birth, childbirth education, choices

Why did we first start writing birth plans?

Ever wondered about the history of Birth plans?

Why do women spend all this time in pregnancy listing the different things they want (or want to avoid) in their pregnancy, birth or with their new baby?

This short lecture starts the discussion about the history of birth, human rights in childbirth, informed consent – and where birth plans might fit in with all this

Understanding the history of birth including obstetric practice in the 20th century can give really great insight into the development and idea of birth plans.

Who was Sheila Kitzinger and how is she relevant to a discussion about birth plans?

Begin a discussion about human rights in childbirth and consent and see how birth plans can help you.

 

Prefer to listen on Soundcloud? I’ve got you covered!

 

Keen to know more about any of this?

The history of birth:

http://www.slate.com/articles/health_and_science/science_of_longevity/2013/09/death_in_childbirth_doctors_increased_maternal_mortality_in_the_20th_century.html

Sheila Kitzinger:

On birth plans:

https://www.researchgate.net/publication/229837300_Sheila_Kitzinger’s_letter_from_England_Birth_plans

https://www.independent.co.uk/news/people/sheila-kitzinger-natural-childbirth-advocate-who-challenged-the-medical-establishment-and-aimed-to-10182999.html

About human rights in childbirth

Human rights in Childbirth:

https://theconversation.com/50-years-on-were-still-fighting-for-womens-childbirth-rights-15016

https://www.midwives.org.au/resources/human-rights-childbirth-and-midwifery-care-joining-hands-change-21st-century-any-woman-any

 


 Jennifer Hazi is a mother, midwife, childbirth educator and doula educator & mentor in Sydney, Australia.

She is really passionate about women having voices and choices in maternity care and absolutely loves working alongside women and their loved ones during this time. 

She teaches childbirth and parenting education online and in person, works clinically as a midwife and provides physical and educational support to families with new babies up to 3 months old.

Jen also speaks and writes regularly about childbearing, motherhood and transitioning to parenthood.

birth, childbirth education, maternity system

10 ways to give birth like an anarchist.

  1. Ask questions. About everything. Literally everything. “What are you doing? Why are you doing that? What other options do I have? Are there any risks with doing that? What else can you do instead?” Ask questions about where you birth, when and with whom. Ask what the evidence is and if there is any contradicting it. Learn about levels of evidence and recommendations in pregnancy. Know your hospital’s policies on induction, monitoring, appointments, home visits, breastfeeding and bottle-feeding, support people, bed sharing, everything. Read every one. And learn the difference between policy and evidence.

  2. Birth at home. On your turf. This is probably the closest you will come to completely disrupting the system. When you invite your midwife in, it is in your space, according to your rules.

  3. Say no. Without justification or explanation. (You know, there is no legal requirement for you to give a good enough reason for refusing something?)

  4. Be difficult. Don’t sit down, stand up. Let them sit. You have the power, you take the higher ground. Tell them to wait when they knock on the door, and if they come in unannounced send them out again. Reclaim your space and your privacy. This is your body and you choose who sees it. Be that “bad patient” the one who takes their time, who waits until they are completely sure to make a decision. If your appointment isn’t long enough ask for another one. If that’s not enough ask for another.

  5. Move beyond the binary thinking. It isn’t public v private, midwife v doctor, home v hospital, vaginal v. cesarian. There are a million different possible ways your birth can go. I guarantee there is always a third option. It is possible no one has thought of it yet. It is NOT possible you only have 2 options. This kind of thinking makes people very easy to control. Tailor your care to your needs. Be in the centre of every decision. All of you. Not just your uterus and the life it contains, but your hopes, dreams & identity including spirit and emotions.

  6. Prioritise your needs above your baby. You matter. You matter because you are a person in this world and your experience and decisions matter. You matter just because of you. It is also good to know that no one in this world will love and care for your baby more than you will. So make sure you are ok, because if you are ok you can make sure your baby is too.

  7. Make decisions based on your feelings. The maternity system is obsessed with data. There is a risk for everything, Every choice has a number. And sometimes those numbers are really important. and sometimes they are arbitrary. It is ok to make a decision or not make a decision based on how you feel. This is just another kind of knowledge.

  8. Never ever ever start a sentence with “Am I allowed to…?”. Try “I want to”. Or even “I am going to”.

  9. Know your power. learn your rights. Get a doula. Collect the people around you that hold you up. Don’t allow anyone in your space that keeps you small. That is your mental space as well as your physical space. You are so powerful. You have not just created but also gestated a baby inside you. Your body is amazing. Don’t let anyone make you feel anything less.

  10. Change your mind. If it feels like things are spiralling out of control or even gently heading in a direction you don’t feel comfortable with and you want to get off the train. Get off. Shut it down. Try something else. You DON’T have to do anything just because you said you would. You have no obligations to anyone but yourself. And I mean only yourself. Not you and your baby (see 6). Change your mind whenever you damn feel about it.

 


Jennifer Hazi is a mother, midwife, childbirth educator and doula educator in Sydney, Australia.

She is really passionate about women having voices and choices in maternity care and absolutely loves working alongside women and their loved ones during this time. 

She teaches childbirth and parenting education online and in person, works clinically as a midwife and provides physical and educational support to families with new babies up to 3 months old.

Jen has also teamed up with some amazing doulas, midwives, IBCLC’s and other professionals to facilitate advanced learning and education for doulas and birth workers at We Birth.

Jen also speaks and writes regularly about childbearing, motherhood and transitioning to parenthood.

 

birth, caesarean, childbirth education, induction, maternity system

Making difficult decisions

 

During pregnancy and birth, many women are required to make decisions or agree/decline care plans offered by their doctor or midwife. 

In other areas of health, we might have the opportunity or feel secure in asking for second opinions, researching other options or just saying no.

When we are having a baby however, quite often our default position is to give our decision making and reasoning over to the “experts”. After all we don’t want to make the wrong choice… and what do we know?

Unfortunately, not all decisions are so black and white, not all opinions of all midwives, doctors, birth centres and hospitals are the same, and not all policies and standard protocols are made for you, with your unique circumstance, opinions and beliefs.

Some people caring for you and yours have a very narrow focus of what “safety” is. Does safety in birth simply mean that you and your baby survive the experience without obvious disability or morbidity? Or does safety in birth mean that at the culmination a strong and vibrant woman is physically, emotionally, spiritually and mentally prepared for the work of mothering? With a baby that is switched on and primed with the instincts and reflexes to thrive?

Does safety in birth simply mean that you and your baby survive the experience without obvious disability or morbidity?

Or does safety in birth mean that at the culmination a strong and vibrant woman is physically, emotionally, spiritually and mentally prepared for the work of mothering? 


Asking questions doesn’t make you a disagreeable patient. It makes you a woman prepared for the responsibility of motherhood. 

If you have time (in pregnancy for example) working on a birth plan can be a helpful tool to guide your decision making, or at least give you some idea of good questions to ask.

If childbirth is throwing you a curve ball and you need to make decisions on the fly, the BRAIN mnemonic is pretty helpful to give you some questions to ask, and help you tease apart your feelings and options when making decisions.

Asking the person caring for you “is this necessary?” just doesn’t cut it. Generally speaking the person caring for you doesn’t get into the business of babies because they are uncaring, so if they are offering you an intervention/ solution/ plan of care if it usually because they think it is necessary.

Using the BRAIN mnemonic you will have an opportunity to weigh up your thoughts about the offered plan. its pretty simple and you can save it and keep it with your hand held notes.

 Women centred care. It means that although you might employ people around you to care for your baby and you medically, ultimately you are the one who


Benefits: What are the pros to this plan? (usually pretty easy to answer)

R

Risks: What can go wrong with this plan? (“risk” is a funny word to use, but the truth is nothing in life is without risk, so whatever you choose will not be completely risk free. Walking down the street is risky, driving a car is risky, and i have heard it said that “birth is as safe as life gets”. Word of warning: If someone says there is NO RISK to an intervention they are offering i’d advise digging a little deeper)

A

Alternatives: What are the other options? Are there second opinions? What do other doctors/midwives/hospitals/policies do? Tell me all the options and scenarios.

I

Intuition: What does your intuition tell you? Is this decision feeling right? We may have fear, and this still might be necessary. I’m not saying everything that is offered is going to feel great, but try and listen to your inner-self when you decide if this feels correct.

N

Nothing. What about if we wait? Don’t do anything? Go home? Come back? Come back later? Change our mind? Get off the train? (you get the point). Sometimes we are not at a point of no return, even if it feels like it. Is it just a scheduling issue, or is there an actual concern with your/your baby’s health?


 

The great thing about using your brain is it is not about “pushing an agenda” or any kind of birth philosophy.

It is all about giving you a voice, and helping you be in the centre of decision making.

Where you belong.

 


Jennifer Hazi is a mother, midwife, childbirth educator and doula educator in Sydney, Australia.

She is really passionate about women having voices and choices in maternity care and absolutely loves working alongside women and their loved ones during this time. 

She teaches childbirth and parenting education online and in person, works clinically as a midwife and provides physical and educational support to families with new babies up to 3 months old.

Jen also speaks and writes regularly about childbearing, motherhood and transitioning to parenthood.

birth, maternity system

Searching for a safe haven in all the wrong places

Nearing the end of your pregnancy, the sun sets as you begin to feel an odd, warm niggle. Noticing your stomach begin to tighten, mild cramping sensations come every now and then like little waves in the lower part of your abdomen. This is it. You think (you hope, but not completely believe) it is the beginning of your labour. 

 As the evening wears on you may experience some diarrhoea, notice a “show”, and begin to feel a little out of your head, somewhat separate from the world. 

You have prepared yourself for birth and discussed early labour in your birth class. This was confirmed by your midwife or doctor, and you know that this doesn’t mean your baby will come straight away. It could be hours or even days for these mild (and still exciting) niggles to build into the powerful waves you are expecting “active” labour to be made from. Do you call your midwife/doctor? 

No? yes? when?

 

 

You have been forewarned that until your contractions are rhythmic and regular, with a rawness and real intensity you are better at home. “stay at home as long as you can” they said. Armed with heat packs and a little guidance on warning signs, as long as things “remain normal” you are told you don’t need help.

But this is only partly true. Of course you need help. But what is the price of seeking help early in labour?

Your body is telling you this is the time for you to start to retreat into your nest, to ensure you are safely in your birthing space.

While your wits are still about, your neocortex is still firing and you haven’t travelled too deeply into labour land, now is the time to draw near to you the people you trust and care for, who will take over your higher reasoning. This is when you should be able to safely switch off the part of you that needs to think and reason and instead focus inward on your child and your inner self. This will help increase your oxytocin production and (you have been told) that is the key to effective contractions. Contractions are of course the ticket to meeting your new baby.


Your body is telling you this is the time for you to start to retreat into your nest, to ensure you are safely in your birthing space. While your wits are still about, your neocortex is still firing and you haven’t travelled to deeply into labour land


But you have been forewarned the hospital is not the place for you right now. Instead, women are told, openly, honestly, from a place of love and care; “stay home”, “not yet”, “it’s too early”. It is known, the midwives cry “You don’t want to be here too long/ too early”. If you are found in hospital labouring in the early stage, the pre labour, the false labour, all names for the stage of birth when productivity and efficiency are not generally expected/demanded, someone here will take umbrage with your inability to withstand isolation in your most vulnerable state.

You thought to come to hospital wanting someone to see you, to witness. But instead, now, you’re being watched. You feared being ignorant of labour and now you’re surrounded by authorities in birth, and your body is their jurisdiction. 

In a perfect world, women at the beginning of labour (if not birthing at home) will use this time to transfer to the safety and warmth of their birthing space. To wrap themselves in the sacredness of this time and patiently await the progression of their labour. Allowed space and time for this to unravel organically, not needing to be consciously analysing the strength and regularity of their contractions to determine the perfect window of time to relocate to the hospital. Now we fear arriving too early, only to be told to return home, or too late. At best they have an experienced friend or doula who can help guide them through this decision, at worst she is alone or with her partner who is equally terrified and overwhelmed.

Women are told constantly throughout their pregnancy, in many subtle ways, that birth is dangerous and that only with the experts are they ever truly safe. Then the moment their body sends them the signal to seek out sanctuary they are dissuaded from listening to that most primal instinct.


Women are told constantly throughout their pregnancy, in many subtle ways, that birth is dangerous and that only with the experts are they ever truly safe. Then the moment their body sends them the signal to seek out sanctuary they are dissuaded from listening to that most primal instinct.


During the majority of their labour; slow and cyclical as it may be, women are told their place of birth is not available to them. 

Come in pushing they joked (or were they serious?). Stay home with your fear, don’t squander our reassurance – we are stockpiling it for later. So call us if you’re worried, we do this all the time, your body says find safety, but it’s wrong, trust us, we know. 

We know this place isn’t safe for you yet. We can’t keep our hands to ourselves, and you need to be untouched for as long as possible. 


 

Jennifer Hazi is a mother, midwife, childbirth educator and doula educator & mentor in Sydney, Australia.

She is really passionate about women having voices and choices in maternity care and absolutely loves working alongside women and their loved ones during this time. 

She teaches childbirth and parenting education online and in person, works clinically as a midwife and provides physical and educational support to families with new babies up to 3 months old.

Jen also speaks and writes regularly about childbearing, motherhood and transitioning to parenthood.

Find her at www.jenniferhazi.com