• Rosemary Joyce

Positive birth... Why it's not what you think.

There is a false assumption in Western culture that a positive birth experience means that Mama and baby have an unmedicated, unassisted vaginal birth (where as in actual fact this called a ‘physiological birth’). This false assumption sets up many families to feel a sense of failure if their birth does not fit within these parameters. It fails to highlight the fact that many families have positive birth experiences even though medication, intervention or caesarean section were part of the process. It does not appreciate that a woman who has had a physiological birth can still have a traumatic birth experience. And it does not make room for the reality that even if Mama has a positive physiological birth, Dad may still suffer from birth trauma.

Positive birth... It's got nothing to do with nicely manicured nails and flower petals in the water.

We believe that when mum and dad-to-be are surrounded with empowering continuity of care, evidence-based antenatal education and a village of people who have shared their positive birth stories with them, physiological birth should be a normal experience for most families. This is an important factor of human existence for many reasons, including the passing on of healthy microbes to the next generation, hormone production and the initiation of a positive breastfeeding journey (just to name a few). However, just as in the rest of life, there are those of us who seem to always find themselves straying from the ‘beaten track’ and doing things a little bit differently. With a little bit of know-how, a positive birth experience is possible no matter whether you are having a physiological birth journey or doing things in your own unique way.


Achieving a positive birth experience is actually a lot simpler than most people think. That's because it is not based on clinical outcomes, but the way you were made to feel at the time. In a nutshell, it’s whether or not the people surrounding you during your birth respected your rights as a health consumer. Let’s take a closer look at what this means for you as the birthing parents...


Health and Disability Commissioner Act

Code of Rights for Health Consumers

1. The right to be treated with respect and privacy

2. The right to freedom from discrimination, coercion, harassment and exploitation

3. The right to be treated with dignity and independence

4. The right to services of an appropriate standard

5. The right to effective communication

6. The right to be fully informed

7. The right to make an informed choice and give informed consent

8. The right to support

9. The right to complain


In New Zealand we are incredibly blessed to have both rights and choice. Don’t ever take this for granted. Historically, decision making was the role of the medical professional. The focus was on the duties of doctors to each other and the need to eliminate those who practiced alternative medicine. There was no emphasis on the role of physicians to their patients. This began to change with the “rights” movements of the 1960’s-70’s. Bioethics emerged, whose focus was on protecting vulnerable patients and research subjects from the power of medical institutions and new technologies. In our days, many countries to do not have as much freedom to make decisions as New Zealand (including Australia and England where the concept of ‘informed consent’ has been rejected). What this means for you and your family is that during your pregnancy, labour, birth and parenting you will be a ‘consumer’ of health services, and you have the right to make informed decisions about every of aspect of you and your baby’s care.


The Birth of Baby #4

Our youngest baby was born in the midst of my study to become a childbirth educator. Filled with empowerment, confidence and evidence-based information, we had begun preparations to welcome bubs into this world at home in the company of his/her siblings. We had carefully selected our midwife, and chosen 3 close friends to act as our doulas/child minders. Our beautiful plans were thrown out of the window when at 35wks of pregnancy our midwife decided to spend her weekend white water rafting (Note to midwives –Don’t say to your clients, “Don’t have your baby this weekend”, as they probably will go ahead and do it). With an unexpected haemorrhage, womb baby and I suddenly found ourselves in hospital with labour starting soon after. Goodbye home birth, hello back up midwife. However this little baby was in no hurry to be world-side. It took 2 days, a lot of tears and some really tough decisions for this baby to be born. It was one of the hardest things I’ve ever had to do (hubby too). Despite all of this, it was a really positive experience! And this is why…

Everyone in the room was treated with respect and privacy.

We were given information, and then freedom to make informed decisions. And these decisions were respected. Our choice of support (i.e. our doulas) were respected and encouraged to actively participate in supporting us with a circle of love.

These simple things made a HUGE DIFFERENCE to our birth experience.

Your LMC (lead maternity carer), any doctors involved in your journey, and any other health professionals you meet along the way (from a nurse helping you with a pregnancy test to a sonographer doing a pregnancy scan) have obligations that they are required to meet. They are:

  1. To inform you (the consumer) of your rights; and

  2. To enable you (the consumer) to exercise your rights

Your rights are very important for you to know. Just because they exist in NZ doesn’t necessarily mean they will be practiced. Research suggests “that women’s perceived control over decision-making in childbirth is surprisingly low and that maternity care providers’ (providers) understanding of women’s legal rights in maternity care is poor.” (Powell, Walker & Barrett, 2015).


As you prepare for your positive birth experience, be sure to write down your code of rights and place this somewhere like your wallet. You just never know when you might need to have this handy.


Like to have more information about how to have a positive birth experience? Join a community of empowered parents to be in The Birthing Room’s Antenatal Classes.


References

Health & Disability Commissioner. (2009). The code of rights. Retrieved from http://www.hdc.org.nz/the-act--code/the-code-of-rights

Ministry of Health. (2017). Complaints about a health and disability service. Retrieved from https://www.health.govt.nz/about-ministry/contact-us/complaints-about-health-and-disability-service

Powell, R., Walker, S., & Barrett, A. (2015). Informed consent to breech birth in New Zealand. The New Zealand Medical Journal, 128(1418).

Torres, J.M., & De Vries, R.G. (2009). Birthing Ethics: What Mothers, Families, Childbirth Educators, Nurses, and Physicians Should Know About the Ethics of Childbirth. Journal of Perinatal Education, 18(1), 12–24. doi: 10.1624/105812409X396192

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