To charge or not to charge.

When working in a caring industry there appears to be an assumption that, as the practitioner does the job they love it, they should not be rewarded for their labour.  Well, this is going to be a tiny blog post  as I am going to point you towards some people who have said exactly what I want to say.  (stop laughing at the back.  I can be succinct!)  You remember how lazy I am don't you?  Why reinvent the wheel?

So let's hear from my best birth buddy Maisie Hill: The Birth Woman and her fabulous blog What do doulas charge?

There have been times when I've been asked why I charge what I charge and some have even asked at the outset if I think that I ought to charge as much.  Pre-birth I hear how expensive a doula is, post-birth I too have been told many times that I don't charge enough.  It is a topic of debate amongst some doulas, as it should be.  I stand with my best birth buddy and make no apology for my charges.  I spent a long time worrying about it, but when I thought about it and stripped what I do to the bare bones and then looked at what it meant for my time with my family, friends and myself, I realised that I was not putting a true value to what I do.  Yes, I know, it's an amazing privilege to be with women as they birth their babies and my heart fills with joy as I see them embrace motherhood, but the cost of this is to my family.  I work because I love it and I want to do it.

Feeling hot hot hot

Summer has finally arrived.  The sky is a fantastic blue and as to clouds... what on earth are clouds?  It's wonderful.  I love and adore it.  Floaty dresses and sandals, walking home from the theatre with no cardigan or jacket.  My bones are beginning to feel warm again.  It's truly wonderful and I laugh at the people who grumbled we had no summer, that now grumble it is not autumn.

'What about me Mars?  Do I get dispensation because I'm pregnant?'

Of course you do darling.  But I have one word for you: WATER.  Make sure that you are drinking lots and lots of water.   Just being pregnant raises your body's core temperature.  Add that to the temperatures outside... well I'm guessing that you're not loving the heat as much as I am at the moment. So, carry water.  Drink water.  I'm sure you're already be careful about the amount of caffeine and fizzy drinks you imbibe.  They don't help when you're hot.

Don't worry about stopping in the shade for a while.  Allow your body to cool down.  This is the time to indulge in a nice smoothie or a gorgeous ice cream.  Think of it as being 'medicinal'.  Seriously... ignore everyone and have a second scoop.  Whilst we're talking about food, what about a nice slice of watermelon.  Cool and refreshing.  This is the time of year to enjoy those lovely cold soups.  In fact, I'm looking forward to whipping up a nice vichysiosse.

Thankfully maternity fashion has much improved from the day of the 'tent' dress.  So look for some floaty dresses in breathable fabrics and pop on those lovely sandals.  Get someone to paint your toenails and walk gently.  The weather feels like the Caribbean, so walk like it.  We Jamaicans say 'soon come'... let that be your mantra.  'Me soon come' and stroll, stop in the shade and rest, take your time.  Sip a nice cool drink (okay so if you were in the Caribbean you might sip rum, but I'm thinking more virgin cocktails or mocktails at the moment).  That cooling spray you've packed in your birthing bag, either unpack it or buy some spares.  Pop that in a little bag with your water bottle and you are good to go.  If you feel yourself getting hot, find the ways that work best for you to cool down.

I remember when Space Fairy (my middle child) was born.  I could barely leave the house.  It was a hot summer and just getting to the gate was exhausting.  There were days when the effort was too much.  So yes, you get dispensation for being pregnant.  As for me, I have my book, there's a park across the road and I have water.

How you feeling? Hot hot hot!

Have you had that baby yet?

Over the past week, the world's media has been making its home around St Mary's Hospital in Paddington.  It has been widely reported that the Duchess of Cambridge will give birth there, in the Lindo Wing.  Personally, I'd send Catherine to the birthing centre there.  The midwives are amazing and totally woman centred.  The decision wasn't mine and so The Lindo Wing it is.  Of course the other thing that I would have asked the Duchess to consider would have been not telling anyone her guess-date.  That's right.  I'd have mentioned that she might like to hold that to herself.  

Why?  Well it's simple really.  Babies arrive when babies arrive.  There is a gorgeous mum at school and her baby's guess-date is any day now.  Each time she walks into the playground people wonder if her baby will 'ever come' and 'doesn't she look huge'.  We remain caught up in the whole Due Date thing and imagine that on that date the pregnant woman will wake up and before she goes back to bed that night, she will be holding her baby.  It is a small percentage (4% if I remember rightly, but do correct me if my stats are off) that give birth on the 'Due Date'.  First babies, in my experience, tend to come 'late'.  Now, I use late lightly, after all full term is 37- 42 weeks and therefore a baby is not 'late' until 42 weeks and 1 day.  This is where I forward the link to a fabulous blog post about those last days of pregnancy.  You see, we are all in such a rush to get these babies out, partly because everyone around us has been ringing us off the hook to ask 'Have you had that baby yet?'  Then of course we start to hear the risks of babies being inside too long and we begin to slowly fill with fear.  We do not birth well when we are filled with fear.  Adrenaline, which helps us to fight or flee, surges through us.  Oxytocin is what we need to birth our babies and the two do not sit well together in the birthing room. 

I have no idea when the Duchess of Cambridge conceived her baby, and I have no idea when it will arrive, but I do hope that she goes into spontaneous labour and no one 'hurries her and the baby along'.  I also hope and pray that she knows what she wants and makes good decisions with her husband.  I stand by my opinion that Kate needs a doula and I also think she needs a fabulous midwife to be with her as she births her baby. 

As for the photographers and reporters who are camping out.  I do hope that they are prepared for the long haul.  This baby will be born when it is ready.   Do babies tend to come to plan?

Why Kate needs a doula.

I know, you're probably, possibly groaning thinking that this is the longest pregnancy in Christendom.  To be fair, most pregnant women think that their pregnancy was/is the longest one.

I love birth and so I'm not feeling over saturated with royal baby information.  I've read some interesting articles such as Is Kate being bulied about her birth? by Milli HIll and her follow up article Has Kate's birth plan inspired a new kind of birth talk?  I've also read the wonderful Sheena Byrom OBE's blog post Catching Babies: A gift for the Duchess of Cambridge.  There are other articles out there.  Some talking about the cost of refurbishing the new baby quarters, others talking about her severe morning sickness, hyperemesis gravidarum and endless 'what will the Royal baby be called?' speculations.

Despite the plethora of articles and blog posts, here I am adding in my two penneth worth.  I think that Kate, the Duchess of Cambridge, needs a doula.  I do.  I truly do.  Of course I would love to have my phone ring and 'get the call', but that's not likely.  With my doula clients I like to spend at least two antenatal sessions with them talking about their birth hopes and preferences.  Sometimes people get caught up in the whole birth plan thing but I never have a problem with people wanting to plan.  I suggest that they have a couple of other plans in their bags.  

Much has been made of Kate's plans to use birth hypnotherapy.  Not all of it is positive.  We live in a world where the media view of natural birth is that it is la la land.  Of course Kate, as the Royal Bride, soon to be mother of the third in line to the throne, has been given the best team to support her as she births her baby.  The fact that the perceived best are two 'surgeon-gynaecologists' rather than two midwives experienced in normal birth caused my eyebrows to rise.  I know, you want to know why I feel like that (well, maybe you do).  I feel like that because the lovely Kate is reported to want a natural birth.  I happen to know that doctors have less and less experience in natural or indeed normal birth.  They train to sort out the problems, and thank goodness for them, but how, with that training, can they know what normal looks like?  How long is labour?  Well, it's not what it says in the medical books. Okay, I confess, I haven't read many medical books.  I do know, however, that birth is measured in terms of progress.  1cm an hour from established labour, though for some it's 1cm per hour from the moment of first assessment.  With a royal baby waiting to enter the world, will the two surgeons want their moment in the sun?  'I delivered the heir to the throne'.  Will they err on the side of extreme caution and worry for her 'tired cervix' a few hours into labour?  Will Kate be 'allowed' to labour at home for as long as possible?  So many questions and each spawning more. Do I think that these doctors are good at what they do? Yes.  They are undoubtably good at what they do.  Are they the best for Kate? Perhaps not, unless there is a medical emergency within her birth, and I am yet to be convinced that birth itself is a medical emergency.

So why does Kate need a doula?  This is her first time on this journey.  First time babies have a reputation for being 'late'.  Does Kate know her options about expectant management, the risks of induction or caesarean?  Will Kate be able to use informed consent?  I hope so.  I really hope that I am completely wrong about the two doctors charged with supporting the Duchess of Cambridge when she births her child, for make no mistake, pizzas and parcels are delivered.  Babies are born and mothers created.   I wish, for Kate, a perfectly normal birth.  A birth where she can use water (bring in your own pool Kate, I don't think they'd say no to you... or would they?) if she wishes, plug in her hypnotherapy cd, move freely and hold on to her man as her baby, yes her baby, makes its way into her arms. 

Let's hear it for the boys

"Mars, why do we need you when we have me?" is a question that I hear from time to time when I meet my clients for the first time.  It's funny how many people think that a doula makes the father redundant.  

So, let's put that idea to bed.  What does a doula do?  She's there as a support to mum and partner.  She's there to help with the gatekeeping and to remind dad that 'this is normal'.  She's there to free dad to be dad and to be all that his partner needs during this amazing time.

I recently attended a birth where both Mum and Dad said they booked me because I was outspoken, just like them.  I know... my dreams of being this gentle, quiet, wise lady are dashed!  Still, one out of three isn't bad! lol  It was a glorious birth.  When I arrived at the birth centre, dad was doing his thing.  He knew the kind of support that he wanted to be, he knew the support that his wife wanted, he knew that he could do it.  He surrounded her with love and reminded her of this whenever the opportunity presented itself.  The midwife and I sat back and let it all happen.  I was simply there as their consistency and to be a voice should they need it.  He sat behind her as she pulled on the cloth hanging from the ceiling.  He wiped her face and brushed back her hair as she laboured.  He was silent when she wanted no noise and spoke softly when she needed encouragement.  When his son was born, he cried and held them both.

He apologised to me for not being in touch during the first few days of his son's life.  I had sent a couple of texts to let them know that I was thinking of them and around if they needed me.  He eventually replied saying how both he and his wife were lost in a love bubble with the most incredible baby in the world.  When I eventually visited them, they delighted in showing me the gifts that their new son had received and he told me how he wanted to shout his joy from the rooftops.

Thirteen months ago, I watched another father do the same.  When I bumped into him in the high street, I swear he was floating ten feet off the ground, that's how in love he was.  I saw him again this morning.  He was still floating.

Throughout my time as a doula, I have watched men go from nervous excitement to passionate father.  It is a wonderful thing to see.  I have laughed (I mean nodded in agreement) when these fathers have told me that their daughters will never have boyfriends or husbands.  I have agreed that their child is the most beautiful child in the hospital, city, country and world.  

I love the fathers.  I celebrate the work of Empwered Papa (Joe Valley) and Becoming Dad (Darren Mattock) and look forward to reading The Expectant Dad's Handbook by Dean Beaumont.  I love that first moment after a baby is born when Dad's face is awash with joy, awe and respect.  I am excited at the thought that part of my work is to watch new fathers being born.  I say it often, but I am blessed amongst women.  

So to all you fathers, dads, papas and padres out there... Happy Father's Day!  

Let's hear it for the boy!

What's the alternative?

We all like choice don't we?  We like to be able to weigh up our options and decide the one(s) that work best for us.  Sometimes, when we choose, we make a decision that we didn't want to make because we weren't in full possession of the facts.  It is important that the decisions that we make are made with informed consent.

Last Monday I went on a march to help save independent midwifery.  I marched with a group of doulas, midwives, independent midwives, parents and children.  Why did I march?  Well that's simple.  I believe in choice.  I think that it would be a shame if we were to lose independent midwifery because of insurance being linked to midwifery.

I don't just believe in independent midwifery.  I believe in  midwifery full stop.  Midwife means to be with woman.  What independent midwifery gives is the opportunity for the mother to know the midwife who will be with her when she births her baby.  I don't know a single NHS midwife that doesn't wish for this too.  There are some lucky places in the UK where women can meet and know their midwife, but not everywhere.  This saddens me.  Surely this should be the national norm?

This, of course, is the point where people start talking about the risks of birth.  There are risks in everything and I think that when we are able to make decisions based on fact rather than scaremongering, that can only be a good thing.  More and more women are being labelled high risk.  Pregnant with twins? High risk.  Higher than average BMI? High risk.  Over 35? High risk.  Baby is breech? High risk.  How much higher are the risks?  What are the actual risks?  Even borderline women are being denied choices.  One of my ladies was borderline diabetic.  She was denied use of the birthing centre.  When we went in to the labour ward, the midwife wanted to know why we were there.  She couldn't see the issue.  There will be many good reasons, but each case deserves to be looked at on its own merit.  One of my favourite homebirth teams has been disbanded.  Now women wanting a homebirth have less opportunity to get to know their midwife.  Another homebirth team that I have been worked with has been reorganised and one of the midwives seconded off.  It wasn't her choice.  That same team operates with less midwives.  I cannot see how this helps women have choice in childbirth.  We read in the papers about the lack of midwives, but there are midwives qualifying who cannot get work.  None of this helps the birthing mother.

What can we do to protect women's choices?  How can we support a maternity system that seems to be being eroded?  There are so many questions in my mind.

Mothering Sunday

Today I am as happy as can be.  My number one son is home from university for the weekend.  He's growing into a fine young man and I'm so so glad to have him here spending time with me.

This week I was at the home birth of a beautiful little girl.  Mum was a warrior goddess and she birthed her daughter.  'I won't forget any of this pain' she said several times through the labour.  'I won't be one of those people who forget'.  24 hours of labour.  She used a TENS machine, had some time in her birth pool and then had a few drops of Rescue Remedy in her water.  It wasn't an easy labour, but she made it seem so.  She moved slowly and purposefully through and found it easier when she was vocalising during the contractions.  When she wasn't contracting she was fully in the room.  The following day she told us how little she remembered of the pain and how thrilled she was to have birthed her baby.

I have such a place of privilege watching new mothers be born, because I believe that the mother is born with the baby.  When I think of the way each of the midwives supported her and shared their innate beliefs about birth, I am slightly jealous (perhaps a lot jealous) of the love that they showed to her through that long day and night.  My thoughts move back to the birth of my first born, to the births of my four subsequent children and then to the mothers that I have supported.  I am filled with joy!  

So I raise my glass to all the mothers that I have supported, at births and/or postnatally, with breastfeeding help, with food, with company.  I raise my glass and say 'Happy Mothering Sunday' from your doula whose privilege is to mother you when you need me.

 Mother & child by Georges Hatsatouris