“I do not care what kind of birth you have… a home birth, scheduled cesarean, epidural hospital birth, or if you birth alone in the woods next to a baby deer. I care that you are supported in your choices, and that you were respected.” January Harshe
In my work with new families, and also being of an age where lots of people around me are having babies, I cannot tell you how many times I have heard stories starting with "I had to..." or "I couldn't....". Some of these stories are about birth, some about feeding, some about parenting in general. Sometimes, of course, things don't go to plan and interventions are necessary. However, research also tells us that this is not the majority.
For instance, in the UK, the C-section rate is around 25% and rising; the WHO recommends a rate around 10-15%. UK breastfeeding rates are among the lowest in the world. Are British breasts defective? No, but the support certainly is at times. That's for another blog, but the point is, ultimately, YOU are the one who has the choice of what happens to you during birth, in regards to feeding your baby, and how you choose to parent. Professionals can of course make their recommendations, but these should be evidence-based, and respect the patient's wishes.
So what are the guidelines around birth? In the UK, health professionals are given guidance by NICE, the National Institute for Health & Care Excellence. In their Intrapartum Care recommendations, they state:
"Providers, senior staff and all healthcare professionals should ensure that in all birth settings there is a culture of respect for each woman as an individual undergoing a significant and emotionally intense life experience, so that the woman is in control, is listened to and is cared for with compassion, and that appropriate informed consent is sought." (my emphasis)
Yet, in a recent survey by the Positive Birth Movement, 57% of respondents said they were not given, or did not feel that they had, a CHOICE about being induced. The number of parents suffering with birth trauma also seems to be on the rise. That does not seem to match the guidelines.
So, what can you do? Firstly, educate yourself on your rights and your choices (have a look at our K blog for more information!) AIMS have a really useful publication called Am I Allowed? as well as lots of other resources that can help, particularly if you find yourself under consultant-led care for any reason. Secondly, be prepared to QUESTION anything you're told or advised. If you find it difficult to advocate for yourself (and it can be difficult), consider having a partner or trusted friend/family member with you who will. You might even consider a doula who would be able to advocate for you. Find out more about doulas here.
If you've ever been to an antenatal class you might have come across the acronym BRAIN, which can be really useful for questioning any course of action:
What are the Benefits?
What are the Risks?
What are the Alternatives?
What do your Instincts tell you?
What happens if you do Nothing at this stage?
You can use BRAIN for most things, even outside of birth and babies, but it's a good one to keep in mind.
Feeding can be a minefield. I would hazard a guess that if you've had a baby, at some point you've received conflicting advice related to feeding them. The first question I would ask here is, how much breastfeeding knowledge does this person have? Sadly, in the UK, most health professionals have little to no training in this, and that includes paediatricians and GPs, unless they have chosen to get training in their spare time. Midwives and Health Visitors should have a minimum level of knowledge, but how deep and current the knowledge is may depend on where and when they qualified, as well as the area in which they're working. Unfortunately, research does suggest that personal experiences related to feeding is likely to have an impact on advice given. So, if you are given some advice related to feeding your baby, refer back to the BRAIN acronym above, and consider getting in touch with a breastfeeding counsellor or International Board Certified Lactation Consultant for clarification. This goes for advice relating to medications as well.
OK, so now, you've had your baby, you're feeding your baby with breast milk or formula or both, and you need to parent them! Again, I have no doubt that almost everyone you know will be giving you advice on sleep, feeding, not spoiling your baby blah blah blah. And here is another area where research improves and knowledge changes as we go on. At the end of the day, you have to do what feels right to you. Maybe you're like me, and you like to research everything first. How do you know if what you're reading is true, reputable or trustworthy? Well, ask yourself, who wrote it? What are their qualifications? What would they get out of people believing them? Is this source biased towards a particular viewpoint? What does the evidence say and why? The wonderful Professor Amy Brown has written a book on just this topic, called Informed is Best, which you might find helpful.
What about if other people are questioning you and your methods? Again, ask yourself, why does it matter to them? Why are they so bothered? Sometimes, it's because they feel guilty about how they raised their own children. Our parents, for example, might feel hurt in some way if we choose to parent in a different way from how they parented us. It might make them feel that we don't value them. Birth and feeding are highly emotive experiences, and sometimes we can lash out at others for having the experience that we wanted but didn't get. Or, perhaps, they feel that you're struggling and want to help. Is it the kind of help that you need? Again, try to advocate for yourself and your baby, or find someone that will.
Ultimately the most pertinent questions are what's best for you and your baby? And how can you make that happen?
All the best!
NICE recommendations for Intrapartum Care https://www.nice.org.uk/guidance/cg190
Positive Birth Movement https://www.positivebirthmovement.org/
National Breastfeeding Helpline 0300 100 0212
International Board Certified Lactation Consultants in the UK https://www.lcgb.org/find-an-ibclc/
Drugs in Breast Milk help service https://www.breastfeedingnetwork.org.uk/drugs-factsheets/
Informed is Best, Amy Brown https://www.pinterandmartin.com/informed-is-best