My baby would have died!

How many times have you heard this one? I needed interventions, if I hadn't been in hospital my baby would have died. This is such a difficult thing for me to hear. Because in almost every case it is just not true. Think about it! If you were a midwife, at what point would you choose to call in the Doctors? Only when the baby is certainly going to die otherwise? Maybe what it has a 50:50 chance of survival without medical intervention. 1 in 10? 1 in 100? 1 in 1000? What level of risk could you tolerate when its you are professionally responsible for the possible outcomes? I'm guessing its towards the 1 in 1000 end of the scale. Am I right? This is the reality of the situation. Yes, there are very rare circumstances which present a real medical emergency -- a sudden turn of events which puts baby in immediate danger -- but these are not the norm. More usually midwives are aware that labour is putting a strain on the baby. They monitor the situation over a period of time. It is a gradually evolving situation. Their evaluation of the risk evolves over time too. Risk to the baby, and to themselves professionally.

But sadly the situation is not always communicated clearly to labouring women. What language do professionals use in the delivery room? "OK, the baby is distressed now." "We need that baby out now", "I think we need to just give the baby a helping hand". Its natural woman who hears these things is likely to come away with the impression that their baby was saved from certain death, but in the vast majority of cases its just not true.  To add to the confusion, professionals are often keen to justify the choices made during labour after the fact, for their own sakes as well as for the parents. "Its a good job you had a c-section, look at the size of his head." These comments are no doubt well meant, and may provide some comfort in the short term, but in the long term they perpetuate the myth that birthing is horrendously dangerous, especially outside of a hospital setting.

A recent study in the UK found that for the majority of pregnancies, those were there is not pre-existing medical concern. Giving birth outside hospital, in a midwife lead unit was just as safe for babies, but with a lower rate of interventions, and a higher level of maternal satisfaction. And for second time mothers with no risk factors, giving birth at home was equally safe. This news may have shocked the nation, but it did not shock our midwives. They already knew that while there are some risks to giving birth out of hospital, there are also risks associated to giving birth in hospital. Every little intervention can affect the natural course of child birth, which is at its essence an intimate bodily function, fuelled by a cocktail of hormones, notable the "shy" hormone of love Oxytocin, and involving the woman opening her bottom to a level she has never experiences before. Its no wonder that some women find they were labouring well at home, but everything cools off at they bump down the highway and into a brightly light busy hospital. It is possible that simple going to hospital could put your at a higher risk for prolonged labour, which is probably the most common cause of interventions.

But there are other factors at play here too. At home, there isn't the back-up of medical support. This might sound like a dangerous situation, but when you consider that all interventions also come with some level of risk to mother and baby, it might be advantageous to put a bit more space between yourself and the surgery.

You see, I was one of those mothers who had a prolonged labour. 28 hrs in total, and because the baby was wrapped in the chord he became distressed as I pushed him out. I won't lie to you, that was a horrendous birth. Painful, long and difficult. And towards the end, everyone in the room felt some fear as they listened to my babies heart beat drop lower and lower with each contraction. I am quite convinced that had I been in hospital I would have had an assisted birth.... if I even made it that far. I may have hit the "failure to progress" criteria and had my labour augmented by synthetic Oxytocin, which may have put my son under even more pressure. I may have even ended up with a c-section. But I wasn't in hospital, I was in my bedroom with two highly qualified midwifes. I was too far from hospital to "save him" in the last few minutes of birth. They started uttering the phrases about... as polity yet urgently as they could, and they waited and encouraged my to push out my baby.... and I did. As soon as his head was out, he cried and by the time I figured out how to turn from all fours to lie on the bed, shaking like a leaf he was as rosy as a baby can be. 

It was certainly a tough labour which left my with little energy for appreciating my baby before I passed out from shear exhaustion, but at least I came away with the knowledge that my body CAN do the job it was designed for, and with my womb intact ready to carry and birth another baby without the additional risk of a scar. At least I was there in my bed, with my baby and my husband. Ultimately this tough experience, which I would not wish on anyone opened the way to the gloriously triumphant birth of my second son three years later. A wonderfully fun and loving birth which gave us a easy start as a family of four.

Should I breastfeed or bottle feed?

I enjoyed breastfeeding my two boys. Breastfeeding can be all-consuming at the start while you and your baby are learning together, but once you get the hang of things it seems easier than bottle feeding to me.

First there is the practical side of things. You don't have to sterilize anything, take bottles with you, think about how long you will be away from home etc. As long as you are there, baby has everything they need to eat and drink. This was very important to me because I've always been somewhat impulsive, and not a great planner. Plus you can feed your baby the moment you want to... no waiting around for bottles to cool while baby cries. And do I even need to mention the cost of formula? 

I also like the way that breastfeeding encourages you to trust your baby. Its hard to do at first as you are learning to read the way your baby communicates, but since you are not measuring you HAVE to go by how your baby seems and the signals that they are giving you. And best of all (for me) you don't have to follow a particular routine, or analyse what your baby needs next, because the breast meets almost all their needs. Hungry, thirsty, tired: it doesn't really matter. You give them the breast and they either perk up or fall asleep. And if they only drink three sips, nothing is wasted.

At the end of the day, babies LOVE to breastfeed and the breast is such a powerful tool for parenting. I have a huge respect for all those mums (not to mention the dads) who care for their babies without it, whether out of choice or necessity! Please don't call your choices selfish!

Are there any downsides of breastfeeding? Well you do tend to be glued to your baby, which is both a blessing and a curse. There is still plenty of chance for your partner and family to be involved, but if your baby doesn't take a bottle you may not feel able to leave your baby completely for more than an hour or two at a time. Of course many mums don't want to anyway, regardless of how they feed. 

Some women feel uncomfortable about breastfeeding in public. It certainly takes a bit of getting used to, but it is much easier is you make friends with other mums, so that you can stick together the first few times.

You might think that you would get more sleep bottle feeding, but studies show that breastfeeding and bottle feeding mums are equally well rested (or should I say poorly rested!). Although breastfeed babies wake more often, they fall asleep again more quickly because they don't have to get up to make bottles and because breastfeeding releases hormones which make baby AND MUM sleepy. Breastfeeding mums who choose to cosleep get the most sleep of all, because they can feed lying down and even fall asleep during the feed. (And the evidence now suggests that sharing a bed can be safe for most babies with a few precautions.)

Breastfeeding hormones seem to have some effect on me, beyond making milk, which could be seen as a positive or negative: they seemed to make me a bit more patient and confident and content... more "motherly" I guess(?), but I also have less get up and go. Breastfeeding can also affect your libido -- giving birth and caring for a newborn tends to anyway, but if you are breastfeeding this might continue for longer. It seems to vary a lot from woman to woman. On the positive side it can suppress your monthly cycle for months, or even years, and can even be a pretty good contraceptive. Do your homework on this if your interested, I don't want to be held responsible for any surprise siblings!!!

If you decide to breastfeed, its a good idea to get informed beforehand and find out where to get local support after your baby is born to improve your chances of breastfeeding successfully. In the UK, look out for Baby Cafes and La Leche League groups