Tag: birth support

Bum-first babies are not being difficult or awkward, they are simply comfortable. This doesn't need to be "fixed".
Birth, Homebirth

Bum-first babies are wonderful!

GMD Admin

Key points:

  1. Breech is normal and not something that needs to be fixed
  2. Birth works best, and is most predictable, when left well alone
  3. The statistics women are told about breech birth are all based on the hospital environment
Babies in breech positions are not being difficult or problematic - they are comfortable. This doesn't need fixing.

Women engaging in NHS care are sometimes being told the position of their baby every time they have a scan, and focus is regularly being put on the position from as early as 33 weeks. Despite the fact that the entire function of labour is to move your baby down and into the best position for them, this information is being sought way before labour without any thought to how it might impact a woman’s confidence – or have they actually put a LOT of thought into that and that’s WHY they do it? The same seems to be true for “low-lying placentas”. Women are being told at their very first ultrasound that their placenta is “low-lying”, which means it is within 2cm of your cervix, but this isn’t the same as placenta praevia which can be one of the very few true birth emergencies. According to the NHS, placenta praevia affects 1 in 200 pregnancies, which is 0.5%. But who knows what they actually include in that statistic if they’re also scaring women with “low-lying” placentas that are not and will not become an issue.


I got off on a bit of a tangent there (that didn’t take long, did it?) but there are so many similarities between the “concerns” that come up towards the end of pregnancy that it’s hard to talk about one without referencing others. Anyway, back to breech. Let’s just think for a moment about the space your baby has to occupy when they are still inside your body. They are pretty snug in there, and they are likely to move around a lot in order to stretch out different parts of their body in different ways. Apparently, most people change positions in their sleep 10 to 40 times each night, and for 50-70% of people their instinctive posture is flat on their back, but that leaves a significant number of people (up to half in some studies) who feel more comfortable, instinctively, in a different position. There is no normal, or right, or “optimal”. Breech has been used as a tool to scare women, break down their confidence and ultimately medicalise their birth.

Birth needs very basic things for it to go smoothly. The woman, like any other mammal, needs to feel safe, warm, undisturbed and unobserved. She doesn’t need to understand the mechanisms that are taking place within her body, much like she does not need to know the technicalities of an orgasm for her to experience one, and she doesn’t need to know what position her baby is in. Birth is safest when these basic needs are met, in any situation, so when we remove these basic needs (by going into a hospital for example) we are making birth less predictable. Why would it make sense to ignore these basic needs when there is a concern about the baby or the mother? The basic needs are not a cherry-on-top, if all else is well kind of thing, they are the very foundation of birth going smoothly.

There are lots of statistics about breech births, and they are often used to scare women into a scheduled caesarean (major abdominal surgery) purely because healthcare providers are scared. The studies that produced these statistics were carried out in hospitals, where women’s basic needs were not being met and they were surrounded by fearful care providers. So what does that actually tell us? Not much, except that interfering with birth is dangerous. I would be much more convinced by the data if it was comparing outcomes of mothers and babies (not just physical but emotional) who gave birth in hospital or at home with medical staff present, versus those who had freebirths. That would give a true picture of the impact of pathologising a baby’s position.

Okay, so let’s just talk about the way women are treated in the system when they have a baby who is bum-down. Firstly, she is told that this is a problem that needs to be fixed, either by attempting to forcibly move her baby the “right way up” by applying immense pressure to her bump, or by “admitting defeat” and booking a caesarean section at 38 weeks (before her body has chance to go into labour naturally).

External cephalic version (ECV) is a procedure that is designed to “fix” a breech presentation. This procedure can take up to 2 hours including monitoring and carries a risk of premature rupture of the membranes, placental abruption, preterm labour, foetal distress and vaginal bleeding, all of which would lead to more interventions. But don’t worry, one clinic reassures us by stating; “ECV is typically performed near an operating room in case an emergency c-section is needed.”, so if they cause an emergency at least they can solve it quickly. Women often endure this ECV procedure in the hope that they will then be supported to give birth vaginally, but the truth is that the fear of care providers will have a huge impact on the way they treat a woman during labour, and you can bet that her basic needs will not be met.

What can you do to avoid the position of your baby being a barrier to the birth you want? Don’t give that information away. When asked if you would like to have your belly palpated or measured, consider what information they are looking for and if it would be helpful for you (and them) to have it. When going for a scan recognise that they WILL see which way up your baby is and that regardless of how many weeks pregnant you are, this information might be used to scare you. What is the purpose of that scan? What are you getting from it? Could you get what you want in a different way? If you’ve already been told that your baby is in a “difficult position”, what are you doing to protect yourself from further fear mongering? How can you reground yourself and build your confidence back up?

A few ideas:

1. Surround yourself with women who believe that birth is normal, whatever way round your baby is, and have complete trust in you and your intuition

2. Practice saying no to things that do not serve you – the more you shut out the external voices, the easier it will be to listen to your intuition which will keep you and your baby safe

3. Come along to one of our groups and speak to other women who might have been in a similar position to you, or might have birthed a baby in a breech position completely unassisted

4. Speak to us about how you can navigate the system, or step away from it

 

Useful resources:

Hands off that breech! | AIMS

Coalition for Breech Birth | Facebook

Breech Without Borders | Facebook

Breech Birth UK

Birth, Resources

Writing Your Assertive Birth Plan

Amy
We often speak to women who don’t know where to start with their birth plan and have even been told more than once not to bother, but if you’re choosing to birth within the maternity system then we have a few tips for you!
 
Writing your birth plan isn’t just an opportunity to put clear instructions in writing for whoever attends your birth, but the process of writing it will bring up questions for you that you may not have considered before.
 
 
 
 
If you’re not sure where to start, or you have written your plan but want to make it solid, here are a few things that might help;
 

1. Plan for your ideal birth 

If you’re not planning for your ideal birth, then what are you planning for and why? If you start at the end, you can work your way back, figuring out along the way what will make your ideal birth more likely, and what might become a barrier. When you figure out those barriers, you’ll notice that most of them are within your control. By doing this, you will work out what your hard lines are and under what circumstances you might move to plan B (if you have one).
 
 

2. Remove the barriers at the earliest opportunity

 
Knowing what barriers might come up in pregnancy (especially around 36 weeks) and during labour is a really good starting point. If you are seeing a midwife and/or intend to have one at your birth, you can ask them what THEY would consider a reason to transfer to hospital. You can then look at that list and decide for yourself what your reasons would be. Growth scans, for example, are a big one towards the end of pregnancy so deciding for yourself how reliable you think they are, and whether that information is useful for you and would have a bearing on where you want to give birth – if it wouldn’t, then remove the barrier by declining the scan. Use the BRAIN acronym to decide what is working for you and what isn’t; BRAINsign
 
 

3. If you say no, you can always say yes later

 
Lots of women find that when it comes to vaginal examinations and monitoring, it’s much easier to say a firm no to all of it in your plan and at your appointments, knowing that if at any point you do change your mind the option is always still open to you. If you say yes to something you don’t feel comfortable with, you can’t undo that vaginal examination or doppler reading and it becomes much harder to then change your mind and find the strength to say no. It’s also always okay to take more time to think about something before you make a decision. The same goes for saying no to birthing in hospital, if you plan for a home birth then all of your options are still open to you, you can decide to go to hospital any time you like. It’s much harder, however, to decide last minute that you’re having a homebirth if you are inviting midwives to attend.
 
 

4. It’s good to be specific

 
If there were ever a time to be really clear about your needs, it’s during pregnancy. You might have really specific wants and needs – you’re not being fussy or awkward – express them! If it is important to you then it should be important to the people you are inviting into your birth space. For example, if you want a silent birth space, don’t say “please keep the noise to a minimum” because that isn’t actually stating what you need, and a midwife’s ‘minimum’ might be very different to yours. Phrases like “if possible”, “kept to a minimum” and “only if necessary” are incredibly open to interpretation, and makes it an almost pointless sentence because you’re then leaving it up to someone else to decide.
 
 

5. Write your plan for the worst midwife you’ve ever heard of

 
We hope that your interactions with midwives have been positive ones, but we also know that some do not respect birth as a bodily function that needs patience and privacy to go smoothly. Aim your birth plan at that midwife who is tired, twitchy and looking for any excuse to transfer you to the hospital. That way, if the midwife you’ve met a few times who is supportive and respectful turns up, she’ll totally get why you’ve written it that way. It’s a set of clear instructions on how you expect to be treated. You don’t need to ask permission (“please” and “if possible” are hinting at seeking permission) and you don’t need to be polite.
 
 
These are just a few ways you can write an effective, assertive birth plan. If you would like any support in writing or implementing your birth plan, or book in a holding space session to chat about your plans, please don’t hesitate to get in touch: hello@greatermanchesterdoulas.com
 
 
 
You can find our birth planning templates and examples here;
 
These assertiveness phrases may come in handy either in writing your birth plan, or implementing it if you come up against resistance; https://www.youtube.com/watch?v=kxGBEwFAGho
 
 
If you are struggling with having your wishes heard and respected, AIMS has a really good helpline and have some template letters that might come in handy; https://www.aims.org.uk/campaigning/item/template-letters
Uncategorized

Why it takes so much more than just hiring a doula to have a good birth

Amy

 

As we hear more and more about doulas, it’s easy to get the impression that having a doula will somehow magically lead to having a better birth experience. It often feels like one of the things on the ‘positive birth’ checklist; hire a doula, do a hypnobirthing class, read a birth book etc. and it’s true that having a doula can significantly reduce the risk of interventions and birth trauma, but that is largely due to the work that a woman does with her doula, and by herself, during pregnancy.

What we have learnt from women

Through our years of working as doulas in Greater Manchester, we have come to realise that birthing within the maternity system can and often will come with complications, barriers and difficulties. One of the best ways to combat these hurdles is to know what’s coming. Knowing how the maternity service works and knowing their policies gives you a head-start and also shows you that there are other options, such as birthing outside of the system. Knowing your rights and your options are the first steps to having a positive birth. A doula can support you in learning all of this, provide you with information and books on the subject, they can give you information about how the system works and how you can navigate it, and tell you all about the birth process, but it takes you to make the difference. 

Women who have had a traumatic birth in the past often come to us believing that their body failed them and that they need to do something different this time. Hiring a doula is a great start because it gives them the space to talk openly about what happened last time, a place to wonder whether those things were necessary or completely unacceptable, a place to cry and ask questions. Once women learn and start to believe that the process of birth is not inherently dangerous, and is not a medical event, it leads to an awakening that is incomparable. Getting to this point though takes a whole load of courage and openness from that woman, and when that woman is heard, she can find the answers she’s been looking for. So many of the women we listen to were having a perfectly normal, healthy pregnancy and labour until it was interfered with by medical staff, and realising that sometimes complications in birth are caused by the interference is key to protecting themselves against it. Their body did not fail them, the system did.

We have been programmed to think that authority means safety, but in so many instances we have been proven that in fact, the opposite is the case. When we trust someone else’s word over our own feelings of discomfort, we are left feeling violated. When we look to someone else for the answers, especially in birth, we are handing over our control and ignoring our intuition. We often hear in women’s stories that the parts that felt the most traumatic are when they went against what their body was telling them, and just did what they were told – so far I haven’t met a woman who regretted following her body. Our intuition is what has kept us alive and safe for so long, and birth is such a private and personal event that it makes very little sense to look for external approval or guidance. When we trust women, birth is safe. A doula is often the only person in the birth room who is solely focused on you, as the birthing woman, and having someone who completely believes and trusts in your body at that moment can make a huge difference to the energy. Questioning the authority of medical staff is necessary to get the birth you want, because going with someone else’s flow will inevitably lead you down a path that makes you uncomfortable or feels wrong. You ARE the authority, and you DO know best, even if you have never birthed before. Birth is a hormonal event and a normal bodily function – if you were monitored, observed and examined whilst trying to have an orgasm it probably wouldn’t go very well, would it?

Birth is led by the hormone oxytocin – as are orgasms – and for oxytocin to be released it needs the right environment. For women to release oxytocin they need to feel safe, warm, unobserved and undisturbed, so when you put a labouring woman in a brightly lit hospital with a bunch of strangers, unfamiliar loud noises and smells, and continue disturbing her with monitoring and examinations, it’s no surprise that birth takes longer or is more difficult. When birth is undisturbed, endorphins are released to match the intensity of labour as it builds – this is what makes labour pain manageable. When we interfere with the body’s natural pain killers, we cause more harm than good. Understanding what birth needs is a great foundation for planning where you want to give birth, and who you want to be there. Doulas can be really helpful in supporting you to navigate the maternity system when you are “going against medical advice” or just declining what you are being told is “how they do things”.

What we wish women knew before giving birth

We wish that all women knew that they were in charge of their body and their birth, that they didn’t have to agree to anything that feels uncomfortable or compromise with medical staff. We wish that women knew that birth doesn’t need to be fixed or monitored or sped-up and that they have the right to say no or to seek the care they are not being offered. We wish that women who have had traumatic experiences knew that they were not alone and that what happened to them was not okay. We wish that women weren’t expected to be “good girls” and do what they are told even when it feels wrong and that it’s okay to be “difficult” or “bossy” – in fact, that shows a belief in yourself, and the ability to assert your boundaries!

The work we do is to create the space for women to ask questions, to speak up and use their voice, to take what they need and to take back their power. We listen to women’s traumatic birth stories, we help them to write birth plans, we share information and experiences, we are behind them when they are navigating the system, or choosing to birth outside of it, and we have that unwavering trust in the birth process and in the woman in front of us. 

We support their choices, we hear their voices and we are privileged enough to witness their power.

But ultimately, what makes a positive birth is a woman who is ready to go deeper, to question what she is being told, and is fully supported in her decisions.

black Big Lottery Community fund logo banner
Funding, News

COVID-19 response funding from National Lottery Community Fund

GMD Admin

This week started off on an incredible high with the news that we are being awarded almost £12,000 in National Lottery Funding for our COVID-19 response project.

This is going to make a significant difference to women in our community and means that we can confidently offer fully funded support to any woman who wants and needs it.

Why have a COVID-19 response project?

It quickly became clear that pregnant women and new mothers are being hugely affected by the new measures put in place due to the pandemic. This includes restrictions imposed by individual Trusts, inconsistently and without first exhausting alternatives, in direct opposition to guidance from the Royal College of Obstetricians and Gynaecologists. There are also many doulas who are not able to provide their services to women in our community, and as a result, we have experienced an increase in the number of women asking for our support.

Women have the right to choose where to give birth and with whom, but those options are rapidly being taken away from them or made completely inaccessible, making women believe that they no longer have a choice. Women, now more than ever, need personalised emotional and informational support whilst navigating the maternity services in the state that they are currently in.

Women who report birth trauma are most often not talking about the physical birth process, but the way they were treated during labour and birth. During the COVID-19 pandemic so far we have already witnessed the stripping away of women’s options for labour and birth, and women are fearful of the consequences of the restrictions put in place.

During this pandemic, women are likely to be and are already being subjected to human rights violations and unnecessary interventions under coercion – leading to an increased risk of traumatic birth experiences. There is also the added risk associated with isolation of new mothers, whilst being separated from their friends and family who would ordinarily be part of her support system. These two things will lead to an increase in postnatal depression and PTSD which will have a long term impact on the overall well-being of both the woman and her baby.

Big Lottery Community fund logo

What are you planning on doing?

This funding will be used to deliver one-to-one support sessions and community groups via video chat, for women planning their birth during the pandemic and women who are facing or who have experienced birth trauma as a result of COVID-19. We will be facilitating community groups, and providing Holding Space sessions and birth doula support (both face to face and virtually), free of charge for any woman who cannot afford to pay.

We aim to create a safe space for women to access emotional and informational support and to help them feel less isolated and more supported and empowered in their birth choices. We will help women to navigate the new restrictions within maternity services and support them emotionally through unexpected changes to their birth plans. This will extend to virtual support during labour and birth for women with additional vulnerabilities. For women who are facing the trauma of birthing alone because of COVID-19 restrictions, we will provide in-person physical, practical and emotional support throughout their labour and birth.

We are sending all our thanks to National Lottery players and The National Lottery Community Fund for recognising the importance of our work. It has been a much needed boost being awarded funding during a time that is scary and uncertain for both women and small organisations like ourselves. We hope you are as excited as we are that we will be able to continue to support women, even during a global pandemic! 

If you are a woman who could benefit from this project please get in touch, we would love to hear from you.

Much love,

Lori, Elle & Amy   

 

 

 

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

A healing second birth – Part 2

GMD Admin

We’re back again with the next part of this inspiring birth story. Here Jess shares her experience of the last weeks and days of her pregnancy and the beginnings of labour!

Jess with her toddler and breastfeeding her newborn babyEden’s birth story Part 2:

Every evening for over a week I’d get these annoying period type cramps. Once I even had a contraction. I’d also get these strange nerve pains that would make my legs feel numb, quite scary when I first experienced them. I’d have to do a low squat & breathe through them. Anyone witnessing me doing this as I walked around Tesco must have thought I was in labour! ? In fact someone once asked me if I was okay!! All these things were uncomfortable & annoying but I took them as normal late pregnancy issues & tried to let go and enjoy our last days as a family of three.

For a few weeks I felt the need to slow down and conserve energy. We had help from family so I was able to spend time connecting with baby, resting, meditating, writing, nesting & batch cooking. Looking back I think these quiet times helped lay the foundations for the birth we were to have. Some dear friends put on a mother blessing for me & I made a birth altar in my bedroom with the affirmation art they made for me & other things I cherished.

I also met with my doulas, Greater Manchester Doulas, a few times and generally talked about how things had been. They were my true antenatal care, they listened with no agenda & made me feel valued. The main thing that kept coming up for me was not knowing the midwife who would attend my home birth. Everything I’d researched about the smoothest & safest way to birth was for the mother to be undisturbed so she can tune into her own body. So the idea of having someone there who knew nothing about me & who I’d never met before seemed bizarre and scary. I hadn’t had good experiences with my midwife team so had no faith that they would respect or even consider the importance of the energy or atmosphere they’d bring. So I decided we’d contact them late on in labour & ask them to stay in another room unless needed. I dared not tell any of the midwives this was our plan as I couldn’t face the barrage of questions and scare mongering that would have been bestowed on me so late in pregnancy. (Continued in comments)

Jess sat with her toddler breastfeeding her newbornInstead I wrote a birth plan and Ben and my doulas agreed to speak with them when the time arrived.

As the days rolled by and the baby got lower and heavier in my pelvis and the cramping and nerve pains continued, I began to get cabin fever. The day of Eden’s birth I was so grumpy and restless, like when you have an itch that you can’t quite scratch. Looking back this must have been a result of a hormonal surge in my body preparing for labour. I spent the day on my own and slept a lot. I had the urge to make a really nutritious and carb heavy lunch which is unusual as we tend to eat our main meal in the evening. The restlessness grew stronger as the day went on. I text a few friends and made a plan to meet up the next day with Luca in tow. I had no idea how I’d physically manage to wobble around a park with a toddler at nearly 42 weeks pregnant, but that feeling of needing change was intense! Later that evening Ben persuaded me to go for a walk with Luca and our dog Tilly. Walking any distance would set off the nerve pains so I wasn’t always up for them. It was a beautiful sunny evening and after our return, still feeling fed up, I decided there was only one thing for it…. a glass of wine! Well, this certainly got the baby moving! He started somersaults and pushing right down into my pelvis and generally having a dance party!! ?

Luca’s bedtime came round and I lay with him and fed him to sleep while Ben went to get us both food. While I lay there I began to realise the period cramps that I often experienced in the evenings were coming and going in more of a pattern than before. Not wanting to get excited I didn’t allow myself to think this could be the start. At this point in my pregnancy I was genuinely considering the idea that I might be pregnant FOREVER!! ? Luca went to sleep easily and we ate takeaway and chatted. Ben suggested watching TV but I didn’t fancy it. I felt an energy in me stirring, a really subtle shift of consciousnesses where half was busy somewhere else, perhaps preparing and paving the way for the journey I was about to take, while the other half was here, in the now. I knew I wouldn’t be able to concentrate on much. I was in the ‘doing’ phase of labour: also the ‘denial’ phase where it’s actually obvious things have started but you pretend to yourself it hasn’t!!

newborn baby breastfeedingWhen Ben asked how I was I told him the cramps where coming and going but not to get his hopes up as they would probably fade away. I could talk quite easily through them. It was about 9pm and the surges were probably every 20 minutes (although I wasn’t timing them and had no intention to start doing so either; I wanted to just stay in the moment). I suggested we got an early night incase things stepped up but by the time we’d sorted the dishwasher etc it was 10pm before we went upstairs. I told Ben to sleep in Luca’s room as I wanted him to get as much sleep as possible and not worry about disturbing him. At this point I was also really craving to be by myself.

To be continued…

Part 3 coming soon! In the meantime follow Jess and her wild adventures through motherhood on Instagram @these_adventures_of_ours

Doulas

What it means to be a full spectrum doula

GMD Admin

If you’re here, I imagine you are probably aware of what a doula is in the context of birth and postnatal support. Doulas are most commonly known for working with women and their families, providing continuous physical, emotional and informational support through positive pregnancies, birth and the early days of parenthood. However, we see pregnancy and birth as just one part of a full spectrum of reproductive experiences and bring this model of care to any pregnancy discourse and outcome. Given all this we consider ourselves to be full spectrum doulas.

But what is a full spectrum doula?

In short, a full spectrum doula is one that offers support across the full spectrum of reproductive experiences. We trust women and their inherent strength to make the best reproductive decisions for themselves, offering witness, companionship, information, resources, advocacy and support. Here are some of the ways that our full spectrum ethos influences our work as doulas and the support we offer:

Conception Support

Every pregnancy has to start with conception! As full spectrum doulas, we can support you in looking at your physical and emotional health and wellbeing before you are even pregnant, helping you to be in the very best place before heading into any future pregnancies. For some, growing a baby isn’t easy and not every pregnancy and conception journey is plain sailing. We can be there to guide and support you through these possibly challenging times.

Abortion Support 

We are pro-women and pro-choice, providing non-judgemental, compassionate support, focused solely on nurturing your needs throughout your experience. We can provide one to one support before, during and after your abortion, depending on the method chosen and the support we offer is always completely tailored to your needs and wishes.

Birth Doula

As your birth doulas, we will provide continuous support for you and your family throughout your pregnancy, birth and the early days with your newborn.

Miscarriage and Stillbirth Support

We offer both emotional and practical support to families experiencing loss. We hope you know that your loss matters and that we can be here to support you through this time and help you through your grieving process.

Postnatal Doula

The first few weeks following the birth of a new arrival is often a bit of an overwhelming whirlwind. As your postnatal doula, we will provide non-judgemental practical and emotional support for you and your family, helping you to adjust to life with a new baby.

Holistic Support

In addition, we recognise that each of these reproductive experiences are significant but also interconnected and we bear this in mind throughout. For example, a previous baby loss experience may or may not influence how you feel about your pregnancy and birth and this could have an impact on your needs and the type of doula support you want. As full spectrum doulas, our support is always holistic and women-centred. We support you as a whole person, and see you as more than just your current pregnancy and birth.

We’re always up for chatting about the way in which we support women so if you’d like to learn more about what we do, please get in touch.

Much love,

Lauren, Christine & Elle x