A Dad’s guide to natural birth and home birth
By David Wildhoney
Introduction
Childbirth is a rite of passage that men can be privileged to share with their partners. The experience will be more profound if it happens naturally, that is to say, without medical intervention. It can be an intimate, shared experience for the new mother and father, taking place at home, in warm, familiar surroundings with soft lighting and music. Natural birth can also happen in a hospital, or a birthing centre. Some feel more comfortable knowing emergency services are nearby in case something goes wrong. Things are changing for the better in hospitals, but they can be alien places run according to routines, which makes it harder to have a natural birth.
I’m a big fan of natural birth because of my own great experience. Some Dads go so far as to say the experience can be orgasmic (for her). I don’t think that’s quite accurate, and some Mums will get mad if you suggest such a thing. But most who have experienced natural birth will agree that birthing a baby is the most natural thing in the world, and it can be more ecstatic than it is traumatic.
I've distinguished between home birth and natural birth at hospital, because I want to make it clear that the important thing to me is natural birth if it is possible. My partner and I chose to have our birth at home, because we felt well enough prepared (see below), and because we thought it would improve our chances of natural birth. Our reasons are explained below.
I know I can come across as if the way we did things is the only way. I had to simplify the story down to the choices we made. But a lot of the time we felt uncertain, and today I am simply thankful that Fortune was on our side, and everything went well for us. I respect the decision of those who choose to birth using medical interventions. I hope you will understand my enthusiasm for the home birth we chose.
I've distinguished between home birth and natural birth at hospital, because I want to make it clear that the important thing to me is natural birth if it is possible. My partner and I chose to have our birth at home, because we felt well enough prepared (see below), and because we thought it would improve our chances of natural birth. Our reasons are explained below.
I know I can come across as if the way we did things is the only way. I had to simplify the story down to the choices we made. But a lot of the time we felt uncertain, and today I am simply thankful that Fortune was on our side, and everything went well for us. I respect the decision of those who choose to birth using medical interventions. I hope you will understand my enthusiasm for the home birth we chose.
Below, you will find my opinions and experiences. It’s not intended as medical advice or a guide to pregnancy. You should talk to the National Heath Service (NHS), as well as natural birth advisers such as independent midwives, if you intend to have a baby. It is my personal story, and I publish it here as advice and encouragement to those men, and women, who think they may want to take part in natural birth, but don’t yet know where to start.
Having a baby comes naturally
Some people might think that natural birth is not for them. In this modern era, we can hand over responsibility to medical science. Birthing can appear to be a scary process that we are not equipped to deal with. That’s not true. A natural childbirth is simply a contraction of the mother’s body that pushes a new baby into life. It’s what her body is designed for, though age and ill health can make birthing harder.
Natural birth aims for a birth that is free of medical interventions. As I say, I think hospitals are improving and may be the right choice for some, especially if you feel confident about home birth, but we decided home birth after careful consideration, as follows.
Hospital births also aim to be free of medical intervention, but the sad fact is that, in the UK, around one quarter of hospital births end up with a “Caesarean Section”. That is, a birth where the womb is cut open to deliver the baby. Sorry, there’s no really nice way to say that, and while the process is usually safe, it does leave scars and sometimes lasting damage and is unnecessary for most women. However, Caesarean is an easy way of resolving births that do not proceed according to the schedules laid down by the hospital. Intervention often starts when labour is slow to start. Then, medication is given to induce the contractions. If the cervix sphincter won’t open when contractions are surging, a Caesarean might be necessary. The use of epidural anaesthetics also helps to confuse the body’s natural rhythm.
Hospital births also aim to be free of medical intervention, but the sad fact is that, in the UK, around one quarter of hospital births end up with a “Caesarean Section”. That is, a birth where the womb is cut open to deliver the baby. Sorry, there’s no really nice way to say that, and while the process is usually safe, it does leave scars and sometimes lasting damage and is unnecessary for most women. However, Caesarean is an easy way of resolving births that do not proceed according to the schedules laid down by the hospital. Intervention often starts when labour is slow to start. Then, medication is given to induce the contractions. If the cervix sphincter won’t open when contractions are surging, a Caesarean might be necessary. The use of epidural anaesthetics also helps to confuse the body’s natural rhythm.
Ina May Gaskin is an American pioneer of natural birth, and her book, “Ina May’s Guide to Child Birth” became central to my understanding of giving birth. She reminds us that peasant women have babies in the fields and go back to work She compares birthing to having a poo. It’s all about sphincter control and relaxation. Imagine having a poo while a doctor in a white coat stares at your private parts, and you get the point. If you can’t bear to see such things written about, well, you may not be an ideal candidate for natural birth, but I would ask you to try to know and accept your physical dimension.
According to Ina May, only 2% of home births end with Caesarean interventions. She says home births sometimes go on longer than hospitals will allow them.
[Update: April 2009, the NHS posted a news article on its website which said that home birth is as safe as hospital delivery – see link below].
I’m not suggesting that people should avoid hospital. If there are complications, then you will need to go to hospital. If a home birth goes on too long, there comes a time when it s time to call the ambulance.
If you feel prepared for natural birth, and have an experienced midwife who will be there, you may decide to have a home birth, with hospital as an emergency option. Some people prefer the hospital environment, saying it makes them feel safe. Some hospitals are becoming friendlier to natural birth, and have maternity wards equipped with soft lighting, mood music and birthing pools. In all cases, preparation for a natural birth makes it more likely that you will avoid medical intervention, whether you choose to give birth in a hospital or at home.
Whether you intend to try for a home birth or prefer to be in a hospital, if you want to experience a natural birth with your partner, then you need to take responsibility for it from the start. Focus on the birth before you conceive, or as soon as you know you are going to be a Dad. You need to prepare yourself. Don’t be alarmed! This involves no more than simply getting yourself in good shape.
Preparing for Natural Birth
So, what do you need to do to have a natural birth? A healthy body and a positive attitude are all that is required. But for most of us, in these modern times, a little physical and mental preparation is needed. Both partners should do this, not simply to keep your partner company while she gives up the party life, but because Dads need focus too.
Preparing your body
Physical preparation starts with giving up drinking and smoking for some. Dads can argue that they be allowed a little flexibility here, since they are not directly nurturing the baby. But just as a woman's body and eggs are. sperm is affected by intoxicants and toxic living, and some say this can even affect the well being of a the baby conceived from your sperm. New Dads need to refocus on being a father, and giving up bad habits is a suitable start. A good target for sobriety is the birth date. As usual, take it one day at a time, and don't give up giving up if you falter.
We also need to get into good physical condition so that our bodies are ready for the physical work. Strength and suppleness are needed by both parents, but especially in the mother’s bones and tissues of the pelvis. Breathing will be important. So, go to yoga. There are special classes of yoga for pregnant women, and Dads need to encourage and make time for their partners to attend from the time that Baby is conceived. Dads who like an anaerobic workout might prefer Astanga. You can both share a morning routine of sunrise salutation that takes a matter of a few minutes and helps you bond at the start of the day.
In the last months of pregnancy, go on courses that will help you practice birthing postures, such as the National Childbirth Trust (NCT) courses, which you can attend as a couple. The NHS also offers a Saturday course on what to expect during birth. Go on both courses; don’t worry about duplication, repetition helps to make the process more familiar.
Preparing your mind
Mental preparation allows you to feel prepared for the physical event of birth. This starts with reading about birth. The rather dry medical texts that are given to you by the NHS midwife are a start. But I found that it really helped to read about real birthing experiences, both at home and hospital. Here, Ina May Gaskin’s book is unique. She describes scores of births that she has attended as a midwife, so you don’t need to feel so scared of the unknown. This is important because our western experience of home birth is so limited. We handed over responsibility to doctors who keep a professional distance from the processes of birth, which are at least partly emotional and even spiritual. So it is invaluable to read of the experiences of empathic midwives. This will give you the courage to think you can do it naturally.
The NCT course and the NHS course will both also help with mental preparation. You will learn what to expect, gain confidence, and learn about things that can go wrong, and about things that you need to make decision about. But one of the most reassuring things for us was a regular meeting with a private midwife. Reading and classes are good ways of learning, but nothing can replace the advice of an expert you learn to trust, and has time to talk to you. Below, I talk about our decision to use a private midwife.
You can also practice for birth through visualisation. Some birth preparations encourage visualisation of birthing as a muscular contraction, and release. Mental, spiritual preparation can be linked to the physical through breathing. Breathing is central to birthing, breathing with contractions. This is taught during yoga. You can extend this by meditation. Meditation encourages you to observe your ego and your body rather than to simply respond to their demands. This is useful not only during the birth contractions, which are so strange they feel like pain, (ok, here I am risking the wrath of women who tell me the contractions are pain and how would I know), but also in life after birth. The ability to meditate while your child is crying from teething, etc, is invaluable. My partner and I both practised vipassana meditation before birth, but you will also get this training from pregnancy yoga. Try to practice your yoga, pregnancy postures and breathing at home with your partner.
Start to make your home into a place for birth. Install a portable Jacuzzi in the lounge, a rubber plant, jungle lighting, mood music or what ever ambience you fancy. Relax in your birthing room. Massage your partner; help her ‘stretch her yoni’ (if she will let you). Let your whole life embrace your new role as birth partner and father.
Practical arrangements that need to be made for natural birth
1. Inform your GP and the NCT straight away
When you know you are pregnant: tell your GP, and ask about natural birth. Join your local National Childbirth Trust group, and meet up with your local home birth support group. In our case, we changed GP when we found one who supported our decisions.
2. Hire a midwife or join a support group six months in advance of the birth: Be informed
Hire an experienced and qualified birthing expert six months before the baby is due. They’ll help you make all sorts of difficult pre-birth decisions, meeting you for fortnightly checks in the comfort of your own home. Sounds expensive? My advice is to consider this a priority. Don’t spend on anything else in advance of the birth, no pram, no nursery, nothing, except the basic birth kit and a birthing pool. There'll be plenty of time for that, and it can be obtained relatively cheaply second hand. Invest all your money in a dedicated birthing expert. The NHS midwives are often excellent, but they are overworked and you can’t get a quiet space with them to discuss your fears. On the birthing day, you can’t rely on NHS midwives coming to your house. An experienced dedicated midwife might also save you from ambulance paramedics hustling you off to hospital for reasons of routine procedure. This happened to friends of ours, who separated her from the baby after birth just to run tests. Only later she found out this was routine.
As a very rough guide, a midwife (a registered nurse specialist) costs around £2,600 for the six months including and following the birth, and a lesser-qualified counterpart, a doula, costs around £1,000. Some doulas work for free. But do be aware that maturity, experience and clinical qualifications are important, especially if things go wrong. If you don’t have an experienced birthing partner, i.e. a qualified midwife, you might prefer to give birth in a hospital.
As a very rough guide, a midwife (a registered nurse specialist) costs around £2,600 for the six months including and following the birth, and a lesser-qualified counterpart, a doula, costs around £1,000. Some doulas work for free. But do be aware that maturity, experience and clinical qualifications are important, especially if things go wrong. If you don’t have an experienced birthing partner, i.e. a qualified midwife, you might prefer to give birth in a hospital.
Talking to a midwife six months before birth is important for dealing with the decisions you will have to make. I think you will be able to achieve the same for no cost, by being a regular participant in your local home birth support group. But I took the easier route and hired a midwife. It would be great to be able to reply on the NHS for this advice, but the problem with talking to NHS midwives is that often you see a different one each time, they are rushed, and have routine guidance for problems. So you can’t form a relationship, and if you are hesitant, they are inclined to tell you follow the NHS guidance, which can’t take into account individual circumstance.
I'm not going to go into all the details of birthing decisions that need to made, except to give one example of why you might want expert advice - simply deicde to do what the NHS tells you to do. We were told that my partner needed to have an injection of “anti-D” because she was Rhesus negative. But we had read that if both parents are Rhesus negative, that the baby will be Rhesus negative to, and there will be no problem, so no factor D necessary. But because the NHS procedure is to inject the mother, rather than find out the father’s blood group, the NHS refused to test for my blood group. I got tested privately. After that the midwives still wanted to inject anti-D into my partner, since they were not aware that there was an alternative. Maybe it sounds like I’m fussing, but I prefer not to be injected with stuff, even if the risks are only one in a million, and the same goes for my partner.
The NHS gives good advice, but there are alternatives. Having our own midwife on hand to tell us that our position is reasonable and within her experience, helped a lot when we were faced with implacable routines devised by the NHS. She advised us to ask the NHS doctors “what will happen if I don’t do what you suggest?” If the answer is nothing, then why do it?
I'm not going to go into all the details of birthing decisions that need to made, except to give one example of why you might want expert advice - simply deicde to do what the NHS tells you to do. We were told that my partner needed to have an injection of “anti-D” because she was Rhesus negative. But we had read that if both parents are Rhesus negative, that the baby will be Rhesus negative to, and there will be no problem, so no factor D necessary. But because the NHS procedure is to inject the mother, rather than find out the father’s blood group, the NHS refused to test for my blood group. I got tested privately. After that the midwives still wanted to inject anti-D into my partner, since they were not aware that there was an alternative. Maybe it sounds like I’m fussing, but I prefer not to be injected with stuff, even if the risks are only one in a million, and the same goes for my partner.
The NHS gives good advice, but there are alternatives. Having our own midwife on hand to tell us that our position is reasonable and within her experience, helped a lot when we were faced with implacable routines devised by the NHS. She advised us to ask the NHS doctors “what will happen if I don’t do what you suggest?” If the answer is nothing, then why do it?
There are a surprising number of decisions to be made, from whether to birth at home or hospital, whether to have ultrasound scans, whether to allow the doctors to take samples of amniotic fluid for antibody tests, whether to with vitamin K, and more. You can probably guess that in our case, we avoided just about all the invasive tests, but we did allow the heel prick test, and ultrasound, which let us see pictures of our foetus, and also allowed us to know that a Downs syndrome baby was unlikely. But, as we looked at the live ultrasound pictures, the tiny foetus struggled like crazy, and we wonder whether she felt the inaudible vibrations. She is very sensitive to sound now.
Note: at the time of writing, independent midwives cannot obtain insurance – see Insurance below.
You can find a midwife from Independent Midwives website (see below for link).
You can find a midwife from Independent Midwives website (see below for link).
3. Get a comfortable birthing pool (if you planning a home birth)
Get the birthing pool well in advance. Don’t get something you have to erect when the waters burst, and then fill with water, and then keep warm over a period of maybe 12 hours. One of the best tips our midwife gave us was to get the Jacuzzi-style pool branded as Lazi-spa. It cost £280, which was less than renting a specialised birthing pool. [Update Feb 2010: we obtained our Lazi Spa from DrinkStuff (link below), and the latest price was £397]. It is a fully featured, inflatable mini-spa, with heating and water purifier, so it could be set up three months in advance before the birth. An inflatable pool sounds flimsy, but the Lazi-Spa has two-foot-thick tubes for sides that you can sit on when inflated and full of water. It’s important, because your partner will need to bear down on them during labour. We turned our living room into a spa.
Enjoy having a spa in your home. Use it each night for bonding with your partner before you go to bed. It will relieve her back pain. You can both do yoga in it. It will be good for your sex lives. Then, come birth time, it will be already full of warm water, and a familiar place to be for both of you, with music and candle light standing by.
4. Birth box
A box of stuff you need for the birth, including chocolate bars and Lucozade for energy boosts and comfort for your partner, a birthing plan agreed in advance with your partner, in case you need to rush off to hospital and need a script, and a soft blanket and hat for the newborn.
Insurance
It is important to be aware that midwives in the UK are at present unable to obtain insurance cover for any accidents that might happen. A government review of this is due to report in June 2010. You can find out more from the Independent Midwives website (below), but so far as I know there is no compensation available when things go wrong in home birth, and your midwife should let you know of this. If this worries you, then you must have follow the NHS advice.
My birthing experience
The birth went quickly, and my partner hadn’t wanted me in the birthing pool at the end, so I felt that I had not contributed as much as I had imagined I would. But she said that she really valued my presence. She said that the moment just before our daughter was born, when I held both her hands and looked into her eyes, gave her courage to let go an allow that final contraction to sweep through her. The other things, she said, were that I organised a great birth pool, massaged her during labour (massaged her lower back, seated behind her), timed her contractions before the midwife arrived, protected her head from the tap when she was holding onto the sink, after trying sitting on the toilet, supported her down the stairs into the birthing pool, let the midwife and homeopath in, organised them in the next room, and that I knew where the Lucozade and chocolate was, and remembered the cotton hat and bamboo fibre blanket for our newborn daughter. Ah. So I am appreciated, then;-).
Finally, don’t be fixated on the perfect natural childbirth. We are, after all, in the hands of the universe, and anything may happen. If your midwife thinks it’s time to go to hospital, accept that and go. Whatever happens, the process of proper preparation for birth will leave you enriched and ready for the process.
Links
This birthing experience happened in March 2008, and this article updated in February 2010.
***ENDS***
Maybe instead of disclaiming your oversteps before making them and then considering yourself absolved, realize that those sensations ARE PAIN. Deal.
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