Interview with Beverly Ann Lawrence Beech, author of Am I allowed? What every woman needs to know before she gives birth.
1. Am I Allowed? – it is the most frequent question I am asked, am I allowed a home birth, am I allowed to refuse an induction. What the majority of women fail to understand is that it is their body, their baby, and they are the ones who do the “allowing”. So the answer is an emphatic YES. which is why I wrote the book to explain to women what their rights are, what the research actually says, and what they can do about it if they find they are at odds with the staff.
2. What are the responsibilities of your midwife? The midwife is there to support and advise you about your choices, what is available and help you get the kind of care that you want.
3. How can you draw up the best birth plan? As I explain in the book, birth plans are an invaluable means of discussing with your midwife what your expectations are, but beware, this is fine if you are having continuity of care and you get to know the midwife. The downside, is that if you are attended by a whole series of midwives and doctors and you are attended during the birth by midwives that you have not met before and who do not know you they can reset birth plans, and as earlier research has shown, women with birth plans can end up with more intervention.
4. What kind of birth do you want? The majority of women want a normal, physiological, birth and some women want to book a caesarean operation, often because they have had a medicalised birth before and do not want a repetition. The book explains the difference between a normal birth and a medicalised birth, where the woman is subjected to a whole series of interventions, such as membrane sweeps, induction or acceleration of labour, epidurals or other drugs, all of which alter the progression of a normal labour. Am I Allowed? explains the differences and takes women through their journey from conception to birth and postnatally.
5. Should I worry about my due date? As I have said in the book, women are given a “due date” which is based on a statistical average length of pregnancy, women are not told that “term” can be anything between 37 and 42 weeks, that is a range of 5 weeks, so any woman whose pregnancy lasts longer than 40 weeks will be “encouraged” to have an induction. This results in those babies whose gestation would have been 42 weeks or even later will have been born prematurely, and no one appears worried about the implications of that.
6. I am told I am not “allowed” to have a home birth. Every woman, no matter what her risk status is is entitled to birth at home. At least 60% of women and babies are fit and healthy and the research shows that home birth is the safest place to be, followed by birth in a Free-standing midwifery unit. We know from the research at least 10% of women would birth at home were they encouraged or supported to do so, yet few Trusts have home births greater than 3%, therefore, it is clear that the majority of Trusts actively dissuade women from birthing at home.
7. What are my risks of having a caesarean section? The caesarean section rate in the UK is over 25%, in some hospitals it is over 30%, which means that 1 in 4 women will have a caesarean. The WHO has noted that “there is no improvement in the health of mother or baby when the caesarean section rate exceeds 10%. Furthermore, the induction rate is around 30% so women should be cautious about booking an obstetric unit delivery.
8. I have been told I am not allowed to go beyond my birth date
The medical profession is obsessed by due dates. The range of a potential due date extends over 37 days (over 5 weeks) but women are put under pressure to have an induction as they approach 40 weeks. This ignores the fact that some families have pregnancies that last 43 or even 44 weeks, but no-one asks the woman if she knows how many weeks her mother, aunt, grandmother, sister were when they give birth, discounting those who were induced.
9. Keepsake Video – Should I?
Women are often encouraged to have extra ultrasound in order to have a picture or video of their baby taken by commercial companies, who advertise Keepsake Videos of babies in the womb, accompanied with claims that ultrasound is safe. The medical profession has warned that Keepsake Videos are only safe in professional hands, and that “souvenir [keepsake] ultrasound is not recommended since the benefits cannot outweigh any potential risks.” (RCOG 2015b). Scan photos are sometimes made available as part of NHS screening. Bearing in mind that there is very little research on the long-term effects of ultrasound I would advise women not to waste their money and increase the risk to their baby.
