Saturday, 26 February 2011

First Loves

I'm about to fry breakfast.  The house is quiet.  All the children are out, Colourful Radio is on.  The music is good.  DJ Elayne Smith is talking about first loves.  And so of course my mind turns towards my ladies and their babies.  The new first loves that are being born.

These babies are nurtured and cherished inside the womb where they have all that they need as they await birth.  The parents look forward to the time that they meet their newborns.  Some will have made plans almost from the moment of conception.  Some will wait a while and others will realise in the last few weeks that perhaps they have much to do.  This is when a Birth Doula or a Postnatal Doula comes into her own.  She will help you talk through your hopes and fears and let you know that you are normal.

Once the baby has been born and as the initial excitement begins to calm, attentions turn to the postnatal period.  This baby will need feeding and nourishing and so will this mum.  Hopefully mum will have thought about this antenatally and have her support systems in place.

One of my favourite things to do on a postnatal job is to cook up a storm.  I'm currently supporting a twin mum.  My job is to go in a couple of mornings a week whilst she takes her daughters back to bed and cook to fill her fridge.  I love it!  I have the radio on and I am left to create gorgeous foods.  I even taught myself to make quiche, including the pastry.

Whilst there last week I met another twin mum who had come by deliberately to meet me.  She was killing two birds with one stone because her primary goal was to be reassured by twin mum 1 that impending multiple motherdom wouldn't be the end of her.  She already had an older child that she had breastfed through to the age of one.  Her brief telling of her clearly traumatic birth story, and the initial postnatal period, made her worry about feeding the new babies understandable.  She had had little support and felt chained to the house for the first year.  She is determined not to have this happen again.  Of course there are many "scare" stories about having twins.  Which multiple mum hasn't met elventy million people whose faces have exhibited pure horror at the mention that twins are expected?  Which multiple mum hasn't been told that she'll have her hands full, that breastfeeding twins is going to be impossible?  And this is where I come in.

Of course it's possible to exclusively breastfeed twins and a new mum does not need to feel chained to or trapped in her house.  What she needs is confidence in her own ability to feed and faith in her babies.  Having support on hand for any unscheduled bumps in the road is a very good move. An excellent port of call is to find an IBCLC like my lovely friend Helen Beaumont Manahan who is currently helping me revise for the big IBCLC exam I'll be taking in July.  Local IBCLCs can be found here.

I am sadly unsurprised by the number of multiple mums to be who tell me that they will be mixed feeding their babies because they've been told they will not manage otherwise.  A stumbling block has been set before they've begun.  However they choose to feed their babies is, of course, a decision for them to make.  I'd support them in all choices after all every breastfeed counts.

Now having seen the time I realise that all the dancing the around the kitchen, frying and eating of said breakfast has taken up a fair portion of the day.  The lovely Helen and I will be celebrating life and belatedly toasting her IBCLC status at the Kings Cross Champagne Bar in a few short hours before taking ourselves dancing (yes IBCLCs and Doulas dance!).  Both activities are two of our loves, but they pale into insignificance when we think about our mums and their babies.

Sunday, 20 February 2011

Cut to the chase

This morning I woke to this article on my fb newsfeed.  Kirstie Allsopp appears to be declaring war on the NCT and all proponents of natural childbirth.

Now, is it just me or is bashing all things natural with regards to children and childbirth the new thing?  Are we seriously saying that because a few people don't achieve or have the norm, no one else should celebrate it?  Why are we accused of stigmatising women who don't have normal births?  And why (yes... I'll stop asking questions in a minute) has it taken Kirstie 3 years to comment on this?

I have had two caesarean births myself.  The first when Number One Son's heart rate started to drop and I failed to progress (more on whose failure later), the second because the Wee Weapons were a transverse lie (sideways on) which isn't a vaginal birth position.  Did I feel a failure either time? No!  Did anyone make me feel a failure? No! I will quickly confess though... I preferred Number One Son's birth because I felt more a part of it having laboured for 6.5 hours prior to the operation.  With the Wee Weapons I felt coldly detached from the whole process.  No one ever talked about that aspect of caesarean birth and which is why I encourage my ladies to make a Caesarean birth plan (their plan B and nothing to do with Strickland Banks).

I know what Kirstie lacked, I think.  She lacked information and some objective support.  Maybe she got all of that, but it doesn't appear to have worked.  Her article is angry.  It is emotive.  She talks of recklessness, stigmatising and she gets cross when Belinda Phipps uses her own analogy (seatbelts and car crashes).  She sounds in need of a good birth de-brief. (I'm available Kirstie!!!!) It's unfair to criticise the NCT about lack of caesarean teaching.  There are so many things that can happen in birth, no antenatal childbirth educator can cover them.  Yes I know the statistics for caesarean birth are high, but really... should we blame the antenatal classes?  Shouldn't we look at the rates of caesarean birth and ponder why they are so high?  Shouldn't we educate women in the ways of normal birth so that they have a better chance of achieving them?  (Sorry... I was doing the question thing again, wasn't I?)

And when people say that the only thing that matters is a healthy baby, I do have to pause before I answer and say that perhaps a healthy, happy mum as well is the way to go.

Let me briefly tell you about a wonderful couple I supported through to the eventual caesarean birth of their beautiful son.  We had covered birth in our antenatal sessions, Mum knew what she wanted, Dad was fully supportive of all her choices.  Labour started well, Mum and Baby were happy.  We arrived at the hospital full of faith that this would be a straightforward, normal birth.  Things did not go according to plan.  Dad guided Mum through her contractions by talking her through ski runs they'd done.  When she needed a break and a rest, I talked her through some guided imagery (namely my favourite thing... floating on a clear blue sea, under a gorgeous sky with silver fish gently nipping at her toes).  We were an amazing team.  For some reason her son didn't want to descend fully into the pelvis.  We were at it for the longest time.  The doctors were itching to come in to talk to Mum, but Dad talked to them outside the room and when he came back in the two of us helped Mum grieve the loss of her dream birth.  With each stage that a new intervention was due Dad would do his thing with the doctors and come back in to share with his wife.  The whole time Mum and Baby were happy.

Eventually time had run out.  Mum and Baby were tiring and having grieved the loss of a vaginal birth Mum and Dad allowed the doctors in to talk about caesarean birth.  Let me quickly point out that had there been an urgent medical reason for a caesarean birth the doctors would not have stayed outside the door.  It is a testament to their woman friendly attitudes that they respected the decisions of my couple.

After the boy was born, Mum thanked me for my support and told me that she might not have had the birth that she wanted, but she had the birth that she wanted.  Healthy happy baby, healthy happy Mum.  What more could a Doula ask for?

Monday, 14 February 2011

Television Birth

Past and current clients keep telling me to watch One Born Every Minute.  Despite my deep love of birth, it has never appealed to me.  Until tonight I have watched about ten minutes in total.  That was enough to send my blood pressure through the roof.

Tonight I decided to watch because I had an email from Maggie Howell to say that one of the ladies would be giving birth using Natal Hypnotherapy.  So I put aside my many many prejudices and I watched.

It was all I could do not to leap into the television and dim some lights, shut everyone up and allow the mums to just go into themselves.  I do not understand this obsession with having women lay on their backs to birth.  That goes against gravity, imagine pushing up hill.  Not so good.  And the level of noise in the birthing rooms, from the supporters and midwives was astonishing.  That said, I did see some lovely midwives and I wouldn't want you to get the impression that I'm not a fan.

When a woman goes into labour and her body gets ready to birth her child what she wants is a sense of privacy and safety.  More times than not she will want all the noise around her to cease.  All of that is a bit difficult with a camera pointed straight at her, a midwife telling her not to make noise whilst narrating her contractions and encouraging her to do purple pushing.  Purple pushing is where the mum is told to hold her breath, put her chin on her chest and push through her bottom.  The purple describes her face as it fills with blood and the veins on her neck begin to bulge.  She is not allowing her body to be filled with oxygen and all the noise goes into her throat.  The mouth mimicks the mouth of the vagina.  When a woman is in the early stages of labour her mouth is a small circle and short intakes of breath can often be heard.  As she progresses through the labour her mouth opens and she begins to "whoooo" and then to "aaaaaaaaaaaaahhhhhhhhh".  When she is told to be quiet and to not lose energy through her noise she can begin to lose confidence in herself and her ability to birth.  Of course there are times when directed pushing is incredibly useful and, not to put too fine a point on it, paramount for the safety of the baby (it gets the baby out more quickly).

I have seen many women give birth without purple pushing to the astonishment of their midwives.  They've gotten into positions that make them comfortable and ignored the demand that they get back onto the bed and lie down.  At one birth a few years ago my lady had the back of the bed raised and she knelt down the length of it.  Two midwives told her she needed to change her position because they were finding it hard to see what was going on.  Her husband told them to allow his wife to trust her body.  As her son eased into the world, to my surprise, the midwives both said that they had never seen a woman birth like that before.

They are changing though.  I meet many midwives who are as hands off as they can be, who speak with quiet gentle voices and are not afraid of the silence as mum closes off her thinking brain and goes into her instinctual self.  They move about unobtrusively ticking all their boxes waiting for the baby to come. In a time where our Prime Minister has turned his back on his promise to hire more midwives we need this type of midwife more than ever.  The mums want a midwife who is there for her.  Who sees her as a woman and not just another someone to contain.  There is a Facebook campaign to save midwifery and I would encourage you all to join it.  There are so many scare stories in the press about the safety of mums and babies being compromised.  This is not the time to reduce the staff.  If the birth rate, as reported, is rising, then we need more not less midwives.

This is not the first fight for midwives.  Independent Midwives are also fighting for their survival.  If we want women to be able to exercise choice in birth then we have a responsibility to sign up.  We don't need to be Egyptian to make our voices heard.

Don't believe the birthing images that you see in the soaps and even on "factual" programmes like One Born Every Minute.  Just know that your birth journey will be unique to you.

As for me.  I don't think I'll watch again.  Turning purple is not a good look for me.

Sunday, 6 February 2011

Just dropped in

So I had to share this birth story with you all.  Before you read any further just know that all is well.

I was having a quiet Saturday, having hosted two, that's right two, birthday parties for the Wee Weapons this week.  Lady Baby had a craft party at Sally Bourne last Wednesday.  It was a real cupcake bunting affair.  Boy Child was not impressed and so had a football party at Power League.  I drank wine.  It was easier that way.

My next client was on my mind.  Her EDD was today but that was not to be the plan.  Both her and her husband were hoping that the baby would wait at least another week.  Instead she called me at 12.30pm to say that she'd been having cramping pains since 8.30am and that they were 10 minutes apart.  Lovely!  So I knew that at some point that evening I would get the call to go.

Did a few things at home, Lady Baby had a party to go to (the wee socialite) and the Big Three were all busy doing different things.  Boy Child and I hung out.

Then at 4.30pm I get a second phone call.  The contractions are now 5 minutes apart and she's thinking of attempting to watch a film whilst lying on her side.  I asked if she wanted me there, but she was happy to continue on for a while.  So I got my stuff together, arranged for my neighbour to have Boy Child (and Lady Baby on her return) until Number One Son arrived back to take over.  At 4.38pm I get a third call.  She's not so sure that things are working and is wondering what to do.  So I offer to go over and tell her that should she decide to go to the hospital I'll divert the cab.

I take Boy Child to the neighbour and wait on the cab.  Which reminds me... I need to change cab company because they are not as good as they used to be and I need my cab company to be quick and reliable.  At 5.09pm I get the fourth call, they have just arrived at the hospital.  I can hear her in the background and the sounds are promising, not so much for me as the baby sounds imminent and I don't want to miss it.  I arrive at 5.23pm and go straight into their room where mum is on all fours rocking.  She's calm and the contractions don't seem to be bothering her.

Whenever the contractions were strong she stood, much to the chagrin of the midwife, and swayed.  She began making louder moans and when the contractions were rising she would hum.  There was no time or need for a vaginal exam.  Her waters had gone moments before I walked in the door and she could now feel the head bearing down.  The midwife brought in a birthing stool and told her to use it, but she didn't find it comfortable and wanted to stand.  The midwife told her she was more at risk of tearing by standing, having previously told her she was happy to support her in whatever birthing position she wanted to use.

Now, this is where I want you to remember my second sentence - Before you read any further just know that all is well.  

Whilst the midwife was explaining why she would want mum to squat, mum had a strong contraction and the baby shot out.  The cord snapped and she fell onto the floor (know that all is well).  Of course this caused shock for mum who was convinced she had damaged and concussed her baby.  The midwife grabbed the baby and checked her over whilst simultaneously leading mum to the bed.  I hit the help button so that another midwife could come in and check over mum who was bleeding (due to the placenta still being in and the cord having snapped).  The time is 6.23pm.

The second midwife gave mum the syntometrin injection and manually removed the placenta.  I kept hold of mum's hand and talked calmly to both her and dad about the resilience of babies and kept encouraging them to listen to her cries and to watch her skin pink up (babies are rather blue/grey looking when born).

The midwife calls for the paed to come and assess the baby and they are kept in overnight for observation.  My lady needs stitches for a second degree tear and once that is all done baby is weighed and is a lovely 7lbs.  Lots of smiles from both mum and dad and one very alert baby surveys the scene (well as far as her wee unfocussed eyes can see).

The midwives leave and mum and baby now have uninterrupted skin to skin and wait for breastfeeding to begin.  The wee girl begins the breast crawl (try to ignore the number of people around the mother, also you don't have to be lying down for the baby to crawl).  It isn't long before she has found her way to the breast and lies happily with it in her mouth.  She makes some small feeding attempts but is mainly happy to gaze up at her mother.

When I leave them, Mum, Dad and Baby are all happy in each other's company.  I received a text this morning telling me that there have been many poos and lots of feeds.  I'll see them again in a couple of days to de-brief the birth and check in on any issues.

No matter how long I do this, or how many births I do, something always surprises me.

Lady Baby at her Cupcake Bunting Party

Designed by Lady Baby (yellow icing with mini cupcakes on top)

Boy Child. Man of the Match