Something to ponder upon

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My first year with HypnoBirthing
I took up HypnoBirthing out of curiosity. I had one mom that birth via HypnoBirthing in 2013 and she really amazed me. Smilling and saying ‘no pain’ upto the very end. I also attended a talk by Bee Ting and that made me more curious.
I went for the Practitioner course in February last year at Singapore. I wasn’t so sure how it works at first. I started introducing it at one of my antenatal talks in March 2014 and immediate few mothers signed up. Yati just taught the lessons as we were instructed but the first few mothers were not so successful. It took me and Yati at least 5 to 10 moms to realize how it actually works.
One mom who birth with some other ObGyn asked me why is it that most doctors do not accept HypnoBirthing while I support it. I gave a thought and I think that it was because, firstly, I have a low Caesarean rate to start off with. I support vaginal births all along and my total Caesarean rate for the years prior to HypnoBirthing was lingering between 10 to 15 % (Both planned and unplanned). The other reason was I saw how much easier breastfeeding was with HypnoBirthing mothers and I have always been a strong advocate of breastfeeding. So, it just sticks to me and I am loving HypnoBirthing more and more.
HypnoBirthing has actually changed my whole perception of birth. We were always told that pain from childbirth is the most painful thing a woman can ever experience. Now I realised that childbirth is not that painful at all. With the right mindset and support from the entire team, all women can endure the pain of childbirth. Childbirth was not supposed to be a painful experience. My mothers have never stopped amazing me. Mothers sleeping, eating or taking bath at 8 or 10 cm. I just had one mom last week who slept for 4 hours at 10 cm dilation until the membranes ruptured.
All along we were told that first time mothers need to be taught to push. Nowadays, I tell mothers that if I leave you alone like the cat, you would birth anyway. Animals do not need to be taught how to push. Why should humans! And, because the baby would come out slower, less tearing. Birth was not supposed to leave any tear. Vaginas were supposed to expand slowly to accommodate the baby.
Conventionally, we were taught that during the second stage, women need to whole their breath to push. With the birth breathing, it works as well, and even better. Women do not need to hold their breath at all.
In the past, I have never heard of delayed cord-clamping. We have always known that breastfed babies were anaemic but formula fed were not because of the fortified iron in formula milk. Now, I realized that it was not meant to be like that. Babies were not supposed to have the cord clamped too early so that the baby has enough iron stores for the next 6 to 12 months. And, this is important for the development of the baby.
Controlled Cord Traction for the placenta has always been a routine practice. In fact, I have never learned about natural third stage. In the past, occasionally, I had cases of retained small pieces of placenta that came back few weeks later with bleeding as well as infection. To cope with that, I routinely scan all uteruses after delivery. With that, the cases reduced but I still get it. Nowadays, I routinely wait for all my placentas, irrespective of whether HypnoBirthing or not. No more cases of retained pieces of placenta so far. And, I no longer scan the uteruses.
Episiotomies have never been a routine practice in the past so that did not change. But, practice of suturing the wound has changed. The first few cases that refused suturing, came back with perfectly healed wound with no traces of tear at all. I would say that the wound healed better without suturing. Nowadays, I give option to all skin nicks and first degree tear the option of not suturing as long as no active bleeding and no zigzag tears or multiple apices.
Breastfeeding was a miracle. I have always struggled whenever there were flat nipples, inverted nipples. With HypnoBirthing mothers, the babies latched on so naturally after birth. It does not matter whether flat nipples, inverted nipples or no nipples! They would just latch the moment they were on the breast. It made me realize that all babies were meant to have no problem with breastfeeding. It was the sedative pain killers that sedate the baby and made the baby loose the natural ability to breastfeed.
Breastfeeding has always been a struggle during the first week due to poor supply. I have always asked my mothers to persist for one week and the supply would be abundant. I now realize that it was not supposed to be like that. The reason why the supply was low was because babies were sedated during the first few days of life. Sedative pain killers remain in the babies’ body for 72 hours. They feed less because they are sleepy all the time. By day 4, they would be alert and very hungry and mother’s supply still low because hardly breastfed during the first 3 days. With HypnoBirthing, babies are very alert during the first 6 hours and would suck and suck non-stop. This stimulation would encourage early initiation of established milk supply.
How has HypnoBirthing changed my practice? Without realizing it, my Caesarean section rate was only 6% last year (for both planned and unplanned). Lowest ever. Why? I don’t think I have reduced my threshold of Caesarean in general. I think I just had more and more moms who really want natural or vaginal birth. And, with their mindset for a natural birth, my Caesarean rate goes down naturally.
Irrespective of whether HypnoBirthing or not, I have changed certain practices. I allow more ambulation and intermittent CTG. I allow different birth positions even if they had Pethidine or Entonox as long as they don’t looked overly sedated. Delayed Cord Clamping for all. Skin-to-skin for all. Bonding and breastfeeding for 1 to 2 hours for all. Options to suture for all. Natural third stage for all.
I have changed my way of induction too. I routinely use the Foley’s balloon for all. There are 2 ways. I can insert the Foley’s balloon and allow them home. Most moms would admit in the next one week in labour and gives birth naturally. Or, I may admit them for Foley’s and proceed with further induction. Moms love the Foleys because it’s totally pain-free and drug-free.
What are my future plans? I have started giving skin to skin and initiate breastfeeding in the Operating Room. Not all cases yet. But I plan to give this service to more moms in this coming year.
Rooming-in was never allowed. Now they allow it for single rooms only. I am planning to make it available for all in this coming meeting with the Paediatricians.
I am now discussing with several other hospitals regarding this mother-friendly care services. I will soon be giving training to the staffs from other hospitals on HypnoBirthing and WaterBirth. I plan to bring HypnoBirthing and WaterBirth to more hospitals in the future.
It has been a busy year and I foresee a busier year ahead. I am definitely going to further promote HypnoBirthing and WaterBirth to all Malaysian mothers and hopefully, one day, gentle birth would be available to all.
“Towards a Gentle Birth For ALL”