Are London Maternity Services Really That Bad?

Chris turned my eye to this article in Wednesday’s Evening Standard that showcases the inadequacies of London’s maternity services for birth and suggests growing numbers of average pregnant ladies (i.e. non “new age hippies”) now resort to DIY home births for fear of over-medicalized hospital births.

It’s a long, rambling article so to summarize:

• Mothers do not get one on one care: Soaring birth rates, a shortage of trained midwives and clinical-minded, controlling consultants result in a lack of support and choice for women (particularly older mothers). 
• The Association for Improvements in Maternity Services (AIMS) claims London has some of the most interventionist hospitals in Britain.
• A recent investigation by the Conservatives found that more than four in 10 NHS hospitals have refused to accept expectant mothers at least once last year.
• Labour’s women-centric vision of childbirth featuring choice and continuity of care have fallen down; parenting charity the NCT claims just over 7% of women in the capital give birth how and where they want.

Wow. On this basis, I’m shocked that we haven’t seen a mass exodus of pregnant women from the capital. Maybe they are all just giving birth at home instead?

I’m no “new age hippie” but I did plan for a home birth, decide to be a natural birthing warrior and criticize the ambiguity around the closure of the home birth providing Albany Midwifery Unit, cited in this article.

Yet I still feel that there is a huge middle ground between a completely natural home birth overseen by an attentive midwife and a completely medicalized and/or clinical hospital birth with little aftercare and support. This article oscillates between the two extremes. I think that’s a bit misleading.

My birth plan didn’t go to plan: I ran overdue and requested daily monitoring rather than induction; was finally induced at 2 weeks 5 days post dd when my blood pressure spiked; I had some “medical intervention” at the hands of a consultant when LLC’s heart rate fluctuated during birth. Yet I delivered a healthy baby; I felt the midwives and doctors considered my wishes; sure, they could have spent a bit more time post-birth helping me learn to breastfeed but overall, I couldn’t fault my care.

I have met many other new mums whose birth plans have not played out in reality (it seems they rarely do), who have some complaints but overall had a positive birth experience. Yet our voice is glaringly absent from this article. Not to mention the voice of the many women that prefer to give birth in a hospital and have no interest in home birth.

The article shows little discretion for how women can proactively improve their birth experience. Women must ask questions and be their own advocate when it comes to maternity care. If I hadn’t asked for daily monitoring, I would have been induced as a matter of course at 42 weeks. I learned in retrospect I could have given birth in a neighboring mid-wife led birthing unit if I had requested this even though this option was not offered to me. There are definite gaps in ante-natal service choice and information, all the more reason why women must ask or they won’t get.

The article also courts political drama. The Conservative report that women have been turned away from certain maternity units is a problem, but would it not be worse if maternity wards took women into care with no staff to accommodate them?

There may be truth in many of this article’s assertions. The issues run deep and I'm not belittling the problems that exist. But does it take it too far? Are London maternity services really that dire? Have you given birth in the capital and if so, what was your experience?

Sweep, Sweep, Sweep but Still No Peep

I had my first membrane sweep today – I say first because I’m booked in for a second on Wednesday of next week. Maybe I won’t need that, but from today’s prognosis it appears that labor is not yet directly around the corner for me. As you can imagine, this was not the news I was hoping for. Let’s hope that appearances are deceiving in this instance!

Without going into TMI overload, as of this morning my cervix was still posterior and it took three attempts for a midwife to reach it to perform the sweep (though one midwife said her short fingers didn’t help the situation). On a positive note, it was also very soft and cooperative once the sweep got underway. I didn’t find the procedure painful; more uncomfortable but I never imagined that a midwife rummaging in my inners would feel like a treat.

Following the procedure I had a some show (also positive) and was sent home with instructions to eat more curry and pineapple, to bounce on my ball, walk but not tire myself and to have sex. The midwives are not shy and retiring – they tell it like it is.

I’m trying to keep my chin up. I would have loved to hear that I looked ripe and ready for labor imminently, but it sounds like I’m moving in the right direction so I need to focus on that.

I have one more week on the NHS to attempt a home birth.  Though I'd like to do this, I've always prepared myself that this plan might not come off.  What I'm struggling with more is that once I hit 42 weeks the standard NHS procedure is to induce labor.  I'm not looking to fight medical advice, but if all is well with baby at that time I can't help wondering if that's an indication that my body isn't ready.  My first priority is to bring our daughter into the world safely and I would not turn a blind eye to induction in the case of any health concerns for baby/me. Yet if all appears well, the push to induce "just because you are two weeks past your due date" when due dates are known to be a faulty science frustrates me.

I don't know if I sound like I'm losing site of the bigger picture....it's just after preparing to attempt labor as naturally as possible, induction means using intervention to kick off the very event and that's not something that appeals to me.  But we'll cross that bridge if I come to it and hopefully I won't.  As of now I am grateful that all is well with our little one.  Come on out baby - we want to meet you!

Party Like It's 2009!

Par-tay! Yup, that what Chris and I are doing this New Year’s Eve 2009. Scene of the crime: our living room. Life and soul of the party: Chris post a half day in the office, big blooming me, Rico the cat purring and bump kicking....along with board games, a yummy Mexican dinner and some bubbly. A random mix for a random lady.

Yes, it is the close of 2009 and yes, our celebrations fall nicely in line with our imminent life chapter where New Year’s celebrations are likely to be toned down at notch or two. In all honesty, I’m one of those who sees New Year’s fiestas as often over-rated and overly expensive. I think even our local pub has a cover charge. Whenever too much expectation is placed on one night it often doesn’t live up in reality. Some of our best New Year celebrations have been at home with friends, something that shouldn’t be too tough to integrate babies into.

I started 2009 with my usual “Goals for 20xx” list. I think I had about 20 items on my list. You know I tend to go overboard with the damn lists. Well, I’m not going to bore you with the details of my to do’s aside from to say on the whole, it’s been a pretty productive and life changing year. We have our little lady on the way and I began writing again, a latent passion that I’m pleased has been galvanized by this new pregnancy/parenting phase of my life. Ticking those two items off gives me great satisfaction and a sense of accomplishment.

As two become three, (or four counting little Rico), 2010 promises to be all the more life changing, exciting, challenging and hopefully productive. I feel I have so much more to learn and that I want to achieve in this new life chapter that I better keep my 2010 Goals List short and sweet or it may run a million miles long.
Three major things I’d like to achieve are:

• Have our baby! This is on the cards, and although women may be built as baby making machines, to actually do the deed will be my biggest feat to date. I hope we are able to have our home birth as planned, but ultimately all we want is our little lady, safe and sound.
• Find our new life balance with baby while maintaining our own independence as individuals and a couple, something of a life ethos for Chris and me and a running theme through my blog and soon to be website. 
  
• Launch my new website, which will feature my blog (a journey of my transition to parenthood and chronicle of pregnancy and parenting advice/news/etc from both sides of the pond), a sharp & topical weekly advice bulletin from other pregnant and parent writers (an expansion of mama chat) with real advice to share and a forum for my freelance parenting writing projects. This launch is on the cards for January 2010 once I overcome a few technology hurdles so watch this space! Parent blogging is such a hot commodity on both sides of the pond that my mission often seems daunting but I’m dedicated and hope you enjoy the read. Three social networks I’ve recently joined but can tell will prove invaluable to my blogging journey are the British Mummy Bloggers, Mom Bloggers Club and My Best Birth, where there are countless impressive, creative and real mama bloggers that generously share wisdoms and knowledge about their lives, their birth experience and making headway in the black hole of parent blogging. If you are also an aspiring mama blogger definitely check them out.

Now I better re-join Chris in the living room after this frenzied "close of 09" post! Happy New Year!

"Secret Report" Leads to Axing of Home Birth Group

The home birth may be slowly growing in popularity and availability here in the UK, yet it's still considered risky taboo for many and scare stories like this highlighted by The Times don't help its case.

The Albany practice, an independent South London midwifery group specializing in home births has had its contract terminated by the NHS because of a confidential report suggesting it had ten times the normal rate of babies born with serious complications like brain damage.

Yet experts, Albany advocates and government figures alike have raised concerns over the confidentiality of this inquiry and why it was not carried out in conjunction with the Care Quality Commission, the health regulator.

King’s College Hospital commissioned this report and claims that its findings do not equate with an anti home birth stance but rather the need for closer monitoring of midwifery services. Yet details of the "serious shortcomings" identified and comparative assessment of birth rates between Albany and other midwifery practices are glaringly absent, and create a transparency gap that undermines the very nature of the report's findings.

It's crucial that NHS and contracted home birth midwives follow strict due diligence and safety protocols. When they do, it's been shown the home birth can be a fantastic experience. Shortcomings should be identified and rooted out, however the key here is identification and transparency. Axing a leading midwifery service over ambiguous failures only serves to scare and rile up the masses.

Pregnancy Courts Debate

Pregnancy is smitten by debate. Pregnancy is a sucker for debate. Pregnancy just can’t get enough of debate.

And that’s usually okay with me, for as pregnancy courts debate I am encouraged to think laterally and broaden my perspective. Only occasionally when the debate in question concerns copious baby retail options (i.e. what are the relative merits of baby mattress types?....gag me and fast!) or the sweeping scythe of the nanny state do I want to bang my head against a wall and renounce all deliberation as painful and/or confusing and/or insane.

Today debate was so “hot to trot” that pregnancy managed to finagle two dates. I’d like to share the details and my take:

Debate #1: A Council in Wales hands out pink badges to heavily pregnant ladies so they can bag favourable parking spaces. An online news blogger decries this as yet another policy that will be abused. 

My father-in-law brought my attention this afternoon’s BBC Radio 2 report. I can’t find anything in print on this story, so please let me know if you can. Without more information it’s hard to pass judgement, but my gut instinct is that walking an extra 50 extra feet might do a pregnant woman good. Badges like this most likely would be abused unless monitored, which I don’t see as the best use of Council resources.

Debate #2: Are Doula’s “helping hands or stepping on toes?” The BBC today reports anaesthetist Dr Abhijoy Chakladar’s view that the increasing trend of women hiring doulas (birth assistants that offer emotional support before, during labour and postnatally) is a side effect of lapses in midwifery care that often hinders clinical decisions by disturbing the relationship between the mother and medical team.
 
I beg your pardon? My understanding is that doulas offer mothers and their birthing partners emotional support and encouragement in preparation for and through birth, as well as during the early days of parenthood. Doulas are not medically trained and unlike midwives, are not responsible for the physical care of the woman through her birth. While it’s important that doulas don’t overstep this boundary (and perhaps some do), to suggest that their presence upsets the clinical side of birth wreaks of practitioner speak to me! Many women hire doulas to develop firm emotional support and coping strategies that help them approach labor as naturally as possible and don’t want a clinical birth. Doulas should not be berated for helping women participate actively in their birthing experience - having said that, should medical care be needed, it is not their place to argue with practitioners but to support their client through whatever shape the birthing experience takes.

What to Pack Should Be the Least of My Concerns

I've got a little over 9 weeks to go until DD-Day.  Earlier today I started pondering what should be included in and when I should pack my infamous hospital bag.  Yes, I'm still planning a home birth, but packing a hospital bag is like a right of passage for pregnant women.  Even if you plan for a home birth, a hospital bag should still be at the ready just in case.  It's an acknowledgement that your baby is almost in town.  It's a sanity guard for when you're in the heat of labor and need to bust a move for the hospital.

I felt a little bizarre thinking about my hospital bag this early but it's my first time, I have pregnancy on the brain and I want to be prepared. 

Fast forward two hours and I was standing in Boots (aka CVS) grimacing over an aisle of pads and adult diapers.  I saw some Depends but I'm pretty sure that's not what I'm after.....I'm certain that they make specific maternity pads for after the birth, right?  If anyone has any advice here please share.  All the diapers and pads started to blur and then I lost the will, quickly exiting Boots and rolling my eyes that maternity pad shopping is now on my radar.

When I travel Chris usually audits my suitcase to stop me bringing too many things.  He says I like to take my clothes on vacation.  I'm not a fussy dresser, I just like options and tend to be indecisive.  That doesn't bode well for packing a maternity bag that I probably, hopefully, may not need.  Was this going to get stressful?

No!  Leave it to me to create unnecessary stress.  I'm going to stay strong; there are lots of check lists (yay, lists!) out there about what to include in hospital bags and on my walk home from Boots I promised myself that I'm going to take a minimalist approach....I'll tell you how I get on once I actually pack the bag.  Aside from working out where I can get some maternity pads and finding out what the heck arnica actually is, I have most of the things I need and ample time to get organized.

I've also stumbled across a not-so-surprising US/UK difference in hospital bag advice: In the USA diapers and maternity pads are usually provided; in the UK they are not and need to be packed (ahh, the differences of private, pricey healthcare versus NHS no frills).

Aside from the usual suspect advice and items to bring for mama, baby and birthing partner included on most hospital bag lists, here are a few other gems that I've heard.  If you have any other tips, please add a comment!

• Pack 2 small bags - one for labor and one for your hospital stay - this may help you stay better organized
• Remember to pack your glasses; even if you wear contacts, you may not want to wear them through labor
• Pack a pair of flip flops for the shower; if you're a clean freak like me who wears flip flops to the gym pool, this advice was a real winner!
• Bring along some baby wipes or cotton wool for changing your baby; these are not provided by the NHS
• Pack baby nail clippers or an emery board in case your little one has long nails that need trimming
• Pack your Baby Book to jot down all your baby's birth information

Parenting Trials - Prepare to be Judged

As promised here are my 30 week pictures - a close up of bump and shot of T&D and me during our weekend explorations.  T&D live in Holland and T tells me that home birth is very common and accepted there.  Following my research into the differing views on home birth in the US and UK, I was interested to hear of another Western country that champions home birth.  T, if you have any more information to share on this point please add a comment!

I was interested to read Kate Harding of Salon.com's comments on this story about a mother who was booted off a Southwest Airlines internal US flight with her 2-year-old because he wouldn't stop shouting "Go, plane go!" and "I want Daddy!"  Looking at and beyond this specific incident, Kate both suggests that parents have a responsibility to act like adults and proactively encourage appropriate behavior from their children in public BUT that sometimes even parents' best efforts are in vain and in those instances the greater public needs to understand and accept that kids are kids who can't always be reasoned into socially "correct" behavior.

I initially read this story because Chris and my transatlantic life is going to involve frequent plane travel and I'm anticipating needing to develop a bag of tricks for soothing an infant, then toddler then child when we take to the skies.  We are aware that confined spaces at 30,000 ft and screaming children are not an ideal combination, and I'm sure we'll do our best to make our journeys smooth for our family and our fellow passengers.  From this story's headline, Southwest's actions seemed pretty harsh at first glance; but then again, I wonder how much this mother did to soothe her little screamer?....

Little children attract attention, for themselves and for their parents.  They often can't be reasoned with and don't conform to social norms so I'm prepared to become less inconspicuous as a parent than I am now (or than I was before passers by started clocking my pregnant belly).  I don't know how I'll deal with this but I expect I probably won't have time, energy or the focus to really care, but I do agree with Kate in that parents need to be adults and encourage decent behavior from their kids.  If my little one is screaming in the middle of a supermarket and I'm more concerned with what brand of oatmeal to buy than quieting her, I will probably deserve dirty looks.  In fact, I'm sure I've dished out those same looks to women who ignore their crying kids and barge through crowded train stations running over people with their weapons, aka strollers!  But on the other side of the coin, if parents are genuinely trying to soothe their tantrum-throwing mite in the corner of a restaurant, I think fellow customers should cut them some slack.

As at parent every day is going to be a journey and trial, at home and in the public eye.  Chris and I are gearing up to enter an arena where everything from vaccinations to bathing to blankets to transatlantic travel will be debated and often judged, and we're just going to have to get on with it through all this white noise.  Having said that, I do feel it's important that parents act like parents and set some boundaries for their little ones whether at home or out in public.  As long as we are trying, hopefully others will recognize that and not be too harsh in their judgements!

29th Week Updates

One of my earlier postings on ebay shopping was just published yesterday on The Green Baby Guide!  It's a great site for discovering more about green pregnancy and parenting practices so do check it out after taking a peek at my article.

Yesterday I hit the 29 week mark; here's a snapshot of some developments:

Baby is now the size of a butternut squash - I am starting to wonder where these increasingly larger fruits/veg are going to fit inside my midsection!  My preg updates remind me to keep up with the healthy eating regime (was there ever a break from that?!) to fuel the rapid brain development of my girl, and her little bones now need lots of calcium since they are hardening!

I "officially" booked a home birth at my midwife appointment yesterday.  It didn't involve anything technical but it's now down in my "sacred" maternity notes, official notice that we plan to proceed in that direction!  I'm feeling very positive - slightly daunted - but overall pleased.  I know attempting a home birth doesn't necessarily mean we will have a home birth, but I hope we can.  I've done my research and feel as prepared as I can for someone that hasn't given birth already!

Let's Talk Therapy

Running late, Chris and I stumble into a cozy living room full of unfamiliar faces. The lighting is soft and comforting and there are cookies on the table. The atmosphere isn’t quite strained but not entirely comfortable either. There is an expectant vibe in the air.

We take our places on the sofa with a sheepish smile and an apology. Smiles and nods abound. Have we been transported into a comedy sitcom? No. Have we arrived for a group therapy session? No again. We’re attending the monthly NCT home birth talk in our area.

By now you probably know I’m interested in exploring home birth and I learned about this class from my area NCT bulletin board. Hosted by a woman who has had 1) a planned home birth that transferred to the hospital, 2) home birth and 3) planned hospital birth, it promised to be an informative and open forum from someone who has been there done that.

I’ve swayed back and forth on the merits of home birth, my main concern being that something may not go to plan that could harm our baby. This has been a major sticking point for Chris, who wasn’t at all convinced by this potential plan. I also had the impression that women often consider home birth for later pregnancies once they have a better understanding of how they will cope in labor and birth. So the pendulum swings between reservations and opportunity, though recently I am moving in favour of going for it. Once got over the somehow amusing shock that we were sitting in a session such as this, we both came away feeling encouraged about home birth for the following reasons:

• UK hospital midwives may care for up to 5 women simultaneously; at home birth you have one dedicated midwife who monitors you throughout established labor
• Hospital transfers can be quickly arranged for any home birth not proceeding as planned; in fact, because of your one to one supervision at home it’s more likely that a midwife will identify any issues “sooner” than she might in the hospital
• If being at home makes you feel more relaxed and at ease, this is likely to speed up and progress your labor, all in the interest and health of the baby
• If more relaxed, there is less chance you will need medical interventions during birth; if you do, the midwife is able to perform an episiotomy, use forceps and give you an injection to deliver the placenta at home
• Home birth is conducive to natural forms of pain relief: TENS, water birth, upright positions and gas and air (no epidurals)
• If you decide you can't cope with labor at home, a hospital transfer can be immediately arranged
• At home your husband/partner may feel less of a spare wheel and better able to get involved by virtue of it being your own home
• After birth there is no risk that your husband/partner will be dismissed from the post-natal hospital ward because it’s outside visiting hours
• Should any sudden, horrible, unfortunate incident occur, it is just as likely to happen in the hospital

Some of these points may be more specific to my area (i.e. we live 10 minutes from the hospital so if we needed a sudden transfer it could easily be arranged; home birth is an available birthing route through the NHS in my area so admin arrangements with the local hospital should a transfer to hospital be needed aren't a complicated issue as could be the case if using a private midwife; there are not the same insurance issues you may run into in the USA where home birth isn't always covered by insurance) but they are all food for thought if you think home birth may float your boat.  I'm not saying it's the way forward for all, but it may just be for me.

Mainstream Media Bias Enters Birthing Debate

My great college journalism professor, Michael Walsh, made it his mission to enlighten his students about the big black cloud of mainstream media bias at large within American journalism. I'm not talking editorial writing or even news reported from a publication with overt political sympathies (i.e. most of the UK broadsheet press), but the tendency for news reporters from "apolitical" sources to shun balanced factual reporting in exchange for stories that perpetuate or support a "hidden agenda."

The problem with this type of reporting is its widespread distribution of essentially skewed information to the public at large.

Earlier this week, the popular Today Show ran a short feature entitled The Perils of Home Birth that wreaked of journalistic bias. The feature, broadcast to millions, suggests that home births are becoming a popular, but risky fad amongst young urban professionals. The report doesn't include any interviews with certified midwives but instead gives air time to New York Magazine journalist Andrew Goldman who likens home childbirth to a “spa treatment.” It also exploits the single, sad story of a young couple who lost their daughter during a home birth - an incident that could well have occurred in a hospital. The report seemingly plays into the agenda of ACOG (American College of Obstetricians and Gynecologists)and its growing vendetta against midwives and out of hospital births. Riki's Lake's The Business of Being Born film is referenced in the feature, and she responds to the report on her site. The American College of Nurse Midwives, similarly disappointed, responds here.

I keep mentioning my interest in learning more about home birth, but stern voice over stories like this that cater to fear factor and emotion rather than fact are not inspiring or helpful. Shame on the Today Show. Rather than dig deeper into the pluses and minuses of home birth or explore the reasons for ACOG's firm stance against it, they threw honest journalism to the dogs.

It's times like this when I'm grateful for the UK's professional acceptance of home birth and efforts of NHS professionals, like my local midwife, to allow women to explore the facts and make informed choices.

"Tub" Trucking at 23.5 Weeks

Chris and his brother have been calling me "Tubs" for some time now. I'm pretty sure it's a nickname given with affection, thus I've not let it damage my self image too much and have overlooked that the name originated from the cannibalistic shop-keeper's wife from The League of Gentleman. But anyway - now, as you can see, at 23.5 weeks pregnant, the name is actually pretty fitting for the little tub at my front.

This week our baby is the size of a large mango. She is ducking, diving and kicking with regularity. I guess she's small enough that there is plenty of room to groove in my womb but large enough that I can really feel her. My weekly Babycentre update says the blood vessels in her lungs are developing in preparation for actual breathing, and at the end of this week she will be considered "viable" for birth (though she'd still need pretty in depth medical support to function). Other developments this week....

A huge shout out is in order to our fab friends E&L who are also expecting and due just about 10 weeks after us!! It's really exciting to have another good friend jump on the pregnancy bandwagon at the same time. E&B have been so helpful to me with their pregnancy tips and chats and I hope I can be of similar support to L on her journey. I'm sure we'll have plenty of insights to exchange - very exciting!!

Friday I had my third midwife appointment and was re-introduced to the kind and calming midwife that I met at our hospital open night a couple of months ago. She confirmed that "all looks in order" and our missy's growth is on track. I also spoke to her about my interest in natural birthing and exploring home birth. She suggested Chris and I attend the home birth night at our hospital next month to learn more; she was very encouraging, not at all dismissive or judgmental, and made me feel at ease about exploring our options. I'll keep you posted on what I find. But all around, it's all go!

Speaking of "going," every time a pregnant lady has a midwife appointment, you need to bring a urine sample in a little test tube thing so they can check your pee for glucose and protein. Being that peeing in a cup, or tube, has become a popular pastime by default, you'd think I'd be a bit better at it! Does anyone else have issues peeing in a cup or am I the only one with a sheepish hand raised here?! When I had my booking in appointment at the doctor they literally gave me a huge beaker to pee in that I couldn't fit between my legs. That led to some cool half squat crouching moves.... Now I need to regularly pee into this small test tube thing that is challenging with my urinary aim or lack thereof. Once I do hit the jackpot the tube fills really fast and is prone to splashing out at me. Gross. Maybe this is TMI, but I'm hoping I'm not the only one who has been embarrassed at the hands of this ritual!

Enjoy the 23.5 week close ups!

Medical News Flashes: Home Birth & Breastfeeding

The following two articles may be of interest:

On the My Best Birth site, Ricki Lake draws attention to a new study just out in the Canadian Medical Association Journal on the safety of home birth versus hospital birth. In brief, this article paints an encouraging picture of home birth that is worth a look.

Also -

Today the BBC reports findings of a BJOG study that indicates drugs oxytocin and/or ergometrine, commonly used to treat bleeding after birth, may impede a woman's ability to breastfeed her baby. The Swansea University team that carried out the study also found that high doses of painkilling drugs have a similar effect.

With healthy and not so healthy debate raging around breast versus bottle feeding (this weekend a friend just told us a funny story about bottle milk being referred to as "the devil's milk"), this study promises to add more fuel to the fire around factors that affect a woman's ability to breastfeed.

Though experts warn that no firm conclusions can be drawn at this stage, I think it's important that pregnant women are better informed about the about the associated risks of medications used during labour and birth. In the BBC article, Rosemary Dodds, NCT policy research officer suggests that "women at low risk of bleeding may not need to take these drugs."

Birthing Warrior

I’m nearly halfway into my pregnancy and am starting to think about the miracle of birth and mission that is labor. Actually, I’ll be honest – I’ve thought about labor and birth on numerous occasions since conceiving. As I’ve said and you may realize, I’m a thinker for better and for worse. I haven’t been to any of my pre-natal classes on this topic yet, but I’ve done some reading, asked around and formed some opinions. Who knows if these will change as hormones continue to wrack my body and my due date approaches; who knows if I’ll stick to my guns in the throws of squeezing a baby out of my lower regions…. But for this moment, this is where I am.

I always pictured birth as you see it in the movies: lying spread eagle on a hospital bed, pushing with all my might. I also promised myself that I wouldn’t shout nasty things at Chris like, “How could you do this to me?!!” Plus, I’d be comfortably numb by a wonderful, soothing epidural. With medical pain relief practices like epidurals now common place, why would I take on body splitting pain? Those natural birthing ladies had to be mental…

So I thought, until I started exploring and my initial perceptions on labor and birth came tumbling down, down down…

I was surprised to learn that many women don’t give birth in a hospital bed, but instead from an array of upright positions ranging from kneeling to squatting to down on all fours. Maybe I was naive here, but I really didn’t have a clue. Aided by birthing balls, floor mats, steady relaxation breathing, pelvic rocking and most importantly gravity, women who birth upright often deliver with shorter labors and less medical intervention like forceps, ventouse and episiotomy. Epidurals, on the other hand, leave you immobile from the waist down in a hospital bed, catheterized and with greater chance of distressing your baby and needing delivery interventions since the drugs slow your labor and reduce your urge to push!

In the United States, epidurals are a very common form of pain relief – probably why I’d always associated them as given for birth. In the UK, they are also widely available but perhaps not pushed as much as less invasive pain relief options like gas and air are popular (which doesn’t appeal to me either since I don’t want to feel giddy or drunk when laboring). But I’m not picky or nuts...I’ve just decided that I’m going to be a Birthing Warrior. I want to be upright, I want to use my “in for four, out for four” breathing and I want to get in a zone and deliver naturally. I’m also curious to learn more about those TENS machines. I can’t imagine how exactly birth is going to feel but I am preparing myself for pain – “good” pain, that I am going to power on through like a Spartan and triumph over in order to bring my baby into this world. Cue glory music.

Shock of shocks, there are an overwhelming wealth of resources out there on natural birth that I just don’t have time to sift through. For a good overview, check out My Best Birth, a website associated with Ricki Lake and Abby Epstein’s documentary film ‘The Business of Being Born.’ My friend SH suggested this film to me, and though I haven’t got my hands on it yet it promises insightful observation into the “medicalization of pregnancy” in the United States and the more natural birthing options and venues that women can consider. More on that when I’ve watched the dvd. I also happened across this Giving Birth Naturally Site, which has a lot of information on the subject. Encouragingly, when I asked midwife at my hospital about natural birthing, she was very supportive.

While I’m on a roll here, I’ll also throw in my new found interest in exploring a home birth. I like the idea of avoiding the germ infested hospital and giving birth in my own domestic bubble of bliss. The neighbors might think a wild fox got trapped inside our house, but I’ll get to recover from labor in my own bed, with my own nice food, safe and sound with my family. Ideal. Unless, family and friends remind me, I face any complications in which case “Isn’t it better to be in the hospital?” Hmmm.

Interestingly, the American College of Obstetricians and Gynecologists does not support home births while the Royal College of Obstetricians and Gynaecologists/Royal College of Midwives does for women with uncomplicated pregnancies. Then again, pregnant B shared this NHS article with me, which discusses how home birth risks are still unclear. So as usual, there is not clear or right answer. Weighing up all the factors, I’ll probably end up choosing the hospital but I am still going to talk to my midwife about home birth...

I know that each labor and birth is different and birth plan and all, I can’t over-plan and will just do what is best for baby and me in the thick of it. I'm not knocking any form of pain relief because if you have a choice you need to do what's right for you, but my mental plan of action is to go as natural as I can – and the mental part of it has to be half, if not a little less than half, the battle.