Birth Choices

In this episode, we speak to our very first international guests, Úna and Andreas, who share their story of navigating their pregnancy and birth choices as expats having their first baby in Portugal. We hear about their experience of initially choosing a private obstetrician based on word of mouth, before changing care providers late in the third trimester once it became clear that there was a misalignment between their birth preferences, the evidence, and the practices of their chosen care provider. Úna and Andreas’ story is one of research, advocacy, intuition and trust. It highlights the importance of digging deeper in the stories that are shared between the networks of families and friends, doing the work and ultimately trusting your instincts to choose a care provider and place of birth that makes you feel the most at ease, irrespective of the label.Links:- "Birth and Breastfeeding: Rediscovering the Needs of Women During Pregnancy and Childbirth"  by Michel Odent- Doula Carla and her NGO work at OVO Portugal- "Expecting Better" by Emily Oster  - World Health Organisation recommendations on episiotomy- "Hypnobirthing: A Natural Approach to a Safe, Easier, More Comfortable Birthing" by Marie Mongan - "Choosing a Care Provider" episode

In this episode, we speak with Elysia’s younger sister, Corinne, who shares her journey from planning a publicly-funded homebirth to an unexpected diagnosis at her 20-week ultrasound that changed the course of the rest of her pregnancy and her birth. The ultrasound revealed Corinne had placenta previa, a marginal cord insertion, and an extremely rare condition called vasa previa. Corinne walks us through how she processed this news, how she prepared for her lengthy hospital admission, and pre-term caesarean section. She reflects on the beautiful support her MGP midwife provided in the midst of a now very medicalised pregnancy, and the impact that midwifery-led care and education had in preparing her for birth and beyond. Corinne shares the choices she made in her caesarean section, the breastfeeding supports she leaned on in postpartum, and how her village rallied around her in surprising and sweet ways throughout.Links:Joan Kirner Homebirth ProgramMAMA Antenatal Breastfeeding WorkshopChoices in a Caesarean Section Positive Caesarean episode on The Great Birth Rebellion podcastMAMA Lactation Support and Sarah IBCLCAustralian Breastfeeding AssociationTo learn more about your choices in pregnancy, birth and postpartum follow us on Instagram or visit www.birthchoices.com.au

In this episode we speak with Sammy Veall, artist and former yoga teacher and studio owner, about the contrasting pregnancy and birth experiences of her two boys. Sammy shares her experience of an unplanned caesarean in a private hospital under obstetric care, and how that experience shaped her decision to have a homebirth after caesarean (HBAC) with private midwives for her second son. Sammy speaks beautifully about the ripple effects of her positive and transformative birth experience on not only her mothering, but career and life choices more broadly. A content warning — Sammy speaks openly about a non-consensual stretch and sweep late in pregnancy with her first baby, and the physical and mental impact this had on her both in the lead up to and during that labour, as well as in preparing to birth again. We discuss epidurals, and the impact of that loss of sensation for Sammy, physically and emotionally. Sammy speaks about the importance of following your own instincts and listening to your own inner voice, of choosing a care provider that not only aligns with your wishes for birth, but the preparatory work you are doing. She shares her experience of care from a private midwife and doula in pregnancy, and how those relationships, and that of her husband, supported her through her own crises of confidence in the lead up to labour, as well as through the intensity of her labour and physiological birth of her baby and placenta at home. 02:59 Initial visions for birth and choosing her first care provider06:13 First pregnancy08:21 Stretch & sweep leading into labour 12:07 Epidural and unplanned caesarean18:38 Postpartum experience and coming to terms with first birth experience24:07 Preparing for a second birth, working through previous trauma26:46 Navigating societal and family’s views on homebirth and HBAC28:00 Choosing private midwifery care31:39 Choosing doula support 38:21 The onset of labour53:58 Postpartum experience and support56:37 Empowerment beyond birth Links:MAMA Midwifery Practice MAMA Midwifery Birth Class - VBAC Rhea Dempsey’s Birth Debrief & Embracing the Intensity birth course Jo Askham doula 

In this episode we speak with Kelly Langford, co-founder of Victoria’s first private midwifery group practice MAMA Midwifery, about choosing private midwifery care for your pregnancy and birth. After being mentored into private practice early in her midwifery career, Kelly is a passionate advocate for families and midwives alike. Kelly joins us to talk about what a private midwife is, what continuity of care from a private midwife looks like (and the different ways you can choose to be supported, whether you are birthing at home or in hospital), exciting changes affecting the maternity space right now, and what she loves most about providing care to families in this transformational time of their lives.Links:MAMA Midwives MAMA Lactation Support

In this episode we speak with paramedic and fellow student midwife, Ruth, about her experience of choosing her care provider and place of birth in her first and second pregnancies, receiving care from private midwives with admitting rights in a private hospital in Brisbane, and then after being unable to find that same model in Melbourne, choosing to birth at home with the support of private midwives (and an unofficial backup plan with a supportive OB). Ruth talks us through her marathon first labour, and how morphine (while deviating from her plan) allowed her to get the rest she needed before birthing her first daughter in the pool. Ruth speaks so eloquently about her experience, including of postpartum haemorrhage and the experience of having a big and otherwise well baby in the special care nursery. For her second birth, after being unable to find a similar model of care, Ruth chose to birth at home with private midwives. She takes us through that decision and the considerations given her history of PPH, and the fast but intense labour and waterbirth of her second daughter. We talk about the experience of continuity, the experience of good postpartum care both in hospital and then at home, and the importance of thinking about what you want out of birth and choosing your care providers and place of birth with that in mind.Links:Study comparing outcomes among women who begin labour intending to birth at home vs those intending to give birth in hospital: Reitsma, A., Simioni, J., Brunton, G., Kaufman, K., & Hutton, E. K. (2020). Maternal outcomes and birth interventions among women who begin labour intending to give birth at home compared to women of low obstetrical risk who intend to give birth in hospital: A systematic review and meta-analyses. EClinicalMedicine, 21, 100319. https://doi.org/10.1016/j.eclinm.2020.100319Kindred Midwifery, Obstetrics & Gynaecology (Ruth's Brisbane care providers)MAMA Midwives (Ruth's Melbourne care providers)

In this episode we speak with Georgia and Talbot, barrister and engineer, about their decision to birth their first baby at home. Georgia and Talbot initially chose a private midwife as no publicly funded programs were running after COVID, but late in pregnancy, after agonising over the decision, changed to a publicly funded program. Georgia reflects on the impact of her mum’s work as a midwife on her philosophy of birth (and the beautiful support she then gave them during labour and birth), and how when seeking a physiological birth, home felt like the most appropriate choice for them. They take us through those last weeks of pregnancy, including one of the best oxytocin-inducing activities we’ve heard yet. Like many first time birthers, Georgia set her expectations on a marathon birth, bossing her way through labour and denying it until they could deny it no longer. This is an exhilarating listen for reasons you will come to understand. LinksBirth Time — the documentary Internal pelvic release through The Pelvic Space 

In this episode we speak with Res McCalman, a Ballardong woman, midwife and researcher who is part of the team responsible for the Baggarrook Yurrongi culturally inclusive caseload midwifery pilot program, a project which implemented continuity of midwifery care for First Nations women and babies at three key maternity sites in Victoria (with plans for expanded rollout). In this episode Res speaks about the choices available for Aboriginal and Torres Strait Islander women and those having a First Nations baby in Victoria, and the importance of offering culturally responsive, strengths based care (and how that is defined). Res speaks about the importance of listening to women’s experiences of care beyond the statistics, some of the findings from her and her team’s research, as well as what birthing on country is and how those models of care seek to recognise and reintegrate the rich history of birthing practices that existed before colonisation. This is a must-listen for anyone working in the maternity space, as well as for those seeking to understand more about care provider choices for First Nations women and babies. Links:Read more about the Baggarrook Yurrongi program here, and the study via the Lancet here Res McCalman — Research output (where you’ll find the papers she discussed, including "Safe, Connected and Supported in a Complex System" and more)Pregnant in Victoria and seeking a referral to one of the caseload programs? Read more about Baggarook at The Womens’ (Parkville), Galinjera at Joan Kirner (Sunshine), and  Nangnak Wan Myeek Program at Mercy (Heidelberg).Find out where your local Koori Maternity Service or Aboriginal Maternal Child Health Service is at this link.   Molly Wardaguga Institute for First Nations Birth Rights (Charles Darwin University) Visit our birthchoices directory of care provider and service offerings for First Nations mothers and babies across Australia (and please let us know of any programs we have missed!)

In this episode we speak with Kyla about her experience of navigating her choice of pregnancy care provider, and deciding to birth in a private hospital under the care of an obstetrician, with doula support. Coming from the US, Kyla was drawn to the possibility of public maternity care and also knew from her research that midwifery-led care was appropriate for her and her hopes for birth.  Kyla’s pregnancy took place in the time of ongoing COVID restrictions and changes to pregnancy care, which meant that for her booked hospital, all appointments were by telehealth until well past 20 weeks. It was at this point that Kyla chose to reconsider her care provider and place of birth, and with the guidance of Sarah from @nurturedbirthmelbourne, decided to engage a private OB who was supportive of her desire to have a physiological birth, then engaging a birth doula for additional emotional and physical support. Kyla talks us through how she ensured that her OB was the right fit for her, and her experience of going well past her “due date” — feeling the social pressure but good in herself and support from her care provider to wait until she went into spontaneous labour at just shy of 42 weeks. She speaks positively about how doula support enabled her to labour at home before presenting to hospital ready to push her baby out, continuing to use her TENS machine as her main comfort measure. Kyla’s story is a great example of knowing your options and seeking out a care provider and the kinds of support that you want, no matter what category they fall under. Links:Birth education via MAMA Birth with Confidence by Rhea DempseyCare provider choices

In this episode we speak with first time parents Emily and Josh about their experience of navigating their choices in pregnancy and birth, and preparing for what was a beautiful physiological waterbirth in the public system. Em and Josh sought out continuity of care through their local caseload program, and chose additional support from a doula. We hear about the positive social influences on their mindset for pregnancy and birth, their experience of reviewing the evidence on midwifery continuity of care in choosing where and with whom to birth, and in navigating other choices throughout their pregnancy and birth. Em experienced hyperemesis gravidarum (HG) right until the very end of her pregnancy, and speaks of the value of continuity of care while navigating that emotional and physical rollercoaster. They take us through their experience of coming up against hospital-based timeframes and the advocacy and support needed to allow physiology to unfold, while birthing in the system. Theirs is a wonderful story of the power of getting informed and arming yourself with a great support team, and how a positive first birth is not only eminently possible, but really powerful. Links:@karlismith.doula & The Hospital Birth CourseRhea Dempsey’s Birth with Confidence & birth courseGreat Birth Rebellion podcastHyperemesis Australia Cochrane Review (2024): Midwifery Continuity of Care & birthchoices care provider info page

In this episode we speak with private midwife Clare from @tobirthbeautifully_ about the births of her four boys by caesarean section, and her various experiences of both labour and theatre. Choosing midwifery-led care (via MGP) for her first pregnancy, Clare takes us through her first labour and birth, and the choices she made which she feels contributed to her first caesarean section, setting the path for the three experiences that followed. Clare continued to seek a vaginal birth after caesarean (VBAC) in her second, third and fourth pregnancies, while also developing her preferences around caesarean section. For the birth of her fourth baby earlier this year, by then a privately practising midwife with a passion for homebirth, Clare considered homebirth, before ultimately choosing private obstetric care with a provider who respected and honoured the very clear preferences she had for not only the timing of her caesarean (and her desire to labour), but for the caesarean itself and the management of both her and her baby. Clare reflects on how her experiences and development as a midwife contributed to the choices she made in her various pregnancies, labours and births, evolving alongside her and her practice. We touch on positive postpartum, the experience of honouring rest while wrestling with feelings of loneliness, and the self and external judgement that can come as a midwife birthing your babies by caesarean. LinksVisit Clare on Instagram and via her websiteDr Sarah Buckley’s “How to have the best caesarean” and book “Gentle birth, Gentle Mothering”