Where I live in West Kent woman can choose to give birth in hospital, in a birth centre or at home. This is in line with the Department of Health guidance on women’s choice of place of birth which states that there should be a ‘national choice guarentee’. However there is great regional variation across the UK regarding this, so women in West Kent are pretty fortunate that they have these choices. Despite this, in my work as an antenatal practitioner I find that few women have had a conversation with their midwife regarding place of birth. There appears to be an assumption that women having their first babies will go to hospital to give birth. The recent Birthplace Study has shown that for ‘low-risk’ women having their first baby, there is no difference in risks for the baby between choosing to give birth in a birth centre or in hospital. The study showed a slight increase in risk for baby for women having a first baby at home, however this risk was still low. There was no difference for women having subsequent babies at home. As well as this, women who planned birth in non-obstetric settings (ie not hospital) had significantly fewer interventions, fewer caesareans and more ‘normal’ births than those who planned birth in an obstetric unit. Understandably when I signpost women and their partners to this information they want to know why this is and what they can do to facilitate a straightforward birth, wherever they choose to give birth.
So here is my top five things to do to create an optimum birth environment (regardless of where that is)…
1. TURN OFF THE LIGHTS!
The hormones required for labour and birth work much better when the lights are low. Even in a hospital you can turn the lights down/off. LED candles are useful to take to a hospital, but don’t forget to take them out of your bag…
Keep voices low and words to a minimum. If you talk quietly to the health professionals caring for the labouring woman they will most likely speak quiely too!
3. SHUT THE DOOR!
Privacy is really important for a labouring woman. Sometimes in hospitals this is forgotten and various health professionals come and go at will, shut the door and ask people to knock before they come in.
4. COVER UP THE CLOCK!
No one knows how long labour and birth will take so forget about looking at the clock and just be in the moment.
5. HIRE A DOULA!
A doula provides continuity of care, a familiar face, friendship, warmth, empathy and will help a woman feel safe and protected.
and one extra one for hospital birth… ‘Bring romance into the hospital’ (from a woman on a recent antenatal course)
For more details regarding The Birthplace Study http://www.rcm.org.uk/college/policy-practice/midwifery-research/birthplace/