Midwives support during labor and birth

Dr Vijaya explains how midwives can support the mother and her partner in labor and birth and how it helps reducing stress levels

When you look at labor and birth, I think one of the things that we have to understand that that’s a very unique process, which every woman and her baby, there is a dance that’s going on through that labor to determine is it safe? Is it normal? And what is the extent that this is going to be long? Is it going to be short?

And oftentimes, one of the, things that we hear from mothers, especially those who are trying for a VBAC, for example, they’ve had them gone, and, or even those who come for the second pregnancy, we’ll hear saying that, you know, like, I went in, the doctor checked me, I was told that I’m XYZ centimeters or I’m not open at all.

And I was told that these are the things that I know that need to be done, including a vaginal exam without much permission taken. And then, then I was looked at in terms of how much, how, how I’m making progress. And if I was fine, I was given whatever amount of, you know, support that I needed.

But then when I was not progressing according to a certain, certain timeframe, for lack of a better word; I was put under the gun and I was either, I was either taken in for further interventions or a cesarean section. One of the amazing things about midwifery is that midwives are very skilled at just sitting on our hands over the years.

When I was a younger midwife, I would think what would happen if, you know, I didn’t do something for this woman. And I would feel like if I did, if I stepped out or if I did not rub her back, or if I did not, you know, do certain movements with her, I would feel like I was not doing enough. And the more you see births and the more, and this is what happens when you are in an environment which is focused on only the needs of that mother on that day, you very, very subtly you start to understand that some women will need all the support in the world. Some women will need all the verbal encouragement. Some women will need you to just remain quiet. Some women will need to swear at every contraction, but they’re not complaining. They’re swearing, and that’s okay. Some women will wind through it and then then you ask them, do you really want to go for this?

They’ll say, yes, some women will. Some feel it as torture. And those are the women whom we need to offer different methods of either pain relief or even give them a choice of whether they want to continue the labor or go in for a cesarean. So there is no, maybe if you recognize that there is no standard of either progress of labor or the care that a woman needs. It recognizes that every labor and birth is sacred and unique and that the best we can do is to allow that labor to enfold, be watchful, be protective of the space that it provides the safety net, understanding that allowing a physiological birth automatically ensures safety.

If we don’t understand that physiology is safe, then we are doing more harm than good. But if all of those things are checked in the tick boxes, know that the maximum we can do is to let her experience from that pain comes the power and each contraction or each expansion, there are different words that are used by different, professionals who are, who, you know, the birth workers.

But whether it’s the contraction or expansion, whatever we call it, that each thing allows her to come closer to seeing her baby. And the key element of this is the checkups that happen in the antenatal period. And another big key element is helping them having a good childbirth education class for not only the mother but for her partner, for her family.

So when they come into the birth space, they already understand that this is not something that is abnormal. It’s not pathological. It is important for them to feel the pain and that feedback is what keeps her and the baby safe.