I’ve always loved using Penny Simkin’s Road Map of Labor with my clients as I found that the colourful and informative yellow brick road really helped parents approaching childbirth to get a good understanding of the process. Penny’s illustration shows three different pathways and as I wanted to be able to show what a physiological birth might look like, complete with a ‘rest and be thankful’ stage and third stage of labour, I decided that I was going to try and design a version of my own.
I spent some time drawing and adding the things that I wanted to include and after seeing my cousin, Annika Langa, posting her wonderful illustration on Facebook, I thought that I should ask her if she would be interested in drawing it for me. Annika went to South Africa as a young journalist to report on the Apartheid regime coming to an end. She later married Paul Langa who is an ex-political prisoner who spent time with Nelson Mandela on Robben Island. You can read more about that here on Annika’s blog. She also has a shop on Etzy where you can find her other creations.
Annika agreed to produce the Path to Birth and after many months of hard labour, my Path to Birth was born. The illustration is not a ‘map’ of how to get somewhere but rather a colourful way to hold discussions with pregnant women and their partners about what a physiological birth looks like. As well as discussing the different ‘stages’ of labour and the importance of keeping well hydrated and energised, you might also want to talk about things that are not on the drawing. The pool and birth ball could initiate a conversation about other types of pain management that are not depicted. The woman is naked giving birth, is this something that worries the woman you are working with? Has she thought about what she would like to wear? There is a mention of how often contractions are coming and how long they are. Is that important to know? Should they be timed or will you notice anyway if they’re coming closer together. Are there other signs that labour is progressing?
The third stage of labour is seldom discussed, unless it is covered in the antenatal preparation that the couple attends. That is why I wanted this to be included in an illustration of labour and birth as the birth is not completed until the placenta has arrived. As we doulas like to say, “we meet and greet the placenta”. I felt the syntometrin injection (which by the way can be spelt with an “e” at the end or without) had to be on there as many women believe that you need to have this injection for the placenta to come out, just like many believe the cord needs to be clamped and cut immediately. Those of us working around pregnancy and birth know that the scissors used to cut the cord does not look like a normal pair of scissors so this is another point for discussion. Who cuts the cord? What other options are there? Do you need to have an injection? What is the injection? Some hospitals now use only syntocinon for the expulsion of the placenta whilst others still use it in combination with ergometrine.
Oxytocin is featured a lot on the path to birth because the release of this hormone is so important in a physiological birth. Oxytocin means “quick birth” in Greek and the more of it you have in your body during labour, the quicker it will be. Endorphine actually means “the morphine within” so if women understand that labour is manageable by nature, this might alleviate some of their fears. It’s all very cleverly designed but the environment has a huge impact on how easily these hormones are released by the woman.
As a woman follows the path, climbing upwards, reaching new found levels within herself, there are points when adrenaline is injected to remind the woman that she is having a baby and that she needs to be in a safe place. These are old warning systems from our early ancestors who needed to make sure they were back in their cave when the baby was going to be born. If women know that they are feeling the way they do because of physiological changes in their body, the can feel safe knowing that this is normal. I often see the ‘mini-transition’ around 4-5 centimetres and then, of course, the transition as the woman is approaching full dilation of her cervix.
So, my Path to Birth was designed as a complement to Penny’s great Roadmap of Labor, which I hope that you can all see. I hope you find it useful for preparing couples for the life-changing event of childbirth and that in some small way, it will contribute towards making their experience a good one! That is my one and only reason for creating this illustration. To help women have good birth experiences, what ever that may be!
Kicki Hansard is a member of Doula UK, however any opinions expressed on this blog are personal views and not necessarily the view of Doula UK.