Does Birth Matter?
By Sharon Gavioli

“ Change and growth take place
when a person has risked herself,
and dares to become involved in
taking more responsibly
for their own life.”

Herbet Otto

The births and mothering of my children have been the most life-changing, challenging, empowering and joyful experiences I have encountered. Through these experiences I have grown as a woman, as a mother and as a person. They also led me to assist women and their partners discover what is important to them when birthing their babies and how they approach parenting. It is a privilege to be involved with women during this amazing time of their lives. At times it is also frustrating and there are moments when I wonder whether the way we birth our babies does matter.

In the current environment, it appears to be increasingly difficult for women to give birth naturally or even vaginally. This is especially the situation for women choosing private care. The indemnity insurance crisis is affecting how women’s labours are being managed. Recently, there was an unconfirmed report that in a two-day period nearly 90% of women at a private maternity unit birthed their babies by caesarian. As much as I believe there is the need for appropriate medical intervention that enhances the well-being of mother and baby, I find it difficult to believe that so many women required this type of birth. Have we as women lost so much trust in our own bodies to birth our babies? Or is it that we place too much trust in a system that we think will provide the best care for ourselves and our babies?

For women in Brisbane, there are limited options in the type of care available. Only a small number are accepted into the Royal Women’s Hospital Birth Centre and there are only two homebirth midwives. My personal journey of birth saw me progress from a women placing her trust in the medical system to a woman who placed trust in my own ability to birth my babies and seek out appropriate care that would support me in my choices.

The birth of my first baby was nearly 20 years ago in a Private maternity unit with obstetric care. My goal was to have a natural birth. I attended pre-natal education and attempted to express my desires for the birth to my doctor. Ultimately, I believed the system would do the best for my baby and me. My son was born after a 11 hour labour, where I laboured on my back, was given pethidine instead of physical and emotional support and was persuaded to have an epidural even though I was in transition(no-one informed me of this, I was told it would be hours yet). One hour after the epidural was inserted, my beautiful baby was pulled from my body using forceps (my doctor had rounds to do) and I had been given a large episiotomy. I was unable to adequately hold and welcome my baby and I felt totally exhausted. Despite this, I bonded well with my son and he was a joy to mother. In the months after giving birth, something inside told me that birth didn’t have to be like this and I realised that my whole labour had been mismanaged. I knew I had to take more responsibility for my next birth experience.

With the birth of my second son, I again chose obstetric care with a different doctor who seemed more supportive of natural birth. I birthed this baby without any pain relief and the only intervention I experienced was rupturing my membranes one hour before the birth. Unfortunately this was done without my consent. On reflection, I realised that this birth experience had a more positive outcome than the first. I believe this was largely because I was given a private room and basically forgotten by the medical staff. I was only transferred to the labour ward when I was fully dilated. I was also attended to by midwives as my doctor was unavailable.

I felt much more empowered by this birth experience and again chose this type of care for my third baby. My first daughter was born after a 4 hour active labour, where I arrived 8cm dilated on admission to hospital. I required no interventions and birthed “on the bed” in an all fours position. During my post-partum stay in hospital, I was cared for by one of the labour ward midwives who suggested that the position I chose for the birth really wasn’t a good one. I had done what my body needed to do but it didn’t seem acceptable to my carers. This left me wondering was I wrong to behave instinctively in labour or was it rare for the maternity staff to see a woman responding to her labour in the way she needed to.

As I am a very slow learner and didn’t feel I had a lot of options, I was again cared for in a medical model for my fourth baby. This birth showed me that women really have limited choices regarding their care and most importantly the emotional needs of a woman are not adequately met in this model. This baby was born at 32 weeks after unexplained pre-labour rupture of membranes. I had an elective caesarian, as I was informed I would be putting my baby at risk if I attempted a vaginal birth. I asked for a second opinion, I was discouraged by the midwives to pursue it. Feeling confused, vulnerable and partly responsible, I agreed to the procedure. This birth left me depressed, feeling like a failure but even more determined to help other women with their births.

My last babies were born at home in the water under the care of a midwife. For the first time, I was being supported in the way I wanted to birth. My emotional and spiritual needs were treated as just as important preparation for birth as my physical needs. With these last births, I was able to labour uninhibited and felt very much able to flow with the labour knowing people who trusted my ability to birth were supporting me.
The births of these babies again provided me with opportunities to grow but in a different way to my other baby’s births. I experienced an elation and sense of achievement that I was able to fully embrace in my own environment. Their births showed me the simple power of a birthing woman and that often all a woman needs is to feel safe, loved and supported to birth in her own way. For each woman where they feel safe will be different. What matters most is that they are being cared for by some-one they trust and fully supports them in their choices.

I believe the time has come for women to start reclaiming their right to birth their babies without interference. My babies’ births taught me so much about the sacredness of birth and that this is what I need to share with other women. We as women can no longer believe the system will do us no harm. Birth currently is still very much seen as a medical event, with our care providers waiting for something to go wrong which often does due to the fact women are feeling frightened, unsupported and lack trust in their own ability to birth. Birth is painful but it is a pain we have the resources to deal with. That is, if a women is labouring in an environment where she feels safe, where she feels supported and where she can respond to her labour in an instinctive way.

Our babies have the need to experience their births as nature intended. They need to be welcomed by a mother who is hormonally charged with labour hormones so there is the optimum opportunity for bonding to occur. Women are being convinced that they cannot trust their bodies, that they cannot cope with the pain, and that they need assistance from experts to birth their babies. Women are also being told that there are no positives in experiencing a natural birth. They are told as long as their babies are healthy the way they are born is not important. Each baby’s birth offers women an opportunity to grow no matter what the birth experience is. While I trust each woman’s experience, I also have a desire for women to truly seek out care and support that reflects the way they would like to birth their babies. It is also vital for women to explore their beliefs so they find a place in their hearts where they can trust their ability to birth their babies because the way we birth our babies does matter!