Doula-lly

Progression

2012-02-07T00:02:00.000Z

This is another word that I hear a lot. Progression, or lack thereof.

It wasn't a difficult birth, a caesarean birth or an instrumental birth that brought the word progression to my mind. It was a straightforward, nice and easy birth. The student midwife (lovely girl) kept talking about how much progression she could see. "Ooh lots more show and fluid. Lots of lovely progression", "Baby's coming down, that's progression", "How nice to see progression without intervention".

We use a lot of words when talking to labouring women. Sometimes I think that perhaps we should just be quiet, but that's just me. We set boundaries, goals, barriers, markers etc for women to cross and/or stay within. Are they for the labouring women, or are they for us? There's a need to 'do something' and waiting isn't easy.

I watched a fantastically fast labour that had gorgeously slow moments. She went from 0-60 and dilated at a rate of knots. When it came to the pushing stage, well the baby slowed right down and birthed beautifully. For some, the slowing of the labour would not have been seen as progression, rather a failure to progress, but not for her two lovely midwives. They smiled and agreed that this was what labours were supposed to do. They waited. And things progressed.

We do a lot of measuring when it comes to labour and birth. We talk to our labouring mums about it all and add an unspoken pressure to 'do things right'. Am I guilty of that? Sometimes, but I'm working on it.

Maybe the progression we need is the one where we take a step backwards and let our labouring mums do as their bodies are designed to.

noun

the act of progressing; forward or onward movement.

a passing successively from one member of a series to thenext; succession; sequence.

Mathematics . a succession of quantities in which there is aconstant relation between each member and the onesucceeding it. Compare arithmetic progression, geometric progression, harmonic progression.

Music . the manner in which chords or melodic tones followone another; a succession of chords or tones.

Astrology . any of a variety of methods of comparing thenatal chart to subsequent planetary positions in order toestablish an optimum time to accomplish things or toestablish the probable time an event occurred or will occur.

Failed!

2012-02-04T22:00:00.000Z

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

2012-01-22T14:30:00.000Z

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

2012-01-17T15:56:00.001Z

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

2011-12-31T19:54:00.000Z

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!

2011-12-25T10:28:00.000Z

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?

2011-12-23T18:11:00.000Z

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

2011-12-21T00:11:00.001Z

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".

Pregnancy. A time to relax and enjoy.

2011-12-11T18:38:00.001Z

Except!!!!!!

It has been puzzling me for the longest time. Yes, I know I probably do know some of the answers, but you know when something keeps going around and around in your head? Well this is on permanent rotation.

Mums to be (parents to be) fighting with Health Care Professionals (HCPs). Why is it necessary?

An example. One of my ladies (who will eventually blog her journey and I'm hoping to persuade her to pop it here as well) went into hospital for the birth of her first child. For her and her partner, it was a simple decision. The hospital would be the safest place for this baby because they had never had one before and just wanted to be sure that everything turned out okay before, possibly, thinking about homebirth for any subsequent children.

So, they enter hospital. They decide that the HCPs know what they are doing and they trust them completely. There will be no rocking of THIS boat. Labour moved fairly quickly, but whenever she wanted to move, change positions or simply listen to her body, she was made to feel stupid and uninformed. Then they were left alone for what felt like hours. She begged the midwife to check, despite having been checked recently, because she could feel the baby gearing up for entrance. Long story short… the midwife and the doctor were unhappy with the baby's position and so she was wheeled into theatre and the baby was pushed back UP the birth canal and she was given a caesarean. Both my lady and her partner were completely traumatised by the whole experience and horrified at the way that they had been treated.

Fast forward a couple of years, and they were getting ready to welcome their second child. Enter me! They spoke to several lovely doulas and I was the one privileged to support them. They spoke at length about their fear, about the lack of listening and the sense of abandonment. A labouring woman needs a sense of privacy and security when she is birthing her baby and they felt that they would only get this at home. And so the battle began. They were refusing to go into hospital for the birth of this baby despite the many many conversations about the risk of uterine rupture. Eventually my lady told them that she understood the risks and didn't need them reiterated every time she spoke to someone or had a check up.

She spoke to the Head of Midwifery and the Head of the Homebirth team. It was agreed that she would be supported at home, but they had strict protocols. My lady listened to them and said that the ones that were supported by medical reasoning and evidence based research were the ones that she would happily follow. Don't get me wrong, both my lady and her partner were prepared to go into hospital should it be deemed medically necessary. She had been offered the opportunity to make use of the birthing centre, but she felt that that would not help her feel safe, rather she might feel pressure to transfer over to the labour ward. Finally it seemed that everyone was happy with the decisions made.

The day before her baby finally made an entrance she was told that the senior consultant had been furious to discover that she would be birthing at home. The midwife was told to tell her that she HAD to go in to meet with him to 'discuss the risks properly'. They then proceeded to take her blood pressure. It was high! So, they disregarded that reading and after 20 minutes, when they reiterated their support of her decision, the midwives took it again. Back to normal.

In the two weeks prior to the baby's birth I had received texts and calls that suggested the baby might be getting ready to be born, but nothing happened. I remember thinking, one evening, that I ought to get an early night. I wound things down slowly at home and just before I headed up to bed my phone rang. She was in early labour. She'd called the midwives and wasn't sure what they needed to do as the hospital had told them to come in because they'd seen some blood. Their midwife called them back and explained to dad that it was a show and that all was well, she would see them shortly. Within an hour I was on my way to their home. I arrived to find grandma on toddler duty, two midwives, my lady on all fours and dad beaming. Things were moving quickly, but the two midwives were glorious. They left her to it and waited peacefully. My lady would lean back into her partner as the urge to push intensified and rock forward with me as the surges faded. I remember re-arranging lamps so the the midwives could see and using my mobile phone as a torch. One of the midwives popped a mirror on the floor. Dad couldn't find a small one, so mum (as she explained afterwards) was able to watch her baby enter the world. It was all the encouragement that she needed. Less than an hour after I arrived she was holding her second child. The placenta came easily after she went to sit on the toilet. The checks were carried out and the midwives tidied away their things and left.

My point? Ah yes, there is one somewhere in this mind of mine. Why is it not possible to lay out the risks, accept that the parents have understood them and listen to their reasonings for why they choose to birth the way that they do? Why is it not possible to support without the scare tactics. Why do we move prophylactically?

I'm sure there will be those that say, 'well she was lucky this time', but was she really so lucky the first time, when she was in a 'safe hospital environment'? Her experience begs to differ.

I received this message from my lady a couple of days later:

"…just in case I didn't make this clear in my tired state - I thought the birth was amazing & one of if not the most positive experiences of my life so thank you."

A sad day for birth

2011-10-30T16:44:00.005Z

I have had two Caesarean Sections and, particularly with the second, I am glad that that operation is there. However, today I feel is a sad day for birth. Women are now to be told that they have the right to a Caesarean Section, whether medically indicated or not.

Why does this make me sad? Well it's simple really. We were made to birth. We carry our babies throughout their gestation and then we birth them. More and more we are being told that women aren't able to birth their own babies. Our bodies aren't strong enough, clever enough, intuitive enough, big enough, small enough, perfect enough for us to give birth. Who can help save us, the helpless woman, to do the thing that we have done for millennia, since the dawn of time? Doctors. Doctors who train to save our lives and to spot and stop problems. They don't always succeed, but they give it a good go and on the whole are mighty successful. Our lovely midwives that know and recognise normal birth are being sidelined. Why have a midwife when you can have an Obstetric Nurse?

Birth has been slowly, slowly drawn into the medical sphere. Out of the home and into the hospital. We all know or have heard someone say "if I hadn't have been in hospital, my baby would have died!", and there are some of us who wonder, why it got to that point and what happened in the run up to the lifesaving situation. I know that I'm not the only one wondering how the caesarean rate has climbed to 25%. Surely it can't be true that 25% of women are unable to birth their babies vaginally.

My firstborn was born via Caesarean section. He was due mid December and it had never occurred to me that being so close to the Christmas season this would make his birth date inconvenient. I was told that I would be induced on 15th December. Four days past his EDD (Estimated Due Date). I was young and uninformed. So when I woke on the morning of 15th December at 7.15am and felt the beginnings of labour, I high-tailed it into hospital. One brutal VE (Vaginal Exam) later and the Midwife pronounced that I was only half a centimetre and that I had no reason to say I was in pain. She read through my notes and said, "Oh, I see we're inducing you today. I will get the pessary." My young, foolish, 'uneducated in the ways of birth' self simply waited for her to do what needed to be done. I didn't know that I had gone to the hospital far too soon. I didn't know that I was within my rights to refuse an induction. I didn't know the risks or how it might not benefit me and my baby. Another brutal insertion and the pessary was in. I was told to stop making a noise and abandoned in the antenatal ward. Now this isn't about how my first birth experience scarred me etc, but this is about how lack of information led me towards a major, surgical operation. When I finally hit active labour I was told that I would need an epidural. So I agreed, but my baby didn't like it. His heart rate dropped and suddenly I was being wheeled into theatre to have an operation. I lost 2L of blood during that operation. How does that happen? This is a safe operation. I never lost that amount of blood with my vaginal births. I had a blood transfusion and now, almost 20 years later, I am unable to donate blood.

Was I unable to birth my baby vaginally, or had mitigating factors prevented me?

The Wee Weapons (my twins) were born by Caesarean Section. They were a transverse lie which meant that a vaginal birth was off the table.

So I'm grateful that there was the option to birth my babies safely. I truly am, but this doesn't stop this feeling of dread and sadness I have in learning that women can routinely choose a Caesarean Section. My mind can't help but skip back to the doctor who told me that he was going to America to learn how to do a tummy tuck at the same time as a Caesarean. Nor can I forget the risk factor and I hope that these women are being told the risks and making decisions with informed consent.

Ultimately, however we decide to birth our babies, there is no right or wrong way. We make decisions, we forgive ourselves if it doesn't turn out the way that we had hoped, or if we were led 'the wrong way'.

4:4:1 (part 2)

2011-10-11T14:17:00.001+01:00

Birth three came out of nowhere. Having barely recovered from births one and two, I was looking foward to a bit of down time before the next of my ladies laboured.

I was on my way home at about 9pm on Thursday. I was tired and hungry, and looking forward to communing with my bed. It was not to be.

Lady Three had attended my antenatal classes for multiples three years ago. That birth had ended as a caesarean section, so for this next baby she had a caesarean booked. She had had talks with her consultant who advised her that whilst it was 50/50 having a VBAC, as an older mum (41), a section would be safer. It also helped her and her husband to plan, as he travelled a lot and they were able to ensure that his work commitments left him free for the birth.

I arrived at hospital three to find my lady contracting nicely and using gas n air. She was in a state of semi-panic, understandable really. Baby Three was just over five weeks early. Suddenly, all their plans had gone out of the window. They had gotten off of a long flight from New Zealand and on arriving home her waters had gone. Here she was contracting and yet she didn't know whether she wanted to proceed with the caesarean or go for a VBAC. It's not my role to advise, but she badly wanted me to advise her. So I simply said, "You are doing beautifully, darling. What do you want to do?" A lovely registrar came in and asked what she wanted to do. The midwife (lovely as she was) assumed she would proceed with the section and was prepared to get things moving. The registrar explained how she positively encouraged VBACs and because my lady was doing so well, she said that she was happy to support her whatever her decision. The registrar and midwife left. Lady Three asked me what I thought. I said that the registrar was right and that she could stop it at any time and request a section. Mum looked to Dad, they both took on a look of excitement. "We're doing this. We're really doing this!"

The gas n air was a godsend. Mum was 2cm dilated. The midwife was keen for Mum to take on some Diamorphine but neither Mum nor Dad wanted anything that would cross the placenta to the baby. The registrar was keen that she didn't get an epidural too early and the decision was taken to give another internal exam in four hours and review. Dad and I worked hard distracting Mum from the slow turn of the clock. She was convinced that we were lying to her and told us in no uncertain terms that she wouldn't be able to cope for eighteen hours with this level of pain. She wanted her epidural and the midwife had better not be late with the exam.

As the fourth hour ended the midwife came back and gave my lady a second vaginal exam. She was 6cm but, for a moment, the midwife thought that she was fully dilated. My lady was filled with joy, she could have her epidural. The midwife left the room and my lady said, "I'm pushing!" I looked and she was. I pressed the call button and the midwife came back. She saw no evidence of pushing, but called for another midwife and a birthing pack. As she left the room I saw gaping and the first signs on a head beginning to emerge. Mum was in shock. She couldn't believe that she was pushing out a baby. Dad was over the moon with joy. "She's doing it! My girl is doing it!"

A beautiful baby girl was breathed into the world. Mum's first words.. "I knew you wouldn't let me have an epidural" and then she kissed her daughter and the joy that filled the labour room was amazing. A planned section that ended as a surprise VBAC!

Lady Four had been showing signs of going into labour for a few days. Things went off and she waited for me to be less busy. Got to love a client like that.

On Saturday night, I fell into bed, late. I had meant to sleep earlier but the previous three births had messed with my sleep patterns somewhat. As I slipped into deep sleep the phone rang. I had had texts from her over the days running up to her labour so I was expecting the call. I spoke to her husband who told me that her contractions were coming every three minutes. I got into a cab and headed over. It was 1.00am. She was contracting nicely but there was no need to move to hospital. I left her and her husband together and I went to bed in the spare room. Eventually her contractions built and I stood with her whilst she laboured. She found it hard to have her husband beside her and so he busied himself with other things and I waited with her. Soon it was time to go. When the taxi arrived the driver told him that he didn't take labouring women and that an ambulance needed to be called. I stepped forward and put on my mother of five voice. "This lady is fine. She will NOT give birth in your cab. I travel with women to hospital all the time. An ambulance will NOT come." I turned to Dad and asked him to put their stuff in the cab, collected Mum and we set off.

We arrived in the birthing centre. It was a quiet night and so my lady got the pool room. She had been assessed in triage and found to be 6-7cm dilated. Wonderful progress. She didn't get on with the TENs machine and so had progressed nicely alone. Unfortunately the Midwife hadn't had any training with waterbirths and went off to find someone who had. Meanwhile my Lady was contracting continually and eventually put herself into the pool. When the midwife came back she tried to hint that it would be better if she were out of the pool. After a while the triage midwife came in to take over. She had a lot of experience. She was a calm and quietly spoken midwife who told the initial midwife that talking wasn't necessary and that sometimes the best thing was to remain silent.

By the time the shift changed at 8.30am my lady was making involuntary pushes. Two calm and confident midwives took over and all was well. Sadly my lady was too tired and after an hour and a half pushing, the baby was really low and sitting in the mouth of the vagina, but despite her best efforts, my lady couldn't push hard enough to get her baby out. The baby's heart rate began dropping and we were moved across the hall to the labour ward. There, a lovely doctor came in and after speaking calmly to my lady told her about ventouse and forceps. The doctor decided to go for a ventouse delivery and gave my lady an episiotomy. In less than three minutes, her daughter was out. My poor lady was convinced that she was a failure, something that the doctor and I were at pains to refute.

She found it hard to have her husband there, though she wanted and needed him there. She found the experience too intense whilst looking at him, but he was everything that she wanted. A strong, silent support.

Four births, four hospitals, two boys, two girls, four very different birthing experiences and one very tired but supremely happy doula.

4:4:1 (part 1)

2011-10-11T14:13:00.003+01:00

No, it's not a football formation! It is the interesting week that I have just had. 4 births, 4 hospitals and all in 1 week. 4:4:1.

Now, I know that I'm a busy doula, but this wasn't the kind of busy I had envisaged! What the week has reminded me of is the very different birthing experiences women have.

Take 4 hospitals. The way that the individual hospitals treat women play quite a role in the way these women birth. Of course within the hospitals are the individual doctors and midwives. There will always be the ones that give you pause and the ones you want to praise to the heavens.

So, a quick look back at the week I didn't see coming.

Birth one. Considered an older mum and therefore high risk. A history of surgery, including back surgery. High risk. A fuller figured woman. High risk. The birth centre said that they couldn't take her, but they did promise to bring the birthing centre to the labour ward. They were happy to move beds, balls and equipment. A lovely compromise.

This was a woman who made sure that she was informed. She did her research, changed her mind about a few things that she thought she wanted and went into her birth prepared. Having an epidural wasn't a preferred option because of her back surgeries and so she opted to use remifentanil which is something that I had never seen in action before. She was able to self-medicate as there was a timed, limited dose release. This came in handy when baby boy decided that he wanted to stay inside a little longer than most. This birth was an induced birth, something that my first lady hadn't wanted, but she felt that it was the right thing to do.

It was a long long labour. Baby boy was clearly content where he was. The pessary gel worked up until a point, but the contractions failed to build and remain steady. So the next step was syntocinon. This was hard for my lady. So she stepped up the pain management and began using the remifentanil. In the end, baby boy wasn't in the best position for birth and both he and mum were getting tired. So birth one ended as a caesarean section.

Birth two came along two days after birth one. Another baby that decided to ignore all mention of estimated due dates. Mum asked me if I would visit her in the circus. She would be the 'Woman pregnant forever'. I promised to take the children and to feed her popcorn.

She refused sweeps, though as she approached 42 weeks she began to become tempted. Perhaps the stint in the circus wasn't what it was cracked up to be. She was in a different hospital to Lady One. This second hospital didn't have the best of reputations, but there had been a change in staff and things were turning around. Lady Two was grateful to hear this and no longer worried about the care that she would get. This was a second baby for her. The first was an induction that spiralled down the intervention path. She was desperate to avoid this for the second birth.

We made a plan to meet for coffee and sinfully good cake on the Wednesday to talk through her options. She would be 42 weeks on the Friday. I think it was a conspiracy to keep me from cake. She went into labour on the Tuesday. Her contractions started but they were spaced out. After hours of labour she called the hospital who advised her to go in as she was post dates. She went in and called me to join her and her husband. She apologised for probably calling me in too soon. She laboured beautifully and her husband was great support. We ate chocolate and waited. She didn't progress beyond 4cm. Things were moving slowly. The decision was taken to break her waters. She knew from past experience that it would make her contractions stronger and she wanted to be sure that she had her pain management on board. She agreed to an epidural, but she wasn't happy that she'd made that decision. She had been managing well with a TENs machine, until she dropped it, twice. It gave up the ghost and so she, together with her husband, spent the next half an hour calling all the local department stores to see if she could get another one.

We talked through the pros and cons of the epidural. The biggest pro was that she would get some sleep. She had not slept for at least 20 hours and she was seriously flagging. A tired mum doesn't tend to labour well. As she slept, the contractions built and did their work. She made steady progress until finally she was fully dilated. She was told that the Midwife would wait an hour before getting her to push. Fortunately the epidural was just beginning to wear off as she got to the pushing stage and so she was able to feel her body enough to send her baby down. A very very gentle Midwife encouraged her pushing. Suddenly it was 8am and there was about to be a shift change. The incoming Midwife caused Lady Two some panic because she began shouting "hold your breath, put your chin on your chest and PUSSSSSSSSSSSSSSSSH!" "No!" replied my lady and continued to breathe her baby down. I was so proud of her. Her son was born shortly afterwards. She was so proud of herself for not having the same birth that she had with her first.

Nip and tuck

2011-10-07T10:23:00.000+01:00

I'm not really sure how to write this blog post today. I'm a little tired from doing 3 births in less than 1 week with another gently brewing in the background, but I have to share my conversation with a doctor who was stitching up my client (lovely birth, small tear). Or maybe it would be easier to bullet point his comments and leave you to stare in shock or scream at the screen.

Women should only have one or two babies, especially if they are planning to have caesareans
Women shouldn't get pregnant. It is an awful thing to be pregnant.
My wife and I have one child. I don't think that she should have any more babies.
Midwives don't know how to stitch up vaginal tears very well. It should be left to doctors.
Women's bodies aren't very good at giving birth. They need our interventions.
That said, one intervention leads to another so don't pretend to do it naturally if you want to let us break your waters.
I don't understand why any woman would have more than one child.
I'm planning on studying in America for a year so that I can learn to do a tummy tuck at the same time as a caesarean.

My lady, her husband and I all stood open mouthed as he spoke. I told him that I couldn't wait to see him in a few years and hoped that when I did, he had four children. We don't think he likes daughters. Is it wicked to hope he has girl triplets? (The answer to that by the way is, YES, wicked to the daughters)

With my mum and my children (of which I appear to have too many eh Doc?)

Breastfeeding Twins Pt2

2011-09-26T22:32:00.004+01:00

On becoming pregnant with twins, women are told of the dangers of the babies coming early. This is one of the fears that is put upon them from the start of their pregnancies. Now, don't get me wrong, I'm not saying it is always untrue, because babies are born early the world over, especially twins. I am, however, saying that it is a fear that is often put into the minds of parents-to-be. My response to this, as usual, is to get informed. If you are expecting twins (or indeed any set of multiples), it is a good idea to get some good information. Another good idea is to talk to your care provider about how they treat women expecting more than one baby. This is also the time to ask the 'what if' questions. Women often find themselves working from a position of ignorance when it comes to birth and breastfeeding and it is easier to sit back and let the 'experts' take over. So, I will assume that you've done the necessary research about your birth and talked to your care providers. Now, let's move on to breastfeeding premature babies.

When we talk about birth, we talk a lot about the immediate postnatal experience. Skin-to-skin contact with babies is promoted more and more by midwives and doctors, which is good news because it benefits both Mum and baby greatly. It helps the baby maintain body temperature – something that is vital in premature babies – it helps to stabilise and maintain the heart rate, respiratory rate and it generally settles the baby. It promotes bonding between mother and babies and encourages breastfeeding as the babies are more likely to root for and attach to the breast.

Kangaroo Care has been shown to have improved outcomes in premature babies. What better place to have your babies than on your skin, held close against you?

Once the babies are born, it is important to establish your milk supply, and this can be done as soon as your babies are born, no matter what stage of your pregnancy they arrive. The lovely Kellymom has some good information about establishing your milk supply and expressing. She also has a handy guide for expressing and storing milk for premature babies.

Now, why is it so important that you get your milk supply sorted for twins? After all, there are a fair number of people who will tell you that you “have to” supplement twins anyway and that “only martyrs” exclusively breastfeed. Now, let me quickly set my cards out on the table. I would LOVE for you to breastfeed your twins exclusively and my personal opinion is that the vast majority of twin mums (premature or full term) CAN exclusively breastfeed their babies. However, this is not about my personal opinion and I know that many other factors may come into play.

So, first let's see about reasons for sorting out your milk supply and remember every breastfeed counts. The milk a mother produces for her early born babies is different to the milk produced for term babies. Our milk is very clever stuff. It provides all that our babies need to protect them from infections and these can have very severe consequences in pre-term babies. NEC (necrotising enterocolitis) is one such gut infection that can be life threatening in preemies. Get shown how to hand express colostrum. This is liquid gold. Your babies need as much of it as your body produces. If, for whatever reason, you do not or are unable to produce enough milk for your babies then donor milk is an option. Ask your hospital about this or see if there is a way you can access some donor milk for your babies.

NICUs commonly have feeding schedules for premature babies. I know I sound like THE biggest fan, but Kellymom really does have great links and resources (and the lazy in me says "why re-invent the wheel"). Here are a couple of articles to read about demand feeding preemies and how it gets them home sooner. (KellyMom articles). The feeding schedules can sometimes lull parents into a false pattern. Yes, I know and recognise the importance of sleep, but did you know that your prolactin levels tend to be higher at night? This will help with expressing and your milk yield. One of the downsides of scheduling feeding is what may happen when you bring your babies home. Suddenly it feels a lot more full on and overwhelming. You no longer have those long, deep sleeps. It is one of the things that most new mums find when they bring their babies home. There are no midwives and doctors to peer around the curtain to check that all is all right. You have sole care of these babies and suddenly you have to deal with the feeding and settling at night. It may feel scary and you may begin to doubt your ability to feed them sufficiently.

The fear of hospital re-admittance, having just gotten them home, looms large. It is this fear that often leads parents of preemies to reach for formula. Coming home from a regime where everything is timed and measured may cause doubt and mums forget to listen to their instincts about their babies. They do wonderful work in the NICU and they are there to help you get your babies home, so don't be afraid to ask about breastfeeding, kangaroo care and feeding to your babies’ cues. Be informed, it will help you to manage your concerns.

Let me leave you with some reasons to be proud as you care for your premature babies and some resources for breastfeeding them.

A quick tale about expressing for premature twins.

And on one more note, should you have the privilege of meeting parents of premature babies, here are a few things NOT to say.

You can also read this and other blogs I've written on the wonderful new resource for Mums: Acorn Pack

Letter to my firstborn

2011-09-08T23:49:00.001+01:00

The evening that you were born was strange to me. They took you from my body and told that it was because of my failure. My body had failed to progress beyond 4cm and your heart rate was falling. No one told me that that was a risk I had taken when I accepted the epidural the insistence of the Midwife. I hadn't prepared myself for your arrival. I was pretty clueless. I told myself that I would be a good enough mother. Not for me the dizzying heights of perfection.

Looking back, I think I did okay. That first failure wasn't my last. I failed to see that my instincts steered me right when it came to you, the baby. I put you to my breast and pulled you into my bed. It was a happy relationship that everyone told me was wrong. They laughed at me when you cried and wouldn't settle in a cot. They made me question my ability when they saw that you preferred my arms to prams and when I wore you round the house instead of letting you cry on the floor. I was pushed into weaning you from my breast and filled you with artificial milk so that I could be like everyone else. It wasn't their fault. They knew no better than me when it came to babies and how to nurture them.

Some of my failures held you and I in great stead. I failed to keep you within the pre-school that people said was good enough for you. I wanted better and best. I failed to get you into the school I felt was best, but the school you went to was good and I met lifelong friends. I moved you the next year when a place opened up in the preferred school. I failed to remain within the low expectations people had of me when I grasped this new school by the horns and took on the PTA by throwing my 'I know nobody' self into the heart of school life. I failed to accept that boys like you weren't supposed to achieve when you sat the entrance tests a two schools. The first rejected you by a matter of a few marks, but the second welcomed you in. I failed to hear the criticisms of the choices I made that took you through that school. I failed to agree with the statistics that said parenting you alone would cause you to fail and push you into a broken life.

And what did you do in return for those failures? You grew tall. You grew kind. You grew and continue to grow as the best big brother ever. You surpassed expectations and took hold of your life and began to make choices as a man. You rejected my dream of an Oxbridge son because it wasn't the path you wanted to take. In doing so you made me proud because you stood for what you wanted and began carving your OWN dream.

I look back over those almost 19 years of your life and I'm proud of my failures. I'm so proud of you. The first in the family to go to University. The loving son and brother, who cares so deeply for his family. I'm proud of your loyalty to your friends and your going for your dreams.

A self-indulgent letter no doubt, but when I see you… I see my firstborn baby in my arms and at my breast. I know that I did something right. My failure is my success.

Ask Me About Breastfeeding Twins (part 1)

2011-08-03T10:25:00.001+01:00

Ask me about breastfeeding twins

That's one of the profile pictures on my Facebook page this week. It is World Breastfeeding Awareness week (or World Normal Feeding Awareness Week as they say on Mothering Mutiples:Breastfeeding and Caring for Twins or More page )

So, I suppose I ought to respond as though I had been asked.

On a parenting forum I was called smug when a woman asked about breastfeeding twins because she'd heard nothing but horror stories. I replied that it was much like feeding a singleton except that there were two babies, but fortunately we have two breasts. A non twin mum jumped quickly up to call me smug and tell me that I had NO concept as to how hard breastfeeding twins was. Sadly tone doesn't carry through the printed word and no one could 'hear' me smiling as I responded. I have, of course, helped many women with breastfeeding their twin babies and nursed my own until they were 18 months old. And I still believe that it is as simple as having two breasts. Now fret not, I am not some kind of narrow-minded freak who doesn't recognise that there are sometimes difficulties in breastfeeding, be it twin or singleton. I just believe that we should start with the premise that it is as simple as having two breasts and work from there.

So, let's start with healthy, term babies, the ones with no health issues. Actually, I think we need to start some months prior to this. I think (and remember these are my opinions) that breastfeeding twins starts with preparing ourselves to nurse them. Almost from the moment people find out that they are pregnant with twins the naysayers appear. "You'll never manage to feed twins, it's too much", "You won't have enough milk to breastfeed twins", "I never managed to exclusively breastfeed twins, don't feel bad that you need to use bottles", "No one can breastfeed twins". This is the time to get yourself informed. There are many places where you can get good information. The National Breastfeeding organisations, like The Association of Breastfeeding Mothers, The NCT, The Breastfeeding Network, La Leche League all have helplines, websites and literature. There are of course the various twin and multiple birth networks as well eg TAMBA and The Multiple Birth Foundation. There are some wonderful websites full of information about breastfeeding like Dr Jack Newman, How Breastfeeding Works and Kelly Mom. Of course the growth of social media has simply opened us up to more information (though do be careful about your sources as there are some out there who are simply in it to make a quick buck and their information can be downright dangerous). I shall quickly name a few favourites, but this could take all day, so I really will just post a few. Dispelling Breastfeeding Myths, Mothering Multiples:Breastfeeding and Caring for Twins or More, Breastfeeding Basics, The Leaky B@@b, Best for Babes Foundation and Lakeshore Medical Breastfeeding Medicine Clinic.

A lack of understanding about breastfeeding and breastmilk tends to be the common denominator for discouraging twin mums when it comes to nursing. I remember sitting with one of my clients after she had given birth to twins. The first had fed beautifully and she was feeding the second. A lady from the MBF (Multiple Births Foundation) came to see her and her opening words were not what either of us were expecting. "Don't worry if you can't breastfeed twins, not many can. I, myself, gave bottles. It's good to get them started". Fortunately my lady knew that she wanted to breastfeed and she had done her research and knew the key to producing enough milk for her daughters. Feed, feed, feed according to their cues.

It may well be incredibly tiring, but that doesn't mean that you can't do it. Get your support put into place. Some twin mums swear by maternity nurses. If this is a route you decide to take, make sure your MN knows how breastfeeding works. I recently had a client who was relaxed and breastfeeding beautifully when I left her. I went back a few weeks later after she had had a MN in. She had been told that in order to have things 'work well' she needed to put the babies on a feeding schedule and breastfeeding was only encouraged 6 times a day. Believe me, when you are a twin mum, some form of order is more than tempting. Fortunately my lady knew that a lot of what she had been told to do wasn't helping. Her milk supply didn't seem as good and her daughters were hungrier than they had been. She recognised that it was the feeding schedule and went back to cue feeding.

The same things that apply for nursing a singleton apply for nursing multiples, a few tweaks here and there perhaps, but the basic information about breastfeeding remains the same.

So, for now, assuming that your babies are/will be healthy newborns, put them to your skin and inhale the wonder of them. Let them feed on cue and should there be any difficulties at all, get help immediately. Often it's a simple issue, with an easy solution. Use your helplines, call an IBCLC, call a Breastfeeding Counsellor, talk to experienced breastfeeding twin mums. Let your information be good and something that helps and not hinders you.

There is more to come, but for now let's start with two babies, two breasts. You can do it!

Don't let them tell you birth's not beautiful

2011-07-10T17:54:00.001+01:00

I recent read a story about the unassisted birth of undiagnosed twins. Now this lady wasn't looking for an unassisted birth. The babies were BBA (born before arrival) of the Midwife. It was a planned homebirth and the mum simply trusted her body and her baby was born.

This reminded me of the two babies that I 'caught' in their homes. Both mothers had planned hospital births. These were first babies and both mothers wanted the 'safety' of hospital. The first was insistent that her low pain level meant she would require an epidural, the second wanted to do everything to avoid an epidural as she had done her research and believed that she could do it. The first laboured silently and had a slight change in demeanour and stance, the second roared throughout with an increase in roar and intensity moments before the baby was born. What they both had in common was a faith and belief in their own bodies.

I find it sad that whenever there is an article, blog or news report of an unassisted birth, the first comments are instant 'doomsayers'. "Ooh you are so lucky that there were no complications", "My baby would have died if that had happened to us". There is no denying that there are times when life saving measures NEED to be taken, the clue being in LIFE SAVING. Why is it wrong to glory in the beauty of birth? Why can't women, mothers, pat themselves on the back and say "look at me. I did it!"? Mothering can be a thankless task at the best of times, so why can't we start our mothering careers with a quick "didn't I do well"? None of this is about downplaying some one else's birth experience. This is that moment of congratulation when Mum can look at herself and say "Wow but I was wondrously made, and look at what I was blessed enough to do".

There are many many horror stories about birth out there. Many! The oft trumpeted hospital birth having quite a few. For those that have horror stories there is the birth trauma support group. A healthy baby isn't the only outcome that we should look for at a birth. We also need a happy, healthy mother. What messages do we send to our daughters if we hold back the 'good' birth stories? And when I say 'good birth stories', I don't just mean the unassisted births or the 'I just breathed and the baby came', I mean ALL the good birth stories. The 'I laboured for hours and just when I thought I couldn't go on, I was holding my baby', the 'I had my baby in hospital and the MW was so hands off'. I even mean the 'I knew the pros and cons, I chose to have an epidural and had a lovely birth', and the 'I was induced and it happened quickly and easily'. Funny how women are allowed to have THOSE birth stories and no one accuses them of passing judgement on others.

One of my ladies (remote support) went to 43 weeks with her pregnancy. It's not as uncommon as you might think, given the levels of inductions at 41+ weeks. There are the horror stories of the doubling of the still birth rate. Well who wouldn't run into hospital to be induced if they knew the risk of still birth was doubled! But what do they mean by doubled? 0.3% to 0.6%. Statistics. (Here's a quick look at some hospital statistics for birth and maternal health.) We need to know what they are and what they mean in relation to us and our bodies and babies. My lovely lady, S, wanted a homebirth. Her pregnancy was normal. There were no high risk indicators, both S and baby were doing fine. As she passed her EDD (Estimated Due Date) the talk turned to induction. The risks began to be talked about. The homebirth midwives began to say that they would not be able to come out to her if she went over 42 weeks. Week 40 and her friends were beginning to become impatient. "Haven't you had that baby yet?", "I can't wait to see that baby. Why isn't it here yet?". They began to suggest induction and ask if she was going to be induced. Week 41 rolled up. The homebirth midwives were crossing their fingers, but bound by hospital protocol, reminded S that she would have to go to hospital to give birth. Week 42 appeared. Mum and Dad were trusting her body and knew that their baby wasn't ready to be born. The hospital told her that she would no longer be allowed to have a homebirth and that she would have to go in and have a hospital birth. S asked simply to be monitored and, politely but firmly, told the hospital that her intention was to give birth at home. With each monitoring appointment, all was clear that mum and baby were healthy and happy. S, herself, was beginning to get impatient. "What can I do to hurry this up?" she asked me. "Wait!" I said. "Okay, I'll continue with the monitoring and I'll wait". Week 42 was coming to an end. The external voices were getting louder "This is taking a really long time. Are you allowed to be pregnant for so long?". "Is this baby ever coming?". S trusted her body. The baby was moving nicely. The monitoring still showed a healthy baby and mum. Good, steady heartbeat. Dad trusted Mum. The hospital again told her that hospital protocol didn't allow for her to give birth at home. When she, again politely and firmly, told that that she was staying home, they told her that they had a duty of care to provide a midwife, but that she had to come in to hospital.

Labour started slowly and moved slowly. 36 hours in and Dad called me for a chat. What could they do to get things moving? I replied "Lots of sex and laughter". More waiting. He told me that she was having difficulty using the bathroom. I mentioned that perhaps the head was moving down and getting ready. He replied "No, the contractions aren't regular enough and she only feels uncomfortable". And then suddenly she was in the birth pool, and then 8-9cm dilated. Within a couple of hours she was holding her baby and Dad text to tell me that it was a beautiful birth, he remembered his role in encouraging her when it got harder for her at the end. When their daughter was born, the midwives agreed that there was no way this baby was overdue, but had come exactly when she was meant to.

How different all of that might have been with the interventions. 36 hours of labour and not much seeming to happen? Surely that's cause for syntocinon? Surely she needs to have her waters broken? Surely speed is needed to 'get the baby out'?

It's time to begin loving women again. Loving BEING a woman again. Trusting in women's bodies again. Celebrating the wonder that is a birthing mother.

What's a guy to do?

2011-06-25T17:06:00.001+01:00

I don't know how she told you. Perhaps you came home and the table was set with a beautiful meal and wrapped in your napkin were a pair of knitted bootees (yes, clearly my mind is on a very old TV commercial). Perhaps you were pacing outside a bathroom whilst she peed on a stick. Perhaps she called you at work. But now you know. She's PREGNANT!

So, what do you do? Run screaming for the hills? Jump up and down in jubilation? Sit down with a stiff drink? Weep with joy? Well it almost (note almost - the hills thing… not so good) doesn't matter what you think, say or do in that moment, but a top tip… let joy and jubilation be a major part of it! You're going to be a father.

How are you going to support your partner through this pregnancy? And has your mind wandered towards the birth yet? And then… oh yes… there's more. What about when the baby is born? Parenting!

Okay, one step at a time. Pregnancy!

There is a temptation to Google and to Google a lot! Try not to give in to it. Find some good research based evidence. And when you talk about birth and labour, try not to listen to the 'horror' stories. Tell those people that you would love to hear their stories, but not until you have one of your own to share. The guy at work will have lots to share. You might not want to hear it all.

She may or may not have 'cravings' or like me.. just go off things. It might involve the odd midnight dash to that particular bakery/deli/burger bar/bagel shop. She may eat things that you never want to remember her eating. Go with the flow my friend. Make sure she eats, drinks and rests during her pregnancy. She's not ill, but her body is working hard.

Don't ignore the antenatal classes. Choose them together. Go to one that keeps men in the breastfeeding sessions. You need to know so that you can support her and be her gatekeeper.

Next step. Birth!

It’s not as easy as it sounds. Sometimes you'll need to step up and get on with the job at hand and not think about how squeamish you may or may not feel. Sometimes people say “Well it’s not as if he had to do anything” but let’s think about what you do. It’s a big job. It can affect you physically and emotionally. Whilst Mum is labouring away and not wanting to eat (and Mum should eat) you might feel that you can’t or shouldn’t. Big mistake. No one wants a partner who has passed out due to exhaustion and lack of food and water. Be sure to look after your own needs (remember the oxygen on the aeroplane analogy). Eat, drink, go to the bathroom. Oh and when you eat, her sense of smell is heightened, be wise with your food choices.

Then she will want you to massage her, to touch her, to hug her, to kiss her and as you lean in and your hands make contact with her body she may wrench away from you and ask you in no uncertain terms what the hell you think you’re doing! When she wants a massage you may feel that you’re tired, you just need a rest, but you know she needs you so you press on. Then she tells you to stop and leave her alone and now you feel rejected. Take it on a moment by moment basis. It’s nothing personal. What she appreciates most is your presence. Your partner's strength during labour may surprise you, but you may also be confused by some of her reactions, which can include despair, irritability and even hostility. Keep your sense of humour but check your ego in at the door!

So what happens if she gets to place where she feels she can’t go on?

Look her in the eye. This may help her refocus. She’ll know that you care and that you are committed to this. Keep your talking/jokes etc to a minimum. Let her go into herself and into her “zone”. Remember the thinking part of the brain closes off during labour and it becomes an instinctual, primeval thing. A nice firm touch or massage, maybe a hug show her love and can warm her up if she’s cold and shivering. When she gets to the point where she thinks she can't do any more, tell her you love her and you're proud of her and how amazing she is. It's hard because all you may want to do is to grab as much pain relief for her as possible.

And the next step? I'm going to talk about the days after the birth.

This is where you will come into your own. The Midwife will only come to visit a few times. The phone will ring, almost incessantly, as friends and family want to share your joy. But this is your time to allow yourselves to become a new family. Take time to make sure your partner goes back to bed. Make sure she is fed and watered. She will be tired and so food may not be something she thinks about too often.

She has done an amazing thing and your family has increased. Take time to enjoy them, but remember to look after yourself as well. Send her to bed as often as you can. When the baby sleeps, she should sleep. new parents often worry about what will happen to the baby whilst they sleep. So, after sending Mum to bed, spend time holding your baby, or simply watching your baby sleep. Week six seems to be the peak of tiredness postnatally. If you ensure her to rest in the beginning, she is less likely to fall into total exhaustion. Encourage her to bank her rest. Make no decisions in the middle of the night.

You are your family's gatekeeper. You may want to consider leaving a message on the answer phone letting people know that all is well and that you will call them back in a few days. Perhaps you might ask relatives to put off their visits until you have found your feet as a family. You can ask that family and friends bring food and tidy or take away the dishes. It's also worth considering having an" open afternoon/evening" where you invite everyone around for a couple of hours and lock the door behind them afterwards (don't forget to have someone on tidy up duty). Then when they are all gone, turn the phones off and go to bed. Remember what you learned in the Breastfeeding class. Encourage your partner, especially in the middle of the night when she's at her most vulnerable. Know when to call for help. Keep that list of breastfeeding support lines and Lactation Consultants in your phone and on the fridge. Whenever she sits down to nurse the baby(ies) make sure she has water. Put a plate of snacks beside her Massage her shoulders, tell her what a wonderful job she is doing. Protect her from anyone who tells her she can't do it, including your mothers.

As to the parenting... well only you two know how you want to raise your children. Everyone will have theories but only you two will know what works for you too. Look to your instincts.

Keeping abreast of the matter

2011-06-12T01:31:00.003+01:00

I want to talk about a view boys have of breasts and how I feel it affects breastfeeding!

This example that I'm about to share contains language I wouldn't ordinarily use, but in order for the story to sound 'right', I've had to keep the original phrase.

I read a story on a parenting forum about a woman breastfeeding in the local coffee shop. There were many breastfeeding mums in that day. Two young lads walked in and the first said, "Blimey mate, look at all them tits", to which the second lad said "Don't be silly mate, them's feeding tits, not w***ing tits'.

Now I've been thinking about this a lot just recently. I have an 18 year old son (Number One Son) and a 7 year old son (Wee Weapon 2/Boy Child). Getting Number One Son to 18 has been no easy task. We have had talks about sex, pornography and all the relevant in between conversations. So as you can imagine boys and breasts are something that I'm relatively familiar with and it seems to me that for some, the whole breast issue is a minefield.

I was out to dinner with some friends when one of them told me that she was concerned about the images that her son was seeing on my Facebook page. Now as far as I remember, I had no nude shots on it and I'm reasonably sure that there are no "ooh drunken Doula not on call" shots. Her concern was the amount of breasts that her 15 year old son was seeing on my page. Now I've looked through my page/my wall/my links etc etc and I don't see anything perverted there. And so of course the initial story flew back into my head.

There are a lot of sexual images out there for young boys (yes, I'm aware of the imagery for girls, but at the moment I'm talking boys… oh man, I'm going to have to write again on the subject of girls. I have three girls!). Young boys, old boys, men, all of us, have breasts thrust at us from every angle. Want to advertise a car? A nice buxom woman reclining on the bonnet should do the trick. Want to advertise perfume? Let's have a beautiful young woman strip as she walks towards the camera. Want to advertise aftershave? A couple of squirts and women will throw their clothes off. At least the Wonderbra ad was advertising bras and so one might reasonably expect to see bosoms. Perhaps the "Hello boys" was little more than an invitation to 'dive right in' but hey, if we're going to advertise women's products to women, we must make sure that they will become more attractive to men. And so, our little boys grow up knowing that 'tits and arse' are what they should expect and the idea that a woman's breasts might not primarily be there for a man's pleasure comes as a bit of a shock.

Facebook, of course, does not help here. Pretty much every day another account and/or page is deleted for 'obscene imagery'. Pole dancing is fine. Breast enlargement is fine. In fact pretty much every image of breasts is fine until there is a baby nursing from them. Comments from Joe Public aren't always good/kind/helpful. Shock horror reverberates through people when they realise that a baby is about to be or is being fed. Summer will be interesting. All the spaghetti tops will be out, the low hips, low necklines and highly visible breasts. There will be many photos on Facebook that will cause excitement and pleasure. But a feeding baby, well that's really rather disgusting. Imagine using the breasts as they were intended. Feeding tits!

One of my very lovely twin mums

When Doula-lly went Dou-la-la!

2011-06-04T13:01:00.000+01:00

There's a blog that I've been enjoying and she asked if I wanted to do a guest blog for her. Well of course you know how much I have to say. So I wasn't going to say no now was I?

The blog is Dou-la-la and here is my guest post. Once you've finished with that, why not browse through her blog and see what she has to say. It's well worth it.

Happy Saturday people!

Whizz pop bang! (A brave new world)

2011-06-03T20:36:00.001+01:00

Isn't it funny how many gadgets we need to do our daily bits and pieces? And how wonderful of Nestle to decide to help us out in an area where we clearly cannot manage. No need to train Midwives in breastfeeding support, or to lead breastfeeding workshops. No need for those pesky private antenatal classes where Mum might learn how to initiate and maintain breastfeeding. No need for those Lactation Consultants, Breastfeeding Peer Supporters and Counsellors.

No no. The kind and generous Nestle have decide to provide the first, ultimate, complete, nutrition device. It will only set you back a zillion pounds/dollars/[insert currency] for the initial outlay and then those nifty, convenient little capsules will simply cost pounds/dollars/[insert currency] more than those bulky great tins. I wonder of course if there is space on those teeny tiny capsules to remind the 'makers up' of this formula that the product is not sterile and therefore the water needs to be heated safely. Of course they have been ever so kind as to provide water filters to prevent those nasty bacteria from entering the water. Phew! For a moment there I thought the freshly-made-up-at-the-touch-of-a-button formula might no longer be sterile… but… wait! Let me think about that. Just for a moment, a mere nanosecond. Nope. Still not working. Definitely need to heat that water up to 70+ degrees. Hmmm…. but this product promises formula made up and good to go in less than a minute. <searches publicity photos for the cooling unit, sees none but assumes that the lovely Nestle will have taken care of that minor detail>

This world we live in is making us more and more dependant on the gadgets and gizmos. I may reveal my age when I hark, with unashamed nostalgia and rose-tinted classes, back to the days of 'The Good Life'. I confess. I have been planning to grow my own veg for about 8 years now and as soon as the planning stage is over, I shall move straight into action.

But I do worry. I worry that we leave our children the legacy of 'the button'. Just push this button and that will happen. Push the other and something else will happen. Alongside 'the button' will be the pill. Too fat? Pop a pill. Got Gestational Diabetes? Pop a pill. Got Morning Sickness? Pop a pill. Oh hang on, did that… Thalidomide anyone?

It's all about making it easier. I'm writing on a train, but I'm not using trusty pen and paper (train is far too jerky for that :excuses:). I am using my laptop. I can connect to the internet should I wish. I could do an online shop and have the food delivered in time for my return home in a couple of days. I could blog! I have my smart phone in my lap. I can Facebook and Skype and email and call. It is all so easy now. And there is the dichotomy. I love that it is all so easy now. I pooh-poohed the Smart phone. Who needs the internet on their phones? Why would you need access to your email? Please excuse me whilst I book a shopping delivery.

I don't, however, understand how getting up out of my lovely warm bed in the middle of the night to hit a button would have made life easier for me. It would still be cold in the kitchen and that wouldn't do. I like the warmth of my bed too much. It was one of the reasons why breastfeeding seemed the perfect choice for me. My ultimate, complete, nutrition system, which pre-dates the BabyNes by Millennia, worked very well. I remained in my warm and cosy bed, happily feeding my children.

When we consider the forethought and benevolence of Nestle, we should try to remember that yes, it is being made easier for us. Easier to fill their ever deepening coffers. Easier for them to flout the WHO Code with our permission. The late great Martin Luther King said "Our lives begin to end the day we become silent about things that matter.". Are we happy to stand by and let it be or is it simply just a convenient thing for others and we shouldn't begrudge them the chance to make their lives easier?

Nestle, the great equaliser. Nestle see the poverty divide and makes a machine to ensure even the most affluent households can have unsafe baby formula.

Nestle's 'wonderful' new gadget

A glorious weekend

2011-05-30T14:32:00.001+01:00

Most people that I know look forward to the long, bank holiday weekends. We dream of the lie ins, the friends and family we'll see, the dancing we'll do, possibly even a barbecue or two (weather permitting).

This weekend was a tale of two births. Almost two weeks ago one of my twin ladies gave birth by caesarean section as the presenting twin was breech. Breastfeeding was nicely established and, despite the fact that I am there for postnatal support as well, they said they didn't need me. Perfect! I love what I do and I love it when my ladies don't need me. So I was gently easing my way towards this weekend knowing that I had two ladies yet to birth.

Birth 1:

My client had had a caesarean section for her first baby. Her waters had gone early and he wasn't ready to be born. Long long labour. Syntocinon given to help things along. 4 days after the waters, 1 tired mum, I tired dad, 1 tired Doula later... section. Gorgeous boy!  

S hates hospitals. So when she found out that she was pregnant again she wanted a homebirth. The hospital were not keen, so after fighting for a while she decided to hire Independent Midwives. Everything was wonderful. She went into spontaneous labour as her waters broke on her EDD. I arrived at about 6pm last Thursday.

The IMs were gorgeous. We had met before be make sure we were all on the same page.    S was labouring beautifully in the water. The IMs were reasonably sure that she was fully dilated. She had the lovely purple line up her bottom. But things were stalling. So rest was called for. Got her out of the pool and into bed. Throughout the night we all tag teamed to get some sleep.

In the morning nothing had changed. S was getting tired. Baby was happy throughout. In the end the decision to transfer in was made. S opted straight for section. The lovely Consultant explained that the baby's positioning meant he wasn't going to come out without help. Her gorgeous son was born at 9.40am on Friday.  

It wasn't an easy thing for S to have a caesarean once again, but I'm so proud of her. She was so glorious in labour and though she wept at the thought of the section, she was strong and accepting.

I texted my next lady (who I had kept in the loop) to say that the baby was born and she should go for it. She replied that she would give me a couple of days to recover from the first birth.

Birth 2:  

On Saturday J called to tell me that she had woken with some twinges and some cramping but that all had gone quiet and she was going to get on with her day. That evening she called to say that she was getting irregular contractions but that they were every half hour. I sent her to bed. I got a call at 10.30 on Sunday morning to tell me that she slept a bit but that she was still getting irregular contractions and could she do anything to hurry it up. I told her to enjoy her Sunday and to wait because the baby would come when it was ready.   

Sunday evening I got a call around 6pm telling me that the contractions were every 5 mins thereabouts and that they were increasing in intensity and would I mind going over. After I arrived, J relaxed considerably and things seemed to slow again. I made sure that they had eaten and then told them to go to bed because it might be a long night and they needed their rest. J went to bed around 10pm and P (her partner) faffed about for another hour and a half before eventually going to bed himself. I pulled out the sofa bed and let myself drift off.

6.45am this morning P woke me. I asked how the night went (I had woken periodically and not heard anything). He said fine and that J was getting into the bath. I went to see how she was doing. She was rocking beside the bath and said "I need to get in now". She got into the bath and her breathing changed. J was a very vocal labourer/birther. I reminded her that she could go to the hospital when she was ready and felt she needed to be in her birthplace. She looked at me and said, "I don't think I can get out", then she closed her eyes and roared! I asked P to call the Birthing Centre.

I spoke, evenutally, to the wonderful Belinda Green (Supervisor of Midwives) who asked me what I thought was happening. (I have been at a birth with Belinda before). I told her that I thought she was getting ready to push as she had strong poo-ing urges. Belinda asked if she had poo-ed. I said no, looking into the bath and said yes. J roared again. Belinda said it didn't sound like pushing noises but that if I thought she was close, we should go straight in. Dad picked up the phone to call a cab. J roared. I looked between her legs. Her labia was fully extended and I could see the tiniest bit of the baby's head.   I called to dad "Hang up and call 999 NOW please" which he did and then he babbled to the controller. I asked (rather firmly) for the phone and spoke to the controller who told me I had to drain the bath and then I had to put my hand at J's vagina and my other hand to support the head. Meanwhile J was roaring and I told her to breathe. The controller shouted to me "Are you listening to me? Don't listen to her, listen to me". Then she told me to tell J to push as hard as she could. Whilst all of this was going on, I was talking myself through birth in my head.

One half of me was calm. 'Remember, mums bodies are made to birth. Just let it be. If there's a cord, use your thumb. Relax and be sure to take the baby head and face first out of the water (esp as it's draining away). The other half of my head was screaming [add many many expletives]. My out loud voice said, "Relax J. Good girl. Fantastic. Your baby is coming.". I dropped the phone because, in fairness, the controller was doing my head in with her purple pushing directives. J roared again and her baby slipped gently into my hands. I turned her (yes Reader, it was a girl) and lifted her to her mother's abdomen. The cord was short so she didn't go up very high. A minute later a beautifully handsome paramedic arrived. She was born a 7.19am. J was glorious.

He was wonderful (not cos of his looks) and gentle. He invited dad to cut the cord after it had stopped pulsating. He was happy to do a physiological third stage. All was calm. The three other paramedics waited outside. There was a shift change at the hospital but Mr Gorgeous went off to collect the Midwife. She had not had her tea at home that morning because (as she told me) her boyfriend and flat mate had not replaced it. She's gone into Sainsburys and as she came out she got a call to get to work quickly. Mr Gorgeous met her at the door and brought her straight round. She was gentle, kind and so so loving. She was disappointed that J had to be transferred in for a retained placenta, but she gave it everything to see if they could stay home.   As I said to my friend this morning, this job that I do makes me blessed amongst women.

When breastfeeding goes well but all goes wrong.

2011-05-24T00:26:00.000+01:00

Today I spent time with a distraught mother. She was distraught because two days ago she gave up breastfeeding. It turns out that the baby had a posterior tongue tie and some cranial issues (tension in the neck and he's been a little compacted since birth). She breastfed happily and well for six weeks. Then she was told that his weight had plateaued and that she needed to feed him more because he wasn't growing as he should. And so she began to worry. She internalised her worry and as the stresses of life closed in (by which I mean the normal everyday stresses that have nothing to do with babies) she was told to ignore them and concentrate on feeding her baby.

She closed out the world and concentrated. She saw Midwives, Lactation Consultants, Night Nurses, Doctors. Eventually she went to see a Cranial Osteopath and he said "You've been at this long enough. It's stressing you out. You've done your best". She accepts this as true. She had stopped enjoying her baby and instead obsessed about feeding him. In her words "breastfeeding [was] destroying [her]". She cried as she told me that much as she had loved breastfeeding and how wonderful it was when it was good, she needed to be a normal person again. She needed to go outside again and not worry that her son was being underfed. And the whole time, her breasts poured milk.

So much information, so much help. How do we filter what is good from what is bad? How do we help rather than hinder the Mums and Dads that come to us seeking advice? Do we know when to hold back and simply hold them whilst they cry?

I asked her how she felt about giving up breastfeeding, because I wanted to see if it was something that she had thought through. She clearly thought I was about to persuade her back to breastfeeding. She mounted her defence. I wanted to be SuperDoula and help her find her way back, but I stopped asking questions and simply said "It's okay."

Inwardly, my heart broke. The first time that I met her she was keen to breastfeed and she did so well. When I left all was well. Going back six weeks later the coin had flipped. I don't know what happened to make it so. I taught her how to hand express herself so that she could rid her engorged breasts of their milk and disperse the hard lumps that were forming in her breasts.

I'm sure that there are those who will say that I should have pressed her harder to remain breastfeeding, but I am also sure that there are some who know when to stay silent and let things be. It doesn't mean I'm not sad about it.

Hold on... I'm coming!

2011-05-14T22:07:00.000+01:00

Why are we all in such a rush for everything? We run for buses, trains, to catch the phone, the shops, the bank, the Post Office.

I think that we are really rather spoilt. We live in I Want It Now street, Instantville. Instant coffee, ready meals, packets of pre-grated cheese. Emails, texts, BBMs, IMs, Facebook messages... oh you get the point and you want me move quickly along? Right ho!

I talk about birth a lot. I mean a lot. Once people find out what I do for my "job" they all have stories to tell. I'll listen all day to "good" birth stories, "bad" birth stories and the indifferent ones too. I'll listen to tales of breastfeeding, why it did or didn't happen. Advice given, sought, ignored, rejected. I'm there. I was having lunch with a friend recently and a young pregnant woman, on hearing what I did, came back and asked me for my three top birthing tips. Lunch paused, cue my long-winded version of three quick tips (namely 1. Trust your body 2. Eat/drink/pee/rest and 3. Be mobile. Gravity is your friend).

I spent the evening with a young couple and their 2 day old baby. She was "helped" in an over busy postnatal ward after a caesarean. Baby and breast were grasped and pushed together. The result, painful breasts, poor latch, tearful mum, frustrated baby. No time for sitting, waiting, watching. And we talked. I told her that breastfeeding was like pregnancy. Something that happened over time. Look at the time it takes this newborn to crawl to its mother's breast. No grabbing, no grasping, no shoving together. Just patience and waiting.

Labour is another thing that requires patience and waiting. Labour begins. There may be a long latent labour phase. There is a temptation to 'speed things along'. Mum will have had weeks of calls and comments "hasn't that baby come yet?", "that baby really needs to hurry up and come now", "are we still waiting on that baby?", "aren't you fed up of not having that baby yet?" ad nauseum. The baby moves slowly. Taking time to find the right position, to turn and manoeuvre. To slip into the birthing canal and do the dance around the pelvic bone, ready to exit and be born. But the clock has started. The countdown begun. Texts and phone calls "We haven't heard anything from you for a while. Is all okay?", the pacing in the homes of grandparents and friends. The notes on the midwife's board. Shifts starting and ending.

The second stage where Mum is now pushing. "Hold your breath and push", "C'mon PUSH!!!!!!!!!" "Come on baby, stop keeping us waiting", "Get angry with your baby. PUSH that baby out!", "If that baby's not out in the next couple of pushes, we'll have to do something".

Remember, medical reasons are medical reasons and if that baby needs to be out quickly, then that baby needs to be out quickly. If the baby needs to move with speed to suit timetables and clocks... well wait! Let the baby come.

What about sleep? What about having the baby at home? Patience. Wait. Sleep when the baby sleeps. The house will wait. Baby yoga, baby German, baby origami will all wait. Allow your body to recover from the birth. Take time to look and wonder at your baby. Count those fingers and toes. Watch those gradual changes. Watch as your baby learns to sleep alone and to smile and to laugh. Watch as your baby becomes a toddler, a child, a pre teen, a teen, a man, a woman, a father, a mother. Time won't wait for you to slow down. Time will march on. But you can wait. You can watch. You can wonder.

I have planted some pots outside my front door. The Wee Weapons want to know when the flowers will be big. They want to see the results now, today, this moment. I tell them to wait.

I have a favourite TV commercial. A man is covered in bandages, his foot is broken. The telephone rings. The song plays as he hobbles across the floor to a phone that stops as he reaches it. Hold On I'm Coming!

Wait!

Is ignorance bliss?

2011-05-07T23:09:00.000+01:00

I got a call the other day. It was an enquiry about my antenatal sessions. It's always exciting when someone tells me that they are pregnant and that they want some information about the journey ahead.

We talked about the practical stuff, where we would meet, what I would cover and then WHAM! Out of nowhere she told me "I don't need to know about the birth bit. I'm having an epidural".

And like that I was speechless. Doesn't happen often I can tell you. But I confess to feeling confused. Why would the fact that a woman would want an epidural mean that she wouldn't need to know about birth? I mean am I missing something here? Does having an epidural mean that you hand your body over and "you gets what you gets"?

I didn't try to persuade her of anything, I simply asked her to email me her details and requirements and that we would speak again if she wanted to go ahead. Forgive the natural instinct in me to plan a hundred different ways to explain to her why she might need to know about giving birth and why an epidural shouldn't be her default setting. My tongue was firmly bitten and I knew I would give her the information that she asked for and be prepared to talk about birth in her entirety. Sadly, to date, she has not emailed or called again. I'm reasonably sure that my palpable shock hadn't reached through the phone wires.

What have we done that women are so afraid of birth that they don't want to talk about it? Is the prospect of a drug free birth that terrible?

I was talking to one of the mums at school. She has two children and is thinking of having her third next year (or at least trying for the third for next year). Naturally (well you birth junkies will know what I mean) I asked her how her first two births were. The first was a twelve hour labour that seemed to stall in the middle. She arrived at hospital and was 5cm dilated. She was still at 5cm several hours later. She was exhausted and had an epidural. She relaxed, her body opened up fast. They told her to push but she couldn't feel her body and didn't know what to do or how to do it. When she was told by the doctor (after fifty mins of pushing) that she had ten minutes to get the baby out or she was having a caesarean, she pushed and her daughter flew out. For her second birth she stayed home longer but when she got to hospital and they told her it would be hours, she opted for an epidural again. The baby's heart rate plummeted and he went into distress. Again she pushed her baby out. This labour had also lasted twelve hours. Another of the school mums was walking with us and said, "I hope you got all the drugs!"

There are a fair few default settings that puzzle me. To give birth you need an epidural. To birth twins you will not go to term and you will need a caesarean and NICU. To birth a breech baby you will need a caesarean. You cannot have a home birth after a caesarean. I do not say that having these things are wrong. I am just puzzled that they are the default setting.

The information is out there. There are antenatal classes, blogs, facebook pages. I tell my ladies not to google. I think that too much information is a bad thing, but is ignorance bliss?

Reverting to the age of three

2011-05-05T01:27:00.001+01:00

Today I realised that I spend an awful lot of time asking one question. WHY?

When I meet my potential clients I ask them WHY? they want a Doula. It's not because I don't want to be their Doula, but I want to be sure that we are on the same page. Some, but not many, are looking for someone to "fight" their hospital battles for them. As a Doula I am there to help my clients make informed choices. I point them in the direction of research based evidence and encourage them to ask the WHY? question.

Then I ask them WHY? they have chosen their place of birth. This way I begin to understand how they think and feel about birth. Sometimes fear informs their choices and hides other options from them. They may have heard and/or absorbed all the scare stories about birth. They may feel that with all the horrors of birth they want to be as close as possible to doctors. Research based evidence gives them the opportunity to rethink their place of birth.

Today I was talking to a couple and Dad told me that he just wanted the safest option for his wife and unborn twins. For him the thought of a caesarean didn't scare him as much as the vaginal birth of twins. I asked him WHY? he thought abdominal surgery was the safest option. This gave him pause for thought and he's now looking at research based evidence.

My clients often show me their list of "things to buy for the baby(ies). They ask my advice as to what are the best things to buy. Again I ask them WHY? Why do you need that? Why do you want that? Why is it an essential? This allows them to step back and think about their lifestyle and the ways in which they want to bring up their children.

When we talk about how birth works and what happens when they are in hospital or at home with their midwives, I tell Dad that something to keep in mind is the question WHY? Why this procedure for my partner at this time, in her condition? Why is this good for our baby(ies)? Why are there, seemingly, no other options?

We talk about the postnatal period. My ladies often say that they are going to try to breastfeed and see how it goes. I ask WHY? are they going to try? This allows them to explore their relationship with breastfeeding. Are they coming from a culture of expected failure? How have their family and friends dealt with breastfeeding? Are there medical reasons why they may not be able to breastfeed? This encourages them to know where to go for support should things get tricky.

They ask me whether or not they should follow the different schools of parenting thought. I ask them WHY? do you need to follow any/all/some of these "experts"? This is to encourage them to remember that THEY want the best for their baby(ies) and that parental instinct is not to be sniffed at.

Remember, my job as a Doula is not to make decisions for my clients, but sometimes that is exactly what they want me to do. So when I ask WHY? what I'm doing is asking them to think about their choices.

My youngest, now 7, still asking WHY?

Raise your glass

2011-04-24T10:01:00.004+01:00

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

Let's Trade Shoes

2011-04-16T17:13:00.001+01:00

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?

Subcontracting our parent instincts

2011-04-14T00:22:00.001+01:00

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.

The Death of Birth

2011-04-06T11:21:00.001+01:00

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?"

Mothering Sunday

2011-04-03T00:00:00.000+01:00

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.

HAPPY MOTHERING SUNDAY!

Handing back the keys

2011-03-30T15:01:00.000+01:00

This week I finished working with one of my twin mums. I had been with her about nine weeks in total. I started working with her three days a week, then we slipped down to two and eventually to one. She had given me a set of her house keys in case I arrived when she had gone back to bed with the girls.

Of course to ensure her love and devotion I started my time off with a lemon drizzle cake and a homemade cheesecake. I made a couple of lovely vegetarian meals (she had no meat in the fridge) and made sure that she had lunch and supper every day that I was with her.

In this time she would go back to bed with her girls and sleep. Wonderful! Just what the Doula ordered. Eventually she began arriving downstairs before lunch and we would chat or she would do a couple of bits. Then I would arrive and she would be awake having had a decent(ish) night's sleep. Of course this would be the time that her three year old suddenly decided that sleep wasn't really an option. Then she began popping out for a swim, or to get in some shopping because they wanted an extra large lasagna or a lamb tagine for supper.

At the beginning her lovely husband would leave me notes. Simple notes showing his priorities.

Dear Mars
A and the girls had a rough night. Could you make sure she has a good breakfast and one of your lovely lunches? Have bought ingredients for a fish pie. Could you make a chorizo and lentil stew? Oh and if you have time, one of your delicious lemon cakes.
Have a good day.
N

I knew that she was ready to say goodbye to me before she did. We both knew, however, that her husband was not. So we decided that the following week would be my last and that I would bake a farewell chocolate and banana cake (favourite of the three year old). As I finished I handed back the keys. Such a lovely family but I was glad to say goodbye. Not because I didn't like them, or want to work with them anymore, but simply because it was time for her to take back the keys and continue her transition into Mother of three. I feel so satisfied when I know my ladies are good to go. I work to make myself obsolete and when I am, well I smile.

And as that door closed I began working with another family. Singleton baby. Dad has gone abroad with his work for a week. And so for another lady I am feeding and watering her and sending her back to bed. I'll put a wash on, hang a wash out, take down and fold the laundry. We'll talk about cluster feeding and whether or not it is normal for a baby to wake and look at you like it's party central at 3am in the morning.

I take the keys and go to the butcher's, the supermarket, the chemist. I will mother my mothers.

Here's a little something by Gloria Lemay

Crossing a new threshold

2011-03-20T00:03:00.001Z

It's funny the things that trigger my trains of thought. I was just reading through blog posts and article shares on Facebook when I came across a great share by Invisible Midwives, Broken Birth and Developing Doulas. The article was a from The Daily Mail. Imagine that, the Daily Mail with a positive birth story.

It was a lovely story. I love hearing about birth in all her glory, but hearing a simple birth story is wonderful. And it made me think about the things that women have said to me about birth. I've met with women who have told me that they have low pain thresholds so they won't be able to birth without drugs. What makes me smile is that in the five years I've been a Doula, those are the women who seem to "breeze" through it.

I have been blessed to witness what I can only call "silent" births. Ladies who have gone down into themselves as they labour. They turn off their thinking brain, they shut out the outward stimuli and they become one with their bodies. Now I'm no hippy by anyone's standards, but I can and do testify to the amazing power of their births. One of my ladies, whose story is on my website was keen to have a normal, natural birth. She went into labour and was calm and serene, gently contracting away. We arrived at the hospital birthing centre to be told that she was only a few cms dilated and that she should go home. Fortunately the birth centre was very quiet and I managed to persuade the Midwife to let us hang around a bit. I sent my lady and her husband for a walk. She was soon back as the contractions had built. She either walked about the room or stood in the corner as the surges washed over her. She listened to and trusted her body. Then she made three long, low, bovine noises and the Midwife said "Yep. Things are happening". And within a short wee a gorgeous baby boy was born.

Another of my ladies used gas n air throughout her labour. She fell asleep between contractions. She was sure that she would want an epidural and so it was rather wonderful to watch her snooze her way through labour. Her husband had a huge grin on his face the whole time. At one point the Midwife said "she's really going to have to wake up to have this baby you know". She had a beautiful daughter.

One of my ladies whose birth ended with a caesarean section also laboured quietly through. The labour was long and hard, but she breathed her way through it and had the caesarean when it was clear that this baby wasn't making an entrance any time soon. She feels (in common with another of my section ladies) that hospital was the reason why her contractions were ineffective and kept stalling. She had contracted pretty well at home. She's due a second baby soon and has elected to have a Homebirth (HBAC) and yes, I'll be there for that one too.

Most of my ladies that labour silently don't believe me when I tell them afterwards. They are mostly convinced that they were screaming like banshees. Often a Midwife will not believe that they are in labour because of their lack of noise. It's why I think that it is important to look at the whole woman when she's in labour. Her mouth may say nothing, but her body speaks volumes. I love the Midwives that quietly watch the Mum and gently put things in place for her. It's a special skill to be able to sit on ones hands and wait. Some people have a real need to be doing something, anything all the time. Pregnancy, birth, breastfeeding, child-rearing... it's all about waiting.

Doubly blessed

2011-03-17T13:46:00.002Z

Happiness is mine today!

This weekend I was off call. Oh how lovely to be off call. I've been really busy for the past fortnight supporting three mums of twins. The first mum was doing brilliantly. Breastfeeding was (and still is) going well. The second has one twin who is feeding like a champion and the second has had problems latching on and taking her milk from a bottle. The third is my mum with the boys born twelve weeks early. One of her sons came home and was having some difficulty feeding, the second fed well in the hospital but it didn't work out once they were home.

With each of my visits I have tried to encourage and support to the best of my ability. I have cooked, sent them to bed, kept their spirits up when breastfeeding seemed to be going awry.

What each of these twin mums have in common is the negative opinions of many others. They have been told at various times during their pregnancies and postnatal periods that breastfeeding twins is going to be at best difficult but more likely, impossible. And so the first barrier to successful twin breastfeeding is formed.

Now why do people do that? I mean we have two breasts and with two babies it seems simple. Perhaps it is their own experiences of breastfeeding or their own perceptions. Whatever the reasons, it is a barrier that needs to be broken down.

The second twin mum I've been supporting has plenty of milk. All she has to do is to look at one of her babies and her milk flies across the room. You may think that I exaggerate, but (for a wee change) I do not. As second baby girl is not as good at the breast as her sister she gets some of her feeds from a bottle. Mum puts the pump to her breasts and in less than 5 minutes has filled two containers with milk. Honestly, she could feed an entire neonatal wing on her own. When I first started with them a few weeks ago Baby girl 2 did not go to the breast. Her sucking action with both breast and bottle was not good. I suggested Cranial Osteopathy because it was clear that the issue was not a lack of supply and so it had to be another reason. The lovely Miranda Clayton visited her at home and discerned that there was a weak muscle issue with the baby and wondered if it might be to do with the fact the babies were born at 38 weeks and perhaps Baby girl 2 needed a little longer. Whatever the reason, with some treatment from Miranda and encouragement from me, Mum has had success with breastfeeding Baby girl 2. Baby girl 1 feeds beautifully and needs no encouragement.

My third lady has struggled from the beginning. First the boys were born 12 weeks early, then she was told that one of the placentas had been left inside her after the birth. Now the progesterone levels are high during pregnancy to maintain it and when the placenta has been retained (or left inside), lactation is delayed because of the powerful inhibiting influence of progesterone. In short, breastfeeding is difficult to establish, or in her case, expressing was rather soul destroyingly minimal. As the boys were tiny and premature and the objective was to get them big enough there was plenty of supplementing. When the placenta was discovered her milk production increased but her confidence in her ability to produce enough milk for two was shot.

My role with her was one of faith. She didn't have enough faith in herself so I held it for her and she leaned in my direction. Little by little the milk production increased and the babies' ability to suckle and feed increased. Now the amount of artificial milk is rapidly decreasing and she is beginning to feed them both almost exclusively from the breast.

So, the reason for my happiness? I got two texts over the weekend. The first from lady 3 which read "I did it! Can't believe it myself... I breastfed both together, all by myself, J still asleep :D they r sleeping like angels now...". The second, from lady 2's husband, said "Lady 2 is feeding both babies together for the first time".

So like my ladies, I am doubly blessed.

When the Wee Weapons were tiny

Being part of the Village

2011-03-17T00:53:00.000Z

My lovely friend Maddie Mahon is a sister Doula. She recently blogged about why she does what she does and that has inspired me to copy her (best form of flattery apparently!)

The best way that I can tell you why I do what I do is with stories of my ladies. Yes I know this whole blog is full of stories of my ladies, but what you gonna do? You know I'll tell you anyway.

After the first Doula birth I attended Dad said "I only agreed because you are a friend, but I don't know how we did the first birth without you." Proof I was in the right job.

Another birth: I was called to a client's induction. She was 8cm. She had had an epidural. The male midwife (and before you say "here we go" my favourite midwife is a man... hmm... that smacks of "some of my best friends are [insert group you are insulting]) looked me up and down and said "Why do we need you here? How many births have you done?". At that point I'd done 50. He said "Oh I had to do that many to qualify. I've done over 200 now". I realised that this man felt threatened by me and my presence. My lady wanted to change positions and he told her it was impossible. I asked why. He replied "Who is delivering this baby? Me or you?". I couldn't help myself I said "I thought Mum was birthing her baby". At 10cm he began to direct her pushing. He never looked at her once. He began to count. She began pushing, but it wasn't to his count so he got cross, told her off and started again. Suddenly it was shift change time and he left. He had destroyed her confidence in herself, her body and her ability to birth. Talking to him, asking questions, trying to shield my lady simply made him more stubborn and actually the best thing for my lady was for me to be silent and hold her hand. The new midwife was lovely but the damage was done. The most brutal forceps delivery I've ever seen followed and consequently the baby had real breastfeeding issues. I spent days afterwards with Mum and baby working on the feeding. Finally they were good to go it alone and my time with them ended. A year later I got an email from her. She said "You may not remember me but you were with me at the birth of my son. I just wanted to thank you for your support and to let you know that I'm still breastfeeding a year on."

Twin birth: My lady wanted to have a vaginal birth as normally as possible. The hospital told her why it would be impossible. They were insistent that she gave birth with an epidural and that she laboured and birthed in theatre with quite a contingent of staff. She knew what she wanted and she refused. In the end a compromise was reached, she was allowed (you really should hear what Mary Cronk thinks of the word allow/ed) to labour in a birthing room but had to transfer to theatre for the birth. She was allowed (there's that word again) to use gas n air only as long as she realised the risk of needing a general anaesthetic should the second twin go into distress and she was allowed (and again with that word) to have a minimum number of staff at the birth. She laboured beautifully and quickly. She mentioned labour had started (early) and that she was in hospital. I wandered over slowly because she said that there was no rush and within the hour (minutes before I arrived) she was 10cm. I met her as she was transferring to theatre. The wonderful Consultant put sheets up against the windows to stop the students peering in and turned off a very annoying machine that was continually beeping. My lady gave birth to two gorgeous boys using only gas n air and got a standing ovation from the staff. They were amazed and hadn't thought it at all possible. My lady booked me for the birth of her daughter a couple of years later.

One of my favourite postnatal jobs was with a second time mum. She needed someone to take care of her and maybe watch the baby whilst she slept. Her older son was at nursery. I would arrive and we would chat whilst I began cooking. She was a wine buyer so there were plenty of wines to be used in the cooking... oh how I loved the cooking. She would take the baby upstairs, feed him and go to sleep. I would listen to the radio and sing whilst cooking. When my time with her came to an end her husband promised to buy an aga for me to work on if I would stay. We're still in touch. No aga yet though.

My twin mum with boys born 12 weeks early had breastfeeding difficulties and just a few days ago managed to breastfeed them both at the same time with no help. She thanked me for having faith in her.

I could go on... but there are many stories. Some with beautifully easy births, some with horrendous births. Some with postnatal needs that were simply about being fed and sent back to bed, others with breastfeeding issues. The end result is always the same. Happy ladies, happy babies, happy me!

Why do I do what I do? I love people and if I can help make things a little easier and leave happy ladies and babies (and partners) in my wake... well do I really need another reason?

Sister in the house

2011-03-12T14:09:00.000Z

I spent Wednesday working with a mum to be who is suffering from Pelvic Girdle Pain (PGP). The poor darling has been on crutches since the beginning of January and the baby is not due for a few weeks yet. I cooked up a storm. It was so lovely to open a fridge full of food and a store cupboard full of spices. Wonderful. But I digress...

It had been a long week to date (long fortnight really) and I was getting to be beyond tired. So I made my first mistake... I planned an early night. I should never plan an early night. As soon as I do it is bound to fail.

I had a call from my early March client (a repeat client) to say that she was having erratic contractions. So an early night was a good plan in theory. I'm convinced she saw me lay my head on my pillow because as soon as my eyes closed... the phone began to ring. Her husband was on the line. The contractions were getting worse and they didn't feel safe with their midwives. Could I go immediately? Of course. I jumped out of bed with a fond "farewell pillow" glance. I grabbed my book, a bottle of water, my ipod, my keys and my homeopathy kit (in case she wanted to use it). I called the cab and was off. It was 11.30pm.

When I arrived at the house F, her husband, welcomed me with a big hug and kiss and a whispered "Thank God". I hugged her mother and immediately introduced myself to the two midwives, one of whom was a Sister/Nun belonging to a religious order (I forgot to ask which order... daft Doula). I explained who I was and they looked at me as though I had interrupted something. Mum was upstairs on the bed contracting away. The MWs had been unable to give her a vaginal exam because the pain was too much. This meant that MW1 wouldn't let her get into the birth pool because in her words "protocol says you have to be 5cm or I can't allow you in the water". MWSister meanwhile, was trying to find the foetal heartrate by continually prodding Mum with the handheld sonicaid. She did not turn it off when she was finished so the calm, quiet room was filled with the hissing and the hum of her electrical aid.

I could tell that the dynamic was wrong and that Mum was fearful of giving birth. Dad told me later that the MWs hadn't introduced themselves and that both he and his wife had hoped they would leave. So my job at this birth was to calm the "troubled waters" and provide a sense of safety for Mum and Dad. Dad was no retiring wallflower. His protective stance was one to behold (and stay the right side of).

Mum was breathing through her contractions nicely. Dad was breathing with her and reminding her to relax and to keep doing the wonderful work she was doing. Grandma was going in to settle their 3 year old son periodically. MWSister kept attempting to get the foetal heartrate and calm was restored each time she had. Me, I was re-reading Pride and Prejudice (which is on the Kindle app on my phone) and waiting.

After a while I suggested to Mum that she might like to use the toilet to empty her bladder a little. My main thought was that a little mobilisation would be good for both her and the baby. She had been rocking on on fours on her bed for a while. Getting up was really good for her. She didn't manage to empty her bladder but she did feel the benefit of the short walk and went downstairs to the birth pool. MW1 still wasn't happy about her getting into the pool so Mum and Dad stood beside it and the contractions continued to build apace.

Mum decided (with some gentle persuasion from me) to let MW1 attempt to check her progress. I have to confess I wasn't sure why MW1 needed to as many of the community and homebirth MWs I've worked with are pretty fantastic at looking at their ladies and knowing roughly where their labour is at. So, we moved over to the couch but Mum refused to get on her back for the exam and told us... "she's moving down. She's almost here." At this point evidence of her pushing began to be seen and a discreet wiping up of debris prompted MW1 to say she might as well get in the water.

Oh the looks on MWSister and MW1's faces as Dad whipped his kit off (leaving a fetching pair of cloth boxers on for our modesty) and got into the pool with Mum. She held on to him and breathed. Oh it was such a beautiful sight. Neither MW knew quite what to do, but there was nothing that needed doing. They were simply having a baby. Just thinking back on it fills me with shivers. It was amazing. This was a husband and father's love in action. Dad said "I can feel her coming". The MWs and I reminded Mum to keep her bottom in the water for the birth. It wasn't long before a wee girl slipped into the world at 2.23am. MW1 had been shouting "Don't touch the baby as it comes out, you'll stimulate it!" then when she arrived she shouted "Grab the baby. Bring the baby up". I leant in to Mum and said "Take your daughter. Bring her up into the world". MW1 reached in to look at the baby and to look at the cord. Dad asked her to stay back as he was unwrapping the cord from around his daughter. Mum put her new daughter to her breast where she almost instantly began to nurse.

Eventually Mum and Dad got out of the water to await the arrival of the placenta. MW1 wanted Mum to hand the baby on to someone else, but Mum held her tight and with Dad's support they went upstairs to the bathroom. A bowl was popped into the toilet and we waited for the placenta whilst Baby Girl fed. The MWs stayed downstairs having asked us to let them know when the placenta came. After about an hour MW1 called up the stairs to say that she would have to give the syntometrin injection because it had been more than an hour. I looked at Mum who said "It's coming now" and with a loud whoosh, the placenta dropped into the bowl. It was huge!

Mum and Dad went back to their bedroom where MWSister did the quick baby checks and weighed Baby Girl. Mum, Dad and Grandma all cuddled in bed as the MWs gathered their equipment and left.

What I love about homebirths (apart from the miracle that is birth of course) is Mum, Dad and Baby curled up around each other in bed.

When I left the house was full of wonder and joy. Another beautiful birth and a Baby Girl with no set name. I was thinking Mars!

Pre-natal to Paternal.

2011-03-05T01:08:00.001Z

This evening I've been thinking a lot about breastfeeding. Nothing new there I know. I spent the day in Rex The Great British Cafe. The gorgeous poached eggs on muffins and smoked salmon with the delicious hollandaise sauce was not the only reason for my visit. I find that I study better when I'm not at home. Funny how appealing cleaning the oven/fridge/Wee Weapon's room becomes when there's studying to be done. I was reading about the trends in Breastfeeding and the Tides of practice <frantically looks at study book to check that that was indeed today's topic of study> and then I checked in on my facebook business page. I had commented on How Breastfeeding Works' link about male perceptions of breastfeeding. She suggested I wrote something about how antenatal knowledge helps Dad in supporting their partner with breastfeeding.

So... here are my thoughts (of course it's a blog so the majority of the thoughts will be mine).

I run antenatal sessions with the lovely Rebecca. We specialise in private antenatal sessions in people's homes. We cover breastfeeding in great depth and we feel that it's important that Dad/the Partner knows how breastfeeding works as well as Mum. Let's face it, in the middle of the night - and it's always the middle of the night - when Mum is exhausted and breastfeeding seems harder than it's ever been, Dad wants to rescue the situation. "Darling, it's enough. You've tried hard, this isn't easy. I'm going to go out and get you a bottle. This can't go on." If, however, Dad understands how breastfeeding works, he might take a different tack. Perhaps he'll remind her not to make decisions late at night. It's always worse at night. Perhaps he might rub her shoulders, bring her a drink, tell her how wonderfully she's doing, arrange to call an IBCLC in the morning. Don't be fooled by those with celebrity endorsements, get the real thing, not an imposter. He will support her wish to breastfeed and, using the knowledge he's gleaned antenatally, may be the reason she breastfeeds for one more day.

I confess to finding it strange that often men are excluded from the breastfeeding portion of antenatal classes, perhaps that has changed and the exclusion is less common than I think. Mum's partner is her chief Gatekeeper, or the harbinger of doom. A good partner will know when to encourage and when to gently steer Grandma, Mother In Law, Sister, Friend, Father of "recent baby who has done this all before so listen to me" away from her and encourage her to find her way with feeding. If he has been present at the breastfeeding sessions he will know the importance of stimulating the milk supply and the intensity of those first few weeks. He won't be so quick to rush to the shop.

Too many times I've heard people say "but it's not fair on Dad for Mum to be the only one to feed the baby". Really? It's not fair? Has Dad become redundant suddenly? There are so many things that Dad can do to encourage and increase his bond with the baby. All those nappy changes, baths, massages etc encourage skin to skin time and allow Dad to know his baby. I know that they just want to be supportive, but sometimes that is counterproductive.

It's all about the knowledge really. Dad needs more than glancing knowledge at how it all works. Sadly we don't live in a society where breastfeeding is the cultural norm. We are beginning to see more and more women breastfeeding and it's so lovely when men look on appreciating the art of breastfeeding rather than ogling the breasts. As the Fathers learn about breastfeeding, so will the sons. As they support their partners through pregnancy, birth and the postnatal period we'll see breastfeeding return to its rightful place. Bogstandard and normal.

Happy World IBCLC Day!

2011-03-02T18:56:00.000Z

What?????

Happy World IBCLC Day!

What on earth is an IBCLC? An IBCLC is an Internationally Board Certified Lactation Consultant.

An IBCLC is the person you want should you find any bumps in your breastfeeding road. This is also the person you might want to speak to antenatally if you've heard how hard breastfeeding is going to be. Maybe you've found out that you're having multiples and you want to speak to someone who knows about feeding multiples or any one of her colleagues. You can find IBCLCs across the world.

I was talking to a Postnatal client today. She's from Norway and has beautiful twin daughters. She told me that in Norway breastfeeding is the cultural norm and therefore it wasn't until she came to England that she realised people had issues with breastfeeding. What a wonderful way to live, assuming that breastfeeding just happens and problems are rare. Much preferable to our society's determination to make it seem more difficult than it ought to be. Don't get me wrong, I know that there are reasons why some women can't breastfeed. This I fully accept. I work with these women. I've seen the baby that wouldn't suckle and nurse for 12 weeks, the allergic twin, the "nope, I don't get it...wait (2.5 weeks on)... I get it now" baby. I've seen mastitis, engorgement, low supply, over supply and breast abscesses (I won't link that one. If you don't have it, don't google it. NOT pretty!)

In an ideal world there would be no need for a Doula nor a Lactation Consultant (International or not). However, this world is not ideal and therefore I am able to have a career that I love and adore. In July I will sit the 6 hour IBCLC exam and if I've done enough work, revision etc and not gone into meltdown on the day, I will join the honoured ranks of the IBCLC.

For now though lift a glass with me and give thanks for that person that helps smooth the bumps in the road.

HAPPY IBCLC DAY!

First Loves

2011-02-26T17:31:00.000Z

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.

Cut to the chase

2011-02-20T22:11:00.001Z

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?

Television Birth

2011-02-14T23:03:00.000Z

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.

Just dropped in

2011-02-06T16:28:00.002Z

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

Boy Child. Man of the Match

Long distance relationships

2011-01-29T16:24:00.000Z

Now I'm sure you all know that I love love love my job. So when a friend messaged me to tell me that his wife was feeling fed up as she was now 9 days past her Estimated Due Date (EDD), well what was I to do but offer to help if I could. I suggested acupuncture, booking in treats to while away the time, relaxation etc. He told me that she'd had a bit of traumatic time for the birth of their first and so I offered to do a quick birth de-brief. I ended saying... "of course you'll probably find she goes into labour before she calls me later".

So of course, just before she called me... she began early labour. So it was a brief chat as we talked through her options and the things that she might find helpful. Later that evening I got a message saying that they were in hospital and she was 2cm dilated and her waters had gone. Fab news. I gave the advice I would normally give, eat small bits regularly, drink well, pee at least every 2 hours. I also told them that sideways walking up and down stairs was good for opening the pelvis and encouraging the baby to descend. The reply came that I was mad! Within 40 mins the next message said "You're good!"

I love that I am able to support people even from a distance and so fell asleep feeling very happy. I did tell them to let me know when the baby came no matter what time it was. I got a text a 5.48am to say that their daughter had been born and that all was well.

Yesterday another friend messaged to ask if I had meant my offer of breastfeeding support as she had some questions. I said that she could call. So we talked about positioning and the best way to support the baby at the breast. She wanted to know about expressing so that her husband could help out. We also talked about how milk supply is established and the fact that her 3 week old daughter would now be going through a growth spurt. She put down the phone satisfied with my help I think and I smiled the rest of the day.

I think that the key to support is the being there, whether physically or at the end of the phone/text/email and I am glad that I am able to be there.

Met a couple this morning who are looking for a birth and a postnatal Doula. I told them to take some time to make their decision and they called a few hours later to say I was their Doula. Happiness.

And another text from my friend and his wife "Thanks so so much for your comforting advice. You are special."

Now that's what I call a good day.

Just a few hours old

Some time for me

2011-01-26T19:01:00.004Z

My on call started two days ago so booking a theatre trip was a bit risky, albeit a small risk. I adore the theatre. I booked tickets to see End of the Rainbow at Trafalgar Studios. To say it was sublime is to understate matters. Tracie Bennett was, in my eyes, superb! Wow but I could see Judy Garland up there on the stage.

Today I had a rare day off and so I chanced my arm again and went to John Lewis on Oxford Street where I had booked the lovely Kay Ross, one of the Fashion Advisers to help me choose some new dresses. Well a woman gets bored with the contents of her wardrobe sometimes. A full bag and an emptier bank account later I was on my way home.

Once the children have been fed and watered I shall be turning my hand to making marmalade (oh and roasting a duck because I have a yen for some duck tonight).

So whilst I'm waiting for the Toad in the hole to cook (the Reprobates turn their noses up to duck... well except Number One Son who eats everything) I find myself thinking about my ladies and the ones who do well.

The ones who do particularly well have one thing in common. They recognise the importance of rest once their babies have arrived. They go back to bed and sleep when the baby sleeps. If they can't sleep they pop their feet up and either watch DVD boxsets or flick through trashy magazines. Make a nest, have the phones (if necessary) to hand alongside the tv remote, some snacks and drinks.

Once a baby is born, the temptation is to shrug it off as though you'd done no more than a gentle stroll around the park is high. Family, friends, dare I say society (or is that the latest celebrity to give birth) both show and tell new mums of the importance of not letting the baby rule their lives. "All you've done is have a baby. You're not sick". We're so used to rushing from one place to the other and maybe our work is high velocity. Slowing down isn't easy. It's important for Mum to sleep. Growing, birthing and nuturing new life is more work than you think.

Don't worry, you'll be back to late night salsa dancing before you know it. As for me... the sausages are done!

The wonderful Tracie Bennet in End of the Rainbow

The Proof Is In The Pudding

2011-01-22T00:45:00.000Z

Today I was doing a postnatal job for a lovely mum of twins. Gorgeous little girls. I arrived at 10am and mum and girls went back to bed.

I turned on the radio, emptied the dishwasher and began to cook lunch and supper.

When I do a postnatal job like this the first challenge is to work out what to cook. So, I opened the fridge and saw chicken, grapes, cucumber, spring onions, single cream, fennel, celery, mushrooms, feta, milk and eggs. In the cupboard there were chick peas and kidney beans alongside rice, couscous and pasta.

I can see you all trying to work out what you would have made. Well my first thought was "Hmm... chicken with grapes, no wine... um..." My second thought took me to my secret weapon, Lady Calm.

Lady Calm is my chef extraordinaire. She is amazing!!! She can create a menu out of anything. I list the ingredients in a text, she replies with menu suggestions. She'll even text me the recipe if I ask sweetly. Of course the wonderful thing about my cooking relationship with Lady Calm is that she rarely gives quantities and I rarely ask. We must cook in the same way... a bit of this, a dash of that, a quick dollop here, season, good to go!

Today's menu was baked fennel and cream with chicken and rice plus a bean salad with feta. So that was supper sorted and after thinking about the mushrooms for a while I text for a simple mushroom soup recipe.

"Sweat off onions, garlic and celery in butter, add mushrooms and herbs (thyme or rosemary are good). Top up with stock bring to boil and simmer for about 30 mins. Puree and add seasoning and some cream to finish" came the reply.

Gotta love her. Yesterday it was chickpea cakes and couscous for supper and a feta and broccoli frittata for lunch. I also made a cherry cheese cake (Thanks Lady Calm). On the first day I made a vegetable pasta bake and a lemon drizzle cake.

I've been banned from making cakes more than once a week because they're too delicious! My bad!

My ladies think I'm wonderful because I can create something out of nothing from their food stores. Of course I agree but then I know my secret!

Train of thought

2011-01-20T11:50:00.001Z

Last night I went to visit my February couple for their second Antenatal visit. This was to talk through breastfeeding and how they were feeling in the run up to the birth. I love these visits. The excitement becomes more palpable. Of course this is also when I remind them that term is 37-42 weeks and that perhaps they should think about the 42 week mark as the Due Date.

So I hopped onto the train and grabbed a discarded copy of The Evening Standard and two articles, in particular, caught my Doula eye. The first NHS reforms will put babies in danger, says midwives' leader. The article goes on to talk about how the change could lead to different standards of maternity care in different parts of London. It continues on to talk about the lack of Midwives and "increasingly complicated pregnancies". Now this is scary reading, particularly if you are a first time expectant mum (or indeed a mum several times over). When people share their labour and birth stories they don't tend to be the "well I didn't make much noise, short labour, easy pushing stage, glorious birth, breastfeeding was easy" stories. They tend to be the "[add expletive] horrible, painful, screaming, intervention, emergency caesarean, cracked nipples" stories. So headlines like this will resonate through the "birthing community". All of that, however, doesn't take away from the news of the midwife shortages. We have never been further from One Woman One Midwife. It is truly saddening. It is also the reason so many women are turning to Doulas.

My attention was then immediately drawn to the picture Miranda Kerr, wife of Orlando Bloom breastfeeding their son. This was a picture that she posted on her blog where she shared her birth story. It's a beautiful picture and one, I agree, that shows relaxed breastfeeding and should serve as an encouragement for other mothers. Of course people will jump on this as an example of another celebrity trying to tell us how to do things. When you consider that neither Ms Kerr nor her husband announced the birth of their son in the media, you do have to wonder exactly who is trying to tell "us" how things should be done.

It is such a crying shame that breastfeeding is so slammed in many quarters. There is big money to be made in the commercial baby food industry. In my own opinion the lambasting of breastfeeding and the ignorant cries of "bitty" when a woman is seen feeding her child are the ones that inform society. This needs to change. Just another view from the BMJ.

Me in scrubs having attended a caesarean

Silent Phone

2011-01-15T12:59:00.000Z

So here I am, sat in bed. My phone is silent. That's a good thing. It means that none of my ladies are in need of me (did I mention my god complex?). I'm not on call. I've said that several times haven't I? It's good not to be on call. I can sit back and relax and do some of those things I like to do without interruption.

But I confess! I'm bored. There are times when I long not to be on call, but there is no pleasing me. I keep checking my phone to make sure it's not broken. I scrabble around in the bottom of my inbox to check for missing messages. I look through the pictures of the babies that I've seen come into the world. I play around with the photo slideshow on my laptop.

<Interrupts for quick scream of pride/joy/elation. Number One Son has just had his third University offer. So far Manchester, Nottingham and Leeds have seen the brilliance that is my boy. Just waiting on Exeter and Bristol. I think I may burst!>

So what will today bring me? Lots of time with Breastfeeding and Human Lactation and as I read through the chapters I'll be testing my knowledge with the online tests. Then I'll need to find someone to talk to about what I've learnt so that I know it's grounded in my mind.

And talk about "talking too soon" my Christmas Eve lady just called. She has a problem with oversupply. Of course this is a "good" problem to have. Her baby is growing well and she is happy. So a quick conversation, signposting good websites including the wonderful Dr Jack Newman and How Breastfeeding Works. So all should go well there. I look forward to the update.

Calls like that simply serve to make me want to study more and to gain my IBCLC status. I am keen to get it because I love learning and I want the shiny badge. Also, I want to formalise my knowledge so that I can speak with authority (for my benefit) when things outrage me. I also find myself devouring blogs such as The Analytical Armadillo and reading whatever I find.

Time to study! I've answered a call. I've called the world to share my pride. Now back at it.

Did I mention Number One Son got three offers????? lol

My family (the ones I actually birthed)

2011-01-10T00:29:00.001Z

As I've mentioned a time or two... I'm a mother of five. Boy, girl, girl, girl, boy! Number One Son is 18, Miss Thing is 16, Space Fairy is 12 and The Wee Weapons, Lady Baby and Boy Child, are 7 in February. It seems only fair to tell you of my own birth experiences.

Number One Son was born by caesarean section back in 1992. I remember watching Hook the night before he was born. I had a backache and couldn't really settle in one place. I had done no antenatal classes and so was rather unprepared for what was to come. At 7.30am I woke with lots of intermittent pains and set off to the hospital. Oh the joy of hindsight! I arrived at Chase Farm Hospital where a midwife (who I can only describe as incredibly large with enormous fingers) gave me a vaginal examination, laughed at me and told me that I was only 1/2cm dilated and shouldn't make a fuss. It was the 15th December and the hospital had wanted to induce me (Christmas was looming after all) so I wasn't sent home. Instead a pessary gel was inserted and I was left on the antenatal ward. Because I had been told off by the admitting midwife I tried hard not to make noise as my contractions built. A passing midwife came over to me as tears ran down my face. She asked if I was alright. All I could do was shake my head and cry.

I was moved to the labour ward where I was given an epidural (I didn't have the wherewithal to ask about other options and my lack of knowledge also meant that I didn't know to ask). I had progressed to four centimetres, but didn't budge from there. Number One Son didn't like the epidural and his heart rate plummeted. I was whisked in to an emergency caesarean and six and a half hours after my labour started my first son was born. I lost two litres of blood during the caesarean and had to have a blood transfusion through the night. Number One Son was cared for by midwives and his first feeds were formula milk. I had no knowledge or real care as to what was happening to him. I was completely out of it. The next day he breastfed like a champion and after five days I was allowed home.

Miss Thing was born just under two years later at The Whittington hospital. Like her older brother her labour started four days after her Estimated Due Date. I remember that they gave me Pethidine for her birth. I didn't like floating away from my body, and I could still feel the pain. As with her brother's labour I was stuck at 4cm. I could feel the dread that the same scenario would be repeated. This time, however, the midwife broke my waters and I progressed very quickly. I remember constantly asking if Number One Son was watching Sesame Street and being told that he was. The cord was wrapped around Miss Thing's neck twice and tightly. So it was cut and she was ventoused out rather quickly. She lost a lot of blood and had to be taken to SCBU (Special Care Baby Unit) where she would have a blood transfusion. And so my second baby was separated from me after birth. Like her big brother, however, she also breastfed like a champion.

My gorgeous Space Fairy was born at the end of a hot summer four years later. I remember having a bit of a back ache the day before but not thinking much of it. Her brother and sister had been born four days after their EDDs so of course I knew that Space Fairy would be another eight days in arriving. I woke with a real need to clean. The rest of the family were sleeping and I didn't want to wake them. I spent the beginning of my labour loading the washing machine, cleaning the sink and doing gentle squats as the dull pain filled me. In the end I called the hospital and apologised for not knowing whether or not I was in labour. I got the usual advice, have a hot bath and take a couple of paracetamol.

I remember travelling to the hospital but not really having many contractions at all until I pressed the button at the entrance to the delivery suite. Then my contractions rolled over and over me causing me to bend over double. I was sent to the bathroom to provide a sample and told that the delivery suite was full but that I'd be fine as I probably had a while to go. It was a sheer force of will that got me out of the bathroom because the contractions were intense. In the end I was found curled on the floor in the corridor trying to get back to the Midwife's station. I remember hearing them ask if anyone had seen me and I couldn't make my tiny squeak heard as I whimpered "I'm here". Space Fairy was my easiest birth which is funny because the Midwives and Doctors thought she would be enormous and that I would need a Caesarean. I was using "Gas n Air" which my Midwife took from me because she said it wasn't helping me concentrate on pushing her out. This baby stayed with me from the start and like her siblings, breastfed beautifully.

The Wee Weapons were a different birth entirely. Finding out that it was twins was enough to send me into hysterical denial. I'd always dreamed of having four children. Five was taking the mickey somewhat. My blood pressure shot up at seventeen weeks and so I was monitored closely and I remain amazed that my arm retains any blood. As I was at risk of Pre-Eclampsia it was decided that I should have a Caesarean section three and a half weeks before my EDD. It was a very different experience to my first section. It felt cold and clinical. I remember looking at the babies and wondering if they were mine. I didn't feel the same emotional rush as I had with the others. I know now that when a woman goes into labour oxytocin flows and that hormone is the love hormone. Again my babies were taken from me, after I had seen them briefly, whilst they were being checked over. Boy Child was the big twin at 5lbs 14oz and he was also the one that was taken away for three hours of observation and no-one came to tell me how he was doing. Lady Baby was away from me for about an hour, all 4lbs 5oz of her. Their first feeds were formula because "well they're twins and they're so tiny they need help". Again my current knowledge tells me that I could have breast fed and expressed straight away. We were home a week after their birth where, despite the doubts of my Community Midwife, I breast fed them.

So there you have it. My birth stories. I wish I had known what a Doula was because I could have done with one for each birth. Of course my own experiences have simply informed the way that I practise and I encourage my ladies to know their options. I think it also explains the joy I have when I see Mum and baby/ies tucked up together after birth.

Miss Thing, Boy Child, Number One Son, Lady Baby & Space Fairy

Think Twice

2011-01-09T10:47:00.000Z

I'm a mother of twins. They are babies four and five in my household. It was a shock when I discovered there were two babies growing inside my womb. I laughed for a long time and it was not so much joy as hysteria. Of course looking at them now, they are seven next month, I cannot imagine my life without them. They really are a double blessing.

Those earlier days of pregnancy were filled with the not so helpful comments of some passerbys. "You're huge!" "Is it twins? It is! Oh my goodness." "Double trouble." "Did you mean to get pregnant with twins?" ad nauseum. This didn't end with their birth. Strangers seemed compelled to ask "Were they ivf?", "Did you know it was twins?", "Ooh you've got your hands full", "I know someone, who knows someone, who knows someone with twins. It's really difficult, you're going to need lots of help", "Are they twins?". It was tempting to walk with an A4 leaflet answering their many questions, my two favourites being "If you tell me how your children were conceived in intimate details..." in response to the IVF question and "No they're triplets. I left the ugly one in the car" as a witty riposte.

Of course that's just one of the blessings/curses that comes along with twins. When you've had a hard night they are not best appreciated, but when you're on top form you just smile knowing that you're rather clever for producing two at once.

There are some bigger things to think about when it comes to a twin pregnancy and twin birth. And long before the mother of singletons you find yourself having to make decisions and future plans. What type of birth will you have? Where will you have it? Assumptions are made that you will have a caesarean birth, use a maternity nurse/night nanny and bottle feed. It is easy to feel overwhelmed with it all and sometimes it is hard to see anything positive in the middle of the harbingers of doom.

Well take a step back. You have time to make decisions. At the beginning just enjoy being pregnant. Enjoy the fact that you have growing more than one life. Put the worries aside, surround yourself with the positive stories. Don't listen to labour stories until you have your own to share (something I tell all my mums). Take a deep breath. Twins! A double blessing!!

My babies four and five. Reception year.

Today I became an Honorary Grandma

2011-01-03T21:47:00.000Z

Now at my..ahem.. young age, Grandma is not something I aspire to. Today, however, my twin dad told me that the support I had given and continue to give to him and his wife is priceless. They wouldn't be where they are today without it. He said that the highest compliment he could think to pay me was that I was "Grandma" to his children. This was the man who was initially sceptical about the role of a Doula.

Now... I know what he's saying... and I thank him for it, but one of my friends said

"Grandma? You? I don't think so - that young man needs his eyes testing! He needs to be aware that he has a rascally, getting up to no good, fun! fun! fun! auntie for his lucky twins!"

Of course I have no idea what she means lol!

What a great start to the year. The boys are doing well, one still needs lots of care but the second is growing well and gets more and more kangaroo time with his mum.

Another of my ladies whose baby didn't get latching on for the first few days is doing very well and feeding at the breast more and more.

A current client, due in February, called just prior to Christmas because she'd been told the baby was breech. She text to say that her daughter is now head down.

My early March client is a repeat client. Looking forward to catching up with her and the family as we look towards the birth of her second. All going well. My late March/April client initially wanted my Welcome Home Package but after we met she decided, with her husband, that my Birth and Postnatal Package would work better for them. I love it when I get to support them pre, during and post birth.

My repeat client for May wants a homebirth after her first was born by caesarean section. She's well read and knows that with the right support it can work.

I'm looking forward to 2011. Seeing old clients/friends, supporting new clients and watching some of them become friends.

Yeah... I think I'm getting what I hope for. It's certainly a great start to a new year.

What will 2011 bring?

2010-12-31T19:22:00.000Z

I'm just getting ready to go out and party. Well I'm no longer on call and there's Caribbean food and dancing calling my name.

And my mind has, naturally, drifted forwards to 2011. Birthwise I'm booked through May. Two of the bookings are from repeat clients. There's something wonderful about a couple choosing to use my services again. It's the ultimate testimonial. Some of my past clients have moved abroad. One emailed to tell me that even though the birth was very different from what she wanted (caesarean section) I was still supporting her. One of her friends had found my "How To Make Your Caesarean Personal" on a parenting forum and sent it to her. Others emailed to tell me their news and tell me that my support the first time round allowed them to have similar births. Some moved away after I had supported them a couple of times (not taking it too personally lol) and have said that they won't have more without me. I'm up for first class tickets to a luxury destination in order to support them :wishful thinking:

What do I want in 2011?

Well the current economic climate has made it quiet for Doulas. I give thanks that I'm booked up. I know some who are struggling and so giving up Doula-ing in order to get work. That saddens me because I truly believe that women need and will continue to need Doulas. Postnatally there isn't much work about. People are tightening belts and getting by. Of course this quiet allows me space to study and to read, but I do miss it. My Mum says that the reason I love being a Doula is "because [I] have a lot of knowledge and [I] like to share it!" There's a lot of truth in that.

So my wish is simple. Yes I wish to keep working, but as I look forward I want my ladies to have boringly normal births. No high dramas, no dramatic arrivals. Just bog standard birth! I want their babies to be healthy and strong. I want my mums to be filled with confidence and joy. I want my dads and partners to see the amazingness that is birth and to feel pride in the ones they love.

I know it may not be that way. I know that some will not have the births that they want, but I'll be there. Supporting in all circumstance.

A repeat booking came in last night, so I'm on my way to the 2011 I want.

For now... excuse me... need to get dressed and put my lippy on! I can hear the music and the food smells good!

What a birth!

2010-12-30T02:11:00.000Z

I love waterbirth. Really love waterbirth, especially home waterbirths. The babies seem to be so serene afterwards. I may have mentioned how much I love it when they rise to the top of the water in their mother's arms. Gorgeous. And I love the fact that the water creates a natural barrier to the world so that mum can get on with the business of birth.

Some of my favourite waterbirths have been etched in my memory. It doesn't take much to bring them back to life in my mind.

One is used as a birth story on my website MammyDoula. Sara's story has brought many potential clients to my door. One told me that she had tears streaming down her face reading it. I find it hard to believe that that beautiful baby is now 3 years old. And so gorgeous still. I'll never forget Sara vaulting into the water as soon as the Midwife said it was okay. Who knew pregnant women could leap so high!

Another of my ladies laboured beautifully at home and when we arrived at hospital the Receptionist made the mistake of trying to direct her to the labour ward (she was booked into the Birthing Centre). Whilst her husband and I tried to be diplomatic and make nice my lady said "I don't need to go there. I'm going to the Birthing Centre". The Receptionist told her she would have to wait to be collected by a Midwife but my lady was already gone, leaving her husband and me trailing in her wake. We arrived at the Birthing Suite and my lady burst into tears (transition). "I knew it would be too late. I didn't get a water birth the first time and I won't get one now". The Midwife filled the pool as quickly as she could and even before it was ready my lady climbed in. "Push your bottom down" the Midwife cried, "At least push your bottom down". A beautiful girl shot into the world and was so keen to say hello that she swallowed some water which meant an overnight stay in the hospital.

A repeat client laboured really well at home and was 10cm (fully dilated) but had to go to hospital because of a previous retained placenta and blood loss. She had negotiated a waterbirth at the hospital as a compromise. Her wish was a home waterbirth. In the end being at the hospital was a good call because she had a large postpartum haemorrhage. Before that, however, she got into the birthing pool. It was the weirdest hospital birth pool I had seen. It had the feel of a private sauna in an exclusive club. The tiles were black with "glitter". We kept laughing, even as we tried to maintain a quiet birthing space. It was also the first time I had seen a Midwife try to practise directed pushing. My lady zoned her out and listened to her body and breathed her beautiful daughter out. She was in the water for less than 30 minutes.

My first waterbirth almost wasn't. E had gone into the hospital to be checked because she had seen some blood. It had been her show. She had had a sweep early that week and been told that she was 2cm dilated. She called to ask me what she should do, she sounded very tired. I suggested that if they let her she stay and sleep and see what happened. Her husband went home and I ordered a Chinese. Of course she called as I lifted the fork to my mouth. I arrived at the Birthing Centre and she practically yelled at me "GIve me a [add expletive] epidural!" I reminded her that the pool had filled and maybe she ought to give it a quick go. She got off the bed and had 2 big contractions. She climbed into the pool and gave one push and her son was born.

They're not all quick. Some of them are slow and steady. One Mum laboured long and slow in the water. In the end she came out of the pool and the Midwife was ready to transfer her to hospital when the baby finally arrived. For her second birth she thought she'd give the water another go but she had little faith that she would give birth in it. Less than 20 minutes after getting in her second son was born.

Another had my lady falling asleep, that's how relaxed the water made her. But the ones that make me chuckle are where Mum gets in the water, telling me that she's not sure it will help. The water soothes them and makes the pain seem to float away and then suddenly they are holding their babies.

Yes. I love waterbirths, long or short. They are definitely my favourite.

Possibly my favourite ever waterbirth, certainly two of my favourite people

How did I get here pt 4

2010-12-28T22:04:00.000Z

So, the presents are opened. The turkey is almost finished. The lazy days are well and truly here. I, of course, am missing being on call and being with my ladies. I know... I look forward to my off call times so that I can go to the theatre etc without having to keep an eye to my phone.

Who knew when I first started this journey that I would become so passionately committed to it.

After I had done my first "official" Doula birth I was raring to go. I remember sitting with one mum whose husband couldn't sit still at all and suddenly went out to get a curry mid labour. Mum and I both laughed. She felt that she had been a bit fraudulent as her labour stopped when I got there, however when she was relaxed the contractions came back strongly.

Eventually we moved to the birthing centre at her local hospital where she had a beautiful waterbirth. It was the first waterbirth I'd seen and it was magical. I adore waterbirths. Watching the baby rise up towards its mum is so fantastic. Oh I could wax lyrical for ages!!

Now I had to do four births (at a minimum) to get my Recognition with Doula UK. In the end I did five. One was a caesarean section. I had to fill in lots of paperwork and get my clients to fill in some more. Once that was done I had to visit my Assessor Mentor to debrief the births that I had attended to talk about what had happened, what I had learned and what I could still learn. I am so glad that Doula UK have their Recognition process. It really helped shape the Doula that I've become. I often call a lovely Doula friend to debrief the births I've attended and I know that my AM is available, even now, whenever I need her.

We are all told, at Doula UK, about the importance of study and so I attend workshops and courses that help me on this journey. I've attended breastfeeding workshops, breastfeeding courses and talks on birth etc. I read. Oh my goodness how I read. Ina May Gaskin, Michel Odent, Frederick Leboyer, Marc Weissbluth and any number of lactation books such as Breastfeeding and Human Lactation. The list is long and I wouldn't want to bore you, but I love it all and I read books, articles online etc etc.

The place I learn most about birth is at the actual births themselves. I have been to completely natural and physiological births, medical intervention births, inductions, caesarean sections and a crash caesarean section. I have even "caught" a baby when the labour progressed far faster than either Mum or I were aware. I have been at and supported those mums whose babies have decided to come many weeks early.

I love the strength of my birthing mums. I love seeing the dads rise to the challenge of unconditional support. I've been with mums as their sole birthing partner and with couples as a quiet presence in the corner of the room.

Do I have the best job in the world? How on earth can I be unbiased about this? Of course I do.

It's not always easy

2010-12-27T00:54:00.000Z

People often tell me what a wonderful job I have. I agree. I think it's amazing that people allow me into one of the most intimate moments of their lives. What a privilege, one I hope never to betray.

Sometimes though, it just ain't easy!

At the moment I'm worried about my twin mum who gave birth 12 weeks early. Her mood is low. The shock of the early arrival of her boys, the lack of touch, spending time in hospital over Christmas and not really leaving the building... well is it surprising?

I don't know how to help her. I have a desire to put it right. I can't. To be fair it's probably not my place. That doesn't stop my desire. Once I become someone's Doula, they have me for life. You may worry about my stalker abilities but it's the way I feel about my families. No call too trivial. Just as happy to discuss the pros and cons of cotton wool balls versus pads or optimal positioning for babies in the womb.

Just a couple of short months ago I took a call from a past client. She'd text me to tell me that she was expecting her third baby, a little unexpected but such a wonderful blessing. Within two weeks she called and I cried as I heard her miscarrying on the end of the phone.

Being a Doula is about supporting the parents, particularly the mum. This support is not dependent on healthy mum and child. This is about being there for the good and/or bad. I'm fortunate. The good far outweighs the bad. I've cried for twins born too soon that didn't make it and for mums holding a surviving twin. I've also cried tears of joy for the babies that I've seen enter the world and I've thanked God for their safe passage into this world.

I've been proud of the mums who struggled at the beginning but made it through. Today I had an email from a twin mum who found it so hard at the start. People told her why it would be difficult or impossible. I was at the end of the phone for her and she breastfed those boys for 10 months until a medical condition meant she had to stop. I've had emails from mums who were still breastfeeding a year on after the most traumatic of births.

I love my job. It brings me the most joy and the deepest heartbreak but I wouldn't change it for anything.

Being a Doula... It's not always easy.

Happy Christmas!

2010-12-25T09:58:00.000Z

The baby is born.

The presents have been unwrapped. The turkey is in! Off to my sister's with the children.

This Doula is not on call. Let the merriment begin!!

:D

What a turnaround!

2010-12-24T20:11:00.002Z

So it's Christmas Eve!

Early yesterday morning I got a call from my lady. Her waters had gone. It was 6.30am. Okay, being on call over Christmas brings the risk of having to work on Christmas Day, but it looked like all was okay and that I was going to squeeze the birth in by the skin of my teeth. I cancelled the back up Doula, grabbed my bag and was good to go.

I arrived at my lady's house where she was contracting nicely but not ready to leave for the hospital. We settled in and her contractions began to increase, so much so that she was insistent on going to the hospital. Her plan from day one was to have an epidural. This is quite an unusual choice for a woman who uses a Doula, but my role is one of support, not decision making.

On arriving at the hospital we were told that her cervix wasn't yet open and that she would have to return home as she was in latent labour. She wasn't very happy, but we went back home. About 8 hours later her contractions were good and strong and lasting over a minute and coming every 3 minutes. So, we hopped a cab back to the hospital. The cab driver spent the majority of the drive telling us why we should have called an ambulance.

Back into the hospital again. Met a lovely midwife from earlier that day. Client examined, cervix barely open. 1cm dilation. The cervix needs to dilate to 10cm before the 2nd stage of labour (the pushing) begins. I don't think devastated is quite the term to describe how disappointed she was. We were sent home again. Now this rarely happens, mostly because I'm good at keeping my ladies at home but also my ladies tend to want to stay home until they practically feel the baby coming. We were both disappointed and my lady was getting very very tired. I don't mention my worry that perhaps I would have to miss Christmas with my children.

Home again and the contractions were falling off. One of her friends was going to stay with her so that I could pop home to wrap Christmas presents and get some sleep to be fresh for the next day. The hospital wanted her in for a 7am induction as it would be 24 hours after her membranes had ruptured (waters gone). As it drew closer to the time that I was to leave she suddenly begged me to stay. Remember, Doula in it's original state means female slave. So stay I did. I slept badly on cushions on the floor. Not a good look.

She slept on and off and contracted through the night. We called ahead to the hospital who told us to come in at 8am. We arrived to find 2 other couples waiting, 1 for a caesarean due to a breech presentation and another couple who looked like labour was progressing rather nicely. At 8.42am they took the labouring couple to a room and the section couple went off to be prepped for theatre. At 9.00am we heard that the labouring couple had had their son. Fantastic.

At 11.30am we were finally shown into the room where my lady's birth was due to take place.

At 1.50pm the lovely midwife finally gave my client a vaginal examination. She frowned a little and said that she would need to get a doctor in to confirm her findings, an undiagnosed breech presentation! At 3.10pm a beautiful baby girl was born by caesarean section. Not what Mum was expecting but a happy end to over 36 hours of intense on/off labour.

After ensuring that mum had successfully breastfed baby I left and have come home to wrap Christmas presents, prepare Christmas stockings and basically collapse in a heap!

Christmas a season of great joy and one mum in particular is smiling tonight!

My lovely lady Tamsin and her daughter Matilda born May 2007

Doula-lly

Progression

pro·gres·sion

Failed!

Waiting on a baby

Baby Blue and all the hullabaloo

Happy New Year

Happy Christmas!

What's the cost of a Doula?

A tale of two births

Pregnancy. A time to relax and enjoy.

A sad day for birth

4:4:1 (part 2)

4:4:1 (part 1)

Nip and tuck

Breastfeeding Twins Pt2

Letter to my firstborn

Ask Me About Breastfeeding Twins (part 1)

Don't let them tell you birth's not beautiful

What's a guy to do?

Keeping abreast of the matter

When Doula-lly went Dou-la-la!

Whizz pop bang! (A brave new world)

A glorious weekend

When breastfeeding goes well but all goes wrong.

Hold on... I'm coming!

Is ignorance bliss?

Reverting to the age of three

Raise your glass

Let's Trade Shoes

Subcontracting our parent instincts

The Death of Birth

Mothering Sunday

Handing back the keys

Crossing a new threshold

Doubly blessed

Being part of the Village

Sister in the house

Pre-natal to Paternal.

Happy World IBCLC Day!

First Loves

Cut to the chase

Television Birth

Just dropped in

Long distance relationships

Some time for me

The Proof Is In The Pudding

Train of thought

Silent Phone

My family (the ones I actually birthed)

Think Twice

Today I became an Honorary Grandma

What will 2011 bring?

What a birth!

How did I get here pt 4

It's not always easy

Happy Christmas!

What a turnaround!