How To Exit The Maternity Merry-Go-Round

My clinic last week was full - busting even - which is a true blessing.

My clients frequently comment on my positive work environment and each time they do. I pause and count my blessings. I have always been lucky in that I have been able to see my previous work places for the positive things that happen in them but I have never worked in a space where the energy is quite as clean.

All of my work now happens at The Little Yoga House in East Belfast and stepping into that space is immediately soothing on the nervous system and everyone comments on how relaxing it is to be there. Tara, the owner of this cute little haven, has lovingly curated a space that is home to a community of women at all stages of their lives. Everything in The Little Yoga House is toxin free. The wax melts, the cleaning products and (most importantly) the vibe.

I work in “The Snug” which is an ideal space for me.

Every Tuesday and Wednesday and some Fridays and Saturdays I set up my couch: sheet, heated blanket, sheet, then the positioning system to facilitate comfortable side lying, leave out a blanket, the wedge pillow for the bump and two cushions for leg positioning - ready!

Over on the little shelving unit in the corner I set out my essential oils and carrier oil. Simply unzipping my essential oil bag allows the scents to escape and immediately the room fills with the most exquisite smell.

Then I set up my laptop and start my playlist of 432hz Solfeggio frequencies and my clients start to arrive one after the next bringing with them not only their hopes and dreams but also their worries and concerns.

There are some concerns that come from self doubt. The usual questions like "will my baby be okay?", "will I cope in labour?" or, my favourite: "How will I know that I am in labour?" (you will!).

Outside of these, most of my clients' concerns are instilled in them at their routine appointments. It is a true shame that a lot of the time women are more scared leaving an appointment than they were going in. 
It seems that reassurance comes in small doses and practitioners are quite matter of fact these days about ticking their boxes.

"Women need to be made aware of the risks of birth" has been the mantra ever since the findings in a landmark court case back in 2015 and ten years on the anxiety that practitioners transfer to women as a result is beyond the pale.

The Montgomery case brought the informed consent argument to the fore and it resulted in a change in the law around consent. Rather than basing a recommendation on clinical judgement and opinion, a doctor has since been obliged to take “reasonable care to ensure that the patient is aware of any material risks involved in any recommended treatment, and of any reasonable alternative or variant treatments.”

On paper this looks great, doesn't it? 

What does it mean to take reasonable care to ensure that someone is aware of "any material risk" of a recommended treatment?

The Montgomery case outlines the importance of exploring "treatment options" and comparing them against each other, but increasingly "waiting" is treated in the same way, especially waiting when some issue has been identified (which is almost always). 

Women who decline treatments often have the wits scared clean out of them.

The word ‘stillbirth’ rolls off midwives’ and doctors’ tongues far more easily than ever because ultimately that's a "material risk" regardless of what you do. You decline intervention, your baby could get injured or die (but most likely won't), you accept intervention, your baby could get injured or die(but most likely won't) and you are responsible for whatever choice you make.

"Informed choice" means that your midwives and doctors throw the hot potato to you - that's all. It's an impossible situation to be in as a woman.

For many first time parents the decision seems easy, they'll go with the recommended course of action because the experts know best.

Chances are that second or third time around women start to question the maternity care pathways and they often do it with scars on their wombs. A previous caesarean section is a so-called "risk factor" along with an evermore endless list of other "risk factors". 

Welcome to the maternity merry-go-round where we turn healthy first time mums into "high risk" mums by ignoring birth physiology and then, when they come back wanting to do things differently next time, we tell them that they have this or that risk factor and therefore they "can't".

The good news is that you can do whatever you want! You don't have to have any routine maternity care at all if you don't want to. The other good news is that if you would never consider a freebirth, you can speak to midwifery sisters or consultant midwives and arrange for an out of guideline care plan. This will require self-advocacy in the run up to labour and you will have to have your partner ready to point to it and advocate for you in labour if necessary. 

But what about this lingering doubt that might now be stuck to you? Now that you have been told in great detail all the things that can go wrong, you might be pre-occupied with those thoughts rather than the anticipation of welcoming your baby.

With clients who tell me that they can't get a scenario that has been described to them out of their heads I usually offer some perspective on the idea of “risk”.

“For instance”, I’ll say, “you got into your car to come see me today - with your bump. Did you focus on the worst case scenario that could happen every time you sit behind your steering wheel, or did you just focus on getting here? Let's find out how likely it is that the scenario you are afraid of will happen at all and take it from there."

Most likely - regardless of what you choose - you and your baby will be fine. 

Recently I have been finding it very easy to relate to this primal fear for the safety of your child. My baby is twenty five years old and has just come home from five months travelling around Peru, Columbia, Guatemala and New York City. The last two or perhaps even three months she’d been travelling by herself.

I know that she is more than capable of solo travel 6000 miles away from home but I also sometimes got afraid of never seeing her again.

When I did feel that fear, I resorted to the hypnobirthing method that I developed and then published in my book back in November 2022.

It’s called the R.O.A.D. To Birth Hypnobirthing method and it goes like this:

R. - Recognise and Release your fears
O. - Overcome obstacles
A. - Accept what you can’t control
D. - Do the work

R.O.A.D. To Birth is part of the Born Through Yoga Movement for Birth and Nurturing Newborns programme, now, and those couples who apply and practice it really love the approach.

Born Through Yoga has the added element of movement in pregnancy and during labour which is integral to birth but lacking in most hypnobirthing approaches. Currently the online programme is on pre-sale, check it out here. 

The acceptance piece is the most challenging part of the puzzle. I find this to be true for most aspects of life. I had to breathe deeply and trust my daughter to find her way and just like the vast majority of babies, Lena arrived home safely. I am happy to report that Lena is currently soundly asleep on the sofa in our newly decorated living room with Dylan-Gherkin (the cat) on her chest.

Just like my clients, I had to acknowledge that there was the possibility of tragedy, which is always there, and yet, the most likely outcome - despite venomous spiders, crocodiles, snakes, volcanos, scuba diving, skydiving, several bus rides stretching across an unfamiliar land, plane rides, NYC subway trips, solo walks around NYC neighbourhoods and a final long haul flight home - was that Lena would turn the key in the lock of our front door last Wednesday morning and be home.

And so it is.

After twenty years of working in the world of birth, most of those as a registered NHS midwife, I can say with certainty that by far the most likely outcome for you is that one day you, too, will worry about your baby travelling the world. Try not to allow yourself to be overwhelmed by the risk-based language that you will be exposed to in your pregnancy journey.

Birth is overall safe for you and your baby.

Has your maternity journey been reassuring or fear inducing? Let me know in an email to [email protected]