Why Optimal Birth?

"Galactic Baby" -award winning image from Cat Fancote - all rights reserved https://birthphotographyperth.com.au/

Over the past few years, there have been times when the debate about childbirth and especially choices about how and where to give birth, have become deeply polarised. As always, the media have been quick to reduce the debate to extremes, pitting dire warnings of “great danger if a baby is born at home” or against midwivesd "obsessed with natural birth at any price".

While these extreme views may exist among birth practitioners they are uncommon. Any birth practitioner not blindly wedded to the guidelines will acknowledge there is much about the status quo in many obstetric units that work actively against "a good birth". It’s also recognised that challenging institutional drivers of practices can be very difficult, even those with little or no evidence to support them. Medical intervention has a place and can save lives but it is quite clear that many interventions are used inappropriately, are often ineffective and are, at times, harmful. This is particularly relevant to the current solutions offered when a labour dystocia is identified. Despite being one of the leading reasons for a multitude of interventions and the main indication for caesarean birth, there is not only no consensus on the interpretation of labour dystocia, basically it means difficult or obstructed labour, but there is no consensus on optimal solutions. 

As a midwife my role is to help women have the best birth possible and to ensure they leave our care intact, whole and unharmed, ready for the next part of their journey into motherhood. The question that drove my practice in the birth room was how can I support and optimise the birth process. To do that I needed to develop a deeper understanding of birth physiology.  Physiologically informed practice is my passion, and the reason I came to find out about about biomechanics, the study of human movement. The baby's path through the pelvis is amazing and it is insufficiently studied in obstetric and midwifery training. We learn from a pathological framework and don't have enough information to understand the reasons behind mechanical dystocia. In turn, this impedes our ability to recognise the signs before a dystotcia becomes a crisis and impedes our ability to offer physiologically informed solutions. 

After years of self directed study, courses and training, putting it into practice and seeing results I started teaching. By asking the right questions I can now recognise signs of a mechanical  dystocia over the phone. We all have this knowledge and ability, the solutions are not diificult and they are not harmful. I'm eager to share because it makes a difference! 

It was already clear before the pandemic that interest in biomechanics was increasing and my life was going to be filled with teaching, I was and still am delighted!  I was spending half my life on planes and trains travelling to hospitals as far apart as Chile and Oban and it looked like I was in for a busy year.

Covid brought everything to a crushing halt - but only for a little while. It forced the development of an online presence - and broke resistance to distant learning. It's changed "everything". I'm talking to and teaching birthworkers around the world, have a 4000 strong social facebook group that's a lively and supportive forum for physiological birth, working with midwifery lecturers to help bring biomechanics into midwifery degree courses. I said I wanted optimal birth to change the conversation about childbirth - it's a thrilling ride and the enthusiasm and positivity I'm getting with every course I teach is more than empowering. Can't wait to see what happens next!