Hello Friend! How are you doing?
As a black mum who has experienced labour and delivery twice now (I know, I know, we have a new addition – I did mention recently that a lot has happened which I will be sharing soon; our baby boy was indeed another miracle), I felt it would be helpful to share some tips that I believe helped me to have two successful labour and delivery experiences in a UK hospital.
This past week (13-18 September 2021) was ‘Black Maternal Health Awareness Week’ and it has prompted me to write this blog post now. Research carried out in the United Kingdom (UK) has found that ‘black women in the UK are four times more likely than white women to die in pregnancy and childbirth’ (MBRRACE, 2020). This is a shocking result and as a black woman of childbearing age, I felt alarmed, scared and angry, amongst other emotions. It also led me to ask several questions such as why is this the case, what can be done about this, and what can I do about this? In answering one of my questions, work is being done to change this statistic, as well as support and change black women and birthing peoples maternal health outcomes in the UK. Fivexmore (a grassroots organisation) is an example of an organisation that is committed towards changing this narrative.
When the above research was published, I had already given birth to my first child and this led me to reflect back on my experience as a black woman who went through labour and delivery in a UK hospital. Firstly, I would like to say that I am so grateful for the National Health Service (NHS) that we have in the UK. No system in the world is perfect and that goes for the NHS too. However, we are extremely blessed to have an amazing health service like the one we have in the UK. I cannot sing the praises of the NHS enough. However, like I have mentioned, no system is perfect, and the NHS is not exempt as we can see in the above research report. The first step towards change is admitting there is a problem, which this research has established there is. The next steps are to then work towards change for the better and I believe there needs to be a collective effort towards changing this statistic. Apart from the work that needs to be done by the government and relevant organisations, I believe black birthing women and their families/support network, need to be prepared and equipped before we go into labour and delivery, hence my blog post. On reflection, I consider myself to have had positive experiences which I believe was helped by preparing well beforehand and knowing that I had to advocate for myself. I am a health professional working in the UK so it is most likely that my background also informed my actions prior to and whilst going through labour and delivery. My experience as a black birthing person in 2021, amidst the pandemic was surprisingly but thankfully somewhat similar to my first. The difference this time round was the new safety measures that also had to be followed.
So, in answering one of my earlier questions which was, ‘What can I do about it?’, I want to share 5 (five) things that I feel helped me to be better prepared when going in to labour and delivery and which I believe contributed to my positive outcomes
- Be prepared. It’s important to be well informed before going into any situation and in particular before going into labour and delivery, especially if this is the first time. I did lots of research before going in to have my first baby. I attended antenatal classes, which provided information on labour and delivery. I read a book, researched online, spoke to my mum friends, spoke to my midwife at my appointments etc. Any reputable reference sources that I could get my hands on, I consumed so that I would inform myself on what I was about to undertake.
- Research your preferences for pain relief (and ring your chosen hospital to check that these are available and routinely offered). To be fair, most maternity units offer almost all if not all the pain relief options that are needed during labour and delivery. However, it is a good idea to check what medicines your chosen hospital offer for the labour and delivery process (yes, you can do this in the NHS too). I didn’t want an epidural both times. During my first labour experience, I used gas and air, and diamorphine injection but I felt that, second time round, I needed something stronger than diamorphine but not as strong as an epidural. During my research (reading up, speaking to other mums etc), I knew that patient-controlled analgesia (PCA) ticked the right boxes for me. I also recall that PCA was not mentioned during my first labour and delivery experience (I used the same hospital both times) so I rang the hospital where they confirmed that this was indeed available. It was good that I did because when I went in to have my second baby, when I mentioned PCA, I got a feeling that there was a bit of uncertainty. I then mentioned that I had called prior and was informed that this was definitely offered. I discovered later that PCA was not regularly used so it needed a bit longer to set up.
- Write a Birth plan. This is a plan written by a pregnant woman prior to labour and delivery that sets out your preferences for labour and pain relief. I wrote one using a template I found on good old google, and listed my preferences for the kind of labour I would like, what kind of pain relief I would like and wouldn’t like (e.g., I didn’t want an epidural), who my birth partners would be, my preferences for vitamin K, delayed cord clamping etc. It basically includes what your preferences for your ideal labour and delivery process are. I will say that you need to bear in mind that the labour and delivery process is very unpredictable, and anything can happen so your birth plan is not rigid and should state that. (At the end of day, the safety of yourself and baby is the utmost priority and the medical team, with your informed consent, should do what is best for yourself and baby). Make sure you take your birth plan with you. When I had written up my birth plan, I printed a copy out and put it in my green pregnancy notes/book so that I wouldn’t forget to take it to hospital with me. I also gave a copy to my husband and mum who would be accompanying me. Once I got to hospital, I showed my birth plan to the midwife looking after me, who made sure to advise the next team of its contents at staff handover.
- Ensure your birth partner(s) read and understand what is in your birth plan. I cannot stress this enough. During the labour process, I was in so much pain that my main focus was trying to do my breathing, use gas and air (such great stuff, ahh) and deal with the pain. So it was very important that my birth partners (my husband and mum) knew what my preferences were and so were able to be my voice and communicate that to the team looking after me. They were able to act as my advocates when I was otherwise incapacitated with pain and pain relief medication. I will also add that any communication with the health care team is done in a respectful manner. Even at times when things may not be going to plan, when it seems that you are not receiving the best care, where the situation is getting a bit tense and/or stressful, remember to do so in an assertive and respectful manner. If at any point you feel your care as a woman in labour is being compromised, please SPEAK UP.
- Pray: As a Christian, this final tip is very important. I believe God hears and answers our prayers and that nothing is impossible with him. During my pregnancy, I would regularly talk to God about what I wanted my pregnancy, labour and delivery to be like. I prayed for a safe delivery, a great medical team who would look after me well, a quick recovery after delivery and a healthy baby. During my second pregnancy, I told God that I didn’t want a tear as I had a second degree tear the first-time round. Let’s just say that overall, God heard and answered my prayers. I would encourage you to pray and ask God for what you want for your pregnancy, labour and delivery and believe that he hears and will work all things out for your good.
So, these are my top tips based on my opinion and experiences so far. It is not an exhaustive list and everyone is different. However, I believe these tips contributed to me having positive labour and delivery experiences as a black woman who had both her babies in the UK. I hope this helps you too. Please let me know what your thoughts are. There is a long way to go towards change but we can play our part by making sure that before going in to have our precious babies, the birthing person and their birth partner(s) are well informed and ready to speak up and be their own advocate.
With all my love and prayers xx