SAFETY - A guide to feeling safe in birth

A positive birth experience is about ownership, feeling loved, cared for and safe. Safety in birth has objective and subjective considerations. There is SO much to be said surrounding safety in birth. For now, let’s focus on some things you can do to feel safe during birth.

Safety can be considered in the following acronym… SAFETY. Now now, don’t say we didn’t make it easy to remember!

Safety

S - Setting - Think about the setting and how we can optimise all the happy hormones, particularly Oxytocin, the hormone responsible for labour, love, bonding, milk ejection reflex and help with healing. What in your environment setting makes you feel loved, cared for and safe? Consider the five senses: Sight, Hearing, Smell, Taste and Touch.

What can you place around you to see? Photos from your wedding day? Birth affirmations to ground and encourage you? Candles, fairy lights and people you trust? Can you remove or hide medicalised equipment?

What can you hear? Your favourite dance tunes, spa music or affirmations? Would you benefit putting a sign on the door to minimise noise interruptions?

What can you smell? Relaxation diffusers, your partners cologne, or a blanket that smells of home? 

What can you taste? Your favourite snacks or simply anything to take away the taste of vomit from your mouth!

What can you touch? Your pillow from home, your partner’s hand, a massage or the sensation of water?

Consider other happy hormones at play during your labour and birth: Dopamine, Serotonin, and Endorphins and how you may influence those.

A - Advocacy - Do you feel prepared to advocate for your care and ensure you are being heard, understood and respected? Does your birth partner(s) feel confident and able to advocate these for you? Do you need to prepare ways and phrases to use to help you communicate your preferences and choices?

Advocacy is one we get told about a lot, but can actually be quite a tricky one to act upon. A lot of us are people-pleasers. The only person who needs to be pleased in that room is YOU. Anyone in that room who makes you feel ashamed, guilty or wrong for speaking up should not be in that room, and you have the right to make that call too. This is just one days work for your care team, but this day will impact you for the rest of your life. They won’t remember it. You will carry it.

If advocating feels scary for you to do, spend some time preparing some phrases and you can even come up with a code word for your midwife or your partners to help you initiate conversations around establishing your choices.

F - Feelings - Tune into your intuition and emotions. Your feelings are valid and should be made known so that decisions around your care can be holistically considered. Your body and instinct is strong - listen to it and trust it. Does your doctor or midwife trust it? Do you feel afraid, unsure or disempowered? Or do you feel at peace, confident and empowered? Do you truly feel cared for and loved?

E - Evidence - If you are being advised something you are unsure about, you should only consent if it’s fully informed. Giving fully informed consent means having access to the information, evidence and guidelines behind the advice.

You have the right to understand what this evidence means, what the quality of evidence is and how it impacts you. Think about how you feel when making decision and whether you would benefit having someone there/on the end of the phone to help you understand information and make decisions. Doula’s are great for this!

T - Team - We always get a say about who is around us during birth. You need to feel supported, comforted and free from judgement, guilt or shame in your setting. Choosing birth partner(s) who you know, love and care for you will make you feel safe; birth partners who can manage their stress and will put in the preparations to best support you.

Some maternity teams have ‘continuity of care’ structures in place so that you are cared for by the same midwife/midwives throughout your pregnancy and into birth. The hope is that this increases familiarity, trust and comfort with those caring for you. This isn’t the case everywhere you go, so it may be that you will have a different midwife for each appointment and during your birth.

If this is the case, I want to reassure you that the vast majority of midwives are incredible human beings who love their job and want to support you the best they can. If you have a midwife or other HCP who makes you feel uncomfortable, uncared for or safe, you have the right to request another clinician. You need to feel safe with those responsible for yours and your baby’s care.

Y - Your Rights - Understanding your rights, hospital policy and law is really helpful to know help you navigate your care, your options and your empowerment. 

You never have to do anything is labour and birth. You have the right to autonomy. You have the right to decline. You also have the right to not have to give a reason for this, or even to listen to the information/advice to why your healthcare team think you should do something.

You have the right to request interventions but just as you have autonomy, our healthcare team also have the right to autonomy so have the right to decline providing you with this intervention. Good care would see you having a respectful conversation surrounding the evidence and experience, as well as your needs and values.

You have legal rights put in place to protect you and give you access to care that hospital policy may prevent. Hospital policy should be based on the best research available and the recommendations presented at a higher level. Because it’s up to each hospital to implement their own policy, is not always the case that each hospital has policies serving your best interests as an individual person.

Hospital policy is not law; it serves to guide and protect both staff and patients, but it cannot be used to control or coerce your decisions. Hospital policy can often act as if one-size-fits-all. If there’s anything we know about birth (or humans in general) is that every person and baby is different. Hospital policy therefore can’t always serve us equally in our best interests.

Good patient care is not a one-size-fits-all. It takes the best research available, clinical expertise and the individuals’ needs and values into consideration - known as evidence-based care/practice. The hope is that you will receive this care. Learning all about this will help you recognise when you aren’t receiving the best care so that you can advocate for better.

By remembering SAFETY, you can recognise and prepare for feeling safe, loved and cared for in birth.