How to avoid fake news…

Without assuming we are all aware of what fake news is,  I’ll share my understanding.  Fake news is when misinformation is published, passing itself off in the form of commentary, news or journalism.  Unfortunately often real news is hard to distinguish from fake news.

Last week the birth world was a buzz reacting to ‘media’ claims that the midwives of the United Kingdom had turned their back on their ‘natural birth’ campaign .  The reasons given for this abandonment was due to the death of babies caused by midwives blind pursuit of a natural birth.  In addition to those damning accusations it was highlighted that the heavy push for ‘natural birth’ was causing immeasurable feelings of guilt and anxiety in mothers.

These reports were all fake news.  A few years ago the midwives of the UK  did change their focus from ‘natural birth’ to ‘better births’ to be more inclusive, informative and for many other reasons.  Everything that was reported in the media last week was fabricated, outdated and misguided.  Fake news in the media is dangerous to its readers, none more so than the women in our society who will be, are, or were pregnant.

Throughout history birthing women have looked to their peers and elders for guidance as they navigate their maternal path.  Slowly our villages became larger, industrial, medicalised, and as individuals we became more isolated.  Today, in Australia, most birthing women have access within our medical system, to midwives and other experts in the field of childbirth, however with varying and often conflicting advice, time constraints making all to clear the current crisis that our maternal health system faces, women are turning to current, accessible, objective sources of information to make decisions about their pregnancies and births.

Sadly what they are faced with is article after article of opinion, conjecture, misinformation, and fake news.  Simply because an author has medical credentials, quotes experts, and provides evidence, this does not make their word real.  There are plenty of agendas to be supported and all of us have bias, whether we pretend to or not.  No one is truly objective when giving advice to you about your body, your health, your choices, or your birth.

So what can you do to avoid this.  There are a few basic checks you can make.

  • Is the source reliable.  Seek out information about the writer and where the article is being published
  • Read the entire article, not just the headline and first paragraph which are often there to get clicks and sell papers
  • Check for bias.  There are two sides to every story.  If both are not represented than you are not reading objective information
  • If any links, evidence, or references are made, look at them.  Do they actually support what the writer is saying? Are they current and still relevant?
  • Check the date of the article, old articles are often no longer relevant.  I’ve been caught out on this myself
  • Finally and most importantly ask the experts…but who are they?

No one is going to be more objective about your body,  your health, your choices, or your birth than you.  No one is better at objectively loving and  protecting you and your babies than you! Pregnancy and childbirth can be all-encompassing and at times overwhelming.  Find YOUR experts.  Not the hospitals, not the governments, not societies but yours.  Research them, know them, contact them. I have yet to meet a genuine and objective expert that is not willing to answer questions. More often than not if they can’t answer your questions they will refer you on to someone who can.

Value your investment in your outcome.  Embrace the importance of your ownership and leadership of your journey and your birth.  Consider the impact of what you read and hear on your decision-making.  Are they YOUR experts or are they fake news?

A life without trauma

This week is Birth Trauma Awareness week.  I never speak too often on the reasons why I became a doula and the reasons why this work I do is a true calling for me.  Like so many other doulas, child birth educators, therapists, midwives, and other birth workers the roots of my passion to support people in birth is deeply rooted in birth trauma.

I have three children and each of their births added complex layers of joy and trauma.  Rather than sharing those stories this week I have decided to open up a little about the ‘traumatic’ birth that thrust me in to the birth and doula world.  I had no idea at the time that my darkest days would be the seed for my deep belief that ALL births can be without trauma if only women would be supported wholly.

Lily’s Gift

When it dawned on me that my newborn niece, only 48 hours old, would not be getting better, would not be leaving the hospital, one thought came to my mind, one thought that stole my breath, strangled my stomach, and filled me with such sorrow that my heart and mind broke.  Lily would never see the moon.

You never really know how you will feel and behave when your flesh and blood has died.  You never dare to entertain the idea that your babies, your sister’s babies will die.  It is what nightmares are made of. Suddenly you find you are living in the nightmare.

Lily was born after a long, hard labour.  At the time, I had no idea. I had never been around birth however I remember feeling with certainty that my sister was stronger than she had ever been, wiser than she had ever been, and more vulnerable than she had ever been.  I knew she could do it. She was doing it and she did.

When death happens at the same time or soon after birth it is a truly surreal experience. I have come to understand now why.  Your most treasured, blissful, awe inspiring and loved filled moments are all unfolding during your worst nightmare.

When we left the NICU, after Lily had been taken off the machines and died, peacefully, intimately in her mother’s arms.  The staff said to me, “your family is so amazing” “you’re are so amazing” “your love is so amazing” I was silent. I had no idea. I had never been around the death of a baby before. Now many years later I understand. My family did something amazing.  We participated. We held space for each other.  We grieved lily and we celebrated her. We bathed her, held her, dressed her, and tucked her in to bed.

Those moments. Those tender and best moments meant what was a dark time, a horrific time was not also a traumatic time. It was also one of the happiest times of my life.

Thank you for taking the time to read about my time with Lily.  Having the deep and authentic connection with my family meant that I was truly able to honour Lily’s life in those precious moments and now looking back I know what may be horrible, devastating, heart breaking, so so sad, and tragic need not be traumatic.

If you have any feelings of trauma associated with your births please raise awareness and share your stories. Be kind and gentle to yourself.

The Illusion of Choice

The battle for ownership of birth rages on. I try very hard to hear all sides of the argument.

As a doula I support all women, wanting many different things. Some want hospital births with all the pain relief, some want complete drug free births, some want undisturbed hospital births, and some want homebirths, with and without medical attendance.

As a doula, I do not associate with the medical system. A doula’s role is not a medical one and therefore I am able to support birthing women where ever and whenever birth happens. Not all doulas will support a ‘freebirth’ and that is entirely their call. I think it is great women who decide not to step in to the medical system have additional emotional and practical support available from a person who has experience being around birth.

At this moment freebirth is not illegal. It is therefore a choice of every women to have a freebirth.

In my opinion, with the laws and regulations imposed on women, freebirth is the ONLY way women can make truly independent choices about their pregnancy and birth. It is the only environment where a birthing person will have almost complete control. Not just in choice of location and it’s atmosphere but also choice in who is allowed in that space and for what reason. I am so happy that this is a choice for all birthing women.

Some women, including myself, prefer to have some back up in case something were to go a miss. Unfortunately, there is no choice for me. No choice that would mean I had control over my environment, the people in my environment, or my body for that matter. I am not low risk. Actually, to be more accurate, I am not typical.

Women are told to trust the system, that we have choices and our choices will be supported. The truth of the matter is we don’t have ALL the choices, we have the choices ‘they’ want us to have. Now its not like just anyone has decided on what choices we will have. These choices of choices have been painstakingly reviewed and assessed by leaders in the field of maternal science and health. These choices of choices are being presented by and supported by experts. Right?!?

In the last fortnight, Royal Women’s Hospital Melbourne shut down their breech birth clinic. This was done without warning or consultation. After some investigation I found that the clinic was closed due to lack of experienced staff. This is just one example of how the medical system is failing birthing women. It isn’t the hospitals fault that there are no skilled staff. It is the entire medical systems fault and dare I say greater societies too.

Repeatedly I hear women being told “no you can’t do that, it is too risky, your baby is too big” “your baby is too small” “your pelvis is too narrow” “you’re too old” “your BMI is too high”. Suddenly we find ourselves stuck in a system that doesn’t know what to do unless a birth is a text book one…funny that…I wonder why?

 

In the medical establishments enthusiasm to remove all risks associated with birth they have also systematically removed their skills, one by one.

 

By advocating for only guaranteed perceived good outcomes every possible diversion from their unrealistic perfect model of birth is deemed a risk and instead of educating themselves on how to deal with the diversion they have trained themselves to remove it. If they are unable to remove the risk then they deem the birth process a failure, baby and mothers as failures, bad candidates, and dangerous. They say “you don’t want to kill your baby do you?” “we can save you” How absurd.

In their wisdom and for our protection of course, they have also made it illegal for anyone but ‘them’ to perform anything that remotely looks like medicine. This includes any assistance of childbirth aside from basic first aid. The sages of the community who once held invaluable skills, life saving skills to assist in birth rather than intervene are dying out and with them dies the knowledge and skills to deliver breech babies, and multiple babies, and ‘stuck’ babies.

And here we are today. What choice do we have?

Give birth at home unassisted even if we don’t want to. Even if we want to have assistance available we cannot have it because we are too risky. Too broken. Too dangerous. Or shall we go in to the medical system whose support of choices only applies to one kind of birth, with staff that are, often only skilled in one kind of birth. Experts who are not skilled enough to work in birth, so expose us to medical and surgical risks instead because at least they can ‘control’ those…

What choice do we really have?

Going out of business…

If you have had a doula you will know that a doulas presence is invaluable.  If you haven’t had the opportunity of learning first hand what a doula does please take the time to read and listen to reviews, scientific articles, blogs, magazines, podcasts, books, and social media (please see the links provided below)

Primarily doulas support women through pregnancy, birth, and the post partum period.  Not necessarily to have a natural, drug free birth absent of all modern and medical support often we are getting water, carrying bags, holding monitors and heat packs in place.

There is a problem, being a doula as a job is not sustainable financially, working in a relatively unknown industry, paying for our own training, also being business owners with all those expenses financially and hours upon hours upon hours of our unpaid time.  This has led to doula prices raising and raising and suddenly I am hearing within the industry “doulas are a luxury not a right” “If they are that disadvantaged than maybe they should look for affordable food and nappies, not cheap doulas”  Doulas are now marketing themselves as products.  They are “charging their worth” and “making a living wage” The issues I have with this is

A) no one could possible pay me what I am worth, there is no dollar value you can give me to compensate for the hours on call, time away from my family, 3am wake ups, and labours that last for days

B) should one person be paid more because they chose to own and pay a mortgage on an expensive home and holiday overseas every year? Do I deserve less because I keep my expenses low? and

C) doulas are NOT a product.

Doulas represent many positive changes today, women all over the world, including doulas, have been called in to action to bring awareness to womens issues, gender equality, slut shaming, body positivity, obstetric violence, birth trauma, abuse, women’s health, informed consent vs informed choice, depression, feeding aversion, the need for post natal support, the need for community support for breastfeeding to work, participative health care.  I witness these women tirelessly devote hours of time, giving up much sleep to keep the fires burning, to wipe the brows, lessen the pain, and protect that which IS of value.

By hiring a doula your are not only honouring your value and the value of your experience, you are also acknowledging the value of an industry that is pushing boundaries, changing laws, fighting for choices, respect, to be heard. An industry that without your help will all but disappear and what will be left? A luxury.  A product only attainable to the highest bidder.

Research – Impact of Doulas on Healthy Birth Outcomes

Media – ‘Society makes us scared of giving birth, but it doesn’t have to be like that!’

Media – Postpartum doula eases transition to motherhood

Working with Childbirth Pain, with Julie Bonapace

Top 10 doula bag secrets revealed

I kind of feel like I am telling everyone how to do a magic trick here.  Every doula is so different and what they bring to each labour they attend is just as unique, however I have come across some very common and essential items that doulas pack when attending labours and I want to let you in on our secrets.  Here are the top 10 things you are likely to find in a doula bag or basket;

  1. A water bottle, staying hydrated is super important when you are supporting another person in labour.  Mamas are usually supplied with cups and jugs of water but we wont to make sure we are stocked up and don’t have to leave the room.
  2. Hairties, clips, and bobby pins. If you have hair NO ONE can have enough of these
  3. Various breath fresheners, these are great for everyone in the birth space.  Often you have to be up close and personal and you are regularly in attendance for a long time.  I am more than happy to receive morning breath from my mamas but I want to save them from mine.  Often clients have wanted to brush their teeth but don’t have the energy, gum can help here.
  4. deodorant, same reasons as above.  Also during an intense or long labour its nice to take yourself away and freshen up. It can make you feel like a new person
  5. A change of clothes! I cannot encourage this enough.  At the time of a birth being covered in bodily fluids and soaked in a shower is just par for the course then you have to step out in the light of day and often meet family members on the way.  Driving home in a set of fresh clothes feels AMAZING

6. Pen and paper, it is great to record certain events during a labour.  Recording regular events can also be used to involve a support person who may otherwise feel at a loose end.  Mamas often like to look back at the details also

7.A battery operated oil diffuser, a carrier oil, and essential oils.  These should only be used with the informed consent of the client.  My oils of choice to take to a birth are;  Peppermint (great for nausea, a drop in the toilet to encourage urination, and to banish any odours.  Use in a limited capacity due to some concern it can affect breast milk production, best not to diffuse but a sniff or a few drops in the room should be fine) Clary Sage (this oil known for female health and wellbeing, it is great for the working uterus and the hormones related to female cycles including birth and labour) There are many more however that is another post for another day

8. Your phone and or camera, it is becoming more common for couples to hire a professional to take photos during their labour and birth if this is not the case it never hurts to have a camera handy to capture moments that would otherwise be lost

9. LED candles.  These babies are a must have.  Labour rooms are best kept dim to encourage oxytocin production.  LED candle lights allows for come gentle soft lighting.  It makes the room feel pretty magical too

10. Honey and snacks.  It is great to have a back up snack ready to go in case anyone (including yourself) is hungry and it means you don’t HAVE to leave the room.  I also cannot stress enough bringing some honey for the mamas.  Labour is hard work and when you need energy the most, you can feel the most exhausted.  Mamas are not often wanting to eat as they move in to second stage however a little bit of honey can go a long way to getting the little boost that is needed.

So they are my top 10 doula bag tools to assist during labour.  Use them yourself or pass this list to your support people so they can be totally prepared.  One absolutely honourable mention…

11. The birth plan.  Whilst most mamas know that birth rarely goes to plan, having a few copies of the birth plan is great to hand over to your care provider to have your wishes and requests down on paper. Even get it laminated.

Of course I have to say the most amazing thing I could possibly bring to any labour I attend is me.  Knowledge that has been passed down to me from experienced doulas (teachers) and even more so from the mothers whose births I have attended including my own.   My unconditional, non-judgemental, fierce support for you and your birth desires.  My hands to hold up, hold to, and soothe.  My presence and undivided attention and dedication during your beautiful birth.

Please add comments on anything you brought to your labour that you couldn’t live without

NAVIGATING A VBAC Part Two

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Why VBACs require more support?

I am about empowering women and mamas to find the strength that is within them to achieve whatever they are working for.  In this way all of the clients I support find their own way to surrender to birth and experiencing the transforming power of becoming with their baby.

If a pregnancy and birth remain ‘complication’ free (according to hospital standards of ‘complications’) than my job as a doula can be focused completely on a mama and her  preparation for a conscious and connected birth. If however the hospital perceives an increase in risk, for example a uterine rupture, the ability to allow for a physiological natural birth is hindered.  This in turn increases the chances of intervention and greater pain during labour, and ultimately lowers a women’s chances of having a VBAC.

Hospitals do not see the hand they play in decreasing chances of a VBAC, often it’s not even considered because all the decisions made by the hospital staff are to ensure a healthy baby and mother. Therefore anything and everything will be sacrificed in efforts to follow strict procedures put in place to ‘save mothers and babies’ and we are expected to comply because they are the experts and they know best.

I would never suggest a client ignore medical advice.  All information should be considered when making decisions for you and your baby.  Surprisingly, despite everything we have ever known and been told and continue to be told we are in fact in an optimal position to advocate and achieve a natural physiological SAFE birth, more so than hospitals, OBs, nurses, and policy makers.

Let me tell you why;

  1. We see ourselves as individuals.  Policies are made and generalised to the greater public.  This means that any measures put in place to increase outcomes apply 100% to only a small number of women.  While your exact individual circumstance may not directly require a particular intervention it will be done regardless to reduce any chance something may happen if you are possibly one of the unfortunate few and that is not identified in time.
  2. We are able to incorporate the latest research from around the world into our care plan.  All research being considered should be checked to ensure the results are significant and valid.  Hospitals are tied to managed care plans based on what has always been done, previous experience in the field, and older research.  Many procedures are outdated and don’t reflect current evidence.  Delayed cord clamping for example was recommended for decades before the practice was implemented in hospitals.  Its worth investigating the latest research and evaluating whether it’s relevant to your situation.  At the very least request that the hospital staff produce current evidence to support their path of action.
  3. We have the luxury to control patient litigation against hospitals and its staff.  Sadly potential litigation is a major consideration for hospitals.  It is expected that they will produce good results and if something goes wrong often patients blame the staff.  Right or wrong these cases are costly financially and emotionally.  Hospitals are therefore risk averse and more concerned in the quantity of alive patients than quality of alive patients, no matter the odds. Knowing all of this puts us in a position of power of understanding and working in and with the system.  Showing hospitals that you understand and accept the risks can make a difference.  Owning our births and taking them back starts here
  4. Our gut feelings, our feelings of security, safety, and happiness directly effects our birth experience and outcomes.  Dr Sarah Buckley’s work on the Hormonal Physiology of Childbirth is game changing and proof that intervention, fear, withholding natural pain management, and the way women are treated in childbirth influence birth and post birth outcomes. Its time we start listening to our instincts and demanding they are considered in our care.

As a doula knowing these things and having been there myself women need more people in their corner.  Someone to protect the space from others that may try to intervene in a perfectly healthy labour simply out of fear.  Women need more support, more love, more trust.  MORE OXYTOCIN.  Luckily doulas have this surplus.

Part One

 

 

 

 

Navigating a VBAC

Vaginal Birth After Cesarean (VBAC) is a great opportunity for mothers to have a reduced intervention based birth post surgery if she desires so.  VBACs are often assumed difficult to ‘achieve’, in themselves the births are no harder than any other however having the opportunity to give birth can be challenging in our current health system.   Below are some great tips to help you on your VBAC journey.

  1. Hire a doula – studies show being attended by someone like a doula can increase your chances of a vaginal birth and reduce incidence of intervention
  2. Know your care provider – shop around for your care provider, whether your going private or public don’t settle for someone who is not in line with your birth goals
  3. Know hospital policy – All hospitals have different policies surrounding VBACs, its worth getting in touch with your local hospitals to find out about theirs
  4. Know your rights – it is your body and no one can tell you what to do with it, no test, no intervention, no surgery
  5. Know the statistics and research – it is very hard to give informed consent if you are not informed correctly and sadly the hospitals legal obligation to ensure you are informed is limited.  Make sure whatever information you gather yourself is from a reliable source.
  6. Use your B.R.A.I.N Benefits, Risk, Alternatives, Intuition, and what if we do Nothing
  7. Be prepared – be prepared to face opposition from your care provider on one or more of your desires.  Be prepared that they may say you are putting your life or your babies life at risk, this is why it is so important to know the statistics and research relating to your choices.  Are they referring to a 0.1% increased risk or are they speaking of a 50% increase.  What are the risks of the intervention?
  8. Surround yourself with love – major complications during birth are actually quite rare so during your labour and birth surround yourself with people who are witnessing you in love and not concern.  The medical support is their IF you need it.
  9. Don’t take on negativity – a lot of us have a habit of projecting our own fears on to others, friends do it, family do it, even care providers can do it.  Know that you are the expert of your healthy birth, a previous cesarean does make you damaged goods, an emergency, or unhealthy.
  10. You can do it – I know you can

I hope these help, if you can share anymore tips, have a question or something to say please comment below.

Let’s stop normalising birth!

Yes, you heard right! Almost everywhere I look there is a hard push to normalise birth. In an honourable effort to rail against the medicalised model of birth we have alienated, disempowered, and abandoned almost all birthing women in this modern risk adverse society.

The reality is almost 100% of births are happening in hospitals and after spending the last 12 months in these hospitals training to be a doula what I must share from my experiences is infuriating and at times disturbing.

It’s about time we start exposing birth for what it truly is and what it means and stop focusing simply on the biological outcomes. We have put humans on the moon surely we can look at raising the standard of birth and assessment of its positive outcomes beyond one main criteria.
So, consider the current management of birth.

All Australian families and birthing women have access to state of the art maternal care, for free.

The biological outcomes of all births are strictly and expertly recorded and scrutinised. Data is collected from every hospital birth (and some home births) most often by midwives. This data is published annually.

Organisations across Australia work diligently to analyse this data and change practice and procedure to lower maternal and neonatal mortality.

As consumers of these services we are promised that our caregivers will do everything and anything to avoid maternal and neonatal death. This is what is expected and as such all policies and legal requirements are based on…well…death and avoiding it.

I cannot help but feel we are missing something here. Birth as it usually unfolds uninterrupted is not an illness, or an emergency. It is not a leading cause of death in women or children, it is not a problem to be solved.

So why do we medicalise birth to such an extent that women are almost literally tied down to a hospital bed covered in leads and monitors.

Why are interventions being performed that not only cause emotional and physical trauma but also increase the risks of infection, further intervention and death to both mother and baby?

During a safe, natural, life giving event why are we suddenly debating which care model is less likely to kill someone?

Why are we discounting our amazing bodies and what they can do all on their own?

Why are we increasing our actual chances of trauma and death due to a perceived risk of trauma and death?

Why?

Birth should not be normalised. It shouldn’t be sugar coated by only sharing positive birth stories. Nor should it be treated as a threat or a disaster waiting to happen. Birth is a miracle. Birth is a mystery. Birth is an innate, intellectual, independent happening. It’s extraordinary.

Birth cannot be fixed. As hard as it may be for the ‘doers’ to accept, if you intervene and disturb its natural flow there are consequences. Far reaching consequences that are not recorded and analysed diligently every year, consequences that the hospital staff need not think about when they go home after their shift ends.

I have seen these consequences, I’ve held them as they sobbed overwhelmed with fear, anxiety, and chronic pain. I’ve sat and listened to them struggling to find their way blind sighted, shocked, and dumped in to motherhood without having experienced their own babies birth because they handed it over when they walked through the birth suite doors, of course because as they are told otherwise their baby may die.

We need to take our births back. We need to be able to walk in to a hospital and say we want to do it all on our own and only get help IF the shit hits the fan because that is our right!
We need to be able to do this without having to fight with people and prove to the world that we are not being selfish or stupid believing we can do it and that we do have more concern for our babies well being than anyone else.

Let’s not give in, we must demand better, you deserve to believe in yourself, surround yourself with those that believe you can do it too and come out the other side a conqueror not a victim.