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THE COMPASSIONATE BIRTH by Love Alda

There seems to be two ‘camps’ when it comes to birth these days – the pro-natural camp and the medicalised camp (with a lot of sub-groups in between just to confuse matters even more). A lot of emphasis is placed on how babies physically enter the world (and rightly so), but somehow the emotional journey & challenges that birth and the first wobbly steps into parenthood hold, is often neglected. As professional birth photographer, mentor and three-times mother, I get to witness both the best and the worst of both these schools of thought. Sadly I often see women who feel confused, unheard, pressured and disappointed in birth as a result of these very polarised views.

I have seen enough to know how incredibly empowering natural birth can be and how often unnecessary interventions can lead to traumatic birth experiences. The truth is for the most part Mother Nature is on the side of the laboring mother and the benefits of natural birth are countless from reducing the risk of post-natal depression (something I am but too familiar with) to just feeling good about yourself. I have also, however, seen how medicine saves lives and how mothers are made to feel that they did not give birth if they did not do so naturally. Somehow the heart of birth is getting lost in a series of protocols, procedures, policies, practices and facilities unconducive to birth on the one hand and choice-bashing, stigmas, pressure and rejection on the other.

I think a good starting point is to say that for most women birth can happen in an un-eventful, natural way if they so choose and are adequately supported in their choice. If we lived in a perfect world I would wish that for all. But for some (a very small percentage I might add) it can be catastrophic and in those instances I am but too grateful for medical intervention that takes nature’s laws into account. It is clear that as with breastfeeding vs. bottle feeding, there is a time and place for both natural birth and c-sections and that compassion is what is truly lacking in today’s ‘modernized’ births. The focus should be on optimizing the birth experience for the parents from both a clinical and emotional point of view and aiming for positive births and not perfect births.

Clarity creates confidence and I would like to encourage parents to follow these 5 steps in achieving an empowered, optimized & positive births.

1. Select a Compassionate Birth Team that is Right for You

Do you know how often I am told by pregnant clients that they do not like their OBG’s ? And yet they follow their advice blindly and let them lead one of the most important experiences of their lives ‘because they know best’. There are OBG’s and midwives out there who respect nature’s laws and care about both you clinical and emotional well-being. Health-care providers who would honor your preferences in birth as far as humanly & safely possible and not try and ‘scare’ or ‘guilt’ you out of your choices. Granted they are not a dime a dozen but it is worth putting the effort into finding them.

Doulas can also be invaluable when it comes to setting the ‘tone’ for your birth team, but ideally they should just have to reiterate your preferences – not fight for them as so often happens. Unfortunately there is a lot of improvement to be made by some of the hospitals in South Africa when it comes to honoring mothers’ experiences, but that is a topic for another day and for now doulas can help bridge that gap for you.

2. Empower yourself with Knowledge

You do not know what you do not know. This rang very true for me when I was breathing through incredibly painful surges, courtesy of my induced labour. Clarity creates confidence. Knowledge is indeed power. Knowledge that is – not just information. Information without context can leave us confused, overwhelmed and very unclear. Enroll yourself for an independent pro-choice antenatal course – one that will cover ALL aspects of birth (before, during and after) and give you a lot of ‘do’s’ instead of ‘don’ts’. Decide what is important to you and then discuss that with your birth team. Together you should outline your ‘goals’ and develop a ‘loose’ plan for achieving as many of them as possible, remembering that birth can sometimes be unpredictable. In Sister Lilian’s words, “Women must be given an option A, B and C and whatever works for her on the day is the best plan.”

3. Pay Attention to Your Birth Environment

One of the main reasons why some women choose home births is because they know their preferences will be respected there – they are masters of their own universe at home and feel relaxed and at ease there. But not all of us can or want to give birth at home. If you are choosing to give birth at a hospital / active birthing unit you need to make sure that they can address your needs from both a physical and emotional point of view. For example: if you want a water birth you need a hospital that allows and encourages water as a form of pain management. If you have a high risk pregnancy the neonatal facilities might be important to you.

4. Aim for a Positive Birth – Not a Perfect One

How you become a parent is far less important than becoming one, however to minimize the importance of your birth experience would be like telling a blind person he should be grateful that he is not in a wheelchair. Your birth experience is important, but it doesn’t stop being important because you chose to give birth at a hospital or a C-Section was needed. You would, however do well to know that although birth can be extremely positive and empowering the “perfect birth” does not exist.

It is wrong to coerce women into having C-section or traumatic vaginal deliveries for your own personal gain, but promoting the notion of ‘the perfect birth’ creates stigmas, illusions, pressure and ultimately disappointment in birth. I’ve seen hugely traumatic natural births (in both the home and hospital environment) and I’ve seen empowering, gentle C-sections. I’ve seen women feel fantastic about themselves after an empowered natural birth, but I’ve also seen women feeling rejected after a C-section. I’ve seen nature being both a healer and a hurter in birth and I’ve seen medical professionals respecting and defying its laws.

Ultimately you should feel clear, heard, respected, supported and empowered, regardless of what you view as ‘the perfect birth’ so that you may experience a positive, optimized birth, not a perfect one.

5. Don’t Neglect Your Postnatal Experience

You might have heard of the importance of the ‘golden hour’ after birth. The ‘golden hour’ is all about giving your baby the best start possible. Most of us know that bonding between mother and baby is important, but research has shown that what happens in the first 60 mins of a baby’s life can maximize that bonding. Again optimizing this period should be aimed for instead of perfection. In the instance of a c-section keeping the baby skin-skin in post-op could be a way to optimize an unavoidable intervention.

But it is not the golden hour that I really want to focus on. Once a newborn is safely in his parents’ arms we tend to think that the journey is over when in fact it has only begun. I know from personal experience, as well as checking in with my clients after birth, that how the mother experiences those first post-natal days are crucial. Becoming a parent can be wonderfully traumatic. Again a good ante-natal course should prepare and empower you for this period and your birth team should support you as well.

There should be less ‘right and wrong’ in birth and a while lot more compassion. Compassion for nature. For emotions. For choices and for the journey & challenges of becoming parents.

To diminish birth to a mere ‘natural or c-section’, ‘epidural or no pain medicine’ ‘breastfed or bottle’ is taking away from the miracle that is birth and becoming parent, as well as the compassion that it can inspire in those surrounding it. Birth should always be a celebration and a labour of love.

This article was written with a focus on private health care, but if public health maternity and labour care is more important to you I would like to encourage you to read more about the Compassionate Birth Project, lead by Robyn Sheldon

http://www.care-challenge.com/en/ideas/the-compassionate-birth-project
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Love Alda

Alda is the mother of three beautiful children and one of Cape Town’s foremost and well-published birth photographers and mentors. Being a mom has had a profound influence on her work. Birth photography is a labour of love to her – a joyous celebration of this beautiful, fragile life we all share and she has attended and captured many, many births both natural and c-section.
She is the founder and chair of the South African Birth Photographers Association and has recently completed a course through UCT in Medicine & The Arts.
As birth professional and mother she enjoys nothing more to share and knowledge and experience with parents eager to be empowered with knowledge and information.
Among her many accomplishments she has recently partnered with Nikon to represent them in the birth photography market and has also started a birth professional mentoring initiative for birth photographers, midwives, doulas, OBG’s and more at www.aldasmith.com

Visit Alda at www.lovealda.com
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