Positive Birth News

birth stories, news and articles to encourage and inspire


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Failure to Progress or Failure to Wait?

Failure to Progress and Preparing for a VBAC

For most mammals birth seems to be fairly straightforward. They seek a safe and private place to birth in the middle of the night. Some choose to birth alone and others have ‘midwife mammals’ by their side. If there is danger they either have a speedy birth or stall labour until there is another safe opportunity.

For humans, it seems far more challenging. We have to feel safe in our environment, safe with the people around us, and safe with the physical and emotional process that is taking us over. We have learnt to fear birth with our minds and hearts, yet nature requires us to feel safe in order to give birth. Sometimes ‘failure to progress’ is the result of this struggle.

‘Failure to progress’ is one of the common reasons given for a caesarean during labour. This label is a blanket term for times where contractions have slowed or paused, dilation has gone backwards, or contractions are continuing but the baby is making no further progress towards birth. Women’s stories suggest that the label ‘failure to progress’ is often used when their labour has taken several days, or simply longer than expected or allowed by policy.

There are many variations in labour and doctors and midwives face the task of judging when medical assistance is needed and when all that is needed is patience. No one wants an adverse outcome, however in the rush to keep birth safe, some mothers and babies are hurried into treatment for an emergency that just does not exist. Some caesarean births due to failure to progress are actually caesareans due to impatience and failure to wait.

“After 50 hours of intense labour, I had a caesarean.

I haemorrhaged and my uterus collapsed requiring manual internal manipulation to contract it back down again. I had to have the caesarean under general anaesthetic because of my previous spinal surgery – I was unconscious for the birth of my baby.

My husband was allowed into surgery to be with our baby. I’m glad of that, because I wasn’t ‘there’.

The last thing I remember was being pregnant. Next thing I knew, at least a couple of hours later, I was being wheeled up a corridor past a baby in a clear plastic crib and someone was saying, “That’s your daughter.”

It was a very surreal and disjointed experience. To this day, I still feel a gap. I don’t feel like I birthed my daughter, yet she’s gorgeous and I love her like I’ve never loved anyone or anything before.

It should not have happened this way. It was an unnecessary caesarean performed due to medical impatience with my long posterior labour. Neither my precious daughter nor myself were at risk during labour except when they intervened.”

From Jo’s VBAC story “Triumphant Birth”, in Birth Journeys – positive birth stories to encourage and inspire

The alternative response to a labour that seems to be failing to progress is to ask what obstacles are there to this birth. If a mother feels frightened, threatened, nervous, embarrassed, angry, unsupported, alone, disempowered, violated, exposed, worried, overwhelmed or any other negative feeling then this can slow her labour down and even stop her labour from progressing.

Women’s birth stories show that there are many ways to help a birthing mother to move through or let go of thoughts or influences that have made her feel unsafe or threatened if this is the cause of a slowed or stalled labour:
– a change in environment (can she leave the room, open or close the curtains, change the atmosphere if not location)
– a change in activity and pace (get moving if she has been still, be still if she has been moving)
– a challenging question (eg, what is it you are frightened of? What are you avoiding? Is she intentionally avoiding the intensity of labour mentally or physically by avoiding certain movements or positions that make her contractions more intense and more effective?)
– the removal of an unwelcome person in the room (is there an uninvited or irritating presence in the room? If it is a midwife or nurse, can you ask for a different one or buffer her from this person’s impact)
– or the inclusion of a loved and longed for person (is she missing someone special?)
a few simple encouraging words (you are made to do this, you are bringing your baby into the world, positive affirmations)
– a description of what her body is doing or needs to do (open up and let your baby come down)
– a cry (release the built up stress so she can feel ready to birth her baby)
– a reminder of the skills she has learnt and the strength she has to give birth and to be a mother (has she forgotten the birth skills she has learnt? Or is she worried that she doesn’t have the ability to be a mother to this baby?)
– some time alone (maybe she needs some quiet space to reflect and gather herself. A trip to the toilet seems to work well according to women’s experiences!)

Preparing for your next birth

It is important to understand the factors that contributed to the path of your last birth and to consider the possible impact your feelings (whether you felt safe or unsafe) had on your labour. It is wise to discuss your previous birth in detail with your chosen doctor/midwife for a birth after caesarean. Pay attention to the way your chosen carers talk about your past birth as this will tell you what you can expect from them.

If your doctor seems to blame you and your body for a failure to progress, then be wary of both the doctor and the truth of what they are saying. Keep in mind that a very, very tiny percentage of women actually have a physical reason why they cannot labour and birth vaginally and statistically you are unlikely to be this woman.

If you hear words like “Your pelvis is too small and your baby got stuck. Luckily we saved your baby’s life just in time. You’ll never be able to have a vaginal birth of course” then you can thank this carer and start looking for another! They have just revealed that they are unaware of or insensitive to the emotional issues around birth and they already believe you and your body ‘failed’. You could enquire about the evidence for their verdict or you could simply put this energy into finding a more supportive and respectful doctor first. There are ways to discuss a ‘failure to progress’ that would be more supportive, caring and respectful.

One doctor or midwife’s ‘failure to progress’ will be another’s call to action: how can I help you to feel safe enough to give birth?


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Positive Birth Story: Choosing Support

Renae’s story illustrates the power of allowing ourselves to be supported during pregnancy and labour. Renae shares her journey from a difficult first birth to a beautiful, powerful second birth. Renae had wanted and prepared for a natural first birth. She had a positive outlook, she had done the birth preparation and she was realistic, but not frightened. However her plans and expectations evaporated as she was overwhelmed by the pain of an intense induced labour. Renae opted for an epidural and experienced a damaging forceps delivery, under the threat of a caesarean.

Before she even became pregnant with her second daughter, Renae decided that she needed and wanted more support next time. She decided that a doula would meet her needs. Renae’s doula was a source of supportive friendship, informative discussion and beautiful encouragement during Renae’s pregnancy. Renae’s second birth was empowering and drug-free with a natural third stage and ‘delayed’ cord clamping. It was everything Renae had hoped for.

My First Birth
I went into my first birth with positive expectations. My sister-in-law had two natural and positive births so she was a great influence on me! My husband and I did a Calmbirth course which I loved (but he thought was a waste of time). I did a heap of magazine reading and read a few books. So I wasn’t scared, but realistic. I thought labour would be natural and instinctive.

I was five days overdue and my doctor was concerned with my blood pressure. I went in for my 41 week appointment and was sent straight to the hospital from there. It caught me off guard! At about 7pm the next night my doctor put in the gel and the machine picked up that I was having ‘tightenings’ but they weren’t considered contractions. They weren’t too painful and I was able to sleep that night. The gel was repeated the next morning but it still wasn’t bringing on labour so I had my waters broken at about 1pm. When that didn’t start labour I went on the syntocinon drip at about 2.30pm.

It took about an hour and then the ‘real’ contractions started. I breathed through them and by 6pm I was at 4cm. I was doing OK but would have done better if I could have moved off the bed, had a shower, or walked around but I was continually hooked to the bed! Then all of a sudden I had this huge long contraction that just didn’t stop! Oh my, it was so painful! I lost my focus. I had the gas and I’m not sure if it helped or hindered the situation. The drip had caused the long contraction so they turned it off to give me a little break. My doctor came back and checked me. I was 7cm (9pm). I was over the pain so I chose to have an epidural. The next two hours were pain free and I progressed to 10cm by 11pm.

I pushed for about an hour and frankly gave up. I just wasn’t getting anywhere and I was exhausted. So my doctor called another doctor who did forceps deliveries and I got a huge top up of epidural. The new doctor said “If this doesn’t work you’ll have to get a c-section!” so I pushed as hard and long as possible (with him pulling!) and with that my baby Eloise was born.

I had an episiotomy, and her head tore me down the middle, to the side, and her hand got me inside too. Thank goodness for epidurals! They put my baby on my chest and it took so long to stitch me up, she was pretty much screaming the whole time. I was shivering and not well at all. I didn’t feel the instant relief or a flood of love. I was so overwhelmed by what had happened.

Soon after my first birth I felt positive. I believed that everything had happened how it had to happen and I was OK with that…for a while. But then I got talking, thinking and did more reading. Now I realised I wasn’t really happy with how things went at all.

I didn’t feel I was strong enough to speak up or question the midwives or my doctor. I went along with what they said even if I was uncomfortable with it. The pain seemed to overtake my will to labour my way. At one stage, when they were putting the drip in my arm, I asked if I had to be hooked up to the drip the whole time. The midwife had said “Maybe, we will have to see how it goes.” Now I know that once you’re hooked up, it stays that way!

Choosing a Doula
Before my next birth, I decided to hire a doula. The idea mainly came from reading the Birth Journeys book. Hardly anyone around my area had even heard of one and I had to do a lot of explaining to my friends!

I felt I needed someone with me who knew what I wanted and would speak up for me. My husband was there for me but he is not the type to question a professional. He was very supportive of my decision to have a doula. He felt that his job would be a lot easier on the day too. I think any pressure or worries he felt from our first birth were relieved knowing we would have a doula there.

Sophie was a student doula and I knew her through a friend. We were pregnant at the same time (but only saw each other once during this time) so we had the basis of a friendship already. Then we bonded over our mutual feelings towards birth activism on Facebook and got talking about our births. Her birth was awesome and empowering. Mine was not! We had our first doula meeting at a play café with our daughters and we found we had an easy friendship. Sophie is so different to me in her parenting style but we agreed on some fundamental points and that got us talking.

For a while I considered going in for a planned C-section. I thought it would be easier and at least I would get the baby with no damage to that ‘sensitive’ area that was so hurt last time. However talking to people and reading Birth Journeys (again!) helped me to want a positive natural birth. My mum is a very positive person and said from her experience (6 births) the first one is always the hardest! She helped a lot. I also had a miscarriage between Eloise and Charlotte and that seemed to change my perspective.

Sophie was always only a conversation away with positive words and support. At one stage the baby was posterior and I was so worried about birthing a posterior baby as I had heard so many bad stories. Sophie sent me links to read to help baby get in a better position and every time we talked she would remind me to do the exercises – I was lazy at doing them!

Sophie helped me to feel excited about birth. Just knowing that she would be there with me made me look forward to it! She gave me two books to read (one by Ina May Gaskin) and they were both a bit out of my comfort zone as Sophie is a lot more of an ‘earth mother’ than me! But I loved Juju Sundin’s Birth Skills. I read it when I was 36-38 weeks while on holiday and it got me in the mood to have a baby! I had lots of conversations about induced labours compared to natural labours. I also talked about being in control and having delayed cord clamping, a natural third stage and allowing my waters to break naturally. My friends couldn’t understand why I would want any of these or that they had that choice.

I also talked to my doctor about my thoughts and my fears and she was wonderfully supportive. The midwives however, had never had a doula, rarely did delayed cord clamping and never did a natural third stage! I was told that delayed cord clamping is dangerous, a natural third stage can cause a haemorrhage and that my doctor wouldn’t do it! It shows they were misinformed! I just said “OK” and went ahead and wrote my birth plan with my doctor’s support. My doctor understood that I was well read and wanted the things I wanted for a reason! I never knew which midwife I would get so there was no point in challenging them.

My Second Birth

I was sure Charlotte would be late like her sister and I was determined not to be induced this time. I decided I was willing to go two weeks over. I decided to go to one last movie in Adelaide (100km from home!). I decided not to waste my time at home and go and enjoy myself. Whilst at the movie (10.30am, Life of Pi) I had a few niggles but wrote them off as braxton hicks – I was in denial from that first pain!

I had lunch with a friend after the movie at 1pm and kept getting slight pains. At one time I had to sit down instead of going to get a drink as I couldn’t walk! But once again, I decided it was nothing. After lunch and a walk around the mall, I went to Bunnings to buy a hose (It was suddenly very important to buy a hose!!) but I left empty-handed as the pains were getting stronger and more frequent. I also had a headache so I bought some water and panadol and decided to drive the hour long trip home.

On the way home, I called my husband and told him that I thought I might be in labour, but probably not, as it felt too easy. I called my doula Sophie and explained what was happening. She confirmed that it sounded like early labour and suggested I have a rest once I got home. During the drive the pains were bearable, coming every 15 minutes or so.

When I got home, there was a lovely surprise from my husband (Matthew) – a beautiful clean house. He must have had the nesting urge instead of me! Instead of relaxing, I ran around the house packing my maternity bag. I was still in denial. With each contraction I would think ‘Yep, this is definitely real’ then when it was over I would think ‘Nah, it didn’t hurt much, so it must be braxton hicks’. I thought I should time them properly using an app on my phone and it turned out the contractions were 10 minutes apart and lasting about 40 seconds but they were still completely manageable.

I decided to listen to Sophie’s advice and I went to bed. It was the best decision because I fell asleep in between the pains and I’m sure they slowed right down. I felt very refreshed after my sleep. The next few hours were spent having a nice long shower, texting Sophie (we were both very excited!) and watching TV. I held a heat pack to my lower bump and paced the kitchen during contractions. I focused on not clenching or holding on during contractions but letting go and relaxing. In between I rested on the fit ball with my eyes closed. It was quite enjoyable!

At 8pm Sophie arrived. She was a lovely, calming presence (like I have often read about doulas) and she helped me to accept that this really was happening and I would meet my little girl soon! By this stage contractions were five minutes apart, still around 40 seconds long and not that painful. I continued to pace and added in counting my steps. I handled the pain quite well this way. Sophie had brought with her the best contraption, a stretchy belt to hold a heated wheat bag in place on my tummy and one on my back. It was a wonderful addition!

Packed to the Rafters was on, and as it is my favourite show, I watched it in between the contractions with both Matt and Sophie sitting on the couch. It was a very calm and enjoyable time. During the ads we talked about our children, about Sophie’s labour, my previous labour and worked on convincing Matt that this was the real thing.

I called the hospital at 8.30pm and told them what was happening. I told them I wanted to stay at home as long as possible and they were happy with that as their midwife started work at 11pm. I also called the on-call midwife who delivered my first daughter and she reminded me that the second stage with her was quite fast, which I didn’t know. I also had to factor in the 30 minute very bumpy drive to the hospital.

By 11pm the contractions were closer and stronger, so I decided to leave for the hospital. I had so many contractions in the car and I dealt with the pain using strategies from Birth Skills by Juju Sundin. I pulled myself up on the roof handle, tapped my foot and counted the taps to distract myself from the pain – it worked so well.

We arrived at the hospital at 11.30pm and I said to Matt that our daughter would be born the next day. I thought we still had hours to go. It still wasn’t as painful as I thought it was going to be. I was contracting frequently but they were short and once again pacing, breathing and counting helped.

My midwife Marlene wanted to check the baby’s heartbeat but only managed two short readings as I needed to move around to manage the contractions. Marlene then checked my dilation, (which was horrible as I was lying down). She knew I didn’t want my waters to be broken so she just did a quick check and found that I was 8cms but my baby’s head was still high. As she removed her hand, something made me gag and I started to vomit. This somehow triggered my waters to break! Stuff was gushing out both ends, and my poor doula had to hold a bag for me to vomit. She was amazing and cleaned me up a bit before helping me to the shower. My husband had gone to get my birth plan and decided to also bring our bags in (as it was going to be ages until the birth) so he missed all the messy stuff!

Once in the shower I felt overwhelming pain and I squatted and held onto the rail. It was a completely instinctive movement. I let out a loud moan. I had been quite silent until now. Matt later told me it sounded very animalistic. I experienced immense pressure through the constant contractions. I didn’t quite ‘get’ what was going on and I put my hand down and right on my baby’s head. I yelled ‘I can feel the head!’ Sophie was behind me the whole time holding the water on my back and telling me how well I was doing and that this was all natural.

Marlene instructed someone to call the doctor and asked me if I could get onto the bed. I said ‘NO!!’ and got on to all fours. Marlene somehow got in behind me (a very small space!) and did her thing as I did mine with a lot of noise. I hardly remember pushing but instead seemed to ‘moan’ my baby out.

It was incredibly intense and then BAM! There was my little girl! I was in shock and just stayed there for a minute, speechless! As I wanted to delay the cord cutting, Marlene had to follow behind me holding Charlotte, while we went to the bed and waited. When the cord stopped pulsating Matt didn’t want to cut the cord and neither did I, so Sophie did the honours.

Charlotte was handed to a stunned Matt as I wanted to deliver the placenta naturally. It happened quite quickly and easily. I only had a slight tear which didn’t need to be stitched. From the waters breaking to Charlotte’s arrival it was only about seven minutes! We had only just made it to hospital in time. We don’t even know the exact arrival time as it happened so fast and everyone forgot to look at the clock!

My second birth still makes me feel great! From moments after the birth I couldn’t stop smiling! I was in shock that it was so good. I feel like I’m amazing for doing it exactly how I wanted it – and it makes me feel proud. I feel that birth is so instinctive if you just let it be! As I’ve read – birth is not a medical problem – it’s a natural part of life.

I bonded with Charlotte so much quicker and she is an easier and more settled baby than Eloise. I actually thought I hated the baby stage, but turns out I don’t!

I had a positive birth experience because I believed I could have one. I was in control and made the necessary changes that I needed to make to make it happen. I looked at birth as something natural not medical and I did the reading to back it all up.


What do you want other women to know about birth?
That knowledge is power and if you don’t get the answer you want from your doctor or midwife – go to another one until you find one that supports you! To be strong – it’s your body, your choice!!

What do you think your journey from your first birth to second birth shows or offers to teach other women?
One bad birth doesn’t mean they will all be the same. You can make small changes to help you be in control and get that positive feeling. Talk to women and read about positive birth experiences because how you feel about birth starts in your head!


Renae is 29 and she lives on a sheep and cropping farm in the near the Clare Valley in South Australia with her husband Matthew and daughters Eloise (2) and Charlotte (5months). Renae is a kindy teacher but she is focusing on being a stay-at-home mum until her kids are all at school. Renae loves to read and still gets to do a lot of it as her girls have been wonderful sleepers!

Sophie is a doula who has studied with the Australian Doula College.


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Doulas and Partners

Why would women have a doula when their partner will be there to support them?

Men attending their baby’s birth is a relatively modern phenomenon. My father was not present at either my birth or my brother’s birth and in the 1970s this was the norm in Australia. Fathers are now expected to be present and to shoulder a large part of the birth support role. Now many men want to be there. They want to support their woman and they want to see their child into the world. But how prepared are today’s men for this new role when their own fathers were at work or down at the pub when they were born?

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Consider that first time partners have (most likely) never seen a birth. If it is your first birth, then the chances are you haven’t either. Your partner (most likely) hasn’t read positive birth stories, watched gentle birth DVDs and has consumed less information than you.

They have (most likely) been told sensationalised and frightening birth stories including stories from men about seeing their partner in pain, seeing blood, poo, vomit, fluids and very intense and stressful situations.

Your partner is also carrying the legacy of their own birth story and they have (most likely) not reflected on their entrance to the world and what this has taught them about birth.

They may be frightened – but they’re probably not about to let you know because they want to be a rock for you. Your partner may not have gone through the same journey of learning and transformation as you in preparation for this birth and the transition into parenthood.

If this is not your first birth, then your partner may be distressed by the memory of your last birth. Even a straightforward and uncomplicated birth may have been a shock. They will have had less opportunity and less support than you to debrief and integrate their experience.

Men don’t get to meet up with other men post-birth and swap experiences the way women do. Men don’t usually get to go to birth circles or have heart to heart discussions about their experiences and feelings. They don’t get to do prenatal yoga and meditation where they can bond with their baby and visualise the birth they want and how they want to feel. They will have had less opportunity to do the healing and growing needed to go into another birth feeling ready, open and strong.

Your partner has a huge emotional investment in this birth. It must feel like the lives of the two most precious people in the world are in a boat out at sea and your partner is waiting, hoping, and willing that they will see both you and your baby safe in the harbour at the end of birth.

A doula won’t take away from your partner’s role, nor destroy the intimacy of experiencing this rite of passage as a couple. However a doula can support and reassure your partner so he can support you throughout the birth. Your partner deserves this support as much as you do!

Some ideas and resources to help your partner feel positive, supported and ready for birth too!

Becoming Dad is a blog, a facebook page and a movement created by Darren Mattock: Connect your partner up with Darren’s community for support in the transition into fatherhood. http://becomingdad.com.au/how-can-dads-make-a-difference/

Men at Birth is a collection of men’s birth stories edited by David Vernon (also a contributor to Birth Journeys) (Scroll down the linked page to find this book)

Beer and Bubs is a childbirth class for men held in an informal, friendly pub environment. Men have the chance to talk with a father who has done Beer and Bubs before and since experienced the birth of their baby, as well as learn from childbirth educators. Available around Australia.

Cheers to Childbirth is the book that grew out of the Beer and Bubs program, written by Lucy Perry with birth stories from celebrity dads.

Birth Journeys – positive birth stories to encourage and inspire contains three stories which share men’s experiences of birth (so do pass these stories over to your partner if you have the book!). These are Lachlan and Bree’s story of their first birth, Christian’s story of his second daughter’s birth in the water (she was born in the caul!), and Chris tells the story of his second baby’s home birth. There is also a piece by David Vernon on how men can prepare themselves to support their partner during labour.


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Ten Great Reasons to Choose a Doula

  1. A doula can help you have a better experience of your baby’s birth. A 2012 review of studies showed that women with continuous non-medical support throughout labour have better birth outcomes in every way.

    “Bottom line: Continuous support in labour increased the chance of a spontaneous vaginal birth, reduced intrapartum analgesia, caused no known harm, and women were more satisfied. In addition, labours were shorter, and women were less likely to have a caesarean section or instrumental vaginal birth, regional analgesia, or a baby with a low 5-minute Apgar score. There was no apparent impact on other intrapartum interventions, maternal or neonatal complications, or on breastfeeding… continuous support was most effective when provided by a woman who was neither part of the hospital staff nor the woman’s social network, and in settings in which epidural analgesia was not routinely available.From Continuous support for women during childbirth, Hodnett ED, Gates S, Hofmeyr GJ, Sakala C, October 17, 2012 http://summaries.cochrane.org/CD003766/continuous-support-for-women-during-childbirth#sthash.VsvNUnvh.dpuf

     

  2. A doula is an independent, educated professional who will give plenty of time to hearing you, sharing information and helping you to identify what you need and want for your journey into parenthood. A doula has usually studied pregnancy, birth, labour, how to support couples and how to be at births. An experienced doula will have knowledge and intuition.
  3. A doula can help you and your partner to understand and communicate with health professionals. A doula can offer you suggestions for how to bring up issues or ask questions. She can support and assist you and your partner to explain what you need, want and are concerned about.This is particularly helpful if you are seeking non-standard care (eg for a VBAC) or you are planning and preparing for a natural and unhindered birth. Some might even say if you are seeking a natural birth then you are automatically seeking “non-standard” care in many hospitals in Australia and the US! If the policies and practices of your place of birth are not aligned with your birth wishes then a doula will be a very good ally.
  4. A doula can give your partner a break, work with your partner as a team, or support your partner in a practical role. A doula won’t take away from your partner’s role, nor destroy the intimacy of experiencing this rite of passage as a couple. However a doula can support and reassure your partner so he (or she) can support you throughout the birth.
  5. A doula is someone to ask you questions and help you reflect on your pregnancy, birth and motherhood. She may ask questions you wouldn’t think to ask or may avoid asking yourself. This process helps you to know yourself better and helps her to support you.
  6. A doula knows how to be around women in labour, to set the tone and protect the birth space you want. A doula is trained and practised in being with birthing couples without allowing her personal circumstances, history or other factors to affect her or you. A friend or relative may not be able to give unconditionally like this especially if they have not experienced positive births before or are bringing their own fears or negative experiences into the room.
  7. A doula is someone who knows your needs, wishes and your history in a personal and emotional way – as long as you let her in and trust her. Your partner also needs to be comfortable with her and trust her. Someone who knows you well is better able to read your needs and support you than a midwife who has only just met you and you are one of several women in her care at that time. A doula who you feel comfortable with will help you to labour well because her presence makes you feel safer, unobserved and more relaxed. This supports the hormonal processes that drive labour.
  8. A doula is someone to stay with you if your partner needs to go with your baby to the nursery, or you need some medical attention post-birth. This is not a scenario you would wish to focus on, but it is reassuring to know that in this situation you would have support.
  9. A doula is someone to visit you in the post birth days to help with breastfeeding, mothering, and your wellbeing. This may be as simple as making you a cuppa, bringing you one-handed healthy food, or holding your baby while you shower. These things are really helpful post birth especially if you do not have other people who will be there for you in this gentle, reassuring and ‘no strings attached’ way.
  10. A doula becomes someone special who has witnessed your baby’s birth in a non-medical, personal way. She will be able to share in your story, hear and understand your feelings, and affirm your memories of what happened. She will hold a special place in your heart and your family.
    Not convinced? Are there blocks to you considering a doula for birth support? Making Good Decisions for a Positive Birth examines some of the common reasons shared with me for not choosing or not needing a doula and asks you to dig deeper and examine what is behind the reasoning. Only you can know whether your reasons are based on evidence, a deep consideration of your needs and an understanding of your fears.


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Beyond Birth: The List

I still remember the day.

We just had our first visit to the hospital antenatal clinic and we were so excited to receive a bag filled with brochures, discount vouchers, guides to pregnancy and labour, and advice about all the products we should have now that we were about to become a family of three.

We were paying off a new home and a new car. We would be going from two incomes to one. We didn’t know how much money we would have. We didn’t know much about babies at all. The only time we had changed a baby’s nappy we had to fasten it together with bandaids!! (I’m not kidding!)

Now we had this list to tell us what we needed. We would be alright.

But there was a problem. This list was enormous. Apparently our baby was going to need an incredible number of things to survive and thrive! Not just milk, nappies, clothes and a place to sleep.

Nappy wipe containers with heaters, special wedges to keep him from rolling over in bed, nappy dispensers and special nappy bins, disposable nappy bags, a portable change mat and nappy change bag, a change mat cover for a change mat to go on a change table, a bouncer, a rocker that played music and had pretty light, mobiles that spun around and played music, play mats, bottles, special teats and formula just in case we couldn’t breastfeed, a steriliser for cleaning the bottles, a bassinet, a cot, a cot mattress and linen, dummies, blankies, lovies and onesies…what were we getting ourselves into?

This was going to cost thousands. Already my stress levels were rising. How could I be a good enough mother when I’d already failed the first step? I couldn’t afford all these things on The List.

So we did something radical! Instead of starting with everything we decided to buy the minimum and see how we went. We bought a beautiful convertible cot, we were given a pram, we bought modern cloth nappies, some beautiful linen for the cot and the basic clothes (singlets) the rest we were given as gifts. And we had the all important car capsule on hire. My big luxury was a rocking chair – a beautiful cane rocking chair that I just had to have.

We had no change mat, no change mat cover, no bassinet, no dummies, no blankies or lovies, no steriliser, no bouncer, rocker, nappy wipe warmers or any of those extras. Most of the items on the list got a firm line through them.

And, it actually worked out fine. Our baby didn’t want to sleep in his cot much. He preferred to sleep on my chest. And it turned out I don’t like rocking chairs. But apart from that we didn’t waste much money!

After our son’s birth we bought a baby bath, a change mat and a modern take on the old fashioned very simple bouncer. As we got to know our baby we experienced how useful these would be and we were able to buy the items that suited our needs and our baby.

And perhaps because we didn’t have everything on the list we had to rely on ourselves to soothe our baby instead of using devices.

We felt the joy and exhaustion of dancing around the lounge room (we got to practise our ballroom dancing at the same time and now my husband does a great foxtrot with a tiny baby in his arms). We learnt new songs and remembered old lullabies to hum or sing to our baby as his head was snuggled over our shoulders or beneath daddy’s neck. We bought good baby carriers as we learnt that our baby wanted to be held in our arms and the pram became a shopping trolley. We learnt that in truth, what babies and new parents need most is left off The List.

So here is My List:

  • Love – love for yourself, your baby and your partner
  • Patience – with yourself, your baby and your partner
  • Support – yes, you need and deserve support. Don’t try to do this all by yourselves.
  • You – your baby needs to be in your arms, on your chest, and preferably at your breast. Your baby needs to be held close by you. At first this is a very physical closeness and babies want to be held by you as much as possible. Later as your baby grows up this is an emotional and mental holding close as you keep in tune with how your child is experiencing the world and provide stability, love and reassurance. And forever it is holding your baby in your heart – no matter how old they are now!
  • Breast milk (or the best substitute available for your baby’s needs if this is not an option)
  • Somewhere safe for your baby to sleep (cot, bassinet, arms reach co sleeper, baby hammock, well researched safe co-sleeping)

There are many practical things you will need and want to help you care for your baby. These are the simplest and most important ones on my list.

  • Breastfeeding – bamboo breast pads, nursing bras and a good breastfeeding pillow. Some breastfeeding tops or stretchy T shirts and long tummy covering singlets to wear underneath. The phone number of your local ABA group and the breastfeeding hotline. Better yet, go along to meetings and make contact with your ABA group in your last months of pregnancy. If you need support after birth these women will be there for you!
  • Baby clothes – soft, natural fibres, without intricate fasteners and no appliques (cute as they are the underside of a heavily appliqued top can’t be that comfortable for a little baby)
  • Nappies – of your choice. Cloth nappies are amazing these days and all in one pocket nappies are my first choice. There’s nothing wrong with buying a mix of disposable and cloth nappies to see you through the early days if you’re not sure about washing all those cloth nappies and their inserts. If you decide to use disposable nappies think about those with the least environmental impact if possible. But the highest priority for me was nappies that worked, nappies that didn’t break (no more bandaids to fasten a broken disposable please!!) and nappies that were comfortable for my baby. You may like to learn about elimination communication too. I have friends who have great success with this approach to toileting and baby care.
  • Wipes – bamboo velour cloth wipes, disposable wipes – I quite liked Gaia and other eco brands.
  • Change mat – buy a nice comfy one with good high sides to help keep your baby from rolling. Don’t go for seatbelts though! Get soft and easy care covers and make sure either cover or mat has a water resistant layer for little change time accidents.
  • Change table – (yes we got one second time around!) yes they are very useful. You can judge whether you need one or not.
  • Baby wraps – nice soft really big ones. Don’t bother with ones less than 1m square as they won’t last long. Baby cocoon wraps look quite good too for keeping your baby snug and secure feeling. But both my babies hated being wrapped from quite early on and I didn’t wrap for many months.
  • Lotions and Potions – tea tree oil to make up a weak antibacterial wash for wiping your baby’s bottom if needed. Olive oil for their skin. There are many beautiful products for looking after baby’s skin. Look for simple ingredient lists and be aware that your baby’s skin can react to the same products that another baby’s skin loves. Take it slow.
  • One baby sling or carrier – a stretchy or woven wrap like a Moby wrap, Hug a Bub or any of the many beautiful woven wraps is my first choice after two quite different babies. You can buy different kinds of slings and carried nce you know what suits you, your baby and your lifestyle. You don’t really know until your baby is here. Please don’t buy a carrier that pins your baby to your body with their legs dangling straight down. Do look for carriers that an older baby almost sits into (such as the ergo carrier) as this is much better for their body.

https://www.facebook.com/notes/birthtalkorg/do-i-need-a-doula/238875327307

This article by Birthtalk shares the benefits of choosing a doula and talks with mums who have had doulas to find out how their doula helped them.

Melissa and Debby of Birthtalk were professional contributors to Birth Journeys and they support women and couples to help them heal from previous births and prepare for a positive birth. You can read more about Birthtalk and the services Melissa and Debby provide on the Birthtalk website.


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Positive Birth Story – Finding My Voice: my journey to VBAC

Kush and her girls My wonderful VBAC starts with the terrifying caesarean I experienced bringing my precious three year old into the world.

I now know that fear and stress can stop labour progressing. If someone had told me there was nothing to be afraid of, Maitreya’s birth could have been very different.

My mum had six kids and she was told she couldn’t possibly birth naturally because of a rare condition where she has two wombs. My mother in law was full of stories about the horrors of birth and seemed to delight in telling me as many bad stories as possible. I had been led to believe birth was a terrible, dangerous thing. I didn’t know birth could be empowering, spiritual and an amazing natural process that my body was built for. I have one amazing book and an amazing doctor who helped me see this.

My First Birth
I really wanted a natural birth. I went to birth classes and read a few books like Kaz Cook’s Up the Duff and The Complete Book of Pregnancy and Childbirth by Sheila Kitzinger. I thought I was prepared but all I knew was the mechanics of labour, not the emotional and spiritual side of birth. I was really vague with my first birth plan. I thought that they would know best and I should leave it up to them.

When I went in to labour in the afternoon, I tried to stay at home like the midwives advised me, but the phone rang constantly. At first it was just a couple of casual calls and one of these was very welcome, as it was a friend telling me she was pregnant! I remember saying “Yay! I’m in labour, talk to you soon!” Then my partner’s family caught wind of what was happening and they seemed to call one after another to ask how long I had been in labour, when I was going to go hospital and lots of other questions.

We also had a few unexpected visitors and my partner, Josh, decided they should be invited in for a drink. I was embarrassed to have contractions in front of the visitors so I kept leaving the room when I had them. I wanted my partner to be there for me but he was so distracted by the phone and the guests that he didn’t even have time to ask me how I was going. He seemed to treat it as just another day.

I felt stressed and I wanted to go to the hospital to be away from all the intrusions. I asked Josh to call my mum and ask her to meet me at the hospital. He had to ask the last of the friends to leave so he could drive me in. It was about 7pm.

I thought it would be quiet in the hospital but my birth room seemed so busy. People were coming and going. The lights were bright and it was noisy. I started to feel scared. Everyone seemed to be talking around me and not to me.

I had tested positive for Group B Streptococcus so a cannula was put in straight away for antibiotics. It seemed like that was an excuse to give me everything they had. I agreed to it all in a haze. One of the midwives broke my waters with the crochet hook looking thing, then I had syntocinon a while after that. At dawn they gave me pethidine. I didn’t know what it was at the time. I remember being told “We are giving you this to help you get some rest” but it had the opposite effect. I started chatting away to a student nurse about a girl I knew at school who had the same name as her. I’m sure she thought I was crazy!

I felt this excruciating stinging pain between contractions, but a midwife told me that I wasn’t having contractions so I wasn’t in pain! My mum told her, “She is in pain! Something’s not right!” The pain went on for a long time. I was exhausted and worried.

After 20 hours of labour, I was being monitored constantly and I was told to stay on the bed. Finally, a midwife told me that I hadn’t progressed and I was actually going backwards due to the swelling of my cervix. I had only reached 5cm dilation and now I was back to 3cm. I was bleeding and my baby was distressed. They brought me the paper to sign for a caesarean. I was terrified of losing my baby and I agreed straight away. But I felt like I had failed.

My little girl, Maitreya May, had a rough start so we couldn’t be together for a few hours. She had a huge cone head because she was stuck for such a long time. I had a long recovery afterwards.

In quiet moments, I felt this huge regret. I believe that the trouble I had breastfeeding was because I didn’t see my girl for what seemed like forever after the birth. She had trouble latching on, but after almost two months of pain and perseverance we sorted it out and went on to breastfeed for two years. Maitreya always wants to be with me and as a bub she wouldn’t let anyone else hold her including her dad. I think her fear of separation comes from her traumatic birth. I felt like I had no voice when it came to people wanting to hold her, even when I knew she would scream. I didn’t have the confidence to say “I’d better take her back” when she was upset (which was pretty much every time someone else held her).

My Second Birth
The obstetrician who performed the caesarean was an older gentleman, and when he came to follow up and check my incision he said I should get my hips x-rayed if I wanted more children. He said my hips could be too small to birth naturally. That really worried me but I didn’t get an x-ray as I was breastfeeding Maitreya and then I was pregnant again!

I was now terrified of birth and what might happen, so I spent the first half of my second pregnancy trying not to think about it much. I had heard of VBACs from books but everyone I knew just said why bother. They said I would probably have another caesarean anyway so why not just book myself in for one and then I wouldn’t even have to go in to labour.

My doctor told me that a VBAC was possible but that the likelihood was slim and most women go on to have another caesarean. She was full of facts. She told me,“If you go overdue it’s a caesarean. If you labour for more than 12 hours – it’s a caesarean. If you don’t progress quickly – it’s a caesarean.” This didn’t help me prepare for a natural birth. And to top it off, one of my shared-care midwives told me a horror story about a lady’s scar splitting and bubs hand sticking out of the tear!

I still wanted a natural birth despite all the pressure so I made sure I was fit and healthy. I did yoga because I wanted to be able to move, walk, pace around and have an active birth. I told quite a few people that I didn’t want to hear any negative birth stories.

Birth-Journeys-Cover-Large

During my third trimester, the book Birth Journeys came into my life and I realised ‘I can decide what happens to me during birth. I can be excited and positive about my birth. It’s my birth. I will be informed and make choices and not just let myself be told what to do. I will listen to my body and my instincts.’ I learnt that I could speak up and ask for what I want starting at home and working my way up to telling the doctors. I told Josh that he could either be supportive of me or not be there at all this time! He was pretty sorry and would be very attentive this time.

In my final month I decided I wanted a more supportive doctor. Dr Patty was another one of the doctors at my clinic. I had seen her once or twice in the waiting room and once she said “Ooooo… look at that lovely round belly” in such a motherly way that I immediately warmed to her. I had found out that she was an obstetrician about half way through my pregnancy, so now I picked up the courage and asked to see her instead of my normal doctor (Patty is now my regular doctor too).

Dr Patty is such an amazing woman. She is originally from San Francisco and she goes back every year for Christmas. While she is there she spends a few weeks volunteering in a women’s clinic in Mexico. She told me how poor the clinic is. They have hardly any equipment so there is very little intervention there! She is more at home with natural births and has had to learn lots of ‘old midwife tricks’. I can tell she cares so much about the babies she births. One wall in her office is covered with pictures of babies she helped into the world and now my little Xaani is up there too.

Patty asked me what I wanted to do and I said I would like to birth as naturally as possible. I told her about my first birth and my regrets. She said that I would be fine to have a VBAC, but there would be more monitoring this time round just to make sure I was progressing and that the baby was okay. She said I could move as much as I liked with the fetal monitor on, I just had to try not to get tangled!

While Patty told me the statistics on uterine rupture, she also asked me if I wanted to have a big family. She told me that statistically the risk of uterine rupture would go up with each caesarean I had, but it would actually go down with each VBAC. I have always wanted a lot of kids because I love being from a big family, so this made me even more determined to go natural.

I asked Patty if there was anyway to tell if my hips were too small and she said not to worry. In the 18th and 19th centuries poor nutrition, rickets and illnesses such as polio caused pelvic anomalies. As the obstetrician who performed the caesarean was from the older generation and older style of doctoring, he would think that a caesarean was because the mother was unable to birth rather than blame a failure in the medical system to provide a safe environment so labour could progress naturally. She kept saying that my body was fine and there was no reason that this birth would be like the last. She encouraged me and made me feel in charge of my birth – she made me feel confident.

I had learnt that I’m a very private person and I don’t like to feel as though I have an audience. The one thing I really wanted was to have the minimum number of people in my birthing room. Dr Patty agreed that I could have just one midwife with me. I felt very supported by the hospital and midwives, especially by Hannah, the midwife who attended my birth.

When I went in to labour I made sure my home felt safe; no phones, no visitors, just my mum, my partner and my little girl, Maitreya. My mum stayed with Maitreya and I chose when to go into the hospital. I felt happy, safe and in control this time. There was just one midwife and my partner present and the lights were down very low.

I started doing my birth dance, walking round in circles and occasionally squatting with support from Josh. I thought it was going to take a long time as I didn’t feel overwhelmed by the contractions yet, so I had a shower. The contractions were nothing like I remembered. They swept in like a wave and then faded away. I didn’t feel like I was out of my depth and drowning like I did the first time. I remembered to breath into the pain, not vocalise it but use the energy to help my body do what it needed to. I came out of the shower and sat on the birth ball.

I remembered a few mums from Birth Journeys talking about visualisation and how it helped them, so I visualised opening and my baby traveling down. It was working! I was progressing well and I knew this baby wouldn’t get stuck.

I did have one surprise visit this time, but it was a welcome one! Patty said she had asked the hospital to let her know when I came in. This was her night off and I was in a public hospital so she was in no way obliged to be there. She said she hadn’t birthed a baby for a while and she didn’t feel right if she hadn’t ‘caught a baby’ for a long time. She made me feel special. She wanted to be there for me and my baby and her joy was lovely to see. Every birth was a special moment for her, not just another day at work. I wasn’t just another birthing mum, and my birth mattered.

The final stage was tiring and my legs were shaking through most of it. Josh and Patty were both so encouraging, they were saying things like “You’re almost there”, “You’re doing great”. They really made me feel like superwoman!

After only three hours of full labour, my beautiful baby girl arrived. Patty caught Xanni Lily and handed her to me for skin-to-skin contact. Xanni latched on, her eyes opened and she looked at me. Contented, elated, proud and in awe of my baby and myself – this is exactly the birth I had dreamed about!

Kush is a 35 year old mother of two amazing girls, Maitreya and Xaani. Kush started making modern cloth nappies for her first bub and loved making these and other baby gear so much that she just couldn’t stop and had to start selling them! She now runs a business called Kushy Komfort (http://kushykomfort.com.au) selling her modern cloth nappies and other environmentally responsible products for mums and bubs. Kush lives in rural NSW with her partner of 18 years, a cat, dog, fish, chickens and a pet spotted python called Monty.