Failure to Progress?? More like set up to fail.

If you have ever given birth, or know someone who has given birth, you may have heard the phrase “failure to progress”

Often, when medical intervention is needed during labour, it is justified using “failure to progress”.

It is one of my most hated phrases.

Imagine that you are in labour and you get told that you need medical intervention because of a “failure to progress”.

Imagine what hearing those 3 little words could do to your confidence, how guilty it could make you feel. How frustrated you could be with your own body.

But is it really our bodies that are failing at birth?

Well of course not! It is our maternity system, and our wider society, setting most of us up to fail.

That is the problem. Not women’s bodies.

Let’s have a look at some of the ways we are being failed:

  • Most of us approach labour feeling absolutely terrified. We have been surrounded by images and stories of how horrific birth is, how painful it is, what an ordeal it is. So naturally we get frightened and our body goes into ‘fight or flight’ mode which is not helpful. The adrenaline produced can interfere with our body’s physiological birth process and can cause labour to be slower, more painful and can lead to baby becoming distressed. Some simple relaxation techniques can help the birthing woman to control that ‘fight or flight’ urge and stay calm, allowing the body to do what it needs to do. It would be awesome if we saw more positive births in the media, on TV, in films so that our perceptions of birth could be altered.

  • Most women go into labour assuming they will give birth on their backs because that is how birth is portrayed on TV and in films. And for some unknown reason, far too many medical professionals either actively encourage women to lie down, or don’t do anything to help them try different positions. When you lie on your back, you restrict the movement in your pelvis (it is believed you lose around 30% of space compared to when you are in an upright, forward leaning or all fours position). Lying on your back also means that baby has an uphill journey over the curve of your spine and is fighting against gravity . No wonder many women struggle.

  • We are all treated the same; there is a huge lack of individualised care. Most care teams have policies and procedures which can lead to many people feeling a weight of expectations – they are offered things as choices but don’t feel able to say no. Many parts of maternity care are routinely accepted as the norm, but a good care provider will work with you to determine whether the guidelines and any interventions are suitable in your circumstances. In practice, these blanket polices can mean women undergoing unnecessary interventions/tests/procedures.

  • There is a serious lack of decent antenatal education. NHS antenatal provision is not available everywhere and well respected courses,such as the NCT antenatal courses, can be too costly for some parents-to-be to afford. Many women have no idea what is actually happening inside their bodies during labour, and they certainly don’t know how they can help birth go as smoothly as possible.

  • Hospital labour wards are a far cry from the birth environment you really need as a mammal. Bright lights, loud noises, lots of interruptions and strange people all add to feelings of anxiety and stop you being able to fully relax and allow your body to do what it should be doing.

  • We don’t receive the continuity of care that has been proven to improve birth outcomes. Being able to build a relationship with one midwife, or a small team of midwives is beneficial for building your trust in those who will care for you in labour and for being confident the people caring for you fully understand your birth choices. Unfortunately this is not currently the norm in the UK. Our midwives are overworked and unable to spend enough time with us to find out what is important to us and supporting us to have the positive birth experience we all deserve.

  • Induction of labour is on the rise, having increased by more than 10% in the last 10 years, and more and more women are feeling pressured into induction without fully understanding the risks or benefits for themselves or their babies.

I’m sure no healthcare professional ever sets out to intentionally stand in the way of a woman’s progress during birth, yet so many of the current procedures and guidelines do just that.

Can you imagine if you were trying to have sex and someone was coming into the room every 15 mins to monitor your heart rate, take your temperature and check how aroused you were? Would you find it easy to stay in the right mood? I certainly wouldn’t be able to crack on with it knowing someone was going to interrupt us at any time or feeling as if someone was watching me and making notes all the time! And I don’t mind a bit of dirty talk if I’m in the right mood, but I wouldn’t want to be answering irrelevant questions in the middle of our intimate moment!

Now I know there are some amazing people working for the NHS who are working tirelessly to improve women’s experiences, who are fighting for change, who are doing everything in their control to support women in all the necessary ways. But it is a big organisation and change happens slowly. I was shocked to learn that new evidence can take a decade to find its way into new guidelines.

The way we feel about the birth of our baby can have a long-lasting impact on the rest of our lives, so we deserve more. We deserve a maternity system that properly supports us, we deserve to be better educated, we deserve to be treated like individuals.

We deserve better birth experiences!

So what can I do if I am pregnant and want to have a positive birth?

Well here are my top tips!

  • Take a decent antenatal class.

  • I am absolutely biased but I can’t recommend hypnobirthing enough! Hypnobirthing classes can help you with relaxation and breathing techniques, but also with other tools to enable you to keep calm during the unpredictability of birth.

  • Practice relaxation and breathing techniques throughout your pregnancy so you are able to stay calm and relaxed as much as possible in labour

  • If you are aiming for a vaginal delivery research positions and techniques to remain comfortable, upright and active during labour

  • Understand what your options are for all aspects of your care – monitoring, internal examinations, pain management and many more areas! Ask questions and gather enough information to be able to make an informed decision.

  • Take control of your birth environment and do what you can to make it more conducive to labour…..dim the lights, play relaxation tracks or music, move the furniture around.

  • If you feel that the presence of an experienced and supportive birth worker would be helpful, consider hiring a doula. If not choose your birth partner wisely and ensure they understand all the ways they can support you. Be clear with your wishes and help your birth partner(s) be the support you need

If you are struggling to get the care and support you deserve then please get in touch with AIMS (www.aims.org.uk) AIMS stands for ‘Association for Improvements in the Maternity Services’ and they supports all maternity service users to navigate the system as it exists, and campaigns for a system which truly meets the needs of all. helpline@aims.org.uk or +44 (0) 300 365 0663.