Will you have your perfect birth experience if you hire your own obstetrician and book yourself a place in a private maternity unit? Imagine the following:
You find yourself pregnant and your friends are telling you to prioritise booking an obstetrician as the most popular ones get booked up very quickly. You have the money and you are determined to get the best possible care. You are delighted to find that not only has the private hospital you had your heart set on availability but the obstetrician you have heard so many good things about is free too. You feel delighted and relieved that you can now go through your pregnancy knowing that you will be receiving the best care and services available.
So you decide to start going to yoga classes, antenatal classes and you start reading books. You begin to like the idea of a natural birth, with the minimum use of drugs. You start wanting to take responsibility for your own birth experience. You realise there is research to suggest a link between drugs used in childbirth and drug abuse in later life (Jacobson et al, 1988). You learn that keeping the umbilical cord pulsating until it stops, before cutting it, will increase neonatal iron storage at birth (Ceriani Cernadas et al, 2006). You read that if you have a straight forward natural birth, there is no need to have an injection to deliver the placenta; your body can perform this all on its own! Perhaps you even decide to hire a doula as you have learnt about the favourable statistics linked to having a doula at your birth. Statistics like a 50% reduction in caesareans, 25% shorter labour, 60% reduction in epidural request, 30% reduction in analgesia used and 40% reduction in forceps delivery (Klaus, Kennell & Klaus, 1991).
You are now feeling happy and excited about knowing so much more about your options and choices. You feel “in control”. You decide to speak to your obstetrician about your wishes but throughout the meeting you find that there is little common ground. He/she does not share your enthusiasm about a physiological third stage and suggests that you have been fed unrealistic information. You feel very confused and unsure. You are trying to make sense of the situation; surely you are paying this person to give you what you want? The very least you expect is for your obstetrician to listen to you views, discuss them with you and provide facts and figures as to why he/she doesn’t share your thoughts. You are no longer happy with any information that follows “in my view” or “based on my many years experience”. The discussion soon moves away from your ideas and birth preferences to talks about inductions dates and pain relief, possible risk due to the size of the baby or its position. You start to get a horrible feeling that your obstetrician wants to schedule you in for an induction two weeks before you due date, even though there is no medical reason for this. There is a growing feeling inside you of mistrust and suspicion.
When you leave the meeting you feel communications have broken down and you don’t feel like speaking to your obstetrician anymore. You find that you start keeping things from him/her and that you dread each weekly meeting where you feel unheard and bullied. You start worrying about what is going to happen when you do go into labour. How can you trust that this person is going support you in your wishes and not look for any excuse to go down the medical route?
Fortunately, what you have just read does not happen all the time, but it does occur more often than you can imagine. I am not suggesting that all obstetricians are nasty, “out to get you” people who only care about when they can clock off but I am talking about a very common misconception. Going private does not necessarily guarantee that you will get what you want and the décor of some private maternity units warrants a payment to you for putting up with it rather than the other way around. The misconception is what someone means when the say the “best care”. To you, this might mean a comforting voice or hand, someone that will listen to you and be empathetic, someone that will do everything to fulfil your wishes, as long as there are no medical indications to do otherwise. However, to someone else it might mean the latest technology, rigid procedures and protocols, preventative medicine, keeping “on top” of things, removing or actively managing any pain and trusting the experts.
If your choice is to have an elective caesarean section or your wish is to have an epidural as soon as labour starts, then going down the private route will probably be a good option for you as the NHS isn’t always very receptive or able to accommodate this. In all likelihood you will have made an informed choice and have understood the risks and possible complications associated with these options. A good birth experience is about having made informed choices, about feeling that you took part in any decision making and that any procedure was explained in detail. Whether you have a drug free vaginal birth or an elective caesarean is up to you but do read up about the pro’s and con’s of these choices.
If you are looking for a more natural birth with the minimum of interventions, the best route is to hire an independent midwife and book yourself in for a home birth. An independent midwife trusts that the overwhelming majority of women in her care will be able to birth naturally and will do everything to support you in your wishes, as long as you and the baby are well. Being at home, in your own environment with everything around you that is familiar will help you relax and produce the hormones needed for a straight forward birth.
If a home birth makes you feel uncomfortable, why not have a look at a birth centre or midwife led unit? You have the right to give birth where ever you choose to and can look at more than one hospital local to you. Remember, you are “allowed” to do what you want. This is your body, your baby and your birth experience!
If you do find the route of hiring a private obstetrician the most appealing, make sure you find out about their views and philosophy on childbirth. Perhaps look at their caesarean rates versus vaginal deliveries. Speak to some of their previous clients and ask them to be honest about the care they received. When visiting a private maternity unit, find out what kind of births are most common and what kind of priorities the women who come there have. Most midwives will be able to tell you whether the place is suitable for you or not if you let them know how you picture your birth. Their births statistics should also be available to you.
Going back to the initial question at the beginning of this article, the answer must be “No”. The birth process is unpredictable and there is no way to guarantee a perfect birth experience by any means. Each couple needs to work from their own life experiences and personalities, manage their expectations and understand their rights and choices; after all each birth is unique. Remember, you need to take responsibility for your own experience and no matter who your hire to attend your birth or where you have your baby; you are the one who will be doing all of the labour!
References:
B Jacobson, K Nyberg, L Grönbladh, G Eklund, M Bygdeman, and U Rydberg (1988), Opiate addiction in adult offspring through possible imprinting after obstetric treatment. Karolinska Institute, Stockholm, Sweden.
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1664218
Kennell J, Klaus M, McGrath S, Robertson S, Hinkley C. JAMA 1991 May Continuous emotional support during labor in a US hospital. A randomized controlled trial. 1;265(17):2197-201 Department of Pediatrics, Case Western Reserve University, Cleveland, OH. http://www.ncbi.nlm.nih.gov/pubmed/2013951
The effect of timing of cord clamping on neonatal venous hematocrit values and clinical outcome at term: a randomized, controlled trial. Ceriani Cernadas JM, Carroli G, Pellegrini L, Otano L, Ferreira M, Ricci C, Casas O, Giordano D, Lardizabal J.
Pediatrics. 2006 Apr;117(4):e779-86. http://www.ncbi.nlm.nih.gov/pubmed/16567393?dopt=Abstract
Article Source: http://www.articlesbase.com/pregnancy-articles/bying-the-perfect-birth-experience-738253.html
About the Author:Cert Soc Sci (Open), SNHS (Professional Relaxation Therapy), is an experienced doula, recognised with Doula UK and a Certified Doula with BOND and Nurturing Birth. She took part in the documentary about doulas called "Mum + One" which is currently being shown on the Discovery Home & Health Channel. She holds talks about doulas to student midwives and alternative health practitioners and is currently studying for a degree in Psychology.
Kicki is a facilitator of Doula Training courses and also run Prepare4birth Courses in central London.
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