Your Rights in Pregnancy and Birth

AIMS (Association for Improvements in the Maternity Services) are pleased to announce the third book in their Guide series: The AIMS Guide to Your Rights in Pregnancy & Birth. This replaces their book ‘Am I Allowed?’. I’m a big fan of AIMS’ work, and not just because they published my Water Birth article last year!

I haven’t read a copy as it’s not published yet, so I do need to caveat this recommendation. But everything AIMS produces is well researched and evidenced, so I have no doubts this will be of high quality.

Their blurb:

“Not only does this book provide clear information about your rights in pregnancy and birth, but provides the tools to assert those rights.”

The book is currently available for pre-order so that you get a copy hot off the press in November.

Asserting your Rights

In terms of rights in pregnancy, Birthrights are also very good for information and they’re currently looking for people who would be interested in legally challenging visitor restrictions in maternity services at their local Trust. You could be in the early stages of pregnancy and concerned about the fact that your partner will not be with you during scans or at other crucial points during your maternity care.

You could also be a partner who is keen to be at their loved one’s side. Or you could already have been affected by the restrictions, for example, having received bad news on your own, having asked for your partner to be there. You are unlikely to receive financial compensation, but Birthrights will ensure your legal costs are covered. To find out more with no commitment you can contact them at [email protected]

Making Decisions

If you’re trying to make decisions, it’s always worth remembering that everything suggested to you is an offer. You’re only being offered treatment, you don’t have to accept it, if you don’t want it! (It may not seem like it at times, but it’s your body and your decisions to make). It’s also helpful to use the BRAIN acronym to make sure you’re getting all the information you need.

Front cover of The AIMS Guide to Your Rights in Pregnancy and Birth

Nitisha’s Birth Story – Home Birth After Caesarean

I love a birthing story! I’m always excited to read about other mamas experiences in the Big Birthas Facebook group, and so I asked for permission to share this one with you. This is Nitisha’s home birth after caesarean. It actually took place in November 2019, but proving that baby brain is a lifetime condition, I completely forgot to add it until now. Sorry about that, and welcome baby Maya!

Nitisha's home birth after caesarean - welcome baby Maya!
Welcome baby Maya!

I got my homebirth after caesarean! 💪🏾

  • Waters broke at 36+7 naturally and so did contractions
  • 1 sweep at 37+3
  • Natural birth (no pain relief, too quick to get into my birth pool) delayed active management
  • Risks: high bmi, age, previous caesarean
  • Prep: yoga, aquanatal, positive birth company digital pack hynobirthing, saw a chiropractor, spinning babies exercises, positive birth after caesarean audio course.
  • Birth partner: Doula + hubby
  • Main sources of information: chilled mama and positive birth after caesarean.
  • Hyperemesis gravidarum (4-26wks) and pelvic girdle pain
  • I denied consultant led care after first appointment as we both agreed I was informed about the risks for a vbac and I felt there was nothing he could tell me that I didn’t already know /mythbust
  • Previous birth: induction led to fetal distress and emergency caesarean
  • Breastfed toddler throughout pregnancy
  • Toddler upstairs asleep through whole thing (rare occasion of sleeping through the night in his own bed)

After not feeling very informed in my last birth (waters broke, spontaneous start to contractions, induced before 24hrs post waters breaking) I was determined to be informed regardless of location and delivery.

This pregnancy and birth was so healing for me.

I really felt in control of my body, conversations which took place, and all options around delivery. I’d planned for hbac, hospital vbac, and caesarean, wanting to take control over any situation. I hadn’t planned for my labour starting the same way but was determined for it not to end emotionally the same way.

The VBAC consultant midwife was supportive and has changed hospital policy for midwives to use sense and monitoring birthing mums to individualise care and reduce need for vaginal exams! I had requested a meeting with her before the 36wk birth choices meeting as I didn’t want to be blindsided by policy and what they “wanted”. I had this at 32wks and planned my birth plan before of what I would accept and wanted. By the end of both meetings I was happy with my birth plan.

Home Birth After Caesarean

My waters broke 36+7. At 37 weeks I went to the Antenatal Day Assessment Unit and they confirmed my waters had broken. They checked mine and bubs stats; we were all fine so I respectfully declined any intervention for 72 hrs and said I would monitor bubs and fluid release.

Irregular contractions started within 24hrs of waters breaking. At 37+1 I went back to hospital for fetal monitoring and to check my stats and everything was fine. 37+2 – no checks, irregular contractions which increased during the night. 37+3 72hrs were up. I went back for monitoring and talk with a consultant and our stats were checked. The consultant said she thought I should be induced or have a caesarean because of my bmi being so high, I was told I only had 20% chance of giving birth vaginally.

I had a vaginal exam to assess options: cervix was 1cm thick, soft and 2cm dilated. Considered BRAIN and opted for a sweep. No contractions following sweep. Toddler wanted more feeds that night and we danced together. 37+4 still no contractions: walk with hubs, went for breakfast, chilled, massages, naps, laughs and lovin’, once toddler returned from nursery, more feeding. Rang doula to discuss plan.

I had settled that I would have an appointment at 37+5 to arrange what would happen if baby hadn’t come by 38wks. I would be induced with as little dose as possible of syntocinon. Once contractions began, turn the syntocinon off to allow body to do what it could and turn on if any stalls. The plan was also to discuss intervals of drip dosing and levels & what point I would have a caesarean section.

The contractions came back!

At 11pm, in bed, contractions came back. I was so chuffed as I felt the sweep was really invasive, made me feel uncomfortable and thought I shouldn’t have done it. I didn’t monitor, just let it happen. They became regular, so started to monitor. 1am I woke hubs and he rang doula and mother-in-law.

Just before doula arrived I went to my birthing room to relax and take in what was happening. At this point didn’t know whether we would stay at home or go hospital. Initially I was dancing to my 90s RnB club hits, but I was getting sleepy so laid down with a leg elevated to keep my sacrum free. The contractions were starting to increase and I needed my doula to push on my hips. I needed to change position, I went on my knees with my ankles out further than knees (one strong mama tip) and leaned on the sofa with my hips being pressed down during contractions.

Midwives arrived

Things progressed quickly, midwives called at 04:xx arrived 06:xx. During this time I carried on as I was, but the pain getting more intense. It felt like my whole pelvis was expanding. This is normal, I just didn’t know. I did keep checking my puppy pad for blood or meconium. At one point my hubby said I turned and growled at him.

When midwives arrived I wanted to go to hospital because I didn’t know that the pelvis pain was normal, instead I had 1 vaginal exam with consent, I was 10cm and midwife could feel baby’s head. I wanted to get in the pool but couldn’t wait, one breath and baby was out! I didn’t get a chance to catch her but I did cut the cord.

During birth I didn’t think I was Hynobirthing breathing well & didn’t really work for me, I was a bit too cave-woman rather than peaceful 😂 but my doula said I was doing it at the start and to relax but the elevator breath and the final breathing the baby out was great.

Congratulations Nitisha and welcome baby Maya!

Hopefully your husband has completely forgiven you for growling at him!

You can read more birth stories here:

Sarah’s Homebirth Story

Birth in a time of Covid-19

Twin Home Birth at 42+2

Or look under ‘Birth Stories’ in the Labour and Birth menu.

Give Birth Like A Feminist

I don’t usually post on weekends and I don’t usually publish posts so soon after another has published! I try to keep to a 3 weekly schedule, which is generally manageable. But this morning on Twitter I saw that Give Birth Like A Feminist is now £1.99 on Kindle. The offer is only until the end of August, so I didn’t want to waste any time letting you know!

Book Cover of Give Birth Like A Feminist by Milli Hill
Give Birth Like A Feminist – £1.99 on Kindle

**Full Disclosure** If you buy a copy from the link, BigBirthas will get a few pence for referring you. It’s not much, but referral fees do help to pay for the hosting costs of running this site. If you’d rather not, just open the Amazon site in another tab and search for Give Birth Like A Feminist yourself and buy it that way.

So many people have found this book really helpful and empowering.

Here is a quote:

Giving birth like a feminist doesn’t mean giving birth a certain way, just as doing anything else – career, relationships, parenting – ‘like a feminist’ doesn’t require a one-size-fits-all approach.

You can give birth like a feminist in any setting and in any way, from elective cesarean in a private hospital to freebirth in the ocean. All that’s required is that you have somehow moved from a passive place where you view birth as something that happens to you and over which you have no control, to a place of understanding that you may get a raw deal in this experience if you don’t wake up and get yourself into the driving seat. Essentially: take charge, take control, and make conscious choices.

Here are some of the reviews:

My copy arrived yesterday and whilst I’m only up to page 29, my heart is singing! This book needed to be written and more importantly needs to be read. Birth is a critical and pivotal life event, not only because new life begins but, of equal importance, because it creates a mother/parent. How that birthing person is made to feel is so important because the experience stays with them. Looking at the stats: 1 in 3 suffering some sort of birth trauma? This is totally unacceptable. We need to rise up and reclaim birth and change the power dynamics. This book is not about turning our backs on medical advances but about giving a damn about the human experience. This will be a slow process. Turning a juggernaut takes time. Can’t wait to read more! Milli, I’m with you

Amazon review by doulabud

This book is absolutely everything. Every pregnant person, father-to-be, mother-to-be, midwife, doula, obstetrician, nurse, hospital administrator, law-maker, and human being should have this in their library. This is such a fundamental issue and fixing the broken system of birth in most cultures in the 21st century is essential and life-saving for everyone. This book takes a completely non-judgmental approach to birth choices, focusing on the history of childbirth and how women’s rights to control and understand their own bodies has been stripped from them in the past century. And best of all, it’s an easy read- it’s approachable and straightforward. Incredible read- and so, so important. Thank you for your work, Milli Hill!!

Amazon review by Linsay

I apologise in advance if this book makes you angry.

Sadly, some of the stories, quotes, statistics, and research presented will frustrate and infuriate. But I’m guessing if you found this site, you’re already a bit frustrated and infuriated by the pregnancy and birthing experience!

Patient and Public Engagement

Let’s talk about PPE. No, not *that* PPE, I’m talking about Patient and Public Engagement, also known as PPI – Patient and Public Involvement!

I’m pleased to announce that lately, organisations have been approaching BigBirthas to get involved in projects at the planning stage. This is great news!!

It is no longer acceptable (why was it ever?) for organisations; bosses, politicians, researchers, and healthcare professionals to make decisions about us, without us. People in positions of power, if you’re not asking about our lived experience, if you’re not listening to our stories, in whose name are you working? Are you really the experts here?

These sorts of scenes are just not acceptable:

Engaging with your audience (or representatives of it) at the outset has some very tangible benefits.

  • There’s a good chance that if you’ve overlooked something, service users will spot it. It’s our lives you’re talking about after all, and we’re literally the experts!
  • You can get the language right. You’re much less likely to draft something patronising, presumptuous, implausible, or antagonistic if it’s co-written/proofread by members of the intended audience.
  • You’ll understand what’s important to us; what floats our boat and what gets our goat. If your clients connect with what you’re saying, they’re more likely to listen. Honestly, if you want us to listen to you, it’s only reasonable that you hear us too!
  • Getting the language and tone right in documents encourages staff to do the same in their interactions.
  • Engaging with your audience at the earliest stages means you’re asking the right questions at the outset.

I’ve read so many hospital policies and research where it’s clear no representation was present at planning, drafting, or proofreading stage! It’s very easy for phrasing to become ‘us and them’, paternalistic, and ‘we know best’ in style when you’re external to the group in question. There are very few people for whom that approach yields the best engagement! Even worse, that language feeds into the psyche of those acting on your words.

How to find your audience

Therefore, if you want to do best by your clients, you need to get your audience involved, preferably as early as possible in the project. But how do you recruit your service users? If you’ve tried putting up posters and putting a link on your website and that’s not getting you anywhere, what next?

Reach out.

Former service users may have even more insight than current ones, but are less likely to see your invitation. If it’s too costly to contact previous service users directly, could you advertise in baby and toddler groups, with health visitors as well as maternity clinics? What about maternity voices partnerships?

Are the service users you do engage sufficiently representative of the diversity of your clients? Do you need to try thinking more out of the box to reach more of the people you should be speaking and listening to?

Have you considered why people aren’t engaging? Are you offering expenses or any incentive for people to give you their time and effort? Is it something super simple like the time you’re trying to connect? Avoid daytimes and particularly the school run, provide creche facilities, or reimbursement for childcare. For in person meetings, make sure parking is good and preferably free, and there are good public transport links.

Are you clear about what you’re asking/offering, and who the work will benefit?

If You Represent An Organisation

Big Birtha is always happy to give an opinion, and is on several advisory and oversight committees already. If you want more than one person’s input (you really should!) we have a BigBirthas Facebook Group of 300+ members, from which you could recruit participants. Or if you just want to ask a few general questions, and sound out some ideas we could facilitate a Q&A style open meeting and see what happens. We’re passionate about this stuff, and changing maternity services for the better, so you’re likely to get some great engagement!

Just get in touch via the Contact Big Birtha link. Explain what you’re up to and we can discuss how Big Birthas can get involved to help you make your next project as engaging as it can be, which is in all of our best interests.