Bying the Perfect Birth Experience

Bying the Perfect Birth Experience

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

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