Birth, Homebirth, Pool Hire

Why is the deadline 30 weeks?

We recently made some changes to our pool hire service, and you might be wondering why. So here is a brief explanation of why we have decided to enforce a 30 week booking deadline. We know that not everyone will agree with our approach, and we’re okay with that – these changes have been based on our observations and what we have learnt from women over the past few years of running the service. We will continue to learn as time goes on and things may change again in the future, but for now here is our stance and why:
 
We started running this pool hire service back in 2020 and during that time we have learnt a lot. We included free support sessions within our hire because we recognised that so many of the pools were coming back unused because women were being coerced out of their home birth by the maternity system, and those women weren’t getting emotional support or accurate information from their midwives. We continued to book women in who were approaching us late on in their pregnancy, but we learnt quickly that women who are waiting until a certain point in their pregnancy to be ‘signed off’ or ‘given permission’ by a medical professional were also the ones who would accept that ‘permission’ being taken away again.
 
Sometimes women would take us up on the support session near the end of their pregnancy, around 34 weeks when suddenly “risks” started cropping up (like growth scans), and we were the first people to tell her that she gets to choose, that all of the appointments, measurements, examinations and procedures are optional, that she doesn’t need permission to give birth at home. It is heartbreaking to see that realisation dawn on her face when she is so far down the line that it feel impossible for her to do anything about it now.
 
Women who were looking for external reassurance from appointments, inaccurate measurements and scans, and permission were not wholeheartedly planning a home birth. They were hoping for one, but that hope was balancing on a jenga tower that could be knocked over at any moment by a medical professional. A medical professional who works within a system that doesn’t understand normal birth or the basic needs of a woman in labour. A system that builds its policies on fear of litigation rather than what women actually want or need. What we found was that women who were hoping for a home birth very rarely had one.
 
We understand why this is the current norm – we are brought up to believe that others know our body better than we do, and that we need “experts” to be able to give birth safely because it is a dangerous and unpredictable medical event. That’s why so many women do turn to midwives or doctors for external reassurance. We understand how hard it is to question that cycle or and it’s even harder to break it. It can be scary to take radical responsibility for our decisions, particularly when something is presented as a health issue/medical event. The truth is that birth is a normal bodily function, just like sex or having a poo, birth is incredibly predictable when left alone and we ARE the experts on our own bodies. 
 
Home is safe. It’s where we perform all of our other bodily functions. It is where the only bacteria around is the stuff we’re in contact with every day and are therefore used to. It is where we get to choose who comes through the door, and where we are free to move around and be ourselves. It’s also proven to be safe for birth through studies (and the existence of so many generations before us). Biologically it makes perfect sense – we are mammals, and other mammals find a safe, dark spot where they will not be disturbed or observed. Women need these basic things too, and none of these needs are met within a medical setting. Giving birth at home is the biological norm and is always an option.
 

You do not need someone’s permission, or for someone to write it in your notes, or to be ‘signed off’ to plan a home birth. It is your human right, and your birthright.

 
Our organisation is rooted in women’s rights and bodily autonomy. The maternity system does not respect these things. We will no longer nod along and stay quiet when a woman is walking through or into a system that is set up to fail her. The reason we no longer take bookings after 30 weeks is because we want to make it clear that women do not need to wait until after this point to start planning something that they know feels right for them. We want women to recognise that they can do whatever works for them, without checking with a midwife or asking for permission. This autonomy and critical thinking is necessary for having a good birth, because if a woman is deciding to engage with the maternity system (which is also something we assume is necessary but isn’t) then she is likely to have to assert herself at many points in her pregnancy, labour and birth. She is likely to be told that she “needs to” or “has to” do things that she’s not comfortable with (which is a lie, she never has to). She is likely to be coerced with emotive language instead of genuine evidence. She is likely to be told that she is “not allowed” a home birth because she is too “high risk” based on inaccurate information. 
 
We don’t write this lightly, and it is no way an attempt to scare you or place any blame on you. The dependence on the maternity system is something that is deeply ingrained and socially accepted, it’s not the fault of the woman who engages in it, the fault lies with the system itself. We feel it is our responsibility to be honest about the system and the way it treats women. We know that this doesn’t make us very popular (particularly with midwives) and can often feel confronting or upsetting for women who are still in that relationship with the system. But we hope that our reminder that women are completely capable, incredibly wise and are their own experts will plant a seed. We hope that women hear that they deserve to be treated with respect, rather than as a faulty piece of birthing equipment, that they deserve to feel strong and wise, rather than unsure and deflated, and that they absolutely don’t need anyones permission to give birth wherever they damn well want to.
 
I’m sorry that we are unable to offer you a birth pool after 30 weeks, but we hope that you are able to find one.
 

We are hopeful that this deadline will encourage women to question the care that they are and have been receiving that made her feel like she was “high risk” and had to wait for permission. Questioning this as early as possible (before or) during pregnancy is what will lead women to navigate or step out of the system in a way that works for them.

Birth

International Cat Day & International Female Orgasm Day

Monday 8th August 2022 is both

International Cat Day AND International Female Orgasm Day!

Now you might be thinking… Okay, but why are you lumping them together and what is the connection to birth? And I can see where you’re coming from, but hear me out.

Cats

Cats are wonderful creatures, and they are also mammals, like us. When a cat is pregnant we can often tell purely by her behaviour before she starts growing noticeably. When that lovely bulging belly is getting bigger we often try to guess how many kittens she might have in there! We don’t take her to the vet to check though, unless we think there is something wrong, right? We don’t poke and prod her to try to make our estimations, we just know that there is a range of normal and that whatever number of kittens she is growing is going to be the right number, and we’re excited to find out. Do you think she is worrying about it? Nope. We often give her some extra love and attention, and vice versa, as she reaches the end of her pregnancy or more privacy if that is what she is indicating. We follow her lead. The human female however is often exposed to even more fear and more poking and prodding the closer she gets to the end of her pregnancy. Why?

When the mama cat goes into labour we use hushed voices and we keep our distance. We keep the lights low and we absolutely do not interfere with the perfect process. We trust her and her instincts. When her kittens are born, she does all the instinctual checks herself and she separates her kitten from its placenta using her own natural tools, in her own time. All is well. We do not touch her kittens because it is well known that this can disrupt the bonding of a mother and her baby and that this can be detrimental to the survival of the kitten. Both her and her kittens know exactly what to do, and we don’t doubt it for a second. Why do we doubt women? Why do we interfere? Why do we separate the mother and baby, or feel entitled to even touch the baby?

Women need the same basic things that cats need in pregnancy and labour. To feel safe, warm, undisturbed and unobserved. We know this for other mammals and we usually respect it, trusting in the process and not interfering. So why do we interfere so much with human birth?

Female orgasms

Did you know that the complete anatomy of the human clitoris wasn’t accurately described until the late 1990’s by a urologist Helen O’Connell? That’s really recent!! The female orgasm has long been a mystery that isn’t deemed important enough to talk about. The truth is that we don’t need research or diagrams, or any understanding of the process to be able to orgasm, but some recognition of our amazing bodies would be nice. We instinctively know what feels good, and the more time we spend alone, communicating with our own body, the more we understand ourselves. The more external influences we get, from partners, friends, the media or porn, the less we understand and trust ourselves. The same can be said for birth.

Orgasms are also wonderful. And guess what? They need the same basic things to go smoothly. Orgasms and birth are not two separate things, they are the same event separated by time. For a woman to orgasm she needs to feel safe, warm, unobserved and undisturbed. Have you ever tried to orgasm when one or more of these basic needs are not being met? Would you be able to if someone knocked on the bedroom door? Would you be able to if you were cold and uncomfortable? Would you be able to if you didn’t feel safe? Or if someone was taking your blood pressure or sitting in the corner taking notes? Probably not.

A release of oxytocin and dopamine. Uterine contractions. Increased blood pressure, respiration rate and heart rate. Involuntary groaning. Sound familiar? 

Something else that is similar between orgasms and birth – you can do it completely by yourself. In fact, in most cases it is less complicated when you do! In both orgasms and birth, they go most smoothly when you are not thinking about how the people around you are perceiving you or your movements or your noises or thinking about someone else’s thoughts or feelings. They both also work much better without the idea of time in your head, whether that is “is this taking too long?” or “this will have to be quick because I’ve got to leave for work in 20 minutes”, it’s much simpler without that pressure. 

Birth CAN be orgasmic. It’s not weird and it’s not impossible. It’s actually pretty normal when you think about how similar the processes are and the hormones involved. The thing that makes this kind of birth so illusive is the fact that for the most part the basic needs are neglected in birth, particularly within a medical setting. If you couldn’t orgasm in a hospital, why choose to give birth there? If you couldn’t orgasm at home with a member of the medical profession sitting in the corner taking notes, or worse – touching you, why would you choose to give birth in that scenario? Plan for birth as if you are planning for the best orgasm of your life. Set the scene so that you can do whatever the fuck feels good for you in that moment without judgement or observation. That includes when deciding whether you want your partner, or your mum, or a doula or a midwife present. 

In conclusion

All mammals need the same basic things for both orgasms and birth (yes, other female mammals have orgasms too!). So why is it that in the last few generations we have created an environment for birth that does the complete opposite of meeting those needs? The truth is that in the way the maternity system is set up, we’ve almost completely removed the possibility of having an orgasmic birth whilst at the same time making it incredibly likely that the bonding between a mother and her baby will be interrupted. This is diabolical, and seems pretty intentional when you look at it from this angle. If a woman comes out of birth on a post-orgasmic high, feeling totally connected to her body and her baby, there is much less chance of her being controlled by, compliant or complacent in the patriarchy in any other area of her life. I can’t think of any other reason why our society would have created a system that oppresses women and goes against our nature in such an obvious, yet accepted, way. Can you?

Birth

The issues with “active management” of the third stage

I have a few issues with this phrase and the way it is presented to women both in pregnancy and in the moments after birth. Language is incredibly important when it comes to pregnancy and birth, and for too long the negative impacts of the language used in maternity care has been ignored. I believe that “chemically induced third stage” is a more accurate term for what is currently known as an “actively managed third stage”.

The phrase “Active Management” and what it implies

Firstly, the phrase “active management” comes with some serious implications. It suggests that this is the safe, controlled way of birthing your placenta and that waiting for your body to do what it is designed to do is “unmanaged” and therefore dangerous. I went to a birth recently where the midwife described the cervix as a “vice” and told the woman that “sometimes nature just doesn’t do enough to get it out” – this kind of attitude towards women’s bodies is a huge problem in my eyes.

The importance that is put on the length of time passed since the baby was born is immense, but with very little evidence. By calling it a “chemically induced third stage” it is making it clear that this is an intervention that involves medication and is the act of forcing the placenta to be born before the body is ready to do so on its own. It seems appropriate given that it is essentially the same as chemically inducing labour – injecting a woman with an artificial “hormone” to force the uterus to contract.

 

What the body needs for a smooth birth of the placenta

The birth of the placenta needs the same basic things as the birth of the baby. A woman in labour needs to feel safe, unobserved and undisturbed – the same applies to the birth of the placenta given that it uses the same hormones.

If you ever witness an undisturbed birth, and the environment stays the same after the baby is born, you will see a smooth birth of the placenta too. It may not happen fast, but it will happen. If you witness a birth with midwives present, or people around who are looking for danger, on high alert and full of adrenaline, you will see the environment change entirely. The voices that were soft (or better still, silent) for the many hours prior are suddenly at a normal volume, asking questions and stating observations, the lights might even come on and suddenly the birth space is no longer the safe cacoon that it was before.

If midwives are present, the clock is started – they are counting down the seconds until the placenta is born, perhaps not once considering that by asking the woman questions and observing her so closely they are hindering the process. The fear is contagious, even if it is not justified. Despite there being no known “normal” length of time for the placenta to come, the 60-minute limit is applied and so the pressure begins, even though there is no evidence (nor common sense reason) that a woman’s cervix would close itself naturally before birthing the placenta. It does however make sense that this might happen if the woman has induced artificial uterine stimulation due to the use of Syntometrin.



The risk and varying definitions of post-partum haemorrhage

The common British definition of a haemorrhage is 500mls, whereas in Holland the definition is 1000mls. Whenever there is a big difference (in this instance a HUGE difference) in policies and guidance, it makes me question where they are getting their numbers from. What are they basing these thresholds on if they are so vastly different?

We know that when a woman is pregnant her blood volume increases dramatically, so whether this extra blood comes out immediately after birth, or in the weeks or months following, it is likely the same amount in total. The measurement of blood loss also doesn’t tell us much – one woman could lose a lot of blood and feel perfectly fine, another could lose a small amount and feel awful – surely the way the woman feels should determine whether medical attention is needed, not an estimated measurement.

The supposed benefits are based on very low-quality data, all of the studies were undertaken in hospital settings and according to the Cochrane Review;Although the data appeared to show that active management reduced the risk of severe primary PPH greater than 1000 mL at the time of birth, we are uncertain of this finding because of the very low-quality evidence. Active management may reduce the incidence of maternal anaemia (Hb less than 9 g/dL) following birth, but harms such as postnatal hypertension, pain and return to hospital due to bleeding were identified.”.

We know that the risk of having a PPH is significantly lower for women who plan a home birth, even if they transfer into hospital for the birth itself. So why is the same low-quality data that only applies to hospital births being implemented into standard practice at home births too?

Also, as a side note, the maternity system can’t be massively concerned about preventing PPH when they are inducing women at alarming rates, which also increases the risk of having a PPH.



The risk and definition of “retained placenta”

re·tained pla·cen·ta

incomplete separation of the placenta and its failure to be expelled at the usual time after delivery of the child.

So what is the “usual time”? The National Institute for Health and Care Excellence (NICE) recommends that; “the third stage is diagnosed as delayed if it takes longer than 30 minutes to deliver the placenta with active management or 60 minutes if allowed to deliver the placenta physiologically with maternal effort.” 

* Notice the use of the word “allowed” – this is what I’m talking about with the use of language *

However, this doesn’t even begin to encompass the wide range of normal. From listening to women’s stories who birthed with no medical staff present, their third stages lasted varying amounts of time with no ill effects. In one freebirth study published in a midwifery journal, they varied from 30 minutes to 5 hours, and some women anecdotally report going to sleep for several hours before birthing their placenta.

According to an article in ‘Best Practice & Research Clinical Obstetrics & Gynaecology’, in less developed countries, retained placenta affects about 0.1% of deliveries, whereas, in more developed countries, it happens in around 3% of vaginal deliveries. Considering the intervention rates are higher in developed countries, this leaves a lot of questions about what is causing the increase in cases of retained placenta, how they are defining “retained placenta” and whether these stats are referring to women who do not have the injection or include those who do.

There are very clear symptoms of a retained placenta that is causing an issue, but in the standard practice of midwives, they do not wait for any of these symptoms. Instead, like many of the standard practices in maternity care, they simply assume that the body is incapable of performing its natural functions and intervene too soon. 

These are the symptoms of a retained placenta;

  • Constant pain
  • Fever/high temperature
  • Passing large pieces of placental tissue
  • Heavier than expected bleeding
  • Foul-smelling vaginal discharge

* Note that having an extended period of rest between the birth of your baby and your placenta isn’t listed as a symptom, so decisions to intervene should not be based on that without any actual indications of a problem.

 

The risks of Syntometrin

Syntometrin is the injection given for an induced third stage. It is made up of oxytocin and ergometrine maleate. Women are quite often told all of the risks of doing nothing, and only the so-called benefits of having the injection and getting it “all over and done with”. From my experience, the only reason women have accepted the injection (even when they had previously declined), is due to fear and/or to stop the constant pestering. The coercion that I have witnessed during that golden time between the birth of the baby and the placenta is truly awful and eventually takes its toll.

We know that with the injection the placenta tends to come fairly quickly, but at the cost of added discomfort due to fundal pressure and cord traction (having a midwife push on your bump and pull on the cord). But there is rarely any mention of the risks and side-effects of having the injection.

In reading the information provided on Syntometrin, here is what I found on the risks:

  • Ergometrine is known to cross the placenta and its clearance from the foetus is slow. Concentrations of ergometrine achieved in foetus are not known.
  • Ergometrine derivatives are excreted in breast milk but in unknown amounts. It can also suppress lactation.
  • Ergometrine can cause vasoconstriction
  • Caution is required in patients with mild or moderate hypertension, cardiac disorder, or hepatic or renal impairment
  • Oxytocin should be considered as potentially arrhythmogenic
  • Patients should be warned of the possibility of dizziness and hypotension

Some of the reported adverse drug reactions:

  • Anaphylactic/anaphylactoid reactions associated with dyspnoea, hypotension, collapse or shock
  • Headaches
  • Dizziness
  • Myocardial infarction (heart attack)
  • Chest pain
  • Vomiting
  • Nausea
  • Abdominal pain
  • Hypertension

 

“It might just be sitting there”… So what?!

We often hear this from midwives; “It’s likely that your placenta has detached from the uterine wall and is just sitting there on your cervix”. Okay, that makes sense… so what? What is the issue?

In our work as doulas, we trust in birth, we trust in women and their intuitive wisdom. We trust that if a woman feels well, she is well, and if something isn’t right she will know what to do. Women who have had undisturbed births describe feeling contractions and then a sudden urge to move positions due to feeling uncomfortable sitting or lying down, and with this movement, they birth their placenta. These women weren’t timing their third stage or being told when and how to move – just as in their labour, they were listening to the most up-to-date information their body was giving them and acting or waiting, accordingly.

So is a placenta truly retained if it just hasn’t had enough time to come out yet? If it isn’t causing any of the obvious physical symptoms of a genuine issue, does it just need time and patience? Does the presence of someone who is timing this pause have a negative impact on the process? Why are we treating every woman as if a PPH is incredibly likely when that isn’t the case? In the same way that the “failure to progress” label is put on women whose labours aren’t following an arbitrary timeline, intervening can lead to a whole host of other issues, not least that woman feeling like her body failed when the reality is that the maternity system failed to wait.

 

 

Resources:

https://sarahbuckley.com/leaving-well-alone-a-natural-approach-to-the-third-stage-of-labour/

https://www.medicines.org.uk/emc/product/865/smpc

https://www.evidentlycochrane.net/third-stage-of-labour/

https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-12-130

https://www.bellybelly.com.au/birth/how-inductions-increase-the-risk-of-haemorrhage/

https://www.sciencedirect.com/science/article/abs/pii/S1521693408000965

Birth, Human Rights

10 Things We Wish All Women Knew

1. Freebirth is LEGAL

This one is pretty simple so I’ll keep it short. You have the right to birth your baby wherever you like, with whomever you like. You have the right to decline maternity care altogether if it isn’t serving you. You have the right to give birth without a midwife present. It is not illegal. We often hear from women; “I was told it was illegal and that my partner could be arrested!” – this is complete rubbish. It’s a scare tactic to make us think that we HAVE to engage with maternity services and that we HAVE to have a midwife present. Can you imagine the ruckus it would cause if women realised that they didn’t need to put up with being told what to do, how to move (or not move), when to push, or being poked and prodded whilst they’re trying to listen to their body? … it might just topple the system.

 

2. Birth is a normal bodily function that needs very basic things to go smoothly

Birth is made out to be this really mysterious thing that, if you’ve never done it before you couldn’t possibly know how to do it without being told. But that’s just not the case. If we treated all bodily functions in that way, intervening before giving the person enough space and time to follow their own body, it would cause all sorts of issues. If we decided that it was too risky to poo on your own because you might brew a poo that’s too big to come out, so it’s much safer to cut you open and get the poo out that way instead… we’d be in a pretty big mess. And you would probably question it because… we’ve been pooing by ourselves for millions of years. But surely birth is different… oh wait. No, it isn’t. Human women have been giving birth without being told how since the beginning of humans, and before humans, the rest of the females of all species did it too. You might hear the argument “yeah but… loads of women and babies used to die from childbirth!”, and that’s not incorrect, but the technology didn’t fix that problem. We are much healthier as a species nowadays and we learnt that washing our hands can help to prevent infections, that’s all. If anything, technology has made birth more dangerous – just take a quick look at America, a very technologically advanced country – while the global maternity mortality rate has dropped by 44% worldwide between 1990 and 2015, and by 48% in developed countries, the US is one of only 13 nations who has seen its maternal death rate rise. Birth is safest when the birthing woman feels safe, supported, unobserved and undisturbed. The maternity system is based on being risk-focused and avoiding being sued. These two things do not work together.

 

3. You can still opt-out of things, even if they’re seen as “the norm”

It might seem obvious, given what I’ve already said in the previous points, but it’s never presented as an option. You can decline any part of what is considered the “normal” path through the maternity system. That includes booking in. The only thing you legally have to do is register your baby within 42 days of the birth with the Registrar of Births and Deaths in the area in which your baby was born. Women give birth at a wide range of gestations too, and the scope of “normal” gestation (between 37 – 42 weeks) would be a lot wider if the medical model didn’t feel the need to rush the process for no good reason. There are plenty of women who ignore their due date altogether, and they are the women who have a peaceful pregnancy because they know that their EDD is just a number, that is only 4% accurate, and will likely result in the pressure being piled on by professionals, friends and family. There’s another thing you can decline or reject.



4. Pregnancy doesn’t change the fact that you are the only person

who gets to make decisions about your body

When you conceive a child, there is suddenly a whole load of things you are expected to do, whether you like it or not. There are lists upon lists of things you can’t do or eat when you’re pregnant, things you should definitely do because you’re pregnant, things you need to buy for your baby and appointments you have to attend. But is there any other time in life where you would just accept all of these things that people are telling you, even if they didn’t sit right with you? Is there any other time in life where you would be expected to let someone touch, measure, press on your belly even if it was uncomfortable? Or let them put their fingers inside you without asking or sometimes without even warning you? No. What do we want our daughters to know? That it’s okay to say no. That our bodies are our own and nobody gets to touch it without our consent. Right? But for some reason, when we’re pregnant we’re expected to just grit our teeth and get through it because it’s “standard procedure”. That’s not okay.



5. Your human rights don’t go away just because you’re growing another human

In the UK, unborn children do not have separate legal recognition from their mothers. This means that nobody can override your human rights for the sake of your baby, unlike in some other countries. This means that there is no limit to which you are the sole decision-maker when it comes to your care, or opting out of it altogether. This actually makes things a lot simpler than in countries where the unborn baby has rights too. You and your baby are one. What you decide is right for you, is right for your baby by extension. You absolutely matter.



6. You get to decide whether or not you want to go for a scan or appointment

Although scans and appointments are considered the norm nowadays, with women booking in around 12 weeks and having a few scans along the way, this is always a choice. These appointments and scans are not without risk. The information discovered during these appointments is something that can be used to coerce you, no matter how inaccurate the information is. The language used in these appointments plants the seed of doubt, giving the message that at some point your body will fail and you’ll need help. It very rarely gives the impression that birth is normal, and something that when uninterrupted is very unlikely to end up in an emergency. The maternity service is not designed to be woman-centred, it’s designed to manage birth, which just isn’t something that you can do with a bodily function. Treating women like a big, mysterious ticking time-bomb creates fear and will ultimately create emergencies in the process.



7. Birth is not inherently dangerous, but the way women are treated in labour is

As stated in the previous point, birth is not inherently dangerous. It becomes dangerous when we interfere with it. When a woman comes to the end of her pregnancy, there is a whole dance that her body is doing that involves a delicate balance of hormones. Labour begins when the baby is ready, and it will take as long as it takes. Sometimes it starts and then stops again. Sometimes it slows down for a long while then picks back up. Sometimes there are no signs at all and then comes on hard and fast. Labour, even though it can stop and start in different places, is actually very predictable when it is left alone. When people talk about birth being unpredictable, what they have seen or heard of is birth that is interrupted and disturbed by interventions. The evidence is out there – Marjorie Tew who set out to prove that hospitals had made birth safer ended up proving the complete opposite. Michael Odent explains that there are maybe 5 types of true emergency in birth and they are very rare. The intervention and caesarean rates do not reflect that number, which means that we are making birth dangerous by treating it as an emergency and interfering with a bodily function.



8. You don’t have to compromise, in fact, you don’t HAVE TO do anything

As stated in nearly all of the other points, there is no point at which you HAVE TO do anything. This phrase, however, is used in almost every conversation I hear about birth. Women are told by friends, family, strangers and midwives that they “have to” book in by a certain date and that they “have to” go for that growth scan because “it’s for the best” (despite the fact that they’re notoriously inaccurate), without knowing the risks associated with engaging in maternity services. This language is powerful, but you don’t have to listen to it. Anyone who tells you that you “have to” do something (e.g. wait to get in the pool or push now or be monitored in some way) or they use the phrase “we just need to do this” (e.g. a vaginal examination or listening in), should be kept far away from your pregnancy and birth.



9. Nobody gets to tell you what you are or are not “allowed”, or what is safe,

and you don’t need anyone’s permission

If you drive to a doctors appointment and the doctor says; “You didn’t drive here did you?! You’ll have to walk home because driving is too dangerous!” you would probably be outraged because you are a grown-ass woman who has weighed up the risks and benefits of getting in your car today and someone is deciding for you that it is too dangerous. So why is it that, during pregnancy, when we hear the words ‘risky’ and ‘safe’ used, we accept it? Because of the emotive language used around it – this is a tactic that is used frequently and is very effective. But population-level advice and statistics are not the only things that factor in risk and safety. You are a whole woman who has emotional, physical, practical, spiritual and mammalian needs, and nobody else will have the same priorities as you. Your risks and benefits would look very different from someone else’s, so it’s impossible for someone else to judge what is safe for you. In terms of being told what you “have to” do and what you’re “not allowed” to do… you are an individual with capacity and rights, which means that you get to decide where you have your baby, who you invite into your birth space, whether or not you want to engage with maternity services and to what extent. You get to decide when to get in and out of the pool, and if and when you cut your baby’s cord, and who gets to touch your baby. Nobody has the right to allow or not allow when it comes to your body, your baby and your birth.



10. Your intuition can be trusted – it won’t lead you wrong

We often hear women saying “but what if something is wrong and I don’t know about it”. The monitors that we’ve invented are trying to mimic what our body already does, so that it can be plotted on a chart, but those machines can never replicate the instinctual responses that our bodies have. You will be the first to know if something is wrong because nobody else can feel what you’re feeling or even attempt to interpret it from the outside. We all know that when a pregnant woman is stressed, her baby will feel it because of the increased cortisol in the body, and the same is true the other way around. If you are able to listen to your intuition and follow what your body needs, it will not lead you wrong. We hear women saying “I knew that I needed to push but they kept telling me not to”, or the other way around “I knew that I didn’t need to push yet but they kept telling me to” and it’s those women who come away from birth feeling traumatised, it’s those moments where the people around her were speaking louder than her intuition that she feels out of control and it’s in those moments where birth becomes dangerous. Our intuition is what has kept the human race alive and thriving for such a long time, so don’t doubt it.

 

Related Links:

https://www.facebook.com/groups/freebirthnorthwest/

https://www.facebook.com/groups/manchesterbirthsupport

https://www.bellybelly.com.au/birth/fetal-ejection-reflex-what-is-it-and-how-does-it-happen/

Uncategorized

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

 

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.

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

A healing second birth – Part 2

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

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.