the information, take the time to discover what your intution, your baby and body need you to know You may like to ask for time for this and to make a decision ( see my next point below)
Nothing: What would happen if I do nothing? What would happen if we wait and how long may we wait for? Again you can cycle through the first part of the acronym and apply it to the strategy of waiting- What are the benefits ? risks? Etc
Smile: It can be very stressful trying to make decisions in a pregnancy that has taken an unexpected turn. We may be tense and worried about what may happen and concerned about making the right decision. Try consciously shaking out your body and stretching. Sit tall and smile- even if you don’t feel like it at first. The physical movement in your face fires off neurons and chemicals flow- a message of positivity is being sent through your body. This will be ok. I am ok. I can do this.
3- Taking off the pressure
On the spot under the gaze of your consultant or midwife you may feel pressured to make an instant decision. There is usually more time than you think even if you are in labour. It is important to ask and check so you can create some space and time for you to make the right choice from the right feeling place for you.
Thank you for all your information I /We would like to go away and think about it to make our decision.
How much time do I have to make my choice? Can I have ten minutes, half an hour?
Even if the decision is a no brainer, but it may not be the route you had hoped it can still be worth asking for a few minutes so you can come to terms with the change of plan emotionally and energetically. So that when you choose your next step you do so with calm strength dignity, and love.
Give yourself as much space and time as you can for each decision to feel good.
Remember- You are the mother, the one at the centre of this amazing birth experience and you deserve for your wishes to be heard and respected.
Much love to you on your journey.
Fear can be tricky and confusing. It’s hard to maintain perspective when you are in the throes of a strong emotion like fear. It can Impair your intuition and cloud your usually good judgment. Is it a genuine warning signal of danger to act on now or is it overblown panic triggered by old memories stored in your cells or negative thought projections? Sometimes a little bit of time breathing into the emotion in a space of stillness is enough to bring you back to the ground and allow some inner wisdom to penetrate. Sometimes it takes a little more and over the years I have found lots of helpful little tips to support me to reframe my experience.
At first I used to panic and shutdown when I felt the stirrings of fear in my belly. When fear ran riot I would feel the urge to run, to shut it down, to do anything other than sit in stillness and let it run through until I could feel a more solid base through the emotion.
I thought of fear more as an enemy and obstacle to overcome than a friendly messenger. I saw her as something to push away or push through and had no idea of the possibilities that would open up if I welcomed her and experienced her with as much willingness as I would joy or happiness.
This pattern was particularly acute in pregnancy. I was vulnerable and open like many pregnant women. Birth is not an activity you can repeat until you get it right, nor is it entirely predictable and I felt the pressure which fuelled my fear.
I persevered with the innerwork and nowadays I see her as a useful friend who serves to keep me on track and motivates me to dig deeper for freedom and peace. Not necessarily a comfortable friend mind. The physical sensations that alert me to fear are the same, quickening of the pulse, shakiness in my belly for example.
I can still get scared when I’m feeling fear. But I have a number of tools and tips that help me out. One of the earliest breakthroughs came from playing with the letters of the word itself. I created an acronym that totally freed up my way of experiencing fear. This ability to let the scaredness run through without letting it run me into hasty fear based decisions took some practice. I had deep grooves and was used to freezing up in the face of fear.
However, with a new perspective I suddenly found fear much easier to handle and without squashing it down was able to work with it and still keep going towards my goals. I remember the first time very clearly and use it as a reminder whenever I forget. The overwhelmingly frightening experience of fear as stronger than me dropped away and I moved from powerlessness to an exciting sense of possibility.
Ok so enough explanation. Here are my two perspectives on fear: The first is the way I used to experience and see fear and the second is my experience using my acronym.
Looming blackness hovering round the edges of my vision, dread, like a dead weight pulling down at my stomach, pulling my leaden feet down into the earth so I can no longer move, crushing my chest so I can no longer catch my breath. Panic, swirling round me so fast I can’t keep up or make sense of the sensations. I can’t think straight. It’s stronger than me. I don’t know what to do. I can’t do it anyway. I just want to get out of here. Now.
I notice the quickening, in my breath, in my being and all around me and I stay still. I know it is just energy. I feel it moving fast towards me and through me and I keep breathing. Even though my breath catches at first, I stay with it. I send myself love and compassion and I wait. I breathe more deeply and I find I can appreciate this strong energy as it moves and I stay still in it. I notice the speed of the energy. I feel its vibrations. It buzzes. I keep breathing and I am still alive. I calm and I begin to see. I am still here. The whole world has not ended. All will be well. I am brave and I open fully into the energy and I move through it. I remember that I can do this. The message becomes clear and I can move beyond, richer for the experience, stronger for the journey.
How differently did you feel as you read each description?
If you read quickly skimming through then have another go.
You may like to take a pen and paper or journal to note down any insights.
Shake yourself into a neutral place before starting then go back and read each one again slowly. Feel your way into each statement and notice how you are sitting, how you are breathing and how your body responds to the words. After the first statement bring yourself back to neutral then read the second one through in a similar way.
How did you experience it this time?
For me contemplating Fear as fresh energy appearing rapidly feels like freedom. I am much more able to cope with fear when it is just energy and it helps me to meet that particular fear freshly each time. Somehow it loses its charge. Its power to cripple me and leave me enslaved to its demands is gone
Of course the trick with any tool is to remember to use it especially in the beginning.
If you like this idea write it out and pin it up somewhere prominent and try reading it out when you next feel fearful. Take a few minutes just to feel the energy moving whilst you stay still and see where your stillness leads you.
No matter how much emotional preparation we do during our pregnancy (and I do highly recommend innerwork and emotional preparation) we cannot be sure we will not meet our old friend FEAR just around the corner at an unexpected and possibly vulnerable moment. Shifting my perspective and transforming my relationship with fear has been fantastically freeing for me and I hope you will also benefit.
Do let me know in the comments how you find it.
Part two of my favourite tips to ease pregnancy and labour is all about dates. I have a long love affair with dates and here I share some insights into why dates are beneficial during pregnancy (or at any time) along with a recipe you may like to try out.
As a child, dates were a mysterious and luxurious sticky fruit I only ever saw at Christmas. I somehow had the idea that they were mainly for adults, visitors and important people. I used to look at them and marvel without touching, feeling their specialness that wasn’t yet for me. Somewhere along the way my views changed. Probably helped along by my husband. When I moved to Birmingham to live with him I was surprised to find those ‘special’ boxes of dates were pretty ubiquitous in his house and to be consumed at all times of year. I began to eat a lot more dates. As gloriously sticky as ever I now love them and they are always a staple in our cupboard. Dried or fresh they have still retained a sense of mystery and luxury that enriches me as I consume along with the more everyday nutrients they contain. I chop them into my homemade muesli, eat them alone as a snack when my energy levels were low, pack them as energy boosters on long wilderness walks and recently revisited my favourite biscuit recipe from my university years.
Throughout both my pregnancies I ate them constantly, usually straight out of the kilo box kept on the sideboard. I had no idea that my instinctive choice to nourish my body had led me to a perfect power pack of nutrients and minerals for the needs of my pregnant body nor that this was backed up both with some solid research and by ancient religious texts.
In the Qur’an, surah 19, Mary is instructed to eat Date fruit:
(Qur’an 19:23-26, An Explanatory Translation by Muhammad Marmaduke Pickthall I.D.C.L.)
This short passage also alludes to the benefits of water during labour, both to drink and bathe in, and hints at the relief to be gained from an upright birthing position hanging off the branches of the tree. It also indicates the altered trance like state of deep inner awareness that is experienced in deep labour. In this case Mary is guided by a voice that is either attributed to the Angel Gabriel of Jesus himself. In fact, there is so much to be inferred from these simple few lines that it could fill a whole other post at least…
Each delicious mouthful of dates provides you with a veritable powerhouse of vitamins, minerals and amino acids, including but not limited to:
Investigating the benefits of date consumption for labour this study from 2011 found a significant reduction in the need for induction and a more favourable delivery outcome. The study compared 69 women consumed 6 dates daily for 4 weeks and were compared to 45 women who ate none at all. The women in the date eating group showed higher cervical dilation, significantly higher proportion or intact membranes, higher incidence of spontaneous labour ( 96% versus 79%) They also found the mean latent stage of labour to be shorter in this group of women ( 510 minutes versus 906 minutes) –
(Side note: I am not a big fan of rigid delineation of labour into structured phases nor the use of the word delivery but that is the terminology used in the study from which I am quoting.)
As if energy boosts, delicious tastes and shorter labour wasn’t enough, I came across this study that compared dates against intramuscular oxytocin administered immediately after birth. The dates again came out top with significantly reduced bleeding compared with the use of synthetic oxytocin and were recommended as an alternative in normal delivery. ( sorry for the terminology again, it’s a direct quote.) Yet another reason to keep dates a supply of dates handy. for eating dates.
Perhaps. I would have eaten them with more conscious awareness, savouring the historical link to Mary and her Divine Birth, celebrating her intuition that brought her exactly where she needed to be at the foot of the date tree and her surrender to the Divine wisdom she received there. I would invite this appreciation awaken and anchor that knowledge and ability in me for my own birth experience. Perhaps I would also have visualised those super nutrients travelling on their journey to the muscles of my uterus, nutritional support to honouring the work they would do during labour.
Did it help me in labour? I certainly had an amazing time in labour but it would be difficult to retrospectively split myself in two and have one of me abstain whilst the other avidly devours dates to see how much influence the dates had in that…
Nevertheless, providing you like dates, this is one of those simple, easy to implement actions that can’t hurt and is totally delicious along the way. Yummy snacks with no guilt whatsoever!
Variation – Replace oats with semolina.
I would also love to hear from you. What are your favourite ways to eat dates? Do share any tips or recipes and we ( I and my two enthusiastic young cooking assistants ) will test them out!
Sources of nutritional information in this post:
Zita West, Natural Pregnancy
Dorling Kindersley 2005
Dr Yehudi Gordon, Birth And Beyond: The Definitive Guide to Your Pregnancy, Your Birth, Your Family – From Minus 9 to Plus 9 Months Vermilion 2002
This is the first part of a three part series on three tips for ease during pregnancy and labour that can be easily integrated into your every day activities and suggestions on how to do that. Today I am writing about squatting and how I found an effortless way to integrate the practice into my ordinary life to the benefit of my pregnancy and birth experience.
Bang! Crash! Ball after ball whizzes past my ears. I swerve matrix style keeping my eyes on my target, a foot above my son’s head, just out of reach of his fingertips. I take a deep breath in and throw with all my might watching in satisfaction as the ball sails easily past my son, down the corridor and with excited glee he trots away, out of sight after it.
Enjoying my brief respite I smile in satisfaction too. My hands fall to my belly and I gently stroke my now quite large bump and wonder what my baby thinks of this new game. As my son’s smile lights up the top of the stairs once more and balls renew their relentless downpour I reflect that my children are indeed, as the saying goes, my best teachers. Thanks to my son’s delight in the ‘stairball’ game I now have a regular squatting practice, cardiovascular work out and am getting toned arms to boot.
I was already aware that gentle exercise in pregnancy was beneficial, particularly given our overly sedentary lifestyle. I knew being fit was useful as labour can be a pretty intense experience that has been compared to the energetic output of running a marathon. I felt fairly fit and active. I had to be looking after my young son. I had been active in his pregnancy too, swimming, pregnancy yoga and lots of walking. I continued with these as they were all enjoyable activities I could do with my son. But I wondered about my core strength. I wondered if I was doing enough.
The words of Ina May Gaskin echoed in my mind, “Squat 300 times and you are going to give birth quickly.” Ina May is pretty cool and her results speak for themselves (Only 1.4% Caesareans and 68.8% Intact Perineum from 2028 births for example*) so taking her advice on squatting seemed like a good plan. But despite a strong, strong desire to ensure I was doing everything I could to promote a smooth labour and birth my resistance to actually squatting on a regular basis was huge. I bet there are many who struggled as much as I did to implement this simple, useful, and easily accessible piece of advice. I tried a few times but quickly got bored and found an excuse to do something else. On other occasions I simply forgot and would be reminded later with a twinge of guilt, not enough of a twinge to get me off the sofa though, Until the game…
Suddenly I was squatting for between 20 minutes and 2 hours a day. Not continuously for 2 hours, I cried off for breathers and I listened to my body, building up my stamina for this new activity gradually. But each time the balls came flying down the stairs I carefully bent my knees in a squat until I could reach the ball.
The barrier to squatting successfully broken I began to find other ways to incorporate squatting into my daily life. Where I’d been going wrong was to doggedly persist in the one solid session approach which just wasn’t working for me.
I found that on the rare days when ‘stairball’ game was not part of the curriculum I could use the stairs as a reminder and squat once at the bottom and top of the stairs each time I went up or down them. Which was fairly often given the state of my memory and the needs of my bladder during later pregnancy. I used the stool bought to help my son access the toilet so I could adopt a squatting position there too. I also replaced bending over with squatting whenever I needed to pick something off the floor. The repetition gradually sunk into my mind and body and I found I was creating a habit. I was remembering more easily that I was intending to do lots of squatting and each time I was reinforcing the habit some more. Not that I needed too much internal reinforcement when my son was around…
Since then I have applied these principles to other areas of resistance in my life to great effect. Such as my impromptu yoga sessions : I no longer wait to find a full hour slot. I do what I can where I can, shorter and more often. I add in random moves such as cat stretch whilst playing horses with my children, or even deliberate poses when the music stops in musical statues.
Thinking up innovative ways to maintain connection with much loved yoga practice and other facets of my former life has been lots of fun, once I broke out of my box. Just as the brainstorming exercise of finding 50 uses for a particular object helps break us out of creative stupor by forcing us to get creative in limiting circumstances, so I am no longer am I confined to my box of how I have always done it, now the box is a boat, a rocket, a hat, and suddenly a world of possibilities is opening up in seemingly unconnected areas.
Back to the squatting, did all this effort pay off in the way Ina May intimated? Well it was certainly not the only factor but my son was born easily at home in approximately 3 1/2 hours from start to finish, and my arms still look great. So I would count that as a resounding Yes!
Incorporating exercise into pregnancy in the context of our often sedentary modern lifestyle is a great and healthy thing but must be done appropriately to your individual fitness and health. When starting anything new and particularly during pregnancy be mindful of your body and start small and gently. Be kind to yourself, listen to your body.
Here are a three posts with more detailed information on how to squat safely and effectively and why it is useful in pregnancy. http://www.katysays.com/the-hunting-and-gathering-mama/
The suggestions in this post for exercise are not intended to replace advice by your midwife, doctor or other health professional. If in any doubt as to the suitability of any exercise please consult your doctor of other qualified health or fitness professional for advice. BirthEssence is not to be held liable for any injury or misadventure from following advice in this post and appropriate supervision and/or medical advice should always be sought.
* Information from Ina May’s Guide to Childbirth, Ina May Gaskin, 2003 Vermilion Appendix.