How Astronauts Are Born

Any medical labour ward I ever worked on, the managers knew that my passion was with providing physiology informed care. I was usually asked to look after women who wanted as little intervention as possible, like this one night in my early months after qualifying to practice as a registered midwife.

I was sent to this young couple having their second baby.

I knew how important the birth environment is. It needs to be calm and dimly lit. I particularly loved being up in the middle of the night to witness births. It is easy to create a birth cave when the rest of the world is asleep. Even the busy labour wards held a special atmosphere.

Background music ✔️

Aromatherapy diffuser ✔️

Low voices ✔️

Twinkle lights ✔️

Setting the mood is important. It helps the birth hormones flow.

She was on all fours, kneeling over a birth ball on the bed.

She was breathing deeply, focused, determined, eyes closed, her gaze turned inward. One surge and then the next.

Gentle encouragement from me.

Her husband's soothing touch on the small of her back.

Time seems to stand still in a birth room, every moment suspended in the expectation of welcoming new life.

Especially at night everyone gets drunk on the birth hormones as it all unfolds.

Very slowly I could see the little head emerge, or so I thought.

With every bit of her pushing effort there was a little more to see.

Her soft tissues were stretching perfectly and all the signs were there; birth was imminent. 

Suddenly a perfectly round bubble filled with water emerged with the baby's head inside of it.

I could see the baby's face, his eyes were closed.

I hadn't expected THAT!

This baby was going to be born inside his bag of waters.

Most commonly the waters release before this, or, the waters could have been broken by a midwife or doctor (this often represents the first step in a cascade of interventions and it is worth knowing whether you would like to accept or decline this at the birth of your baby if it is offered to you).

Bits of vernix were floating around the amniotic fluid as he blinked his eyes open.

He looked straight at me and then he smacked his lips.

Only there was no sound because he did it in his bubble filled with water.

Wow!

He looked like he was dressed in a space suit, his head inside his helmet, as he was looking around his new universe. The vernix seemed to sparkle in the low light that was flooding the room. It made it look as though the galaxy was reflected in this baby astronaut's helmet. 

What did he make of what he was seeing?

Just as I had finished that thought, his mother had another contraction and his body slithered out.

His father was mesmerised.

I helped the little astronaut out of his space suit and passed him through to his mother still wired to the placenta by the umbilical cord.

At this stage it is important to recognise that the birth is not yet complete. The placenta is part of your baby and it is waiting to be born. Witnessing this transition is nothing short of magical. If left undisturbed, this is a subtle unfolding as the baby's circulation is taking over to work independently from his mum. The interface between mum and baby is right where the placenta nestles into the uterine tissue and as the baby is starting to breathe on his own, the placenta gets ready to be born. 

The moment our little astronaut inflated his lungs for the first time was when he was passed through his mum's legs. He looked straight at her face and as she scooped him up he threw his arms open just in time to go chest to chest with his mum. His transition was gentle. He didn't cry, he just clung to his mum skin to skin. She took a moment with her baby hugged to her chest.  After about half an hour she felt the placenta detach from her womb and it slipped out with a push. 

The room smelled of amniotic fluid and frankincense essential oil. To me this is the smell of birth. If you love essential oils as much as I do consider packing some in your birth bag. They are fantastic at adding calmness and they can even help you with pain. I love using them for my clients.

Since this special night shift I have seen other babies born in their membranes. Sometimes the membranes cling to the baby's head snugly and sometimes a bubble of membrane is born way before the baby, but never have I seen another baby who was born with a perfect space helmet around his head.

I loved being at births and I saw the magic regardless of how the babies were born. Over time it became clear to me that women who really want physiology informed care because they know it makes an uneventful birth most likely are at a disadvantage. In the system I worked in women who understand physiology and are asking to be supported in its unfolding are seen as having 'unrealistic expectations'. Birth truly free from interventions is largely down to luck if you seek maternity care within the current climate. Lucky to go into labour before you are offered the first sweep around 'term', lucky to never have a blood pressure even marginally outside of range, lucky to grow your baby just right, lucky not to *have* pregnancy diabetes...the list goes on. Thankfully this little astronaut and his mum knew to comply with hospital protocol, he came on our timeline and so I never had to start talking about interventions. His mum 'progressed normally' but I have seen many a mamababy who didn't. Trying to give a parent who you've met for the first time fully informed choice in labour is nigh on impossible. 

That's why I handed my registration back to the NMC.

It's been three months since my last shift on July 21st and I haven't looked back. There's something to committing full on. The Universe truly does reward following your heart. Since I let go of my registration Essentially Birth has blossomed in ways I couldn't have imagined.

I've been able to give it all my attention. Freeing up extra time has meant that I could provide some body work support in labour to my regular clients and that has been beautiful. I even got to see a little boy tumble into the world not so long ago.

I've also had space to nurture my love for writing about birth and the birth world as I see it. Writing these blogs has become a solid part of my routine and I love flicking through my diary for inspiration. I am surprised at how colourful my journey through life has been. My reflections are rich and thoughtful and I am reacquainting myself with who I truly am. I don't always agree with my former self but boy do I love her! Of course I have changed perspective and I hope I keep doing so. I think changing one's mind occasionally is a sign of humility and it reflects growth. Looking back at myself through the lens of experience I can see that I was never all in on being an NMC registrant. Something about it felt off, I felt stifled but I was prepared to 'compromise' if it meant I got to be around birth. I was still buying the narrative that midwives were autonomous practitioners. The uncoupling began once I started to recognise that we weren't, not even a little bit. I know that there are many midwives who advocate for women in very difficult circumstances and I admire them deeply. They make a real difference to the families they serve and I hear about them all the time. Those midwives stand firmly beside the women they support but that doesn't make them autonomous. All of their actions are determined by the guidelines, even if they help negotiate out of guideline care plans for you in multidisciplinary team meetings.

Out of guideline care is defined by the guidelines.

Regulated autonomy is not autonomy. 

As a student midwife I learned how to calculate 'due dates' according to Naegele’s Rule. Doctor Franz Naegele was a German obstetrician who lived between the years of 1778 and 1851 and he left us with the pearl of wisdom that the duration of  a human pregnancy is 280 days. Midwives have gradually been exchanging their pregnancy wheels with scanner probes but ultimately that's the same concept, a due date is a due date no matter how arbitrary. Doctors decide when babies are due, midwives are just the messengers. I also learned that labour happens in stages. The three stages of labour were first described by Doctor Friedman in 1955. He based his findings on studying 500 first time mums at the Sloane Hospital for Women in New York City. Two of the most fundamental doctrines surrounding pregnancy and birth were issued by male doctors a long time ago. Regulated midwifery practice has never been informed by birth physiology and I would say that the guidelines have 'unrealistic expectations' of women rather than women having unrealistic expectations of birth. Midwives are employed as the messengers who nicely explain to you the things we need to do to you to save you from your own physiology. They dress it up as 'supporting normality' or the 'midwifery model of care', I did this, too. As Yolande Norris-Clark aka the Bauhauswife so brilliantly describes it, midwives are the controlled opposition to the medical model of birth. It took me a while to realise that midwives work under the same premise as doctors; the midwifery model is the medical model.

Back in my student days I couldn't yet make sense of exactly what it was that was tugging at me. I was, however, harbouring suspicion about some of the foundational concepts of registered midwifery. One of those is the fallacy of 'Evidence Based Practice'. 

On May 21st, 2007 I wrote this:

'[I] Was actually really motivated and inspired after the conference (a home birth conference in Dublin where I got to meet Ina May Gaskin for the first time a few days previously) but this week has knocked it right out of me gain. First of all we talked about Evidence Based Practice all week which can become tedious. Although I know why in the NHS evidence is important to move things on, I am not sure it is wise to totally disregard what is called anecdotal evidence when it seems so obvious that we are heading back to the roots. We need radical midwives! Why re-invent the wheel when nature has a perfect system in place for birth?' 

You can see I was naive. We didn't go back to the roots we are in the process of tearing them out and we still disregard the experiences of those who provide physiology informed care and witness caesarean rates in single digit percentages. We still need to learn to listen to anecdotal evidence because - as I see it - it is not possible to 'evidence' ourselves out of medicalisation.

Need perspective on your choices? My book can help you. It offers you a practical approach to birth preparation and outlines the rationale for the interventions you are likely to be offered in pregnancy together with a section for balanced and informed decision making. If you would like to book a one-to-one with me via zoom to discuss any particular questions you might have, email me at [email protected]

If you live in Northern Ireland, you have the opportunity to join me face to face for my 60-Minute Pregnancy Aromatherapy Sessions or 90-Minute Stretch And Massage Sessions at The Little Yoga House in Belfast or at The Greenhouse Wellbeing Hub in Dungannon. I also offer a Just Me Session for women outside of pregnancy at any stage in your life. Check my services out here. Just click on the location you want to see me at and find out abut my services.

On November 18th I will be at my stall at the annual Health & Wellbeing Day at the Stormont Hotel, Belfast. I will also give a talk and I would love to see you there.

On November 25th I am hosting an  Aromatherapy For Beginners Christmas Workshop in Belfast. Babies in arms are welcome!

I look forward to seeing you soon.