I have recently returned from a 3 week visit to Canada, where my daughter gave birth to her second daughter. The delivery was a planned home birth – the first I had ever witnessed. And despite my initial reservations, I was thoroughly impressed. It was for me, of course, something of a busman’s holiday (spending time on holiday doing a lot of what I do in my working day) but also an opportunity to learn some new lessons and reinforce others. Here are some observations.
A recent review published by The Cochrane Library finds that consistent midwife care throughout pregnancy is linked with better outcomes for both the mother and her baby. The study didn’t look at home births but I was reminded of many of the findings by my daughter’s experience.
As a British trained health visitor, I am used to a midwifery care model, with doctors only being involved in antenatal care and deliveries if the mother is high risk or there are other concerns. 90% of births in the US are attended by doctors. In the private sector in Hong Kong, doctors ubiquitously provide antenatal care and delivery. The Hong Kong public sector follows the British model. However, the Cochrane study looked at women seeing “small teams of midwives or one primary midwife” and even this is quite different to what most women experience using the public sector midwifery care model.
Throughout my daughter’s pregnancy she saw the same 2 or 3 midwives. She was comfortable talking with them, able to call with problems during the pregnancy and felt at ease with them in her home for the delivery. More importantly my son-in-law who, to put it mildly, would best be described as “Type A personality” was also comfortable. Initially sceptical about a home birth, he met (or should I say, “interviewed”) the midwives in the early stages of the pregnancy. After spending time with them he quickly became confident in the midwives’ ability but would have still preferred a hospital birth right up until the actual event. As it turned out, when the midwives arrived promptly to his call that labour had begun, armed with bag-loads of equipment and a calm, confident but professional manner he felt completely reassured. He was so chilled and trusting in their skills that he actually spent time in his garden and pottering around the house. He is now a self-professed convert for home birth.
The delivery was a very calm, almost social occasion. At no time were any voices raised. The care was professional, unhurried, filled with explanations and consultations. Nor did I feel like intervening or wish there was a doctor present. My daughter was completely confident in the skills and experience of her midwives and I am sure this trust enabled her to give birth, without drugs, safely and happily.
Back on familiar ground for me, you’d think that with my undivided, 24/7 attention breastfeeding would be a breeze for my daughter. But it wasn’t so. It was a sober reminder to me of just how much work is often involved. Eventually we got there but this intensive experience reminded me of the following key points:
- Patience, calmness and gentle handling. I quickly saw that the baby did a lot better without my intervention. Of course, many studies have shown this before but I now realise I have got to learn to sit on my hands and let the mum and baby do the latching! Far better to coach mum through this process.
- Focus is needed in the early weeks of feeding, not multi-tasking.
- Skin to skin contact is always rewarding.
- Small frequent and effective feeds are often better than marathon sessions.
- Swapping from one breast to the other several times during a feed often helps during fussy periods.
- Weighing too frequently is not good. Giving confidence and support is more important. Watching urinary output is a better way of monitoring.
- Pumping is hated (“Oh no mum! not pumping again”) and loved (“look how much milk I’m producing!”). It is, of course, much easier and better to bond with a baby than with a pump!
- Breastfeeding is so empowering.
That was me! I have discovered new respect for them. What a lot of scrubbing and sterilising, cooking meals only to be re-heated because the moment it was put on the table, the baby needed feeding! And mountains of laundry! I can see how people become a bit obsessive-compulsive when they have a baby – I took great delight in scrubbing every nook and cranny of the pumping equipment. It’s also quite a lonely role. I itched to be caring for the baby and cuddling her but I know that the support role is vitally important to enable the parents to enjoy and bond with their baby.
This was my biggest shock. I was very excited to be able to spend time with my 5 year old granddaughter and arrived with a bag bursting with treats, goodies and gifts. I envisaged us curling up together to read books or play with toys whilst her mum fed the baby and rested! But not so: she didn’t want me, she refused to allow me to bath her, she sulked if her dad was out of sight, she turned her nose up at my cooking (it’s not THAT bad) and preferred her mum choose her clothes and read stories. Worst of all, she warmly greeted her local Canadian grandma when she visited (grrrrrr!). I was devastated. It took one of the midwives to point out to me that it was perfectly understandable that she should react towards me like this: she was bound to feel unsettled and put-out with the arrival of the new baby and the changes it brought. And, of course, since I had recently arrived from Hong Kong, almost literally coincident with the baby, it was me she chose to blame for the massive change in her family. Of course, I had many times offered such explanations to my own clients but I thought I was special!
Thanks to Lydia, Ben, Elli and Lucinda for the privilege of sharing this special time.