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Sophie Messager

Tag: plan

  • 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.

     

  • 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.

     

  • Online services-why should you pay for them?

    Online services-why should you pay for them?

    It’s a very strange and stressful time we are living right now, especially if you are pregnant.

    There is, understandably, a lot of anxiety about the unpredictable and fast changing nature of maternity services.

    I am seeing a lot of comments on social media about people wanting free antenatal classes (because their hospital ones got cancelled), and also questioning why people should still charge for online work, as well as accusing people who charge for online services of taking advantage of vulnerable people

    So I wrote this blog to explain, and debunk myths.

    I have written in the past about why doulas charge for what they do , and also the amazing lengths they go through to help their clients . The same rules apply here.

    Those “free” NHS classes were not actually free. The people delivering those classes were paid to teach them. Whilst the NHS is free at the point of contact, it isn’t “free” (because you pay for it with your taxes) and the people who staff it aren’t volunteers.

    Whilst I understand that many people might be struggling financially, many are also still employed and earning a salary, or at least 80% of it.

    Most of the people who provide perinatal education and support are self employed and run micro-businesses. I’m talking about doulas, independent midwifes, antenatal teachers, antenatal and postnatal exercise instructors, manual therapists etc. These people are it, i.e. their whole business is composed of one person. If they do not teach or do what they normally provide paid services for face to face, they don’t earn any money.  Zip, nada. Right now, most of them are also trying to juggle doing this whilst having kids at home full time.

    I am one of those people. My income has almost entirely disappeared. I still feel grateful, because my husband is working part time in an employed position and working from home. Still, this crisis means that my little, successful-ish, micro business, which took me 7 years to build up, has been reduced to nearly nothing. But at least I know I don’t have to worry about having food on the table. Many of my birthworker and perinatal educator friends aren’t so lucky, because they are single mothers, or their partner also runs a self employed micro business.

    Yet I am also seeing that most of these people (myself included) are still giving a lot of their time for free right now, running free Facebook groups for  pregnant women (believe me these are busy right now), answering worried messages, speaking to anxious women on the phone, running free zoom drop ins etc .

    It is the same as in real life: people should run free/charity stuff if they can and want to, but it shouldn’t be a obligatory or expected thing. If people cannot earn a living, they simply will not be able to carrying providing these services.

    So why should you pay for antenatal education, birth support, or postnatal education/support, if it’s moved online? For the same reason as when would when you pay for support : you pay for the time and money the person supporting you has spent training, the time they have spent prepping the class or one to one, and the years of knowledge and expertise they have built.

    Right now the people delivering these online classes are spending a lot of time thinking and prepping for these to make sure they work online (because making it work online isn’t the same as making it work IRL).

    They are also spending a lot of time self teaching themselves how to use online delivery systems they had never used before (like Zoom), without any support through it.

    Many are also spending money buying extra equipment (like video cameras and microphones or even laptop computers etc) to allow them to run their online services.

    They are all having to manage this whilst having to deal with their own anxieties about the unusual situation we are all in, their own families’ needs, and worrying about their client’s well being.

    I’m an experienced doula, and since I have been working in the birth and postnatal education for ten years, I feel confident and competent in delivering this to families. Yet, at the moment providing Skype or Zoom support to my clients is taking A LOT more time than when I’m doing it face to face.

    This is because when I’m face to face I no longer need to prepare much ahead. I have enough knowledge to deliver at the drop of a hat, I have a small bag of props than I can use to deliver almost every aspect of birth and postnatal education, and I can react to my clients feelings and adapt accordingly.

    This isn’t the case with the Skype or the Zoom stuff, because not only do I have to think and prep in advance how to deliver stuff that is easy face to face but much more complex online (for example teaching someone how to use a sling), but I also have to constantly keep up with the forever changing medical guidelines (the Royal College of Obstetrician has published 8 updates to their guidelines since they published the first one on the 9th of March, that’s 2 to 3 updates a week!). I am also having to keep up with local trust changing guidelines, as well as rake my brain to think about how my clients can support themselves after the birth in the hospital when I know I won’t be able to be there with them physically. Believe me this takes a lot of head space.

    I am not complaining, mind you, because I love learning new skills and this sure is keeping my brain on its toes!

    But if I wanted to be totally fair, I should actually be charging MORE money for all of my time, to reflect all the extra time spent preparing. Instead because most of us want to support women regardless of their circumstances, many of us are offering discounts, payment plans, pay what you can, or indeed free services.

    I am worried that some of these valuable micro businesses, run by passionate people who do it because they care rather than wanting to make a quick buck, will simply disappear.

    Yes, many celebrities are offering free online classes, but these celebrities are likely to have plenty of money. They are also likely to receive revenue through advertisement, so, again, these free classes may not be actually “free”. Whilst their offer is laudable, is it also sadly contributing to the idea that all online stuff should be free. You simply cannot extrapolate what celebrities are doing to micro businesses which are only known to their local community.

    Another thing I have seen is that people say you don’t need the paid services, because you can teach yourself, with these free/cheap resources. Whilst this is true : you can indeed learn from a book, free courses etc, this isn’t the same as getting into a live course or one to one work with an expert in the field. The main ways you can educate yourself about anything fall into 3 categories: DIY, group courses, and one to one tuition. Each one of them has pros and cons, but it isn’t necessarily fair to compare the DIY approach to what you’ll get if you hire someone to work with you one to one. I have explained the pros and cons of this in a previous blog called three ways to educate yourself about birth.

    So if you still have a salary, please consider paying for support rather than just doing free classes. If you are doing free classes with a micro business person and enjoying it, consider giving them a donation, or hiring them for their paid services.

    I promise you that you will still get value for money and incredible support. You will also contribute to keeping someone’s only way of earning a living afloat. And if you worry that online support doesn’t work, I have addressed it in this blog (along with plenty of free classes links). My blog is also full of free recently added resources for pregnancy birth and beyond, including a recent post on how to have a positive birth in unpredictable times.

    I wrote this blog to explain, and debunk the myth, please feel free to share it widely.

    If you have found this blog helpful and would like to support my work and help me continue provide valuable free information to birthworkers and expectant and newborn families, you can donate to my paypal account paypal.me/SophieMessager.

  • How to have a positive birth in unpredictable times

    How to have a positive birth in unpredictable times

    I am writing this because I know that if you are pregnant right now, the lack of information combined with the unpredictability what maternity care might look like when you give birth might be making you anxious.

    I am seeing a lot of worried pregnant women and new mothers asking worried questions on social media at the moment.

    So I am going to try and give you some ways to prepare.

    I have already collated all the information produced by the royal college of obstetricians in this blog.

    Here is a summary of what restrictions are in place right now (I will aim to update it as it changes):

    • No partners or visitors are allowed to accompany women at antenatal appointments (such as blood tests, scans etc).
    • No partners or visitors in antenatal or postnatal wards.
    • Only one partner during labour. This only includes established labour, so if you start labour at home you’ll be able to go with your birth partner of choice to the hospital (as long as you are both symptom free), if your labour is induced, because this is taking place in the antenatal ward, your partner will only be able to join you once you are in established labour and you transfer to the labour ward.
    • Your birth partner can only accompany you if they are well, i.e. free of COVID-19 symptoms (so it might be a good idea to plan for a backup person if you can).
    • Several trusts have suspended homebirth services due to ambulance services being stretches.
    • Because staffing levels are stretched, some trusts have also closed their birth centres.

    Because of the above, it is likely that the only option available for the majority of mothers will be giving birth inside an obstetric unit, or to give birth at home unassisted (something known as freebirth-which is legal in the UK- see Birthright’s fact sheet on unassisted birth , and AIMS’s articles. If this is something you are considering, educating yourself deeply on the topic is paramount).

    I’m aware that this may feel like a rock and hard place situation for many women.

    Whilst I am seeing a lot of anxious mothers on social media groups, I am also reading a lot of positive birth stories, with women relating stories of incredibly supportive midwifes in the face of stretches circumstances, as well as being apologetic about the current restrictions.

    As someone who has been supporting pregnant, birthing and new families for over 10 years, I am accustomed to the fact that birth in unpredictable, and that what makes a good birth experience isn’t what the birth looks like on paper, but rather how the parents were made to feel during the birth.

    I encourage all the families I support antenatally to write 3 birth plans: Plan A which is your ideal scenario, plan B for curve balls such as when induction of labour is needed, and plan C for a caesarean. I wrote a blog about this here .

    I have supported plenty of women who told me that they didn’t like the idea of writing a caesarean birth plan just in case, but that when it came to it made all the difference because it meant they still got some aspects of what was important to them (such as skin to skin in theatre). The situation we are facing now is similar.

    I also encourage women to think about what is really important to them, i.e. I know that there will be plenty of things in their birth plans that they aren’t particularly bothered about, but to highlight in bold or red the stuff that really matters.

    This doesn’t mean that losing your preferred birth options doesn’t matter. It does, and so does grieving the loss of said options. Your feelings matter, and I know this is a very unusual and stressful time.

    Just like I encourage expectant parents to cover all possible scenarios ahead of the birth (because deciding whether you are happy for a major medical intervention to happen during birth is easier to ponder whilst you aren’t in the middle of labour), I know that by getting prepared as much as you can for all possible scenarios, you are more likely to have a positive experience, and to have put things in place that will allow you to retain some elements of control and decision making, regardless of how your birth circumstances unfold.

    Since it is likely you might give birth in an hospital labour ward/obstetric unit, think about how you can make the space as private and homely as possible.

    Here are some example of things you could bring to make the room as cosy as possible:

    • Dim the Lights/use fairy lights/LED candles. A great tip to darken a room without curtains is to bring a couple of rolls of foil: moisten the widows and you can stick the foil to them, making instant black out (make sure to have a torch in case staff doesn’t have one). Another option is to use a sleep mask.
    • Bring some pillows from home/some blankets (they’ll smell like home and be softer/nicer than hospital ones)
    • Bring something nice to smell, such as pregnancy safe essential oils, which you can put on a tissue.
    • Your own music/noise cancelling headphones, some people like to make a playlist.
    • Create a playlist of your favourite music, whether it’s calm or upbeat. Music can help reduce stress and the perception of pain during labour. Start working on that playlist while you are in birth preparations by finding what genres or artists are soothing/relaxing to you. Listen to those tracks or stations throughout your pregnancy; it’ll be familiar during labour and help promote relaxation.
    • Some pictures. I’ve seen couples putting up pictures and/or affirmations on the wall. Some included pictures of the scan, pictures of a favourite holiday place etc. You could make a collage to take with you and blue tack on the wall.
    • Move the furniture around! Here is a video showing how you can move things around inside a typical labour ward room and make use of the furniture to have an active birth

    What if your labour is being induced:

    • First know your rights and options, and that being induced for “postdates” can be a bit of a grey area. I wrote a blog about this here .
    • All of the above, plus stuff to keep you entertained, like books and downloaded movies. Induction can take some time (sometimes several days) especially for first time mothers. Since you will be on your own in a ward, with several other women in the same bay, privacy can be an issue, so sleep mask, earplugs and noise cancelling headphones can be really helpful.

    Regardless of how and where you hope/plan to give birth:

    • Write a multipart birth plan, the process of finding out about options is as important as ever. Remember that nothing should be done to you without your full and explicit consent, even simple medical procedures such as vaginal examinations.
    • The positive birth book has a great set of free icons to download if you’d like to make a visual birth plan-they are also great as a prompt if you aren’t sure about what topics to cover
    • Use the BRAIN  (Benefits, Risks, Alternatives, Instinct, Nothing) acronym to help you through decision making and asking the right questions.
    • In your birth plan, you might want to start with a paragraph introducing yourself to your caregivers, highlighting any really important aspects. The quicker they can get to know you and what you prefer, the easiest it will be for them to establish rapport and support you as best they can.
    • Practise ahead of time techniques to help you stay as relaxed as possible, such as meditation, breathing and relaxation techniques, or movement.
    • Consider hiring a doula. Whilst it’s unlikely a doula will be able to come with you due to the one partner only rule, most now offer remote services. Not only your doula will be invaluable in helping you prepare, she will provide a much needed friendly voice at the end of the phone or video call. I know it sounds odd that we can provide help remotely, but I have personally supported several couples through birth over the phone and I know how much of a difference it can make.

    Ultimately whilst we can control certain things, I think what this extremely unusual circumstances have shown us is the we have the illusion of control of scenarios, when really we don’t have control over it.

    I will leave you with this quote from Sara Wickham:

    “I am so heartened to hear about the generous and creative ways in which many people have responded to this crisis. I’m taking two thoughts into the weekend with me. The first is that there are still plenty of things that are within our control. And the second is that creativity and connection are key to getting us through this.”

    If you have found this blog helpful and would like to support my work and help me continue provide valuable free information to birthworkers and expectant and newborn families, you can donate to my paypal account paypal.me/SophieMessager.

  • Why I want to change the nature of postnatal support

    Why I want to change the nature of postnatal support

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    Earlier this week I wrote a blog that’s been playing on my mind for many years. It’s called “why I wish I had hired a postnatal doula“

    In this blog I explain how challenging I found new motherhood, how lonely and upset I felt through those early weeks and how I longed for some support but failed to reach out because of a mix of shame for not loving every minute of being a mother, and feeling like I couldn’t justify the expense.

    As a doula, I witness the same challenge in new mothers. Sometimes I do not even know they are struggling until weeks later, because, whilst they sit in the same pit of discomfort and shame as I did, thinking they are the only one that struggle, they don’t usually reach out for help do they?

    I have written before about the topic of making a postnatal recovery plan, and about what new mothers really need, and you’re not meant to be doing this on your own (hint: it’s not flowers or stuffed bears).

    The wisdom in traditional postpartum practises around the world is very simple really, it boils down to 4 main elements of support for the mother:

    • Rest (someone takes care of the chores)
    • Food ( someone takes care of cooking good, nutritious meals)
    • Social support (the new mother is never alone at home with a baby)
    • Bodywork (someone massages the new mother, along with wrapping her hips/abdomen)

    I have a strong urge to write more about this, to spread the word further, I have a list of blogs as long as my arm about this topic, and in fact I now am thinking I need to write a book, or possibly more than one book, about this topic. Something easy to share, I might start with an ebook, like the one I have already written about rebozo techniques.

    I’m a knowledge junkie, so since I started learning about some postpartum practises, I’ve asked everybody I’ve met about the traditional practices from their country, and you know what, every continent in the world has some form of specific nurturing, specific foods, and bodywork and wrapping.

    After all, you’ve not only grown and birthed a whole new human, your body has accommodated this through tremendous changes.

    During pregnancy, the uterus grows from the size of a pear to the size of a watermelon (pushing abdominal organs out of the way, changing the shape of your muscles, ligaments and spine as it does so), then back again after birth.

    It seems crazy to me that nobody makes sure that all the organs, muscles, joints and ligaments have safely returned where they belong.

    I bake a groaning cake for all mothers I support, and sometimes make a traditional Chinese chicken soup too (my husband is from Hong Kong, and there is still a very strong postpartum nurturing culture there)

    Learning to massage and wrap new mothers had lead me onto a journey of discovery about postpartum practises, got me to work closely with an osteopath, create a new type of massage, and develop my skills in an apprenticeship manner. The two combined led me to develop a deep practical knowledge of what happens to women bodies after birth.

    This has fuelled a fire that makes me want to shout from the rooftops that what we get in the Western world just isn’t good enough, and want to work hard to change that.

    If this resonates with you, and you would like to learn some of these nurturing skills, I am running some Rebozo and Postnatal Recovery Massage courses in July-see https://sophiemessager.com/workshops-birth-professionals/

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  • The vision board, an alternative way to plan what you want

    The vision board, an alternative way to plan what you want

    Today I’ve spent the whole morning making a vision board for this year.

    It feels  that I’ve been procrastinating doing this for over 2 weeks now, and suddenly felt the urge this morning, which is the first full moon of the year, and a powerful one at that, a good time to set intentions.

    I’ve been doing this for 4 years now.

    I started doing this as an alternative, no actually, as a rebellion against the typical masculine-orientated process of making a list/bullet point/gannt charts and suchlike.

    Once upon a time I was a control freak scientist who adored excel and Gannt charts. I was extremely process driven, I never forgot a thing, and was irritated beyond belief by people who didn’t prepare and plan things in advance or forgot stuff.

    The birth of my first child rewired my brain, and led to my leaving my scientist career to become a doula. You can read about that here.

    My creativity went through the roof and my organisation skills kind of decreased at the same time. I’m am so much happier for it!

    The only problem was, I didn’t know how to organise things except in the way I had been taught.

    The first couple of years of my self employed life I rode on the wave of excitement and novelty, so things were effortless and easy.

    Then a couple of years later, I felt overworked and out of control.

    What I didn’t realise at the time, was that the process I was using was a male one, a linear one, and that it didn’t suit who I was anymore.

    So I started experimenting with more fluid, intuitive, creative, and feminine ways of working.

    Making a vision board was such a process.

    Here’s how I do it:

    I gather a bunch of old magazines (I need quite a lot so I accumulate them over the years, many being free magazines I grab in local cafes etc).

    I set my intention of what I want this vision board to be for (for me, it’s what I’d like more of in my life this year, but you could use it for something entirely different).

    It’s nice to meditate before you start, especially about how you’d like to feel, rather than setting targets for now.

    Then I sit at my kitchen table with a cup of coffee, and flick through the magazine and rip any page that has a picture that appeals to me. I am completely intuitive about this, I’m not analysing it.

    After I’ve got enough pictures, I then cut them nicely using a rotary trimmer and scissors. As I do this I discard some pictures already.

    I lay a large piece of flipchart paper on the table, then arrange all by themes. Some pictures don’t make the cut.

    I visualise what each picture means for me as I set them in place. It’s quite vague at this stage but it feels important to do that. It doesn’t have to be logical or fully fledged either, usually at this stage it’s just an idea.

    Finally I glue all the pictures in place, and set the finished vision board in a prominent place in my house.

    Over the last 3 years I’ve been doing this, as I look at the board from time to time, it’s fascinating to see how what I visualised has manifested itself, often in different ways to what I had imagined, but manifested itself nevertheless.

    I wrote this to encourage others to try it and I’d love to hear, or even better, see, what you come up with and what effects it has for you.

    Here’s what the one I made today looks like.

     

  • What do you get when you hire a doula, or why she’s totally worth the money

    What do you get when you hire a doula, or why she’s totally worth the money

    This week I saw this meme.

    It made me want to write about what you get when you hire a doula.

    The birth/wedding spending is a very well known analogy in the birth world. Most people spend A LOT more time and money planning for their wedding day than they do for their birth.

    I’ve written about this before here.

    So why do I feel compelled to write about why doulas are worth the money?

    Because I keep hearing/reading stuff about the fact that doulas are expensive.

    This simply isn’t true.

    The fact that people are reluctant to invest much time and/or money is preparing for their birth is a reflection of the low value our culture places on motherhood, and of a lack of understanding of the impact that birth has on women, and on society as a whole, but this is a topic that deserves its own blog post.

    I’ve written recently about the value of a doula, but this time I’d like to explore and explain what you really get when you hire one and why it’s worth every penny.

    My friend Maddie McMahon also wrote a brilliant blog about doulas and money this week.

    And doula SallyAnn Beresford also wrote about budgeting for your birth.

    I’d like to correct some misconceptions about doula work and its worth.

    I think the biggest misconception is that you hire a doula to support you through the birth of your baby and that’s all that matters.

    Recently a colleague was asked how much she’d charge to only come to the birth, and do no antenatals.

    This has happened to me too and I had to explain it just doesn’t work like that.

    Much of the work we do is in the preparation, the getting to know you and the support and information we give prior to the birth.

    I saw another meme last week that summed it up very well “the power of a birth plan isn’t the actual plan. It’s the process of becoming educated about all your options”.

    It’s a big myth that there is no point writing a birth plan because birth is unpredictable (and I encourage all my clients to write 3 births plans (Read about this here)

    So back to what you get from your doula, and I’m in the thick of it at the moment as I’m supporting a woman pregnant with twins and one planning a VBAC , one having her first baby, one having her 2nd baby and one having her 3rd (they are not all due at the same time!).

    The minute you hire a doula, she’s completely dedicated to you.

    Whilst most of us have letters of agreement that cover a certain number of antenatal appointments, we also state that you get unlimited phone and email support from us.

    These days I’m in contact with my clients via email, text, phone and whatsapp groups.

    All this work can seem invisible because it’s not face to face, but I spend hours for each client beside the face to face meetings, researching information for them, on whichever topic they need information about.

    I send them various signposts, from online articles, examples of birth plans I’ve collected through the years, books etc. I contact other people for information when I’m facing a situation that is new to me (this happens all the time by the way as everybody is unique).

    I help them write their birth plans, reading through and making suggestions about things they haven’t thought about.

    I send them up to date hospital policies that I’ve managed to collect through my knowing of the right person to contact at the hospital.

    I lend them books and DVDs, slings and other pieces of equipment.

    I signpost them to the huge network of midwives, doctors, osteopaths, massage therapists, and other complementary practitioners that I trust and with whom I’ve built links over the years in my community.

    I suggest they meet with a different consultant or with the consultant midwife, and I often accompany them to the appointment.

    I’m truly passionate about this (and all the doulas I know are too), so I put absolutely no limit on the time I spend doing this.

    With more complex pregnancies,  it can mean an incredibly high number of hours.

    And of course I meet face to face with my clients at least twice antenatally (not including the first time we meet for an interview).

    I prepare extensively for these appointments, discussing what they want ahead of time and preparing the right props to take with me.

    I listen deeply to their wishes, their concerns and worries, and I try to provide the information that maximises the chances of them achieving these wishes.

    This is the antenatal prep.

    Then there is the on call period. Most of the time we go on call from 38 to 42 weeks pregnancy, or until the baby is born which can be longer than 42 weeks.

    This means that for up to a month (it’s pretty rate that it’s shorter than 2/3 weeks especially for first time mums, and I’ve been on call for 5 weeks in the past), we are on standby 24/7.

    We literally put our life on hold. We don’t go away more than an hour from our house. Most of us have young children ourselves so we have to make very complex childcare arrangements to be able to drop everything and come to your whenever labour starts (including at night). We can’t drink alcohol, even at a party. We can’t let our hair down. We tell all our other professional engagements that we’re on call and may need to cancel at short notice (“unless I’m at a birth” becomes a recurrent sentence).

    We pack clothes ready for the next day so we are ready to disappear in the middle of the night when needed. We need to be careful what we wear in case we have to hot foot it to the birth. We repack our doula bag, making sure everything we need is in there, and replenishing supplies.

    Our phones are glued to us 24/7, and placed on the bedside table at night (And we’re always making sure the battery is charged).

    We sleep less well (we experience a level of heightened alertness and often wake up at night to check our phone in case we missed a text/call from you). We always make sure we are reachable, are paranoid about phone reception which something means giving someone else’s landline just in case (some clients live in areas with poor mobile reception).

    Our clients are always on our mind. We care deeply for you at this vulnerable time.

    We know that we might need to come to you very quickly when labour starts. We never know when.

    We have to remind our partners of the fact that we may disappear in the night or day, and make sure they know what’s happening with the kids etc.

    Our partners and children find the unpredictability difficult to handle ,especially as they don’t know how long we’ll be gone for.

    We keep telling our friends and family : if my client calls I’ll need to go. I choose to take the car instead of the bus when going to town, incurring extra parking charges, because I want to be as quick as possible in case I get called, plus my doula bag is usually in the car and it’s really big. I have to remind my kids when we go to the park or the cinema, remind my husband when we go for a rare meal out. Several times I have had to tell my choir leader at the beginning of a concert that if I may need to disappear.

    We miss study days and conferences we have paid for because we don’t feel safe going that little bit further away in case labour happens during that time.

    It takes a very special kind of person to cope with this level of unpredictability and low level tension on a constant basis. It gets easier as you become more experienced but it never quite get to the state when you feel completely relaxed.

    The on call period is up to 30 days, 24h a day. This can mean a total of 730h or more. So if you think that my birth package starts at  ÂŁ950, one third of which is for the on call period, that’s 316 divided by 730, which amounts to 43p per hour. Not exactly minimum wage hey?

    Then there is the birth itself.

    I’ve been a doula for 6 years and the shortest birth I attended was about 3h long (I always stay a few hours after the birth to make sure mother and baby are ok and help with establishing feeding etc, so I was there for 6h). The longest was 4 days. The average was 21h.

    We spend hours supporting you and your partner, holding you, massaging you or whatever other comfort method helps at the time, managing on very little sleep and food.

    We help you navigate unexpected curve balls. We stay strong. We cheer you on.

    We have a firm commitment to the families with support and we’re not going anywhere until the baby has been born.

    When we get home after a birth, we often take days to recover.

    Then there is the post birth support. I offer a minimum of one postnatal visit and unlimited phone and email support for 6 weeks after the birth. I also offer standalone postnatal support for an hourly rate of ÂŁ25.

    Some parents take to parenthood like a duck to water and require very little support from us. The shortest postnatal job I’ve done was a one-off visit of 3h. The longest one was 2 years.

    Some parents have very complex situations to deal with and this can mean hours of support.

    I recently supported a new mother of premature twins so she could achieve her goals of breastfeeding them and this took much hard work, sweat and heartache, with incredibly rewarding results at the end.

    Some parents struggle with feeding, with adjusting to being parents, with sleepless nights, with conflict with their partner, with being a single parent, with complex medical situations and more.

    We’re there for them and we don’t go anywhere until we have helped them achieve their goals. We move heaven and earth, we reach out to other knowledgeable people, we spend hours talking and researching topics.

    I haven’t written this to moan about it all and I sincerely hope it doesn’t come across this way.

    I do this because it’s all worthwhile and I don’t resent it.

    I do this because it’s a calling and because I care about birth, and about women.

    But I just want you to know what it means to be a doula, and how challenging it can be at times.

    I want you to know that when you hire a doula, she puts her life aside for you for weeks or even months at a time.

    Because you are worth it.

    And your doula is worth it too.

  • A tale of two VBACS

    A tale of two VBACS

    I wrote this blog with Sarala’s permission, and it is now featured on the Cambridge vbac friends blog

     

    Sarala’s two VBACs in the Rosie Delivery Unit and the Rosie Birth Centre as told by her doula

  • Are you full of should?

    Are you full of should?

    This week I had a very interesting coaching session with Charlie from Your Time to Grow.

    I wanted to talk about how I’ve been feeling like I’ve got too much to do, and how to manage my time better.

    It is a recurrent problem for me, I am a busy self employed person with many hats, and many people relying on my support. I am also the mother of 2 young kids, and a wife. There are A LOT of things to fit in my day, and I was wondering how to make it fit better, because I felt that I just didn’t have enough time.

    In the past, before I became a mother, I was scarily organised. I was one of those people who planned everything, never forgot anything, and had no tolerance for people who didn’t plan or who forgot stuff.

    I was a control freak.

    Motherhood rewired my brain completely and I slowly morphed into a less organised but much more creative version of myself.

    I wouldn’t trade my more laid back, less organised self for my old control freak self, because I feel much happier and relaxed as I am today.

    But I guess some of that control freak mentality is still ruling me a little.

    Through the coaching session, Charlie pointed out that when I talked about my day and my workload, there were a lot of “should”. I should be more organised, procrastinate less, do more of this, less of that. You get the picture.

    I was full of “should”, and with the should, also full of guilt about the stuff I wasn’t doing.

    The thing is, guilt doesn’t serve any useful purpose, in this situation does it? It doesn’t help me do my work any faster, it just makes me feel crappy.

    I also realised that I am spending far too much time focusing on what I’m not doing, where I’m falling short of my own standards, rather than focusing on what I’m doing well.

    At the end of each year, I tally up what I’ve achieved professionally, and trust me, the list is usually pretty impressive. But at the time, in the trenches, I often forget to celebrate my own achievements, and instead I tend to focus solely on my shortcomings.

    Charlie pointed out that I’m actually achieving most of what I set out to achieve. It was very useful to have that pointed out, because I realised that not only I’m actually getting things done, but also that I don’t like to work with a rigid schedule, so that the mindset I had, that I ought to stick to rigid rules and planning, simply is never going to work for me . It got me thinking that it’s OK to work with more flow in my day, and this actually works better for me.

    It was a bit of a lightbulb moment to say the least.

    I realised that I am doing OK. That although not everything on my to do list gets done (does it ever?), and that it can take me a while to reply to emails, the important things get done and that I work better under a deadline than when I have plenty of time ahead.

    And, most importantly, it’s ok to work like that.

    Having this discussing freed me of guilt, and left me feeling quite liberated.

    It was like someone had just given me permission to be myself ,rather than trying to work by other people’s standards.

    I’m going to be experimenting with a new, more flowy way of planning, one that feels good and true to me, instead of forever seeking the magic tool that will fix my workload problems. Because let’s be honest, it doesn’t exist.

    What about you, are you full of should?

  • Why you need to write a postnatal recovery plan

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    If you’re pregnant or have ever had a baby, you’re heard of birth plans, I’m sure, but have you heard of writing a postnatal plan? I doubt it.

    As a doula , antenatal teacher and babywearing educator, I’ve been working with expectant and new parents since 2010, so I have met quite a few pregnant and new families and their babies (I think it’s something like close to a thousand now).

    So you see I thought I kind of knew quite a bit about postnatal recovery. Expect I had missed something crucial in the mix.

    When I attended the doula UK conference a few weeks ago, Mia Scotland (she is a clinical psychologist and doula, and author of the awesome “why perinatal depression matters”-the best book I have read about depression and perinatal mental health) gave a talk about postpartum practises from around the world and the dire lack of them in the West. I kind of knew all of this-I bang on about it in my antenatal classes-my friends from China, Africa, India or South America tell me stories of spending a month in bed with their babies whilst family members rally round to take care of chores, or people fighting over who is going to cook them delicious, nourishing food, or daily full body massages etc. Heck I even teach a postpartum massage from Ecuador called closing the bones.

    What do we get in the UK? Two weeks leave for the partner, and we get told to “leave the chores” and “sleep when the baby sleep”. But chores need doing eventually (you need to eat, at least, and some clothes to wear for you and your baby!), and what if your baby only power naps in 40 min batches? When do you rest then? Also most mums have no family nearby, and the majority of them find themselves alone at home all day with their new baby-with no social network because their friends are at work. So you get an exhausted and lonely new mother, with no support. Feeling guilty because she isn’t feeling serene and fulfilled by new motherhood. Ah! This isn’t what we were supposed to get as a species. This isn’t right, and deep down, we know it.

    So yeah I’ve been rabitting on about all this to pregnant couples. But that wasn’t enough.

    What Mia suggested if that we encourage expectant couples was to write a postnatal plan. This was new to me. I think this is a genius idea!

    It’s quite revolutionary when you think about it.

    A postnatal recovery plan.

    Just like a birth plan-I guess we could call it a postnatal recovery preferences plans.

    It’s a lot more focused than just talking about what’s missing in our culture. It is encouraging parents to think about what is missing and what they can do about it. BEFORE they have their baby.

    So what would it look like? I asked my birthworkers friends on Facebook over the week-end to come up with an acronym. They came up with several brilliant ideas! The one that appealed to me most was the RECOVER acronym by author and breath coach Catherine Holland. I then adapted her idea and added the words describing what each letter prompts for. It’s a great starting point for parents to think about and put support in place for after the birth.

    Rest-you need to recover from growing and birthing this baby. Adult help, daytime naps (Sleep when baby sleep ), early nights, taking it in turns, or other sleep deprivation strategies that work for you.

    Eat-nutritious food- fill your freezer, ask friends and family to cook and deliver food, take away menus…

    Chores-can you get another adult to help? A cleaner, family members, friends, a postnatal doula, mother’s help?

    Optional-refers to the visitors below but also to the fact that the plan will only work if it is tailored to your needs-some new mums prefer to stay at home, some prefer to go out and see people for example

    Visitors-This can be a good or a bad thing, depending on yourself and the visitors. Visitors who come and expect to be waited upon, and insist on holding your baby, can leave you feeling exhausted with a cranky baby. Can you discuss this with friends and family ahead of time? If you don’t want visitors but don’t want to confront them, note on the door with “new mother and baby asleep” might do it.

    Emotional Take it easy, this is a big change and the first few weeks are usually very chaotic. New parents need solid emotional support, Think “mothering the mother”. Yet most are bombarded with well meaning “advice” which can undermine their confidence. Find someone to talk to who can listen unconditionally.

    Receive- this isn’t a time for you to give to other people-you are supposed to receive support. Demand nurturing present for yourself, like a postnatal massage. It is much more useful to have nurtured parents who feel strong enough to look after their baby than lots of flowers, babygros and cuddly toys.

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    Of course a postnatal doula can help you design such a plan, signpost you to the right people and provide all the support highlighted above 🙂

    Let’s start the postnatal plan revolution!