Sunday, 29 April 2012

Oxytocin - but no mention of chocolate!

How do I do the MAMA Conference justice?  I'm not sure that it will happen, but hey, a girl can try right?

I've just popped the roast into the oven, so can compose my thoughts for you all.  I shall try not to distracted by the torrential rain outside my window.  

Doula UK are hosting a Study Day that I'm keen to attend, but because of being on call it's not going to happen.  My disappointment is lessened by hearing the amazing Kerstin Uvnas-Moberg on the first day of the Conference.  Her talk was all about Oxytocin: the impact on motherhood.  Talk about preaching to the converted and then blowing said convert's mind!  She didn't just talk about the need for oxytocin in breastfeeding, she talked about skin to skin, kangaroo care and how Dad plays a part.  She didn't, however, mention my favourite oxytocin rush - chocolate.  I was nodding away and saying 'yup, uh huh, that's right, true'.  I was having a wonderful time.  I was surprised though at the number of people who didn't know it as standard, but then isn't that the beauty of Conferences like this?  Gosh but I wish health visitors and more doctors had been in attendance.  They might see the benefit of words of encouragement and be a little wiser in the sharing of the risk factors. 

Of course that leads me nicely to the fact that there is a downside to oxytocin.  A downside?  I know.  I felt the same.  I mean oxytocin=happy loveliness doesn't it?  Free flowing milk, mother baby bonding, laughter, joy, contractions (or surges depending on your preferred language).  But no, apparently there really is a downside and it is the other side of the trust coin.  When oxytocin flows we trust more and walk with the assumption that all is well and that everyone wants the best for us.  One of my beautiful Sister Doulas reminded me of another aspect of that downside.  Labouring mum is oozing oxytocin and suddenly she hands over all that she wanted to the doctor or midwife and blindly trusts that going with the flow is all that she needs to do.  That is one of the reasons I wish more doctors, midwives and health visitors were at the Conference or conferences like it.  

People talk about the lioness aspect of motherhood, the protecting of our cubs.  Well, woe betide anyone who messes with an oxytocin filled mother.  That lioness will roar and you may well lose your head as she reaches out to prevent harm to her cub.  

I, as you might remember, had two Caesarean births.  The first was possibly preventable.  I was induced and my baby wasn't happy with the epidural that I had (it may well have been a combination of both) and the second was a planned Caesarean birth as my twins were a transverse lie.  When Kerstin talked about the effects of oxytocin, so many things were confirmed and made sense to me.  When Number One Son was born, despite the 'emergency' Caesarean birth, I felt such a wave of love (followed by mass exhaustion, but that's another blog).  It was a different story with the Wee Weapons' birth.  They handed me two beautiful babies and I thought 'meh!'.  The wave of love came later with the breastfeeding.  Speaking to Kerstin afterwards was really useful as she mentioned the effect of being a mother already, helped.

So with oxytocin comes the responsibility to be the 'physical and mental hands to hold and support women' [Kerstin Uvnas-Moberg].  The perfect description of a Doula and/or Midwife I think.

Saturday, 28 April 2012

When Mammy met MAMA

You find me riding on a high.  I have just spent the last couple of days at the wonderful MAMA Conference in Troon.  What a gorgeous place.  I got on a plane at windy, stormy, rainy Gatwick and got off in a rather windy, rainy Glasgow.  Of course the weather changed the next day.  I think it's because the rather lovely Steve McNamara (husband and proud supporter of Cassie, one of the organisers of MAMA Conference) told me that I really needed to see the view from Troon on a clear day.  The two and a half days that I spent there were spent in glorious sunshine.  Okay so it was wintry and cold, but honestly, who knew I'd leave stormy London for bright and beautiful Troon?

My plan is to just talk about MAMA Conference, but I think that it will take more than one blog post.  I learnt so much there and so much of what I already know and feel was cemented.  What a privilege to spend time with and listen to some of the most incredible and inspirational people in the world of birth. 

and so many others, but I will come to them as I blog.  Now, you might think that adding publishers to my list of incredible and inspirational people is odd, but not if you remember the power of the pen.  Where else are we going to find the works of amazing authors in our birthing world?  Yes, I know you can go to Amazon etc, but do they really hold some of the lesser known titles?  Do they 'big up' books about oxytocin, the workings of the womb, physiological birth etc?  It was difficult to buy books from the Pinter and Martin stall as I have so many of their titles on my bookshelves, beside my bed, in my bag, beside the kettle!

So let me open this series of blogs with a word of thanks to Cassie McNamara and Nikki who organise the MAMA Conference, who worked hard to bring together the leading lights and encourage collaboration between those of us that care so passionately about birth and the way that it works in our world.  We went from hearing about the amazing qualities of oxytocin to learning about the effects of premature clamping of the cord (thank you Dr David Hutchon and Dr Sheena Kimmond).  Along the way we learned about perinatal mental health, womb ecology, labour rhythms, challenging choices and ended the Conference being inspired by Ina May Gaskin as she talked us through confidence and trust in birth.

Bear with me, I'm gathering my thoughts and digesting all that I heard and learnt over the last few days.  If I could, I would make each and every one of you attend the next MAMA Conference in Edinburgh next year.  In fact, why don't you begin to give it some thought, oh and check out the tweets about the conference and do look for more blogs about it.  There is a lot to learn and be inspired by.  As the amazing Sheena Byrom said, it is so wonderful to see the collaboration of us all.  And in the words of the Chair, Gillian Smith, Royal College of Midwives Director for the UK Board of Scotland (phew.. what a mouthful) - "WOWSER! WOWSER! WOWSER!!!"

With the lovely Karen Law (thanks Sheena Byrom)

Saturday, 21 April 2012

Birth Affirmation

I've been umming and aahing about the blog that I want to write at the moment.  I can't write it because I'm rather cross and angry and no one want to read that stuff.  So in light of the 'you can't', 'your baby will die' and the 'your baby will be brain dead unless you do it my way' comments that some of my ladies have heard recently... it's time for some Birth Affirmations that my lovely Doula Sister, Katherine Woodbury has gathered.

I trust my body

My body was made for this

I listen to my body and I respond accordingly

I wait on my body to direct my next breath, my next surge, my next release of breath, my next inhale.

I am connected to my infant; my baby knows my heart beat, my breathing, my voice, the feeling of my love.

My body is perfect for birthing, it grew my baby all the while I just went about my normal living.

I trust it's wisdom and knowledge.

I trust it's ancient structure, and I give birth easily and effortlessly as I trust my body to do the work.

I am celebrating myself, my life and my coming birthing day

I see myself in perfect health

I affirm myself as a good mother

I am meeting my daily energy needs, I exercise regularly, I sleep and rest, I take in good foods and plenty of water

I am accepting my birth, my body as it is, my self as a new mother

I take care with comments from others, and recognize even well wishers can inadvertently give me suggestions that might diminish my belief in myself. I take myself away from these people quickly and easily.

I learn the greatest "pattern interruption" that I have is my blessed need to use the ladies room, and I use it whenever a situation is not to my liking.

I lovingly accept my changing body

I easily recognize where stress is coming from and I learn to release that easily.

I use proper foods in good proportion that is just right for nurturing this new life inside me.

I accept that others may not be as focused as I am on the baby, and I release any concerns about what others are doing and I choose to take care of myself first.

I notice when I get tense, and I consciously relax those areas of my body.

I start with relaxing my shoulders, and breathing all the way down "to my toes".

I remind myself to relax my whole body often.

When ever I feel tension in my back, I breathe into it, and relax.

I relax each muscle at a time.

My body is beautiful, I have a loving and caring team of professionals around me through my pregnancy and birth

My body is growing a new life inside

I am proud of my body and I  trust it.

I trust it to add all the toes and fingers and to choose the right eye colour and hair, and to make a strong heart, and lungs and body. All I have to do, is continue to breathe and my body will do all the rest!

I accept each stage of the pregnancy as a new wonderful adventure.

I accept each stage of the birth as a new wonderful adventure

I accept all the states of motherhood as this same wonderful adventure

I love myself, I accept myself, just the way I am.

As I prepare for labour I remember I am in control

I trust my body, I love my body! It's just amazing! I am an amazing being.

I wait on what is best for my baby and I let my baby set the pace

My mind and body are calm

I stop my mind from running to thoughts of worry or fears,by using positive thinking as my first affirmation.

I notice when my thoughts are fearful, and I choose to change them.

Even though I'm feeling unsure, a little fearful, and a little vulnerable, even though I'm not sure of what is coming or how I will be, I totally love and accept myself and my baby.

 I feel so good about this I know it's going to empower me and I know when I've my baby iin my arms,  I will have made a personal transition in my journey as a woman. I look forward to this transtition, and I'm excited about this next phase of my life.

If in doubt, breathe out

The power and intensity of your contractions cannot be stronger than you, because it is you.

If it hurts, get off it, move it around, rub it better.

Just as a woman’s heart knows how and when to pump, her lungs to inhale, and her hand to pull back from fire, so she knows when and how to give birth.

Focus on what you can do, then do it with all your heart.

Birth is a safe and wonderful experience.

I will give birth without complications.

I am not afraid.

I know my baby feels our calmness and confidence.

I trust in my ability to give birth.

My body knows exactly what it is doing.

I am confident in my ability to birth
naturally, painlessly amd easily.

During labour and birth,I am completely relaxed and comfortable.

I will have an uncomplicated, peaceful,joyous and pleasurable birth.

My baby is healthy.

I am completely cooperating with my body.

I will breathe deeply and slowly to relax my muscles making it easier for my uterus to work.

My body is made to give birth, nice and easy.

I believe my baby’s birth will come quickly and easily.

My body is completely relaxed.

All I need to do is relax and breathe – nothing else.

Everything is going right.

I feel the strong waves of labourand know that everything is normal and progressing.

Relax my mind and muscles.

I have Courage, faith and patience.

My body knows how to have this baby just as my body knew how to grow this baby.

Keep breathing slow and even. Inhale peace, exhale tension.

Keep my mind on acceptance and surrender.
I surrender my birthing over to my baby and my body.

My body has a wide open space for my baby to descend. There is nothing in the way.

My body will give birth in its own time.

I love my baby and I am doing all that is necessary to bring about a healthy birth.

Birth is an easy and natural occurrence for which my body has been perfectly designed.

The strength of my uterine contractions is a sign of my feminine strength.

I have the energy and stamina to birth my baby.

There will be no complications.

I surrender to the contractions and relinquish control of the forces within my body.

I allow my body’s natural anaesthesia to flow through my body.

I do not fight the birth in any way. My body is totally relaxed. I am not afraid.

The power and intensity of my contractions cannot be stronger than me, because it is me.

I am ready and prepared for childbirth.

My job is to simply relax and allow the birth to happen.

Just let my body do it; let it happen.

I see myself handling everything beautifully.

Each contraction produces a healthy, positive pain that I can handle.

Birth will go exactly as it should.

* My mind and body can handle a labour of any kind

* I will have a strong and healthy baby

* I trust my body to know how to birth this child

* I trust my instincts to know what I need in labour

* I trust my instincts to do what is best for my baby

* I am a strong and capable woman

* Only I can give birth to this baby and I accept responsibility for that challenge

* My body knows how to birth my baby

* I trust my instincts

* Babies are born when they are ready, not when doctors, midwives or anyone decides

* My body is indeed beautifully and wonderfully made

* It’s good for me to take care of myself. I get to have a voice

* I have to be truthful with myself

* Listen to my body and heart

* I deserve to have the birth I desire

* I trust my body

* I trust my pain

* I trust my labour

* I trust in my baby

* I am a strong and capable woman

* I am a powerful, loving and creative being

* I am now willing to experience all my feelings

* My pelvis releases and opens as have those of countless women before me

* I accept myself completely here and now

* I now feel inner peace and serenity

* I accept this labour as my labour and believe it is the right one for me and for my baby

* I love and accept my body completely

* I accept all my feelings as part of myself

* I feel the love of others around me

* My baby knows all is well

* My heart knows what my baby needs, my mind is learning

* I am a powerful, loving and creative being

* I accept myself completely here and now

* I now feel inner peace and serenity

* I accept all my feelings as part of myself

* Good strong contractions help my baby come into the world

* I embrace the concept of healthy pain

* I have enough love to go around, the universe always provides

* I am strong, confident assured, assertive and very feminine

* My body contains all the knowledge necessary to give birth to my baby

* My baby knows how and when to be born

* Birth is a safe and wonderful experience

* My baby will be born healthy and at the perfect time

Some of these may or may not appeal to you, but however you view them and/or use them, I'm guessing they are better thoughts to fill your heads with.  I know that I like them. 

Go, birth the way it was intended, giving thanks for the life saving interventions and for the trouble free births.

Saturday, 7 April 2012

When you've won the fight and the course changes

I'm very blessed to work with some really amazing women.  One of my recent ladies is one such woman.  She had a crash caesarean with her firstborn after an induction led to the hyperstimulation of her uterus.  This caused her son's foetal heart rate to plummet and she was rushed into surgery.  This was very far from her hopes and plans to have a vaginal birth.  During this pregnancy, she had done her research and knew that she wanted to be mobile during the labour and that she would trust her body and react accordingly.  She studied and practised hypnobirthing with her partner and was careful to practise optimal foetal positioning.  All of this went out of the window and there was no time or chance of a Plan B.  This baby needed to be born.  

When we met, she had very clear ideas as to how she wanted to birth this second baby.  Her plan was to have a VBAC - Vaginal Birth After Caesarean.  Now, understandably the hospital was keen that she should be aware of the risks and took the opportunity to tell her often.  Her plan was to have as natural a birth as possible, with minimal intervention. It was for this reason that, together with her partner, she decided to look for a Doula.  As soon as I met her, I knew that there would be nothing for me to say or do but be there with her.  Suggesting options, unnecessary.  Yet my role was not redundant.  I remember the email telling me that the baby was breech and that might mean a Caesarean Section, something she dearly wanted to avoid.  My first thought was Spinning Babies, but she beat me to it.  Co-incidentally, Doula UK were hosting a Spinning Babies workshop with Gail Tully just as I was due to go on call.  Doula UK were in need of a model and so my lady stepped up.  Of course within a couple of days of being told that her baby was breech, she was scanned and told that her baby was now cephalic.  She was very happy to demonstrate the different Spinning Babies techniques that she had used.  It was a wonderful workshop because being as shy as me (read that as talks plenty), she was full of information about how she used the techniques and the ways in which she had informed herself.

The reason my lady was induced for her first birth was that she had gone to 42 weeks gestation.  She comes from a family who carry their babies to 43 weeks, so we were all prepared for the long wait.  In fact I felt confident enough to book theatre tickets for plays that would be performed in her 41st week.  2 days past her EDD I got a text to say that she was feeling a few twinges, but nothing to write home about and that she was having a show.  Now I was due to go to lunch with friends the next day, and I had really been looking forward to it.  I resigned myself to the fact that I would miss it, but hey... new life was coming into the world and that makes up for everything.  I got a call around 3.30am and I went over to see how they were doing.  The contractions seemed steady  and manageable so I sent her and her partner back to bed whilst I bedded down on the couch.  They got a couple of hours rest before it all began to ramp up.  Dad went out to collect their babysitter and then we set off for the hospital. It had been agreed (after some negotiation) that my lady could use the Birth Centre.  

We arrived at hospital at 6.30am to be told that there weren't enough midwives on the Birthing Centre, but that if we were able to wait until 8am, a new shift would start and there would be the requisite number of midwives.  A vaginal exam showed her to be 2cm.  The SHO told her that she wouldn't be sent home because she was a VBAC.  8am arrived pretty quickly and we went downstairs and began to get settled in the Birth Centre.  The very lovely midwife was smiling and welcoming.  She began her observations: blood pressure check, quick read through of my lady's medical history and then left the room to get a couple of bits.  My lady went to the bathroom and when she came out she looked crushed.  Her maternity pad was stained green.  This meant that the baby had passed meconium.  That put paid to all hopes of birthing in the Birth Centre.  I smiled as my lady reminded herself that dilation wasn't linear, things could change.  We went back upstairs to the labour ward where she would need continual foetal monitoring.  The Birth Centre midwife asked if she could give a quick vaginal exam as she felt the baby was coming quickly.  My lady was found to be at 8cm.  A new midwife came in to relieve the first midwife and she was just as lovely.  By 10.15am my lady was spontaneously pushing, but for some reason she had a sudden onset of fear and seemed unable to push her baby out.  The senior midwife apologised for becoming bossy, but she knew that the baby had meconium behind it and with a dipping heart rate wanted the baby out quickly.  The doctors were called in and an episiotomy was given.  As they attempted to attach a ventouse cap, my lady pushed her daughter out herself.  The baby was followed by a flood of meconium.

Was it a successful VBAC?  Yes.  She birthed her baby vaginally.  Was the birth what she had envisioned?  No, but she was grateful for the help that the midwives and doctors had given her when all that she fought for had changed course.

Oh and for those interested... I made it to lunch :D