Birth companions: drawing support from outside the room

AIMS Journal, 2023, Vol 35, No 3

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By Jo Dagustun

I’d always thought quite traditionally about who would be in the room at my labour and births. It would be my partner and the local midwives, plus - I came to learn - whoever the midwives wanted to bring along. When I gave birth to my youngest child, I thought about including siblings too; in the event, I was happy to welcome two of them straight after an early morning birth, waking them up so they could welcome their newborn sibling and at least see part of the ‘action’ (a straightforward physiological third stage). The flexibility I had to welcome them in was enabled by giving birth, for the second time, at home.

But for that final birth, I also drew on support outside of the room. As a social geography student, partway through studying contemporary UK birth culture for a PhD, I’d done a lot of reading around the subject and been to a number of birth related conferences, and I knew that I wanted to bring into my labour and birth something of what I found there. Call it inspiration or even ‘positive energy’. And at six months pregnant, attending a conference in the International Normal Labour and Birth Conference series, I stumbled upon a mechanism through which I could do this. In one of the sessions in the main room, we heard from a speaker about a birth (of one of her family members) that took place at home, and then watched a beautiful video of a calm and straightforward birth.

The great thing was that the video was accompanied by a piece of music. Sometime between the conference and when I went into labour, I looked up the piece. And then, in early labour, I got the laptop set up, and at some point - perhaps when I was near to giving up walking around the house, moving and breathing myself through my contractions, and was about to retreat instead to the sofa, gas and air in hand - I started the song playing on a loop. Again and again and again. Perhaps for a few hours. I remember well feeling that I was playing a scratched record for some of this time - presumably the effect of the gas and air. (I think I paid for that Entonox use later, experiencing what I was later to understand as an asthma attack that night!)

So, a simple song, imbued with meaning, got me through my labour. It kept me mobile and standing for longer than I’d managed previously. It helped me remember that I wanted to get up off the sofa, onto my hands and knees for the birth itself (although I remember well that the midwives weren’t encouraging, suggesting that I could stay on the sofa to give birth). It was that song that got me as close as I have ever come to ‘normal labour and birth’, and I was very pleased with myself that I’d invited it into my birth room.

Now, I appreciate that others might find such inspiration at antenatal groups or classes, but the only one I’d been to - over the course of four pregnancies - was a day-long session at the local hospital before number two, when quite frankly all I took away was new knowledge about monitoring ‘clips’ that might be put on a baby’s head during labour. I’d done plenty of reading, of course, starting with Janet Balaskas before my first birth in 1989. But all of that learning was for me, in the moment - when attended by people who I didn’t know and who didn’t know me - simply impossible to enact.

Thank you to Sheena Byrom, the conference presenter who shared the video and music that came to be of such support to me during my own, final, birth. Thank you to Anna Coonan-Byrom, who was the midwife in the inspirational video. Sheena and Anna, that’s one more successful physiological birth supported: please make a note of it in your birth records. For I really did conceptualise you as my virtual midwives for that fourth and final birth, who attended me via that piece of music, not having formed a better relationship with any of the many local midwives. Why would I, when I didn’t know which of them - or even which completely new face - would turn up at my house to support my birth?

A few weeks ago, I attended an online seminar entitled, ‘What would birth look like in a feminist future?’ What an important question! Such birth imaginaries are crucial, both to drive systems change and to help us individually prepare for our births. Personally, I can only imagine a future in which women will be supported by a maternity service that really understands how to support us as we seek to allow the intricate physiological process of labour and birth to unfold. I have not experienced such support, and am not sure that many of us have. I did, however, have a glimpse of such a fit-for-purpose maternity service at my final labour and birth. I also had a glimpse when hearing about the work of the South London Albany Practice. May all women have much more than a glimpse in future.

Finally, my experience of continuity of care (through its absence) tells me that having the opportunity to build a trusting relationship with my own midwife (or two) antenatally - my own midwife who will be there for me during labour and birth and beyond - is fundamental to a fit-for-purpose maternity service, regardless of how birth unfolds and wherever it takes place. How else can we create a space in which we are really heard, our needs and desires respected, and our family’s safety protected? How else can we ensure that the midwife attending our births is a true companion and source of support, rather than a distraction or irrelevance - on standby simply for emergencies and easily usurped by a piece of music or telemedicine?²

Author bio: Jo Dagustun is an AIMS Volunteer.