Making Birth Plans
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Lucy Atkins discusses the topic of planning the birth of your baby.

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Nina Sebastiane: Giving birth should be one of the most fantastic experiences that a woman will ever have. But for some the whole process can turn into a worst, a complete nightmare and a best, a bit of a let down. Lucy Atkins is the author of Blooming Birth and she has written a book to help you take control of your birthing experience and she is here with us today. Welcome to the Baby Channel Lucy. How does one begin to plan for something that's so unpredictable and so unlike any other experience you go through? Lucy Atkins: Right. Well, I think that's the key issue in a way you can't. There is absolutely nothing you can do in a way because you don't know what's going to happen to you, you don't know what's going to happen to your body. If your baby lies in the one position that's going to mean something completely different happens from what you might want to happen. So there is an element about birth that you just can't do anything about. But that doesn't mean you can't prepare for it and there is just of tons of stuff you can be doing to get your head around it, to learn enough about it, so that things don't shock you. Things that are quite normal things that happen to almost every woman in child birth that you don't about that freak you out. And if you've learnt about them in advance, you can have a much better time, you can cope much better. So I think this sure answer is you can't control it, that you can't really, really plan for it but you can do a awful lot to prepare for yourself emotionally and practically to have a much better experience than you would if you didn't. Nina Sebastiane: Yeah. Research suggests and I know from my personal experience that fear was the thing that really got to me. It was really the fear of pain I suppose that I was most freaked about and had to deal with before the actual labor. Lucy Atkins: You're completely normal because 8 out of 10 women in survey say that they found it much more terrifying. They found birth a terrifying experience. The first time moms, that is 8 out of 10 who have said that. I think that is not, it's not a simple answer but it's largely because in advance we don't face up to the fact that we're absolutely terrified. It's a very frightening thing to think. You've go this huge baby in your tummy, has got to come out. Nina Sebastiane: I know it's delirious to think how that will be work. Lucy Atkins: Yeah. It's got to freak you out. Nina Sebastiane: I found in three- four months. Lucy Atkins: And the fact, I think probably, well a lot of us do is we think when we just got it; there is only one or two ways the baby can come out. We're just got to get through it, so we mustn't be frightened, we must not think about the fact that we're frightened. And I think that's a huge mistake because if you're suppressing your fears, you don't actually work out what's going to make you feel better during childbirth, how you're going to get through the experience calmly. And you end up therefore having a much more sort of emotionally fraud experience than you would if you've to, so this is what's I'm frightened of and this is what I'm going to do to cope with it. Nina Sebastiane: Do you think that in Britain that we're specifically good at focusing on the negative. I know any soap that you watch. If they do it, if it is a drama or about a birth or labor, there is always something going wrong. Isn't it? Lucy Atkins: Yeah. I've got a whole section on that because there was actually a study about childbirth in the media and it was an academic study that showed that the portrayal of childbirth in the media is so can widely out of guilt and what actually happens. You get this sort of insane births where somebody in the TV show they go into labor and two minutes later the baby is born. Nina Sebastiane: Yeah. Lucy Atkins: And the reality for most of us, is that we were in labor for three days. Nina Sebastiane: It's a lot longer than that. Lucy Atkins: We say, we're in labor for three days and still nothing has happened and it's a completely different experience. The other thing I think about the media that this study also showed is some, is that so much of the media portrayal of birth is of emergency -- some terrible things going wrong. Nina Sebastiane: Well it is. I mean everything. I remember at one point with my first pregnancy, I was watching something on the TV and felt oh god, I'm going to have to turn that off, it's all getting a little bit too intense there. Lucy Atkins: There are Reservoir Dogs, isn't it? When you've never actually given birth, you see these things happening, terrific medical emergencies as dreadful blood God, you think I can't possibly go though this. Nina Sebastiane: No. Lucy Atkins: I'm a normal person. How am I expected to deal with this? And yet we're not encouraged to express these as fears. And for me, I just say it's completely reasonable to be frightened when you're having this and we also -- I suppose the other aspect of fear is that we don't, most of us have never seen childbirth, we don't talk to our mothers about childbirth. It's not in the olden days, it was part of community thing and you would have seen other women giving birth and it will be much more normal as now people get packed off to hospitals and have these dreadful dramas and the babies out and nobody wants to talk about it. Nina Sebastiane: So what kind of practical preparations then can you do to get yourself, mentally prepared? Lucy Atkins: I think probably one of the first things you've got to do is get a realistic picture in your mind about what labor, not any one labor what should be like but what it can be like. And a lot of what you'll learn in childbirth classes is this is the textbook version, this is what should happen and it's not what really does happen to most of us. So I think the probably the key thing you've got to do is you've got to know the facts, that you've got to know that your cervix, the neck of your womb has to dilate and the baby has to come out. But you also need to know in real women's experiences. How does that happen? And it can be a good example is most of us think your waters break and you're in labor. In few hours later, the baby is going to come out. Actually what happens with huge amount of first time birth is nothing really happens and then you start getting contractions and then you might have contractions for even days, I mean even a week, it's not abnormal to have mild contractions that you can cope with perfectly well but they go on for a very, very long time. Nina Sebastiane: So be patient because it's -- Lucy Atkins: Yeah. So labor doesn't necessarily happen in this sort of cataclysmic way. But a lot of women are very freaked out by that and they think something is going wrong. So I think the key thing is that you've got to learn what it should be like and also what it could be like. Nina Sebastiane: Okay. Also there is a lot of discussion, a lots of books house at the moment on the alternative things that you can do around your birth and around your labor. Things like aromatherapy, massage and hypnotherapy, what do you think of those? Lucy Atkins: I think my main opinion about anything that you do to prepare yourself for birth is that a good birth is the birth you're coping with at that time and if things like aroma therapy and massage are going to help you in some way to cope or to feel calm or just to feel better about what's happening then I think that's great. I think there is a definite, there is an argument that says if you're physically relaxed as relaxed as you can be in that sort of extreme situation, you're likely to have a better or a smother experience of childbirth because your body is giving off the right hormones and you're not in this sort of fight or flight situation. Nina Sebastiane: This kind of tensed body situation. Lucy Atkins: Yeah because if you think about in terms of pain if you bash yourself on something and you are tensed and scared, the pain as much worse, but if you take a deep breath above it, it's better. I'm not saying that's, I'm that's incredibly simplistic example to use when it comes to childbirth. Childbirth is so much more than that. But if things like relaxation and visualization and hypnotherapy, all of these things I think they're not the golden ticket to a brilliant birth but they can be very helpful. Nina Sebastiane: And I say exhaustive, in a most positive sense, but there are 320 pages in it and it says in this book, what got a mum off, is it two or three? Lucy Atkins: Three. Nina Sebastiane: So you went though it three times. What brings a mother to the point where she has to write this? Lucy Atkins: Well for me, the point of writing it was I had a difficult experience of childbirth first time though not abnormally difficult. I went to a sort of yoga classes, I felt, I am a healthy strong person, got no medical complications, happy healthy pregnancy, surely I'm going to be out to push this baby out. And the reality of course, was this sort of great medical situation where like nothing happened and the labor didn't progress and I ended up having cesarean. I was just really blown away by that. It wasn't that it was a terrible experience. It was just a very difficult one to get my head around because I never thought that would happen to me. I had no idea that one in four births, the caesarian these days. Nina Sebastiane: That's a huge statistic. Isn't it? One in four and written you have the c section. I know many friends of mine who went though the same experience, who had this, again this great vision of how it's going to be all plinky-plonky music, lovely serene experience and the baby is just good, Lucy Atkins: Yeah. Nina Sebastiane: Plop out. But it didn't happen that way. Why do you think that is? Lucy Atkins: I'm not a doctor and I'm not a medical person but the doctors I've spoke to for the book and there is a strong tendency in first birth for the baby not necessarily to rely in exactly the right position and which can slow up labor and lead to something called Dystocia, where labor doesn't progress. That's a very, very common cause of first time cesareans during labor. The women become exhausted and the birth isn't progressing. So there's kind of -- that's one reason. Another reason is that doctors these days are much more willing and ready to give cesareans. Nina Sebastiane: Do you think that perhaps it's a good fall back position. I'm not saying that people but perhaps if there is any slight complication, if the mum is getting nervous and she is tensing up and the dad is thinking, oh god what's happening, all we move likely to go down that route instead of going okay let's stop regroup and reflect on what's happening. You can get this baby out conventionally, let's give it a go. Lucy Atkins: I think that there is a very good argument for that. But I think as a normal woman who is not a medical person, you're not in a position to argue that in labor. If that's what happening and doctors are saying that you need a cesarean, I personally you just think you got to do, you got to go through with that. But what I do think you can do in advance when you're pregnant now, is think about it because I just literally didn't think about it, I didn't turn to that page in the childbirth book, didn't go to that class, never going to happen to me and had I realized how common it was, I would have really looked into and thought how am I going to have good cesarean, how am I going to find that these un-traumatic event? And in the book, I've got a chapter on that and I've got a section in the chapter on ways to prepare yourself. Should you have a cesarean birth and it's not a good thing or bad thing and there are a lot of complex medical arguments but that's not really for people like me to get into. Nina Sebastiane: No. Lucy Atkins: We're just mums and if a doctor is standing over you in labor telling you, you need a cesarean, I just think you've got to go with that. Nina Sebastiane: Absolutely. Well, as a mum of three, do you think that men in this country are getting better as birthing partners, are they getting more jend up about what they should be doing at this point? Lucy Atkins: Yeah. Nina Sebastiane: Your partner is in excruciating pain, she just wants all of this over. I remember the time I'm thinking, my last sort of thoughts before my daughter was born was, this baby is just got to get out. There is no other way, I'm beating around the bush, I'm just going to have to push and take courage. Those were the words that sort of strung up in my mind. And my partner was brilliant, extremely supportive but I think also petrified. Lucy Atkins: I think that can be so freaky for a man to see the person you love suddenly in this animalistic state of, where they don't know what's going on and I've had through the conventional route and you're -- at some point during labor, you have to let go and it's like you have to let this in order just to get the baby out, you have to let this primitive side of yourself takeover. And I know this is a controversial thing to say but it's almost worse for the man at that point. I think by that time in labor it's so extreme and you're in such a kind of different place that you're just getting on with it, you're just -- I think I never felt stronger than when I was at my most extreme moment in labor. Nina Sebastiane: Yes. Lucy Atkins: But my partner, he is standing there, watching me bellowing and shrinking and it looks terrible and which is why I find watching birthing video is absolutely horrifying and I've had three babies. I mean, when you watch it from the outside, it looks absolutely a pulling. Nina Sebastiane: Thank god, somebody not show me at that point. Lucy Atkins: Yeah, but when you're in it, it can be bad and that's why you need to prepare and you need to know, your obstetrician need to know what drugs you want to use if you're not coping and what methods, what are the methods. But if you do, if you're lucky enough to get to that stage of labor where you're doing it on your own and you're really focused on it. It looks an awful lot worse. It's not a awful lot worse it is, but it looks very freaky. Nina Sebastiane: Did having a c section in your first pregnancy, how did you go into the second and third knowing that, because obviously you decided to have VBAC vaginal birth after caesarean in your second? Lucy Atkins: Yeah. Nina Sebastiane: What mental decision went on? Lucy Atkins: Well, I think probably what I decided to do was to try very hard not to have another caesarean because I did find the caesarean being on. I'm quite frightened of doctors, I'm kind of the person who shakes when I go into the GPs office -- I really didn't like being operated on. So my main thing with the second birth was I just don't want to go there again, if I can possibly avoid it without jeopardizing my own safety, particularly obviously the safety of my baby. What I did was it was think, I've got to do something different this time but I have no idea what to do that was different that would make it a better experience because there didn't seem to be anything to read or any way of learning how to make it different and better. I was in America and a lot of people in America have these things, could deal with who are childbirth experts, who come to the birth with you and who I wrote the book with, was some which is used to dealing with people, who are just really neurotic and scared about childbirth and she took me through this whole process kind of getting my head around what had frightened me the first time and what I wanted for this second birth because part of the problem was I didn't even know what I wanted, I just knew what I didn't want. Nina Sebastiane: So for you, your birthing partner wasn't really your husband or your partner, it was another female who did this for living. Lucy Atkins: Yeah. Although, no I would disagree with that and my birthing partner with all my births was very much, my husband, he was the one I wasn't aware of anyone else in the room except for him in all of the births really. What she did for me was help me prepare for it, she helped me get my head around and she was there in labor but she had done so much work for me in advance, she didn't need to do anything on the day because it all went really, really well. So she definitely didn't step in or behave like my husband or he was the one that I was really consciously aware of and I would -- labor stopped every time he left the room to pee - it was that kind of -- she definitely didn't takeover from him but she very much helped me get my head around it and make good choices about what I was going to do this time that was different. Nina Sebastiane: If there is a mum who are watching -- mum to be should I say thinking, okay, I'm going through my first birthing experience couple of months, and I'm listening to the meditational tapes and I've got my plinky-plonky music ready to go and I'm doing my yoga classes when I can and I'm concentrating on my breathing exercise that anything else, as a writer of a 320 page book and a mother of three that you could give her. Lucy Atkins: I would say to her, go and read about epidurals and caesareans because you can't assume because you've done it alright which is what I've felt the first time I go for birth. I've been to yoga, I've done my breathing, and I've been to NCT classes. You can't let make that leap, you don't know what's going to happen to you and you can certainly make your chances of having a good birth much better by doing all that stuff I believe, but you can't control it. You do what you've got to do is think what will I do if it's doesn't go to plan. And I think that's the one thing about childbirth that you that is the definite, as the unexpected happen, it always does, there is always something. When my third baby was born at home, plinky-plonky music really beautiful birth and then we had to go to hospital because my placenta smelled funny. But that's the unexpected and I think if I hadn't get to know in my mind about the fact, I'm not have been in the hospital, didn't know really until the moment he was out where I was going to have him. And I kept a completely open mind about it. I wasn't freaked out by then having to get into the car and go to the hospital having just produce the baby. I think that's the one thing I would say to anybody who is really looking into birth is don't just look in to the good, don't just write the birth plan as your Utopian Dream for this birth. Have a contingency plan, have a backup, know what you're going to do if you're not coping. What you're going to do, who is going to help you, who is going to comfort you, what's going to comfort you? Nina Sebastiane: Great. Lucy Atkins, thank you so much for coming and talking to us today. Lucy Atkins: Thank you.