THINK…an open letter…

Physiological 3rd stage, breastfeeding the pla...

Physiological 3rd stage, breastfeeding the placenta out. (Photo credit: Wikipedia)

Dear Maternity Care Provider…(Obstetrician, Midwife, Maternity Nurse, Health Care Support Worker, Lactation Consultant, Doula, Antenatal Educator…And to myself, not just to you…)

You have knowledge, experience and skills that support women daily and those of you in the medical maternity services save the lives of thousands and millions of mothers and babies across the world…thank you…

You have knowledge, experience and skills that you are educated to use and perhaps scared into believing are always essential, whether through pressure from insurance companies and policy makers or simply too long on the ward and not enough time in the community experiencing natural, joyful pregnancy, birth and breastfeeding…isn’t it time that you went out from your clinical space to sit on your hands quietly and watch a mother birth her baby without your help…?

Pregnancy, labour, birth and breastfeeding may not always be easy, may not always run to a timetable…but before you step in with those life-saving essentials, take a breath…

Please THINK…why do you work in maternity care…what drew you to this profession…to this vocation…?

Please THINK…what does this woman, this mother, in front of you, need?  Right now.  What is it that will best serve this mother in this moment?

Please THINK…I know that I talk too much, and therefore I must listen too little…it is habit, learned behaviour…I am working on THINKing more before I speak…LISTENING before I THINK…Join me in breaking the habit…Please THINK…Please LISTEN…

THINK…

T… is it true?  A mother came to class recently and told me that her doctor measured her height and the distance between her hip bones and pronounced a concern that she may be too small to birth her baby vaginally…This mother is not of white Caucasian descent and tells me that she is in fact taller & wider of hips than many of the women in her own country…Her husband is of the same ethnic group and the men too, she assures me, are shorter and slighter of build than men in the UK…But *it is a hospital measurement*…apparently she was told British women average 5’4″ and this mother is just 5’1″…But women in her country give birth vaginally all the time she tells me hopefully…And I try to reassure her, to tell her to keep faith in that knowledge, because measurements based on a predominantly white Caucasian cohort will not reflect the facts of her own heritage…This mother has a little over 6 months of pregnancy left and now one of her main tasks will be to unlearn that comment…To ignore the medical need to measure & compare at 20 weeks…perhaps again at 34 weeks…Is it TRUE?  Can you show me hard facts that account for all other variables and indicate that smaller women find it hard to birth their babies vaginally?  Can you show me hard facts that indicate that her baby, with her genes and those of the father with the same ethnic origin is likely to be too large for her pelvis and prevent vaginal birth…does the birth rate in her own country support your fearful comment on her stature?  Is it TRUE…?

H…is it Helpful?  A friend of mine had her baby, all went pretty well, and then came breastfeeding…it wasn’t instant, like lots of mothers she needed to learn the art, and so did her baby…but someone working (and they did not make their role clear, which itself is unhelpful) in the post natal room told her that she would not be able to breastfeed properly because her nipples were too big…Fortunately, my friend had been to some positive about birth and breastfeeding groups and asked me to visit as a breastfeeding mum for some mother-to-mother support…Luckily, she went on to breastfeed successfully, but the damage had been done, her confidence was rock-bottom and her breastfeeding journey had a bumpier start than it needed to be…THINK…before you speak…is it HELPFUL…?

I…is it Interesting?  And if it is, interesting to you…or to this mother?   Why is it interesting?  Does it appeal to morbid curiosity…and so could it be scary or even terrifying to a woman carrying a baby in her belly right now?  Is it drama filled?  Could it stress out this hopeful mother?  Most of us know a story about a mother who went into labour and had contractions for 3 days and then had her waters broken and then was induced and then had to have a caesarean birth after all…What sort of birth is this mother hoping for?  Do you have any concrete evidence that she won’t be physically or mentally capable of achieving that birth?  Do you have an irrefutable reason to suspect that her labour will last for days instead of hours?  Still need to tell her this story…?  Is it INTERESTING…?

N…is it Necessary?  Does this woman NEED this test, this vaccination, this vaginal examination…?  Or is it policy?  Is it recommended but not mandatory?  Did you make it clear this mother has a choice about the care you are offering her?  Recently, many women have willingly received the Whooping Cough vaccination…and yet shockingly, some of them were not offered the injection but simply told they *needed* to book in for it to be done, and many of those and others who chose it remained ignorant that they were in fact receiving a triple vaccine…and was it necessary?  Or could they have chosen…?   In labour, a woman moves & moans rhythmically in her birthing pool and you can see the purple line creeping up the natal cleft and hear her vocalisations deepening and intensifying…you’ve listened in to the baby between rushes and all is well but you haven’t checked her dilation yet…you ask her to leave the pool (her sanctuary) because you *need* to do an internal examination…Do you?  Does she want to leave her water?  Does she want you to examine her?  Does she know that she can refuse you?  Is it NECESSARY…?

K…is it Kind?  A mother I know had a long labour, not excessively so, but long all the same and through the night…and a full 2 hours of pushing…so she was a little tired but still elated & smiling as her baby came earthside at last  and into her arms…her birth plan asked for a natural third stage (physiological third stage  & delayed cord clamping)… the midwife practically whispered “You’re very tired, let’s just manage this stage…” as she slipped the syringe into her thigh…No doubt the midwife was acting out of perceived kindness to save the mother some time and shorten the process…but did early cord clamping for that injection of syntocinon reduce the blood transferred to her baby and affect its iron stores?  Did the management of her third stage increase or prolong lochia? Will she always wonder if she could have finished what she started naturally…?  Is it KIND…?

I promise to LISTEN more and to THINK before I speak…will you join me?

Will you commit to THINKing more about the mother in front of you and what she needs right now, not what protocol & policy state, but what is true for her, helpful at this time, interesting to her ear & her heart, necessary for her health or that of her baby, and what is kind to this woman, to this mother…?

Can you THINK…?

I believe you can…I believe you will…

Blessings & Prem

OMx

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Travelling the Labyrinth…

What surprised me about Birthing From Within…?

What surprised me most was that it provoked so may questions!  What did I learn?  Am in a labyrinth or leaving one?  Am I being called to enter or called to return?  Do I want another journey?   Will there ever not be a labyrinth to travel?

Turns out that there are myriad labyrinths in my life…I am slowly exiting the one that was the birth of my second son…I believe I have just stopped resisting the call to take the next step and journey into a new labyrinth…

Birthing From Within Labyrinth Art

Birthing From Within Labyrinth Art

I am about to embark on the full BFW Mentor & Doula Program…I do feel called, but I have been questioning myself…am I ready…is now the right time for my family…is this really my path…?

I do feel called…after a week surrounded by the beauty of Galstonbury, bathed in the spirit & character of the town, precious days spent amid a circle of incredible, inspiring, good hearted women, I know that I was not the only one being called, not the only one searching my soul…I know that I am ready to step on to this path, and to release the resistance, begin the letting go of some old ideas, to allow some part-known truths to crystalise…

I am called…Fresh from the 3 day introductory course…trying to make sense of it all, slowly integrating the experience, practising some of the skills I began to learn…

My Birthing From Within journey really began when I was pregnant with my second son, when I was still hurt, disappointed, frustrated by elements of my first son’s birth…and it had been a *good* birth, a *natural* birth, so I questioned my *right* to feel that way, but I acknowledged that I did…

Ina May Gaskin’s book “Spiritual Midwifery” had been my bible in my previous pregnancy, and I read it cover to cover again…her assertion that “This is not pain, this is an interesting sensations that requires all of my attention” had become my personal mantra, and it worked for me in both labours…Thanks to Finn for reminding me that this too is non-focussed awareness…I loved her attitude of putting out positive energy during labour, to love those caring for us & to feel that returned as sustaining love & strength…I loved that Ina May was resolutely positive about birth…And I knew that I had some issues to resolve before this next birth, or they may cause me to lose my way in labour or to slow down & resist as Ina May had raised…

I am not sure where I came across Birthing From Within, only that it was likely through a wise woman friend…And it felt right, so I read it, and I explored aspects of my pregnancy, labour & birth experience through creating art…but I drew the line at practising the pain coping techniques…Those I avoided, I coped in my first labour, I figured that I could cope this time…and it turns out I did, happily, luckily!  And whilst I (thought) I got what Pam England was saying about not writing a birth plan, I couldn’t shake off the need to clarify what it was about my first son’s birth that I did not want to repeat…I felt slightly indignant at the notion I was not preparing *properly* if I wrote a plan…so I wrote one…I’m not sure anyone but my husband & best-friend-come-doula ever read it…

My first son was born in hospital, after transferring in from home to the labour ward, no intervention, a forward-flesh-tear…My second son was born at home, in water, with his brother smiling at me as he watched *our* new baby arrive, no tear…It was the birth I had dreamed of, I was elated, I was passionate, I was determined to help other women to prepare so that more of them could labour & birth their babies *naturally*…

Even before Glastonbury, the BFW introductory recordings had me challenging my mindset, here are the musings that I drafted just before heading off to Glastonbury:

Childbirth Preparation is sometimes an odd phrase, since it implies that preparation is necessary and therefore can influence the outcome…

In reality, whilst we association preparation with control, *control* has little place in childbirth…

I am about to undertake the Birthing From Within training in Glastonbury and I am aware that in her book of the same name Pam England does not advocate making a birth plan.  She feels it can distract a woman from real preparation for birth…I understand this, and yet…it seems to me that for many women it is about exploring their options, becoming informed, communicating their emotions, hopes and expectations with their birth companions and care-givers…for some it may even feel a sacred ritual…

So, if women in my classes ask me about birth plans, I suggest that they keep it brief and that they start it with a request to their caregiver to help them achieve the birth they want…avoiding lists of “dos & don’ts” that may irk a tired midwife or ruffle the feathers of a proud consultant…

I suggest they communicate their preferred place of birth and to make it clear they expect to be supported in their choice; I emphasise the need to plan to birth in the place where they feel most safe, not the place where they think they should, or where a loved one would have them be, or where they have been told they are “allowed” to be because of policy or staffing levels…I aim not to be contentious but to encourage because we women need to speak with loud, clear voices so that our needs are heard and met, not sidelined in the name of saving money or easing logistics, so that we and our babies are as safe as we can be as we birth as we should and not as we are told…

And whatever their intentions,  I remind them is that there is very little that can be controlled in labour & birth, and that their breath is the one thing over which they alone can always have control, so we do a lot of work on connecting to the breath and exploring ways of breathing that may be useful, comforting, and calming in labour & birth…but which ultimately I hope will allow them to be so familiar with their breath that they will instinctively breathe in the way optimum for their stage of labour on the day…

Birthing From Within - Finger Labyrinth Glastonbury

Finger Labyrinth Magdalene Chapel Glastonbury

…Back to the present…I feel a little silly!  I had misunderstood all this time…Pam England was not telling women not to plan for birth, but to plan in a deeper, more meaningful way…a piece of paper is no more than a talisman if there is not some effort & experience behind it to strengthen & sustain the birthing woman…

I use the words “surrender” and “breathe your baby into the world” a lot…although perhaps that is shifting already…Virginia Bobro cautioned against “bumper sticker” birth…In the beginning, I resisted strongly…Harumph, arrogance…she is wrong, surrender is a powerful word…Slow dawning realisation, I am so arrogant…ask myself, have I truly offered women the opportunity to learn what surrender actually is, what it means…

I resisted…asking questions, more, deeper, what is behind the statement, the fear, the need to avoid…I resisted the shift in language I will need to fully integrate…

And I felt horribly fearful that I have been letting women down all this time…Have I unwittingly given promises of something not mine to give…have I implied that their birth choices are not valid…that their births were to be scorned…

I do hope not, and I cannot cling to those fears because they are only manifesting from a place of love in any case…they reflect my desire for every woman to feel elated at the birth of her baby…to be proud of her journey through the labyrinth…to feel she can celebrate her immense strength, her complete selflessness, her own birth as a mother…these fears provoke my own inner enquiry, demanding that I seek answers, that I move forward, that I act each moment from a place of love…

And so, I journey on, letting love guide me and opening my heart in the name of service to all women…

In Prem,

OMx