Home Birth Conference - Reflection
“There’s no place like home”
The title for the Home Birth Conference 2019 held in Christchurch, New Zealand 2nd to 3rd November.
Two days of beautiful sharing, caring, love, connection, laughter, discussion, and in some moments, tears. A time of holding space as stories were told of the sacredness and personal journeys of our lived experience of birthing and being born.
Those attending included midwives, student midwives, doulas, birth educators, health promoters, mums and dads and several babies and toddlers from around New Zealand.
14 presenters spoke on a variety of topics, including 3 who told the story of their birthing experiences.
A midwife skilled in and passionate about home birth and currently working within a tertiary obstetric hospital shared the need to bring home birth knowledge and skills into the hospital setting, and to encourage colleagues to ‘centre the women’ and protect their innate wisdom and desires if needing secondary care (Geddes, 2019).
The interplay of the nervous system and hormones termed “Neuro-asthetics” was emphasised in the role of acknowledging our senses, feelings, intellect and physical abilities and the importance of art, music, poetry, stories and nature within the birth experience. And the hormones, oxytocin (love hormone), vasopressin (love and protection), serotonin, melatonin, prolactin (also involved in making meaning out of our experiences), dopamine (addictions and wanting more and more) and our endorphins (pleasure hormones), all an integral part of the birth process. (Davies, 2019).
The need for sharing, caring support groups
Creating ‘Mother to Mother’ peer support and breast feeding programmes and linking mothers to them. A place for sharing experiences, hearing and being heard as mums (and dads) tell their stories. Support for parents to be able to make informed and educated decisions about their birth, and in guiding and enabling mums to listen to their intuition, their inner wisdom and innate knowing. When birth proceeds as nature intended, it can be the most empowering experience. It is our experiences in life that give us challenges for growth and personal development.
Maori cultural perspective and how this impacts cultural care and understanding
Anton Matthews gave us two engaging insightful cultural presentations. The first, ‘When Tikanga meets Ture”. Tikanga is one’s custom, habits, manner and guiding principles. Ture is the law, rules, statutes, Acts of Parliament and the judicial system.
In this day, Ture trumps Tikanga but unfortunately many may feel unsafe as they lose their dignity and respect in this process.
For Maori in New Zealand, Tikanga enables being able to have your say. Everyone involved sits and discusses the best course of action. Every one has a voice and is listened to. Respect is gained for all and the decision is made. There is much we can learn from this process for all cultures and groups. Sharing and conveying our ideas, things that have meaning for us, and connecting on a deeper level for the best outcome for all.
Tikanga provides us with a guideline for life. Ask yourself and others “Am I showing Aroha (love) to ….., in my actions and words”. We do know, from small children to adults, if we are showing aroha or not - to the land, to trees and plants, to animals, to one another (Matthews, 2019). Aroha means love, deep affection, giving unconditionally.
Tikanga provides this guiding principle of how we should care for and relate to one another. How do we ensure Tikanga for all - ask the person what is important for them and respect the values and beliefs they hold dear to their culture and their heart.
The second part of Anton’s presentation was on New Zealand’s Treaty of Waitangi. Te Tiriti o Waitangi was an agreement signed in 1840 between the British Crown and Maori Chiefs. A founding document with 4 principles. Partnership, Protection - of rights for all, Participation - same and equal opportunity to participate, and Reciprocity - recognising differences in privilege and providing opportunity and knowledge for all to succeed. As Anton stated “If we all do these 4 principles, we will be okay”.
Birth is an ancient tradition - we have all been born.
I remember from my early research as a midwife teaching nurses in their nursing and maternity training, that the uterus is capable of birthing the infant without any pushing ‘assistance’, yet this is rarely seen in hospitals. According to Cinelli (2018), environments that disrupt a woman’s innate ability will not enable her to have that kind of birth. A birth where the brain releases a large amount of oxytocin which triggers additional contractions that expel the baby from the body without any pushing necessary, are a normal part of natural birth called the ‘Fetal Ejection Reflex’ that only occurs if there is no disturbance.
“Fetus ejection reflex precedes possibly the most transcendent moments in a woman’s life, the knowledge of herself and her part in creation of another life, the deep rooted discovery that she herself has transcended her fear and can become the roaring lioness that will protect and care for her new baby” (Littlejohn, 2014).
Water birth and during labour
25% of women in New Zealand, birth or labour in water. Research findings show water birth is associated with a high level of satisfaction and that there is no clear difference in maternal and neonatal outcomes between land and water births. Women spoke of the freedom, of owning their experience, that “no-one can do things to me when in the water”, and that “the pool, dim lights, warm water felt like it was theirs”. (Kara, 2019).
Mindful birthing
Allowing space for different emotions without judgement and for the birthing woman to say and express how she feels, enables pleasant and unpleasant responses to open up (Veidman, 2019). As Brene Brown (2019) writes, “We cannot selectively numb emotions. When we numb the painful emotions, we also numb the positive emotions”. We can use mindfulness to embrace pain and change our relationship to it.
When birthing plans, ideals, and dreams change we need to enable time to adjust, to reset our focus and enable the accompanying emotions. For many, birth is a traumatic experience created through one or a series of unexpected, dramatic, isolating events, and may include comments, not being heard, wishes being denied, consent not being given, information withheld, obstetric opinions and actions and more (Sargent, 2019). Carla Sargent spoke of: the mother’s extreme anxiety, belief her body is faulty, inadequate, silently blaming and berating herself, feeling not enough, anger at her partner but doesn’t know why, and fear of her next birth; and that ‘it is not the mother who failed, it is the system that let her down, failed by the system of care’.
When as a society as we going to look at this. When are we going to guide each women to trust in her body’s innate ability and wisdom? To enable the birthing process to evolve as nature intended. To teach every woman how to care for and listen to herself.
Women who choose home birth are not stupid or irresponsible. Rather they are aware, active in their learning and in their educated decisions agreed and discussed with their partner, midwife, and others involved. Personally I chose to birth my first child at home to keep him safe from the interfering practices that were rampant at that time. A gentle, loving and very empowering home birth, ironically, in Christchurch, exactly 36 years before this conference. Sarah Buckley in her book ‘Gentle Birth, Gentle Mothering’ writes “women are the experts in their own bodies and babies, and that, given full information, they will make the choices that are right for themselves and their babies, whether or not these choices are in agreement with current medical or cultural beliefs”.
Homebirth is on the rise in New Zealand and 5.9% of babies born in Canterbury NZ are born at home. Statistics from an Australian study shows the chance of a normal birth are 6x as high in a home birth and 2x as high in a birthing unit (Clapman, 2019).
Where to from here
Sheena Ross, a fierce protector of women’s rights blends politics and midwifery activism. She spoke of “The invisible world of birth” and that “silence and invisibility go hand in hand with powerlessness”. We have ‘History’ and ‘Herstory’ - the culture of our birthing experience. 40% caesarean section rate in Christchurch now. And nowhere in the world is a Museum of Birth !! (Ross, 2019).
“Spontaneous labour in a normal woman is an event marked by a number of processes so complicated and so perfectly attuned to each other that any interference will only detract from the optimal character. The only thing required from the bystanders is that they show respect for this awe-inspiring process by complying with the first rule of medicine—nil nocere (Do no harm)”. Kloosterman (1982).
References
Brown, B. (2019). The Gifts of Imperfection Quotes. www.goodreads.com/work/quotes/7261277-the-gifts-of-imperfection
Buckley, S. J. (2019). ‘Gentle Birth, Gentle Mothering’. www.sarahbuckley.com/gentle-birth-gentle-mothering/introduction/
Cinelli, E. (2018). The Fetal Ejection Reflex Is Crucial In Childbirth, Here's Why. www.babygaga.com/fetal-ejection-reflex-explained/
Clapman, V. (2019). Personal communication Home Birth Conference Christchurch.
Davies, L. (2019). Personal communication Home Birth Conference Christchurch.
Geddes, D. (2019). Personal communication Home Birth Conference Christchurch.
Kara, K. (2019), Personal communication from Midwife doing Midwifery Masters in water birth, Home birth Conference.
Kloosterman, G. (1982). Quoted by: Buckley, S. J. (2014) in article: Hormones In Labour & Birth – How Your Body Helps You
www.bellybelly.com.au/birth/ecstatic-birth-natures-hormonal-blueprint-for-labor/
Littlejohn, M. (2014). What is the Fetus Ejection Reflex. http://www.spiritualbirth.net/what-is-the-fetus-ejection-reflex
Matthews, A. (2019). Personal communication Home Birth Conference Christchurch.
Sargent, C (2019), Congruencies and healing of birth trauma. Home birth Conference. Author of ‘Where the Heart Is’ - a book of birth stories inspired by Ina May Gaskin.
Ross, S. (2019). Personal communication from Home Birth Conference, Christchurch.
Veidman, E. (2019). Personal communication from Home Birth Conference, Christchurch.