Sunday, 24 April 2011

Raise your glass

Today is my birthday and I've been on this earth for 44 years.  In that time I have been pregnant with and given birth to five gorgeous children.  I have been truly blessed.

As well as giving birth to my lovely brood, I have seen many many other babies come into the world.  Every birth day brings joy to my heart.  Some of the births are not what I would have liked to see, too much intervention, doctors or midwives who forget that there is a mother in the room birthing a child (or more).  Many of the births I see are wonderful, mother empowering births.  All of my ladies display an incredible strength and I stand in awe of them.

Today is also Easter Sunday and whatever your belief (or not) today is a day that the loss of a Son is remembered and the hope of His return.

So today I want to raise my glass to the mothers that have lost babies and/or children and to the babies/children who have lost mothers.  I think of my friend Dominic who died 22 years ago leaving behind his mother.  I think of my gorgeous friend Jo who died in November last year leaving behind three children.  I think of my friend who went through the pain of having a healthy twin boy die unnecessarily  when her concerns weren't listened to through labour.  I think of my friend Pam who was my breastfeeding guru (she was on my speed dial) who died last October.  I think of my lovely Mrs Cross who died aged 93 at home in her own bed last August.

Now before you think I'm being maudlin on my birthday, I raise my glass to these people because they have helped to shape the woman that I am today.

I raise my glass to those wonderful men and women who allow me to be part of a very special time in their lives (often more than once).

And I raise my glass to my mother who told me my own birth story rather simply:  "It was a nothing.  Me finish cooking the dinner and sorting de tings me need to sort,  Me never bother with all dem drugs and people bothering me fi tings.  Me simply tek meself to the hospital and push you out.  It na tek much."

So Happy Easter people.  If you think of me today with any birthday wishes, raise a glass to mothers throughout the world, those who are holding their babies and those that are not.

Laughing with family and friends 

Saturday, 16 April 2011

Let's Trade Shoes

Take a step back for a moment.  Take your shoes off.  Go on… take them off.  Wiggle your toes about a bit.  Feel the freedom and the release.  Look back at the distance you've covered today.  Pat yourself on the back.  You've done well.  You've come far.

Now… leave your shoes where they lie.  Look at your pregnant wife, girlfriend, partner, sister, mother, client.  Take her shoes, yes that's right.  Her battered, comfy, fit to bursting shoes.  Pop them on.  Go on… squeeze your feet in.  Done?  Good.  Let's take a walk!

Labour has begun. The signs are simple, they're not huge billboard announcements or anything.  There's some backache, possibly some cramping in the belly.  Your sense of smell is going crazy.  You can smell next door's damp dog long before it lopes into view.  You can't get comfortable.  You're moving from side to side, foot to foot, up stairs, down stairs, into the bathroom.  You pee, your bowels open.  You feel a wee bit wretched.  You ignore all of this.  You sort your photo albums, you watch a comedy, you go for a walk, you try to sleep.  Nothing really works but you'll try anything.  Then it all stops (maybe) and you have some respite.

The cramping in your belly is getting worse.  Your back is "killing" you.  Suddenly the room is too bright, people are talking too much, your partner is cracking jokes.  You want to throw something at the television.  It hurts.  You're thinking it will probably get worse and you might be in for a long long night (and day).  You get in the bath, out the bath.  Maybe you take a paracetamol, maybe you apply a wheat pack to your back.  It's manageable but you're not sure.  You breathe in and out deeply, you try to shut out all the external stimuli.

Now you leave the bath.  It's no longer working its magic.  The pressure in your belly is intensifying.  You know you need to be in your birthing place.  You can feel the excitement around you as your partner rushes about to put together the final pieces for your baby bag.  The hospital/midwife is called.  The phone is given to you.  You try to talk through the contractions but really you want the world to go away so that you can go down into yourself.

You make the journey to the hospital in a car that seems to find every bump in the road, every red light, every 'Sunday driver'.  You are taken to a room where a midwife asks to examine you.  You don't want to be on your back but you don't want to make things difficult.  You lower yourself onto your back, the midwife turns away to fetch gloves, gel, blood pressure cuff, thermometer.  The contractions continue.  You can't lay on your back a moment longer.  Your partner tells you to wait for the midwife, the midwife tells you she'll only be a minute.  You wonder why all the prepping is taking place now whilst you are on your back. You try to shift and move and the midwife arrives back and tells you to lay still so that you can be examined.  Hands palpate your belly, a thermometer in your mouth.  You are questioned about whether or not you have passed urine, if you can give a sample, if you've felt the baby move.  You drag yourself out of your primeval, instinctual self and try to answer.  Another contraction hits and you again try to move.  Then you feel fingers entering your vagina as your midwife checks your dilation.  All this touching and talking.  You want to do the right thing by your baby, but you need to move.  You need to be in another position.  You need to be alone.  You don't want to be left alone.  You are contrary.  You apologise, you cry, you shake, you smile, you laugh.

Lights are high, voices loud.  Knocking at the door, heads popping round.  Different pain relief options are proffered.  You thought you were doing well, suddenly you're not so sure.  You look for reassurance.  Eyes are on pieces of paper, machines, results.  You can't do this.  You can do this.  What is that pressure?  You feel the need to open your bowels.  You feel your body moving instinctually, voices telling you to stop, to start, to pant, to breathe, to hold your breath, to put your chin down.  Shouting, cheering, talking.  You want to listen to your body but you can't hear amongst the noise.  Time passes, clocks are watched, deadlines are set.  Your body doesn't feel your own.  Manoeuvred into positions that you don't want to be in.  Speaking without words, no one hears.  You hear that the baby needs you to do this now.  There's talk of instruments and cuts.  You just want this baby born.

STOP.  Take those shoes off.  Breathe.  If you could plan this journey… how would it be?  Who would walk with you?  What would they do?

Thursday, 14 April 2011

Subcontracting our parent instincts

It was a simple comment made by the Liberal Democrat's leader Nick Clegg that got me thinking.  I know, how scary.  Nick Clegg got me thinking!

He was asked about his thoughts with regard to Gina Ford and it was his mentioning how he felt he was subtracting his parental instincts that stopped me in my tracks.  That's exactly what I'd been talking about with a client. Everything that she did, she did instinctually.  I was merely there to smile and encourage.  She laboured beautifully.  She called me at 3am.  I arrived at 3.30am and went to bed.  At 5.30am we were at the hospital and the baby was born at 6.52am.  It was a lovely birth and she was my first "screamer" in ages.  She gave birth in the midwifery led unit where, strangely, the Midwife wanted her to do some purple pushing.   She tried it but instinctively knew that it wasn't working for her, so she screamed her baby out.  Imagine the laughter when, once holding her son, she declared "Was that it?"

When it came to birth positioning, she knew what she did and didn't want.  She wanted to labour in water, but she had no desire to birth in water.  She was 9cm dilated on arrival at the hospital.  There was an anterior lip.  But she knew she needed to push.  She got up onto all fours and she went with her body, even though she was scared.

Her son decided that breastfeeding wasn't really for him.  He wanted to sleep.  He wasn't so keen on suckling.  So the first few days of his life he had his Mother's milk spooned into him.  He would give a few half-hearted suckles.  Mum held him close and put her hand to his feet.  I asked her why (I had been about to suggest it myself).  She said that she felt he needed the purchase, something to push against and steady himself as he fed.  She was right.  He suckled a little better.  She knew it would improve, but she had tearful moments.  At no time did she consider stopping.  Her breasts became engorged and so she expressed a little off.  Then she massaged her breasts and she felt the shift and the change in the lumps.  She knew to move her son around the breast to help break down the lumps.  Then just like that he nursed.  He suckled.  He took a long long feed.  Dad burst into tears of joy.

This is the beginning of their journey, but already both Mum and Dad know that they trust the things that they want for their son.  They are willing to listen to their instincts even though they've never done this before.  They know that they want to wear their baby.  They know that no book can tell them how to raise their child.

Too many times mums are in hospital for days after the birth of their babies.  And with each one I watch as they struggle to listen to themselves having been told different ways to do the same thing.  Babies that have been given formula at the start because they are too small, too jaundiced etc.  The mothers are afraid to trust their breasts to feed their babies.  They suddenly need to know exactly how much their babies have taken in.  "Feed until the baby is sick" some are told.  The mums know that that can't be right, but they don't trust themselves.  Mothers that squat, lie down, sit down etc when their bodies are telling them that those are the wrong positions to give birth in.

We read too much, google too much, ask too much.  We need to start to listen.  Listen within and know that our instincts are there to steer us right.

Wednesday, 6 April 2011

The Death of Birth

I'm currently reading Ina May Gaskin's Birth Matters.  A deep sense of sadness overwhelms me, not because of her writing, but because of WHAT she is writing.  She talks about how birth came to be in hospitals and no longer in the home.  She talks about all the "safety" measures that seem to have caused the maternal death rate to rise.  The spiral is set. As birth becomes more institutionalised, it becomes more complicated; it needs to be made safer.  Women are told more and more that they need to be in hospital to ensure the safety of them and their babies.  Interventions occur, birth becomes more complicated.  And then Ina May delivers the devastating blow… in America you are more likely to die in childbirth than your mother!

But that's America.  It couldn't, wouldn't, shouldn't happen to us here.  Instead we read in newspapers about the babies born on hospital floors, the emergency caesarean on the ward floor because Mum has been told she's being silly.  Babies born in corridors because there's no room.  Mothers turned away because no one is listening to them when they say they know the baby is coming.  "Don't be silly dear.  You're nowhere near ready to give birth.  We'll see you in a few more hours".  Reliance on machines and gizmos and gadgets.  I recall reading about a man who had invented a machine that would prevent unnecessary vaginal exams and allow mums to have the minimum number of interventions.  All you had to do was to hook up the wires and probes and monitors.

Then mums are told that breech babies HAVE to be born by caesarean section or at the very least the delivery has to be managed by a doctor, which tends to involve Mum with legs up in stirrups and any number of hands on her body.  "Hands off the Breech" says Mary Cronk.  Our Midwives are being more and more de-skilled.  Hospital midwives, in particular, seem to have to stick to a set of protocols and make sure that the boxes are ticked.  No waiting to see, no watching the mother, no reliance on experience and the ability of Mum to birth her baby.  Doctors called to fix stalled and failed labours.  Whose failure?  Mum's?  Baby's?

Don't get me wrong.  I have a deep respect for Doctors and Midwives.  I see the job that they do.  I have no desire to be a Midwife because I like the fact that I can be with my ladies from beginning to end.  To learn to know them and watch as their stomachs grow and hear the stories of how the baby tossed and turned and hiccoughed the night before.  But my heart breaks every time I hear another mother told, 'Of course you're not in labour!  As though she wouldn't be so calm if she were in labour.  Really?  It's impossible for a mother to move calmly through labour?  Where does the screaming come from?  Who screams?  My ladies don't scream.  They panic for a wee while, their eyes go wide, they tell me that they want an epidural, a knife, anything to get to the baby out NOW!  And then they breathe and they relax and they let go and the baby is born.  Midwives that are happy to call for epidurals at 10cm, Doctors that give time limits despite the health and happiness of Mum and Baby.

I'm tired today.  Tired of reading about the culture of fear that surrounds  birth.  Tired of listening to yet another woman on the bus telling her pregnant friend, "It's horrible! Take all the drugs they give you!" Tired of picking up another paper and reading where birth went wrong.

It's time to take back birth.  To accept the ones that need interventions, thank God for the interventions, and relax a little and say.. "Hey, the caesarean rate used to be so much lower!  What happened?  How do we go back to that?"

Sunday, 3 April 2011

Mothering Sunday

Today is the day that we (on this side of the world/in this country) dedicate a day to celebrating our mothers.

Traditionally my children wake me up with an extremely milky cup of tea (I don't like milky drinks) and an over warmed (in the microwave) pain au chocolat.  They whisper excitedly outside my bedroom door… well the Wee Weapons do.. and then they push the door open and carefully hand me a tray with said milky tea slopping over the sides.  Sometimes there will be flowers, usually there is chocolate.  They look at me expectantly and I hand over chocolates. Then they say "Bye Mummy.  Enjoy your lie in".  I count my blessings, then shove my head back under the duvet because 7am does NOT constitute a lie in to me.

About four years ago I was there for the arrival of a very special Mothering Sunday gift.

I was working with a lovely couple (pretty much all of my couples are lovely) and I was on call.  On Friday the telephone rang to say that A was in labour or certainly at the beginning of labour.  And then a strange thing happened… I heard nothing more, not a call, not a text, not a message for 24 hours.  

On the Saturday evening I went out to dinner with a group of girlfriends.  I called my lady to tell her that I was having dinner 10 minutes from her house and that I could get to her quickly if she needed me to.  

We order dinner and the first telephone call comes.  The girls at the table get very very excited.  They don't understand why I'm so relaxed.  A brief chat with Dad helps me to establish that she's labouring beautifully at home, but doesn't want me yet.

Dinner arrives.  We eat.  The dessert menus are passed round.  The second telephone call comes.  Cue more excitement from the girls.  Another quick conversation with Dad reveals the fact that Mum is fine and doing well, but that Dad is getting increasingly nervous.

As we finish dessert the third telephone call comes.  Dad says that Mum doesn't think that she needs me, but he thinks that he does.  The girls almost combust with excitement.  I leave cash and grab my bag.  This Doula is good to go.

I arrived at the house.  The lighting is low, Mum is in the bedroom, one leg up on the bed, slowly swaying from side to side.  There is an interview about the Gulf War on the radio.  I settle down and wait for Mum to say that it is time to go to the hospital.  This is one of my "low pain threshold" mums.  She has already told me that she will do her best but she may well want and demand an epidural.  I am not to dissuade her.

Suddenly she makes three bovine sounds.  I ask "What can you feel?".  She turns to me and says "a burning between my legs".  I ask to look and I can see a ball of membranes bulging between her legs.  I quietly ask her husband to call 999.  He does so and hands the phone to me, panic slowly filling his face.  

A blue light flashes through the window as the Operator asks me repeatedly "What can you see?  What can you see?  Can you see a leg? A bottom? The cord?".  Quietly and gently I reply "No, just a ball of membrane".  An urgent knock on the door and ring on the bell and I look at Dad.  He grabs the bags, I shake my head.  He looks ready to cry but instead runs down the stairs, flings open the door yelling "Upstairs!!!" and rushing back.  Four burly paramedics stomp into the beautifully calm room and the head man looks at me and says "What can you see?".  I say "A ball of membrane.  A head. A body. A baby!"  and like that Seren slips into my arms.  It is 00.20am. My thoughts are simple.  Don't drop the baby!  The head paramedic says "Do you want gloves?"

I crawl home at 5am having held a bicycle lamp so that the Midwife, who eventually arrived, could check for and repair any tears.  The house is tidy.  Mum had been shaking her head saying "I wanted a hospital birth!"

There is whispering outside my door "She doesn't know it's Mothering Sunday.  It's a surprise." Lots of giggles, warm milky tea and an over warmed pain au chocolate.