Birth Crisis
the book 

Taylor and Francis
Buy from the publishers £12.99  

Birth Crisis Book

1st June, ISBN 0415372666

Table Of Contents
BIRTH SHOCK
How is birth turned into an ordeal?
BIRTH CONTRASTS
Birth experiences.
What does it mean to be in control of birth?
Making an informed choice
INSTITUTIONAL POWER IN A HIGH-TECH BIRTH CULTURE: HOW AN ANTHROPOLOGIST SEES BIRTH
Birth plans. Fragmented care. The language of obstetrics. Becoming a patient. Conformity and passivity. Joking behaviour. Reality is in the case notes. Harpooned to a fetal monitor. Ceremonial dress. The cut. Cleaning up.
MANAGING THE REPRODUCTIVE MACHINE
Clock-watched birth. A race to the finishing post. Induction. Misoprostol. Suggestions to avoid unnecessary induction. Amniotomy. Episiotomy (How to avoid an episiotomy, How a midwife can help, The partner, The doula). Why mess about? The ‘no indicated risk’ Caesarean. Side effects of Caesarean section. Action a pregnant woman can take.
SEXUAL ABUSE AND BIRTH
Loss of control. Preparing for birth after sexual abuse. Pregnant again. Ways of preparing for birth.  Some listening skills. Non-helpful responses. Helpful responses. The childbirth educator. The partner. The doula. How a midwife can help a woman who has been sexually abused In pregnancy In childbirth.
NIGHTMARES, FLASHBACKS AND PANIC ATTACKS
Flashbacks.Panic attacks.
Nightmares.
The symptoms of PTSD.
PAIN
Killing pain with drugs.
A good birth.
Entonox and opiates.
The epidural.
OTHER WAYS OF HANDLING PAIN
A birth companion. Cutaneous injection of sterile water. Transcutaneous Electronic Nerve Stimulation (TENS). Acupuncture, acupressure, shiatsu and reflexology. Hypnotherapy. Touch relaxation and massage. Practising touch relaxation. Ways a woman can handle pain herself. Relaxation. Breathing. Visualisation. Vocalisation. Position change. Movement. Water. Warmth.
‘IF ONLY I HADN’T’
Choices. Maternal fetal conflict. Who’s to blame?
How to listen. Feelings of guilt.

Moving Forward ImageExcerpt from Chapter 12
Moving forward

I believe that when a woman is distressed after childbirth she benefits from both exploring the traumatic experience and also from looking ahead. She is helped to move forward into the future, and to do this she has to find strength within herself. Before that can happen she needs to create a narrative of the traumatic experience and have it validated. It cannot be swept into oblivion. So ways have to be found of enabling her to stand back and look at it carefully what happened between individuals involved and the emotional impact on her at the time and after. Only then can she move on. Eventually, like poetry, the narrative of the trauma that she creates is ‘emotion recollected in tranquillity'.
THE BABY
Trying to be a good mother.
Bonding.
THE PARTNER
Sex.
Reclaiming your genitals.
Sexual difficulties.
Sex after a traumatic birth.
MOVING FORWARD
Put your birth story into words. Get hold of your records. How to crack the code. A self-help group. Demanding twilight sleep: control or subservience? Face up to fear. Tell the story. The listening experience. On the phone.
PREGNANT AGAIN
A planned Caesarean. VBAC (vaginal birth after Caesarean). A doula. Birth at home. Labour at home as long as you can. A birth centre. Using a birth pool. Continuity of care. What about a private obstetrician? An independent midwife? Labour and give birth in any position you choose. Research a birth plan and explore it with your midwife.

 

Excerpt from Chapter 3. Institutional Power

Obstetric skills are valuable in high-risk births, when used with discretion. They can be life saving. But the technocratic management of childbirth combining technology, critical observation (often by complete strangers), intrusive monitoring and constant interruptions disturbs the flow of natural hormones that reduce pain and stimulate pleasure and excitement, blocks the spontaneous physiological process, traumatises women and often leaves them not only physically but emotionally damaged. Every intervention even apparently minor ones, such as rupturing bulging membranes, talking during a contraction, getting a woman up on a bed and encouraging her to push when she has no urge to do so introduces the need for further interventions artificial uterine stimulation, painkilling drugs, instrumental delivery or Caesarean section which increase the possibility of haemorrhage, pelvic infection, a newborn who is admitted to the intensive care nursery, post-natal physical exhaustion, difficulties in breastfeeding and post-traumatic stress disorder.

 

Excerpt from Chapter13. Pregnant Again

CONTINUITY OF CARE
This is easier said than done. Though much lip service is paid to it, a shortage of midwives makes it difficult for midwifery managers to guarantee. The standard pattern is team midwifery, and these teams may consist of up to 16 midwives. It is much better for a midwife to have her own caseload and work with one or two other midwives whom the mother also gets to know. Research shows that women receiving one-to-one care rate it highly. They say that it helps communication and they get the information they need at the right time. A relationship with a midwife they already know stimulates self-confidence.

Some midwives like the factory system and don’t want to have to manage their own time. But many are themselves happier with a caseload practice, more responsibility, and autonomy and flexibility in their work.

Happier midwives make for happier mothers.