Using EBRAN to support with an empowered birth: A consultant led pregnancy

This post was written in October 2020 by Bump to Baby Chapter team member Jamie-lee when she was 38 weeks pregnant with her second baby. Jamie-lee had a previously straight forward birth but following diagnosis of an autoimmune disease, Jamie-lee’s second pregnancy was consultant led. Jamie-lee wanted to ensure that she remained informed around her birthing choices. She remained empowered to feel in control using EBRAN. 

In 2016 I had a relatively straight forward pregnancy and birth, remaining midwife led throughout. I had a calm water birth on the Birth Unit and I look back on it fondly. Fast forward 4 years and I am expecting my second baby. During this time I have developed an autoimmune disease, psoriatic arthritis. Not only has this made adding an addition to our family a little more challenging, it has also meant that this pregnancy I have been consultant led as opposed to midwife led.

Early Pregnancy

In the initial months of pregnancy, I didn’t really notice much different in my pregnancy pathway other than having two consultant appointments. In these they briefly discussed various risks. They ensured I knew what medication I could take if needed, and potential abnormalities that could appear in my 20 week scan. My pregnancy went relatively similarly to my first one. One bonus being that my autoimmune disease actually went into remission – which can be common for these kinds of conditions. 

First Growth Scan

At 33 weeks I attended a growth scan, something that I did not have with my first pregnancy. This was because my condition and the medication I take can increase the risk of having a small baby. The growth scan went well and baby was actually measuring slightly ahead – a healthy 5 pounds.

Following the scan I had a consultant appointment. I felt surprised when I was advised that I should be induced between 38-39 weeks. Even if I went into labour naturally it was recommended I be on the delivery suite so I could be on a monitor for my entire labour. Whilst these were given as recommendations, I was told that I was at increased risk of stillbirth due to my condition. Leaving the appointment, I felt disheartened and also apprehensive as I thought about the risks to my baby. I knew I had additional risks but as I had felt well during my pregnancy and my scans had gone well, I had assumed that my labour would be treated similarly to my first birth.

Using EBRAN

Over the next few days I mulled things over. I then gave my fantastic midwife a call. She made an appointment for me to go in and see her. I armed myself with knowledge and used EBRAN as my husband and I discussed what the consultant had suggested.

These views are very much my own opinion and what felt right for me absolutely may not feel right for another woman. You do you mama and feel empowered to use EBRAN to its full potential for you and your baby.

E – is it an emergency? The answer here is definitely no as we were still talking about something that was weeks away.

B – what are the benefits? The benefits were that my condition does increase the chance of complications the later into pregnancy I get. However upon researching these and discussing with my midwife the increase was actually very small.

R – what are the risks? I worried that if the baby wasn’t ready to come then may need varying levels of intervention. I also discussed with friends that because my immune disease is likely to flare post-birth, I felt that having as gentle birth as possible would potentially give my body the best chance of not having a huge flare.

A – what are the alternatives? I explored a few alternatives, one being an elective cesarean and my midwife fully supported this. I felt that it would allow me to keep some degree of control and I began to explore “gentle cesareans” as something to discuss with my consultant.  

N – what happens if we do nothing? This is what I decided to go with. Providing my autoimmune disease remained in remission and that baby still looked happy and healthy at my next growth scan.

Support from my midwife

I saw my midwife the following week and we discussed all this. She very much supported me to put my preferences forward to the consultant. She also discussed with me the Birth Options Clinic, which may be an option for me. This is a clinic run by consultants and midwives that allows you to make a management plan for your pregnancy and labour. The Birth Options Clinic is defined as suitable if you are the following:

“you are considering care which is outside of recommended guidance, or if you have risk factors in you pregnancy and want to know your full range of options, or have specific anxieties about labour and birth and want help to devise a plan that is right for you”. 

Full term

Fast forward to 37 weeks and my growth scan and consultant appointment quickly arrived. The scan went well. Again, baby was measuring a very healthy estimated 7lb10oz. I was also told his head was too low in my pelvis to scan. This gave me a little boost that he was ready in a good birthing position! I saw a different consultant at my appointment this time. Despite that I had gone in armed with my preferences and statistics to support them, she very quickly agreed that I didn’t need an induction unless I wanted one. I could also deliver on the birth unit if I wanted to. The consultant gave me an open appointment and advised me to get in touch if anything changed with my health or if I had any concerns.

I felt elated, and so happy. The techniques I had learned from hypnobirthing and The Bump to Baby Chapter had allowed me to feel empowered in discussing my birth. I wanted and to come to a decision that allowed me to feel in control whilst also keeping myself and my baby safe. Using EBRAN so far throughout has allowed me to feel in control at all stages. I am now 2 weeks from my due date and rather impatiently awaiting the arrival of our little bundle.

Read more about EBRAN in our blog Making Informed Birth Choices: EBRAN.

Click the link for more information about The Bump to Baby Chapter’s Hypnobirthing and Antenatal Online Course. Know what you can do to stack the odds in your favour for the birth that you want. Videos, checklists, audios & a support group all created by a midwife to get you feeling excited, prepared and confident for birth.