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Hi and welcome back to another episode of The Empowered Birth Podcast. Today I’m bringing you an episode based on something I speak pretty often to my clients about. Most women who come to me are looking for a completely different type of birth then either they’ve had or that people around them have had but they often times have difficulty explaining or clarifying what they want. Most of the time after digging a little bit and asking the right questions what women want is an undisturbed birth. Today I want to talk about how to keep your birth undisturbed both at home and in the hospital.
Before I go further let’s talk about the definition of undisturbed. Webster Dictionary describes “undisturbed” as: not disturbed : not altered or interfered with. What this means depends on different women but some things I hear usually are:
“I don’t want monitoring unless necessary” “I want to labor at home as long as possible.” “I want to be able to have the freedom to move and do what I want.” If at home I often the atmosphere is usually the main point and I hear women say things like “I want it to be quiet and calm.” “I want the lights to be low, music to be playing.” “I dont want people to talk to me, I just want to be left alone.”
Sarah Buckley wrote an article explaining undisturbed birth for AIMS (Association for Improvements in the Maternity Services) and I love the definition she gives:
“Undisturbed birth represents the smoothest hormonal orchestration of the birth process, and therefore the easiest transition possible; physiologically, hormonally, psychologically, and emotionally, from pregnancy and birth to new motherhood and lactation, for each woman. When a mother's hormonal orchestration is undisturbed, her baby's safety is also enhanced, not only during labour and birth, but also in the critical postnatal transition from womb to world. Furthermore, the optimal expression of a woman's motherhood hormones, including the fierce protectiveness of her young, will ensure that her growing child is protected and well nurtured, adding another layer of evolutionary fitness to the process of undisturbed birth.”
I talk further about this hormonal cascade and the beauty of how our bodies were designed to work during birth in a purely physiological capacity in episode 5. Make sure you go back and listen to that to get a full picture of what I am talk about today.
If we go back to Dr. Sarah Buckley’s definition of undisturbed birth I see some very important points to draw out. When she says “smoothest” she is making a strong point that you can have a smooth hormonal orchestration but the goal is to have the SMOOTHEST!
The best place to have the smoothest transition and facilitation of this hormonal cascade is in the most familiar place possible. That is at your home. Some women don’t have that option or there are other reasons that home isn’t a possibility so they either choose to stay in a home like setting at a hotel, friends home or a birth center as that medium place.
Women who have set their mind on undisturbed birth understand the process and often times this knowing is what drives them to stay home. But being at home is not the only stipulation of having an undisturbed birth, although it is a great first step. Let’s talk about other things that may be involved at home that would help you achieve this physiological ideal of undisturbed birth and then we will get to what you can do in a hospital setting to make it as calm as possible:
Your Provider- The type of provider matters. Just because you’re hiring a homebirth midwife doesn’t mean you will have an undisturbed birth. Some midwives have a hard time keeping hands off. The more hands and bodies in the picture the less likely the hormone cascade will happen the way it was designed. Things to look for in a midwife if you want to have a hands off birth are:
Her comfort level and knowledge with the physiological birth process
The more experience, not always better- Sometimes midwives become set in their ways. Asking a question to get a better idea on how she operates is “how would you describe your role at births?”
Your support team- I love having a party at my birth. I feed off of the energy of those I invite to support me. I have stipulations of who I have at my birth:
They need to know and be comfortable with the birth process
They need to trust me and my decision making as well as my instincts
They need to be ok with just being. If an undisturbed birth is what you want then the more talking and interruptions there are the less likely you will be able to get into the zone and allow those hormones to flow freely. I had a lot of people at my last birth but they were all very quiet and respectful of the process. It was long and hard and they each knew their role and didn’t interfere with what I needed to do.
Everybody has a role. Some people, like me enjoy having people attend and just knowing there are those in the home while I’m birthing. I think I’m able to relax and be because I know everyone I have invited into the space has a specific role. Some of the roles I had people do are:
Midwife- Her role was to observe and step in if needed
Midwife assistant- Assist the midwife.
Husband- main support
3 friends (they helped watch my daughter, boil water for the pool, got me jimmy johns after birth, and just sat there and held space)
Environment matters when it comes to undisturbed birth so while having a homebirth is ideal if this is what you’re wanting there are still some things you can do in a hospital setting to help facilitate a hormone cascade.
Labor at home as long as possible! If you want to be undisturbed staying in your own environment as long as possible is helpful. Some people are nervous staying at home. Many question if they will know when to leave. This is where hiring a doula can come in handy! Support through active labor at home is super helpful and most of the time doulas are trained to know when it’s time to transfer. The further along you are in your labor the less a transfer will significantly interfere with the hormone cascade. “high adrenaline levels in early labour, which reflect activation of the woman's fight-or-flight system in response to fear or a perception of danger, have been shown to inhibit uterine contractions, therefore slowing or even stopping labour. Noradrenaline also acts to reduce blood flow to the uterus and placenta and therefore to the baby.” - Sarah Buckley
The less strangers the better- At a hospital birth the most familiar person is going to be your partner and your doula. The next person that will be familiar will be your provider. Depending on what type of provider you have they may or may not be in the room during your labor and may only come in at the very end as you birth your baby. You will have nurses that most likely you will have never met before. If you are planning on birthing at a teaching hospital residents are also likely to be in the room. If you want an undisturbed birth make sure you’re speaking with your provider and letting them know you would not like anyone in the room that is unnecessary. That means no extra nurses, no residents. The less people interrupting you the better, especially towards the end when you’re pushing.
Your provider- Your provider should know your desire for an uninterrupted birth early in the pregnancy. Having constant communication and conversations about your desire will reinforce the importance this is for you. Some things to keep in mind is asking if they have seen a natural birth before, one that is quiet and mother led, especially when it comes to pushing. The more noise and coaching that happens the more likely the hormonal cascade will not happen as designed.
The quickest and easiest births I’ve witnessed are the ones where the mother takes full responsibility of her birth, makes the decisions, sets her mind on what she wants and normalizes the birth process for herself. She has gathered a support team around her that is experienced and knowledgeable about the type of birth she wants and she is uninterrupted with respectful whispers and a knowing trust from those around her that she is capable. This is the support every woman deserves to have.
To end I want to read the closing statement of an article Dr. Sarah Buckley wrote on undisturbed birth. I’ll post the full link in the description below so you can read the whole thing:
The full expression of these labouring hormones requires specific conditions: that the labouring mother feels private, safe and unobserved. This basic need is recognised by traditional systems of maternity care, which prioritise the emotional well-being of the labouring woman and ensure that she is cared for in a familiar place with known and trusted helpers. These factors will keep her as calm and relaxed as possible, and her adrenaline levels low.
Conversely, if she is not feeling private, safe and unobserved in labour, her adrenaline levels will increase, slowing labour and decreasing blood and oxygen supply to the baby and leading to fetal distress for vulnerable babies. Our current maternity care system does not done for slow labour and fetal distress. Interventions used for these indications such as synthetic oxytocin and caesarean surgery can further interfere with the hormonal orchestration for mother and baby, creating a cascade of intervention and depriving both of the ideal start that Mother Nature intends.
As Professor Kloosterman states so eloquently: 'Spontaneous labour in a normal woman is an event marked by a number of processes so complicated and so perfectly attuned to each other that any interference will only detract from the optimal character. The only thing required from the bystanders is that they show respect for this awe-inspiring process by complying with the first rule of medicine – nil nocere [do no harm].'
For those of you who are wanting to dive deeper into what this may look like at home or at the hospital you can book a 60 minute birth planning session to go through more ways specific to you and your desire for birth to have the blissful experience you’ve been dreaming of. You deserve to be supported. Take this first step in having a blissful birth and schedule today by going to bit.ly/birthprepsession. Also if you’re looking for more community support make sure you join our free facebook group at facebook.com/groups/empoweredmamastribe. We would love to walk along side of you in your journey! This group is continuing to grow and morph and it’s exciting to hear all of these stories of women who are pursuing passionately an empowered birth!
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