Positive Birth Book
Milli Hill's (Christmas) birth story
Challenging negativity and fear of childbirth, and brimming with everything you need to know about labour, birth and the early weeks of parenting, The Positive Birth Book is the must-have guide for pregnant women. A widely acclaimed bestseller since it was first published, it has empowered hundreds of thousands of women worldwide to make informed, positive choices about their births.
Fully revised and updated, this new edition will help you work out what kind of birth you really want, and learn how to maximise your chances of getting it. The book’s trademark Visual Birth Plan icons can be downloaded for free to help you create a birth plan for every eventuality.
My birth stories
I can still remember the moments that followed my first positive pregnancy test. Alone in the house, I stood in front of the long bathroom mirror. Contemplating my reflection, I had two clear thoughts.
Thought 1: Oh. My. God. There’s a BABY in there.
Thought 2: Oh. My. GOD!! It’s got to get OUT!
The rest of my very long pregnancy was largely spent preoccupied with these two thoughts, mostly the second one. I was 31, in love with my partner, and thrilled to be expecting. At the same time, I also someone who had got drunk and agreed to do a parachute jump, only to find when they sobered up that backing out simply wasn’t an option, and that – worse still – the plane had already left the ground.
For the entire pregnancy, I felt like I was several thousand feet up and about to free fall against my will. I cried uncontrollably at the slightest opportunity, which, as women often do, I blamed on ‘hormones’. But actually, I was just bloody terrified. They were ‘tears for fears’.
It’s well known that there are two basic responses to human fear:fight or flight. In pregnancy, so often a time of great fear for women, this can translate into taking one of two paths – neither of which is ‘right’ or ‘wrong’. Some women go for ‘flight’ and just don’t engage with the situation. They use phrases like, ‘I’m just going to go with the flow’,or, ‘There’s no point preparing for birth because it’s so unpredictable’.Then there are the ‘fight’ group, who turn having a baby into a PhD.I fell into the latter category.
I read every book I could get my hands on, even a history of birth.I attended several courses, both on my own and with my partner. I joined online groups and I googled things. A lot. Often in the middle of the night. I planned a home birth on the advice of two different friends, both midwives, who told me I’d be less likely to have interventions and added, ‘At home you get two midwives. In hospital you’re lucky if you get one’.
As I got nearer to the big day, things started to get political.Suddenly my midwives, who had been all smiles about my birth plans up to that point, told me that I might not be able to have my baby at home after all. ‘If there aren’t enough of us on duty when you go into labour, you’ll just have to come in to hospital.’ The obligatory google revealed that this was a common story – almost every woman who was planning a home birth was getting this late memo.
Conspiracy theories abounded. ‘They wait until you are too pregnant to argue before they give you the bad news’, was a common theme, and most home birth websites and groups told stories of women ‘standing their ground’, even in the throes of labour, and engaging in a kind of stand-off with the midwives, in which a baby slipping out on the bathroom floor with no professionals to catch it became the ultimate bullet.
This did not help with my already sky-high terror levels.
However, I channelled my hormonal rage and fired off letters to myMP and Head of Midwifery. This did little to help, but it did at least give me a project for the strange couple of weeks of maternity leave before the baby was born, and it was arguably more stimulating than picking out nursery colour schemes.
What happened next would make my home birth crusade pale into a distant memory. My due date arrived: 21 December. I went to a festive party that night and took great pleasure in answering the inevitable question, ‘When are you due?’ by saying brightly ‘Today!’.This seemed to scare the life out of people, who were perhaps expecting an Eastenders-style delivery in which I gave birth under the Christmas tree without even having time to remove my tights.
Sadly, perhaps, there was no such drama. The days passed, andChristmas was tense. The comical reindeer babygro we had hoped to dress our newborn in was put aside, and everything in general became a lot less funny. The phone rang just after Christmas. It was the hospital, and I was summoned to see a consultant. ‘Uh-oh’, my wry midwife friend told me. ‘You’re becoming a problem. They’ve decided to get a man in.’
She was right. After months of midwife-led care, I found myself in the office of a very big bloke in a suit. I was a week ‘overdue’. He told me that the risk of stillbirth would increase if I went past 42 weeks and said that he wanted to book me in to be induced in a few days’ time.He also offered to give me a ‘sweep’. (See page 224. He had very big fingers. I declined.)
I had four sweeps done by the midwives who continued to visit me at home, and in spite of extreme needle phobia I tried daily acupuncture. As things got more desperate, I went for bumpy car rides, ate multiple pineapples, meditated, visualised and chanted.Finally, at 42 weeks, I drank castor oil, which, for those of you who are curious, tastes like melted tea-lights and makes you shit through the eye of a needle. If you’re still curious (and I’d understand if that last piece of information had dampened your appetite slightly), turn to page 223 to read about natural induction.
The castor oil did seem to have some kind of effect, other than that described above. A trip into hospital for monitoring confirmed I was having very mild contractions, visible on the graph and regular. ‘Go home and have your baby’, they said. ‘But before you leave, let’s just give you one more really vigorous sweep.’
World-renowned midwife Ina May Gaskin (see page 169) would have been horrified by this suggestion. The cervix, she explains, is a sphincter muscle, and like all other sphincter muscles, it will completely close for business if it doesn’t feel comfortable and safe.And this, I believe, is what happened to me. My shy little cervix, which was presumably just beginning to get going on Project Labour, didn’t like that vigorous sweep one bit. It slammed shut in horror – and those mild contractions in hospital were the last signs of natural labour I experienced. A few days later, at 42+3, I agreed to be induced.
They say what doesn’t kill you makes you stronger and it’s certainly true that all of my experiences played a huge part in shaping the passion for improving childbirth that I have today. My induction ended in a healthy baby, my completely beautiful and loved little girl, Bess.But it also ended with my feet in stirrups, an episiotomy, and a forceps delivery. It ended in an unpleasant third stage in which the obstetrician leaned on my stomach in a way that made me feel hugely embarrassed and objectified. And it ended in several months of struggling to come to terms with some of my birth memories, as I felt shattered and more than a little bit lost.
From personal experience I learnt how hurtful it can be to be told that ‘you have a healthy baby and that is all that matters’. My experience set in motion many thoughts about what needed to change about birth so that as few women as possible would start motherhood feeling physically and emotionally damaged. But changing birth for everyone else would have to wait: first, I had to change it for myself.
My second daughter was born at home in a birth pool, with her dad, two midwives, her auntie and her two-year-old sister present. I had asked the midwives in panic during that pregnancy, ‘But what shall I do with my toddler! Surely she can’t be around at the time of the birth?!’.‘Why not?’, they asked me. ‘What don’t you want her to see?’
Their question challenged me, and revealed to me just how muchI was still misinformed about childbirth. With their help, I was able to reframe my perception, and to anticipate birth as something calm, normal and beautiful. There would be no screaming, no bloodbath, no loss of dignity, no begging for drugs. All the things I had been told about birth as I grew up as a woman in 20th-century Western culture, I needed to unlearn.
Finally, I did something that I had been too scared to do in my first pregnancy. I watched birth films. I can still remember the one that affected me most: in a darkened room, a woman was on all fours in a birth pool. There was no sound but the gentle lapping of water as her body made small rocking motions back and forth. Every few minutes, she made what could only be described as a low mooing sound. Then, with a sudden movement upwards that broke the sense of tranquillity, she reached down and in a few splashing motions brought her baby to the water’s surface.
I was transfixed. This did not look scary at all. It was so peaceful, so everyday. And nobody touched her, nobody ‘egged her on’ with incessant chants of ‘push’; nobody took her baby, declared its sex or wiped it or cut its cord.
This was the birth I aimed for, and although it wasn’t quite like this, it came close. I still had so many fears, and, although I was already a mother, I felt in some ways a novice: I’d never gone into labour naturally, and I’d never pushed a baby out unaided, for starters. So I panicked a bit, and cried a bit, and doubted myself quite a lot. I didn’t quite have the confidence of the quiet moo-er in the dark pool – I was a bit more flappy and a bit more vocal. But in the end, my 10lb 4oz daughter came out quickly and easily, with only a small tear that did not need stitching.
I had independent midwives (IMs) – an option available at the time of my second and third births in 2010 and 2013, but which has since been complicated by insurance issues. I always feel slightly awkward about confessing to this, as I’m aware that many people are not able to afford to ‘go private’. What prompted my choice was finding out that my localNHS midwives were now operating on a ‘bank’ system, making it likely, they told me, that I would a) not know my midwife and b) get a midwife who had never attended a home birth, let alone a water birth. There was still the problem of them potentially not being able to attend at all due to staff shortages. I lost confidence in the system, and raided my savings account.
Of all the financial decisions I’ve made in my life – many of which have been really rubbish – this must be the one I’m most at ease with.For the amazing, loving and supportive care that I received, and the blissful, joyful birth experience that ensued, I would have paid much, much more. Many people dig deep in their pockets or get help from
family to make their wedding day really special. Why should the day we have our babies be any different?
Giving birth ‘outside the system’ suited me well because my body clearly did not want to fit in with the system. Again I went ‘overdue’, but this time I just sat it out, with no sweeps, pineapples or other desperate measures. My baby came at 42 weeks on the dot. Had I been under NHScare, I would almost certainly have been induced again.
My independent midwives exuded confidence in women’s bodies and this enabled them to stand back and trust me to be the ultimate decision-maker. This kind of care should be available to all women, not just the lucky few. After that great home water birth experience I setup the Positive Birth Movement (PBM), in the hopes that by creating a network of groups where women could come together and share information and stories, birth could change for the better. Often ‘the system’ gets the rap for women’s negative birth experiences, but maybe if women – who are, after all, ‘the consumers’ – had a better awareness of their choices and rights, they would become more demanding, and the system would have no choice but to accommodate them.
The PBM – which started as just a small idea – spread like wildfire.Within just a few weeks there were groups popping up all over theUK and beyond, and at its peak the movement had over 450 groups in countries around the world. The PBM network ran for nearly a decade, from 2012 to 2021.
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