The Elusive ‘Great Birth:' how social media perpetuates 'birth goals.'

I am the first one to admit, for both my births, I had a very clear vision in mind.

For my first birth, being my first, I felt I would be safer in a hospital. I considered I was young, I was healthy; my body would just be able to 'do it' but just incase...a hospital would be able to help. I did research a lot; multiple books, podcasts, Vlogs, birth classes, research papers. I was armed with knowledge but that knowledge was mostly centred on what my options were in a hospital setting and how labour can progress (or regress I suppose) in a hospital. I think the fact that I chose a hospital, suggested I still felt a tiny bit of uncertainty of whether my body was best for my baby (but also, it was free and I felt confident that it would be ok).

My first birth definitely did test my knowledge. I was confronted with so many interventions as soon as I walked in through those doors. I had my 'birth preferences' typed out that were completely ignored and I was offered morphine and a vaginal examination almost immediately. It was blanketed in 'hospital policy' and so the 'people pleaser' in me found myself agreeing to things I never thought I would. I ended up with at least five vaginal examinations over the course of my 28 hour labour. I was given antibiotics in case of infection. My labour began stalling. We tried gas and air, syntocinon (which they accidentally had put at the maximum), manual retraction of the cervix, an epidural before I was scheduled in for a caesarean after I didn't birth in the timeframe they had given me.

I was left a sobbing, snotty mess, feeling disempowered and shattered that my nine months of preparation had left me with all the things I didn't want. I couldn't get out of bed for my baby for the first three days. I would think back to my birth and cry and I believe that my birth contributed to me developing postpartum depression.

I read a pre and postnatal personal trainer's post a few months after my birth. She wrote, that if you don't get the birth you want, you didn't put in the work you should have. She explained that her first birth was traumatic and so she did some research and some journaling and voila! she had a 'great birth' for her subsequent ones. I don't respond much to triggering posts, usually. I'm fairly good at thinking, 'I don't agree with that' and moving on but I suppose when it's sensitive and you feel unfairly attacked, you feel as if you'd like to defend yourself. We conversed over the next few days. She explained that she had a hospital birth for her first but chose a planned home birth in order to change the environment. I remember feeling sad that now I had had a caesarean that probably wasn't going to be a possibility for me but I vowed that I would employ a doula next time to help me advocate for myself, if I was to birth again in a hospital. Her post though, did leave me feeling as if maybe I should have done more research.

I always knew for a subsequent birth I wanted to change things. I began speaking to people locally and discovered there was a private midwifery centre not far away. I asked them if they would entertain the thought of supporting a VBAC mother at home and we agreed that because my caesarean was because of a 'failure to progress' there wasn't really anything that would place me at a greater risk (albeit my uterine scar, which to rupture is less likely than it would be to die driving to the hospital). By the time we considered conceiving again, this centre was closing down and I was lucky enough to find someone else that had only just moved to the region. In regional areas, we really don't have many options for birthing outside of a hospital.

For my second pregnancy, I was more discerning on which routine tests I wanted to adopt and which I didn't. Bradley and I had already done genetic carrier screening before our first but we also did the first trimester combined screening, the 20 week ultrasound and regular blood tests. I tested at home on my own, pricking my finger after meals, for gestational diabetes. I had regular appointments with a pelvic floor physio to ensure I was better able to connect with my pelvic floor. Other than that, I tried to relax into trusting my body, a mindset I wanted to have in my birth. I did read some more books, including books on nutrition in pregnancy, gestational diabetes in pregnancy and 'Reclaiming Childbirth as a Rite of Passage' by Rachel Reed. Her book, focuses on how our hormones, as women, are pretty much magic and if allowed to do what they are supposed to, we are less likely to need intervention.

I holistically journaled about my pregnancy, writing down fears, hopes, dreams and I shared these with my midwife so that she was also on board. We discussed any fears I had and created pathways that would be most appropriate should those situations arise.

My second labour was everything I'd dreamed of. In early labour, I sat at the top of our hill, in the grass, in the same spot Bradley and I got married, watching the sheep graze in the paddock below. There was a soft wind blowing and I reflected on the beauty of nature. As night fell, we blew up the birth pool and prepared snacks. There was no thought of 'when should I be going to hospital' in the back of my mind. I gave up on sleep and set up lighting and put up some affirmations (that I never looked at after that but the creation was the important part, I suppose). I swayed around my living room, leaning over the dresser we'd bought for the baby, which has now become 'Charlie's altar'.

I spent a lot of my labour in the pool after our midwife arrived at midnight. I felt the urge to push, which I never did with my first. I felt confident that I could do it; I had to do it! I was pushing for a long time though without feeling progress. As the sun began to come up, I hopped out of the pool and tried lots of different positions. Between 7 and 8am he began to crown and we noticed blobs of meconium coming out. My midwife realised baby was breech and we had ambulance officers waiting outside for when he was born in case he needed resuscitation. When the baby is in the birth canal though, there isn't much you can do but birth it. My neonatologist told me that in this situation in a hospital, they would either use forceps, or have to manually push baby back up the birth canal before having an emergency, emergency caesarean. So either way, given his presentation and the surprise nature of his breech position, it would have been traumatic.

Little Charlie was not only breech, he was the wrong way around, arms back, chin back and not moving or helping me in anyway. I birthed him on my own up to his chest. I felt so empowered at that point. I remember specifically thinking, 'f*** yes. I'm going to birth my baby, VBAC, at home, breech with just a birth comb as pain relief.'

Charlie's birth from there on, was a difficult extraction. It required many maneuvers to get him out and I definitely felt that either my baby or I was going to die. My midwife did an extraordinary job of getting my baby out and I'll always be so thankful for her calm and expertise. The ambulance officers did an extraordinary job at communicating with each other and professionally and respectfully entering that birth space when they were needed. (They did such a good job, that despite him not breathing, his brain was relatively unharmed from a lack of oxygen, of which the neonatologists were amazed.) The ambos, alongside my midwives, worked on Charlie for 25 minutes, doing CPR before eventually intubating him and taking him to hospital. They kept him alive long enough for the doctors to work out he had a congenital neuromuscular disorder.

I was left on my living room floor, surrounded by blood, my placenta detached but not delivered, in the aftermath of what felt like the worst nightmare of my life.

So, I did the work. I made the choices. Was it a 'great birth?' No. It was a birth that will be seared in my memories and haunt me for the rest of my life. Was it a magical night and morning? Yes. My baby came into this world. It was one of the most magical nights of my life.

I read something this morning by a midwife that does a lot of work in the homebirth space. She posted on her Instagram saying, 'Great births don't happen by accident. Access my classes here.' I know her intention was to sell her classes and thereby she wants to sell the idea that if you put work in, you will have a 'great birth.' But it perpetuates the idea that birth is something you have control over.

I was dreaming of birthing my baby in a water birth, surrounded by twinkle lights with soft music going. I was dreaming of experiencing the euphoria of birthing your baby and being able to guide them into this world. I had a taste of that but the rug was ripped out from under me in a cruel twist of fate, nature, whatever you want to call it.

I think though, what I've learnt, is that we shouldn't aim for a 'great birth.' We should aim for a birth, where we, as women, feel empowered. Whether that's through a caesarean, assisted or physiological birth.

At my six week appointment with my obstetrician at the hospital where we were transferred, she told me that, "should I have birthed in a hospital, there may have been a different outcome." (She did not have any information about Charlie's condition, only the transfer.) I responded that I felt confident there could not have been a different outcome and she said "we could have used forceps, and saved you the trauma." When I responded that whilst my birth was traumatic it was also empowering and that was important to me, she responded, "oh, you are one of those women." As if, only some women wish to be empowered during birth.

What I am thinking this morning, is that childbirth contributes greatly towards our self-confidence as we enter motherhood or a new stage of motherhood. Every mother should be supported to feel empowered in birth, whichever way that goes. It should not be insinuated that if you didn't have a 'great birth' it was because you didn't prepare enough or that only 'those' women want to feel empowered.

I believe that great births can happen by accident and also because of the work we put in to preparing. I say 'accident,' insinuating a rare lack of fortune, knowing full well, that I only see great births as an 'accident' because I've experienced at least one birth that was extremely unlucky. So I see an 'unlucky birth' as an outcome of greater certainty than a 'lucky birth.'

I know that we can prepare for birth and I know that most births don't end in trauma (although stats suggest 1 in 3 women feel traumatised by birth, the majority of those in hospital). I acknowledge everyone comes to birth with their own set of beliefs and values and what I consider a 'great' or 'unlucky' birth might differ from another's perceptions. Birth is so multifaceted and even the fact that I was able to carry my baby to term and birth him is not lost on my consciousness. Or even the fact that there was a private midwife that I could choose and could afford to work with (unfortunately our government doesn't yet value it as much as countries like NZ). I don't undervalue that. My point though, is that we can do all we like to prepare for a 'great birth' but is that just setting us up for 'disappointment?' Nature will always have the last say and nature has big things to teach us.

My affirmation during pregnancy and birth was to 'surrender' to the moment; the sensation and it's amazing how much this helps in life, in general. We can't always construct our realities and this especially applies to birth, one of the miracles that is still not fully understood by our human brains.

Perhaps we need to be the change in those 'clickbaity' posts that suggest you can "click on a 'great birth' here" and instead work towards births that are empowering, whether or not they are 'great'. Knowing that we made our own choices in our own home and that I was able to bring Charlie earthside, gives me momentum to keep going even when it feels impossible and I'll forever be grateful for that.