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Sophie Messager

Tag: informed decision

  • 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.

     

  • Period Pain: if you’ve been told there is nothing you can do about it, read on.

    Period Pain: if you’ve been told there is nothing you can do about it, read on.

    If you suffer from period pain, or someone you know does, and if you have been told that there is nothing you can do: you have been lied to. There is plenty you can do, it is just that the knowledge isn’t part of what is taught within Western medical training.

    I got my period pain fixed, and it makes me so angry that women are told this lie over and over again, are told that it is normal, because it stops them from seeking the help that is available. I’m on a mission to change this.

    This is my story:

    I suffered from severe period pain from the moment I started my period. The pain was so severe that in my teenage years I used to be sent to the nurse’s room at school each month. I curled up in pain on the bed there and waited for my mother to come and collect me. I would spent the first day or two of each period curled up in bed with a hot water bottle. Sometimes the pain was so bad I vomited.

    I tried everything from mainstream drugs to homeopathy, but nothing worked. Around age 15 I was put on hormonal therapy for it. At age 16 I started taking the pill. As I no longer had “periods” (the bleeding caused by stopping the pill for a week is different from that of a period) I was free of pain. I stayed on the pill from the age of 16 to until I was 33, when I decided to stop taking the pill because I was diagnosed with precancerous cells on my cervix (I read some research showing a link between long term pill taking and these- If you want to read about it, the book “The Pill, Are you sure it’s for you” By Alexandra Pope, is fantastic).

    My period pain came back with a revenge. My husband, who had never seen me with this pain, was shocked at how bad it was. I remember once we were driving  when it started and I had to get him to park on the side of the road as I writhed in pain on the car seat, white as a sheet and covered in cold sweat, until I waited for the painkillers to kick in.

    I went to the GP for help. I remember being stunned when all I was offered was to take pain killers. I said to the GP :  “Really, in 15 years the medicine still hasn’t moved on?”. At the time I was working in a biotech company, and told my boss about this, and he said “if men had pain in their dick once a month you can be sure there would be a drug for it”!

    I resigned myself to taking ibuprofen every month. Then I became pregnant and the pregnancy and birth seemed to temporarily fix the problem. My periods became more regular and I was pain free for a few years after having my children. Then, a few years after my second child was born, the pain came back. I resigned myself to taking the pain killers again.

    In 2014 I met an osteopath in Cambridge called Teddy Brookes. I mentioned this to him and he said he could help. I was surprised and slightly disbelieving, but it was so bad I was willing to try anything. Teddy is trained in visceral osteopathy, something not all osteopaths are trained in. He felt the ligaments around the front of my uterus (the round ligaments), told me they were very tight, and worked on releasing them. It was not comfortable and I had to do some deep birth breathing during the treatment.

    That evening and night I had a lot of cramps in my uterus, but the next morning I woke up feeling absolutely amazing, both physically and emotionally. I felt like nothing could touch me. The next cycle the pain was less but still there. I got in touch with Teddy and he talked me through how to release the ligaments myself. I had to get my husband to do it as I couldn’t get my fingers in the right direction but it helped. Within 2 or 3 cycles I was completely pain free and I have been for 6 years.

    I was baffled by this because as a scientist I knew that from a scientific point of view, the cramps of period pain were caused by hormones called prostaglandins and I couldn’t see why releasing ligaments would affect this. Teddy explained that there cramps were still there, only that they were comfortable. I was delighted to be cured of the pain.

    As I told women about my experience, some asked me to teach them how to release their ligaments. But I didn’t feel comfortable doing that because everybody is unique and I thought maybe other ligaments would be tight and therefore need a different technique. Teddy told me that it is almost always the round ligaments that are too tight (more on that later).

    Other things happened along the way that helped my have a different relationship to my menstrual cycle. In 2016 I attended a workshop by Alexandra Pope of Red School, that helped me understand the changing energies throughout my cycle and how to tap into them. This led me to make sure I rested as much as possible during the first couple of days of my period. I blogged it about here.

    With my own practise, working closely with Teddy (we created a postnatal massage course together), massaging new mothers with closing the bones, with supporting women with healing as a Reiki practitioner, and with training such as spinning babies and biomechanics for birth, I general became more aware of my body and of the importance of good balance for uterine health.

    In 2019 I attended a workshop on womb health by Arvigo massage therapist Hilary Lewin. She brought a life size womb suit and proceeded to demonstrate in a very visual manner how the ligaments of the uterus affect period comfort.

    The uterus is attached to the pelvis by several sets of ligaments. You can see a 3D illustration of how the uterus ligaments attach to the pelvis in this video. The round ligaments in particular attach from the top of the uterus and to the front of the pelvis. A healthy uterus is normally slightly bend over the bladder. If the round ligaments are too tight, the uterus will be bent forward a lot more, making expelling menstrual blood a lot harder, and therefore more painful (as the uterus will need to cramp harder to get the blood out).

    In this video I explain in a very visual way what happens when the uterus is not optimally positioned.

    Part of the problem is that we live sedentary and unbalanced lifestyle so many of us have tight ligaments (sitting down a lot tends to do that) and don’t even know it. Because everything in your body is linked, having tight or unbalanced ligaments and/or pelvis may affect many other things too, such as causing back pain or bowel issues. Abdominal massage therapist Barbara Loomis explains some of this with great illustrations here.

    Sadly many women suffer needlessly suffer from horrendous pain, and because most of us believe the narrative that there is nothing we can do, we don’t seek help.

    Here are some stories to illustrate the pain of what some go through, and in some case what helped them:

    When I was younger, before kids I had some months were I would be crying & in excruciating agony, where I’d lay fetal style for hours in so much pain. Pain killers wouldn’t touch it. It wasn’t like that every month, but definitely had it a lot! I always had heavy periods with less pain or light with more pain! Doctors would always say : ‘it can’t be that bad’ and would basically ignore me. They wouldn’t believe me that paracetamol or ibuprofen didn’t work for me (I have a condition where I metabolise drugs really fast) I remember once (this is awful but) taking the strongest pain killers my Nan had prescribed to her for chronic pain, they still only barely took the edge off! My husband found me in a ball crying once & tried to take me to hospital but I knew there was no point. Once I started having kids I found they got so much better. I now have fairly ok period pain but I do now wrap my hips, use reiki, have a bath & rest (especially on my first day as much as I can)! Carly Lokrheim

    From the onset of my periods I had severe pain. Every month I used to be floored in agony. I went yellow in skin tone and was physically sick and sometimes past out. I used fear it every month. My bleed was so heavy and clotted I used to leak right through my school uniform. I was taken to the doctors many many times and was fobbed off and treated as a silly girl. I felt (and it was said) that I had a low pain threshold and I would not be able to handle birth. This put me off ever having children (right up until I was in my mid 30’s) As I got older PMT got more and more intense till it started to affect my marriage. At this point I started Ayurvedic treatment which included massage, life style changes and diet changes. This really really helped with my periods and PMT. When we tried to get pregnant I found there was unexplained infertility, I started acupuncture and found it really helpful and also had a laparoscopy and found I had endometriosis scaring and fibroids. I think a combination of all three treatments/practices helped us to conceive and go on to have two babies. I now follow my cycles and adapt my life (as much as possible) to follow my inner seasons or at least be aware of them. I now also use a moon cup and relish my bleed as a time to retreat and surrender. Clare Wilson Hasted

    I had awful period pain from the age of 11 when it started, I would vomit and faint/ pass out with the pain. I was put on the pill at 13 it didn’t really help what did help was paracetamol, hot water bottles and rest. Then in my late teens I read a book called Who dies? and starting using the meditations in there to cope with the pain, I used the same meditations to cope with my contractions. I also took cramp bark. Staci Sylvan

    I tend to bleed for 17 – 20 days and I have excruciating period pains. This started at the age of 13 and has followed my entire life. I had hoped pregnancy might help but 6 weeks after giving birth sure enough agonising pains. I have tried so many therapies, pills  implant etc. And the pain each month is still so severe I missed time off school as a teenager and miss work as an adult. Every job I have had I keep a hot water bottle at my desk and painkillers in a drawer. I have had a mirena since the age of 21 and since then have not missed work due to period pains. My cycle became regular and bleeding only for 5 days. After having my son I had a 4 year break from the mirena. I realised I just couldn’t cope without it, my body hurt so much, I was exhausted and honestly just not a nice person as I was in agony so often, couldn’t sleep, didn’t want my husband touching me. I had the mirena inserted last November and I remember about 7 days later feeling like I had woken up. My foggy head cleared and I felt in control of my body again. I do get pain but it’s manageable with a hot water bottle and rest. I am happier, calmer, more patient and I feel like I have my life back. I can’t over state how much the Mirena has changed my life. It’s spectacular and I will always be grateful to the GP who initially recommended it after about 7 years of begging for help and being dismissed as “you’re female you just have to deal with it”. In terms of the pain  for me it’s thighs, bum, lower back and lower abdomen. It can been so painful I vomit from it. I feel like my whole body is stiff, exercise makes it worse. Rocking my hips on a gym ball cam help or gentle bouncing. When it’s at its worse there is no way I can work, I can barely talk and usually just end up crying. Jay

    As a teenager my period pain was severe. If my daughter experienced pain like that, I would take her to the doctor, or emergency in some cases I had. However, I was too afraid/embarrassed/shamed/whatever to tell my mom or anyone. I remember having to go into work while vomiting and hunched over in pain because my boss wouldn’t take no for an answer because I didn’t sound sick. Sharon Bales

    I’m aware that period pain can be caused by other issues than biomechanics. I know that some have PCOS or endometriosis or other conditions…but it is the same: you are sadly unlikely to get answers from mainstream medical professionals because they simply lack the training, knowledge and the tools to help you. It’s not their fault, rather it is the very narrow view of how Western culture sees the body that is to blame. As Katie Bowman explains in this article:

    “Dysmenorrhea is a pain, literally. It’s a painful period, ranging from light to severe, that can also include vomiting, diarrhoea, headache and fainting. The “primary” means that the dysmenorrhoea is not occurring simultaneously with another known pelvic pathology. (Secondary dysmenorrhoea can be created or affected by issues like endometriosis and fibroids that can cause extremely painful periods, and I know that people suffering from those conditions have likely heard a million “just do this” solutions, and I’m not trying to offer that here, although I hope that movement might relieve some part of your pain.”

    So what can you do to help with period pain? Here are some of the therapies I have personally used or heard that some had success with:

    See a bodyworker that can work on your uterus alignment. This could be an osteopath or a chiropractor or a physiotherapist who is trained in visceral osteopathy. Or you could see someone who is trained in womb massage such as an Arvigo massage or a Mizan Therapy, or a Fertility Massage practitioner. Having a closing the bones massage may help too. Make sure to get recommendation from good local practitioners.

    For the past year or so I had been suffering with debilitating period pains: I would faint, hang from my husband’s neck as if I was in labour, I’d only find relief in the bathtub where I’d be playing mermaid for at least half a day on my first day of bleeding. It got so bad I was checked for endometriosis and cervical cancer (as I also got 1 cycle with constant intermittent bleeding between 2 periods). Nothing wrong physically. After Sophie Messager mentioned her osteopath helping her with period pains to the point she is now pain free, I spoke to my chiropractor, where I’m currently going for regular sessions on another issue. For the past 2 cycles, she’s worked on my pelvis and the round ligaments holding my womb, and – touch wood – I’ve only had the slightest dull sensation on my previous cycle, not even worth calling pain, and am TOTALLY pain free in my current cycle. The difference is totally unbelievable. Ladies, if you suffer from period pain, this might be THE thing that changes everything. I already used rebozos, aromatherapy, herbal teas for myself, but nothing was even touching the edge of it. Until I got the tension in the ligaments released. I don’t even notice now, physically, that I’m on my period. (Emotionally and energy-wise I still do, and aromatherapy, herbs and rebozos still have a role to play there — but now it’s just become a week of gorgeous self-care, not a week of intense pain that makes that self-care so focused on the pain). Japjeet Rajbir Kaur Khalsa

    I personally found osteopathy and Ayurveda completely resolves my painful periods. Also reframing my understanding after reading Wild Power has been beyond powerful. Emma Hayward

    Work on your alignment (either face to face with a specialist such a physiotherapist, Pilates or yoga teacher or with an online course-see a list of courses at the end of this blog). Rosie Dhoopun is an alignment specialist. She shows you a movement routine to ease period pain here.

    Alignment and movement worked for me. Plus surprisingly using cloth pads. I even get mild cramps using a mooncup so use that infrequently. I used to suffer terribly as a child and eat a whole packet of feminax to get through. These last years I use to have such bad knee pain but all stopped since releasing tension. Isn’t it such a shame we are told it’s normal and medication is the best thing. Rosie Dhoopun

    My periods were once every 6 months. And I’d be on strong painkillers for a week to get even near function. I saw a chiropractor, switched to barefoot shoes and started stretching my calves in my 30’s which took me to regular and pain free. Philippa Wilmot

    See an acupuncturist. I have personally had great results treating infertility and recurrent miscarriages with one and I found that it helped make my period more comfortable too. Here is a review of the evidence behind the effectiveness of acupuncture for period pain by the Acupuncture council.

    See a herbalist. I saw Natasha at Forage Botanicals to help with the symptoms of the perimenopause who specialises in treating painful periods.

    See a homeopath. Here is an article with some suggestions on homeopathic remedies that might help.

    See a nutrition specialist with experience in this area. Since painful periods can be caused by too much inflammation in the body, changing your diet may help your pain.

    Nutritional therapy helped me. Period pain was crippling as a teen and rectified by the pill, which I took for ten years but it caused depression. Period pains got quite bad again slowly over the course of a few years and then stopped when I stopped smoking and did a sugar detox! My friend is a nutritional therapist, I was having bad mood swings all the time and awful cramps during my period. I wanted to try anything that would stop me needing SSRIs. She told me it was because the body can take a certain amount of stress but it has limits, so when I stopped smoking, it had better circulation and that helps with pain management and when I stopped eating sugar, less stress on my organs and hormones. Barely a cramp since. Abbi Leibert

    I found my period pain (not severe but present and very uncomfortable) almost disappeared after going vegan. Pippa Moss

    I had breakthrough bleeding in between my periods every month for nearly 3 years, I had all sorts of investigations scans biopsies nothing came back as a problem. Even had 4 miscarriages but still nothing has been found as a problem despite all the blood tests and so on. I discovered something called hair tissue mineral analysis and arrange the sample sent off I also did some additional blood tests privately. I found extensive mineral deficiencies and results consistent with hypothyroid despite normal blood results. I had a specially adapted list of supplements and dietary changes given to me by nutritional list and Six months on no breakthrough bleeding my period is so much more manageable, even more so since I discovered magnesium spray, and I have been wrapping my hips for quite some time. Still not entirely sure what our future holds in terms of pregnancies but at the moment I’m just happy with how far I’ve come in the six months. Nicola Witcombe

    Other more unusual things to try:

    Year round wild swimming (I’m not suggesting you swim in cold water during the actual bleeding when keeping warm is important), but there is mounting evidence that it does wonders to you wellbeing. It earthes you as well, see my blog on the subject.

    Try grounding yourself. Since period pain is at least in part caused by inflammation, and earthing/grounding has been shown to decrease inflammation, it may help. It can be as simple as walking or standing barefoot on the ground/grass. See a review of the evidence behind earthing in this paper.

    Try dancing. Movement has been shown to ease period pain, and boost blood flow. Conscious dance practises, such as 5rhythms, allows you to get deep into a movement that is unique to you.

    Nicky Smith, Ecstatic dance facilitator, says:

    “One thing which really helped me was movement. Our usual & natural inclination is to move away from pain & discomfort, of course! If we can move towards it, even a little, then allow the movement & expression to come from that place in our body it can give the intensity an expression which can support a release. Breathing into that place & moving on the exhale, helping our system to relax into rather than away from. The more I practise this approach the more I can move towards the pinnacle of the pain/discomfort and when I reach that edge my body will naturally start shaking. We can of course induce shaking ourselves. Another sweet release can be with our voice, giving that pain a sound, sometimes alongside movement can be a powerful medicine.”

    Ideally you would be able to see someone who is holistic in their approach and will take a case history and who can suggest an approach that covers all bases. But trying even one therapy is well worth it as it may be your first step on the road towards of a pain free period.

    As a teenager I never looked for help, because period and its pain is/was a taboo; I also lied down in a foetus position crying from pain. No pain anymore after having kids; what helped me was to accept my female body, as well as solving female ancestral karma (Closing the bones, constellation therapy, cranio-sacral therapy). So not one particular method, but rather awareness that menstrual taboos are so deep in our consciousness and that unhealed ancestral female traumas feel so painful in the body because the one/generation who becomes aware of that releases a lot of that ancestral shit with the energy of menstruation. Laura Linde

    What can you do for yourself (without seeing a therapist)

    Wrap your hips! I show you how to do this in this video. Because it supports the pelvis, the uterus and its ligaments, and because it provides warmth, wrapping your pelvis during your period may provide relief. I show a simple way of doing it in this video (there are others on my YouTube channel, and I have a blog on postnatal wrapping that is full of examples of ways to do it). Here is a blog post from Mizan Therapy explaining why it might help.

    Try switching to using reusable menstrual products. Some women report a decrease in period pain when they switched to using washable pads, period pants or a menstrual cup (There is a great YouTube channel about reusable sanitary products and menstrual cups here).

    My extremely heavy flow (so much so I couldn’t go to work 2 days at start of period, leaked through clothes etc) was helped hugely by moving to cloth sanitary protection. They say the chemicals in disposable pads increase flow. There was never a mention of the sanitary wear I used as a cause, rather the potential need for gynae reviews and long term medication. Thankfully not needed thanks to cloth sanitary products. Claire Pitchford

    My biggest healer has been switching to cloth and organic, un bleached sanitary ware and a series of womb massage sessions with Tania Meacher-Payne. She knocked my period down from 10-6 days. Life changing. I call her the womb fairy. Vikki Young

    Work on your alignment yourself.  Alignment specialist Rosie Dhoopun runs an online courses on the topic. In this video she explains a set of techniques you can do yourself.

    There is a list of things to try to decrease period pain in this blog by Katy Bowman :

    • “1.  Two days before the expected time for the flow to begin, reduce the amount of work done and increase the amount of rest.  Take a warm tub bath each evening for thirty minutes.
    • 2.  When the flow starts, go to bed and keep hot-water bottles to the feet and lower abdomen.
    • 6.  To help prevent future attacks of dysmenorrhea give attention to the following:
    • a.  Regular habits of eating, sleeping, and exercise.
    • b.  A wholesome diet, free from spices, condiments, greasy or fried food, tea and coffee, with little or no fresh food.
    • c.  Avoid tight clothing, and see that the limbs, neck, and chest are prevented from chilling.
    • d.  Correct constipation, if present.”

    Take an online course:

    Checkout some websites

    Read some books:

    Here are the ones I have read and loved.

    • Wild Power by Alexandra Pope
    • Period Power by Maisie Hill
    • The wise wound by Penelope Shuttle and Peter Redgrove
    • Women’s bodies Women Wisdom by Dr Christiane Northrup
    • Moon Time by Lucy Pearce

    For supporting puberty:

    • Reaching for the moon by Lucy Pearce
    • How to support your daughter through puberty by Melonie Syrett

    And here is a collection of 28 books on the topic

    I’d love to hear about any other resources or therapies you have found useful!

  • Inducing labour with Castor oil : is it safe?

    Inducing labour with Castor oil : is it safe?

    Castor oil induction has bad press in the UK. Negative stories abound, claiming severe negative effects on mother and baby. For years, I too believed this to be true. I took it for granted that it was dangerous.

    A couple of years ago a doula told me that several of her clients had successfully induced their labour with it, and that the stories didn’t match their experience. She also said that, faced with the prospect of a long induction in an antenatal ward, some women felt that it was a lesser evil. This conversation spurred me to look for the research. I was very surprised to find that it was actually quite safe, and that the stories didn’t match what the published research said.

    Birthworkers often talk about strongly held beliefs within maternity care, that turn out to be myths. You know, the kind of belief that everybody seems to have, without question, that gets perpetuated through stories, yet when you analyse the research you find that there is very little evidence to back it up (the placenta “failing” at the end of pregnancy being one of the most common ones). After reading the research on induction with Castor oil, I was embarrassed to admit that I’d fallen prey to this myth believing myself.

    I cannot help but wonder how Castor oil came to have such bad press in the UK. For some reason it has fallen out of fashion here (Midwife Becky Reed told me that it used to be used in the UK in the past), and yet it is still more commonly used in the USA. A survey of 500 US midwifes in 1999 showed that it was the most commonly used natural substance used to induce labour.  American Midwife Ina May Gaskin mentions it in her Guide to Childbirth. When Ina May came to a the Doula UK conference in 2017, doula Sue Boughton asked her what she thought of it and she said that it was perfectly safe and that they used it all the time.

    This is what Ina May says in her book, Ina May’s guide to Childbirth:

    “Indigenous peoples all over the globe have used castor oil to induce labor for centuries. Taken orally, castor oil acts as a laxative, and the stimulation of the digestive tract often starts labor at term. No one knows why castor oil works to start labor. When there is little or no money to be made as a result of research, generally little or no research is done. Nobody has figured out how to make an appreciable amount of money from castor oil, so this subject has received virtually no research attention. Nevertheless, castor oil seems to be quite safe. Nearly nine percent of nearly eleven thousand pregnant women in a large birth center study used it to start labor, with no adverse outcomes. At The Farm Midwifery Center, we recommend beginning a castor-oil induction at breakfast after a full night of sleep. One tablespoon of castor oil is added to scrambled eggs or is mixed with fruit juice to make it more palatable for the women. If necessary, she takes one more tablespoon one hour after ingesting the first.”

    I want to share what the research says, to help you decide whether you think that castor oil induction is a good idea or not, and also so that there is an up to date review of the evidence to signpost women to, if they feel that it is an option that they would like to explore.

    Before I do this I need to give an important disclaimer: I believe that our culture’s obsession with inducing labour as soon as a certain date has reached  is not only unhealthy, it is also not based on solid scientific evidence. I wrote about this before in this blog. Therefore I want to be clear that I haven’t written this blog to encourage women to induce labour with castor oil. It is designed to provide a review of the evidence so that people can make truly informed decisions.

    what is Castor oil?

    Castor oil is an oil extracted from castor beans, which are produced by the castor plant, Ricinus communis. It has laxative properties. (It is often used to empty the bowel in a medical setting prior to examinations )

    How does Castor oil work?

    The way Castor oil stimulates labour was only elucidated in 2012. Contrary to popular belief, castor oil doesn’t only work by only stimulating the gut (though this might play a role in the process as well). After being ingested, castor oil is broken down in the intestine, releasing ricinoleic acid, the main fatty acid in castor oil. Ricinoleic acid attaches directly onto receptors which are present in both the bowel and the uterus. As well as stimulating contractions of the smooth muscles in the bowel, research has shown that it causes uterus tissue to contract, and that in mice that lack its target receptor (prostaglandin receptor EP3) it does not produces uterine contractions.

    How is it taken?

    Castor oil is taken orally. Although Ina May Gaskin suggest a tablespoon or two (A tablespoon is about 15ml), most of the research studies used a dose of about 60 millilitres (so 4 tablespoons). It is usually suggested to mix it with fruit juice to make it more palatable. Interestingly, in one paper the authors used sunflower oil as a placebo and said that women couldn’t taste the difference between Castor oil and sunflower oil once it had been mixed in orange juice. One publication refers to a cocktail or smoothie as follow:

    • 2 ounces castor oil
    • 1 cup champagne
    • 1 cup apricot nectar
    • 4 tablespoons of almond butter.

    How effective is it?

    There is a Cochrane review of the literature from 2013, which includes 3 studies: . The three trials included in the review contain small numbers of women. All three studies used single doses of castor oil. The results from these studies should be interpreted with caution due to the risk of bias introduced due to poor methodological quality. Further research is needed to attempt to quantify the efficacy of castor oil as an induction agent.

    • In one study of 47 women, there was a significant increase in labour initiation in the castor oil group compared with the control group (54.2% compared with 4.3%)
    • In one study of 100 women , 52 women received castor oil and 48 no treatment. Following administration of castor oil, 30 of 52 women (57.7%) began active labour compared to 2 of 48 (4.2%) receiving no treatment. When castor oil was successful, 83.3% of the women had a vaginal birth.
    • In one study of 80 women (37 in the treatment group and 43 to the control group) the odds of entering the active phase of labour within 12 hours of administration was 3 times higher among women receiving castor oil compared to women receiving a placebo.

    Two other papers not included in the review, were published in 2018. In one of these papers, 323 women (who birthed in a birth centre) used castor oil to induce labour showed that 81% of the women gave birth vaginally, and the authors stated that this was significantly higher than the national average. They concluded that ” Our results show women who consumed a castor oil cocktail to induce labor experienced adverse fetal and maternal outcomes at very low rates. Further research, including a clinical trial, should be conducted to test the safety and efficacy of castor oil as a natural alternative to labor induction.”

    In the other paper, 82 women were divided in 2 groups of 38 and 44 , and respectively received castor oil and a placebo (sunflower oil). Of the women who received castor oil, 42.1% entered labour within 24 h, 50.0% within 36 h and 52.6% within 48 h compared with 34.9%, 37.2% and 39.5% in the control group. The authors also found that castor oil was effective in stimulating labour in multiparous women (women who had already had at least one baby) but not in first time mothers. No differences in rate of obstetric complications or adverse neonatal outcomes were noted.

    I tried to find some research to compare the effectiveness of Castor oil versus the most common form of drug used to start the induction process in the UK : Prostaglandins, which are usually administered vaginally. This proved complex because the Cochrane review cites many different studies, all with different populations and different outcomes. For example one study with women of mixed parity (first time mothers and multiple pregnancies mothers mixed together), found that, in a study of 343 women with a favourable cervix (this means their cervix was already in a condition close to labour) and a 3mg dose of prostaglandins, found that 12% of women were still pregnant after 24h versus 100% of women who didn’t have the induction. In a smaller study of 39 first time mothers with an unfavourable cervix and a smaller dose of prostaglandins (2mg) compared with a placebo, 79% of the prostaglandin group and 90% of the placebo group were still pregnant after 24 hours. When combining the data the reviewers could not reach statistical significance. The reviewers conclude after looking at all the studies that ” Overall therefore, although not certain, it is likely that vaginal prostaglandin E2 compared with placebo or no treatment reduces the likelihood of vaginal delivery not being achieved within 24 hours.”

    This gave me pause for thought, because on one hand, our culture can be quick to dismiss natural remedies as quackery and non evidence based. Yet I was surprised to discover that the research doesn’t show prostaglandin pessaries as being a very effective drug when it comes to labour induction, but because this is part of the normal maternity care, this doesn’t get questioned. You might be surprised to hear that only 9-12% of the royal college of obstetrician guidelines are based on high quality evidence. I also couldn’t help but wonder how many of the women who get offered an induction of labour get given the statistics about how successful the process is likely to be.

    What are the side effects of Castor oil?

    The most common side effects are diarrhoea (which is to be expected as Castor oil is a laxative) and nausea.

    • In the study of 47 women, 45.8% experienced nausea versus 0% in the control group.
    • In the study of 100 women , 100% of women who took the castor oil reported nausea compared to 0% of the women in the control group.
    • Contrary to the high level of nausea and diarrhoea described in the studies above, in the first 2018 study, out of 323 women, only 7 (2.2%) experienced nausea. The authors concluded that ” In the current study, the low incidence of maternal and fetal adverse effects suggest castor oil may be a safe and agreeable way to stimulate labor and avoid unnecessary caesarean birth. Although previous studies cited adverse maternal effects (e.g. nausea, vomiting, diarrhea) as a barrier to castor oil use, participants in this study who received the castor oil cocktail reported a low rate of these effects. In fact, less than 4% of the sample experienced nausea, vomiting, or extreme diarrhea.”
    • In the other 2018 study, 32 out of 81 women (40%) experienced an increase in bowel movement, 4–6 h after ingestion of the oil (42.1% in the intervention group and 37.2% in the control group (who received sunflower oil). The authors did not observe any serious adverse events, and concluded that “Castor oil is an effective substance for induction of labor, in post-date multiparous women in an outpatient setting“.

    Castor oil does not appear to cause severe side effects on the mother or baby. The Cochrane review authors concluded that “There was no evidence of a difference between castor oil and placebo/no treatment for the rate of instrumental delivery, meconium‐stained liquor, or Apgar score less than seven at five minutes.”

    What else matters when it comes to decision making?

    Beside the science showing that Castor oil appears to be pretty safe and effective, there are other aspects to consider. As I explain in this blog , induction of labour is an intervention that has many pros and cons, and you have to weigh the balance of pros and cons for you as a unique individual, with your own unique circumstances. And it is also important to remember that Castor oil IS a form of induction, regardless of the fact that it is a natural substance.

    What are the possible advantages of using castor oil to induce labour?

    • It can allow women to remain in control of the start of the birth process, and to choose where they give birth. When labour is induced in a hospital ward, you are committed to a process, which restricts your birth options. In most hospitals, being induced means the only option is to labour in the antenatal ward (though some hospital offer outpatient induction), then give birth in the labour ward. If you induce labour at home then you remain in control of the choice of place of birth, whether at home, in a birth centre, or in a labour ward.

    The authors of the first 2018 paper stated that ” By stimulating labor and decreasing the necessity for intervention via cesarean section, castor oil as a method of labor induction may enable women to adhere to their birth plans (e.g., at a birth center, vaginally, etc.), benefiting from these positive outcomes”

    • It can allow women to remain in their own environment, with their support partners of choice. Induction of labour can take days, and it is sometimes stopped or delayed half way through if the induction or labour ward becomes full. Because of this, in the recent past I  saw many women undergoing induction lasting up to 5 days. Now in 2020, the new visitor restrictions due to Covid19 mean that partners aren’t allowed in the hospital until women are in established labour. For the mother this may mean days of early labour without any support from anyone she knows and trusts, as well as having no one to help advocate for her.

    I have supported such births recently and they felt very frustrating for the mother, her partner and myself. I provided remote support over the phone, but in my experience the induction felt more upsetting than usual with the lack of face to face support from the partner and myself. I know this frustration is shared by others, and a recent publication has highlighted how women’s rights in childbirths are not being respected since the beginning of pandemic:

    “The position of the rights of women in childbirth is in this context a precarious one. Stories have emerged in mainstream media – supported by personal accounts received by global and European birthrights organizations – of women having their labor induced, being forced to have cesarean sections, giving birth alone, and being separated from their babies immediately after birth.”

    • Impact on support after the birth

    Women whose labour is induced are more likely to end up with medical interventions such as caesarean or an instrumental birth, which may mean a longer stay in the hospital post birth. With Covid restrictions in place, partners are only allowed in postnatal wards for a 1 to 2h visit daily. If a new mother is recovering from a caesarean, or if she is very tired after a long labour and birth, this simply isn’t enough support for a her to get some rest and recover after the birth. Nobody is there to comfort her, or to hold the baby whilst she sleeps. I have listened to many harrowing such stories from new mothers to know that this is a very difficult situation to be in.

    What are the possible disadvantages of using castor oil ?

    • The side effects mentioned above might not be acceptable to some women or their partner.
    • Some women may feel safer being induced in a medical setting.

    In conclusion:

    Using Castor oil to induce labour can cause side effects such as diarrhoea and nausea but it appears to safe for mother and baby. It is also a fairly effective, especially when women have already had one or more babies. Some families may perceive that it is important for them to retain control over the induction process, and may decide that having the diarrhoea and nausea might be an acceptable side effect, compared to the reality of being being induced in a hospital setting.