Failed!

I hear the words "I failed.  I feel a failure" quite a bit.  And I wonder about it.


First time mums (and they are not exclusive) find it hard when they've done all that they can do to facilitate the 'perfect birth' and in reality it is not perfect at all.  The makers of Persian carpets (actual Persians, not factories), so I'm told, always put a slight flaw in their carpet patterns.  This is because only God is perfect.  I kind of like that.  


I've mentioned before the mothers and grandmothers who have told the new mum how difficult breastfeeding was for them and how it will be for her.  I'm sure that I also mentioned that we needed to be careful of the things that we take on board.  These are the things that become stumbling blocks and not stepping stones.


My heart breaks a little when I hear a new client tell me why they don't think that they will do so well at the birthing bit.  It breaks a little more when they tell me that their mother said so.  I tell my children (for as long as I can get away with it) that Mummy's always right and Mummy knows everything.  This is one thing that my children won't hear from me, "my labours and births were difficult and yours will be as well".  I don't think that those mothers mean to put fear into their daughters, but that's exactly what they do.  That fear is something that I have to work with and help the expectant mums to put aside or at least come to terms with so that it doesn't revisit them whilst they labour. 


We look to the mothers and grandmothers in our lives to tell us stories about birth and babies. It is sad when we teach our daughters to fear childbirth.  When we complain that a BBC series like Call The Midwife is too graphic and hide it from our children because we hear labour cries, well what example do we set?  What is it that we are teaching them?  Is not birth as much a part of life as death?  Birth is not always a thing of silence, nor is it necessarily bloodcurdling screams.  We need to tell stories of birth, but not just the blood, guts and gore and "I almost died" stories.  There are plenty of those about and many people to share them.  


Why not share the stories of how we persevered and did better than we expected, even if it wasn't quite the birth that we wanted.  Why not talk about the VBACs and HBACs, the second time arounds where we went beyond the 4cm that kept us stuck previously?  Let's make our Plans B and C and tuck them away so that when our Plan A goes awry, we can reach into our bags for the contingency and know that ultimately we didn't fail.  

Waiting on a baby

My next lady's baby is due any time in the next couple of weeks.  So I've been filling my on call time with cooking, baking and making marmalade.


I have decided that I need to be more proactive with my menu planning.  I need to get on and just blooming do it!  In an effort to do this, I have taken 5 cookbooks down from the shelf. The River Cottage Family Cookbook which holds my tried and trusted bread and pizza recipe.  The Wee Weapons made pizzas and also some butter and were very pleased with themselves.

Jamie Oliver's 30 Minute Meals from which I made a fabulous Jerk Chicken, but I do have to say Jamie... we call them rice n PEAS!!!!!  not beans my friend.


I'm about to look through Economy Gastronomy.  I enjoyed the few episodes that I saw and so bought the book.  Great recipes in there and the blinding revelation that Shepherd's/Cottage Pie is made from leftover lamb and beef respectively, not just mince.  Who know? (Well clearly not me!) 


We're a bit rubbish about new vegetables in this household, so I went back to the River Cottage for their veg book and a couple of recipes scared me, but more excited me.  I need to get some aubergines. 


The fifth cookbook, I mainly look at for pure pleasure.  But I really must start cooking from it because At Elizabeth David's Table (that I first saw on a friend's table) is full of some delicious creations.


So the cookie tin is full of chocolate chip cookies.  The fridge is bursting with fresh ingredients, a chicken is roasting (Economy Gastronomy chicken recipes to be made with leftovers), Orange and Vanilla marmalade has been put into jars and I need to call my friend for her shortbread recipe.


Time to menu plan, but darn these books are so gorgeous for poring over.

Baby Blue and all the hullabaloo

Avid celeb watchers and the fans of Beyonce welcomed the news that Blue Ivy was born 7th January this year.  What surprised me was the furore that followed.  Actually, it shouldn't have surprised me, there had been more than enough speculation about whether or not she was actually pregnant.  I suppose that my disappointment lay within the comments aroused by followers and members of the 'birthing community'.  Comments such as "it's not a proper birth", "was she too rich to have a natural birth?" etc etc.  This makes me so so sad.  


The majority of women who have Caesarean births don't choose to have them.  Perhaps lack of information or informed choice/consent took them down that path.  It could have been for strictly medical reasons.  Perhaps it was their choice, but why do we feel the need to comment so negatively about it all?  Now I'm sure that you know me well enough (and if you don't, well take it as given) to know that I don't believe "healthy baby by any means equals happy mum".  Of course we want our babies to be healthy, we just don't believe our bodies have to be unnecessarily ravaged to get there (please note the unnecessarily).  


Beyonce and Jay-Z released a statement about Blue Ivy's birth in light of all the speculation.  Even this though remains a point of controversy amongst people.  The birth itself was 'via a surrogate', the natural birth was 'a lie'.  People are seemingly not happy to accept the word of the parents themselves.  Is this because it is a celebrity thing and somehow, somewhere in our minds these are not real people?  Do we honestly believe that they have a special gift for knowing more than we do?  


When I had Number One Son, I was relatively clueless about birth.  I never attended a birth class (not even at the hospital - I didn't drive, it was in an awkward location and to be frank, surely you just went to hospital and came home with a baby).  With the knowledge I have now Number One Son may have been born vaginally.  I wouldn't have rushed to hospital at the first contraction or allowed myself to be induced 'because they were going to do it anyway'.  These are hindsight thoughts.  Perhaps it would still have been an 'emergency' section, perhaps not.  Did I birth my son?  Yes, I did.  I just had some extra help.  


Suppose I had been a Child Prodigy and had some amazing singing and dancing talent?  Would my birth have been any different?  Perhaps I would have listened to 'celebrity experts' or friends and simply decided that my birth would be the way that theirs were?  Or perhaps, like the actual me, I would just have remained uninformed because it didn't occur to me to be informed.


I suppose my disappointment lies in the fact that instead of celebrating the birth of a baby (yes, a celebrity's baby, but a baby nonetheless), we have fallen into the media frenzy of denigrating something that a celebrity has or hasn't done.  

Here's a lovely photo of the gorgeous Blue Ivy Carter.

Happy New Year

So, 2011 is coming a close.

This time last year I was documenting the changes that I wanted in the New Year.  This year, well I'm still hopeful of change in the birthing world and in the world of breastfeeding.  Another year has merely increased my love and passion for the work that I do.

I have seen some incredible births this year and I've seen some that have made me cry, and not tears of joy.  Life!  What a funny cycle it is.  

So, my plan for 2012?  To continue to grow in knowledge about this miracle of birth.  To continue to help new families come together.  The first half of the year is mostly booked up and I am grateful for that.  I pray that the births I witness in 2012 are beautiful ones, trauma free ones, joyful ones and that the only tears are ones of joy.  That's what I pray for and what I expect.  Should some of the births not quite all that I hope they are, well I pray for the grace to come through them and to fully support my ladies and their partners.

In 2012 I will meet some first time parents, some established parents and I will have the joy of attending the birth of babies whose siblings I saw into the world.

So, thank you 2011 for all that you taught me.  We won't meet again, but I look forward to meeting your successor 2012.  Here's to knowledge, here's to the new families.  Let's change things, one birth at a time.

Happy Christmas!

Happy Christmas to you and yours.  May 2012 bring you all that you hoped for and more.  With love from me and mine!

What's the cost of a Doula?

Recently a client told me that I didn't charge nearly enough.  I laughed.  I'm not cheap.  And then I got thinking about the cost of a Doula and that made me think about the Sister Doulas who have given up and the reasons why.


Some have quite simply burnt out.  Now, I always wondered how and why that happened, especially as I can't imagine it happening to me.  Well that was until I had done several not so great births in a row.  Then I appreciated the 'burn out'.  Hospital births can really take it out of you.  Let us assume that we all appreciate that the mother does all of the work and that any trauma, shock, adulation and joy belongs to the parents.  Now... let's think about the Doula.


She meets, she greets, she shares excitement.  She talks through hopes and fears.  She de-briefs previous experiences, she helps explore alternatives.  She is there to support, to hold, to gently be.  She signposts, she reminds, she encourages, she breathes.  She sits back, she comes forward, she sits back again.  She is respectful to the midwives and doctors and does not try to influence them (well except when she replies in quiet voices in an attempt to bring the volume back down for her birthing mum).  She hands over water, food, wet flannels and heat packs.  She does not go off duty, she remains in her place.  She exults in the power of woman as each baby is born and she weeps inside for the births that become traumatic.  She holds all of this and smiles and says words of congratulation.  She watches the new families bond and come together.  She encourages mum to feed the baby/ies.  She take pictures, she remembers weights and times.  She kisses and congratulates and takes her leave.  She remains at the end of the phone.


672 hours of on call
calls day and night
an unquantified amount of hours for labour and birth
another couple of hours post birth at a minimum

A tale of two births

I adore twin births.  I admit to bias as a twin mum myself.  My own twins were a transverse lie so the vaginal option was out for me and I take joy when I see other twin mums get the birth that I didn't.  Now, I'm not putting my birth preferences on these mums, I am supporting them in their decisions.  It still, however, fills me with great joy to see twins born naturally.


Today I am going to share the birth story of one of my mums.  First we have to go back to our meeting and her subsequent antenatal visits to the hospital.

It was a late booking.  I was finally off call for the first time in months.  I planned many theatre trips, a weekend away, parties and visits to friends out of town.  I made the mistake of popping my off call status on my facebook page.  Within a few hours I had spoken to this expectant mother and like that I was her birth and postnatal Doula.  I felt bad as I explained that I would do my best to be at the birth but that I had theatre plans and I really didn't want to miss any plays.  She said that she understood.  Her initial enquiry, after all, was for a postnatal doula.  And so I prayed, for once, that the birth would entirely suit my schedule.


We arranged to meet at the hospital where she had an appointment with the consultant.  It is highly unusual for my initial meetings to be like this.  Normally we chat on the telephone and then arrange for me to go round so that we could meet each other.  I suppose it helped that I had been recommended to her by a past client.  We had talked through how she wanted her birth to go and what she wanted to discuss with her doctor.  Her partner had been with her earlier in the day for the scan but work commitments meant he couldn't stay for the consultant appointment.  As usual it was running late.  When she was called, I went in with her.  I said nothing throughout but listened as her reasonable consultant tried to reason her into an induction.  She didn't want to be induced and she was sure of her reasoning.  Mr Reasonable told her that it was dangerous to let twins go beyond 38 weeks and that in his experience the best thing was for her to be induced.  She refused again.  He explained that if she didn't book a slot for induction it would be too difficult for her to get another one.  He then said that of course he would respect her decision not to be induced and book her in for induction at 39 weeks instead.  When she refused again he told her that he would like to see her again at 39 weeks to talk things through once more.  In the meantime he suggested that she got a sweep from either a midwife or me.  I explained that Doulas don't do anything medical or clinical and therefore I would not be performing any sweeps.  I still remain confused on the whole sweep issue.  He said that she could have a first sweep and if it didn't work some days later she could have a second and a third sweep.  My confusion, I suppose, is that if they are so good.. why do women need more than one?  


My lady went in for regular monitoring, which kept everyone happy but the pressure was still on to accept induction.  Finally she agreed to a 40 week induction, but her mindset was that she probably wouldn't go in for it.  Of course once she'd agreed, everyone was happy with her again and there was no more mention of sweeps and inductions.

I went to the theatre.  I saw the amazing Comedy of Errors and the RSC's production of Matilda amongst other things and I waited.  Finally, with no plays to see for several days, her waters went 4 days before Induction Day.  We were so happy, she didn't want to be induced and now she wouldn't have to.  She went into hospital in the early hours of the morning and had the loveliest, quietest midwife she could hope for.  I arrived at 6am and watched in awe as she laboured with a TENS machine, support from her partner and a smile.  The shift changed at 8.30am and another beautifully supportive midwife came to take over.  She was totally respectful of my lady's birth wishes.  


Baby one waited for no one.  My lady's breathing changed and her gentle "this hurts" became slightly more guttural utterances.  The midwife turned to open her birthing pack and said "Don't push yet" but baby one was not to be held back.  Suddenly a beautiful wee head emerged and the midwife turned to catch his body.  His speed meant that there was no second midwife in the room and so the emergency button was pushed (this because the midwife couldn't reach the simple help button).  Suddenly the room was filled with doctors and the atmosphere changed.  From calm and tranquility to a sense of panic. It was as though no one knew what they needed or wanted to do.  Lovely midwife tried to explain that she simply pushed the button to get a second midwife, but no one seemed to listen.  It was all about canulas and misoprostol.  The doctor said "Right, we need this second baby out in 10 minutes.  Are you having any contractions mum?  No, let's get the misoprostol up".  Within moments of the drug being sited and running baby two's heart rate dropped.  The doctor decided to attempt a forceps delivery.  Mum's legs were up in stirrups, people were busy doing many different things and there was no time to wait, listen and discover.  A beautiful birth had suddenly become an emergency.  Baby two was high up and so the forceps delivery was neither gentle nor nice.  Mum had extra internal tearing due to the forceps and the baby arrived battered and bruised.  


Two births, two very different experiences in the same bed.  Don't get me wrong, the fact that the baby's heart rate dropped meant that all bets were off, but did it have to go that way?  I suppose we'll never really know.  The frustration of not knowing what might have happened if they had let mum take a breath and allowed her contractions to come back up... well in doctor speak "at least she has a healthy baby".  In my lady's words "it's as though they let me have the first birth the way I wanted it but then it was their turn to show me how it ought to be done".