Eight Ways to feel more in Control During Pregnancy and Birth

According to a Care Quality Commission survey of maternity care 84% of women questioned believed that communication during their maternity care was insufficient. The report found that many women were spoken to in ways that made them feel anxious or not listened to. On top of how and where you give birth, there are plenty of other things that might help a woman feel more in control while giving birth, and that includes good communication.

Marina Fogle of The Bump Class and Jacqui Tomkins chair of IMUK reveal the extra considerations to help you feel more in control:

1. Put together a birthing plan, but use it as a loose guide

Jacqui says: "Birthing plans have become more of a preference list. Don't become fixated on it and think you have to achieve everything on the plan. Overall, I think it is a really good idea to write down what you're hoping to achieve."

And share it…!

"Tell your birth partner – whoever that is – about your wishes. They need to be aware of your preferences, simply because whoever is with you will be the best person to answer on your behalf when you're busy in labour and might not be able to have the best conversation."

2. Consider hypnobirthing

Jacqui says: "Hypnobirthing looks at the whole process and physiology of birth, whereas antenatal classes equip you with the key skills to navigate your way throughout an NHS system. Hypnobirthing talks about your body's chemical processes and how it can help you, what is happening physically and internally for the baby, how you're a team, and your birth support and how to use them - that little package is gold dust. The confidence that this may give a woman and the relaxation it allows her is a gamechanger."

3. Happy? Ask questions. Not happy? Ask questions.

Marina says: "It's really important to ask questions, understand the answers and if you don't think you are getting an adequate standard to care, then ask to see someone else. Once you are in established labour, you should have a midwife giving you one-to-one care until your baby is born. While most midwives are truly exceptional at what they do, if for any reason you don't get on with your midwife, you can ask the midwife in charge whether you can change. It's usually always possible – remember for her it's another day at work but for you, it's the day your baby is born, a day you'll never forget."

How do you know if you're being listened to?

Jacqui says: "People should give you time, let you sit down and explain what your concerns are. They should answer all your questions and allow themselves time to answer them. If you feel like you haven't been able to point something out or get an answer, something's wrong."

4. Do your research

Marina says: "They say knowledge is power and I believe this is never more true than in pregnancy. Make sure you understand about what happens during birth – both when it's straightforward, but also when you or your baby might need a bit of assistance. A good antenatal course should do this. If you understand what happens with an assisted delivery or why they might be recommending an induction, you are going to be in a better position to understand what the best decision for you is. Similarly, understand what pain relief options are available to you and what they involve and what the risks might be so that you can request and understand what is best for you."

5. Remember C-sections aren't the easy option, but don't feel bad if you end up having one

Jacqui says: "Caesarean sections are surgical rescue solutions. They are not the 'easy option' to which they've sometimes been labelled. It'll take 6-8 weeks to fully recover. It will impact how you can look after your baby, because of lifting and heavy medication. Also, the process of CS – unless it's managed very sensible, separates you from your baby very initially. If a woman is looking choosing a CS, you need to be considering all of your options. When I'm talking to a woman about CS, I do like to remind them it is generally a rescue operation and we don't need the surgeons to step in when the normal process is working. You never want to feel bad about having it as a rescue operation, though."

6. Don't fear the unknown

Marina says: "In low risk births, delivering your baby vaginally is undoubtedly the easiest and safest way to deliver your baby. It can be long and tiring but if it's too much you can always have an epidural. Girls on the Bump Class are often scared of tearing. But it's important to contextualize this – these tears are mostly small, heal well and don't provide any problems afterwards. There are also some preventative measures that you can take such as perineal massage or using a perineal trainer (such as an Epi No) from 37 weeks. A good antenatal class should discuss all these options."

7. There's nothing wrong with saying no

Jacqui says: "Mums-to-be can absolutely refuse everything. You can say: "no, I want you to find the alternative." Women are given the general flavour that they can't do that but, by law, you can totally do that. I've yet to meet a woman who in the process of being pregnant or in labour who doesn't have the best interest of her child at heart. Even if a woman has a poor outcome, but she's felt as though people have listened to what she's said and helped her make informed decisions, she'll probably be in much better psychological nick than someone who had a better outcome, but felt like nobody listened to her."

8. Have a filter when you listen to other people's experiences

Marina says: "Everyone has their unique strengths – stay away from the scaremongers who love telling a horror story (which usually loses nothing in the telling). But practical mothers are often full of great, up to date and useful advice – so stick to the supportive ones and stay away from those who are full of judgment."

Jacqui says:"If you listen to your friends, you need to have a filter and understand that you and your baby are a specific dyad; your friend's experience isn't necessarily going to be reflected in your own experience. The best thing to do is find a health professional, or drop in clinic, or phone, or forums, but overall your best friend and most knowledgeable friend is yourself and you instinctively know how to look after a baby, we all just do it."

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