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Why Continuity of Care in Birth Matters

15/05/2016 21:06 | Updated 09 September 2016

So I've been invited by Milli Hill, Positive Birth Movement founder, to attend and talk at the Celebrating Continuity conference.

Of course, I'm mega excited to be part of this conference and to able to put across why I feel continuity of care is so bloody important for all birthing mothers. My head is full of words that I'm trying to put together in a way to explain what continuity of care feels like and why it's so damn important in the context of birth. So here goes...

Think back to when you were at primary school (a long way back for me). You were sat in your classroom, you could feel your stomach gurgling, you think you may actually be sick. You're feeling vulnerable, you're praying you don't puke onto your maths worksheet and you're hoping that nobody in the room has noticed your sweating forehead and the slight tinge of green on your skin.

The classroom wasn't a nurturing environment, you're not 'cared' for at school, you know you have to be strong to withstand the onslaught of the primary education and the pupils alongside you. So when you're feeling like you wanna hurl, you know that you can't do it there!

You head off to the sick room, you met a strange face, the medical assistant, she asks if you're OK and you know she's been told to ask, to tick a sheet and if necessary, call your mom/carer. You sit, they call and you wait. You hold your sick in and you try to stay strong.

And then in she comes, the woman who has been your constant carer since you were one single cell, she knows you, she cares for you, she protects you and she makes you feel safe. Your brain sends the signal to your body that it's safe to be poorly and the sickness takes over, you puke in the car on the way home and you don't even care because mom will make it better.

When women are heading into the unknown world of birth, she can feel like that small child, scared, vulnerable, inhibited, unsure, looking for that face, that one that says 'it's OK'. Now this face may be their partners, and that's a beautiful thing, but on occasion (myself included) she may need a mother figure. A single mother figure, someone who has been there way before the birth, building a strong foundation to your relationship, growing trust in each other so when the time comes, when you're at your most vulnerable the face you see is a familiar one and when you see that face, you feel safe.

My own personal experience of this was at my fourth birth, my first spontaneous labor, my first home birth, I was holding my own, showing my husband that I was strong (inside I was a mess) and soldiering on, I wanted him to see how brave I was. My doula arrived, and like that day in the sick room when you're mom turns up and says "are you ok?" I fell apart, I fell to the floor, I felt weak and vulnerable and I knew that she would make it OK. And she did, she immediately built a 'nest' in the darkest corner of the front room, she rubbed my back and in some magical way she passed me strength and a message that I was ok. Now this may speak volumes about my relationship with my husband, that I didn't feel he could be the one to allow me to birth naturally, to be the one to give me the space to become as vulnerable as I needed to be to allow the process. But in this wonderful modern world, we are complete equals and whilst it would be perfectly fine for me to let go in front of him (I have done many times) but when birthing our baby I wanted him to see how strong I was, how capable I was, and when the vulnerability kicked in I didn't want to 'need' him. Every relationship is different and couples work differently together, this is just how we work.

Reading this back over, and tapping into the importance of this subject makes me cry, it makes me cry that I didn't get continuity of care for my first three births, because I didn't question it for my first three births and because I didn't know the importance of it for my first three births. And this is what drives me on to do the work that I do, ensuring women learn the importance of continuity of care throughout their birth preparation and providing the continuity of care in my doula role.

Whilst we have come along way already in understanding how important this care is, the 1-1 midwives are providing an amazing service to home birthing mothers and I hear plenty of positive stories of the care and support they provide throughout pregnancy and birth. But we still have a way to go. Last year I took over at a birth from a doula colleague, at this point the couple were being transferred into hospital, their birth had taken another turn. They looked like rabbits in headlights. When ambulance crews and lots of technical talk took over, it all became a bit scary and right at that time,when they were at their most vulnerable, their most scared, their wonderful 1-1 midwife who had been with them from the start -- who believes in the importance of constant care -- had to hand over their care to strangers.

When pregnant, it's a good idea to really think about who you would be happy to see you at your most vulnerable, who makes you feel safe when you're that scared child looking for comfort, who understands the process of birth, doesn't fear it and who can care for you consistently with no other obligations.

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