Realistic birth prep resources - no woo.

[DuploTrain]

I’m 38 weeks with my second baby and belatedly panicking that I have done no prep this time.

When I was pregnant with my first I read Milli Hill’s Positive Birth Book. I’ve just read it again and it’s given me the rage. Things like contractions are magnificent powerful surges, some people may experience them as painful.

My first labour was constant agony for 24 hours. Back to back and no “golden relief” in between “surges”. I feel lied to!

I know I can get through it again but feel like I should do some prep.

I like yoga and think breathing techniques can be a positive distraction. But not interested in visualisations / affirmations/ woo. It’s not going to be a “magical experience”, I just want it to be bearable.

Also I might be considering an induction due to the baby’s size (I haven’t decided yet) so anything with a focus on induction would be helpful too.

Any help much appreciated.

did you actually do the visualisations because they’re the only thing that got me through labour! Genuinely is different for different people and different births. Poor positioning can make it way more painful.

Otherwise, early epidural and keep moving! loads of positions that get the baby in a better position to come out. No lying on the bed feeling stressed, obvious stuff.

Good luck with it all.

I really hope my second isn’t back to back as it was the absolute worst. Felt like such a failure when I’d been in labour for days and I got told “oh don’t worry, real labour would happen soon.” Real labour? Fuck that.

Planning on an epidural this time 😁 unless it all happens too quickly in which case I shouldn’t be as exhausted anyway.

Did you do anything differently when they faced the right way? What do you think got them there?

Hypnobirthing helped me but mine never said that. Thats what makes you feel awful. I found it really helped me deal with pain so wouldn’t write it off at all but yeah that would put me off.

Another vote for Juju Sundin’s birth skills. Read it before I had my third and wished I’d read it earlier. Lots of practical advice.

I loved my tens machine

Had four babies here and only got to have an epidural for various reasons the first time round which was definitely the best! But I would say what helped the most was trying to be as mobile as possible during labour, and walk as much as you can in the last few weeks and during labour- I obviously know this is impossible for lots of people but I found it did help especially with the later stages

I wouldn’t actually recommend this. Some of it’s interesting but one of the episodes was very anti epidural (it actually called it the fucking epidural) which I found quite harsh tbh. Personally I feel like any woman who ends up having one does so because she desperately needs it. When you’ve been in labor for many days with a poorly positioned baby I find it really offensive that someone who had a lovely 6 hour home birth can sneer. Crazily enough, a lot of women go out there willing to be in as much pain as possible to do it naturally. But it doesn’t work out. Also there’s lots of anti induction, pro breastfeeding (and I do actually take a lot of their advice on board), anti medical birth on there so I’m not sure it’s the kind of thing op would like, considering her stance anyway.

I found squeezing a wooden comb into the palm of your hand helped distract with early contractions

The labourpains website (labourpains.org) is really useful if you want to find out more about pain relief options (or anaesthesia for different scenarios). It’s run by the obstetric anaesthetists association and has loads of reliable factual info.

I would like to meet this Milli Hill.Just to give her a piece of my mind about her describing caesarean sections being failures
Both of my children were born by emergency c section.Those sections were life savers.

Juju Sundin's Birth Skills. Brilliant book. It might be cutting it a bit fine though!

Try 47%

That episode of the midwives cauldron podcast is actually the only one I didn't like, but to be fair it wasn't them calling it the fucking epidural, it was an interview with another midwife.

The OP doesn't like woo, she didn't say she doesn't like physiological birth and breastfeeding!

An epidural isn't a sweetie, it's an informed choice with pros and cons

Thank you, it is a really good website, I saw it recommended on another thread a few weeks ago and had a look.

I know people find this acronym helpful but this also gives me the rage...

So many birth books and advice feels very infantilising and dismissive of women's pain and potential medical risks.

And totally agree as a c section mum that being told I should feel guilty or disappointed is beyond offensive. Safe birth for mother and baby is surely the only aim?

Less woo please if any publishers are reading!!

She said that? 😢

I agree but I do think there is a lot of outdated information about it

She didn't exactly say that! At least not if you're referring to my comment. But she wrote about coming to terms with the disappointment of having one. Whereas my experience of EMCS was more like relief, even though I lost a huge amount of blood.

My main beef with the book is how little info about c sections there was, just a tiny chapter in the book. By implication, positive birth is usually vaginal...!

Whereas my recent ELCS was most definitely a positive experience and I'd recommend it highly

I have TPBB and I was quite surprised to read this because the overall impression of the book I got is that it is about informed choice and it's not about pushing a specific idea of birth but about women being given agency and information to make choices where they exist. I will say I didn't have a caeserean (but neither do I think my births were "better" than caeserean; when DS3 briefly went breech, c-section was absolutely my plan).

So I went to see what was said about c-sections. I don't think it's that unusual or particularly telling that c-section takes up a smaller section of the book than vaginal birth - there are so many more variables in vaginal birth that it makes sense to have more time spent on that. And in any case, I think the majority of caesereans happen after a partial labour, don't they? So much of the info about labour will also be helpful to some who have a caeserean.

There is also info applicable to caeserean in the "coping strategies" (stress reduction techniques), the birth planning section - a small section on caeserean choices and a section about making a plan b/c/d etc - acknowledging that there are various factors in birth that are just outside of anyone's control.

But I do see what you all mean - I found the "failed" comment and I think it's clumsily worded. What she is trying to say is that it's common to feel a caeserean is a failure, and it's absolutely not a failure, but that these are feelings that people sometimes struggle with and basically if you're having that feeling not to feel bad about having the feeling (if that makes sense). But she doesn't suggest any other way that you might feel! Which I think is probably where the impression comes from that she is assuming everyone would feel a caeserean must be a failure.

Also, the entire tone of the talk about caeserean, despite trying to be empowering, does betray the author's bias that vaginal birth is the preferable option and caeserean ought to only be used in the most direst of need cases. Which, I think, is a problem in a lot of "physiological birth" stuff - (and the same for breastfeeding).

It's an issue because what I've typically found is if you are looking for info which is uncritically celebratory or neutral about the pros and cons of c-section (or breastfeeding) these sources tend not to have very high quality information about how physiological childbirth or breastfeeding actually works. So if you want to find out about those things, you end up in a space which is biased towards breastfeeding and/or physiological childbirth being the objectively better outcome, and this is a problem because if you are biased towards that, then you'll prioritise methods to obtain these outcomes over presenting information which women can use to say "I prefer BF/PC only if it is going to be straightforward. If there is likely to be complications or discomfort, my preference is FF or CS"

So for example, I mentioned that DS3 was breech for a short period at the end of my pregnancy. My options were presented to me as:

Wait and see if he naturally moves/try "spinning babies" (even though this is not evidence based)
Do ECV to try and force him to move (risk of complications leading to immediate GA CS)
Have a scheduled CS
Go into natural labour, have a vaginal breech birth

If you're biased towards the idea that physiological birth is the "best" outcome or avoiding CS the most important thing, then you'd probably rate those options as:

Best: Vaginal breech birth
Second best: Wait and see
Third: ECV (because it has a not-insignificant chance of GA CS)
Fourth: Scheduled c-section.

Whereas I did not feel that, for me I felt that fewer complications was my priority, so I put the four options in this order:

Best: ECV (has the best chance to enable a head down VB)
Second best: Scheduled c-section/wait and see (I didn't bother with the spinning babies)
Absolutely not an option for me: Vaginal breech birth

The whole point being that the order of preference is going to be personal. But if I wanted to find info about what VBB was supposed to be like, I would have found myself immersed in a world where VBB is presented as objectively better than ELCS (luckily for me I suppose, I was already aware of this by the time that even came up as a question). And what happened at the time is that I had loads of people rushing to explain to me that VBB is no riskier than ELCS if it's supported by experienced practitioners, but that wasn't especially useful to me because I don't dislike the idea of it because I am afraid it is risky, I dislike the idea of it because it is more complicated than a head down VB, I have already done head down VB, I know what to expect, I really didn't want to be in a position where I would have been in labour and then I would have had to get into all kinds of complicated positions etc and I especially did not want the moment where the baby's body is out and the head is not. For whatever reason, whether rational or not, that scares the absolute crap out of me and I didn't want to do it. End of story. I insisted on a scan when I went into labour (foreign hospital and thankfully they thought this was totally sensible too) and I would have immediately gone off for a c-section if he'd turned again by the time that happened.

I really like the BRAIN acronym but I tend to take instinct out of it because I don't think that's really helpful - in my own head I replaced it with "immediate" (as in replacing this with the question - is this time sensitive? - and "nothing" being the question - what happens if we don't do anything?).

Second vote here for the aniball - the skills from it really helped during an induction and forceps delivery.

this does sound woo woo, but I found the comb in palm really helpful during an extremely painful induction. I don’t know why, but it really did work

@BertieBotts I do see what you mean and I think you are sadly right that so much of the narrative falsely groups BF with vaginal birth.

I guess I'm "rare" in that I'm a big fan of so-called extended breastfeeding, but I had both my births CS under general anaesthetic. There was no golden hour and I didn't care, I was just so glad we were both alive.

I think it's a false grouping though. This is the main difference: we as individual mothers have so little control over how our births go. It becomes an emergency so quickly. It's urgent and scary and life-or-death-y. But feeding is more of a slow marathon that you work at, a skill you can build on and learn. If you fumble one day, you can fix it the next.

Maybe there's a gap in the market for pro-BF, pro-CS resources. I don't know, just thinking aloud.

We definitely need to stop telling mums that BF is doomed if they have a CS.
Edited for typos

I’m so pleased I started this thread, I’ve had some really good ideas, thank you so much.

Three people have mentioned the comb, I had no idea it was a thing but can see that it could be a good distraction. Have found a sturdy comb in preparation! Also have a TENS machine.

Have finished reading Dr Sara Wickham’s Inducing Labour. Feel more confident in my initial feeling that I won’t have an induction unless there’s a really good specific reason.

Just started reading Juju Sundin’s Birth Skills. Some useful stuff but still makes reference to the gap between contractions when there isn’t any pain… That’s just not how I experienced my first labour at all (back to back and felt like someone’s knuckles grinding into my spine, agony even between contractions). Without that I think the temporary pain of contractions would have been very bearable.

Tennis ball for your partner to roll against your lower back. Sturdy feather to lightly brush your belly during contractions.

I think I would have punched anyone who tried this 😆 I just wanted to be left alone during contractions. Preferably in silence with the lights low. I had one midwife (thankfully only for an hour or so) who would not stop talking and it drove me bonkers.

I found pacing, bobbing up and down on my toes, and counting helped manage pain. I think everyone is different tbh. The only book I read was Effective Birth Preparation by Maggie Howell which was quite helpful for practical tips, but did include some guff about how birth was better in the olden days.

Agree if you have an induction all bets are off and I would want an epidural.

I am not grouping them together as such sorry - I am meaning that the same thing happens in both.

So for example you can look for advice about how to have a breech vaginal birth and all the info that is actually helpful in how that works contains the assumption that it would be absolutely terrible to have a c-section so it's seeking to reassure you about VBB and show you that it's definitely doable/possible/not risky.

Or, you can access general info about breech babies which explains the options (ELCS, VBB, ECV) and presents them all without the "OMG wouldn't you HATE to have an ELCS???" bias, but it also generally contains loads of myths about VBB and presents it as this suspect, weird and dangerous option.

When the reality is that VBB is possible and probably not as dangerous as claimed but it is also not straightforward and so some people will prefer it but some absolutely won't.

And ELCS is major surgery and has downsides but the upside of it is that it's predictable and extremely unlikely to be traumatic or complicated. Some people will prefer this option and some people will absolutely hate the idea of it and might prefer to explore if VB is possible or not.

But nobody is presenting that balanced view. It's either "Look, VBB is totally possible and safe and wonderful! Much better than a terrible, risky ELCS!!" or "Why would you even want to VBB?? That's weird. Have a C-Section, everyone else does."

And in breastfeeding support. If you're in a situation where you are not producing enough milk (for example)

All the good quality BF support, which actually knows how supply works, also contains this assumption that your ultimate aim is to EBF and that continuing to use a bottle would be absolutely the end of the world because breastmilk is ~magic~ so it focuses so much on eliminating bottles and getting the baby back to the breast. This might involve a lot of complicated or impractical things but they are all seen as "worth it" because they lead to the ultimate goal of EBF. Which to some people, it might be. But someone else might do all of these things and then later feel like why did I spend all that time and energy when I could have just bottle fed/mix-fed and enjoyed my baby? Or they might end up FF anyway and regret not just FF in the first place.

Or you can get the standard NHS advice which is to top up with formula to fill the gap and basically not much info to support BF so you end up fully formula feeding before too long. And then that woman might feel relieved or she might feel that she has failed and she might later come across info about BF supply which makes everything make sense and feel cheated she did not have that info. Or she might see other women struggling on with BF and think "Thank god I never got into that".

There's nobody sitting in the middle who says "What would you like this to look like?" and helps you figure out if your ultimate goal is EBF, or expressing, or some/any BF, or just whatever is the easiest path, nobody really lays out the options of "OK we can top the baby up with formula, or we can keep expressing, or we can do this complicated tube thing, or we can go to bed for 4 days with the baby" (and explains all the short term and long term implications of each of these decisions).

(Actually I think some IBCLCs do offer this support but they seem to be the exception, not the rule).

And yes, I do think the "OMG not c-section!" group overlap quite significantly with the "OMG not formula!" group but the main point I mean is that to get the good quality information that isn't full of myths you end up in a pro-BF or pro-physiological birth space, not a neutral space.

There are probably other areas where the same kind of thing happens, I just happened to notice the similarities here.

There is actually a chapter in Birth Skills about back to back labour - skip to it and read that one if you like.

I had a very intense labour with my second that I really thought had been back to back and reading that section after that labour absolutely floored me - it was incredibly helpful.

I used it to make a sort of dual plan where I said OK, when I get into hospital I'm going to ask for a midwife to check the position of the baby and tell me if they think it's back to back and if so I'm going to do all of these things. And if it's not back to back then I'm going to do all of those things. I even made a smaller, bullet pointed version for each to give to DH to remind me what to do.

That was before the breech thing which sort of took over and then honestly like every birth I never even took the birth plan out of my bag BUT it didn't really seem to matter that much because the process of going through OK, I have a plan for THIS scenario and also THAT scenario just seemed to help me stay calmer and cope anyway.