Wednesday, 29 August 2012

When breastfeeding isn't an automatic bond...

I talk to a lot of women about their pregnancies, their births, their babies and their breastfeeding experiences

They all say so many different things.  I was particularly struck by a conversation that I had with one mum recently that made me stop and think about things that others have said and things that I have felt myself.
"I have read a lot of books about breastfeeding and I don't get that bonding experience that everyone talks about..."
That stopped me in my tracks a little because it's not a comment that is commonly heard.  I wasn't shocked by it, but I was very definitely struck by how few women seem to articulate it.  There are women who are quick to jump up accuse other women of not being loving enough if they say anything less than, "This is the most wonderful experience of my life".  Now that statement is not an excuse for people to say, "Yeah, I agree, breastfeeding Nazis, etc, etc".  No.  Watch your language, please.  There are ways and ways of saying things.  Honesty is good, BUT, it is not an excuse to beat others up for whatever they believe.  Neither do I believe that it is an excuse for others to jump on board and 'attack' mum for facing her feelings honestly. 

So… What DO we say to these women?

I think that the starting point is HEARING what they say.  Some women will tell you that they hate or intensely dislike breastfeeding.  Have they then gone on to say that they are NOT breastfeeding?  The answer to that is often no.  They are trying to reconcile what they feel with what they have been told that they OUGHT to feel.  A wrong response from us could potentially see the end of this period of breastfeeding. 
Once we have heard what they have said, then we need to PAUSE.  Take a step back and think about the response that might automatically flow from you.  Is that a good response?  How much effect do you think your words will have?  Will it be the effect that you want?  Will your words give her what she needs?
One of my ladies breastfed her son for a year.  All along the way she told me that she didn't like it.  When other people challenged her decision to breastfeed:
  • "What about Dad?"
  • "What about me?"
  • "Don't you think he's too old for that now?"
She always replied that she knew the milk that she produced for him was made for him, so why use anything else? When he turned one she moved over to cows milk, because she was happier with its content than the content of artificial milk.
Think of it this way.  Some women don't enjoy being pregnant.  Some love it, some hate it, some just trundle along.  What would you say to her?  What are her choices?  Will your opinion on how she OUGHT to feel, change anything?  What about the ones who are now mothers, but don't enjoy it (at the moment, or at all)?  What would you say to them?
On a personal note, I did NOT enjoy my last pregnancy.  It was my twin pregnancy, but that wasn't why I didn't enjoy it.  I was sick.  I couldn't even keep water down very well.  Some twin mums are NEVER sick.  I shall hide my jealousy...  I had a horrible condition - ptyalism.  Mine was acute, so you can imagine the joy that that brought me(!)  It left me a couple of hours after the twins were born.  I was pretty much convinced that I had it for life.  I hated people continually telling me that all I had to do was swallow.  Swallowing made me throw up.  Not a good look.
I have talked to mothers who loved pregnancy, but hated giving birth and vice versa.  I have a friend who found that she wasn't hugely keen on her baby.  She knew that she ought to be, but she was never convinced that she loved her.  Then one day, six months in, her daughter wasn't well.  And, like THAT, it occurred to her that she loved her baby.  What would you say to a mother like that?  Would you tell her that she was unnatural?  That she was wrong to feel the way that she did?  Or would you walk alongside her and wait?
We can't always help the way that we feel.  Sometimes it's not all that it was cracked up to be, but that doesn't mean we don't just get on with the job in hand.  Who knows, maybe once it's done we'll miss it.  I know I miss the babies kicking inside me and the sickness is practically a long gone memory.

(Originally shared on Acorn Pack July 2011)

Tuesday, 21 August 2012

Be careful what you say. You don't know who may be listening.

I love being a Doula Mentor.  I really really love it. 

Tonight I met with one of my newer mentees.  The enthusiasm and the pure, unadulterated excitement makes me smile.  Every day I fall in love with doula-ing more and more, meeting the new doulas... well that just sends me into spheres of pure joy.

So let me tell you about tonight.  I'm still laughing and almost crying about it.

We met in the pub.  Most of my mentee meetings are over coffee and cake (I love cake).  This mentee is busy in the days so the evenings work better for her.  I suggested the pub.  A glass of wine and a vodka lime and soda later we were sat at a small table and we were talking about how I could support her and how she'd begun her journey.

We talked about the two births that she'd supported pre-doula days.  We talked about books that she's reading and that she'd like to read.  We talked about ways to improve her knowledge and how to build her clientele.  We talked about the fact that both of us are 'doulas with no tricks'.  And then I proceeded to talk to her about Rebozo.  Whilst I was giving a semi demonstration (standing), a guy at the table next to us asked if I was showing her some special ninja moves.  We laughed and explained what a doula is.

And this is the part that makes me cry follows.

The guy that asked the question was sat with two others, one guy, one girl.  The other guy is an expectant father, so we suggested that he look at the Doula UK website and consider hiring a doula.  We also suggested that he look at homebirth.  He was pleased (I think) to get the information but the girl at the table.  Oh dear, oh dear, oh dear.  She had been told by her gynaecologist that once past the age of 35 there was a 1 in 2 chance that the babies would be born with autism, Downs Syndrome, disabled, messed up.  Women who have babies are ruined below and that sex would no longer be good.  In her own words, birth is an unnatural process and babies are ripped, torn and cut out of you.  She had a pathological fear and hatred of birth.  Personally, I want to find that man and in the words of The Sheriff of Nottingham (Robin Hood, Prince of Thieves), I want to cut his heart out with a spoon.  Why?  Because it will hurt more!

A saving grace?  The first guy is really interested in doulas, having never heard the term before, and will hopefully talk to his partner and they may well book one.  The second guy told us the story of his wife's retained placenta.  Their first child was born 'practically perfectly' and the placenta followed quickly.  Their second child, a boy, took his sweet time.  23 hours of slow labour before he finally slipped into the world.  His placenta, didn't want to come.  Eventually the midwife administered the syntometrine injection, but to no avail.  So, she wrapped the cord around her hand and tugged.  No movement.  She went to get a doctor, he repeated the cord wrapping and tugging.  Two more doctors came in and did the same.  Then dad said 'Enough!  I know that you are interfering with something natural.  There will be no more doctors tugging.  We will wait!'.  Two hours later, the placenta separated and came out with no fuss. What a star!  The girl?  Well her sister is 4 months pregnant and had the same gynaecologist and has a lot of the same fears.  My number and website details were asked for.  Of course I had been talking to my mentee about the importance of giving out business cards, because you never know who might need it.  Oh the shame to find that there were none in my bag! lol

Be careful what you say.  Be careful and mindful of who you listen to.  You don't know who hears or what they hear.

Now... where did I put that spoon?

The gorgeous Alan Rickman as The Sheriff of Nottingham

Wednesday, 1 August 2012

And like that a victory!

Sometimes it is difficult to keep a positive outlook when it comes to clients birthing in hospital.  This was never borne out more than in a recent experience where a twin mum to be was bullied (and no I'm not being emotive) and harassed from 25 weeks pregnancy.  Which charm school do some of our Consultants, Registrars and Midwives go to?  I would be living such a carefree and monied life if I had a pound, just a single pound, for every time I hear that a pregnant woman has been told 'Do it my way or your baby(ies) will die'.  In the case of my twin mum her babies had to be delivered at 37 weeks or they would die.  At 38 weeks it was increasingly more likely that they would die.  She declined induction and caesarean section.  Her babies were happy, moving nicely, her placenta was good and her fluid levels were high.  And yet every appointment she went to, she was told 'your babies will die'. 

Is fear really the way to get pregnant mums to agree to hospital decisions?  What happens when that same fear that hospitals breeds cause pregnant women to hide away with their unborn babies?  What happens to those babies that actually need a doctor to help with their birth?  Scaremongering? Me?  Well surely it is the new language of birth?  I've watched bits and pieces of One Born Every Minute and then I had the misfortune to tune in to The Midwives (which is another birth reality programme) and I hate them.  I really and truly hate them.  Fear on the screen.  The air turned blue as I watched an experienced midwife, who in her own words had attended 1000s of births, tell a young woman that she felt that this would be a quick labour and then offered diamorphine.  Now when women talk through their pain management options, they are told that pethidine or diamorphine shouldn't be given in the final 4 hours of birth because it can compromise the baby.  Sure enough, the baby is whisked to the resuscitaire because of the affect of the drug.  I'm not a midwife (and frankly this wouldn't encourage me to become one) but even I know that there are other ways to help a woman manage her pain when the baby is coming fast!

So back to my twin mum.  Despite all threats of dying babies, she remained strong and waited until she went into spontaneous labour at 39 weeks and 2 days.  And man did she labour beautifully.  Not a sound.  Barely raised the level of her breathing.  At one point a consultant came in and said 'Ooh I hear you are 3cm.  I'll pop back later and get some synto up.  We don't want you still hanging about at this stage tomorrow'.  My lady declined.  No indication for rush, babies and mum perfectly happy.  Despite getting to 10cm, the birth ended with a double forceps. Twin 1 was in an awkward position and not pressing down enough on the cervix for her to push him out, plus there was some meconium.  I do wonder if the midwife breaking her waters at 9cm had anything to do with that.  So having survived weeks of bullying, one might imagine it was plain sailing from there.  I regret to say.. nope!  There was another level of bullying to come.  There's something about a smaller twin isn't there?  Just causes panic and protocol driven measures.  Blood sugars galore.  He was born under 6lbs (wonder what he would have weighed if the hospital had its way at 37 weeks) and his brother was over 7lbs.  She was told that she would have to supplement as there wasn't enough breastmilk to get his sugars up.  Mum wanted to express but was told by the midwife that it was too early to express and not worth it.  Despite all of mum's efforts to exclusively breastfeed, the pressure was on to give formula and it was constant.  When mum and dad said that they wanted to discharge themselves they were told that the police and social services would be called.  They were sufficiently frightened enough to do as the doctors wanted in order to get home.  Dad told me that he was afraid he'd never be able to bring his family home (and in fact didn't believe it until they had shut the front door behind them).

So, where is the victory I mentioned in the title?  Little twin, twin 1, struggled with breastfeeding.  Mum was breastfeeding twin 2 and feeding twin 1 expressed breastmilk in a bottle.  The victory was the first breastfeed, since birth, by twin 1.  It's not all sorted yet, but he's getting there and both boys are gaining weight.  My client has told me that she will never go to that hospital again should she become pregnant again.  I don't blame her.  They fought her till she broke.  The best time was during labour with the most gorgeous of midwives who wasn't worried that there were two babies.  Strange to think that that was the most peaceful time.

My crazy pair