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Sophie Messager

Author: Sophie Messager

  • A time in between-Waiting for a birth as a doula

    A time in between-Waiting for a birth as a doula

    I love the article  ” The Last Days of Pregnancy: A Place of In-Between” by Jana Studelska,. I send it to my clients when they are fed up waiting for the baby to arrive. Jana uses a German word: ‘Zwischen’, which means ‘between’, to describe the unusual but necessary waiting time between the end of the pregnancy and the beginning of labour.

    My favourite part of the article is this:

    “I believe that this is more than biological. It is spiritual. To give birth, whether at home in a birth tub with candles and family or in a surgical suite with machines and a neonatal team, a woman must go to the place between this world and the next, to that thin membrane between here and there. To the place where life comes from, to the mystery, in order to reach over to bring forth the child that is hers. The heroic tales of Odysseus are with us, each ordinary day. This round woman is not going into battle, but she is going to the edge of her being where every resource she has will be called on to assist in this journey. We need time and space to prepare for that journey. And somewhere, deep inside us, at a primal level, our cells and hormones and mind and soul know this, and begin the work with or without our awareness.”

    As I sent it to a friend (who is fed up waiting for her baby to arrive) and suddenly it struck me: doulas experience Zwischen too. The on-call period; the waiting time for the mama to go into labour, is an ‘in between’ time for the doula too. A weird period where she tries to carry on her life as normal but always has her client at the back of her mind and isn’t fully present to her family and friends. A doula always has to make sure she can go to her client whenever needed. When I wait for a mama to go into labour, every night I go to bed thinking tonight might be the night. When I am waiting for a while, I often feel the same disappointment/frustration I experienced when I was waiting for my son’s birth, 9 years ago (he was born 16 days after his ‘due date’). I remember waking up every morning, and thinking “still pregnant!” and feeling annoyed.

    Waiting for a labour to start, as a doula, can be a challenging experience. Sometimes, and I found this be especially true for mums who already have babies, the labour starts and stops for a while. I believe it is nature’s wise way of making sure the mother isn’t away for too long from her other child(/ren), because labour is usually swift after this. However it can be frustrating and draining for the mother and her supporters!  I oscillate between moments of quiet acceptance and moments of impatient frustration (It would be so great if she birthed tonight!). This waiting involves an element of tension in both mind and body.

    It is a strange time indeed, the Zwischen-time of being on call; like suspended in time, in limbo, where everything is on hold. We do it because we love our clients and our job, but it can take its toll on our minds and bodies.

    I was reminded of this recently. I was on call for a repeat client of mine for 3 weeks, and feeling very invested emotionally in her birth. The birth happened, and it was beautiful. After she had birthed, I noticed how much more relaxed I felt and how tense I had been waiting for her birth. Later on, as it is often the case when we work hard on something for weeks, only to fall ill when the task is over, my back started hurting. I knew this wasn’t physical because the birth had been quick and easy and I hadn’t had to provide a lot of demanding physical support. My osteopath found my back to be “emotionally and energetically empty”. I hadn’t realised how much tension I had been carrying waiting for my client to birth.

    When I first wrote this blog I was just coming out of being on call for nearly 6 weeks, having had 3 births in as many weeks (not usual – I normally only take a client or two a month, but a client was late and another client birthed early due to medical condition). For the first time in weeks I felt very peaceful and relaxed, and I was enjoying the odd glass of wine, and looking forward to a much needed holiday.

    We doulas really need to excel at self care, lest we suffer from both emotional, physical and spiritual burnout. The “oxygen mask” analogy comes to mind, when in airplanes you are advised to put on your own oxygen mask before attending to your children’s. Self care in that context isn’t selfish, it is survival. If we do not look after ourselves and fill our own tanks, we have nothing left to give.

    My mum recently told me: “Tu n’as pas vole ton salaire” (you haven’t stolen your salary – a French expression, meaning that you are doing more work than is expected of your salary level) and it was good to have someone reminding me of this. It felt very validating. We doulas really give every bit of our being to our clients.

     

  • New NICE induction of labour guidelines. Have we taken leave of our senses?

    New NICE induction of labour guidelines. Have we taken leave of our senses?

    The National institute for clinical excellence (NICE) has published new draft guidelines for induction of labour. They are open for consultation until the 6th of July 2021.

    The part that is most concerning is this:

    Consider induction of labour from 39+0 weeks in women with otherwise uncomplicated singleton pregnancies who are at a higher risk of complications associated with continued pregnancy (for example, BMI 30 kg/m2 23 or above, age 35 years or above, with a black, Asian or minority ethnic family background, or after assisted conception).

    You read that right. The new guidelines propose that everyone whose body mass index is over 30, above 35 years old, who is black, brown or any non white background, who have conceived through IVF, should all be induced at 39 weeks of pregnancy. I couldn’t help but wonder: how many people does this leave, who do not fall in these categories?

    I had a look at the office of national statistics, to check what percentage of the population these groups represent together. I haven’t been able to find detailed enough data to remove overlaps between the groups. However, I have found the following:

    • About 50% of pregnant women are classified as overweight or obese in the UK
    • Black, brown and ethnic minorities represent about 10% of the UK population
    • About 25% of babies born in the UK were conceived by IVF
    • About 25% of babies born in the UK are from mothers over 35

    I know that some of these categories overlap, but I’m guessing that not many people will still fall within the “low-risk” people being “allowed” to go into labour naturally if this guideline passes at it is. Especially as, in my experience, few people question the “guidelines” and apply them as if they were the law.

    Worryingly the rate of induction has already just gone through a major rise. Since March 2020 many trusts have seen steep rise in induction (and cesarean) rates. (this is easy to find in the infographics shared from various trust pages on social media). In my local trust, the induction rate has gone from being between 25 and 30% prior to March 2020 to 39% in May 2021. Doesn’t it feel extremely odd to you that nearly 40% of the population already needs to have their labour artificially started? Isn’t it possible that this rise wasn’t justified by evidence, but rather by a knee jerk reaction to the covid crisis?

    If the above guideline goes ahead as it is, what rates of induction are we going to see? Are we headed towards in a situation where everyone has their labour induced? How is this logical? How is this balanced? Have we taken leave of our senses?

    The draft guidelines  are open for consultation until the 6th of July 2021. If you wish to comment, you are welcome to copy and paste some of my comments to issue your own reply to the NICE consultation. Just email InducingLabourUpdate@nice.org.uk

    Dr Sara Wickham has published an extensive blog about it too.

    Dear Nice labour induction team

    My name is Dr Sophie Messager. I am an ex biology research scientist turned doula and perinatal educator.

    Over the last ten years in this role I have seen the rate of induction of labour in my local trust rise from 24% to 39% without an improvement in maternal or fetal outcomes.

    What I have witnessed however, is that induction of labour often causes trauma for mothers and their partners. I have also witnessed time and time again that true informed decision rarely takes place because the majority of parents rarely get told what induction of labour entails (in primips often a 3 to 5 days process which ends up in a caesarean). They rarely get told that it is a choice (most get told “we’ll book you in for an induction”), and they also rarely get told of the risks that are involved in inducing labour (increased risk of caesarean birth and fetal distress amongst other things). I also see a lot of coercion in making sure people consent to having their labour induced, and in particular implying that the baby might die if they do not agree. I wrote in more details about it in this blog post.

    Since March 2020, most hospitals trusts banned the access of partners to antenatal wards, only allowing them during established labour, I have witnessed women being induced for 5 days, alone in antenatal wards with no support from myself or their partners. This is dehumanising and traumatising for women and their partners.

    Since March 2020, I have also seen rates of induction and caesarean rise by about 10% in many hospital trusts, with no evidence behind the change. In my local trust, the induction rates was 40% in May 2021, when it was between 25% and 30% prior to March 2020. Carrying out a survey of the rise of induction rates since 2020 across UK hospital trusts since March 2020, and the reasons behind them, and whether this rise improved outcomes or not would probably prove very informative. Surely the percentage of women who go into labour spontaneously has not decreased by 10% in less than a year?

    I am worried that the people who are making the recommendation in the guidelines have no experience of supporting women and their partners in labour, and in particular, induced labour, or that if they do, they have no experience of what happens in the aftermath. Most health professionals only get to see people for a few days after birth, until they leave the hospital. Doulas and other private perinatal practitioners often support new families for weeks after birth, and they may be the only ones who truly understand how traumatising induction of labour can be, especially when the process hasn’t been communicated adequately ahead of time.

    The draft guidelines state the following:

    Consider induction of labour from 39+0 weeks in women with otherwise uncomplicated singleton pregnancies who are at a higher risk of complications associated with continued pregnancy (for example, BMI 30 kg/m2 23 or above, age 35 years or above, with a black, Asian or minority ethnic family background, or after assisted conception).

    Yet the guidelines also state that “As there was no evidence to identify the optimal timing of induction in these groups, the committee made a research recommendation”.

    I had a look at the office of national statistics, to check what percentage of the population these groups represent together. I haven’t been able to find detailed enough data to remove overlaps between the groups. However, I have found the following:

    • About 50% of pregnant women are classified as overweight or obese in the UK
    • Black, brown and ethnic minorities represent about 10% of the UK population
    • About 25% of babies born in the UK were conceived by IVF
    • About a quarter of all babies born in the UK are from mothers over 35

    Which percentage of the population does this leaves that still falls within a low risk group? Has this been assessed as part of the drafting of the guideline?

    If the draft guideline gets published as it is we are very likely to see a further rise in an already alarmingly high induction rate, and a concomitant rise in caesarean rate, as despite some flawed research claiming that induction of labour doesn’t increase caesarean rates, in practise (and according to some recent research), induction of labour usually leads to doubling of the rate of caesarean. See https://www.sciencedirect.com/science/article/abs/pii/S0301211521002463.

    I am worried that we are headed for the same rates of caesarean as countries like Brazil or China (which are around 50%), without improvement in birth outcomes.

    Experience and history (for example in the case of the Hannah breech birth trial) shows that when new guidelines like this one get published, they tend to get adopted widely without question within maternity care, and that, even when new evidence disproves the original results, it is very hard to get the system to change, because the belief about what is “normal” has become entrenched within maternity care.

    The long term impact of a rise induction of labour on the health of the general population is this happens is greatly concerning. As concluded by the author of this study explains:

    “IOL for non-medical reasons was associated with higher birth interventions, particularly in primiparous women, and more adverse maternal, neonatal and child outcomes for most variables assessed.“

    More worryingly, there appears to have been no consultation of the interested party, i.e people having to undergo the actual induction of labour (women and their partners) in the drafting of this guideline.

    I urge you to reconsider these guidelines, and in particular, ensure that a consultation of the experience of induction of labour for mothers and their partners takes place prior to any new recommendations being made. I would also like to see the long term physical and mental health implications for families and babies taken into account to balance the recommendation.

    Regards

    Dr Sophie Messager

     

  • You already know what is right for you (how to access your own wisdom)

    You already know what is right for you (how to access your own wisdom)

    What if I told you that you always know what is right for you?

    What if I told you that you do not need to outsource your wisdom, defer to other people, seek answers from outside sources, and that the answers, the real, true, optimal ones for you as a unique being, are already inside of you?

    In my previous blog, I explained that you are the expert is what is right for you and I want to expand on the topic and go further, as well as present ways you can access your inner wisdom.

    I believe that we are all born with inner wisdom and knowing and that we can originally access it easily. Babies and small children know what feels good and what doesn’t. They trust their inner compass. They express their bliss and displeasure loudly. It is very plain for all to see: when they are happy, their whole body is happy. When they are sad you can see it too.

    But then, because we live in a society that expects us to obey and do as we are told, and because this is present at every level, whether it is parenting, education, or the corporate world, we slowly learn to ignore our inner knowing and trusts that authority figures know best what’s right for us. To be seen as lovable, acceptable, we slowly learn to fit within the constraints of what is seen as acceptable in our society. We learn to ignore what feels right, in favour of what is seen as right.

    It can be hard to unlayer the learning of distrust of one’s instinct and to start accessing the inner voice inside. This is especially true when we enter an experience that is outside of our field of knowledge. And this is particularly true of the experience of pregnancy, birth and parenting. I see it a lot in my work as a doula. I see highly educated, intelligent individuals, who find it really hard to trust their instincts in the face of pressure from coercive maternity care policies.

    The same is true when we become parents, and it can be tempting to choose to believe the opinion of so-called “experts” in parenting, rather than following one’s inner guidance. I wrote about this in my blog Why baby books and “experts” can really harm you after you have a baby . It is true for most new experiences in life, most choices, and most life transitions.

    I see this being highlighted more than ever since the 2020 pandemic. There are so many conflicting pieces of information. Experts disagreeing with each other. Public health policies that treat people as a single entity and fail to take into account unique individual circumstances. Forever changing goalposts. Not knowing who and what to believe.

    I am not saying that it isn’t worth consulting people who know more than you do about an area. But as I explained in my previous blog, they cannot make the decision for you, because they aren’t the ones who are going to live with the consequences of your decisions.

    In navigating the perinatal period, and life changes, and for most of us in the current climate, learning to listen to our inner knowing can be a game changer, and bring out a sense of confidence and peace.

    But how do you start to unlayer the belief that the answers always lie outside of yourself? How do you start listening to your inner voice if you have always let the opinion of others guide you?

    There are many different ways to start accessing your inner wisdom. None of them is necessarily “right” or more powerful than the other. They are simply tools. The most important aspect is that you use one that works for you.

    I have been on a massive journey myself to debunk what I thought I had to do. For example I use to believe I was shit at meditation because I thought you had to sit on a cushion in the lotus position, stare at a candle, and think of nothing. This cool little animated video went a long way in helping to undo this.  It is surprising simple. All you need to do is have the intention to do so, and then start applying ways of accessing your own wisdom that work for you.

    Here are some ideas to try to get you started. Remember, that, as with any new skills, the more you practice the better you become. After all, if you were going to run a marathon you wouldn’t expect to do it without training. Start small. Start with the method you feel most excited about.

    Set an intention

    • The simplest way to access your inner wisdom is simply to set an intention to receive the guidance and see what happens.

    Meditation

    • If trying meditation appeals to you, there are many apps, such as headspace (and plenty of others, some of which are free) around to guide you through the process in tiny, incremental steps. It doesn’t have to be a commitment to have 20 min a day, it could be as little as 5 min and still make a difference.
    • Checkout the one moment meditation video. https://www.youtube.com/watch?v=F6eFFCi12v8

    Mouvement

    • Meditation does not even have to be a still process. One can meditate whilst walking, dancing, or other movement activities too. I am a fan of 5rhythms dancing (https://www.5rhythms.com/) and other conscious movement practices,These practises work much better for me than sitting still. I include my wild river swimming in my meditative practices.
    • When you feel stuck, try moving gently, or going for a walk. Bonus if you can get in nature, as it is extra grounding.

    Grounding

    • Walking barefoot on the grass/ground is a super fast way to discharge stress and ground yourself. From a place of grounding it’s easier to access one’s inner voice.
    • Being in nature is generally grounding. I swim in the local river all year round and it is one of my favourite ways to de-stress and meditate.

    Breathing

    1. As with meditation, simply paying attention to your breath can help your mind quieten enough to hear the inner voice inside. Again there are many techniques available, but you already know how to breathe (after all you’ve been doing it all your life), and simply paying attention to your outbreath, and slowing it down slightly is all you need. Some meditation apps include breathing relaxation.

    Heart centering

    • This is a quick and simple way to gain a more heart centered state. Breathe gently for a couple of minutes, then imagine that you are breathing in and out through the centre of your chest.
    • You can also try the HeartMath institute heart coherence technique .

    Journaling

    • Some people find their inner voice communicate best with them via writing. Again it doesn’t have to be complicated. All you need is a notebook and a pen, and a commitment to start with free writing 5 min a day. One thing that can help is simply to state in your mind before you write “what does my inner voice/soul (or whatever other word resonates most with you) want to tell me today”.

    Learning to recognise your body’s response

    • Did you know that you can use your body as a pendulum to get an answer to a question? Start by asking a very easy question, for example, do I like (favourite food or drink). Close your eyes and really feel inside your body. Feel your unique body’s response to the yes inside. Mine is a feeling of energy circulating in a circle around my heart, but yours might be completely different. Then ask yourself the same question for a food or drink you really dislike. Feel the response inside your body. Once you have familiarized yourself with your own response, you can start practicing with every day questions. The more you practice the easier it becomes.

    Drumming

    • I cannot resist mentioning drumming because I love it. It is one of my preferred forms of meditation. You do not need to be musically trained. Research shows that drumming to a simple, repetitive, heartbeat like rhythms, causes the brain waves to slow down, which helps to get the mind chatter out of the way. I wrote a blog called Drum healing, bullshit? about my self-taught drumming journey. Over the last year I have drummed twice weekly in the local nature reserve first thing in the morning. It is the most nourishing spiritual practice for me.

     

     

  • You are the expert in what is right for you

    You are the expert in what is right for you

    You are the expert when it comes to making decisions in your life.

    This is one of the most important points I share with my clients. I think it applies to many things outside of pregnancy and birth too!

    It can be tempting to defer decisions to experts such as doctors and scientists, or anyone you perceive as an expert in the field, especially if you are trying to make a decision in a area of knowledge that is new to you.

    But the role of the experts is advisory.

    They cannot make the decision for you.

    This doesn’t mean that the role of the experts isn’t valuable, because they can curate options that suit you when trying to oversee the whole picture might feel overwhelming.

    I liken it to choosing dishes in a buffet. The role of the experts is to curate the buffet to your needs (for instance making sure there is no animal products if you are a vegetarian), but they cannot choose the dishes for you. You do.

    Not the scientists, not the doctors, not the experts. You are unique with your own unique needs and you get to live with the decisions you make, not the experts. The role of the experts is to lay options in front of you. It doesn’t mean that the a coach isn’t valuable, because they can curate through a lot of options for you, but their job is to lay options in front of you and your job is to choose what’s right for you.

    Because they aren’t the ones who are going to live with the consequences of the decision.

    You are.

    Play

     

  • Postpartum support and butterflies: what do they have in common?

    Postpartum support and butterflies: what do they have in common?

    In my book, Why postnatal recovery matters, I explain that postnatal recovery boils down to 4 pillars: social support, rest, food and bodywork.

    Social support is the foundation on which everything else is built. If you are going to rest, have some great nourishing, food and some bodywork after birth, it’s kind of impossible to do this alone. You need other adults around to be supporting you in order to do this.

    But postpartum support goes beyond the simple practical aspect of having other pairs of hands to hold the baby, cook you food or give you a massage.

    Yes, having another adult in the house means that there is someone to help with house stuff, but most importantly, it means that we aren’t alone. It means that there is someone else to keep us company, listens, and reassure us when we doubt ourselves.

    It means, most importantly, that there is someone to hold the space for us.

    Holding the space looks like someone is doing nothing, but it might be the most important aspect of all. Heather Plett explains this concept beautifully in her article.

    In the episode of the Midwives’s Cauldron podcast I did about postnatal recovery, I tell a story that illustrates this beautifully (you can listen to it here). When my daughter was a baby, she suffered from painful gas at night which left her inconsolable. I became aware that she reacted to certain foods I ate and had to eliminate these from my diet. On a holiday to France when she was 3 months old, I unknowingly ate some food she reacted really badly to, and she woke up in the middle of the night and cried for over an hour. As I got out of her bed to rock and soothe her, my mother heard her cry, and she came to keep me company. She didn’t do much; she just sat with me whilst I rocked my baby. But having another adult there, just being present for me, meant that I felt much stronger and able to support my daughter.

    Recently a new mother I supported as a doula told me something similar: she said you have help during the day, but at night, you’re alone and it’s so hard. I helped her find a night doula, and it made a world of difference to her wellbeing.

    As humans we are a social species, and we kind of intuitively know that we need community support through life transitions. This is why every culture used to have (and many still have) a set of rituals around big life transitions life becoming a parent.

    The polyvagal nervous system theory tells her that we need each other to regulate our stress levels, especially at times when we are vulnerable.

    Postpartum rituals around the world all have in common a period of about a month during which the new mother is nurtured and looked after, almost like a child, because there is an innate understanding that she needs to be surrounded and supported by experienced adults as she navigates her new role and identity.

    Western societies are so focused on productivity that we tend to only plan for practical things. I see a parallel with what people ask me about my doula role. They ask what does a doula do, yet most of my role isn’t easily quantified, because it is more about being than doing.

    An analogy often used for the transition to motherhood is that the change from a caterpillar to a butterfly.

    If you have ever seen a butterfly emerge from its cocoon, you’ll know that as the butterfly first comes out, its wings are crumpled and soft. The butterfly needs to hang upside down from its cocoon or a nearby branch, whilst it waits for the wings to unfold, dry and strengthen. Only then can it take its first flight. If you’ve ever witnessed this you may also know that if the butterfly falls before the wings are dried, the wings are usually damaged.

    Postpartum support is the same. It is about providing stable ground. One cannot help or speed up the wings unfolding and drying process, but they can be the strong cocoon on which the butterfly hangs whilst they unfurl.

    We need to introduce this concept in the postpartum too: that what new mothers need, most of all, are people to hold the space for them, and who trust that they can find their own path, and unfold and spread their wings by themselves, in their own time, once there have become strong enough.

    (PS: if you’re a birth geek like me you’ll be fascinated like I was to learn that there is a substance called meconium, which sounds quite similar to the human version, which the butterfly pushes through its wings to unfurl them.)

  • How to normalise rest and support after birth

    How to normalise rest and support after birth

    One of the reasons I wrote my book, Why postnatal recovery matters, is because I got fed up of witnessing new mothers struggle and blame themselves for it.

    As a society we are blind to the needs of new mothers. When they struggle to adapt and adjust to the intense demands of new motherhood, new mothers tend to think that something is wrong with them, rather than placing the blame where it belongs, which is in a culture that totally fails to support them.

    We also place an abnormal value on independence, which means that new mothers often hide their struggle as feel shame and guilt, mistakenly believing that they are the only ones who struggle. It’s a vicious circle.

    Since I published my book, I have been heartened by positive stories about it. One second time mother in particular, said that because of the book she didn’t feel guilty letting other people look after her after the birth this time around. But there is still SO MUCH we need to do to change things. In my doula work I still witness new mothers blaming themselves for their struggles, and who feel guilty asking for help, who feel guilty at having me to supporting them even!

    We need to normalize rest and support after birth. I believe than when as little as 15% of new families get given the support they need, this will become. I need your help in doing this.

    Please share the message that resting and being looked after the birth isn’t selfish but that it is the norm for our species.

    Encourage expectant families to plan for the postpartum as well as the birth. It’s easier to have support when you put plans in place in advance.

    Play your part in the revolution by giving gifts that actually support the new family, like food delivery, vouchers for a postnatal doula or mother’s help, or voucher for a postnatal massage.

    The more people experience true nurturing postpartum, the closer we will get to the goal of transforming our culture.

     

    If you’d like to read more, I started blogging about this topic in 2016, and you can read more posts below:

    What new mothers really need

    Motherhood is fucking hard and you aren’t meant to be doing this on your own

    Have you heard of a postnatal plan?

     

  • Getting out of overwhelm

    Getting out of overwhelm

    A few years ago I started my journey out of overwhelm. I was overworked and stressed and I didn’t know how to get out of the cycle. I was trying to work harder out of it. It was so bad that I remember stopping to pick some berries on a week day on my way home and feeling guilty because I felt I ought to be working.

    I was stuck into a mindset where my productivity and my worth were mixed up, and I wasn’t even aware of it.

    Luckily I embarked on a coaching programme with Bonny Williams. As part of the programme, Bonny challenged me to spend one hour a week doing something called soft play. The idea of soft play was to spend an hour doing something nourishing and fun, alone.

    At first I struggled to find what to do. Bonny suggested I think about what I enjoyed as a child. I remembered I loved being in nature, build dens, that kind of stuff. I can vividly remember my first soft play: I went for a walk to the local nature reserve, alone, on a week day, when I “should” have been working. I had a lot of stuff to do that and I very nearly didn’t go. But I did, and it felt great and oddly rebellious. And, oddly enough, that day I managed to do everything on my to do list and I felt great.

    Fast forward 3 years, this has become part of my new routine, and had spread new fantastic new habits like year round river swimming, and drumming in the woods and 5 rhythms dancing. I’ve realised this is so important that  days I put the time in nature as the first task on my weekly to do list. And you know what? Magic has happened! I feel a more relaxed, creative and productive than ever. I also have a lot more fun. In fact I’m so elated with the results I’m planning to create a course sharing my experience.

    The bottom line is this: You can cannot get out of the overwhelm created by working hard by working harder. Let me say this again: you cannot get out of overwhelm by working harder.

    Instead, to create spaciousness in your life and more balance with play, you need to let yourself experience that play and spaciousness inside. Once you start experiencing this, all sorts of magic will unfold by itself and you will not look back.

  • Why postnatal recovery matters online course: what’s so special about it?

    Why postnatal recovery matters online course: what’s so special about it?

    My name is Sophie Messager and I am on a mission to revolutionise the postpartum.

    Everywhere around the world, there used to be a period of about a month after birth during which the new mother was taken care of completely. Family members, or members of the community, used to take charge of the household (chores, older kids etc), make sure the mother rested, provided specific nourishing foods, and well as give or organise some bodywork, such as postpartum binding or massage. It was a ubiquitous practice in every continent (and still is in many parts of the world today). In the Western world, we used to have this too in living memory.

    I do not know why we forgot, but I know that what we have isn’t adequate, and that our lack of understanding of this fundamental need puts new mothers under intense stress. As a doula I have been witnessing new mothers struggle alone, trying to meet their own needs and the intense needs of their newborn babies. Not only this, but there is also intense pressure for new mothers to “go back to normal” as fast as possible, which contributes to feelings of inadequacy and suffering. Because we have lost sight of the needs of new mothers, mothers often blame themselves for their suffering, wondering what is wrong with them, instead of seeing that their struggle is caused by a culture that fails to understand and support them.

    Having witnessed this struggle over 10 years, I have wanted to do something to change it.

    In 2020 I published a book called Why postnatal recovery matters, which is a call to action for a change towards a more nurturing postpartum. I wrote it because I wanted to provide knowledge and practical ideas for both new families and the people who support them.

    I decided to create an online course based on the principles highlighted in the book. The course provides more of a held experience, as it is divided into bite sized modules and lessons, and because in each module there is a video where I introduce the topic. I have also expanded on the knowledge I gathered over many years as a doula and perinatal educator, and expanded to write the book and which I have carried on acquiring since. As well as all the videos and text to read, one of the entirely new aspects that the course provides are questionnaires in each of the modules, which you can download and print. These questionnaires encourage you to explore your beliefs and your hopes and fears on each particular topic. You can then revisit the questionnaire after each module, to see if anything has changed. This provides a deep enquiry process which can be transformative.

    After completing this course you will have:

    • Learnt about traditional postpartum wisdom, and why we need it back
    • Gained a solid understanding of why preparing for the postpartum is essential
    • Learnt about your own beliefs and needs for the postpartum.
    • Learnt about the 4 pillars of the postpartum: Social support, rest, food and bodywork, and how to make them work for you
    • Learnt why hiring help, in particular a doula, can be a game changer
    • Learnt how to write a postnatal recovery plan
    • Learnt about preparing for every eventuality, including the unexpected

    By the end of this course, you will feel confident and armed with the tools your need to have a supportive the postpartum recovery, one that places the new mother firmly at the centre.

    This course is for you if you are an expectant or new parent, or if you are someone who supports expectant and new parents.

    What makes this course, and my approach, unique?

    • I have a unique blend of scientific, theoretical and practical experience. I was a biology research scientist for 20 year prior to reconverting to being a doula. What I bring is my unique signature mix of scientific, traditional, and practical knowledge.
    • The course is full of scientific references, with clickable links you can follow, and also full of traditional wisdom.
    • I have extracted the fundamental principles of what constitues a good postpartum recovery, looking at what is common between cultures rather than specific in each individual culture, and divided them into 4 simple principles which are easy to apply. This means that you can make it work for you and your unique family and circumstances.
    • The course is full of stories from my clients and from mothers and birth professionals, which help illustrate the topic with real life examples, as well as give you ideas that you may want to try.
    • As well as being a scientist, I have gained practical experience in many traditional techniques, such as wrapping the hips and belly, which I share with you in the course.
    • Having gained a DiPhe in antenatal education, as well as facilitating hundred of courses and workshops for expectant parents and birth professionals over 10 years, I know how present information in a way that allows students to learn easily and enjoyably.
    • The course has also been co-developed with a group of 85 birth professionals, so you know that the content have been tried and tested by experts in the field.

     

     

     

     

    What’s in the course?

    • The course is divided in 11 bite size Modules
      • Introduction
      • History
      • What we are missing
      • Social support
      • Rest
      • Food
      • Bodywork
      • Hiring help
      • Postnatal recovery plan
      • Special circumstances
      • Conclusion
    • Each module is presented with an introduction video, and a mix of text, pictures, videos, and questionnaires for optimal learning, and to investigate your own beliefs and revisit them as your go through the course.
    • The course includes access to a private Facebook group for sharing knowledge and ongoing support.

    FAQ:

    How long do I have to do the course?

    As long as you need. You get to do the course in your own time.

    In which order do I do the modules?

    As you prefer. You can go through the course in a linear fashion, or go straight to a particular module you are interested in.

    How much does it cost?

    ÂŁ119

    How do I access the course?

    Here 

  • The buffet curator: an analogy for doula work

    The buffet curator: an analogy for doula work

    Imagine you were going to a buffet restaurant in a foreign country, and that you had no idea what the foods on offer tasted like, or what the dishes contained.

    Imagine that you didn’t speak or read the language

    Imagine that you had your own dietary restrictions, such as being vegetarian, or being gluten free, or allergic to nuts.

    Imagine that the buffet restaurant was this enormous place, with more than a hundred dishes on offer.

    Imagine that, as you started queuing in front of the dishes, that people kept moving in front of the dishes, and that you knew people behind you would become impatient if you didn’t move.

    Wouldn’t you feel stressed? Wouldn’t you worry that you are going to pick the wrong dishes, some that you will not like, or that could cause you a major allergic reaction?

    Now imagine if you had a guide, someone who knew the restaurant and all the dishes in it.

    Imagine if, because you even entered the restaurant, your guide had taken the time to find out about your needs, made sure they understood what you wanted (and didn’t want), and then explained to you which dishes you would be able to choose from. Imagine that they had even gone and asked the chef which dishes were safe for you to eat. What if the guide could even ask the chef to prepare a different dish especially for you? How much safer and enjoyable would the experience be?

    This is what a doula can and will do for you, as you enter the maze of choices that pregnancy, birth and the postpartum bring. The many options, including ones you didn’t even know existed. The conflicting advice you find on every single topic.

    A doula is like your own buffet curator. As your doula gets to know you, your unique needs and preferences, she can sift through the many options available to you and present you with a curated list of options which you can pick from.

    You doula cannot pick the dishes for you, only you can do that, but having the list tailored to your needs might save you a lot of time and stress.

    A doula then walks the path with you, supporting you along the way and always being available to any questions as you choose, and get to decide what’s right for you. You even can change your mind at any point! Imagine how empowering this feels?

    If this resonates with you and you would like to work with me, you can find out more about the education and support I provide for families and birthworkers in the form of one to one support, and online courses.

  • Ten reasons to hire a doula even if she cannot be physically present during your birth

    Ten reasons to hire a doula even if she cannot be physically present during your birth

    What’s the point of having a doula if she cannot be present physically during the birth? Aren’t doulas just mostly hired for their supporting presence during that special time?

    Honestly when lockdown started in 2020 and hospitals in the UK introduced restrictions to one birth partner only, I asked myself the same question. I asked myself this question because despite having worked as a doula for over 8 years I had almost no experience of supporting labour remotely. I was utterly dismayed when I found out that I was no longer welcome in the hospital along the families I was already committed to supporting. Yet over the last 10 months, whilst I didn’t attend many births in person, I acquired a wealth of knowledge and experience in providing incredibly different forms of support in the forever changing rules in and out of lockdown. One thing that never changed for me locally is that my local hospital never relaxed the one partner only rule (I know that other hospitals in the country did things differently).

    Interestingly, many couples still choose to hire me for support despite knowing that I may not be able to be present at their birth. I am already booked for several different families in 2021, and including some repeat clients. I’m totally honest with people and explain from the onset that it is unlikely that I’ll be able to be physically present during their birth, unless they birth at home. But in these challenging and unpredictable times, having the support of a doula can still make a world of positive difference to your experience of pregnancy, birth and the postpartum. I’ll make a separate blog post for postnatal doulaing after this one.

    So what difference can a doula make even if she cannot be there with you at the birth?

    • 1) Antenatal education and birth choices

    In the extra challenging situation that lockdown and changing hospital policies bring, having someone to help you navigate your options is more important than ever. As your doula, I have an in depth knowledge of my local hospital policies, often being aware of policy change before members of the public. A doula can help you prepare for the unexpected and help you create birth plan that cover every possible eventuality that may present itself. It’s something doulas have always done, and I wrote a blog post called Why you may want to have a plan C (for cesarean) in your birth preferences.

    • 2) Emotional support

    Having someone you have gotten to know and trust, and who is always available at the end of the phone or email when you feel the need for support is even more important than before. In most trust there is no named midwife or a person you can contact directly within the health system at the best of times, but since March 2020, with the stretched NHS, this has become worse. Several of my clients said they left messages with weren’t returned. Just having someone you know you can call and talk to when you’ve worried about anything during your pregnancy, birth and the postnatal period, can make a world of difference to your wellbeing.

    • 3) Knowledge and information

    As before the pandemic, access to knowledge and information is a big part of doula support. There is a whole maze of information to navigate! Where will you have your baby, what kind of birth do you want, what if you cannot get your preferred choice, what are your rights, what’s the scientific evidence behind what you are being offered, what is right for you, yours and your family’s unique circumstances? I can help you access a whole network of people, from other health professional to complementary practitioners outside of the NHS, from osteopaths to complementary therapists to breastfeeding professionals.

    I supported a family who wanted to have a VBAC (Vaginal birth after cesarean). They wanted to be in the local birth centre but had been told this wasn’t possible. They weren’t based in Cambridge, but through my network of birth workers, I obtained the details of the consultant midwife at their local hospital. They had a meeting with her and got granted access to the birth centre. They had a beautiful empowering waterbirth there.

    I also supported a woman who was facing an induction of labour that she didn’t want or felt was justified. We had a chat over the phone and I reminded her of her rights to choose, ahead of a meeting with her consultant. I received a very grateful email afterwards explaining that she had felt much calmer and confident going into the meeting thanks to our chat, and that the meeting had gone very well. She went into labour naturally.

    • 4) Practical support

    I am skilled in many support techniques that can help make your pregnancy, labour and birth, and postpartum period more comfortable. I can teach them to you, or signpost you to someone who can support you if you aren’t local to me.

    In 2020 several of my clients had breech babies, I was able to teach positional and rebozo breech turning techniques via video calls (I became very good at using a tripod to hold my device, and at contorsioning myself to demonstrate positions!) or in person. I was also able to signpost them to osteopaths who helped balance the pelvis so the baby had more chances to turn, or to acupuncturists who taught them how to do moxibustion. I also helped to access the information to help them decide whether having the baby turned manually (known as an external cephalic version) with an obstetrician was the right choice for them, as well as what would happen during the procedure/

    • 5) Labour preparation

    I can help you be prepared for what do expect during labour and birth, and decide what kind of comfort measures you’d like to use, and explore their pros and cons. I can teach you such comfort measures so you are feeling prepared and confident, even when I’m not physically present.

    In 2020 I started writing custom relaxation scripts to help with things from promoting relaxation and confidence, to help turn a breech baby, to help labour start when due date had passed and an induction date was looming. I recorded myself as I lead expectant parents through those scripts and sent them the recording to listen to. One couple reported that they went into labour after listening to the “overdue” relaxation script I had sent them over and over again, and that the mother went into labour despite the pressures of the looming induction and had a very straightforward birth.

    As well as teaching you some of the many comfort and relaxation measures for labour I know, I can teach the ones that suit you to your partner. This means that your partner will feel more confident in supporting you, that the two of you can work better together, and that you are both likely to have.

    • 6) In person Labour support

    As a doula, I’m still able to provide in person support in early labour at the couple’s home. This means that I can come and support you when labour starts, and help you feel comfortable, confident and safe. This means that you do not have to worry about when it is the right time to go to the hospital (or call the midwife if you’re having a homebirth). This means that there is a reassuring presence in the background. It can help both you and your partner feel much calmer and safe. It means that you are more likely to have a straightforward experience, especially if this is your first baby and you do not know what to expect or what is normal.

    All hospitals still allow one partner, and I have supported families who chose to have me being present at the birth in the hospital, for example if the partner had to stay at home to care for older children.

    • 7) Remote labour support

    Because we will have gotten to know each other well, you’ll have come to trust me and feel safe with me. By the time you are in labour, knowing that there is something you can call at any hour of the day or night, and that I will be there

    As I mentioned at the beginning of this blog, I was myself unsure of what difference I could make remotely. I was pleasantly surprised to find that I could still make a world of difference during labour.

    I could join couples at home in early labour, I could be there on the phone or video calls in early or later labour. Because I had prepared the partner with extra techniques, when they called me describing a stall in labour, I was able to guide them through specific rebozo techniques designed to help resolve such issues with great success. I was still able to provide advocacy and help people navigate their options.

    During a birth in 2020, a partner called me as labour had stalled and there were talks of moving to theatre. As I had taught him some of the most useful labour dystocia resolving techniques I know. After asking him a few specific questions I suggested a couple of positional and rebozo techniques. The baby was born vaginally 40 min later. Another partner called me telling me that his wife had been pushing for 2h, and that due to arbitrary limits on pushing duration from the hospital, transfer to the delivery unit was being strongly suggested. He asked if they could refuse. After asking if both mother and baby were well, I reminded him that it was their decision to make. The baby was born in the birth centre pool 20 min later.

    A challenging time last year was when I had to watch a woman that I had previously supported as a doula 3 times before, walk into the hospital alone for her planned cesarean birth (my local trust currently only allows partners in the ward as they go into theatre, so the mother is alone in the antenatal ward until she gets called to go to theatre). I went to meet her in front of the hospital. I thought I hadn’t made a difference but later one she said “It definitely helped to still have you as my doula in lockdown as it was really lovely and comforting to know you were just at the end of the phone for a chat or advice. It was also lovely to see you outside the hospital before I went in, and to talk to you in the evening about the birth”.

    Zelle the doula shared this account of supporting a birth over the phone (you can read the whole story here)

    “It feels like she’s wrenched the phone out of her husband’s hand, as her eyes lock on to mine “Zelle!” she breathes as a surge crashes like wave over her “Zelle-I-really-need-an-epidural” she scrunches her face up “I can’t CAN’T do thissss”. I am calm. An even tone. The bit I wish I was there for, because I would stroke her hair out of her face and be gentle with her poor tired body and be slow and gentle and grounding. I have to do it all with my voice instead. “A,” I say. “You are so strong. You are magnificent. This is transition, that hard bit we talked about. This feeling will leave.” I’m conscious of the fact the adrenaline will kick in momentarily. ” You know what to do. Your body knows this. You’ve been in labour a *long* time. It’s a lot of hard work. There’s no shame in an epidural if you want one. But you’re wrong on one point, A, you CAN do this. I completely believe with every fibre of my being that you can do this. I believe in you.” She shoves the phone back in to her husband’s hand. “I CAN do this!” she breathes. I am so proud I wipe tears away.”

    • 8) Navigating the unexpected

    If anything happens during pregnancy, birth or the postpartum you can rest assured that I will be there to help you navigate the situation. From labour starting early or labour, or a sudden diagnostic of a medical situation which changes your birth choices, I have supported these kinds of scenarios for the last 8 years and I know how much of a difference it makes to have someone by your side to help you find out how to make the best of it.

    • 9) Postnatal preparation

    Postnatal preparation and support is one of my favourite topics. I feel it is so important that I wrote a book about it, called Why postnatal recovery matters. As your doula, I can help you prepare for the postpartum, be it the immediate few hours post birth in the hospital or at home (including how to prepare for the fact that most partners may not allowed to visit postnatally in the hospital), or the later parts from coming home with your baby, from feeding choices to parenting choices. As part of my contract you get 6 weeks of unlimited phone and email support after the birth of your baby.

    • 10) Postnatal support

    After your baby is born, especially if you are alone in a postnatal ward without your partner, or if you have your partner but medical staff is too busy to help support you, I can do call or video calls as soon as you need me to help answer any needs you may have. I have become skilled at provided feeding help over video calls, either myself or putting you in touch with breastfeeding counselors, who have also become very skilled at providing feeding support over video calls. More in my next blog on postnatal support during lockdown.

    Finally, here is a story from a mother I supported in 2020:

     “It would be easy to feel like pandemic restrictions preventing extra birth partners would make hiring a doula pointless. After all, if they can’t be at the birth, why bother, right? I might have felt the same, if it weren’t for our experience of growing and birthing our daughter in 2020 with Sophie’s help.

    When the pandemic hit, and suddenly even my husband wasn’t allowed in to scans or appointments. Secondary birth partners were banned from births completely. These restrictions still hadn’t been eased by July, when I unexpectedly entered prodromal labour at 36 weeks gestation. After a week of contractions at home that weren’t getting any more frequent, I entered the hospital to have my labour artificially progressed. I laboured, for large parts alone, for five further days, before finally delivering my daughter by c-section (or belly birth, as I like calling it!). Again, even getting my husband into hospital to support me was a fight. The presence of a doula was a complete non-starter.

    So do I regret hiring Sophie? ABSOLUTELY NOT.

    If anything, I am MORE grateful we did because of COVID. More than ever, being asked to navigate the labyrinth of the maternity care system is a nearly impossible challenge women are being asked to undertake. Especially in a pandemic, alone. I have no idea how I would have begun to survive it without the preparation Sophie did with us, and the support she still managed to provide both during and after our birth.

     I had the space I needed to process rather than internalise my grief. I had the planning and preparation I needed to take care of myself both during and after the birth. I had the support I needed to bring my baby home to an overjoyed family that was ready to receive her. I had the confidence to know I can be and am exactly the mother she needs. I was left so in awe of the work of doulas that I’m becoming one. ” Elle.

    If you’d like to read more about this topic, I wrote a blog called The Value of a doula, one called What do you get when you hire a doula, or why she’s totally worth the money, one about how a doula can support you if you are having a planned cesarean birth, and one called The incredible things doulas do to support their clients. Whilst these were written before 2020, much of what I explain in them still applies.

    If this resonates with you and you would like to work with me, I offer education and support for families and birthworkers in the form of one to one support, and online courses.