0:00

Hello , my name is Florence . Welcome

0:02

to the ObsPod . I'm an

0:04

NHS obstetrician hoping

0:06

to share some thoughts and experiences about

0:09

my working life . Perhaps

0:11

you enjoy Call the Midwife . Maybe

0:13

birth fascinates you , or you're simply

0:15

curious about what exactly an obstetrician

0:18

is . You might be pregnant

0:20

and preparing for birth . Perhaps

0:22

you work in maternity and want to know

0:25

what makes your obstetric colleagues tick , or

0:27

you want some fresh ideas and inspiration

0:29

. Whichever of these is the case and

0:32

, for that matter , anyone else that's interested

0:34

, the ObsPod is for you . Episode

0:50

156 , hypno-birthing

0:53

. I

0:55

am very excited to welcome today

0:57

to the ObsPod Megan Rossiter

0:59

. Megan is the founder

1:02

of the BirthEd

1:04

podcast and does

1:06

antinatal and hypno-birthing teaching

1:09

, and I've actually been

1:11

on her BirthEd podcast talking

1:13

all about cesarean birth . So

1:15

it is lovely to have her come back

1:17

and reciprocate and join me

1:19

on the ObsPod and

1:22

we're going to talk all things hypno-birthing

1:25

. So welcome , megan , to the ObsPod

1:27

.

1:28

Thank you so much for having me . It's nice to kind

1:30

of do a tip for tatoo .

1:32

I guess briefly , it might be nice

1:35

to know how you got into

1:37

antinatal teaching and hypno-birthing

1:39

.

1:40

So I originally trained in midwifery

1:42

before my eldest son was born and

1:45

was introduced to hypno-birthing

1:47

by a family friend when I was

1:49

pregnant with him during my second year

1:51

of training and

1:54

was very skeptical . This

1:56

was now seven or so years ago . So

1:58

hypno-birthing is definitely being

2:00

spoken about much more widely now

2:03

than even seven years ago and it

2:05

wasn't something that I had encountered much yet

2:07

in my training or in kind of

2:09

practice supporting families in their pregnancies

2:12

or in their births , and so yeah

2:14

, I was a little bit concerned

2:16

about what it might be . Was

2:19

it going to just be really

2:21

alternative , really strange ? Was

2:23

I going to be hypnotised ? Wasn't sure . But

2:25

anyway , the set of circumstances at the time

2:27

meant that we kind of owed this person

2:30

a favour . So we

2:32

were like , oh , do you know what ? We'll just sign up for the course

2:34

because basically she had offered

2:37

to lend us her house while our house

2:39

was being redone . So we

2:41

decided to go ahead and do this hypno-birthing

2:43

course , kind of as a favour to her , and

2:45

it basically then was like

2:47

the grounding to change the rest of my

2:50

both personal and professional life

2:52

. So I went back to midwifery

2:54

for a short period of time after my eldest

2:57

was born , but due to the cost

2:59

of childcare and everything else that

3:01

is thrown at you once you have babies , it

3:03

just wasn't a viable thing to kind of continue with

3:05

and my sort of alignment

3:08

in the work that I wanted to be doing had

3:10

really shifted . So I

3:12

decided that I would train to teach hypno-birthing

3:15

and anti-native classes and

3:17

founded birthing . And

3:19

the work that I do now is all kind of

3:21

totally out of the NHS working

3:23

with families whilst they are

3:25

pregnant , preparing them to

3:27

what to expect for birth and

3:29

labour , how to kind of navigate the maternity

3:31

system , what to expect as you

3:33

kind of take those very first steps into parenthood

3:36

, both from the kind of perspective

3:39

of hypno-birthing and the incredible

3:41

things that that can do for somebody

3:43

in their kind of birth preparation . But hopefully

3:46

with a kind of having worked on the inside

3:48

of the NHS , with a kind of understanding of what

3:50

that looks like for the staff

3:53

that are working within the NHS and the people that are trying to

3:55

navigate their way through giving birth in

3:57

that kind of environment . Amazing

4:00

.

4:00

I love that story . That's such

4:02

a great story . Like I did this just

4:04

as a favour to do that and then it shifted

4:07

my whole life . It really

4:09

did . That's such a great story . So

4:11

you touched on there that

4:14

idea that

4:16

, ooh , hypno-birthing might be a bit alternative

4:18

, bit kind of . And when

4:21

you messaged me saying how about an episode

4:23

on hypno-birthing , I thought , oh yes , definitely

4:25

, because this is something I definitely do

4:28

not really understand and

4:30

it is something , as you say , I'm

4:32

encountering a bit more often . And

4:36

when you say hypno-birthing

4:38

, I agree you kind of think , ooh

4:41

, hypnosis , that's all a bit weird

4:43

and wonderful and , mmm , bit

4:46

sort of . There's a sort of area of mysticism

4:49

, bit of magic , bit

4:51

of a ooh , not sure . So

4:54

I would love you to

4:56

tell me what hypno-birthing

4:58

actually is .

5:01

So with regards to the word

5:03

hypno-birthing , it basically

5:05

just has a really stupid name , and if

5:07

I could change the name and the people that

5:09

are interested in doing it still know what I was

5:11

talking about , I kind of absolutely would

5:14

, Because it's the name itself

5:16

that is the issue , rather than the actual practice

5:19

of the tools , the techniques , the approach

5:21

to birth preparation . Now I

5:23

think the easiest way to

5:25

break down what hypno-birthing is

5:27

is to kind of break it into two parts . So

5:29

you've got the hypno aspect of it and

5:32

the birthing aspect of it . So I

5:35

should point out at this point actually that hypno-birthing

5:37

is not a regulated practice , so it is

5:39

not standardized . Different

5:41

teachers will teach it slightly differently , different

5:44

programs might interpret it slightly

5:46

differently . So I can absolutely

5:48

talk about it from kind of my perspective and

5:50

my take on hypno-birthing . But you may

5:52

find that different families , different

5:54

people , different teachers might be doing

5:57

it with a kind of slightly different slant , in the same

5:59

way that quite a lot of maternity practice

6:01

. Everybody has their own slightly different

6:03

slant on any number

6:06

of things , and you certainly see that within

6:08

hypno-birthing as well . But yeah , to break

6:10

it into two parts the hypno and the birthing

6:12

, so the birthing part of it is simply

6:14

an approach to anti-natal education

6:16

, so the kind of real foundations

6:19

of it are giving families

6:22

an understanding of what

6:24

happens on a biological

6:26

level inside your body when

6:28

you are getting your baby

6:30

from the inside to the outside . What are the processes

6:33

that take place hormonally , physically

6:36

, within your baby , within yourself

6:38

, and a kind of understanding of what

6:40

it might be along

6:42

the way that can impact that either

6:44

positively or negatively . An

6:47

understanding of what the maternity

6:49

system is in 2023

6:51

, how did it get created to be

6:54

like this ? What are the things that you might encounter

6:56

? How can you make the most

6:58

of it ? How can you take back power

7:00

and control and autonomy and agency

7:03

in the decisions that you are making

7:05

? How can you know what

7:08

questions to ask so that you're really getting the

7:10

most out of your care

7:12

provider's expertise , and what

7:14

are your rights ? What are you actually

7:16

able to ask for , what

7:18

are you able to do so

7:20

that , hopefully , you are

7:22

as close as possible , able

7:25

to have a birth that feels really

7:27

personalised to your circumstances rather

7:29

than ? I think it's mainly a

7:32

mixture of parents and professionals that listen to your podcast

7:34

, isn't it ? But you've probably heard the phrase

7:36

the conveyor belt of care you step on at the

7:38

beginning and you tick a load of boxes and this is the

7:40

birth you get at the end . Actually , it's

7:42

how do you almost stroll

7:44

alongside it and work out which bits

7:46

you want to take , which bits you don't want to take

7:49

. So that's a really

7:51

key part of the message that I teach within

7:53

hipno birthing is actually understanding all of that

7:55

. And then comes the

7:57

kind of almost what you'd consider

7:59

more kind of standard anti-natal education

8:02

is like . What kind of pain relief

8:04

can you have ? What are the potential interventions

8:06

that might be offered or recommended ? Where

8:09

can you have your baby ? Those sorts of things

8:11

that you might want to know about as well . So

8:14

that's the one side of it , and all

8:16

of this is going with a thread

8:18

, I suppose , of confidence building

8:21

, positivity , making hopefully

8:23

those things not feel frightening and scary

8:25

. And that is starts

8:27

to be where the link is then made to the hipno

8:29

aspect of hipno birthing . So

8:31

the word hipno is

8:34

a shortening of the word hipnotherapy

8:36

, and hipnotherapy is a practice

8:39

that is used effectively for basically

8:41

anything that would

8:43

require your

8:45

mindset or something within

8:47

your thoughts or thinking or subconscious

8:50

mind to change . So hipnotherapy

8:52

people use for things like quitting smoking

8:55

, for fears , phobias , anxiety

8:57

, losing weight , those

8:59

kinds of things are where we tend to

9:01

see the practice of hipnotherapy used

9:04

in more kind of day to day situations

9:07

and the idea is that the

9:09

tools of hipnotherapy

9:11

and the tools , therefore , of hipnobirthing

9:13

can be used to start

9:16

to reframe some of the kind of thoughts

9:18

, ideas that might be sitting in the subconscious

9:21

part of our mind before

9:23

we've got pregnant , before we've given birth or as

9:25

we step into future birth . And

9:28

if you are thinking about kind of how the mind

9:30

exists , if you think of it as like an iceberg , the

9:33

top of the mind is the kind of cognitive

9:35

thinking neocortex bit that we're using right

9:37

now , that we're kind of engaging in conversation

9:39

with , the bit we're very aware of

9:41

, and underneath is like the vast

9:43

, vast , vast subconscious , which is full

9:46

of information that we have taken

9:48

in from our entire lives , whether

9:50

we think we have or we haven't . And

9:53

, with regards to birth , this can be

9:55

your own mum's

9:57

experience of giving birth , your sister's

10:00

, family's , friends' experiences of giving

10:02

birth , everything that we've ever seen on

10:04

TV about giving birth , everything that we

10:06

see in the media , everything that we see in social

10:08

media stories . All of that is

10:10

going in and starting to sit in the subconscious

10:13

part of our mind , and the reason

10:15

why this is so relevant is because your subconscious

10:18

mind influences both

10:21

the voluntary and the involuntary

10:23

actions that we take absolutely every

10:25

single day . With regards to

10:27

birth , all of the decisions that you know you're

10:29

making and all of the decisions that you don't realise

10:31

you're making about labour and birth

10:33

will be influenced by what is in that subconscious

10:36

part of the mind . So the idea

10:38

of the hit no birthing tools is to start

10:40

to kind of unpick some of this , start to

10:42

layer in positive confidence

10:45

building ideas so that you are able

10:47

to trust yourself , so that you are able

10:49

to build your confidence , so that you are

10:51

able to kind of tune into what

10:53

you're feeling , what your body is telling you

10:55

, the connection between you and your baby . And

10:58

when we marry those two things up the kind

11:00

of information side of things

11:02

and the sort

11:04

of sense of self trust that we can build in hit

11:06

no birthing then hopefully it

11:08

means you are stepping into your

11:11

birth from a place where you can

11:13

really really ensure you remain

11:15

centred in that experience , and that

11:17

can be . You know , when I talk about trusting

11:19

yourself and tuning into what your body is saying

11:22

, in a big part

11:24

that is trusting in the process of

11:26

birth and actually the sensations that you're

11:28

feeling and knowing how to move and those

11:30

kinds of things . But just as

11:32

similarly it's trusting yourself to go

11:34

. Actually this doesn't feel quite right or something

11:36

isn't quite right or actually this isn't what I want

11:38

. And we can chat a little bit as we go about how

11:41

actually hit no birthing plays into , yes

11:43

, kind of physiological birth

11:45

, as sometimes it might be presented to

11:47

, but actually also

11:49

induction of labour or caesarean birth

11:51

, if those things feel like the right things for you

11:53

to do , trusting yourself to

11:56

make those choices as well . So that

11:58

is my very , very not in a nutshell

12:00

version of that what hit no birthing

12:02

is .

12:03

No , but that's really clear because

12:06

in my mind so

12:08

sometimes I come across a

12:10

woman who's hit no birthing and

12:12

there might be a sticker on the front of

12:14

the notes kind of like flag

12:17

don't , don't interrupt me , I'm hit

12:19

no birthing . And often

12:21

she is very turned in

12:23

on herself and centred on

12:25

herself , and

12:28

so I kind

12:30

of think more

12:32

about maybe breathing

12:35

and relaxation techniques

12:37

, whereas actually

12:40

you're talking more about

12:43

connection with

12:45

your body and feeling and understanding

12:47

your body , which is slightly different to what

12:49

I imagined .

12:51

Yeah , and I suppose there are absolute what

12:54

the hit no birthing , the hit no therapy

12:56

part of the techniques are . They

12:58

are breathing techniques and relaxation

13:00

techniques , but the purpose of those

13:02

is to allow

13:05

you to kind of tune back into your body . So the reason

13:07

for doing them is for , yes , managing the sensations

13:10

that you're feeling , for blocking

13:12

out everything else that might

13:14

be going on around you , to really

13:16

really support the

13:18

physiology and it's ultimately

13:20

supporting the kind of mind body connection

13:22

and we really really underestimate

13:24

in birth and in life just

13:27

how connected your mind and your body are and how

13:29

one can influence the other in

13:31

a massive , massive way . There are practical

13:33

techniques which form part of

13:35

a hit no birthing program which

13:37

you absolutely include relaxation , massage

13:40

, breathing techniques . But the kind of grounds

13:43

at the purpose of them being

13:45

there is to support

13:48

that mind body connection , to support physiological

13:50

processes in your body . Okay , and

13:52

the preparation

13:54

.

13:56

So sometimes I've got women

13:58

who are perhaps very

14:00

anxious and they

14:02

might be choosing a cesarean

14:05

birth . But

14:07

I will still say to them actually

14:09

hit no . Birthing might be useful to you , because

14:12

I've seen some of those techniques

14:14

and grounding can be

14:17

really helpful at keeping them calm . You

14:19

know , not everyone that chooses a cesarean

14:21

feels theatre is a good

14:23

environment either . It may be

14:25

it's the best of the worst , if

14:27

you see what I mean . Both options don't

14:30

feel good and I'm

14:32

never sure , when I suggest it , at

14:34

what point you

14:37

need to start practicing maybe

14:39

some of the techniques to be able to then

14:42

use them at the end

14:44

of pregnancy . So you know , if you're

14:46

because it's not something you can easily just

14:48

do kind of go . Oh yeah

14:50

, it's my subconscious and

14:52

everything you've just explained . It takes

14:54

a bit of practice , doesn't it ?

14:56

Yeah . So I mean , ultimately , it's

14:59

never too late , like if

15:01

you were listening to this and you're 40 weeks pregnant

15:03

and you're like , oh well , that's it , my chance has been blown . There

15:06

is information that you can gather

15:08

, there is learning that you can do . There are tools and techniques

15:10

like breathing technique . You can learn that very quickly

15:13

. You can practice it a bit , and it should , particularly

15:16

for a plant , as an area where you're not completely

15:18

thrown by actually the sensations of labour , where

15:22

actually you can reach for that and utilise

15:24

it pretty quickly . Ultimately

15:26

, though , there's also there is no too

15:28

early time to do it . If we could start

15:31

giving this information to people long

15:33

, long long before they got pregnant , a

15:35

lot of it is beneficial for even at

15:37

the very beginning , navigating your

15:40

booking appointment , the conversations that you're

15:42

having your 12 week scan , all of those kinds of things

15:44

. Actually , if you've got this information

15:46

then and people find it helpful with

15:48

if they don't like having the blood taken or that

15:50

kind of things , these tools and techniques can be helpful

15:52

in those situations as well . So

15:54

, never too late or too early . Most

15:57

people that I work with tend to feel

15:59

most comfortable to wait until after their

16:01

20 week scan . I think that just tends to be

16:03

a milestone that people feel

16:06

comfortable with . But ultimately

16:08

, as soon as you've got an interest

16:10

in it , I would just kind of get going with

16:12

learning a little bit more about it . But

16:15

if you're right , right , right at the end and you're like

16:17

, oh , I just want a couple of things to kind of reach

16:19

for , yet there is plenty that

16:21

you can take from it . Even I've worked with somebody

16:23

literally at 41 weeks of pregnancy and

16:26

it's completely transformed their

16:28

approach , their understanding , the tools that they had at

16:30

their fingertips . So , yeah , absolutely , and

16:33

, as you said , using the tools for

16:35

a planned or an unplanned cesarean

16:37

birth that what we are trying

16:39

to do and what the main purpose

16:41

of the actual kind of practical

16:44

tools that you can reach for

16:46

is . I'm probably teaching you to suck

16:48

eggs here , but for anybody that is listening , it's all to

16:50

do with your nervous system . So your nervous system has got

16:52

two sides your parasympathetic

16:54

nervous system and your sympathetic nervous system

16:56

. In short , we can call it your calm mode

16:58

and your emergency mode . When you

17:00

are in that emergency mode , that's

17:02

when we feel like nervous , we feel panicked

17:04

, we feel on edge , we might

17:06

have a slightly higher heart rate , we might be breathing

17:09

a little bit more quickly . We're just sort

17:11

of not feeling in

17:13

a way that you would want to be feeling

17:15

when you're giving birth , and the impact

17:17

that that can have on a labor is

17:20

that , ultimately , the hormones that you need for

17:22

birth are not created when we're in that

17:24

state . So you need tools and techniques

17:27

, environment support that is going to

17:29

help you remain in the

17:31

calm part of your nervous system

17:33

. But and I think

17:35

we might have mentioned this a little bit when we chatted in the

17:37

in my podcast about cesarean birth

17:39

actually feeling calm

17:42

is important , even

17:44

if you aren't in labor and being

17:46

in that parasympathetic part of your nervous

17:48

system , having tools that actually

17:50

help you pause

17:53

, that help you relax that is going to enable

17:56

you to have better bonding with your

17:58

baby , to remain more

18:00

kind of grounded and centered in the moment , for

18:02

it to feel safer , for

18:04

it to feel more special . So all

18:06

of those feelings that you would , if you write

18:08

a list of feelings that you want to feel when you're

18:10

in giving birth to your baby , most

18:13

of them will only be possible when we are in this

18:15

part of the nervous system , which is that calm

18:17

part of the nervous system , and so

18:19

, like literally deep breathing , stimulate

18:23

something called the vagus nerve that runs through our body which

18:25

activates this calm part of the nervous

18:27

system . Guided relaxations

18:29

they really , really kind of help to settle

18:31

yourself , settle your mind , move yourself back

18:33

into that part of the nervous system . So those tools and

18:35

techniques are there , However you're giving

18:37

birth to your baby , and the idea

18:40

of them is to help you remain calm

18:42

and relaxed , because when we are calm and relaxed

18:44

, the physiological processes that

18:46

happen , regardless of how you're giving birth

18:49

to your baby everything from stopping

18:51

bleeding , postnatally establishing breastfeeding

18:53

, contracting the uterus back down , bonding

18:56

with your baby all of that is hormones

18:58

that are made in that part of the nervous

19:01

system , so absolutely suitable for

19:03

a physiological birth , which

19:05

is you're definitely , definitely going

19:07

to need them and it's not going to work unless

19:09

you're feeling those things but transferable

19:12

to however you give birth to a baby .

19:14

Yeah , I'm thinking as you

19:16

were talking then . I mean

19:19

we see a lot when women come in

19:21

in what we might deem to be

19:23

early labor , that you know you

19:25

come to the hospital and then everything stops dead

19:27

because you're in that kind of alert

19:29

state suddenly because you're in a different

19:32

environment with different people

19:34

that you've probably never met before . But

19:37

I was also thinking actually

19:39

for some women

19:41

. So you know that I'm

19:43

the link consultant for the home birth team or

19:45

I see a lot of women who want maybe

19:48

a vaginal birth after cesarean and

19:50

I normally suggest to people that they make a

19:52

series of birth plans or

19:54

birth preferences , because then

19:56

, whatever happens , they

19:59

know , okay , we're not doing plan A , we're

20:01

doing plan B , or actually we're maybe

20:03

doing plan C because that

20:05

keeps them calm . Okay , this

20:07

isn't what I expected , but I know I've

20:09

still got a plan for that type of birth

20:12

or that eventuality . But

20:14

I was thinking also

20:17

about the fact that sometimes

20:20

people feel

20:22

like , oh my God , I've been

20:24

sent to see the consultant because something's

20:27

wrong , I've got to go and

20:29

see this scary obstetrician . And

20:31

that does happen . I have people come in and

20:33

they're like , oh it , completely

20:36

alert and terrified . And

20:38

actually I work with a

20:40

wonderful midwife who does

20:43

yoga and mindfulness

20:45

and she's very good at just trying

20:47

to bring them back down

20:50

and calm them so

20:52

that they can then actually have the conversation they

20:54

want to have with me . Because the other

20:56

thing that happens when you're super agitated

20:59

and stressed is your brain goes and

21:01

you can't actually remember the things you wanted to

21:03

ask , the conversation you

21:05

wanted to have , and then you go home

21:08

and you haven't got any of them . So

21:10

I think actually maybe people need hit

21:12

and a birthing just for the anti natal . Yeah

21:14

, consultations , but yes , there's

21:16

so much in in pregnancy that we

21:18

expect people to just do Like

21:21

. I often get women who

21:23

haven't had blood tests or

21:25

find having blood tests very difficult

21:27

, and staff say to me huh

21:30

, they haven't had any blood tests , you

21:32

know , and it's like , well , okay

21:35

, but we need to work with them

21:37

and explain why and what strategies

21:40

we might be able to use to make it easier

21:42

and whatever , but they are

21:44

still something

21:46

that a woman could opt out of . I

21:49

wouldn't recommend it . There's reasons why

21:51

we do them , but actually

21:53

we take for granted

21:55

that a woman's going to just sail through and do

21:57

everything .

21:59

Yeah , and going back to your point about kind

22:01

of the actual going into anti

22:03

natal appointments , all of these things . But like and

22:05

because we're all so different , some people

22:07

are really comfortable in a hospital environment

22:10

. Meeting a doctor doesn't bother them , feels fine

22:12

. Other people like this is

22:14

the first time they've ever really interacted

22:17

with health care services

22:19

at all , or they have deliberately

22:22

opted out of health care systems for

22:24

a long time , or they have had

22:26

previous very difficult experiences engaging

22:28

or previous difficult conversations engaging

22:31

with health care services . So you

22:33

know , from a kind of provider

22:36

perspective , who's walking in each

22:38

appointment and how they're kind of feeling . So having

22:41

, from a kind of service user

22:43

perspective , somebody who's actually about to have a baby

22:45

yes , these tools are helpful

22:47

for labor and birth . But something that we talk

22:49

about . Going back to the nervous

22:51

system , when we enter

22:54

that emergency mode , what we can

22:56

trigger when we trigger this production of a hormone

22:58

called adrenaline , which is our kind of fear

23:00

hormone . Most people have heard of adrenaline like

23:02

an adrenaline junkie loves roller coasters

23:05

, loves that kind of feeling of fear Anytime

23:07

we don't feel safe

23:09

, relaxed , unobserved or undisturbed

23:11

. Those are the four things that we need to feel

23:13

to remain in that calm part of

23:15

the nervous system . If we don't feel

23:17

those things , we run the chance

23:20

of producing adrenaline and

23:22

when we produce adrenaline it triggers a response

23:24

in our body called the fight or flight response

23:26

and that basically sends blood to your

23:28

arms and your legs so that you can kind of fight danger

23:30

or run away from it , which

23:33

from an evolutionary perspective

23:35

, very helpful . If you were giving birth in the woods and

23:37

suddenly you saw a saber tooth tiger

23:39

, you would want to get

23:42

away from that danger very , very quickly or potentially

23:44

fight it . But you can actually extend

23:46

this response and I don't think

23:49

I mean you can probably

23:51

share from the kind of inside perspective

23:54

of working in the maternity system , but I don't think

23:56

we tend to see fight

23:58

or flight as the initial

24:01

response . That often you don't see that

24:03

many people ready to have like a real

24:05

confrontation argument if something

24:07

has been suggested that makes them feel uneasy

24:09

. You don't really see that many people just

24:11

stand up and walk out the room . What you

24:13

tend to see is the third response which

24:15

is called for , which is essentially

24:18

complying with something

24:20

to make your life easier , just doing

24:22

what you are told . Because it is that

24:24

I feel uncomfortable . How

24:26

can I make this as easy as possible . I'm just

24:28

going to nod my head and do what I'm told , and

24:31

that is not because

24:33

you're bad at advocating for yourself or

24:35

because you don't know what you want . It is

24:37

like an automatic response

24:40

from your body to try and keep you safe . Your

24:42

body's going right . Something's being

24:44

suggested . I don't like it . Am I going to argue

24:46

? No , that feels uncomfortable . Am I going to get

24:48

up and walk out the room ? No , that feels uncomfortable

24:50

. Should I just nod along ? Yeah

24:53

, that feels like the easiest thing to do here . And

24:55

that's when we end up agreeing

24:57

to things or not asking the questions that we wanted

25:00

to do , and so so much

25:02

of the Hypnoburthing course is actually working

25:04

out . Actually , how do you manage that

25:07

? But it is much easier to manage

25:09

that if you are sitting in a place

25:11

where you are feeling calm , where you are feeling safe

25:13

, where you are feeling relaxed , and then engaging

25:15

in those conversations , as you mentioned , is so

25:18

much easier than actually it

25:20

just being a kind of automatic response from

25:22

our body , a physical response from your body

25:24

.

25:25

That's really interesting . And that

25:27

sort of brings me on a little

25:30

bit to the

25:32

thing that I find a bit difficult

25:34

with Hypnoburthing . Sometimes

25:37

is , I'm told

25:39

, this woman's Hypnoburthing and

25:43

sometimes in the

25:45

birth preferences is the

25:48

idea that I do not talk to her

25:50

and do not interrupt her . That

25:55

is very difficult as a professional

25:57

because we have this whole issue

26:00

of consent and it

26:02

may be something that she's

26:05

learned about and understood antinatally

26:07

, but it may not be and I can't make

26:10

that assumption . So

26:12

I have to have some kind

26:14

of interaction and conversation which

26:16

is then going to immediately

26:19

bring her out of that zone

26:21

, and that's sometimes

26:23

quite difficult to kind of navigate

26:26

for me or for

26:28

listeners that are midwives perhaps

26:30

. So do you have any kind of tips

26:33

or sort of thoughts on how

26:36

to do that in a way

26:38

that is not overly

26:41

disruptive ?

26:42

Yeah , absolutely , and I think this

26:44

is sometimes where the

26:46

if the message of

26:48

hipney birthing has become kind of confused or diluted

26:51

in the way that it has been taught , where

26:54

sometimes you can get mixed messages that

26:56

aren't particularly helpful . So I would never

26:58

say to anyone that I'm working with don't

27:01

ever talk to anybody the whole time that

27:03

you're in labor , because if there's a conversation , as you

27:05

mentioned , that actually needs to

27:07

happen for their safety

27:09

or their health or for their consent or

27:11

something like that , then it is important

27:13

that they are engaged with and that they

27:16

have that conversation . Sometimes

27:18

I might see people write for

27:20

conversation initially to go through

27:22

somebody else . So

27:25

can you speak to my partner first ? Can you speak

27:27

to my doula first ? Those kinds of things you sometimes

27:29

see there . So it might depend slightly on

27:31

what is written in the kind of birth plan

27:33

or birth preferences . So the

27:35

first thing is just that I think most

27:37

people are happy to be disturbed

27:39

when it is really essential that

27:41

they are the person that needs to be spoken to , and

27:44

I think a lot of it is sometimes

27:46

conversation that happens

27:48

or that does need to happen . But

27:50

it might be something like a question of oh

27:53

Megan , can you just confirm what address you're

27:55

going home to , because I need it for the notes

27:57

. Like there is absolutely no reason

27:59

why that question has

28:01

to go to the person that is in labor whilst

28:04

they are in labor , and sometimes , if

28:06

it's a question like that , if it's a kind of clarification

28:09

of something , there's often no reason

28:11

why the other person in the room wouldn't be able

28:13

to answer that . If

28:16

it is a we

28:18

would like to offer you I

28:20

don't know we're recommending continuous monitoring

28:23

of your baby because of X , y and Z , and

28:25

we would therefore need your consent

28:27

or conversation with you about why we're

28:29

offering this and for you to decide

28:31

whether or not . Something that you want to do , I

28:34

think , as a first instance , is

28:36

just sort of pitching

28:38

the time of it . So you're strolling up to somebody

28:40

mid contraction and saying we're

28:43

just asking you if you want this . You know , somebody

28:45

asked me in my first labor if

28:47

I consented to having the injections

28:49

in my placenta whilst my baby

28:52

was crowning . Now , there is absolutely

28:54

no way that you can give

28:56

informed consent whilst there is a baby's

28:58

head sitting on top of your perineum . You

29:01

just go , yeah , yeah , whatever , I don't care , go away

29:03

and you'll say so . It's about

29:05

pitching . The timing , you know , between

29:07

contractions is probably a

29:10

better time to start that conversation

29:12

. Or if they have asked really

29:14

not to be disturbed , it might be that you can say to

29:16

a partner or to a doula let's

29:18

say , it's me and Labour , it's important

29:20

that we speak to Megan for this , and

29:22

if you just let her know that we would like

29:24

to speak to her and in the next few

29:26

moments , whenever she feels ready , then

29:30

we can kind of engage in the conversation

29:32

, just so that that maybe that preempting is

29:34

coming from somebody that she feels safe

29:36

with and so , or if there's no

29:38

kind of instruction like that , then it's , you know , in

29:40

between those contractions . Megan

29:42

, we would really like to talk to you about

29:45

a recommendation that we would like to make about

29:47

continuous monitoring . Have your

29:49

next contraction and then , if you're ready , we

29:51

can have a little chat about it . And so just

29:53

giving like an almost office

29:55

consent for the conversation yeah , yeah , okay , yeah

29:59

, exactly Before you kind of launch into something

30:01

and know that they haven't had a chance to kind of actually

30:03

prepare their mind for that

30:05

conversation is very , very , I

30:08

think , a very good way of engaging it in

30:10

the first place and then , if it

30:12

is something that's quite clear in

30:15

the birth preferences and

30:17

is only being offered

30:19

because it is routine , then

30:21

it might be a question of going . Do

30:23

we actually need to ask this question ? Or

30:26

you know , it's been four hours since the last vaginal

30:29

examination . Everything's completely fine

30:31

. She's written very clearly in her birth preferences

30:33

that she doesn't want vaginal examinations and less

30:35

a clinical need arises . Do we

30:37

really need to be having a full on conversation

30:39

now about the pros and cons of vaginal examinations

30:42

? If it's actually X

30:44

, y and Z has happened and there

30:46

are now complexities and now things are looking different

30:49

and it might give us some helpful information

30:51

, then maybe that

30:53

is a good time to engage in it . But actually

30:55

otherwise , is it a necessary

30:58

conversation ? Or is it one

31:00

that you can kind of look through the birth preferences

31:02

? Or even if it's just a quick , it

31:05

says in your birth preferences that you don't want vaginal

31:07

examinations . Are you still happy

31:09

with that or do you want me to talk you through them ? A

31:12

very kind of quick question yeah

31:14

.

31:14

Yeah , okay , that's really

31:16

helpful . I mean , I do a lot of that

31:18

on the wall , dr . I'm kind of we're

31:20

having a conversation pause

31:23

for contraction , tell me when

31:25

you're ready and we'll restart it , so that that

31:27

makes complete sense . I always

31:29

find the talking

31:32

to somebody else the

31:34

birth partner or the do-love I always find that

31:36

a bit weird . But you just explain

31:38

that quite nicely that

31:41

they're an intermediary

31:43

, as someone that the

31:46

woman trusts and

31:48

their sort of heads up so she can get

31:51

her head in the game .

31:52

Yeah , because they're never going to be able to make sense to

31:54

me , because otherwise it just feels

31:56

weird .

31:58

Sorry , we're all in the room , or

32:00

maybe I've stepped outside the room and got

32:02

the partner outside , if it's sort of specifies that , and

32:06

then it's a bit like I'm going to talk

32:08

about you to your partner so

32:10

I don't interrupt you . But so

32:12

that's really helpful how you've

32:14

just described that actually .

32:16

Yeah , because they're never . They're never going to be able to give

32:18

consent on somebody else's behalf

32:20

and you're never going to be able to

32:22

know that you have passed

32:25

on the message in the way that you want

32:27

it to be communicated , unless

32:29

you speak to them directly . But sometimes

32:32

, particularly when people are feeling very

32:34

anxious about intervention

32:37

or the way that conversations are

32:39

happening , even if

32:41

it is a case of and it will

32:43

obviously depend on the urgency of

32:45

the situation but sometimes being

32:48

spoken to by

32:50

somebody that you know , that you

32:52

have a relationship , that you trust , that already

32:55

knows how you are likely to

32:57

respond to the conversation

32:59

, so is it going to make you feel

33:02

very uncomfortable , very scared , very

33:04

you're going to feel happy with it . Is it going to make

33:06

you feel really allowed to swear ? Is it going to make you feel really pissed off

33:08

? Those kinds of conversations

33:10

? If that came from

33:12

a doula that you had a relationship with , or your partner

33:15

, let's say , you had an instrumental birth in your first

33:17

birth . It was your second birth and

33:19

something had come up that meant the conversation was

33:21

going to happen again . Your midwife

33:24

was there , you were in labor , you

33:26

have been pushing for a really long time . There wasn't

33:28

really any kind of obvious signs of progress

33:30

. But sometimes happens in that situation

33:33

is they either press a button or

33:35

they go out and say we're just going to get the doctor and they're just going

33:37

to come in . Unless you understand

33:39

the maternity system , you have no idea what that means . But

33:41

actually , if there was a heads up to

33:43

a partner , we're going to have a doctor

33:46

. They may want to have a conversation about assisting

33:48

the birth with the use of instruments , and if that then

33:50

is partners head

33:53

to head , look , megan , they're going

33:55

to have a conversation about potentially helping baby

33:57

out . The doctor's going to come in and this is what they're

33:59

going to talk about . Let's take a couple of

34:01

deep breaths , calm ourselves down and then we'll

34:03

be ready to engage in that conversation . That

34:06

can be like , really transformationally

34:09

different to and you know , it's not always

34:11

you that walks in the room , florence , it's sometimes

34:13

it isn't somebody that really has that maybe

34:16

kind of gentle bedside manner . It can be somebody

34:18

that walks in Okay , we're just going to give baby a bit of

34:20

help . Whoa , whoa , whoa , whoa , whoa

34:22

. That , for somebody that has had a previous

34:24

difficult experience , is potentially

34:28

going to be contributing to trauma , making

34:30

it very difficult to say no , put you in that

34:32

foreign position where you're like , okay , just do whatever

34:34

you want , and it really , for

34:36

some people , gives them back a kind of

34:38

element of control . And I think , when

34:41

we're talking about almost like trauma

34:43

, informed care as well is , if somebody

34:45

has come to hit new

34:47

birthing or is writing a birth

34:49

plan that is incredibly detailed Generally

34:53

, if it's because they've had a traumatic

34:55

birth the first time , that is

34:57

what they're asking for , is they are really really asking

35:00

for absolutely everything to

35:02

be explained , absolutely nothing

35:04

to happen without very kind of considered

35:06

informed consent for them to feel as safe

35:08

as possible . And if that request

35:11

is there because it's making them feel safe

35:14

, we need to find a way

35:16

to respect it , in the same way

35:18

that if somebody

35:20

had come in and part of their

35:22

religious practice or their culture was at , the first

35:25

voice they heard was the voice of their father

35:27

. The way that we should be

35:29

respecting that in birth we should also be

35:31

respecting . I don't want conversation

35:34

in the room or I would like

35:36

initial conversations

35:38

to go to my partner . When we start to look at it almost

35:40

as like a cultural

35:43

decision or a decision

35:45

that is based upon somebody's

35:47

personal values

35:50

, then it sometimes

35:52

starts to make it a little bit easier to respect

35:55

and less of a kind of imposition

35:58

on the maternity system as

36:00

it exists . They're not just saying it to be annoying

36:02

, even though it does make things

36:04

sometimes a little bit more tricky when

36:06

we dig a little bit deep and we go why ? Why

36:09

would they not want to speak to me when

36:11

they're in Labour ? Because you know , in

36:13

an ideal world you would only have people

36:15

in that space and midwife that you knew , a doctor

36:17

that you had met before , and if that is what it

36:19

looked like , most people wouldn't care at

36:21

all if a midwife that they knew , that they

36:23

had known the whole way through their pregnancy , came

36:26

up to them and said I came again . Remember we talked

36:28

about this during pregnancy . This situation's

36:30

come up , so now we might want to consider it whatever

36:32

. That is completely

36:34

different to a stranger walking in the room and

36:37

launching into a conversation and

36:40

say part of the decisions

36:44

that people sometimes choose with hypno

36:46

birthing is in direct

36:48

response to the way that the

36:50

maternity system runs

36:52

and what it looks like , rather

36:54

than actually anything to do with the

36:57

birth itself or

36:59

their preferences itself . It's actually caveating

37:02

or buffering . What the maternity system

37:04

can't provide in its current

37:06

state is okay . Well then , what

37:09

can we do to make sure I still feel

37:11

really protected ? But after

37:13

all of that conversation , I don't know that many people

37:15

that would actually be that opposed

37:17

if you just very gently went and spoke to them about

37:19

something that was completely essential to

37:21

talk about .

37:22

No , that's really helpful and I definitely

37:24

see it . With some postnatal debriefs

37:27

. People have said I

37:29

was in the zone , I was doing this

37:32

and then , bam , the doctor

37:34

came in . Why did the doctor come in and

37:37

offer me an assisted birth ? And

37:40

I've explained . Well

37:42

, you know , there's some guidance on

37:44

the timing and it may be the midwife

37:46

in charge asked them to go in the room

37:49

or you know , but it

37:51

shouldn't have been that . It was unexpected . Yeah

37:53

, it should have been that you knew they were coming and you

37:55

knew why they were coming and what they were coming for

37:57

and whatever . So , yeah

38:00

, I definitely agree with what you're saying

38:02

there and it can be

38:04

something is a big surprise

38:07

. Yeah , and it is

38:09

about that fit between the

38:11

system and the individual , isn't it ?

38:14

And that relationship building like , yes

38:16

, ideally it would be for everybody

38:18

, continuity of care throughout pregnancy

38:20

and then in labor , but it's not for

38:22

99% of people . But that

38:25

relationship building does happen if

38:27

you've been in labor for a while and you've had a

38:29

midwife for that entire time . That

38:31

midwives are fantastic at building those

38:33

relationships very , very quickly . So it

38:35

can be that that just comes from them

38:38

initially , because you're like hang on , I know

38:40

you . I try , I don't know you . You

38:42

are dangerous to me right now . You know this is our

38:44

evolutionary responses . Who are you

38:46

danger ? Don't know you . You've been

38:48

here a while , you're all right . I want to hear it from

38:50

you . I will trust you , you're the person I

38:52

want to talk to . Yeah , and those

38:54

things stick with you forever . I really vividly remember

38:57

in my first birth the midwife said

38:59

and because I had worked in the maternity

39:02

system by this point I knew what it meant but

39:04

she said we're just going to call the

39:06

doctors in because you might need a little bit

39:08

of help . Now I know that

39:11

that meant a doctor was coming in to see

39:13

if they needed to do an instrumental

39:15

birth . If I didn't hadn't

39:18

worked on a labor ward before , I

39:20

would have absolutely no idea what that meant

39:22

. So then if a doctor walked in

39:24

and was like , okay , yeah , we're going to do four

39:26

steps , what ? What ? That's

39:28

the fact that everyone else in the room thinks it's

39:30

already been mentioned , but to the person giving

39:32

birth , that is brand new information . So

39:35

it can literally be as simple

39:37

as Megan baby's

39:40

heart rate's dropping a little bit . It might be

39:42

that they need assistance with instruments to

39:44

be born . I mean to call a doctor in

39:46

to come and have a conversation with you about

39:48

what that plan might or might not

39:50

look like . It can be as simple as that , but

39:52

coming from somebody that you trust is different

39:55

to someone that's bold in and

39:57

happening in that kind of gentle , preemptive

39:59

way . Yeah , as you said , it stops

40:01

it being a surprise , because that's not fun

40:03

to the price Amazing .

40:06

So another question that I wanted

40:08

to ask you is

40:10

a little bit about

40:12

the sort of dreaded F word

40:14

of failure in inverted

40:16

commas . So sometimes

40:20

women who may

40:22

have prepared beautifully

40:25

they're going to hit no birth and

40:28

then , for whatever reason

40:30

, the way the labor's going or they're having

40:32

an induction or something else happens

40:35

, they decide

40:37

actually I'm going to have an epidural . And

40:41

sometimes

40:43

I think possibly

40:47

not within themselves

40:49

, but maybe

40:53

when you see social media posts

40:55

and things afterwards well , I meant

40:57

to hit no birth , but I ended up with an epidural

41:01

. Or , I'm sorry

41:03

to say , sometimes I hear staff going

41:06

well , she was going to hit my birth

41:08

, but now , look , she's got everything . So

41:11

how do you

41:13

, the couples that

41:16

you're seeing , or the families you're seeing , how

41:18

do you prepare them ? Because

41:21

they may never have been through labor before

41:23

, they don't know what it's going to be like , that

41:26

if that's what they need in

41:29

that moment , that that is okay

41:31

and they can still use that toolkit

41:33

you've given them and it's not

41:36

a negative thing .

41:39

So I think there's sort of three points

41:41

that I would want to make it so first of all just

41:44

goes back to that kind of the fact that

41:46

hit no birthing is unregulated . So

41:48

I am extremely

41:50

careful in the way that I

41:52

talk about hit no birthing , in the way that I

41:54

talk about the ways that you might give birth to

41:56

your baby and the decisions that you might

41:58

make along the way to not put

42:01

a certain type of birth on

42:03

a pedestal . And

42:05

that came from having sort

42:07

of joined when I created the kind of

42:10

birthed version of hit no

42:12

birthing . I had done a slightly

42:14

more traditional hit no birthing course

42:16

which I do feel in a lot

42:18

of ways put an unmedicated

42:21

home birth on a pedestal , as

42:23

, like this is the aim , and

42:25

then I think it's fine . It's fine but

42:27

it's not the best . It's not the best

42:29

thing for you and for your baby . So

42:32

I saw that and then

42:34

saw the kind of slightly more traditional

42:36

form of anti natal education which

42:39

was either just a list

42:41

of pain relief or was

42:43

almost sort of grooming

42:46

people to just comply with whatever was

42:48

being recommended and not giving them

42:50

that agency and autonomy in the

42:52

decisions that they were making . And I very much

42:54

felt that there was something in the middle

42:56

that was missing , because that

42:59

agency and autonomy and trust

43:01

that hit no birthing teachers is so

43:03

important , even if that leads you

43:05

to go . Actually , I really , really want the plan

43:07

to zarean . Can you all stop telling me to do something

43:09

else ? This is what I want

43:11

to do . This is what feels best for me and my baby

43:14

. You need confidence and you

43:16

need self trust to be able to make that

43:18

decision . And but

43:20

on the flip side , that if people

43:23

were either making those choices

43:25

or there were genuine medical

43:28

complexities in their pregnancy , that meant

43:30

an induction was the right thing to do

43:32

, or labor had been long or particularly

43:34

painful , or they just wanted an epidural

43:37

. Those are also choices that you

43:39

are making and there are no wrong

43:41

choices . As long as the choices are

43:43

yours , the person that is in labor

43:46

, as long as those choices are down

43:48

to you and you're not being forced

43:50

or coerced or pushed into doing something

43:52

that you don't want to do , it doesn't matter

43:54

what those decisions are . So in

43:57

the course that I teach , I very

43:59

much actually specifically

44:01

talk through you've got an

44:03

epidural . How to use hypno birthing . You're

44:05

having an induction . How to use hypno birthing . You're

44:07

planning a cesarean , how to use hypno birthing and

44:09

actually just really making it blatantly

44:11

obvious how hypno birthing fits into

44:13

those situations . Now I

44:16

think one thing that and

44:18

you didn't actually mention this , but I do wonder if it ever

44:20

comes up in your debriefs and you're maybe

44:22

being a little bit kind because I teach hypno birthing but

44:25

I do think we have to be very careful teaching

44:27

hypno birthing because I think when it is taught

44:29

wrongly , or if it

44:31

is taught that there is a certain better

44:34

, correct way to do it , or

44:36

that it sort of semi guarantees

44:38

something that , rather

44:40

than reducing trauma in birth , it

44:42

can be something that contributes to trauma

44:44

in birth . If somebody felt

44:47

like they were promised the world and they

44:49

didn't get the world , they had something that was really

44:51

particularly hard , particularly difficult

44:53

, particularly clinically

44:55

hard , then if

44:58

you spend your whole pregnancy just going like

45:00

I was made for this , my body was made

45:02

to give birth and then it didn't go the way that you expected

45:05

, that's a whole nother layer to

45:07

unpick that can be contributing to trauma

45:09

, which is why I think we have to be very

45:11

careful about the way that we are sharing

45:13

this information and that for me

45:15

, forms a really big responsibility

45:18

in the way that I teach hypno birthing

45:20

and the way that I share it , and I know that that

45:22

isn't necessarily an

45:24

approach that is taken into account

45:26

across the board of hypno birthing . And

45:29

then the final thing that you mentioned about

45:31

either from kind of staff thinking that

45:33

you were supposed to do it a certain way , is

45:36

there is almost

45:38

like a big misinterpretation

45:41

that hypno birthing

45:43

is something that you do , like

45:45

it is an active thing that you

45:47

do in labour . Now

45:49

hypno birthing to me is

45:52

an approach to birth preparation

45:55

. That's kind of it , and there are tools and

45:57

techniques that you might use in

45:59

labour but you might not use them in

46:01

labour . So we have guided

46:04

relaxations , we have breathing

46:06

techniques , there are massage techniques

46:08

. I present it more as like a toolbox

46:11

of techniques for you to kind of pick and choose

46:13

what you need , what you want

46:15

in the moment when you're

46:17

giving birth , and some people will literally

46:20

labour starts . They'll put headphones

46:22

on , they'll play affirmations or

46:24

guided relaxations or something on a loop

46:26

until their baby has been born and it

46:28

might very much look from the outside like

46:30

they have been hypno birthing

46:33

. I would say they've been using relaxation

46:36

techniques , they have been using breathing techniques

46:38

. Equally you could have done hypno

46:40

birthing preparation and in labour

46:42

, not listen to a guided relaxation

46:44

. Once In my second birth I didn't listen

46:46

to a single guided relaxation . I didn't want

46:48

to , I didn't need to . It is more

46:51

about the kind of changing

46:54

the subconscious mind and

46:56

giving you those tools and techniques . It's not something

46:58

that you actively have to

47:00

do when you're in labour , because you've kind

47:02

of already done it , if that makes sense

47:04

, and because it's not something

47:07

that you do . It's therefore impossible

47:09

to do it wrong because it's

47:11

not something that you do or don't do . It's

47:13

a journey

47:16

, a way of reaching the point of birth and approach

47:18

to birth , rather than a kind of tick

47:21

box . The whole of hypno birthing is trying to move

47:23

away from like a tick . It's not a checklist

47:25

of stuff that you have to have completed by

47:27

the time the baby is born . It is

47:29

a kind of holistic programme of education

47:32

.

47:32

That makes so much sense . Thank

47:35

you , I feel like that's

47:39

been a really good conversation and

47:41

I'm conscious I don't want to use up too

47:44

much of your time , so

47:46

I'm going to ask you

47:48

what do you think should

47:51

be our zesty bit for the kind

47:53

of take home message and

47:56

there may be two . Maybe there's one for

47:58

maternity staff and one for

48:00

pregnant women , families

48:02

listening what's the kind of bit

48:04

you'd like people to remember from

48:07

our conversation today ?

48:09

I don't know if it's whether to remember or whether I'm just

48:11

going to add in a little tiny bit

48:13

extra . So , from a kind of maternity

48:15

staff perspective , one of the first

48:18

conversations that we have

48:20

with families in hypno

48:22

birthing and I suppose actually this can

48:24

go for staff and for anybody that's about

48:26

to have a baby is understanding

48:29

the link between your mind and your body and understanding

48:31

how your subconscious mind works . And one

48:33

of the very , very early conversations we have is

48:35

around the use of language , and this

48:38

is something that is just massively

48:41

overlooked in the entire maternity

48:44

system is the impact . The

48:46

main tool of hypno therapy is literally the use

48:48

of words , the way that words impact

48:50

your subconscious mind and in

48:53

the maternity system . We have a

48:55

specific

48:57

language that you use in the maternity system

48:59

that isn't necessarily used or

49:01

is interpreted differently by people accessing

49:04

the maternity system , and there are particular

49:06

phrases that you want

49:09

to be aware of when you are looking after women

49:11

, who are not just

49:13

people that are using hypno birthing but

49:15

literally anybody that is having a baby Phrases

49:18

like the word only , words

49:21

like have to , words like allowed

49:23

to , and thinking of

49:25

what it is that somebody is hearing . If

49:28

you say somebody is only three

49:30

centimetres dilated , whilst

49:32

the factual information that you're passing on

49:35

I mean we could talk about vaginal examinations

49:37

a different day completely irrelevant . But

49:39

the word only to you

49:41

as somebody that is potentially doing an examination

49:44

, is only because it's the lower

49:46

part of the measure that you're using . When

49:48

you hear it , what you are hearing

49:51

is you're not doing very well , you've

49:53

got a really , really long way to go . If it hurts

49:55

this much now , how on earth are you going to keep

49:57

going ? That's what you hear through

49:59

the use of one word . Switch

50:01

it to already or just eliminate the word

50:03

complete . You're doing so well , you're already three

50:06

centimetres dilated . What do you hear

50:08

? You go , okay , I'm doing so well , that's good

50:10

, I've already done this much . And

50:12

what that does to the subconscious mind

50:14

then impacts what is happening

50:16

physiologically . So it's about

50:18

that connection between the mind and then the

50:20

body . So if the mind has gone

50:22

, ah no , can't do it . We tense up , things

50:25

get more painful , things stall , they slow down , we

50:27

feel supported , we feel safe , we feel

50:29

relaxed . Then , actually , things

50:32

are then more likely to go as

50:34

expected and unfold more quickly

50:36

, more comfortably , and they feel

50:38

like really , really , really tiny

50:41

changes to make . But they are also

50:43

really , really , really easy changes to

50:45

make . Losing the word . Only you

50:47

have to move

50:50

to the late award . Now , that's

50:52

different to we would recommend , we would suggest

50:55

. Shall we chat about what

50:57

that does ? The person giving birth may

50:59

well do exactly what is being suggested

51:02

, but that takes the power away from you

51:04

and puts the power onto them . It gives

51:06

them back that agency and autonomy and

51:08

so much of

51:11

the and

51:13

you'll know this through you're supporting

51:15

of kind of people postnatally . So much

51:17

of how we experience birth isn't

51:20

actually what has happened

51:22

on a physical level , but

51:25

it is how we were made to feel . So , having

51:27

an induction of labor where you were

51:29

given a date , you were told you have to come in and

51:31

your baby has to be born by induction . You've

51:34

got gestational diabetes , so we've booked

51:36

your induction for this day . You've

51:39

got to do this , that and the other , and

51:41

that's it . That is

51:43

a very , very different conversation too

51:45

. We'd recommend an induction

51:48

of labor . This is the reason that we are

51:50

recommending it . It's completely up to you whether or not

51:52

you decide to have it . You

51:54

can go where you can think about it . Let us know

51:56

your plan If that person goes away and

51:58

decides they want to have an induction of labor

52:00

. Those two people going into birth

52:02

are going into birth from a very , very

52:04

different place . One is feeling like

52:06

they have handed themselves over , that

52:09

it is being done to them and they are not a

52:11

part of it . The other is going and

52:13

feeling like the most important person in that space

52:15

, which is exactly what they should be feeling like

52:17

when they go into birth . So , being very

52:19

, very aware of the language that you're using

52:21

and the way that somebody might be hearing

52:24

it , that's the key question is yes

52:26

, this is what I've said , but what have they heard ? And

52:28

actually clarifying with them . If you're

52:30

not sure , ask them

52:32

to say it back to you will

52:34

give you a good idea of if what you are saying

52:37

has actually been heard in the way that you

52:39

think you have communicated it . And similarly

52:41

, for anybody that's about to have a baby , if you're

52:43

feeling like you're hearing

52:46

these words , hearing these language , a really

52:48

, really helpful way to almost

52:50

reframe it is to repeat it back to somebody

52:52

and change the word . So

52:54

it's never coming from

52:57

an unkind place

52:59

, somebody saying only three centimeters dilated

53:01

. They are not deciding that they're going to derail

53:03

the rest of your birth . That's not the intention behind

53:06

it . It's come from a place where they've never

53:08

had this conversation , never considered . What

53:10

does that actually feel like ? To be told

53:13

that sentence ? Could I say that

53:15

sentence , could I pass on that information in a way

53:17

that makes you feel better ? And

53:19

then , when we start to look at it from that perspective so

53:21

if you hear it , if you hear , or particularly

53:23

if you're a partner , maybe , and somebody has

53:26

said you're only three centimeters dilated

53:28

, I always say to any birth

53:30

partners that I'm helping prepare , repeat it back

53:32

. So did you hear ? They said you're already three centimeters

53:34

dilated , and what that kind of just

53:36

does is very gently but pointedly

53:39

marks the shifting language

53:41

that needs to take place , and sometimes that's enough

53:43

for somebody to go oh , yeah , yeah , see , already

53:45

, already , and it can be a nicer

53:48

conversation . I love that tip .

53:50

That is brilliant . Zesty there To

53:52

repeat it back , but change the language

53:54

.

53:54

I like that and you can do that as staff , as well

53:56

, yeah , if you're a midwife in the room and an obstetrician's

53:58

done an examination and it's come out as well

54:01

, there are only two centimeters dilated . And

54:03

it's said to the midwife across the room , then

54:05

repeat it back . Who am I talking to ? Am I talking

54:07

about somebody in front of them ? Actually , they've

54:10

said that even as a student , that's . You know , sometimes

54:12

there there's a . It feels sometimes

54:14

like there's a hierarchy in that space and

54:16

if you're somebody that feels like smaller

54:19

in that room which nobody should do in that space

54:21

, but sometimes you do If you're

54:23

a student midwife and there's somebody you know

54:25

, coordinators walked in and said they're only two

54:27

centimeters dilated . We need to get this going

54:29

. Looking

54:32

at the person in labor and going , did you hear ? You're already

54:34

two centimeters dilated . You're doing such a good job . It's

54:38

a really , really sneaky shift

54:40

of power back to

54:43

the person that's giving birth .

54:44

No , that is great . I really like

54:46

that . I think that is totally

54:48

brilliant and a good place to

54:50

leave it . So thank

54:52

you very , very much . It's been a fascinating

54:55

conversation and I really hope people

54:58

are going to enjoy it and

55:00

look you up on the BirthEd podcast

55:03

and you've got a website too , haven't

55:05

you ?

55:05

Yeah , wwwbirth-edcdcouk .

55:11

Fantastic and I will put a link in

55:13

the show notes . Thank you very much

55:15

. Thank you for having me . I

55:17

very much hope you found this episode

55:20

of the Obspod interesting . If

55:22

you have , it'd be fantastic

55:25

If you could subscribe

55:27

, rate and review

55:29

, on whatever platform you

55:31

find your podcasts , as

55:33

well as recommending the Obspod

55:35

to anyone you think might find it interesting

55:38

. There's also tons of

55:40

episodes to explore in my back

55:42

catalog from clinical topics

55:45

, my career and journey

55:47

as an obstetrician and life

55:49

in the NHS more generally . I'd

55:52

like to assure women I care for

55:54

that I take confidentiality

55:57

very seriously and

55:59

take great care not to use any

56:01

patient identifiable information

56:04

unless I have expressly

56:07

asked the permission of the person

56:09

involved on that rare

56:11

occasion when it's been absolutely

56:14

necessary . If

56:16

you found this episode interesting

56:18

and want to explore the

56:21

subject a little more deeply

56:23

, don't forget to take a

56:26

look at the programme notes , where

56:28

I've attached some links . If

56:30

you want to get in touch to suggest

56:33

topics for future episodes , you

56:35

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56:37

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56:40

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56:42

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56:44

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56:48

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57:27

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57:36

I'll see you in the next episode .