A Home Birth!!?? Are you kidding?



All right, calm down.  Just hear me out on this one.  If you are pregnant and there is nothing wrong, there is no reason why you shouldn’t consider a home birth.  Even with your first baby.  Even if you live in a tiny flat.  You should certainly be offered one when you book in with your 12 week check, and I would always say “Take it” and this is why:
baby%20Darcey.jpg
With a home birth you get one to one care with a named team of midwives who you meet and develop a relationship with.  You get all your ante-natal care in your own home so you don’t have to schlep yourself to the hospital and wait there for hours; they come to you in your own home.  When your labour starts, you and all your stuff don’t have to go anywhere, you get to stay at home, where you are comfy and happy, they come to you.  You can use gas and air at home, and ask for pethedine to be prescribed by your gp and keep it in the fridge in case you change your mind and need something stronger.  You can eat and drink and move about as you choose.  You can rent or buy a birth pool and be confident that you will be allowed to get into it when the time comes as you are the only one there in labour. At home your husband can sleep whilst you do your thing.  You are already immune to all the bugs in your own home and you know the bathroom is clean because you jolly well cleaned it.  Your other children can stay in their beds or go out with granny/auntie/the nice neighbour next door or be there with you as their sibling is born and you don’t need to worry about them being disrupted.  You can burn candles, aromatherapy oils and listen to the music you want to. You do not have to labour under hospital protocols and you cannot have continual monitoring because the machine is not portable (hurrah!), instead you would always have monitoring via a sonic aid which is (by the way) just as accurate but they don’t like to offer it in hospital because it takes a midwife away from her other patients.  At home there are no other patients, it is just you and your partner and your lovely midwife. You can get into the bath or shower after your baby is born and know it is clean (see above).  You can have tea and toast after your baby is born and get in to your own bed with your partner and not be separated from him on that first vulnerable night.

If you have never laboured before and you are not sure who you are going to cope, why not go for a home birth and if you change your mind at the 11th hour, even before you go into labour, you can always just go to the hospital… you certainly can’t change your mind as easily the other way round.   And if at anytime during your labour you do change your mind and want to go into hospital they transfer you in and stay with you…  your own midwife who you have developed a lovely relationship with you.  Homebirth (community) midwives tend to be self selecting – they only want to do the job if they believe in women giving birth naturally with support and love from a midwife.   You don’t get a jobbing, bank midwife who is more interested in getting home for her tea than looking after you.

85% of women can give birth with no intervention.  Occasionally something may happen or become apparent during labour which makes a home birth inappropriate, but your midwife will know this way in advance of it being a serious consideration and would always transfer you with speed and alacrity to hospital as soon as it becomes evident.  But 85% of you will have no reason to go anywhere…  you can stay exactly where you are most comfy…  and give birth in the most wonderful way.  

Just have a think about it, would you?

 

Have a look at the homebirth website:  www.homebirth.org.uk 

Posted on Wednesday, February 13, 2008 at 02:10PM by Registered CommenterLucy Symons | Comments1 Comment

Routines

Routines

There has been a lot of chat amongst local doulas recently about routines.  The general consensus is that there are as many routines as there are babies and mothers.  Some of these routines are written in books (like Gina Ford’s Contended Little Babies, or Tracy Hogg’s The Baby Whisperer) and for some of us, the fact that there seems to be a paperback clearly illustrating the path to take, a prescribed route we can study, motherhood seems less frightening.  You have never done this before, when expecting your first baby, and it must seem like a good idea to find the Ultimate Map to Motherhood.  If only such a thing existed.  And if it were to exist, that your baby had read it too.

Darcy%20and%20Mel.jpgI am always happy, as a post natal doula, to support a woman in whatever choices she makes.  My job, after all, is to help her gain confidence and feel happy and content herself as a new mother.  Having someone judge you in those tender early days is recipe for disaster and possibly worse than having no help at all.    A new mother may show me a book, explain a theory and tell me that is what she is doing; I will naturally help to support her achieve whatever the desired end result she hopes for without a word.  I have to say though, from my years of experience, if I have only learnt one thing it is that babies are babies and they tend to find their own way no matter what routine you try to follow.

One very senior and well experienced doula, Stacia Smales-Hill, wrote in our latest newsletter that she had recently met up with three women who had all had babies within a few days of each other and now that the babies were a month old, they had all met up for coffee.  “The subject of routines inevitably came up,” she writes, “The first a devotee of Gina Ford, extolled the virtues of her chosen path.  She had used it with her first baby with excellent results and now was using it for this baby.  The second woman was not sure which approach to take and was reading everything, trying to pick out the good bits from each and was attempting to learn in a reasoned way.  The third hadn’t read anything, didn’t have a clue and was doing what her baby wanted.  All three babies were on the exact same schedule of sleeping and eating.”  Stacia says by way of a ps, “it couldn’t be more perfect if I made it up…”

I have a client at the moment, a very sensible GP, who has just had number two.  This week, I arrived to find her, in her pjs looking quite stunned, the six week old baby in her arms.  “I’m so excited!” She said to me, “She slept through the night!”  She held the baby aloft as if offering her up to the Gods as a thank you for the first good nights sleep she had had in nearly two months.  “Well done you!” I said to her, laughing and clapping.  “Yes,” she said, “well done me…”  We both looked at the baby smiling, a thoughtful silence filled the air.  She cleared her throat.  “It was nothing to do with me, was it?”  “Nothing at all.”  I said, shaking my head.  

Babies do what they do.  You can try to mould them into a routine if it makes you feel better and perhaps they have the personality which will fit that routine and perhaps occasionally quite by mistake it will suit them, and they will fall into the schedule you are trying to overlay on to their natural behaviour, but generally speaking, the baby would have done what it is doing naturally, anyway.  Worse case scenario, the baby will do exactly what it would have done which didn’t fit in with your routine and you, the parents, would feel like total failures.  You should be bonding with your baby in those early days, surviving from day to day on very little sleep and trusting your own instincts as a new parent and not beating yourself up because your baby has not settled into an identifiable routine.  But that thesis doesn’t make a good book.  Perhaps it makes good doula and parent, though.

Posted on Wednesday, January 23, 2008 at 06:15PM by Registered CommenterLucy Symons | CommentsPost a Comment | References2 References

Watch Your Language!

It strikes me as odd sometimes that the language our medical professionals use when talking to pregnant women and women in labour and new parents can be so easily misinterpreted. I suppose to them, the medical fraternity, they are doing their job and communicating using a language which does what they need it to do, but sometimes I wish they would think twice before using some of their words with us.

I had a conversation with a client last week where she described how reading through the notes from her baby’s birth she came across the phrase “unproductive labour”. “How,” she asked me, “can my labour have been unproductive when I ended up with a baby?” How indeed. I know that this phrase refers to the fact that her contractions weren’t of “sufficient” strength (according to whom, exactly?) to produce her baby in the time limit specified by the hospital, but how rude! This sort of judgemental language does no one any favours.

What about being told you have an “incontinent cervix” or a “retrograde uterus”? How about an “incompetent cervix”, then? That you are an “aging primate”? That your baby has an “immature oesophageal valve”? That during labour you are “failing to progress”? Or even that you are “big for dates”? That your waters have “gone”? (“gone where and why am I still leaking, if they are no longer present?” you may well ask yourself.)

How about being told you are not “in labour yet” when you are quite clearly experiencing contractions and a great deal of pain because you are (officially) "not considered in labour until changes happen to the cervix"? Language gives clear messages about power relationships. 
Language gives messages about attitudes and ideologies. Language affects how women feel about themselves and their birth experience and, in my experience, much of the language around childbirth is very disempowering.

What about the very term “delivery”? Does that actually do justice to the mother’s experience of giving birth or does it take away the woman's own work in the process? The phrase: “the doctor delivered the baby” does not even recognize the mother as being present. Instead, some midwives prefer to say they caught a baby; a more descriptive and, it seems to me, more accurate term, because that is what a midwife literally does. How about “the mother birthed the baby”? That phrase reclaims the woman's agency in the process, recognizing her crucial role as more than just a vessel through which a baby is born. Think how powerful a message such changes in language would send to our sisters and to our daughters as they grow up. Think how differently they might come to view birth, how much more confidence they might have in their ability to do exactly what their bodies were designed to do?

As a woman going through pregnancy, labour and birth, you want to be the active centre of your own experience, not incidental or a selection of body parts which may or may not be performing as expected or as “normal”. Language that suggests that you need help or that you have somehow failed is not helpful. Midwives and doctors frequently use the phrases: manage, conduct, allow, permit – which have very distinct meanings in our own vocabulary, and none of them are particularly conducive to having a positive, respected birth experience. Negative language can make a woman feel inadequate and could be laying the foundation for intervention. Women need to be encouraged and to feel they are doing well, not undermined by being negatively compared to NICE guidelines or hospital protocols… All these phrases, like Normal (What is normal?)
; low risk/high risk; 
favorable outcome/poor outcome; 
false labour; 
estimated date of confinement/due date; 
incompetent cervix; failure to progress; 
placental inadequacy/insufficiency; 
dysfunctional labour; 
faulty placement of the placenta; 
untried pelvis/trial of labour or trial of scar; sizeable pelvis… do nothing to inspire confidence in yourself or your own body, do they?

What about being referred to as “Mummy” instead of someone using your name? and even your baby being referred to as a foetus? Surely you are pregnant with a baby, even if you suffer a miscarriage, it was still a baby, surely!

There are many others: 
intrauterine growth retardation, blighted ovum, abnormal hemoglobin, hormonal insufficiency, management of breastfeeding, inadequate milk supply/insufficient milk, average, normal etc and what about those little red books with the growth chart? (I was once told the growth chart was based on American bottle fed babies anyway… and who is to say that your baby will develop the way a chart dictates? And what does that say about you or your baby if it “fails” to meet those expectations?)

Midwives in a hurry may pose a question to you in a way that anticipates compliance: “I need to give you a vaginal exam…” they might say, when they are actually asking your permission to examine you and you may say no if you prefer not to have one. You need to be aware of all these things and arm yourself against them before you embark on your labour and birth.

I have heard midwives and obstetricians saying to mothers: 'well, it’s your choice, but I’ve seen babies die from this...' and other versions of the same shroud waving when trying to pressurize a woman into taking a decision they believe will suit their ends. Of course you don’t want to take a chance with your health or the health of your baby, but given all the information, you could probably make a pretty good decision for your self and your baby if you are given a chance and not patronized or bullied by ill chosen words.

Be aware of the power of language. Guard against anyone trying to undermine you or your abilities during pregnancy and birth. The birth of your baby is your experience and you can be in charge if you choose. Wrangle the power back from those “in charge” and remember as you embark on motherhood how important it is to speak to your little one with care…

Posted on Friday, November 16, 2007 at 06:09PM by Registered CommenterLucy Symons | Comments1 Comment | References407 References

Don't Back Down

A mother at school, J, was telling me a terrible tale last week about how her daughter, E aged 5, had refused to eat her supper. J had just delivered a series of lectures on healthy eating (all supported by the school) and told me that her two other older children had taken them on board and were now toeing the line, but the youngest was absolutely taking a stand. “It’s not like I feed them crap, either.” Said J. I know the feeling. You carefully craft a chicken pie out of all organic ingredients and home made pastry and they would rather chow down on hula hoops and bread and butter, refusing your nutritious and delicious offering, the miserable ingrates.

J decided enough was enough, and at a low emotional ebb, took a stand. (Just writing that has made me break out in a cold sweat). “E was warned quite clearly that if she didn't try and eat a bit of the small portion of food I measured out into a ramekin dish for her supper, it would be served up for breakfast. So she did know what was coming.” J told me. And then as an after thought, J added: “It was only two teaspoons worth.” So, after E refused her supper and J took to her moral high horse, the story goes that E woke the next morning and was served again her delicious salmon en croute and maintained her stance. The other two children, no doubt fascinated with the whole scenario, were lured away to school by a neighbour called in for the sole purpose of enabling J to follow through with her threat.

E and her nostril flared mother, J, settled down for the long haul. This involved much gentle coercion from J, followed by some shouting and then a few comedy phone calls (her husband phoned and J, ever the fast thinker, pretended to E it was the head master from school phoning to enquire where E, now very late for school, was…). At some point during the standoff, E spooned the fish in to her mouth but spat it out and J dutifully scooped it back in to the ramekin. As time passed, E said she needed to go to the loo, it had been several hours after all. J wouldn’t back down again and said that if E was really desperate she should just go… which she did… all over the kitchen floor… and with her pants still moist, E was back in her seat facing the offending fish.

Finally, J resorted to the old chestnut used by most mothers I know at some stage or another: “It is against the law for you to be at home when you should be at school and I will go to prison if the school enforcement officer finds out.” Said J rather sadly. E challenged J to name the school enforcement officer (J did – I believe, for those of you who ever need him, his name is “Lou”) and that, or perhaps the prospect of sitting in wet pants facing a ramekin of regurgitated fish was enough to change E’s mind. E finally ate the pre-masticated salmon she had previously refused and was allowed to go to school. After changing her pants.

How many times have we, as mothers, made rash statements? “If you don’t get in the car now, I will leave without you…” “If you don’t tidy your toys away I will throw them in the bin…” “If you don’t eat that delicious salmon, I will serve it to you for breakfast…” and I think the moral of this story has to be, if you make the threat you really REALLY have to follow through for you ever to have credibility again. J won this round, her daughter E is now happily eating everything set before her, but it was a close run thing. If J had shown even the slightest sign of weakening it would all have gone horribly wrong. So, mothers, keep a cool head and any time you feel an ultimatum coming on, for God’s sake imagine what it will be like when you enforce it. And remember, Lou is there if you need him.

Posted on Wednesday, September 26, 2007 at 02:50PM by Registered CommenterLucy Symons | CommentsPost a Comment | References4 References

The Holiday Myth

Once you have had a baby your expectations for a holiday change.  Or perhaps I should say that they NEED to change and it takes a little while to process and accept this as a new parent.  Once you have had a baby, your requirements as a family change so completely that your old concept of what made a holiday great needs to be radically reconsidered.  Our mistakes as mothers comes, I think, from still expecting that a holiday should be a break for us from our every day lives.  Frankly, (and I hate to be the one who may be breaking this to you) it just isn’t.

A really great annual summer holiday to me, in my twenties, was a week or two at a beach with friends; that was pretty much all I needed, and it refreshed me sufficiently to enable me to face the coming year with a smile on my face.  As a married couple before kids, my husband and I did pretty much the same thing.  Camping, skiing, travelling, you name it, taking in a museum or art gallery or just lying on a beach, we were very good at holidays.  Once we had kids, we foolishly believed that mantra that nothing needed to change and tried to do the same things and quickly learnt that what used to be a really restful or exciting holiday was no longer going to fit the bill.  

As a mother, especially, you learn that when the kids are happy, you are happy.  You learn that flying any great distance with kids is pretty hideous, from the packing (they always need far more than you ever did even when you packed a case covering every eventuality including being invited to an impromptu ball) to the airport (try entertaining two active toddlers in a crowded airport for the hour before you board, or stopping them from running through the queues at the security check) to the actual plane itself (just watch as the harried mother, smeared with vomit and chocolate chases her small renegades down the aisles begging them to go to sleep in the middle of the night whilst everyone else tuts and sighs).  And once you get to your destination, you learn that all you really need is a kitchen and a washing machine and a bath and possibly a nanny… and frequently you find none of these things.  Having self-catered (and let’s face it, only a very few of us can afford the Mark Warner style hols where you really get a break) many times and washed socks in the sinks for a week or two, there is no anger like that provoked in a mother when she sees her children running outside in white socks she has to scrub by hand in a sink…

A holiday suddenly becomes more of the same stuff you do every day but in a different, possibly worse equipped, home, with fewer toys and none of your friends.  Kids still get up at 6am on holiday, but chances are you stayed up late with your husband and had a few drinks instead of also collapsing in to bed at 7pm.  Husbands also have a horrible ability of enjoying a holiday without realising that you are still going to the supermarket (trying to find nutella and the only brand of brioche your son eats for breakfast whilst figuring out that you have to weigh all the fruit and veg before proceeding to the check out, that you need a specific coin to get a trolley and that you should have brought your own bags), cooking the meals, cleaning and tidying and washing the laundry and entertaining the children not to mention removing the nits which can still be caught (to my horror) on holiday.  You still have to do all these things only you don’t have all the things you had at home to make that job just a little easier.  The illusion of a holiday is quickly dispelled and I hope that you, like me, quickly reassess the merits of places like Centre Parcs (oh the horror) because your kids will have a lovely time there.  I am also now deeply in favour of Kids Clubs and would book a camping holiday in a place that offers them, because although your children will always make friends at the pool, you still have to watch them to make sure they don’t drown and that is not possible whilst reading the book you optimistically packed.    Kids Clubs are a way of palming your kids off with other kids for an hour or two (so you do get a rest – or in my case get to go to the supermarket without the kids) and frequently run by nubile teenagers who will babysit for extra dosh, so you can go out with your husband and have a conversation.  I also generally recommend camping as a cheap holiday you can drive to (thereby avoiding the airport and the stress of travelling on a plane with small people, and enable you to pack everything you need – I once packed the microwave in the car for a two month break in France so I could sterilise bottles and defrost frozen baby puree, where we stayed in a house with no bathroom, but that is another story), as it is much more acceptable to go out to the local restaurant with filthy socks, stained beyond recognition, from a campsite than from a nice villa somewhere.  Kids love camping, frequently turn quite feral there and it is a pretty easy and cheap holiday once you get the hang of it, but I’m afraid for mother, it’s not exactly restful.  You can sometimes find a gaggle of like-minded people with similar aged children and take it in turns to cook meals and watch the little darlings commune stylie, but that is the pinnacle of a break for mother in my experience.  We had got living in a tent down to a fine art, putting the kids to bed and sitting outside the tent with a bottle of wine and a pack of cards, huddled over the table and the lantern until midnight, sniggering like teenagers trying not to wake the little monsters…

But let this be a salutary lesson to you all:  kids grow up.  This summer for the first time ever, we took with us kids who no longer nap and who don’t go to bed early either (I tried to face them out a couple of times, but they have greater stamina than me and would stay up until midnight every night if we let them)…  of course they go to bed at 7:30 when they are told to in term time, but on holiday you feel cruel sending a 7 and 9 year old off when they are not tired and don’t want to read (and the pay off of them sleeping in until 8 am is irresistible) but consequently you get no time to yourselves.  We were never without our kids, and much that I love them, I would love just a little time alone with my husband more.  By the end of three weeks, I was getting desperate for just an evening to spend with him talking without someone small telling a funny story which lasts an hour.  I suppose I should be grateful that my children still want to spend time with us and that we have yet to graduate to being really embarrassing and not cool enough to be seen with.  But I wasn’t sad to come home at the end of our holiday.  Back to my home with the fully equipped kitchen and the washing machine and the lovely neighbours who can watch your kids for half an hour if you need to pop out, and school in the morning which means they have to go to bed and I can spend some time cuddled up on the sofa with my other half.  But My Friend Sally says that pretty soon, they don’t go to bed early in term time, either, and you never get to spend time alone with your husband…  make the most of it, ladies!!!

Posted on Saturday, September 8, 2007 at 06:57PM by Registered CommenterLucy Symons | CommentsPost a Comment