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Birth Stories - The Nudge

Authored by Jenny


This one’s close to my heart. I’m lucky enough to have 2 daughters, and have had 2 vastly different births. One (nearly in the car) with the full natural hormonal release of love, and the other medically managed, leaving me shocked and uncentered. Of course I’m always, always just glad to have them; but the road to birth, like the road to conception, doesn’t always go as planned.


As the fabulous Melbourne birth educator Rhea Dempsey says: “In many cultures and across time, the challenging journey of pregnancy and birth was celebrated and honoured as a transformational process, ‘a rite of passage’. Women were supported in this journey, and enabled to find the inner resources they would need to become powerful birthing women and strong mothers. Often in our highly interventionist ‘labour-bypass’ era, a woman’s need to consciously experience this transformational process is not fully recognised or adequately supported.”


Of course all we really want is to hold our little one at the end of it. There are many ways to birth a baby, and this is certainly not to say that one way is better than another. Each woman’s circumstances, risks, and preferences are different, and will be discussed with her care-givers. Interventions such as caesarean sections and inductions can be life saving. For some, because of medical complexity, that will be exactly what you and your baby need, and for some women it’s what they choose, and it’s great that we have that choice.


But for those women who would dearly love a natural birth, the medicalisation of birth means it can be hard for them to have their voices heard, to feel truly listened to, or to feel that everything was done to support them. Again, everyone’s circumstances are different, and this is not in any way to say that there is one right way to birth, rather that women should be listened to.


Complicating and underlying all this is what Rhea describes as ‘the nudge’ towards medical interventions. The idea of the nudge was devised by ‘behavioural economists’ (which in itself is a terrifying term) where opting out of interventions is more difficult than going along with the default processes, such as induction or augmentation, epidural, and far too commonly ending up in caesarean section.


The World Health Organisation states that no country in the world should need an induction rate higher than 10%, or a caesarean rate higher than 10-15%, with a caesarean rate above that causing more health problems than it solves. In Australia those rates are 35% for inductions, and 37% for caesareans, reflecting a contemporary birth culture that does not prioritise natural physiological childbirth.


These interventions are of course sometimes life saving. But in order to support those healthy, low-risk women who are both willing and able to have a normal physiological birth, there needs to be strong and experienced support around them - intention isn’t aways enough, as ‘the nudge’ is especially difficult to actively resist when immersed in the power of labour.


What can women do? Choose caregivers who are aligned with your birthing philosophy. If that’s your trusted OBGYN who has been with you every step of the way, great. If you are yet to decide, and keeping your birth as natural as possible is important to you, surround yourself with those who will support you when it gets tough.

  • Seek out midwife-led care, as this has been shown to result in fewer interventions. Ideally with the same midwife throughout, so that you know, understand and trust each other. This helps you to feel safe, and lets your body get on with it.

  • Whether it’s your first or subsequent pregnancy, get to know the terrain of birth: get some independent birth education at around 6-8 months of pregnancy.

  • Prepare yourself for the physical demands of labour. Undertake focused regular practise: increase your stamina and ‘working with pain’ capacity, perhaps through walking, swimming, pregnancy yoga, physio, stretch or dance classes. Practise breathing, relaxation and body-awareness release processes in order to develop this capacity and resilience.

  • Consider who you have with you in labour. Does your sister or mum (or partner) know what natural birth looks like? Will they support you and your wishes when you yourself feel like it might be too much? Rhea talks about ‘crisis of confidence points’ where things intensify, which may come early in labour, and can be welcomed and worked through with support.


We are lucky here to have some fabulous birth educators and doulas (birth attendants who are there to support the birthing woman) who can give you confidence in your awesome natural ability to do this, and be clear about what you would like to happen, as well as give you techniques to help you when it gets intense. Because it does, magnificently.


Birthing calls on, and releases, our deep, wild, ancient knowing. As the power of the birthing body increases during labour, it goes far beyond what we experience in everyday life and comfort zone. Even the best prepared can hit crises of confidence, and we all need people we can rely on. They are out there, call on them.


Selected resources are listed below, or find others that resonate with you.


Education:

Kath Maxwell, Calmbirth https://www.innerbirth.com.au/

Mindfetalness – to increase attunement and bonding through perception of the baby’s movements, and therefore have more confidence in how the baby is going. https://www.mindfetalness.com/en/


Perinatal care (includes education):

Tanya Hodgkinson https://www.themidwiferycentre.com.au/ Shared midwifery care for those women giving birth at Geelong Hospital

Rosie Fitzclarence https://www.geelongborn.com.au/ Hypnobirthing, birth education and perinatal support

Private midwives for home births: https://thebirthhouse.com.au/

Doulas:

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