In Support of Invisible Midwives Everywhere

05 May 2012 3 Comments

by Holly in Activism, Birth, Pregnancy Tags: , , , , , , ,

Today is International Day of the Midwife. A day to honour all of the midwives who have been a part of all of our lives, after all, even those people without children of their own were born themselves once and chances are, a midwife attended their birth.

Midwives are there for women and their families on one of the most important days of their lives. Midwives nurture women in their care, guide them emotionally and physically through pregnancy, birth and early parenthood. Midwives save lives and witness daily the amazing entry into the world of new little people, quietly, confidently and with compassion. Midwives know when to sit back and be invisible, trusting women to birth their own babies and only coming to assist if the need arises.

Or at least they should.

Unfortunately the systems that midwives have to work within don’t allow them to do their job properly. They are forced to place time limits on the women in their care, to intervene unnecessarily on a regular basis and to persuade women to birth in big obstetric units if their employer is under the false impression that these units will prevent law suits from happening. The fact is that home is the safest place for women to give birth, it is also the cheapest place. Continuity of care from a trusted midwife also results in better and safer births. It’s utter madness that the system doesn’t grab hold of these facts and embrace genuine with-woman midwifery.

All over the world, women and midwives face persecution and legal action against them if they dare to step outside of that system. Agnes Gereb, Hungarian midwife and obstetrician, is currently under house arrest for attending women birthing out of hospital. Even here in the UK, NHS midwives who work with women at the centre of their care face the possibility of harassment in the workplace from their colleagues. AIMS has a Midwife Defence Fund that people can donate to, this fund helps secure legal representation and cover other costs to assist midwives facing persecution. You can donate here: http://aims.org.uk/MDF/

Independent midwifery is scheduled to become illegal as of October 2013, due to red tape. The EU has declared that IMs must have indemnity insurance, but no provider on the market is willing to insure midwives working outside the system. Therefore, by default, midwives will no longer be legally able to practice independently.

IMUK has been tirelessly searching for a solution, but there is no option available that will allow them to continue to provide care during birth for women who are anything other than “low risk”, that is, “risk” as defined by an extremely conservative legal team in charge of defining NHS protocols, which is not always the same as genuine medical risk. Even if it were, women should still have the right to choose their care provider and place of birth.

If I am ever to have another baby, I would not be able to be cared for by a skilled and experienced midwife of my choice in my own home, as I have had two previous caesareans and am therefore “high risk”. The actual risks of a home birth in my situation are tiny and I should be free to choose to birth there with a midwife of my choice. The changes in the law mean that I am extremely unlikely to ever have a third baby and if I do, I would be forced to choose between the luck of the draw NHS service, who treated myself and my husband so appallingly three years ago, or to not have a midwife present at my birth at all. Basically, I don’t want another baby at all if I can’t have the same amazing midwife that I had for the Bean’s birth.

So today, on International Day of the Midwife, I’d like to shout out my support to independent, with-woman and invisible midwives everywhere who are striving to care for women and their families despite great personal risk. You are all superstars.

Rebirth: A Second Chance

24 Mar 2012 19 Comments

by Holly in Birth, Pregnancy Tags: , , , , ,

Rebirth. “A new or second birth”. A chance to start again, a chance to make new memories that heal the old ones. In terms of healing birth trauma a rebirthing might consist of re-enacting the birth in the way previously imagined or it might be a spontaneous and instinctive moment shared between mother and baby in the bath or in bed in the middle of the night.

After the Munchkin’s birth, someone suggested I try a rebirthing in order to heal emotionally from the trauma I experienced. But he was already about three months old, I wasn’t ready to let go yet and wouldn’t be for over two years, and the more time passed the less like a newborn he was and it just felt wrong to try. The very thought of getting my birth pool back out again made me burst into tears. So we never did it. I had to find healing from his birth the long, hard way and we’re finally there after some intensive therapy and an empowering second birth.

That second birth, however, was not the experience I longed for. Though it wasn’t traumatic in any way, it left me grieving. Within days of the Bean’s birth I knew I wanted to try a rebirthing. I needed to physically recover from the caesarean though and I needed to prepare in practical terms. I thought I wanted my midwife and doula to be there and was considering having the Munchkin there too, though at other times I felt I didn’t want him there. Getting everyone together at the same time looked unlikely when my doula gave birth to her own baby a few weeks after the Bean was born.

As the days turned into weeks I started to feel a bit desperate. My little newborn was rapidly developing into a strong baby and I was afraid it would get too late. So I decided to grab the opportunity as soon as the Munchkin was staying at my parents’ house for the night. Finally that moment came, 8 weeks after the Bean’s original birth.

Today, after an absolutely beautiful day out with friends to celebrate the Munchkin’s third birthday, he went home with my mum and hubby and I made our preparations. We inflated and filled the pool, lit candles and put on my birth music. I got into the pool and listened to the song that had been one of my hypnosis triggers that I used during pregnancy and labour, Chimes, a song by an unsigned band called Glow. I thought about being pregnant, remembered my blessingway and the hope and anticipation I had felt about my forthcoming birth. These memories touched some raw emotions for me and I began to cry silently.
I changed the music to the song I had wanted playing as my baby was born. I had played it on repeat for a long time during my actual labour when it seemed I would be holding my baby imminently: Firework by Katy Perry. Cheesy? Maybe, but when I first heard it I felt it was the perfect song to accompany birth. What a strong message of the power and awesomeness of a birthing woman.

Hubby got into the pool with the Bean and passed him to me under my arm and through the water. I brought him straight to my chest and held him, I told him how much I love him and explained that this was how I had wanted to meet him. The tears flowed with overwhelming sadness and joy and hubby snapped away with the camera to capture the moment.

The Bean was calm and alert, looking carefully at me and around at the strange surroundings. We spent a few minutes in the pool and then moved to the sofa, wrapped up warm, where I fed him and hubby brought me some food. It was the post-birth chill that we should have shared but were denied by the circumstances of the Bean’s original birth.

This rebirth doesn’t undo that birth, nor would I want it to. His birth was truly awesome, in so many ways, but it wasn’t joyful. Now I have new memories, the memories I had hoped to create and that does undo some of the emotional damage of his birth.

But it’s late now, so I’m signing off to go and curl up in bed with my baby.

A Healing Birth Can Still Hurt

17 Mar 2012 10 Comments

by Holly in Birth Tags: , , , , ,

It’s a secret no one will tell you. My dear friend, and fellow blogger, Chloe, wrote about this recently. For those of us who have had traumatic births, we sometimes place a lot of hope on a subsequent birth, it becomes a lifeline out of the pit of that trauma. So what happens when that lifeline snaps? What happens when you don’t get the amazing birth you were planning? What happens when, like me, you get a birth that is far removed from the one you wanted but one that was not traumatic, in which you were completely respected and had your contingency plans followed to the letter?

My recent birth genuinely was healing and empowering. It was a positive experience, by and large. I was incredibly well supported, I was respected and listened to. I had all of my wishes listened to and accommodated where at all possible. I came out of it feeling elated that I had done something so rare and thrilled that people were talking about it. It might make a very real and positive difference for other women. My relationship with the Munchkin has improved massively. I can say with absolute sincerity, finally, that I gave birth to him. For years I could not say that, he was surgically removed from me, my caesarean wasn’t the same as giving birth. Now I feel differently and because the Bean’s birth followed such a similar pattern to the Munchkin’s, I can also speculate now that no amount of support would have resulted in a vaginal birth with him either. For years I was carrying this heavy weight around my neck: what if we had just done x, y or z? Well this time we did do x, y and z and it still didn’t result in a normal birth.

But there is a dark side to that realisation. For the first few weeks after the Bean’s birth I felt lighter. I felt relieved. But as time passed I realised the consequence… if nothing I could have done would have made any difference then why did my births both end in caesareans? If it was nothing to do with the support that I had, nothing to do with my antenatal preparation, nothing to do with the external conditions of my labour, then what is wrong with me? Because that is where my mind wanders, towards a reason. I’m not the sort of person who can just accept that “these things just happen”. Maybe once they do, but twice? Twice the same thing happened to me and my babies. To me that means something. To me that means that there is some sort of problem with me.

That’s a dark place to be. No matter how much those around me bent over backwards to make my birth as positive as it could be, no matter how close my bonds are with my children, I am still left aching emotionally. I am grieving for the birth I did not get. Again.

I know there will be people who think, and indeed, say, that I should shut up and be grateful that my babies are alive. I’ve heard it before, I’ve been told that I have “lost sight of what is really important” and to them I say: I matter. My mental health matters. My scarred uterus matters. My obstetric future matters. I don’t intend on having any more children, two has long been my theoretical limit, so right now I’m trying to come to terms with the idea that I will never, ever have a vaginal birth of any kind, never mind the beautiful home birth of my dreams.

There are three little words that I have read dozens of times in VBAC birth stories, three little words that carry such depth of feeling that I don’t think many people could fail to be moved by them and I expected to be uttering them myself: “I did it”. I will never say those words and that hurts.

So to all those wonderful, Very Brave And Courageous women out there who didn’t get their VBAC, or whose births have not taken them on the journey that they expected or wanted: I love you, I am crying with you and it is OK to cry, to grieve.

I Am Woman… Hear Me Roar

08 Mar 2012 4 Comments

by Holly in Activism Tags: , , , ,

Today is International Women’s Day, so I’d like to take a moment to acknowledge the wonderful women in my life and write a bit about what the event means to me.

The theme this year is “Connecting girls, inspiring futures”. I think it is so important that young girls and women are encouraged to think about their sexual health, their futures and their relationships, to value themselves enough to make positive choices. The only way that happens is through the examples of positive role models. There are far too many pop tarts gracing the magazine covers and television these days. Hyper-sexualised “singers”; super-skinny celebs who are famous for being famous and make a reputation for themselves as lacking intelligence; lost and desperate starlets who poison their bodies and have their own rooms reserved in rehab for their frequent falls from the wagon. It’s a sorry state of affairs.

There are a small handful of alternatives out there, such as Tyra Banks, who not only represents a more healthy body type these days, but who works to help girls and young women value themselves. That’s not to say she isn’t also making a lot of money out of the good PR of her apparent altruism, but I think that’s true of most philanthropists if you look at the whole picture. Then there’s one of my favourite singers, Pink, whose attitude and music set a wonderful example to young girls, showing them that they can be themselves in the face of peer pressure.

It’s really important to me to recognise that even in the UK, there is still inequality between men and women. Women still earn less than men in the same jobs; women fill more service roles and less professional roles than men; the socially valuable role of mother is extremely undervalued financially and culturally (how many times have you heard a woman say “I’m just a mum” when asked her occupation?); women bear the brunt of the government’s spending cuts too. Women often seem to be the ones to take responsibility for their contraception too and many of the options are hormonal; that is, they work by changing our biological functioning. What are the physical and social implications of that?

Teenage girls were routinely paraded through the school nurse’s office in the last couple of years, to be given the HPV vaccine, with the promise that they would be protected from cervical cancer. There is some concern that this vaccine gives girls a green light to have unprotected sex, as they, and their male peers, may believe that being vaccinated against one STI makes it safe to have unprotected sex. Not the right message for these young people at all. A number of my friends with daughters of the appropriate age talked about the issues with their daughters and helped them come to fully informed decisions about whether to accept the vaccine or not.

As mothers we are censored and discriminated against for the way we feed our babies, both breastfeeding and formula feeding mothers report being discriminated against or judged, sometimes by businesses but all too often by other women. Whether women really are judging each other is not easy to determine, we often project our own insecurities onto onlookers and read judgement where there is none.

It’s acceptable for the female body to be depicted as a sexual object, but not as a mother growing or nourishing her child. Men’s nipples can be shown in public, but women’s nipples can’t. For a very thorough exploration of the topic of infant feeding as a feminist issue, please see this blog post by The Alpha Parent, particularly points 4 and 5. Caution: If you are offended by the facts of formula feeding it’s probably better for your blood pressure to simply not click the link.

Birth is also a feminist issue, both for the women giving birth and the women providing care. Midwives who refuse to conform to the medical model and instead provide woman-centred care, are bullied and harassed in the workplace, in some cases risking their livelihood and even imprisonment. Pregnant and birthing women are taught to expect to lose all of their dignity during birth, to have decisions about their own bodies made by someone else. This is, of course, absolutely unacceptable and untrue, it is perfectly possible to retain both one’s dignity and bodily autonomy in birth, no doctor or midwife can legally force a woman to comply with hospital protocols against her will, to do so is assault. But the language used by maternity care providers often hides this fact. Women are told that they are “not allowed to do x”, or that they “have to have y”. Care providers who use this language should be reported to their supervisors.

The global picture for women is even more bleak. The very fact that we need an International Women’s Day is itself a telling sign of the huge inequalities and difficulties that women face. I think it’s vital that we take the opportunity to reflect on the situation and see if there is anything we can do to change it. One day a year isn’t much, it’s a token gesture really, unless people really take notice and do something positive. One off events like this are intended to do that, to draw attention to an issue and have an impact reaching beyond that one day.

An individual can contribute in a number of ways, from simply letting those important women in their life know how special they are, to mounting a campaign against a sexist corporation or government! Check out the IWD website for ideas on how you can make a difference.

I’m already a birth and breastfeeding activist, albeit on maternity leave at the moment, so I will mark today with a huge thank you to some very special women:

My mum, Linzy; my dear friends, Jo R-D, Lisa S, Vicki M-W, Debs R, Lori F, Sarah C, Kellie R, Sally P, Chloe B, Gillian S; my friends and colleagues Beverley B, Nadine E, Debbie C-D, Jo W, Ruth K, Ruth W, Caroline W; fellow campaigners Emma K, “Mrs BWF” and everyone else who is working tirelessly to inform and empower other women. Thank you all for being amazing women.

The All Powerful Birth Contract

13 Feb 2012 3 Comments

by Holly in Birth Tags: , , , , , ,

My lotus caesarean was possible because I gave the possibility serious thought and planned for it, just in case. I discussed each aspect in depth with my independent midwife and prior to my labour she even floated the vague idea past the Consultant Midwife at the hospital, as a hypothetical situation, for her to discuss with her colleagues. When we arrived at the hospital we produced the following document, which details all of the conditions on which I would accept obstetric help. It is firmly worded, leaving no room for anyone to override my consent. I am so glad I had it and I am reproducing it here in the hope that others will be able to use elements of it, or the document in its entirety, to enable them to get the care and the birth that they are entitled to. It is written with the fact that I had independent midwives and a doula and was planning a home birth, however, it can be edited for those with NHS care providers and those planning a hospital birth. Please feel free to take what you can from it and share it with anyone you may feel would benefit from it.

Birth Contract

Baby expected: Early 2012

Planned place of birth: Home

Independent Midwives (IMs): ****

Birth Partners: ****

Onset of labour

If delivery prior to spontaneous onset of labour is medically indicated, I will only consider induction of any kind or caesarean section after very careful discussion with my independent midwife (IM) and husband.

Labour/Admission to Ward pre-section

I wish for my husband, IM and doula to have access to me to continue providing support, though I understand if this is only possible by rotating persons present in the delivery room.

My birth supporters have been given direct permission to advocate for me if I am unable to do so for myself.

I do not consent to vaginal examinations.

I do not consent to CFM without careful consultation with my IM about the possible risks vs benefits.

The birth space will be respected; anyone wishing to enter the room must knock and await invitation to enter, quiet voices will be used, lights will be dimmed.

I do not consent to the use of prostaglandins.

I do not consent to augmentation of labour with ARM or syntocinon. If there is a genuine reason to accelerate the birth of my child I will agree to caesarean section after discussion and agreement with my IM and husband.

I do not consent to administration of pethidine or any other opiate pain relief.

I will only consider epidural anaesthesia after careful consultation with my IM.

Birth & immediate post-natal period

I do not wish to be coached to push.

I will be using whatever position is most comfortable for me.

I do not consent to episiotomy unless an emergency situation develops.

I do not consent to ventouse or forceps delivery without consultation with my IM.

My baby will be handed directly to me for immediate skin to skin.

I do not consent to prophylactic administration of syntometrine.

I do not consent to premature cord clamping.

If my baby is in need of medical attention, it will be provided with baby in my arms or on a firm surface right beside me. There is NO NEED TO CUT THE CORD FOR THIS. I am planning a lotus birth, the placenta will remain attached to my baby, even in the event of a caesarean section.

My baby will be treated gently and respectfully; no vigorous cleaning, no routine suctioning of the airways.

I do not consent to routine administration of vitamin k. If the birth has been traumatic then I will consider oral vitamin k only and only after discussion with my IM and husband.

My family and I will not be separated. Provision will be made for my husband to remain with me and our baby at all times.

Caesarean Section

I will only consent to a caesarean section upon careful discussion with my IM and husband.

My IM is to accompany myself and my husband to theatre.

I do not consent to routine prophylactic antibiotics during surgery.

Anaesthesia should be in the form of spinal block, rather than epidural. General anaesthetic should only be administered with the direct consent of myself or my husband, upon the advice of our IM.

Voices will be kept low, as will lighting for the birth.

Forceps are only to be used to extract my baby after thorough efforts by hand have been exhausted. My IM will be watching.

My husband and I wish to discover the sex of our baby ourselves, no one else is to announce it.

The baby will be handed directly to me, uncleaned and with the cord intact and un-clamped.

Administration of syntometrine will be delayed until the cord has stopped pulsating. If this takes an unusually long time we can negotiate.

My placenta is to be kept attached to the baby and removed from me only after the umbilical cord has stopped pulsating. I understand the risks of my abdomen remaining open for this period.

If my baby requires immediate medical attention, it will be provided with baby in my arms or on a firm surface right beside me/between my legs. There is NO NEED TO CUT THE CORD FOR THIS. I am planning a lotus birth, the placenta will remain attached to my baby unless there is a clear medical need to separate them, not including resuscitation, as this can be done on a firm surface beside me. I do not consent to my baby’s primary source of oxygen (through blood flow from the placenta) to be cut off.

If I am unable to hold my baby immediately following birth then my husband is to be the primary contact.

If my baby does need to be taken from myself and my husband then my IM will remain with him/her at all times.

My baby will be treated gently and respectfully; no vigorous cleaning, no routine suctioning of the airways.

In the event of caesarean section, I will only consent to oral vitamin k if for some reason the cord has been clamped prematurely.

If the surgery takes place at night, provision will be made for my husband to remain with me and our baby.

Provision will be made for my baby to remain close to me at all times, including use of a co-sleeper bed/crib.

In the Event of Transfer for Retained/Adherent Placenta

My baby is to accompany me into theatre, as are my IM and husband.

My husband is to remain with me and our baby at all times, if admission is at night then provision will be made for him to remain with us.

Provision will be made for my baby to remain close to me at all times, including use of a co-sleeper bed/crib.

Feeding

I am planning to breastfeed and do not consent to my baby being given formula under any circumstances. If I am under GA then my husband and IM have permission to put the baby to the breast for me and express my milk to be given by cup or syringe. My milk or donor milk is to be given if I am incapacitated or unable to feed my baby myself for any reason.

I do not consent to the use of bottles under any circumstances.

Admission to Special Care

If my baby needs admission to the special care unit, my husband and I will be given unlimited access to our baby and we will be using Kangaroo Mother Care.

Please see feeding instructions above. If tube feeding is required for any reason, the milk MUST be breastmilk.

Entering the Birth Head Space

18 Jan 2012 Leave a Comment

by Holly in Birth, Pregnancy Tags: , , ,

Before Christmas I decided that I needed to start winding down towards my forthcoming birth. I started cutting back on my volunteer and support work and tried to focus on me and my family. Christmas made it easy, plenty of family distractions. Entering January brought some challenges, it has been hard to stay away from the forums and groups that I typically frequent and to keep “work” at bay. If my professional life were completely disconnected from birth and parenting then I would just keep going, keep life normal for as long as possible in order to prevent days or weeks of waiting for birth. But my “work”, such as it is, is to support other pregnant women and new mums through problems they are having with their maternity care providers. I’m a sensitive person, I am easily emotionally stirred by the experiences of others and I find it extremely difficult to turn a blind eye to the problems of others. While this is a massive bonus normally, allowing me to fight passionately on behalf of others, at this point in my pregnancy I really need to focus my emotional energy inward, on myself.

There are others like me, with passion, enthusiasm and time to provide advice and support to those who need it. Acknowledging this and trusting them to continue to do so in my absence has been challenging, it is something I absolutely must do now.

A couple of weeks ago, my tribe of wonderful women friends and my amazing mum, came together with me to celebrate my pregnancy and the new life about to be born, in the form of a blessingway. It was a truly wonderful occasion, with friends coming considerable distances to join me for this, so much thought and attention had been applied by all, especially the lovely Jo who organised it. It was a deeply spiritual ritual, tailored to me and my beliefs, but hopefully open enough for those present to share in the thought behind it even if they came from different spiritual or religious backgrounds. Together we shared our fears and hopes, channelled energy and most importantly…. ate cake!

In the moments since in which I have struggled to keep worries at bay, I have looked down at my henna belly, touched the beads strung upon the necklace made for me and imagined the women of my tribe encircling me. Feeling their energy and support around me and within me is a true blessing.

As I approach this birth, which could happen any time in the next few weeks, I will continue to remember that and draw on it for the strength I need to overcome the challenges of the end of pregnancy and to enter the head space I will need for birthing my baby.

I feel emotionally ready to enter birth, I’m prepared on a practical level too with everything we need gathered together and ready to use. We have had a trial run with the birth pool, inflating and filling it, which, of course, had to be followed by an evening spent relaxing in it by candlelight. So now it is simply a case of allowing baby to be physically ready to choose the day. This is the hard part for me, being gracious and patient, though I know and believe it to be necessary and worthwhile. I’m still a normal human woman, I am uncomfortable with my size now and not sleeping as well as I wish I could, I’m bursting out of all of my maternity clothes and constantly fending off the “When are you due?” question with my suitably accurate “Some time soon” response.

I was given some affirmations at my blessingway and have written more for myself since. I share some of them with you now.

I am a link in an endless chain of birthing women.

300,000 women will be birthing with me. Relax, breathe and do nothing else. Labour is hard work, it hurts and you can do it.

We have a secret in our culture, and it is not that birth is painful, it is that women are strong. – Laura Stavoe Harm

I am surrounded by love and support.

My baby will be born at exactly the right time.

Live every day, enjoy each moment of pregnancy, for it won’t last long.

Every day my baby grows more ready to be born.

My body knows how to grow and birth the perfect baby.

Every day my body is preparing for birth.

Use this time wisely.

Basic Biology

18 Oct 2011 Leave a Comment

by Holly in Birth Tags: , , , ,

This article originally appeared on the site http://www.fourmums.com and has since been reproduced in the AIMS journal. I thought I’d get my new blog off to a flying start and include a copy here. Enjoy.

I’m not a science person. I was never that interested in it at school, I don’t think like a scientist, or at least, I don’t think I do. I was always much more interested in the arts and I still am. But I like science, I think science is important and I’ve picked up a few scientific facts throughout my life that have enhanced my understanding of the world.

Birth both is and isn’t a topic for science. It is a normal biological function and can in some ways be studied, categorised and understood in basic scientific terms. But it is also unpredictable and a deeply emotional time for women and their families and so we cannot view it in a cold, sterile, scientific vacuum.

Here are a couple of very basic scientific facts that I think are important in understanding a little bit about human procreation. More

Follow

Get every new post delivered to your Inbox.

Join 31 other followers