Hello! This FAQ only covers a small amount of the things I’d love to tell you about birth. Shinemama is completely independent – we’re not tied to any doctor, hospital or other organisation so we can tell you the truth – our hands aren’t tied. We can also present your birth choices and help you weigh up the pro’s and con’s from your perspective and for your situation. I take an evidence-based approach and use medical studies from respected journals to support my teaching and am happy to help you find information and provide handouts where I can.

I have completed ICEA training and am working towards certification. I fully support their philosophy, ‘Freedom of choice based on knowledge of alternatives’

So bring on the FAQs! If I don’t answer your question here, please email me!

Do you only support women having home/hospital births?
It’s your choice how you give birth and I entirely support your choice, including your caregiver, your chosen place of birth and your method. However, I am biased towards unmedicated birth and home birth where possible and where risks are generally low because the evidence points to this a) being safer for both mother and baby, b) a less fearful experience for the mother, c) less likely to end in unwanted interventions such as caesarean sections, d) an easier recovery and e) a place where your choices will be upheld and supported.

Wait, HOME birth? Are you crazy? That’s prehistoric, right? My husband/doctor/friend says I’d be mad to consider it
Well, there have been several major studies of home birth versus hospital birth. Generally, hospital birth comes out worse. Infant mortality rates are comparable and some studies show infant mortality rates to be lower at home. There is enormous evidence showing the rate of intervention to be far lower at home – fewer caesarean sections, fewer perineal tears, fewer unnecessary and painful interventions such as amniotomy (artificially breaking the waters), episiotomy (cutting the perineum), pitocin (a drug used to speed up labour). There’ll be more links to this in my resource guide (coming soon!) but for now take a look here for more information on home birth safety. But be aware that your midwife will be watching you carefully throughout your labour. Pick your midwife very carefully – there are different kinds of midwife who vary in experience and ability. An experienced licensed midwife will be prepared with maternal and infant resuscitation equipment and be well drilled in emergency care. She should also be equipped with doppler equipment to monitor your baby well. Having one-to-one care with an experienced midwife is actually very safe as she will spot problems early on and be able to correct them or transfer you. Bear in mind in hospital, you will not have this level of one-to-one care and your caregivers may rely on electronic monitoring rather than observance. Of course, most important is for you to give birth somewhere you feel happy and comfortable. Some women will be happier at home, some will prefer hospital. Some may opt for the ‘in between’ choice of a birth center.

Yeah! But I want the drugs!
Really? Well, that’s fine! But you need to weigh up the risks and benefits. Epidurals are the most commonly used pain relief in US hospitals. They relieve the pain but they have their downside. Once you have an epidural, you’ll be pretty much paralysed so your risk of having an instrumental birth (forceps/ventouse) goes up. Being immobile also means your risk of having a caesarean also soars. The more scary risks include low blood pressure (which reduces oxygen flow to the baby). 12 women in 1000 have a toxic reaction to epidurals including seizures. 67 in 1000 have a misplaced epidural into a vein or artery which can result in bleeding around the spine or in the skull. The epidural is inadequate 7% of the time (which can led to general anaesthetic). Epidural can also worsen migraines, asthma and back trouble.

Bad news, huh? But… I’m not anti-epidural. For some women, fear of the pain may inhibit their birth and epidural may be a wise choice. But the US has an epidural culture and they are used routinely when there’s really no need. For many women, there are other pain relief options they can explore.

Oh, other pain relief options? How much is this going to hurt anyway?
Well, there are two things about labour pain. First of all, in a normal, unmedicated birth the contractions are short and they’re intermittent. You have pain for a minute or so. Then you have a rest. They get closer together as your baby gets ready to be born. Secondly, as you get further along in your labour, your body releases more and more hormones. These hormones will help you to cope. It’s amazing what you can deal with when your body helps you! Also, if you can get rid of the fear of birth, the pain becomes more manageable as the tension and stress leave your body.

You can arm yourself to cope with the pain. TENS is very effective – I used it in all my labours in home and hospital and would have happily fought anyone who tried to remove my TENS pack! (I’ll show you how to use this in my classes). Water is also shown to be very effective – after all, how much better do you feel if you have a hot bath when you have backache or menstrual cramps? There are other options such as massage, homeopathy, aromatherapy, walking, exercise, breathing, hypnotherapy and visualisation which can all range from mildly soothing to immensely powerful. You’ll be surprised by the slightly altered sense of reality you have when you’re in labour – you really can cope with it!

No, I really can’t do it!
Ok, think about hiring a doula. A doula is a professional birth assistant. She won’t offer you any clinical opinion but she will know a whole load of tricks and tips to help you cope with labour. She’ll hold your hand, massage you and talk to you and just help you get through it. Don’t worry, she won’t take anything away from your husband or partner – in fact, she’ll free him up to give you the emotional support you need without having to worry about the practicalities. She’ll also be dedicated to you while you’re in birth. In the hospital, your caregivers may be in and out of your room, spending only a little time with you. Your doula will stay with you. She’ll also help you communicate your wishes and choices when you might be focussed on your labour.

You keep spelling things weird/You talk weird
Sorry, I’m British (blush). I keep trying to say ‘diapers’ but my brain keeps saying ‘nappies.’ Try to think of it as charmingly eccentric?

But my doctor says…
Yep, and hopefully your doctor has your best interests at heart. But be aware that in the USA, many doctors are not at all familiar with natural birth. In the documentary ‘The Business of Being Born’ there’s a great scene where a group of obstetricians admit to having never seen an unmedicated, unmanaged birth. So no matter how experienced your obstetrician, they may just be doing things the way they were taught rather than acting on evidence… or acting on what you want. Obstetricians are very skilled doctors. They know a lot about high risk birth and dealing with difficult situations. But most of us, fortunately aren’t so high risk (although it would suit their pocket book if we were!)

Informed consent is very very very very very very important here. You have the right to ask about any intervention your doctor suggests and even more importantly, the right to accept or refuse it. I like to remember the phrase ‘Use your BRAIN’ For any given intervention, ask about the:
Benefits
Risks
Alternatives
what does my Intuition say?
Now? (Do we have to do this now? What happens if we wait?)

Oh. By the way, a lot of doctors don’t like VBACs (vaginal birth after caesarean). There’s a lot of reasons for this, and they don’t necessarily involve golf courses and tee-off times. But they are safe. They are possible. And yes, you can have them at home. I did, here in San Diego and I will happily tell you how and why. (And I’ll show you the studies that support VBACs if you want.)

You’re doing yourself a big favour if you educate yourself about birth and your options before you go to the labour room. Why not try a Shinemama course?

So are you going to tell me to have a home birth because I don’t think I’m ready for that?/I *really* want those drugs

Well, that’s ok. As I say, I’m out to support your birth choices and in the end, you know what’s best for YOU. I just want to help you research your choices so you can make sure you’re happy with them and maximise your chances of getting your ideal birth whether that’s home, hospital, birth center or in the back of a taxi. (I’m joking about the taxi… hopefully!)

Ok, so what else is in your classes?
Oh! All sorts of things. We’ll talk about anatomy, how your baby grows inside you and how labour works (all that dull cervical dilation/effacement stuff). But we’ll try and make it interesting! We’ll also talk about what’s safe and ok to do during pregnancy and what isn’t (without lecturing!) What are normal pregnancy feelings and ’symptoms’ and what aren’t. We’ll definitely work on coping skills for labour – what you need to pack/store for the birth, how to deal with the pain, what your husband/partner/birth partner can do to help you and what to expect.

And we’ll talk about your baby – what you actually do with him or her when he or she arrives! Shinemama takes an evidence-based approach to teaching – this naturally means we tend to swing towards attachment parenting, breastfeeding and natural birth as the evidence supports these options for the optimal outcome for most mamas and babies. But if these options aren’t ideal for you, that’s ok, you’re still welcome and I’ll help you in any way I can!

Breastfeeding? Uh.. I don’t know about that
Yeah, some women do find it difficult in the beginning and there’s not nearly as much support as there should be. But breastfeeding is great once you get going – it’ll save you several thousand dollars for a start. It also comes with all sorts of benefits. For you, it lowers your risk of certain cancers, boosts your post-pregnancy weight loss and does away with all the faff of preparing bottles. For your baby, it gives their immune system a HUGE boost, offers some protection against respiratory and gastrointestinal problems and some studies show it can even boost their IQ!

What Shinemama can do for you is help you prepare for breastfeeding, anticipate any potential problems and learn what to do about them. Our classes include lots of tips for how to get breastfeeding off to a great start and how to avoid common pitfalls.

Ok, you’ve convinced me. Where/how do I sign up?
Drop me an email at katharyne@shinemama.com – I’d love to hear from you! I can tell you when the next series of classes begins and how to sign up. You’ll be very welcome. Our classes are in the La Jolla/Pacific Beach area of San Diego and are very comfortable, with snacks, comfy seating and friendly interaction.

Shine on, Shinemamas!