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Bodily autonomy and the information we are not given

This post is sparked by my personal experience (it’s Amy here, in case my hilarious t-shirt below didn’t give that away) and also from listening to women talk about their journeys with contraception.
 
Grab yourself a brew (and maybe some biscuits) because this is a long, winding road to a very broad but important point – bare with me.
 
 
Let’s talk about contraception (and information and consent and bodily autonomy… because it’s all part of the same point)
 
Being doulas, you might think that the topic of contraception is a little out of our remit but (as I have so succinctly concluded in the subtitle) that is not the case.
 
As doulas and feminists, we respect every woman’s right to choose what is right for her body, so naturally, the topic of being informed and choices being respected is at the very core of what we believe in. Also, being full-spectrum doulas we support women before they are pregnant and long after they give birth so it does come up a fair bit.
 
 
Let’s start with sex education
Way back in school (Elle would like to point out that it wasn’t that long ago for me), we were only ever told about two or three methods of contraception. We learnt a bit about the pill, maybe a bit on the injection and of course, everyone remembers the demonstration of how to put a condom on a cucumber or banana or any other object that doesn’t look like a real penis so that the teacher doesn’t get embarrassed. I’m guessing it wasn’t all that different for you? But this isn’t enough. If you’re going to teach young people about sex and contraception, you have to tell them all of their options and what each one entails. For example, I don’t remember anyone telling us in school that the longer you are on the pill, the longer it could take to get pregnant once you stop taking it. This might seem like a very way-in-the-future conversation to have with children, but who else is going to tell us that? Especially considering lots of women go on the pill from a very young age. “Wouldn’t that be the healthcare professionals job?” I hear you ask… the answer is yes, it definitely is, but that doesn’t mean that they will fulfil that expectation. The other HUGE gap (or if talked about at all, misrepresentation) in sex education is birth, but that’s a whole other rant.
 
My personal experience with contraception
Over a period of about four years, I tried two different types of the pill and the injection before deciding to have a detox because the hormones were having a very negative effect on my mental health. The side-effects are different for everyone but the general consensus of women I have spoken to is that there is at least one pretty rough down-side to every hormonal contraception option.
 
Condoms were the only other option (that I knew of) – our readily available, non-hormonal, trusty, 98% effective friend. However, it took one of these trusty little guys to split for me to end up seeking emergency contraception. For me (and many women have a much worse time of it), that meant I had to wait about 4 hours at a walk-in clinic (feeling alone and nervous), complete an incredibly personal face-to-face questionnaire and brush off several judgemental ‘I don’t believe you’ looks, for someone to finally tell me about the copper coil! I listened intently as they told me how it was hormone-free, had very few side-effects, could stay in for 5 years (some stay in for 10!) but can be removed any time I want, it doesn’t stall fertility after removal, and it is more than 99% effective…
 
 
…SHUT THE FRIDGE!!
 
Why in the hell had nobody taught me about this option before?! I had suffered through years of hormones messing with my brain, my skin, my personality. I got it fitted that day and four years later have not regretted it once. Now, it sounds like I’m just trying to sell you all on the copper coil, that is not my intention. It works for me and I love that, but the point of my rant is…
 
Why did it take so long for someone to tell me all of my options? Who decides which methods of contraception are offered to us first? If we are born into a religion that believes abstinence is the only way – where do we get the information to decide for ourselves? If our parents decide that sex is too difficult a topic and tick the opt-out box on the sex education form, where do we learn about our body and the changes we are going to go through? Why should other people get to decide what information we get about puberty, sex and contraception? It’s the first step towards bodily autonomy and nobody wants to talk about it! Maybe because bodily autonomy isn’t something that society wants us to have. Working as a doula has taught me that.
 
This power play continues throughout our lives, with anything to do with women’s bodies from contraception, boundaries, birth and beyond.
 
(Sorry, it took me a while to get to the point! Have another biscuit…)
 
From a friends experience
A few years ago, before I was no longer shocked by the controls put on women and their bodies, my friend was seeking the morning after pill at a pharmacy. She had gone to the only pharmacy open that Sunday morning, she steeled herself, walked up to the desk in the not-so-private supermarket aisle where the pharmacy is located and told the pharmacist what she wanted to purchase. There was no medical reason for her to be unable to access the morning-after pill, but the pharmacist said no. He said that he could not dispense the pill because of his personal beliefs.
 
 
I couldn’t believe this was legal, especially with something as time-sensitive as the morning-after pill. I furiously googled it and found that yep, apparently, pharmacists have an opt-out clause which gives them the power to inflict their personal views onto others, potentially causing an unwanted pregnancy. Technically, if a pharmacist exercises this ridiculous clause, they are supposed to offer an alternative, but what good is that on a Sunday when nowhere nearby is open and the customer can’t drive? That’s a pretty risky clause to have, don’t you think?
 
So I have a few questions; would a doctor who is a Jehovah’s witness have a clause to opt-out of giving a life-saving blood transfusion because of her/his personal beliefs? Does a doctor who is Jewish have an opt-in clause to enforce circumcision on all babies because of his/her own beliefs? Is the opt-out clause used for anything other than emergency contraception, or is it a clause solely to deny women the right to decide whether or not to have a baby?
 
Now I am wiser I know that actually, professionals impose their personal opinions on women all the time, it’s just usually less obvious. For example, during pregnancy when something is offered to you (because it is just an offer, even if it doesn’t come across that way), that midwife or doctor should be giving you ALL of the information, the risks, benefits and alternatives, for you to make an informed decision about your care. This very rarely happens, and what we can assume from this is that the person giving you the partial information is deciding, based on their personal views, which information is more important for you to know, and what can be left out. This does NOT equal informed consent. 
 
The patriarchal society that we live in has assumed that women’s bodies, and the decisions women make about those bodies, are to be monitored and controlled. Constant protesting of abortion, the hoops we have to jump through to access all types of contraception, the scare-tactics used in pregnancy and the birth room – it is all about controlling women. Strong, independent women who are able to make informed decisions and stand their ground are a threat to that control. Information is power, and withholding information (or more directly, actual medical care such as the morning-after pill), is to take away a woman’s power.
If we take away a woman’s control of her own body, we are telling her that she is not important and that her body is not hers to be in control of.
 
What does this teach young girls and women about consent? What does it teach us about boundaries? What does it teach us about our power?
 
(and yours too, if you want us to!)
 
 
 
 
 
Resources related to this post:
 
– The most recent changes I found on the opt-out clause (2017):
 
– The Lloyd’s Pharmacy article:
 
– Some fascinating for and against comments from pharmacists about the opt-out clause:
 
– The NHS contraception guide:
 
– Info on the copper coil (IUD):
naomi's positive vbac
Birth, Birth Story, Doulas, Uncategorized

Naomi’s positive VBAC story

Naomi contacted us recently about sharing the birth of her second baby Amelie. Her son Dylan was born by caesarean but second time around she planned for a different experience. With the support of Amy, she had the positive birth she had wished for and we hope that Naomi and her story inspires you as much as she does us.

For the previous two weeks I had been getting lots of braxton hicks and had lost my complete mucous plug, but was determined not to get my hopes up about going into early labour as I went a week overdue with Dylan and I found it so hard waiting. I tried to keep in my head that I would go overdue this time too so that I wasn’t disappointed. I went to bed on the Tuesday evening and had absolutely no signs of labour except from my bump had dropped quite low throughout the day (I was 39+2). I slept so well and got a full 8 hours sleep.

naomi in the pool with gas and airMy alarm went off at 7.45am to get Dylan up and ready for nursery, so I snoozed and got him up at 8 and Ben got in the shower. I shouted through to Ben in the bathroom because I got such a big pain in my stomach but wasn’t sure what it was as I didn’t think I could get such a painful contraction with no build up. He carried on showering and I found myself bent double over our bed breathing through 4 contractions in 10 minutes with poor Dylan watching me wondering what was going on! So I shouted Ben again and he got out of the shower and got dressed and took Dylan downstairs.

I called maternity triage who could hear how regular my contractions were and how much pain I was in and they said to go straight to the birth centre there and then. So Ben called Dylan’s nursery to warn them we were on our way with him and that he’d not had time for any breakfast.  I called my doula Amy to let her know we were on our way to the birth centre, she said she would leave and meet us there. I also called my mum as she was supposed to be having Dylan while I was in labour but I asked her to come and see her granddaughter being born instead as luckily it had fallen on a nursery day!

We all got in the car for the most uncomfortable journey and we were so lucky that it was half term so there was hardly any traffic bearing in mind we were driving towards Manchester city centre in rush hour! When we got near to nursery I was in so much pain I said to Ben don’t take Dylan to his room, just drop him in the office and get back to the car quickly, I felt like the baby was coming soon.

naomi giving birthSo 10 minutes later we arrived at the birth centre and Amy my doula had just arrived before us. The midwives took us into the most gorgeous room with twinkle lights, soft waterfall sound effects and a big projector on the wall with waterfall videos, it was so relaxing. They got me on the futon to examine me and she said that I was 4cm dilated, fully effaced and my waters were bulging. She said I could get straight in the birthing pool and have the gas and air which I did. I forgot how amazing the gas and air is… the hallucinations! And the warm water was so soothing on my back.

I remember at one point feeling a bit panicky about my scar rupturing and asking the midwife if I was showing any signs of scar rupture. And then I panicked that the baby would get stuck like last time and asked her if the baby was back to back like last time. She answered no to both questions and reminded me that this was a different birth and to trust my body.

Amy made me 3 cups of tea which I downed in the pool, and we all had a laugh that I was alternating between gas and air and cups of tea (fab combination by the way!) Like Dylan’s birth, Ben was the official gas and air holder and my friendly face for when I was in crazy amounts of pain. Then as things were ramping up my mum arrived which I was so glad about. She was holding a cool flannel on my head and it was just generally soothing to have my mum there. I felt so safe surrounded by the people I chose to be at my birth and it was so completely different to my poor experience from Dylan’s birth.

Naomi, her partner and her newborn babySoon after my mum arrived my body started to push involuntarily. I didn’t need to be examined, I just knew that I must be fully dilated and my body knew what to do. I looked down between my legs as I thought I had pushed the baby’s head out but it was actually part of the sack full of waters that hadn’t burst yet, so surreal to see!

At this point the midwife used the Doppler and couldn’t find baby’s heart rate so very quickly her and the second midwife said I needed to get out of the pool immediately. I was so worried as it was like history repeating itself, they had to get me out of the pool as an emergency when I gave birth to Dylan.

As I got out of the pool I could feel her head crowning and the midwife could obviously see it too as she put her hand between my legs in case the baby came out! As soon as I was out of the water the pain was so intense as the gas and air had worn off and I had no other kind of pain relief in my system. I laid on the futon and begged for the gas and air but everyone was more focussed on the baby coming out so I didn’t get my gas and air back!

The next contraction came and I pushed so hard and her head was born, then one more push and she was in my arms crying! The sense of achievement straight away was just incredible and  I still can’t believe that I achieved a vaginal birth after so many professionals told me I couldn’t do it.

I also specified in my birth plan that I wanted a physiological third stage which I’m glad about as the placenta came naturally around 10 minutes later. We waited until the cord had stopped pulsating completely and Ben got to cut the cord this time which we were so happy about.

amelie

My doula Amy managed to get some amazing photos of the labour and birth which I’m so happy about as we only got one photo of when Dylan was born. I honestly feel like I would do it all over again, I’m so thrilled I got the birth I wished for all along. 

A perfect example of how listening to your intuition alongside the support of a trusted team who believe in you and your body can lead to a birth on your terms, despite the doubt of professionals. You are amazing Naomi! 

man and women with newborn baby in the bath
Birth, Birth Story, Doulas, Uncategorized

A healing second birth – Part 1

Our recent Wonder Woman was the lovely Jess, wild mother to Luca and Eden. We are lucky enough to be able to share her journey, from a traumatic first birth to the beautiful, healing home birth she had with her littlest one Eden.

Eden’s birth story Part 1:

During Eden’s pregnancy I knew I needed to work through many fears and unanswered questions from my first birth experience if I was going to birth in a way that felt positive and empowering this time round.

Woman with her toddler and a scan pictureI’d wanted a water birth with minimal intervention with my first born, but in the end he was pulled from me with no time for any pain relief. I lay on my back, pain like I’d never known, under bright lights with lots of people watching, I felt helpless and powerless. I tore awfully and had to leave my tiny newborn and go straight to theatre for 3 hours afterwards. Yes I know others have traumatic births and yes I did have a healthy baby, but I’m not ashamed to say it broke me. I felt horrendous. Cheated. Angry. Grief stricken. Violated. Unheard. Except I wasn’t supposed to feel this way. I was supposed to feel lucky, relieved and ecstatic that my baby was safely here and grateful to the doctors that had helped me. People told me how fortunate it was that I hadn’t had the home birth I’d been thinking about having. “Imagine if the doctors weren’t there to help”, they would say. At the time I kind of agreed with them, but I also had this niggling feeling that things could have been different somehow if someone had truly believed in me and if I had truly believed in myself, but I didn’t quite understand what that meant. My body felt like it’d been run over by a train. My mind raced with thoughts of inadequacy; I’d needed medical intervention to get pregnant (IVF) and now medical help to birth my own baby! How the hell was I now expected to trust myself to know how to mother?!

I know that some people reading this may feel triggered by what I’m saying. You may feel annoyed towards me for feeling this way because you had it worse or you wish you had the privilege of birthing a child or you feel differently – maybe you did feel completely supported by your doctors or that you’d never dream of birthing outside of hospital because you see it as a risk. Know that I respect you and I would never judge a woman by her decisions or feelings. I understand these are my own personal feelings and everyone is different. I would say that if any of my birth story does bring up a strong emotional reaction for you, that it might be worthwhile talking it through with someone. Feel free to PM me. Although I’m not trained I can signpost you in the right direction for support.

Anyway it was a long road of acceptance after Luca’s birth. Talking about it with people who understood helped so much. Also breastfeeding, being able to do something with my body to nurture him helped so much.

toddler holding a babyWhen I fell pregnant again, naturally this time, I knew I could never birth like that again. I thought about an elective c-section but it didn’t fit right. So I talked some more, I rehashed Luca’s birth again. I re-examined every part of it, including the lead up to it. More uncomfortably I looked at the responsibility I held in the events that took place. I studied undisturbed birth and accepted some truths about birth in it’s essence. I sat with lots of fears and what ifs. It took a long while to weed out what I truly needed to birth in power. In the end I came to accept my highest need was to be surrounded by those that knew me and trusted me and trusted birth as a process. I’m not sure if I ever fully voiced it out loud but I came to realise that in my current circumstances I felt most in alignment and empowered when I thought about birthing on my own,
and as it turns out that’s exactly what ended up happening!

To be continued…

Stay tuned for the next part of Jess’ amazing birth story! In the meantime you can find her on Instagram @these_adventures_of_ours.

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Lauren’s second home birth

This time 5 years ago I had just given birth to my youngest baby! Elle and I don’t often talk about our own experiences but the birth of my youngest taught me so much about the support I needed (and what I missed out on!) as a birthing mother and it was a huge part of my journey into doulaing so it feels right to share. If you fancy reading on you might want to get comfy with a cuppa as it’s a long one!

Going back to the night before, I was 40+4 weeks pregnant and beginning to wonder if labour was beginning. It was a Friday evening and I was just clearing up the spaghetti from dinner that my almost 2 year old had strewn across the table and floor when I felt the first twinges. As I wiped over the mucky high chair I remember suddenly being aware of a heaviness low down in my bump but as quick as I’d noticed it, it has stopped again.

Lauren the doula smiling and pregnant Was this the start? Not wanting to get too excited I carried on getting Theo cleaned up and ready for bed. 20 minutes later though…more cramps and this pattern carried on throughout his bedtime. Having experienced a long prodromal labour in my last pregnancy I figured I had a couple more days at least until I would be holding a new baby in my arms so after texting my doula to give her a heads up, I went to bed to try and have an early night. 

I lay in bed listening to my hypnobirthing tracks but sleep didn’t come. Instead the cramps built into more regular, stronger surges. I was definitely in labour! After tossing and turning for a couple of hours I couldn’t ignore it any longer, the surges needed my attention so I decided to get up, put my TENS on and head downstairs. Entering the living room I instantly felt relaxed and calm. The pool was up, the lights were low… this was my birth room, this was where I would meet my baby.

Throughout the night I rested on a makeshift floor bed dozing and watching Netflix as the surges gradually got more intense and regular. I bounced on my birth ball and breathed through every sensation, riding each wave until the peak passed. As they got stronger I remember going more within, no longer able to focus on what was going on around me in between each contraction, Labour Land was calling me and it was where I wanted to be. As surges built I needed to reach up, grabbing on to my birth partners neck and as the peak approached I would sink down into a deep squat, feeling the sensation spread over my bump and down my thighs, surrendering to the power within my body. Occasionally fear would get the better of me and I would tense as I felt another one starting… “Oh no not another one! Not yet!” Those were tough, but when I allowed myself to be curious and welcome the sensations it felt so different, intense and sometimes painful but not more than I could handle. Newborn baby sleeping

The early morning approached and I knew it was time to call my doula and get in the pool. She told us she was on her way and I relaxed deeper, knowing my chosen support would be here with me soon. When she arrived however, she had her young son with her! I remember being in the pool and looking up after a surge had passed and wondering why this little boy was in my birth space. Uninvited, intruding, not what I had expected at all. Seeing that I was very much in established labour, she suggested calling the midwives and left to find childcare. 

Theo woke up around this time and was the perfect little birth partner. He pottered around with his bowl of grapes, watching his Very Hungry Caterpillar DVD and occasionally toddling over to me to stroke my shoulders and head. They were such special moments. I carried on following my body, listening to my birth partner on the phone… “Yes, contractions are maybe 6 minutes apart”, I heard him tell the midwives. I knew they were much closer together than that. There was barely time for me to catch my breath in between but I was so deep within that I didn’t want to vocalise and engage in his discussion.

Lauren the doula pictured holding her newborn babyBy the time the midwife arrived and my doula returned I was bearing down, intermittently and involuntarily. I didn’t need anybody to do, I was doing it all by myself but looking back, I really needed someone to hold my space. I was in my labour bubble but I felt alone, not supported and held. The midwives were doing their notes, occasionally bothering me to check I definitely didn’t want any vaginal examinations, my doula was taking pictures, my birth partner was being dad to our toddler… I knew I could do it alone but I wanted to feel that they were with me. Making sense of these feelings though and finding the right words felt beyond me, I had surrendered and my body and baby had all of my attention.

Around 11am I felt the familiar sensations of his head beginning to crown, then the frustrating feeling of him going back inside! He felt so close but so far. I kept trying to  trust my body though and the relief when his head was born was incredible. Sadly, this is the point where things began to go awry…

Newborn baby breastfeedingThe midwives suggested I sit back so I could pick him up once his body was born and like a good girl I did as I was told. The next two contractions came and went and he hadn’t budged. I wasn’t worried but before I knew what was happening the midwives’ fear filled the space and without warning or explanation I was being dragged out of the pool. The next couple of minutes were a bit of a chaotic blur. As I got out of the pool he was born into the midwife’s arms, his cord cut immediately. An ambulance was called and cancelled and I remember feeling like a forgotten, empty vessel, having no idea if my baby was ok. There was absolutely nobody holding space for us and it was not what I had ever imagined would happen.

As quick as the chaos had started, it was over and he was in my arms searching for my breast. I had a physiological third strange and birthed my placenta ~15minutes after he was born. Theo tentatively approached, meeting his baby brother for the first time and surrounded by my two boys I felt more grounded again, rediscovering my centre as our new family life began.

Lauren the doula smiling and wearing her newborn baby in a woven wrapReflecting back on this birth now I’m a doula brings up so much and highlights what I believe are so important to remember when supporting a birthing woman. There is no doubt that it has shaped the doula I am today.

When Elle or I arrive at a birth we come ready to be present with the birthing woman in every way. We leave any baggage at home and have childcare plans for our childcare plans so we can serve her wholeheartedly.

When we are in the birth space we trust the birthing woman unreservedly. We don’t need to tell her which positions she should adopt or to intrude in any way without her permission. Her intuition is going to guide her better than anyone else, she is the ultimate baby monitor and knows what her body and baby needs.

In the birth room we are not always doing but we are always holding space for the woman and her baby. We are aware of when it’s right to sit back and crochet and when she might want us by her side. We know how to sit on our hands without making a woman feel ignored and abandoned. We are all about meeting her wherever she is at and serving her however she needs us to.

When we are with women we are mindful of our mission to support them to birth in their power. We believe all birthing women have innate wisdom and strength and should always be held at the centre of our work as birth keepers with unconditional positive regard, trust and reverence. Birthing mothers are magic!