We recently asked for stories from the people trained in offering closing the bones. We ran a competition to celebrate our 200th member. We wanted their experiences of both giving and receiving. We had many marvellous entries and will be sharing the winning entries over the coming weeks. Here is our runner-up winner, Rosie, with her beautifully touching story, which illustrate perfectly how healing closing the bones can be.
Please visit our sister website to read it
This week I attended the advanced spinning babies workshop with Gail Tully and Debra Mc Laughlin. I already knew many of the techniques, having learnt them with other birthworkers, and having refined them by attending the first spinning babies workshop in 2016.
Spinning babies, the brain child of American midwife Gail Tully, is a set of techniques designed to ” optimize the physical relationship between the bodies of the mother and baby for the easing of childbirth. Spinning Babies is a new paradigm that takes clues from baby’s position and station for natural, physiological solutions. “
It has achieved mythical status amongst birth workers worldwide and for good reasons. Spinning babies has 4 core techniques, called the fantastic four. I was already fairly skilled in the first 3 techniques (Rebozo sifting, forward leaning inversion, and side lying release), having used them with my clients for a few years.
But the 4th technique, known as the standing sacral release, was new to me. I suspected it required a degree of touch and skill I simply didn’t have. I also kind of expected a static technique. I was wrong.
The technique is both more subtle and more simple than I expected. It was also more powerful.
It was developed by Dr Carol Philips, a cranio-sacral and fascia therapist, as an alternative to abdominal fascia release, because she found that the lying down position it required wasn’t comfortable for pregnant women.
First Debra had us realising the extend of our proprioception by laying a long cloth on a massage table and had us taking turns holding one end of the cloth between our fingers with our eyes closed, and gently pulling on it, whilst someone else put their finger somewhere on the cloth. We had to guess where the person had put their finger on the cloth, and much to everybody’s amazement, we all could determine easily where the person’s finger was located on the fabric.
Next she had us holding inflated balloons so we could practise how gentle the touch needed to be for fascia release to avoid blocking the fascia. We had to hold the balloon gently enough to stop it from falling down, but without deforming it.
Then Debra demonstrated the instinctive and involuntary movements that came when she held and gently pressed the balloon whilst someone else held it. The woman holding the balloon proceeded to do some kind of gentle spontaneous dance, which was both beautiful and unexpected.
We all had a go at the balloon dance, and it was fascinating, because we didn’t quite believed that it would work but it did-and the sensations and movements it produced where completely intuitive and unpredictable, as well as different for everyone.
Finally Debra showed us how to place our hand on the pubic bone and the sacrum, to encourage the same spontaneous dance, known as fascia unwinding. It was a fascinating experience, both receiving and giving it, as each of us started doing these amazing involuntary unwinding movements. It was a slightly surreal and also a very lulling and soothing experience.
My mind was blown away and I couldn’t quite believe the process, yet I experienced how powerful it was. I found the idea of this technique incredibly empowering. Usually manual therapy involves someone actively doing something to your body, which somewhat implies that you cannot do it yourself. With the standing sacral release, the receiver is doing their own fascia release, rather than it being done by the giver. The giver just acts as a trigger for the process.
Debra talked about the hands of the giver producing an electric circuit which allowed the process to happen. Some of it really felt like energy work to me. If you want to see what it looks like, this is the closest I have found online, though it isn’t quite the technique we did, which was done standing up, but you’ll get the idea
Being my usual curious self, as soon as I got home I hit google and found this article on the topic. The theory behind the technique is that “The therapist working on a client will introduce touch or stretching onto the tissue. Touch stimulates the fascia’s mechanoreceptors and, in turn, arouses a parasympathetic nervous system response. As a result, the client is in a state of deep relaxation and calm. In this state, the conscious mind is relaxed and off guard. The central nervous system responds to this proprioceptive input by allowing the muscles to perform actions that decrease tone or that create movement in a joint or limb, making it move into an area of ease.”
The next day I got to try it whilst combining it with a closing the bones massage session, and the two techniques complimented each other beautifully. The day after that I did it on a doula friend, and she loved it
Today I tried it on my kids-they moved less than adults and finished it a lot faster-kids have a faster moving energy. I cannot wait to try on pregnant women and during births in particular.
And I am also much looking forward to showing it to birth partners. From what I can tell, it might be both the most gentle yet most effective of the 4 main spinning babies techniques.
Please visit our sister website to read Dr Attila Jonas’s account of closing the bones
This week is world doula week and I thought it would be the perfect occasion to reflect on what I have learnt since I became a doula.
I kind of fell into doulaing when Maddie McMahon invited me to attend her first ever Developing Doulas course, back in 2008. Four years later, Maddie also precipitated my decision to leave my scientific career when she asked me to attend a birth as her backup (I attended the birth on my day off as I was still working 4 days a week as a research scientist).
I remember this birth vividly. It was a long induction, and 3 of us tag teamed to support this couple. On the early morning when I made my way to the hospital, I was both excited and scared. Would I know what to do? Would the hospital staff sussed that I was a newbie and treat me differently?
Once I joined the couple in the hospital room, however, everything fell into place and I found my role to be very instinctive and natural.
I had my eyes and ears wide open and learnt an awful lot that day. As someone who was a staunch proponent of natural birth, I was quite surprised to find that when the couple chose to go for a caesarean, I knew in my bones that this was the right choice for them, and wholeheartedly supported their decision. They were going to end down that route anyway, and it was wise to do it sooner than later because it would be a lot more traumatic later on after many more exhausting hours on the synthetic oxytocin drip.
The mother had a strong instinct that something about the cord was preventing descent. I watched her express this repeatedly to 4 different staff members, only to have her instincts dismissed each time.
Baby wasn’t engaged, and at some point the mum had a wobble and asked me to massage her shoulders. With an epidural in place it wasn’t easy, so I just put my hand on her shoulders and gave her some Reiki instead.
As soon as I did this, her baby dropped into the pelvis ( the change in her bump shape was very noticeable), she opened her eyes in wonder asking what I had done, then we noticed the baby’s heart rate dropped very significantly. The baby then popped back up, and the heart rate resumed its normal rhythm.
I felt very strongly that this baby needed to give me a message.
This is why I felt totally in agreement with the parents when an obstetrician suggested to either keep going with the induction, or stop and go for a caesarean. I knew this baby couldn’t be born vaginally.
During the caesarean they found the cord tightly wrapped around the baby’s body, preventing descent (a very rare occurrence).
This day I learnt two valuable lessons: always listen to mum’s instincts, and that what makes a good birth experience isn’t what happens on paper, but how the parents felt supported and respected through the process.
I went home feeling completely elated, and it felt fascinating to me, because if I had been told a few years earlier than my first birth as a doula would be an emergency caesarean and I would feel happy about it, I would have laughed.
A few days later I went back to my science job, and as I sat at my computer I thought ” what am I doing there? Doulaing is so much more exciting”.
A couple of months later I handed out my resignation. I started doulaing officially a few months later, at the beginning of 2012.
The universe must have heard me loud and clear because I kept being booked by clients both birth and postnatal, and became a recognised birth doula by the middle of the year, and postnatal a few months later.
It was a very exciting but also a very challenging first year.
During this first year I supported glorious, straightforward physiological births, which left me on a high for days. I also witnessed obstetric violence for the first time and spend several days bursting into tears after some of the births.
I guess I took for granted that supporting birth would be amazing, so I was surprised how much I loved supporting new parents postnatally too. Although it felt very different, I loved it as much as supporting births.
There is a kind of intimacy about being in someone’s home in those first early days after the birth, where everybody is open and tender, which feels like a real privilege.
I discovered that I felt just as passionate supporting parents choices after the birth than before and during the birth.
I also experienced doula burn out, and I learnt to develop a completely new kind of way of looking after myself (I wrote about this here). These days, I am religiously having some kind of body work treatment after a birth.
In my early days I experienced trepidation when meeting parents for the first time, and I also used to turn up at antenatal appointments with a teaching plan. I have longed stopped doing this, much preferring a go with the flow approach.
I also experienced rejection, not being the chosen doula after an interview, and even though I knew this was the right choice for the parents, it did hurt a little.
In my first year, I embraced every job that came my way with boundless excitement, whereas now I am a lot more picky.
I have learnt a lot about my own boundaries. And I also have learnt about what makes my heart sing and what doesn’t.
In my first two years as a doula, I had several long term clients whom I supported postnatally for several months. I have since realised that I enjoy much more supporting couples for just the first few weeks postpartum until they find their feet, rather than for months.
I have also learnt that I much prefer supporting first time parents postnatally because I love the emotional support that comes with those first few weeks, whereas with second (or more) time parents, the support tends to be leaning more towards practical stuff and I don’t find this quite as fulfilling.
I have developed a thicker skin when it comes to witnessing difficult moments at births. I still have the odd tear fest though!
There is never a dull moment in the life of a doula, and whilst I have cried tears of sadness and frustration on many occasions, I have also experienced incredible highs, and often cried tears of joy and gratitude, something I have never experienced in any other job.
I am humbled and immensely grateful for how much personal development being a doula has brought me.
Being a doula exposes me to a much wider range of people and lifestyles than my old job did. I often joke that as a scientist I only met other scientists, and sure, they were all different, but as a doula I regularly met people who have jobs that I didn’t even know existed!
Being a doula has broadened my mind beyond belief. There are so many different dynamics, so many different lifestyles and families, and so many different good ways to be a couple, to be parents or a family. I am humbled by it all. Not many other jobs give you such an intimate insight into other people’s lives.
People keep surprising me, and I love it. In this job we get to really know people for who they are and not what their job is. Every time I think I have someone sussed they surprise me with something unexpected. We are all so full of fascinating quirks, and nobody fits into a box.
I have learnt to try not to have any expectations. I used to sit in my car before driving off to a birth, sending well wishes to the mum and her baby. Now I sit, and I just trust and surrender to the process, and I guess, a higher wisdom, that all will unfold as it is meant to. I find this incredibly liberating.
I have learnt so much from the doula community. From new skills to new friendships, nowhere else have I found such an incredibly supportive tribe of like minded women.
I am so grateful for the all the gifts the being a doula has brought me.
I would like to dedicate this post to my gorgeous and wise friend Maddie Mc Mahon, who started me on this journey 12 years ago when she agreed to be my doula.
I have been meaning to write this for a while. This week I had a couple of conversations with people which finally gave me the impetus to write it
I have 4 hats: doula, antenatal and postnatal educator, babywearing instructor and healer, and therefore interact with a lot of people in these fields. Every single of these professions involves nurturing others.
Many of my colleagues find it difficult to charge for what their services are worth. I see a lot of guilt around money, I see people not valueing themselves and the amazing work they do.
So if you’re a doula, a babywearing instructor, an antenatal or postnatal educator, a healer, or if you work in a profession that involves giving a lot of yourself and you find it hard to charge for your services, please read on, because this is important.
First I would like you to ask yourself: why am I doing this?
Set some time aside and really think about what motivates you to do this, what is the drive behind your decision to pursue this job. Chances is you aren’t in it to make big bucks, but because you care deeply about people and you want to help change the world. I find that most people who choose this field don’t usually do it because of the earning potential! (and I should know because I left a prestigious and lucrative 20 years long career in scientific research to do this myself and I sure as hell didn’t do it for the money).
But there is a sneaky, underlying unspoken implication somewhere that if you have a job that you love and that you find completely fulfilling, somehow it’s not OK to earn money from it. This is just wrong.
To make an analogy, my brother is a professional musician. Artists often gets asked to do things for free, or for “the exposure” or because people don’t see their work as “work” they think they are just having fun so shouldn’t expect to be paid for it. This is bullshit. This article explains it well
Next, I would also like to invite you to think deeply about the underlying reasons behind why you feel that you can’t charge a decent amount for your work.
I can’t answer it for you because it’s a very individual thing. What I can tell you is that I consider myself to have fairly good self esteem, but when I started as a babywearing instructor 7 years ago, I had massive impostor syndrome (I’ve blogged about this topic here ), and even though I had spent quite a lot of time and money training and buying equipment, I still felt embarrassed to ask for money for my work.
When you think about it, it is ridiculous. I had spent well over £1500 on training, equipment and insurance (I since went on 2 more training courses, and bought many many other slings and dolls but that’s another story), and many hours reading and researching stuff, and yet there I was thinking I was a fraud.
It really does add up, by the way, I invite you to sit down and do the sums for yourself too, because it helped me value what I did more.
You may find that deep down, the issue is that you don’t value yourself and what you do enough (the impostor syndrome again), and that this is a major block to feeling that your services aren’t worth anything.
I haven’t got a magic bullet answer to this, but I found that writing down what I do when I support people helped me realise that I do A LOT, including things that I didn’t even realised I did, because when you’re good at something, you just do it and find it easy and don’t tend to even realise that it’s a skill and you are doing it, and doing it well at that.
I also found asking for feedback from clients went a long way to help me realise the value of what I do. I keep a file in which I copy and paste ALL the positive feedback I get from clients (and yes I ask for feedback and testimonials because most of the time I wouldn’t get it otherwise). Reading the file really lifts me up when I’m low or doubting myself.
Finally, comparing your prices to local practitioners offering similar services (say, bodyworkers like massage therapists or osteopaths), also goes a long way in realising that many of us do not charge enough money for what we do.
But that’s not the most important message here. This is:
Why do you owe it to yourself and your community to earn a decent living out of your passion?
So, and keeping your “why” in mind, I would like to invite you to think about what’s going to happen if you can’t support yourself and your family and earn a living out of it.
Ultimately, if you can’t afford to earn a living out of your craft, chances are, you won’t be able to keep doing it. So your amazing service may disappear, and you won’t be able to serve your community anymore. That’s right.
If you think about it this way: charging a reasonable fee isn’t selfish, it is something you owe it to your community so you can keep doing it.
Finally, and we’re coming back to the “artists shouldn’t do it for free” topic-if you don’t charge for your work, you are also doing other workers in your community a disservice because you are contributing to the idea that this service should be available for free.
Most of the professions I’m in at quite new, in the sense that few people have heard of them (this is particularly true for babywearing instructor, which didn’t exist as a formal profession in the UK until 2011). So whilst people expect to pay a hairdresser or a plumber (because these are recognised professions and people know their value), they can be puzzled at having to pay for something they haven’t heard about, and therefore do not know of its value.
By charging a reasonable price for your work, you are also helping the community value your work and build up its reputation, because people tend to value more what they pay for. I really like this article by Selena Rezvani, and these quotes in particular:
” As women, whether entrepreneurs, corporettes, or community leaders, we often expect our fellow sisters to do a task for some unclear or nonexistent future benefit.”
“Whatever the reason, if you are asked to pitch in your research, skills, or accumulated experience without some type of compensation now or in the future, I hope you will consider the request very carefully, with a bent toward saying “no.”
“If you have a problem asking for compensation, realize that the effect of not getting paid extends beyond you. If I give a speech to a student-run college club of women for example, and I tell them my expertise costs nothing, what am I teaching them about themselves? What am I saying about how they should conduct themselves in the future or estimate their own worth? Of course, I’m not talking about charity and pro bono type work, which is an exception; I am talking about freely giving away our expertise that we’ve worked hard to build. “
I’m not saying that there is anything wrong with volunteering by the way, because drop-ins do amazing work in the community, and I also believe that the people who cannot afford support services often need it the most.
But I have also seen too many of my colleagues giving discounts to people who earn way more than they do, and that’s just wrong (interestingly it is rarely the people who can’t afford services who haggle prices down). I’m also not saying that you can’t offer your services for a discount or even for free when someone cannot afford it and you feel drawn to helping them. I also love skills swaps and bartering. But by all means, make sure you do it for the right reasons and not at the expense of your wellbeing.
I’ve heard people say “I feel I can charge for my one to one work because I volunteer at this free drop-in”. You don’t have to justify your prices. It’s OK to charge AND it’s OK to volunteer. But you don’t HAVE to volunteer in order to charge for your work.
You owe it to both yourself and your community to charge a decent price for the amazing supportive, life saving, community building work that you do.
When I started working as a doula, one of my biggest fears was: how will I survive the sleep deprivation of a long birth?
The universe was kind to me, because my first birth was a text book, 12h long easy birth centre water birth, I came back elated and full of joy!
And overall, during my first year as a doula, I never had a marathon birth.
True I supported a birth that lasted 2 nights, but as the labour ebbed and flowed and we were at home for the longest part of the labour, I managed to have naps and even went home for a couple of hours, so I wasn’t beyond exhaustion.
My first marathon birth happened about a year into my doulaing. My client waters broke with no contractions, she declined induction. So before labour started, there were a couple of interrupted nights with phone calls etc, until I eventually joined her at home 2 days later. This was followed by 40h of labour-spanning a whole week-end and 2 sleepless nights.
I had no idea that I needed to pace myself. I had no idea inductions could last this long (I know now!), so the first night I didn’t sleep at all, and the second day I didn’t function very well at all.
I had no idea until then how lack of sleep affects your mood for the worse. When after about 24h (it was in the middle of night) the midwife announced that she was only 4cm dilated, I had to go into another room to cry, and I beat myself up for it.
I had no idea moods ebbed and flowed and that after the dark night of the soul (usually around 3/4 in the morning when your body temperature is at its lowest), my mood and energy would lift again.
I had no idea I should make sure I ate and drank at regular intervals.
I was pretty crap at looking after myself.
By the second day I was falling asleep on the chair I was sitting on without even meaning to. And whilst I waited for them in recovery, I fell asleep on a trolley.
When I got home after the birth, and had slept for 12h, I still felt very crap and also very weepy and again didn’t understand this was just caused by the tiredness (I felt OK about the birth).
Since then I have attended many long births (though none were I was present for quite as long as this one). One year pretty much all the births I attended were between 24h and 37h long-which is pretty standards for first time mothers.
So what I have learnt, and how do you look after yourself during a marathon birth as a doula? (I wrote this for my doula colleagues, but if you’re a birth partner, much of it applies too!)
First, talk to the parents about it antenatally, so you don’t feel guilty worrying they’ll think you’re a crap doula when you take a nap. I explain (especially with first time parents) that first time births can take anything between 24h and 48h and that’s normal, and I talk about how to manage the early stages (basically try to ignore it until you can’t). I also explain that I will take naps in order to be at my best to support them, and I’ll also encourage dad to sleep too (we can tag-team). If you can’t sleep, doing some relaxation/meditation/deep breathing/ being quiet in the corner for a while will help as well. This is well worth practising ahead of time as you get better at it the more you do it. And if you’re trained in energy work, like Reiki, a self treatment can really help.
Second-pace yourself. I might go to reassure the parents in early labour, then go home, or sleep on their sofa/their spare room, during the early stages of labour. I’m also more relaxed and much better as waiting than I was in the early days-but I guess some of that just comes with experience. The good thing is, I’ve learnt to doze and sleep pretty much anywhere. It’s much easier in someone’s home by the way, where there is soft furnishing. If in the hospital, I might ask for a mat and curl up and sleep on it for a while. I fold my rebozo and use that as a pillow, and I have a nice warm shawl to use as a blanket in my bag to cover myself with. I never turn down the opportunity for a little sleep, because it can be difficult to guess how long I am likely to be there for, so I would rather prepare for the long run just in case (and mentally it’s easier to be prepared for this and then be pleasantly surprised than the other way round). Even a 20 min catnap can make a huge difference!
Third-stay hydrated/fed. Make sure you have good nutritious snacks in your bag. Junk food won’t cut it. I have a collapsible water bottle which I fill as soon as I arrive in hospital (hospitals are very dehydrating) and I chuck a rehydration tablet in there too (I like the brand Nuun). I have some good quality nuts/dried fruit and energy bars. And some dark chocolate, and good quality instant coffee (instant coffee in hospital is vile)! Oh and when I get really tired I drink some Guronsan (a French effervescent tablet made from caffeine, sugar and vitamin C-you can buy it in the UK too. I guess it’s a bit like red bull but in a much more portable format). I also have a couple of energising rollon essential oil bottles and sprays-made by 2 doulas I love, when I use them it feels like they are kind of with me in the room giving me a hug (you can get them here). If you get the chance to go grab any kind of proper food (for me, getting something hot like soup etc hits the spot) during the birth-do that!
Fourth-Look after your body, do some stretches, go for a walk, get some fresh air. If the birth is going on for a very long time, I get cabin fever. So going to the toilet and splashing water on my face (I go to the outside toilet even if there is an ensuite for example, so I get to stretch my legs), going for a walk, getting a cup of coffee (I encourage the dad to do this too), can leave you feeling refreshed. Similarly, my rebozo has also come to great use to soften stiff shoulder muscles when I have been in the same position for a long time (see my video on how to do that here)
Fifth-be kind to yourself. Don’t beat yourself up, accept the low moods when they come (they will!), because berating yourself will waste precious energy. You’re only human and you are doing the best you can and making a huge deal of difference by just being there. If you need to exit to have a good cry, do (the toilet is a good place for that). If you can call a doula sister for a pep talk, do that.
And finally, sometimes I worked in a shared care team with another doula-it can be absolutely priceless to be able to tag team if the birth goes on for a really looooong time.
Remember-this isn’t selfish, because you cannot be your best at supporting parents through a long birth if you’re dehydrated, starving and exhausted. I also find it really useful to explain this to partners antenatally, because they too, tend to be crap at self care whilst supporting their partners through labour, and to worry that they are being selfish if they need a break/some food/a nap etc. By explaining this and modelling this behaviour, we help them too.
So there you go, my guide to surviving long births. It’s quite simple really. This is what works for me so far, it doesn’t mean that it necessarily will be what works for you-do experiment and find out! I would love to hear tips from others too 🙂
If this resonates with you and you’d like to work with me-head over here
PS: A comment also reminded me-although this is more likely to be the topic of the next post below, that if you are seriously sleep deprived-do try to make safe choices as to whether you are able to drive home or not.
PS: This is only half of the story-I’m planning another post called “How to recover after a long birth as a doula”
Today is Valentines day.
Up until a few years ago, I bought into the “romantic” idea of it.
I don’t anymore. I guess you might have got that from the title of this post already 😉
I think it ‘s a piece of commercial bullshit, and it just makes me laugh, to be honest.
The whole thing is a fake.
I’m not a sad, lonely, Valentines day pooper, envious of my coupled friends by the way, I am happily married.
But love isn’t about giving your loved one presents on a day prescribed by the cards and flowers industry.
Love is about all the normal every day things you do for each other. Love is about support when the going gets tough.
Once when I lived in Paris I had a boyfriend who was “romantic” in the sense that he wrote me love notes all the time. Like the time he wrote “I love you” on each one of my eggs in the fridge. It made my girlfriends swoon. Only when I had a bad day at work, he didn’t want to know.
It wasn’t love. It was show-off bullshit.
It was buying into the outdated idea of romantic love being ideal and all smooth and glossy.
That love is only the lovely pink fluffy time when fall in love and everything is perfect.
Having had this experience makes me appreciate my husband more. He isn’t a romantic note kind of person but he is a rock when I have wobbles, like the time he woke up at 5am to listen to me talk and hugged me whilst I cried when I came back from a long, difficult birth. That’s worth a million “I love you” eggs.
Even when I lived in Paris and still bought into the whole thing, I saw men walking home with a single rose, and it felt fake. I remember hearing a news report on the radio saying “Today is Valentines day-this is the day when your wife will be angry if you don’t come home with a rose”. That sums it up really.
I don’t buy into the idea of having to show love, to show romance, to buy stuff on a day prescribed by the industry which benefits from it. It sprouts every where: supermarkets, cards shops, flower shops, chocolate shops, the list is endless.
I don’t buy into the idea that one’s love is measured by the gift received on valentines day.
I am saddened that personal “romance validation” rests on whether one receives cards/flowers etc or not at the office.
It’s all show and no substance.
A restaurateur once told me that this is the busiest night of the year-busier even than holiday celebrations.
When I used to buy into the Valentines thing, I used to go out with my then boyfriend for evening meal. It was hard to find a table somewhere nice. I now couldn’t think of anything worse than spending the evening in a packed restaurant, “having” to be romantic, surrounded by other couples doing the same thing.
The best nights out often turn out to be spontaneous things with low expectations.
Even at my fucking gym this morning there was a “Valentine days couple retreat” massage table in the hallway, completed with flower petals and LED candles a-flickering.
And don’t get me started with all the over inflated prices of “romantic” items around this time of the year.
Talk about making a quick buck on people’s insecurities.
Give me true real life love every day, warts and all, over the glossy fake version of romantic love peddled by Valentines day and the media.
True real life love, like normal real life life, is a sinusoid curve. It’s full of highs and lows, full of tears and laughter, anger and joy. It’s not photoshopped.
It’s got wrinkles and imperfections.
It’s not always easy.
But it’s real.
I am sure I am not the only one who feels this at the moment.
We aren’t in a particularly happy space in the world right now.
I spoke to several friends recently about the doom and gloom of my Facebook feed.
Some people have chosen to give themselves a social media break as they find it is affecting their mental health.
I feel that, right now, news report should come with a health warning. There is a distinct, “oh what the fuck now?” feeling when news reports appear.
In no order of importance, in my world at the moment, issues I see the most are: The US political situation, the refugee crisis, Brexit (this affects me directly as a EU citizen), the disappearance of independent midwives, the NHS crisis, women’s rights being denied, it goes on and on.
I see a general step back of people’s rights and individual liberties.
I see a lot of anger, and fear.
I have to remind myself on the daily basis not to succumb to that fear. And sometimes I do.
But the thing is-anger and fear do not allow us to be positive forces of change.
There is an old Cherokee legend about the two wolves inside of us. It goes like this:
It is a myth that being overpowering is true power. It is a myth that you can fight hate with hate.
I spent many years in my youth mistakenly seeing as powerful the people who spoke the loudest.
It took me many years to undo this belief and realise that the true source of power is kindness and respect. That true leaders lead by example and by making people feel good about themselves, not by squashing others and by using threats.
I also bought into the bullshit that one had to be “toughened up” to cope with the world.
Only, thank god, now I have read enough research on the theory of attachment to know that we ALWAYS operate from a stronger place when we have been, and are treated from a place of respect and kindness. It builds a solid core, a solid sense of self.
But we are the product of our society, a society that has a deeply entrenched beliefs that babies and children are our enemies, and that we have to “train” them to be human, less they manipulate us, become little tyrants, and we “make a rod for our own back”.
Yet, as Mia Kalef says in her book “The secret life of babies”,
“Logically, there is no possible way a child could ever dominate an adult. Think of it this way : if you have influence over what a child eats….or stays warm or cold, how could you find yourself in a “power struggle” with an infant or toddler? There is no such thing. It’s obvious who has the power”.
I believe what we see at play today is the product of a way of raising children that promotes bullying and disrespect. They say a picture is worth a thousand words-watch this powerful video called “children see children learn“.
As children grow up, and turn into adults, we see the same bullshitty power play taking place. Having been an employee for over 20 years in about 7 different organisations, I can attest that I have seen the carrot and stick approach being the norm, and I can count on less fingers than one hand how many bosses were truly trusting and empowering.
I believe that the power play of many of the world’s leaders is no more than a re-enactment of toddlers fighting over a toy. The new US leader is a prime example of this.
My generation, is, with a few exceptions, the product of this “tough love” parenting. Most of us as still working hard to reclaim a lost sense of self worth that was the result of being parented this way in infancy.
But I also believe what we see today in the world is a revolution against a society that is fundamentally sick, a bit like when our bodies create disease to make us pay attention to the fact that we aren’t looking after ourselves very well and need to rest and recover.
I also chose to believe that good will come out of that revolution. The model of the Western consumerist culture, the model that promotes the individual above all else, simply isn’t sustainable anymore.
People are waking up, and refusing to put up with it anymore.
So back to the love and fear, at this point in time, it is paramount to stay in a love state.
This doesn’t mean that we meekly accept our fate.
This doesn’t mean that we do not fight for what is right.
It means that we need to stay, and fight from a place of true power.
I have seen a lot of kind people in my field lately trying to fight those battles whilst using the very weapons used by the people they despise.
Trying to silence people who objected to their tactics by accusing them of tone policing. Good people, with a kind heart, being lead to using bullying techniques.
It doesn’t work like that.
I am in the middle of reading the most fascinating book by Susan Cain. It’s called “Quiet: The Power of Introverts in a World That Can’t Stop Talking”. It is a fascinating account of the over emphasis our culture puts on extrovert qualities. The book starts with the story of Rosa Parks, the African American woman who refused to give up her seat in the coloured section of a bus, sparking a revolution. Cain says :
I really like the idea of quiet fortitude.
I like the idea of a gentle, but strong, grass-roots revolution.
I chose to remind myself that change starts with me.
That showing kindness to my loved ones, and the people in my close and my wider community, can have an impact beyond what I can imagine.
I chose to believe that staying in a loving, centered state, that sending love and gratitude to the difficult people in my life, to hard situations, to the anger and the resentment, has the potential to change the world.
This is where the true power lies.
I am fuming.
At the beginning of January, and with almost no warning, the NMC (Nurse and Midwifery Council) declared IMUK (Independent Midwifes UK) insurance policy not fit for purpose.
And just like that, without warning, they put an end to independent midwifery practise in the UK.
This has left many expectant mothers who had booked them (including some who were expecting to birth within the next few days) without the support that they had chosen and paid for.
What the fuck?
Who on earth decided to made such a stupid, unconsidered decision?
Shouldn’t they have given some warning? some time for independent midwives to at least, finish provide support to the women who had booked them?
As independent midwife Virginia Howes rightfully stated, if 80 male Drs were being treated in the same way ( 2 weeks notice of not being able to work and loss of income ) an action they believed to be unlawful, by their regulator, the whole country would be up in arms.
Also the 80 independent midwives in question might represent only a small fraction of the 25 000 or so NHS midwives in the UK, BUT (and that is a big but) they represent a unique service that exists nowhere else, and will disappear if they go.
I have an interest in this at both a personal and a professional level.
On a personal level, 7 years ago for the birth of my second child, I hired independent midwives.
Why did I do this? when I gave birth to my first child 11 years ago, the NHS system was different to what it is today. Community midwives in Cambridge still had case loading midwifery, which meant that I saw the same midwife all through my pregnancy. She even came to visit me at home on a few occasions. I had her mobile number so if I had any questions I could just call her. When I went into labour she was on call so she came to support me through my birth. I got to know properly and I liked her a lot.
Fast forward 3 years later, the system had changed. Case loading was no more, replaced by team midwifery, meaning you were unlikely to see the same midwife through your pregnancy, let alone know the one who would turn up at your birth.
In the meantime I had also trained to become a doula, and was halfway through my degree as an antenatal teacher. So I knew quite a lot more than before, and the idea of having someone turn up in my birth space that I hadn’t met before (read, someone I didn’t like) didn’t sit well with me at all.
So this was the deciding factor in hiring an independent midwife. I just couldn’t leave this to chance. I had visions of an grumpy midwife who didn’t like homebirth inventing a spurious reason to transfer me to hospital. I had kind of had a taste of this at my first birth because I didn’t like the second midwife who came to join my named midwife right at the end before my baby was born.
So we hired two fantastic independent midwives, Siobhan Taylor and Amy Cole, of Cambridge midwives. I had a doula too. My husband took some convincing due to the costs, and at times I wondered if this was a little bit too indulgent. But, trust me, your birth is a very important day in your life, which is probably going to impact the rest of your life in a more significant way than your wedding day. Yet if it was your wedding day you wouldn’t think “I can’t have a honeymoon/flowers/cake since I already have a venue and a caterer” right?
Siobhan and Amy came to do all the antenatal care at my house. We got to know each other over many 2h long appointments. I developed a deeply trusting relationship with them. The respect was mutual. They respected and supported my choices. There never was a fight or dispute over my choices. It was wonderful. It was relaxed, warm and friendly. Most importantly, it meant that I was really looking forward to seeing them during my labour AND that I was completely trusting of their support. If they had said we needed to go to hospital, I would have trusted them completely. Together with my doula, Maddie McMahon, they provided the most supportive and seamless birth team ever. It was a wonderful, life affirming experience and worth every penny.
Now compare this to what women get today: they rarely see the same midwife twice during their pregnancy. Most appointments are a rushed, 10 min box ticking affair, where there is no time to ask them how they are feeling for example. They have no named midwife, and when they leave a message on the answer phone of the practise, it doesn’t get picked up until 8am the next day (I tell my clients to always call the hospital if it is urgent). And course, when they go into labour, they have no idea who they are going to meet, and whether they will get on with them or not (I also tell my clients that they can ask for another midwife if they do not get on with the one assigned to them). I also know that this system is also something many midwifes also dislike very much, because it stops them from working in a way that is fulfilling for them too. As Milli Hill said in her recent article, it is “cattle care”.
On a professional level I am completely irate at the idea of choice being taken away from women. And having supported women who hired independent midwifes, I know how much of a difference it makes to them too.
Evidence demonstrates without a shadow of a doubt that continuity of care is safer for women, as well as being more satisfactory. The Cochrane database review concluded that
” This review suggests that women who received midwife-led continuity models of care were less likely to experience intervention and more likely to be satisfied with their care with at least comparable adverse outcomes for women or their infants than women who received other models of care.”
So how does removing the rights of independent midwives to practise will affect women?
First of all, right now, across the UK, there are women who had booked independent midwives and paid for their services, and are left with no other choice than to go back to the NHS.
I can only imagine how devastated they are.
Only last week I supported a mum through a homebirth. The mum in question had had a horrible experience during her previous birth. She was treated such an appalling callous manner, that she has made a formal complaint against the hospital. Of course she then didn’t want to go back to that hospital. And because she also knew that with the current homebirth service being pared down to its bare bones she was running the risk that nobody would be available to come and support her at home, she hired an independent midwife. She had a beautiful, peaceful , healing birth at home, with the kindest, gentlest most respectful support. Luckily for her, she birthed 20h before the time that the NMC announced as a cut off date after which independent midwives wouldn’t be able to support women during labour anymore. Can you imagine how she would have felt if she had birthed only 1 day later? The independent midwife was also beside herself with stress whilst facing the prospect that she may not be able to support this mum.
It is similarly devastating for the 80 or so independent midwifes who are left with the option of not doing the job they loved and trained for, or to return to work within the NHS. I can’t see many wanting to return to the NHS because the very reasons most became independent was because they wanted to provide a different model of care to the one currently in existence within the NHS (namely, one to one midwifery and continuity of care). It most likely means that, in a system that is already stretched beyond belief, we will lose yet more midwives.
Beside making the situation intolerable for women who had booked them, it also drastically diminishing women’s birth choices and options for now and for the future.
It means that, for example, a woman who had a traumatic experience within the NHS will have no other choice but returning to the same hospital/trust care, or to birth alone It means that women whose pregnancy or birth choices fall “outside the guidelines”, for example, women over 40 with their first baby, or women wanting to wait for labour to start naturally after 42 weeks pregnancy, women who are “too old”, “too big”, too or not enough whatever constitutes low risk within the forever tighter NHS guidelines, especially if they want to birth at home, will now find it almost impossible to find someone to support their choice without having a massive fight on their hands.
It means that women who do not trust the NHS system will probably chose to birth alone (Birthing alone is completely legal in the UK-and a choice some women make, because it feels right for them -but I feel very strongly that women choosing to birth alone should do it out of positive choice, not out of fear).
Ultimately it this lack of choice is neither safe nor desirable.
It means that many mothers planning a homebirth won’t be able to find a midwife to support them, because some trusts have stopped providing homebirth support and many other trust have reduced the service so much that many times no midwives are available to support women at home. I have written about this before.
It means that we will lose a lot of skills and experience from these amazing independent midwives. For example the only midwifes I know who are confident supporting a breech vaginal birth at independent midwives.
This just isn’t right.
So what can we do to help?
Write to the NMC-birthrights have written them a letter which you can use as a template
Write to your MP, and to Jeremy Hunt, Secretary of State for Health.
Sign this petition
Fill this survey
Join the “save the midwife” alliance -they also have template letters to write to the NMC, your MP etc.
Share this blog and help raise awareness of this situation.
The most important thing in everything I do is to support informed decision making and empowered choice.
And yet it probably is the toughest balancing act.
In a maternity system that isn’t fit for purpose, how do you prepare parents for what is waiting for them without scaring the shit out of them?
I find this dilemma, this balancing act especially difficult, because one of the first things I tell parents in antenatal meetings, is how much I hate that everybody is telling them horror stories about birth, and how wrong this is.
I have just supported a mum through a very empowering second birth. During her first birth she was treated in the most callous way, which left her and her husband traumatised. She told me she’d had so many friends who had bad birth experiences, and that she didn’t understand why people were putting up with it.
I think that people put up with it because, whilst they know the experience wasn’t good, they buy into the crappy narrative that it was for the best, for the sake of a healthy baby, and do not always realise that what happened to them was unacceptable.
It is not OK if the way you were treated made you feel like shit. Your experience matters, and whilst everybody wants a healthy baby and of course that matters, it isn’t all that matters either.
I have no doubts that interventions are sometimes necessary and that they do save lives.
I am talking about the fact that it isn’t necessarily how the birth unfolded that makes a good or a bad birth experience, rather how people were made to feel throughout their labour and birth.
Obstetric violence is real, and there is no excuse for unkind behaviour, ever, even in an emergency. Birthrights has excellent info on it, and I have written about it here.
What I often observe, sadly, is that the empowered decisions of second time parents often come through a shitty first birth experience.
So what about those first time expectant parents? How do we prepare them for navigating the maternity system? How do we support them in preparing for a positive birth whilst also equipping them with managing whatever curve balls the maternity system might throw at them?
Again, whilst acknowledging the important of a positive mindset (we will come back to that), we cannot ignore the fact that within our maternity system as it stand, only a minority of first time parents experience a positive birth.
According to the Birthrights dignity in childbirth survey, only half of women had the birth they wanted, and
I had a curious experience this week. I went to the local hospital for a routine eye check test. I am almost never a patient, and my interactions with the NHS are usually limited to my work as a doula. It was fascinating to experience the system through the patient point of view. In many respects, my experience was similar to what women experience in maternity care. I saw some lovely (and some not so lovely) nurses and doctors, some of which had excellent bedside manners, and some absolutely terrible. I got wheeled around through tests I had no idea where going to happen or why. I kind of knew some of the tests, having seen an optometrist before, but nobody sat me down and explained what was going to happen. I was not asked for consent before procedures, some of the staff didn’t introduce themselves or muttered an unintelligible introduction under their breath, and one was so tense I felt like asking her what was wrong. Being the curious scientist that I am, I asked a lot of questions and also pointed at flaws in the testing process (like testing eye function with the same line of letters you can learn by heart). People’s reactions to my questioning, where met by either dismissal or a “yes we know it isn’t ideal but there is nothing we can do about it”. Whilst my doula experience made it somewhat easy to navigate, it was still (pardon the pun), an eye opening experience.
It wasn’t an upsetting experience for me, just mildly annoying, but it gave me much insight about how it must feel like, when, in labour for the first time of your life, you turn up in labour at the hospital, especially if you’ve had no antenatal education whatsoever. It must be scary as hell!
Antenatal education is an absolutely paramount part of having a positive experience. I have already written about that here.
But this post isn’t just about antenatal education.
This post is about the difficult of educating first time parents about navigating what they are up against, without creating fear, causing anxiety, lowering their confidence, and generating mistrust towards the maternity system.
It’s hard, and although I have been doing this for over 6 years now, I am not sure I always get it right.
But I try. I try very hard.
One way I try and do this is by discussing the following topics, which all fall under the birth preferences hat : The physiology of birth, the place of birth and the best conditions for birth to unfold, and medical interventions.
When we discuss the physiology of birth I make parents aware of the needs of a labouring woman for darkness, privacy, and quiet. I tell parents that you need the same atmosphere to get the baby out that you needed to make the baby. This is because the hormone that drives labour contractions, oxytocin, is a shy hormone, and is inhibited by adrenalin inducing conditions, like bright lights and noises. This video comparing birth to sex illustrates this concept very well.
We talk about the importance of choosing to birth in the place where you feel the safest. When discussing place of birth options with parents, we also debunk the myth that birth is always safer in the obstetrics unit of a hospital. Recent research like the birth place study actually shows it is safer for uncomplicated pregnancies to be in a birth centre or at home. I’m not saying that birth centre or homebirth is for everyone. I just want to make sure that, whichever choice the parents end up making about where to have their baby, their decision is based on evidence AND that they also know that it’s OK to change their minds one way or another at any point, including during labour.
We discuss all major medical interventions, such as induction, augmentation, monitoring, instrumental and caesarean births, so if any of this presents itself, they have heard about it, know what it entails and have thought about what they would prefer, beforehand.
And of course all these topics are part of encouraging the parents to write their birth preferences. The process of doing this is an important part of the preparation. I encourage the parents to write 3 documents: one with their ideal birth, one for if interventions are needed, and one for a caesarean birth. I have written about the caesarean birth plan here.
Throughout the discussion of all these topics, I try to be as balanced as possible, and I certainly want to avoid coming across as negative towards the maternity system, even though I know its failings, so I tell stories to illustrate many possible scenarios. Mostly, I talk about a continuum. Everything is a continuum. A Gauss curve. We talk about how we can’t predict how we will get on with the caregiver assigned to support us (This is one of the number one failings of our current system- the lack of continuity of care – HOW ON EARTH are you supposed to feel safe in such a vulnerable moment as birth with someone you’ve never met before?) and how to handle it if you don’t like who is looking after you : you just ask for somebody else. I have heard so many stories of parents who didn’t like their caregiver but either had no idea they could ask for someone else, or didn’t want to offend them. You only get one shot at this, so this isn’t the time to worry about somebody else’s feelings. By the way, you can just go to the ward desk to state your wishes, you don’t have to confront the person you don’t like. Remember: you will most likely will be doing them a favour as well, because if you don’t like them, chance is they don’t like you either. They cannot say that, but you can.
We talk about the grey areas in interventions, how sometimes what is suggested it really necessary, and sometimes it’s just because guidelines are being applied mindlessly. If the baby is well, and the mother is well, why not ask for more time?
To navigate these situations, we talk about question asking skills and the BRAIN acronym. If you’re only going to do one thing, the BRAIN acronym equips parents with the right question asking skills to handle anything that’s being thrown at them
BRAIN. Each letter is a reminder for a specific question whenever something you aren’t sure about is suggested to you :
B-what ar
e the Benefits?
R-What are the Risks?
A-what are the Alternatives?
I-What does your Instinct tell you?
N-what if we do Nothing (i.e. can we wait, decline the intervention?)
Remember that informed consent is part of the code of conduct of every health professional. They cannot do anything to you without your consent. Sometimes saying “I haven’t given consent” or “I haven’t got enough information to make an informed decision” , or even “I’ve made an informed decision” may act as a magic word.
That is a lot already but I’m not sure it is always enough, because, even when I’ve been present supporting a birth as a doula, I haven’t always been able to prevent unkindly behaviour, or to avoid caregivers using coercive tactics to obtain consent (“You don’t want to put your baby at risk-do you?” which is a ridiculous question because no parents will ever put their baby at risk unnecessarily), but I have always been able to remind parents that they could ask more questions before making their decision, or to help get a few minutes on their own to reach a decision.
Weaved in and out of this topic, as you have already gathered, is the concept of dignity and respect. If at any point parents feel uncared for, not listened to, not treated with kindness, or if their caregiver’s style simply isn’t to their liking, then they should express their concerns about this.
Sometimes it’s very simple things. Sometimes well meaning behaviour is wrong too. I have heard so many stories of couples being put off by a quiet, silent midwife sitting in the corner in the birth centre. I knew she meant well by being unobtrusive, but many couples told me that they would have liked more active support. So I started telling couples to ask for more verbal reassurance or active support if they needed it. It worked, because recently, a couple told me this is exactly what happened to them. When they told the midwife they needed more support, she really rose to the challenge and became more verbal and openly supportive and they loved it. It completely transformed their birth experience.
I often feel that when someone is unkind, we are all responsible if we say nothing, because how is that person going to know what impact they have on people if nobody tells them?
So to summar
ise, how to prepare parents for a positive birth experience? A common analogy in the birth world is to compare giving birth to climbing a mountain: you’ll need preparation and a positive mindset, and certainly starting the climb with the intention to stand at the top to admire the awesome view with the most glorious “we did it” feeling is a great way to start. And you know that listening to the people who are worried and trying to discourage you with horror stories of people had accidents whilst climbing the mountain won’t help, whereas listening to those of people who had a great time will. But you also know that preparing yourself for whatever unpredictable event might happen : bad weather, having the right equipment and support, knowing the easiest route, etc is also a very important part of the preparation.
If you are a birthworker and would like to work with me, look here. If you are a parent, head over here.
