I grew up on a boat. I was born on a boat; my mum’s birth story is for another post though. Growing up on a boat, even though we were not sailing anywhere most of time, gave me a perspective on life and death that I think would have been different if I’d lived in a house. We lived slightly on the edge of society. Perhaps if I’d grown up on an isolated farm, I would have got some of the same self-reliance adventures. Reeds Almanac was one of the first books, along with Spiritual Midwifery, that I remember looking at. My dad had been a medic and used to tell positive stories of some of the births he’d attended. The Reeds Almanac used to have a section on the first aid of childbirth, and I remember it being interesting to me. I have no idea now exactly what the 1970’s and 80’s book said about birth, but it was definitely in there. I hope to find a copy one of these days and see what was said. I fear there’ll be unnecessary tying & cutting of cords and the like, but perhaps there would be good bits on how to remain calm and keep the birthing person as relaxed, warm and safe as possible. In my late teens, I volunteered with the RNLI on a small lifeboat in Wales and childbirth first aid was not really covered. I cannot remember it ever being mentioned! I’ve done some first aid training a few times since and childbirth has never been covered as standard.
Unfortunately (or perhaps fortunately depending on content and perspective) all that’s said recently in the Reeds Almanac is:
“Emergency Childbirth: A yacht is no place to give birth. Unless remaining within about one hour of harbour, a woman who is more than 32 weeks’ pregnant should not even consider going to sea in a small boat. Before 30 weeks into the pregnancy, there should be no problem embarking on short offshore passages. Although giving birth may be an entirely natural process, it is potentially fraught with danger – for both mother and baby – and should ideally be supervised by a midwife or other suitably qualified person. Labour may start with backache, regular pains in the abdomen, a show of blood-stained mucus and a gush of water from the birth canal. Such a situation clearly demands a PAN PAN (call to emergency services telling them what you’re doing and what help you want, as opposed to a Mayday call which is an immediate assistance request) call followed by rapid assessment and transfer to hospital by lifeboat or helicopter.
Should help not be available, the best advice is to stay calm, unhurried and let nature take its course.”
It’s a great shame that books such as Reeds and general first aid manuals don’t include more information on how ‘nature’ ideally takes its course. The lack of good, easily accessible information on first aid for birth adds to fuel the dominate narrative of birth being something to be feared and somehow always life threatening, and a process that needs to be medically managed, which of course generally it is not. A knowledge of what is nature taking a ‘normal’, ‘safe’ course and what is potentially ‘unsafe’ gives power to the birthing people and their support teams, and the ability to keep calm and assist in the best way they can. Birth without medical professionals happens. Birth without midwives or doctors can occur by choice or chance, and the more informed we are, the safer & calmer we can be.
I recommend all the doula and hypnobirthing clients I work with to consider getting more informed about what they might do in the event of giving birth without a medical professional, no matter what kind of birth they are planning. This is an excellent and affordable course from ex-midwife turned Birthkeeper Joy Horner https://birth-joy.teachable.com/p/unassisted-birth-and-what-to-do-if-you-labour-rapidly-or-your-baby-arrives-suddenly
For any doulas, student doulas, student midwives, midwives, antenatal teachers, Birthkeepers or birth nerds – childbirth emergency first aid is a matter which we could all do with learning, refreshing and understanding better as we continue in our practices. I am delighted to be hosting Joy Horner’s Workshop: First Aid for Childbirth Emergencies on Saturday 17th June 2023 in Portsmouth, UK. Within just a couple of hours of letting my local birth workers community know about the event tickets were flying out! There’s a need for us to understand normal physiological birth, its potential variations and to have an awareness of when things may not be going well, and how we can best act to assist if required.
Knowledge of childbirth and the potential emergencies it could entail along with what could be done to assist is not a secret to be kept by those in medical uniforms or with blue flashing lights. I am not saying that a birthing person or their family, or their doulas or birth keepers should replace medical professionals they cannot, and in 99.9% of cases they would not wish to. I have been a doula at several ‘unassisted’ births, and some very near miss ones, thankfully all without any emergencies. I have also been at medically supported births with emergencies. In all those situations I have kept my cool and done my best to support my clients well, often using the skills I acquired in the RNLI and other first aid practice to know what to do and how to behave.
Here’s what Joy Horner has to say about the doula and student workshop she’s offering:
“I am no longer a midwife but I am Teaching parents, doulas, Birthkeepers, midwives and students about childbirth emergencies.I was a registered nurse and midwife for 37 years, I am a qualified Childbirth Educator and have taught birthworkers and other professionals about childbirth, both nationally and internationally for the past 15 years. Currently the number of freebirths and births without a midwife is on the increase. Due partly to the national shortage of midwives, and the fact that some areas do not have enough midwives to run a homebirth service. Doulas around the UK are being asked to be present at planned and unintentional births without a midwife (BBA), leading them to need more information than their basic training gave them. I am not teaching doulas to act like midwives or paramedics. I am not telling anyone to step outside their sphere of practice. I am providing useful information that doulas have been asking me about for many, many years. Including how to call for emergency assistance, how to stay calm, and help the family stay calm in an emergency situation, understanding what is happening, and what the emergency call handler may ask you to do, what professionals do in an emergency and simple first aid measures to support clients until medical help arrives. I have specifically designed these workshops to help doulas and other birth supporters learn about emergency situations which are quite rare with "low risk" clients in a home setting. But, emergencies can and do happen, sometimes without warning.” Quoted from @wisewoman on Instagram 16th April 2023
Knowledge of childbirth emergencies can also assist many families by protecting them against shock and trauma. Of course, it is always the decision of the expectant person as to what information they decide to access and educate themselves on, and deciding to hand over responsibility for such knowledge to medics is, of course, a valid choice. What is vitally important though, is that you know you could access such knowledge if you wanted to, because if you didn’t know you could, then really you didn’t have a choice.