It’s already May! It’s surprising how quickly April went by considering life has been significantly slower than usual due to isolating at home and barely going out. Have you all been feeling the same?
As most of you are aware right now, the vast majority of hospitals in Tokyo and many other parts of Japan have closed their doors to any kind of labour and birth support – both from the dad-to-be or other birth partners and doulas. This extreme “hospital lockdown” came into effect in its most strict form since Tokyo and the the whole of Japan was placed under a State of Emergency, although gradually since early March things were slowly getting tighter and tighter. This means that in many the majority of cases, women re expected to be in labour at the hospital alone. Even though the hospital staff (midwives and doctors) will be present, it doesn’t mean that they will be able to stay with the labouring woman for the length of her labour – their roles are very different to that of a birth companion, taking on the clinical side of things rather than the emotional and physical side of helping the mum-to-be. They may have other women they need to attend to and other tasks at the hospital they need to do during labour, which means they’ll be in and out of the room accordingly (sometimes being able to spend more time with the woman and sometimes less). Plus, as they work for the hospital, their approach will be according to the hospital’s philosophy which may or may not match what the mum-to-be is hoping for.
I’ve been working with a number of different women over the past few weeks in helping them get prepared to labour alone at their hospitals and it’s been quite an emotionally-charged time for all. Suddenly, the labour and birth environment women have been planning and hoping for has been taken away and that can add additional stress and anxiety to the situation which for some already feels overwhelming. Hopefully, with the following advice, some of the worry about how things will go in labour at the hospital can be alleviated.
1. BIRTH PLAN
Your birth plan is essentially a list of birth preferences, a wish-list of what you hope can happen or doesn’t happen on the day of labour. Of course, it’s always important to be somewhat flexible as unexpected situations can crop up from time to time, however carefully taking time to consider your birth plan for the labour, delivery and post- partum aspects of your hospital stay can leave you more informed, prepared and ready to advocate for yourself if necessary. Going through your birth plan with the doctor or midwives at your hospital before you go into labour is a very important part of this because it will help you see what policies or practices they typically follow, give you a chance to ask questions to be better informed, and also see if there is any room for negotiation on any of the points. This varies greatly from hospital to hospital here.
If you are not sure what to include on your birth plan, how to lay it out (remember, it’s not necessary to use the form your hospital provides – you can use your own), or if you want to go through it with someone impartial beforehand, please get in touch with me. I offer birth plan consultations.
If you need or would like your birth plan translated into Japanese, please also get in touch for more info about this service.
2. BIRTH PREPARATION
It goes without saying that being prepared for what to expect with the process labour and being prepared with various comfort measures and breathing techniques can arm you with confidence and leave you feeling empowered and more assured about how you can help yourself. Birth preparation together with your partner is very important even if they won’t be there at the hospital because they will gain a better understanding of what you will be going through and experiencing, they will learn some skills to help whilst you are still at home together in labour, they will be more knowledgable about how they can support you from a distance while you are at hospital, and they will feel less anxious for you overall.
We are all so lucky with modern technology that we have so many online options for birth preparation nowadays and you can never be over-prepared, only under-prepared. Many of you know the various classes I offer for birth preparation – ranging from my hugely popular (if I do say so myself) group Breathing for Birth classes which are now online, to my comprehensive Birthing with Confidence private sessions which can also be done online or *on a limited case by case basis* in-person. Please get in touch if any of these options interest you or if you are wondering what other birth preparation options are out there for you.
3. HIRE A DOULA
Right now, as I mentioned at the start, the vast majority of hospitals are not allowing any birth support at all while we are under the State of Emergency in Japan. However, doula support can still be an invaluable investment for your family. A doula can help you with the above two points – birth plan and birth preparation – and also help you on the day of labour even if it’s virtual support.
How does virtual doula support look like on the day of labour? Well, as with any labour, your doula will be on-call for you at anytime of the day or night and ready to give you and your partner suggestions on what to do at home (depending on how your labour is progressing), instruct your partner on comfort techniques and massage, be a virtual breathing partner, provide advice on when you should perhaps consider going to hospital and more. Also, once you are at hospital by yourself your doula will stay in contact with you again to help you with all the above – breathing, comfort measures and positions. Another really important aspect at this time will also be advocacy and helping you stick to your birth plan, and to provide informational support and perspective if anything unexpected comes up in labour, and providing some language support if the staff on duty on the day have limited to no English and you have limited to no Japanese. For your partner waiting at home, the pressure can be taken off them somewhat knowing that you have an additional source of support. And they are also very welcome to be in contact with the doula, too, if they want a better understanding of what might be happening and just someone to “unload” their anxieties on if they have any. We doulas can take that.
Also, once baby is born your virtual doula can also provide post-partum support, too, and provide you with breastfeeding support, information, advice with infant care, and help you emotionally process your own personal labour experience.
Having that relationship with a doula that has been built up during pregnancy can help you feel that little bit less alone on the day with someone who has a lot of experience in birth in Japan and who is looking out for you and your best interests and cheering you on. If anyone would like to talk more about the various options I have for this, I’d love to hear from you!
4. TECHNOLOGY
FaceTime, Skype, WhatsApp, Line, Messenger etc. There are so many ways to stay connected to your partner and other birth support people. It’s a good idea to think about who you would most likely be contacting in labour whilst you are at your hospital and for what reasons, and how many devices you’d need if you want to be in touch with different people at the same time. Thinking in advance about how you can set these devices up (phone, tablet, computer if you bring one) in your LDR room, and putting this down in your birth plan is a good idea. Getting the hospital staff to support and help you in setting these devices up is probably going to be necessary, so knowing how to ask them (if their English isn’t great), is good. Also, depending on the hospital, WiFi may or may not be available. Finding out the WiFi situation beforehand and preparing accordingly is necessary.
In addition to this, consider setting up a camera or other recording device – to capture videos of the process or photos. Again asking the midwives on duty if they can help support you in setting these things up is important. Normally your birth support people would be the ones taking the photos or videos, but, since they won’t be there, thinking of how things can be set up in the room so that these moments are captured is a good idea.
5. ROOM ENVIRONMENT
Your labour environment at the hospital is another important aspect to consider because being comfortable in the room you’re in can help things go a little more smoothly. If your hospital offers a tour of the facilities beforehand, either in-person during one of your check ups or virtually via video, it’s good to take a look. Knowing what to expect with the environment on the day can help relax you and take away the fear of the unknown from that side of things. Knowing whether you’ll have control over the temperature of the room, the lighting and what you can wear can make you feel calmer and make for a more positive experience with those things you do have control over.
In addition to all this, bringing some comforting items from home to make the room more your own can help, too. Don’t be shy to bring a photo of your husband or partner, comforting or relaxing objects for you, essential oils, and so on. It can all play part in helping you feel more relaxed.
6. BRING AN ITEM OF CLOTHING THAT SMELLS OF YOUR PARTNER
This one is pretty self-explanatory but it’s not for you, it’s for your baby. In normal circumstances, your husband or partner would be at the labour and be able to stay or visit you afterwards. Now, that isn’t possible and your partner and baby miss out on those first few days together. Having something that smells of your partner that you can either wrap your baby in (such as a baby blanket your partner has kept close for a few days leading up to the birth) or an item of clothing you can hold near your baby can help familiarise your baby with your husband. It can also emotionally help your partner to feel more connected to their baby despite the distance.
Following on from this, having baby hear your partner’s voice can be another way for them to connect. Whether it’s with pre-recorded messages made by your partner to baby before birth that are played to baby during your hospital stay, or whether it’s with regular phone or video calls after baby is born, baby is recognise and respond to hearing your partner and help connect them both despite the distance.
7. LET EMOTIONS OUT
Finally, know that’s ok cry and mourn the loss of the labour you were originally hoping for. Both before labour and during labour. That release of emotion can be cathartic – releasing any sadness or stress can sometimes be much better than trying to “keep it all in” during labour. Once you’ve had that moment (or moments) of release, you can then continue to labour with confidence knowing that what you are experiencing and the sensations you are feeling physically are a positive sign of progress and bringing your baby to you.
If anyone does feel that their labour experience has overwhelmed them or been traumatic in any way, having a session with me afterwards to debrief, cry, and talk through everything that happened can sometimes help. Having a listening and understanding ear to hold space for you to say what you feel you need to say about it all can make a big difference emotionally in how you approach the post-partum period.
I truly hope that for those of you who will be in hospital without your birth support people around you everything will go as smoothly as it can. Please don’t hesitate to reach to me whenever you need to. Even though you may be physically alone, there will always be support for you and hopefully some of the above tips can help.
Tokyo Doula Support 