Hypnobirthing - A Midwives Viewby Louise Broadbridge
In my early 30s, I decided to give up a post as a manager within the NHS to train to be a midwife. I wanted a much more clinically involved career and had always been fascinated with the miracle of birth. I like babies (who doesn't) but I had far more interest in supporting women and their partners in their efforts to get their babies so decided that rather than train in paediatric nursing I would attempt to become a midwife.
I say attempt because I had little confidence that I had the brain and staying power needed. However, train I did and after a very bumpy 5 years, I qualified as a midwife. I absolutely love being a midwife and am very proud and protective of my profession. A profession.
Throughout my time as a labour ward midwife I became known for struggling to provide care to couples that were hypnobirthing and so I decided to undertake the training to become a qualified hypnobirthing teacher in a bid to understand better why I had seemingly developed such an apathetic approach to a practice that, surely, I should embrace.
So, off I went to London on an expensive 2 day course in the hope that my views could be changed and I would be able to embrace the birth plans of all of the couples in my care. It was was one of the hardest courses I have ever undertaken. Not because it was difficult from a brain PowerPoint of view but because I was the only midwife in a class of 40 people being taught by a non-clinical teacher. Throughout the course I felt like the social pariah in the room as I listened to the teachings two things became clear to me; I loved and hated hypnobirthing in equal measures.
The process of natural birth is unarguably an amazing feat. The fact that a woman can not only grow another human being inside her but to actually manage to aid this baby from inside to earthside is nothing short of miraculous. However, it can not be disputed that historically and even still in some places in the world many women have and do die during childbirth. In more developed countries due to the availability of interventions women and their babies are safer than ever before and it is this knowledge that helped me understand my feelings towards hypnobirthing.
So, here are the things that I feel hinder midwives in caring for those practising hypnobirthing techniques:
SURGES - one of the first things often stated on a couples birth plan is the request that midwives refrain from using the word contraction and instead adopt the phrase surges. During our training we are taught in-depth about the physiology of contractions and how to monitor and document their occurrence along with interpreting Fetal Monitoring reports which show uterine contractions. Asking a midwife to not use this word when it is so much a part of their clinical practice is like asking them to call their child by a different name. Throughout the whole of the degree course the word surge is never used. During my hypnobirthing course I asked the rational for this change and was advised that it was due to the word contraction having too many consonants in it, making is not a nice sounding word.
SILENCE - "Please could we request that midwives/doctors do not speak directly to (N) and that any questions are directed through her birth partner." This absolutely breaks my heart and leaves me with a sinking feeling of dread for my shift ahead. My hope for all of the couples in my care is that they look back and remember a feeling of absolute trust and safety. Women should feel cosseted and cared for by their midwife with almost a sense of wanting to take her home with them. This profound and quickly constructed relationship is practically impossible if midwives are unable to directly communicate with those in their care. Many who know me will know that I can be chatty, silly and like a good laugh. However, I am also able to sense when this is and isn't appropriate and as like my colleagues, always strive to make birth environments as calm and gentle as possible.
DARKNESS - "Please could the lights be off at all times unless requested by (N)". I am well into my 40s now and my eyesight is not what it used to be! I am unable to observe graphs and data sat in the dark. Whilst it is totally appropriate to have low lighting we should be ensuring that environments are safe for clinical practice.
CONSENT - So frequently I see posts about consent. Warning women that no-one should ever do anything to you without consent. This is absolutely true and surely a given. However, what these articles, posts and courses never seem to follow up on is that we are well aware and respectful of that. I want women everywhere to be reassured that you are not going to have people assaulting you and performing vaginal examinations without being given a rationale or the right to say no.
OK, rant over! Here are the things I love and embrace about hypnobirthing and have incorporated into my own teaching both face to face and online.
VISUALISATION - It is well researched and proven that spending time visualising a preferred outcome can increase the probability of it happening. What I would urge women to do is visualise all different scenarios. Visualise a water birth, visualise a c-section, visualise a forceps delivery.... What???? Visualise all of these different scenarios swamped in calmness and control. Visualise yourself having a ventouse delivery and feeling safe, calm and cared for followed by you with your baby safely in your arms. If women are encouraged to only visualise one outcome there is much more space for psychological trauma and mental health problems later down the line.
BREATHING- Being able to encourage your body to work its magic can be helped by effective breathing which can also lower pulse rates and anxiety. A great skill to develop during pregnancy.
RELAXATION - Practicing relaxation in the weeks before your labour can really help both you and your partner to recognise signs of stress and tension and give you some tips on how to alleviate them when you need it most.
EDUCATION - A good hypnobirthing course should teach you a deeper understanding of both physiological labour and birth and interventions, rationales and procedures so that you have a level of understanding before you are presented with situations. This will make you better equipped to feel in control and safe.
I have had the privilege to be present at some amazing births both with couples hypnobirthing and with couples that are not. An not all of them were straightforward vaginal deliveries. The fact was that they all had the same basic elements of trust, safety and awareness.