How to prepare for a hospital birth in East Kent. Your body, your baby, your choice!
Myself and my amazing Doula partner and friend Atosa in QEQM after supporting a beautiful birth together.
Preparing to birth your baby in hospital can feel overwhelming! We know that birth is becoming more and more medicalised, caesarean births are at an all-time high, and everyone knows someone who has a horror story about induction, which they love to tell anyone who’s pregnant!
Yet for many people, hospital is still where they feel safest to welcome their baby into the world. There's comfort in knowing that medical staff and equipment are right there if you need them. If you're planning to birth your baby in hospital here in East Kent, I've written this blog post to give you some really important things to think about to help you feel prepared and confident going into some of the choices you might face.
The Reality of Maternity Care
The NHS maternity system does do incredible work, but it is stretched thin. Your midwife might be brilliant, but they've got a caseload that means your appointments can feel rushed. You might see different faces at each visit. And sometimes, the information you're given feels more like a checklist than a conversation about your unique pregnancy and birth. It's just the reality of the system. But knowing this helps you prepare and advocate for yourself.
When you go into hospital to birth your baby, you're entering an environment designed around processes that help the maternity ward run efficiently. Hospitals are built to predict and control outcomes, which works brilliantly when you're unwell and need medical intervention.
Years ago, we would only birth our babies in hospital when there was a genuine medical need. Now, almost everyone chooses hospital birth (or has too as there is no home birth team available) I would love you to remember this; when you're birthing, you're not sick. You're incredibly well and simply using their facilities to welcome your baby into the world.
This though creates a fundamental contradiction. Physiological birth cannot be controlled or predicted in the way hospitals are designed to manage medical conditions. This mismatch between the natural unpredictability of birth and the hospital's need for structure can sometimes create complications in an otherwise straightforward pregnancy and birth.
It's crucial for me to say that for many families, medical intervention is absolutely life-saving and necessary. But there are also many practices carried out routinely that are not evidence-based. People feel frightened into making decisions. This is why becoming informed and confident about your choices is so important.
Understanding Hospital Birth and Intervention Rates
If you're planning a hospital birth, it's important to understand that simply being in that environment can increase your likelihood of interventions. This isn't necessarily because you need them, but because hospitals are designed around monitoring and managing potential risks.
Our local trust has a caesarean birth rate of almost 50% each month. That's nearly half of all births. While some of these are absolutely necessary and life-saving, it's worth understanding how the hospital environment itself can influence these numbers.
In hospital, continuous monitoring is standard practice. You might agree to be connected to the CTG machine tracking your baby's heartbeat throughout labour. While this can feel like it provides reassurance, it can also create problems. This monitoring can often lead to what we call the "cascade of interventions." One intervention can lead to another, which leads to another. For example, continuous monitoring might show a variation in baby's heart rate that leads to concerns, which might lead to discussions about speeding up labour, which might lead to stronger contractions, which might then require pain relief, which might then affect your mobility, and leads to assisted births, episiotomy, or caesarean births.
It’s crucial to understand these patterns before you're in labour, as it makes decision making when you are birthing less challenging.
Understanding Risk: The Numbers Behind the Fear
One of the most challenging aspects of navigating pregnancy care is understanding what "risk" actually means. You'll hear this word a lot, and it can be terrifying when you don't understand the context.
Healthcare providers might tell you that if you don't do a certain test or intervention, there's an "increased risk" of something serious happening to your baby. The way this information is presented can make it feel enormous and scary, but when you dig into the actual numbers, the picture often looks very different.
For example, you might be told that declining a particular intervention will "double your risk of stillbirth." That sounds absolutely terrifying, doesn't it? But what if the baseline risk was 0.05% and doubling it takes it to 0.1%? You're still looking at a 99.9% chance that everything will be absolutely fine.
Or you might hear that a certain choice increases your risk by 50%. But if the original risk was 2 in 1000, a 50% increase takes it to 3 in 1000. That's still a 99.7% chance of a positive outcome.
Questions to ask when discussing risk:
What's the actual percentage or number?
What's the baseline risk we're comparing this to?
How many people does this affect out of 100? Out of 1000?
What are the risks of the intervention itself?
What would happen if we monitored and waited?
Understanding these numbers doesn't mean dismissing genuine concerns, but it does mean you can make decisions based on facts rather than fear which is so important!
Making Informed Decisions in the Moment
When you're in labour and a healthcare provider suggests an intervention, you're often given information quickly and asked to decide. This is when being informed beforehand becomes absolutely vital.
Questions you might want to consider asking:
What are the benefits and risks of this intervention?
What happens if we wait?
Are there alternatives we could try first?
How urgent is this decision?
Can you give me the actual numbers behind this risk?
Understanding these dynamics before labour begins means you can make choices that feel right for you, rather than feeling swept along by the system.
Your Rights Within the System
You need to know that you have choices!
You can:
Ask for longer appointments if you need them
Request to see the same midwife when possible (or change to another one if you want too)
Decline any test or procedure
Ask for a second opinion
Change your birth preferences at any time
Request additional support if you're not feeling heard
Ask for specific numbers when discussing risk
You deserve:
Clear, unbiased information about your options
Respectful care that honours your choices
Time to ask questions and process information
Support that feels personal, not just procedural
Honest information about risks and benefits
Making the System Work for You
Come Prepared: Write down your questions before appointments. It’s really common to forget half of what you wanted to ask the moment you sit down, and quite often impossible to remember everything they tell you, so take your notebook with you, or use your notes app, or record the appointment! You are legally entitled to record your midwife appointments for your personal use, as long as you do so openly and with the agreement of your midwife/consultant. You should inform them that you want to record, state your reasons, and confirm it's acceptable. (It is important to know though that recordings are for your personal reference only; sharing them publicly is a breach of confidentiality and data protection laws)
Speak Up: If something doesn't feel right, say so. If something is good then say so! If you don't understand something, ask for clarification. Your voice matters, and good healthcare providers want you to be informed and comfortable.
Build Your Support Network: The system provides medical care, but you might need additional emotional, practical, or educational support. This is where antenatal education, birth support, and postnatal care from professionals like doulas can fill those gaps.
Know Your Local Resources: In East Kent, you have access to some wonderful birth support services. Whether it's antenatal classes that go deeper than the standard NHS sessions, all the wonderful Doulas here, find some antenatal support that knows this trust and can support you with information that will help you.
Your Birth, Your Choices
Navigating the maternity system isn't about fighting against it or accepting everything without question. It's about finding that sweet spot where you're working with your healthcare providers while staying true to what feels right for you and your baby.
You might want all the medical interventions available, or you might prefer a more hands-off approach. You might change your mind completely halfway through pregnancy. All of this is normal, and all of this is okay.
The key is making sure your choices are informed ones, made with full understanding of your options and the real numbers behind any risks, rather than in response to pressure or fear.
When You Need Extra Support
Sometimes, despite your best efforts, you might feel like you're not getting what you need from the system. Maybe your concerns aren't being heard, or you're feeling anxious about your birth choices, or you just want someone to talk through your options without feeling rushed.
This is exactly when additional birth support becomes invaluable. A doula isn't there to replace your medical team. We're there to help you communicate with them more effectively, to ensure you understand your choices, and to provide the continuous, personalized support that the system sometimes can't offer.
Having someone with you who understands both the medical side and your personal preferences can be incredibly reassuring when you're navigating those in-the-moment decisions during labour. We can also help you ask the right questions about risk and make sure you're getting the full picture.
Some final thoughts…
The maternity system is there to keep you and your baby safe, and when emergencies arise it does that so well. But feeling supported, heard, and confident? That might require a bit more intention on your part.
Whether that's through asking more questions, seeking additional antenatal education, or having a doula by your side to help you navigate the choices ahead, remember that getting the support you need isn't being difficult or demanding. It's being a good advocate for yourself and your baby. You deserve to feel confident and supported throughout this incredible journey, with full understanding of your choices and the real numbers behind any decisions you're asked to make.
Remember this: hospital guidelines are guidelines, NOT instructions. Unless there is an immediate threat to you both you have TIME to make decisions. You can ask questions, seek clarification, and ask for time to think things through.
True consent can only happen when you have enough information to make an informed choice. Don't let anyone rush you into a decision when you don't feel you understand all your options. Your birth, your baby, your choice.
If you're in East Kent and looking for additional birth support or antenatal education that complements your NHS care, I'd love to chat about how we can work together to help you feel more confident navigating your pregnancy and birth choices.
You can also visit www.birthrights.org.uk for support around your rights in birth. Remember, if you don’t know your rights you don’t have any! Reach out if you want to chat any of this through.