Your Birth, Your Choice.

When I first heard Serena Kirby present about her book Better Late Than Never Baby, I was struck with her description of her baby as being “too precious to push”. She was guided by her carers to have an elective caesarean to bring her boy into the world and was happy with that choice.

My own journey of birth choices was somewhat circuitous.  I started out under obstetric care although admittedly the main selection criteria for the obstetrician was his fluency in English; I was pregnant in Greece and at sea in many ways.  After getting hold of whatever books on the subject of birth I could and by the time I returned to Australia, I had elected to go with midwifery led care in a family birth centre and use a birthing pool (which was slightly radical in 1998 Perth) and had a glorious, empowering natural birth.

So whose choice was “correct”?  Both, of course.

The art of a birth choice is that you take into account your own situation; you and your baby’s health, how you feel about birth from being really interested in the whole thing to not particularly bothered, what type of birth experience you are hoping for, what support you have for these aspirations including what your partner wants, what’s available in your area etc and drawing that all together.

In other words, the art of birth choice is in being there and making the right decision for your circumstances. Much like parenting really, where there are usually many different strategies you can follow but ultimately you need to decide which strategy sits right in your heart.

What drives our organisation (Community Midwifery WA) is the desire for women to have all the information they need to make the right choice for their situation.  This is so often not the case.  It all breaks down usually at the first hurdle – attending the GP appointment to confirm your pregnancy.  Women attend the GP for two reasons – to have their pregnancy test results confirmed, and to find out their birth choices, and exactly what next steps they need to take in terms of tests etc.

Their conversations with the GP will usually go something along life this:

GP: “Do you have private health cover?”

You: “Yes”.

GP: “Which Obstetrician would you like?” – at this point a list of Obstetricians in nearby hospitals will be offered.

If you answer ‘no’ to the health cover question, you’ll be referred to a public hospital.

There’s so much missing in this conversation.  How we deliver maternity care is very much based on the prevailing culture and the prevailing culture in Australia is medicalised.  This conversation reflects this medicalised approach to birth as it doesn’t usually introduce midwifery led care, why it might be an option and where to get it.

Birth data released from WA Health in 2011 shows a clear correlation between private health (higher rate of caesareans) and public health with a stronger midwifery culture (lower rate of caesareans).

But Community Midwifery WA is by no means anti-caesarean.  We run a class called “Positive Caesarean” because it reflects our core belief as an organisation that there is no right way to have a baby; and that information will help you make the right choice for your circumstance.

This course talks about the different options you might want to consider with a caesarean such as having your chosen music playing, a request to drop the curtain so you can see your baby being born, as much skin to skin contact as baby’s health will allow and so forth.  You can’t ask for these things if you don’t know they are an option.

In essence we simply want women to feel they have made the right choice for their circumstances, with all the information they need.

And that’s not too much to ask, is it?

Pip Brennan, 48, is the mother of 14 year old Zoe and step-mother to 18 year old Jackson.  She is the Manager of Community Midwifery WA (CMWA), a not for profit organisation.  CMWA is passionate about ensuring that women understand all their choices in childbirth, and that they can access the help and support they need in the early weeks and months of being a new mother.

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