This week is Birth Trauma Awareness Week (6-12 September).
We took some time to talk with renowned birth educator and counsellor Rhea Dempsey about the functional pain of labour, some of her personal birth highlights and what’s happening for those birthing in the pandemic.
What is the number one thing you like to emphasise to pregnant women as they approach childbirth?
If they want to avoid unnecessary intervention in their labour, they need to reframe their attitude to labour pain. Rather than seeing it as ‘suffering’, realise it is functional: your body working at peak-performance levels and not something to be afraid of.
Having the right support will raise your pain tolerance too, so make sure you’re supported by experienced midwives and others who can offer ‘working with pain’ expertise. Because our culture’s default response is a ‘pain relief’ model, women really need to seek out this ‘working with pain’ support.
Most women also don’t realise that many routine practices regularly used during labour and birth are not best practice or supported by latest evidence. So I also encourage them to really do their research about the routines, protocols and statistics of their chosen place of birth.
You’ve attended thousands of births—what are some of the most memorable moments?
There are so many. Being present at all the births of the next generation of my family—all my grandchildren, grandnieces and nephews has been such a joy. Supporting women who are burdened by difficult life stories to find birthing their babies healing and strengthening, has been a humbling honour.
I’ve accompanied women who have birthed in so many settings: hospital rooms, operating theatres, lounge rooms, bedrooms, bathrooms, backyards, front steps, the backseats of cars, nature strips, back patios, in baths, birth tubs, spa baths, all beautiful powerful births.
I remember one homebirth where, just when we needed it to fill the tub, the hot water heater gave up. So, in a community effort, a hose from the hot water tap of the neighbour on one side was set up, and a bucket brigade of volunteers ferried hot water from the neighbour on the other side.
The water in the tub was perfect and the baby was born into the water a little later—a little boy who announced himself to the neighbours (all gathered in the garden next door), and was lovingly greeted, not only by his siblings and parents, but also with the cheers of delight from his neighbours!
How did you get into this line of work?
The birth of my own first sweet baby in the seventies was so far from the ‘natural’ birth I intended that I was left in shock. I was a healthy, low-risk woman; a fit physical education teacher with no fear of healthy functional pain, and I thought I had done all the right things and followed the right advice. Yet I was subjected to interventions I didn’t want (or, I realised later, need).
I now realise what I experienced would today be termed ‘obstetric violence’. Trying to piece together what had happened set me on the path of my work. The home births of my subsequent two babies, with my partner, support people and qualified homebirth doctors present, were very different because I made more informed birth choices. My work grew from my passion to share what I had learned about birth and our maternity system with other women.
Why did you want to write books about birth and pregnancy, given there are so many books on the market?
Many birth books are ‘how to’ or descriptive ‘stages of labour’ books. Women tell me that the information in my workshops and classes give them a bigger picture than this. I still talk about the stages of labour and practical ways to prepare, but I also explain the wider context: the social, cultural and maternity-system factors that will affect a woman’s birthing capacity.
Births occur in a context. In my second book, Beyond the Birth Plan, one woman who wanted to avoid medical intervention memorably describes her experience of being offered an epidural eleven times. All the deep-breathing exercises in the world won’t help you if your caregiver is doing that! Research shows most women want a ‘natural’ birth but say they aren’t able to in hospital. My books unpack why that is so, and what women can do about it in their birth preparation.
How are things changing at the moment for birthing in the pandemic?
During the pandemic, high levels of anxiety in pregnant and birthing women may negatively affect the hormonal surges optimal for birth, so we might predict higher levels of birth interventions occurring during this time.
Sadly, also during the pandemic, hard-won birth options that we know best support physiological birth—water immersion, support from independent, experienced caregivers (in addition to partners), and continuity of midwifery care—are being denied women. The Australian College of Midwives and others have found that denying water immersion, for example, is not supported by the evidence. These options were already difficult to access pre-COVID.
The concern is that the pandemic is something of a cover under which to deny women options that are what women themselves want; that the present restrictions are merely a continuation of opposition that is driven less by evidence than by the convenience of caregivers (at best) and (worse) by a drive to maintain a ‘power over’ systemic structure, in which birthing women are not at the centre of maternity policy recommendations.
What is your wish for this sector?
For new mothers to emerge from the births of their babies feeling strengthened rather than depleted, unsupported, traumatised and depressed—the latter is not a great way to step into motherhood.
To this end we need to promote the gold standard model of midwifery care: continuity of care, in which a birthing woman is attended one-on-one, continuously through her labour by a midwife with whom she has developed a relationship during pregnancy. It’s what women want, but at present in Australia only 8% of pregnant women can access this model.
Research across the world shows this model is best, not only to support normal physiological birth but also to support positive pathways to motherhood for all women, now matter the ultimate pathway the birth itself takes.
Any tips for dads and partners?
Yes! To understand two important aspects.
First, the importance of their view of labour pain: Do they see pain in labour as a sign of something going wrong, or can they understand it for what it is: healthy functional pain of the kind they may well cheer on in a sporting setting. Can they see their partner’s power and potency as she rises to the occasion, and encourage her on? Or will they take pity and try to ‘save’ her from it (and themselves from the challenge of witnessing it!).
Secondly, to understand that the magic oxytocin ‘love bomb’ of normal physiological birth, which so supports bonding between the mother and baby, will also open their own hearts.
NEED TO TALK TO SOMEONE?
Perinatal Wellbeing Centre (Canberra): 02 6288 1936
Lifeline: 13 11 14
An author, childbirth educator, counsellor and doula with over forty years experience Rhea’s first book Birth with Confidence is a word-of-mouth classic.
Beyond the Birth Plan, her new book is available now at rheadempsey.com.au.