Continuing the Passion and Possibilities Interview Series with a wonderful interview with Lorna Philip who is a Doula based in Birmingham. We discuss everything from what is a Doula and why you may choose to hire one, to how doulas can support you before during and after birth.
Watch the video or listen to the audio only version below the video. If you are limited for time use the notes underneath to skip to what most interests you.
Following 20+ years supporting mums, dads and children working in coordinating family health services, promoting and supporting breastfeeding, teaching infant massage, to name but a few of her previous roles, Lorna discovered her purpose and passion as a Doula
She supports all kinds of births and her heart particularly singswhen she supports women who are experiencing a VBAC ( vaginal birth after Caesaerean birth ) or who are creating positive births after a traumatic birth.
3.35 Defining a doula in a nutshell- a Doula is a lay person trained and experienced in birth offering practical and emotional care to the woman and her family.
4.16 We talk about what the role entails beyond ‘professional hand holding’ and how important these tasks are to the woman
6.00 We mention the research that shows benefits of a support person who is not a medic or a family member and discuss why- more objective and not emotionally tied to woman and situation.
7.28 why being a doula is not all about holding the babies cute though they are and what it is about instead.
8.55 Why it is not the mode of birth – vaginal versus caesarean for example that makes the birth special and the transition to motherhood smooth or traumatic. And how a doula supports a smoother transition to motherhood.
10.00 we talk about the miracle of birth and the role of a doula in influencing the calm trust atmosphere in the room
14.50 How to prepare for the postnatal period during pregnancy and tips to make sure you have enough support.
15.33 Dealing with resistance: I can’t afford a doula… Payment plans, gift vouchers and changing the mindset to give yourself what is priceless rather than pricey.
19.05 Mother burn out and how to avoid it
19.18 Who is a doula for- Hint if you are thinking its not for me its for x, y z, types of women you will be wrong.
20.15 Local support options:
Bethel Doula supporting vulnerable women with a free doula
And Cando-Doulas supporting women with learning difficulties.
For all nonlocal women there is likely other similar schemes in your area. If you would like a doula but don’t think you can afford one even with saving please ring a doula and ask what is available and what options exist in your area.
22.30 Addressing the results of the MBRRACE- UK (Mothers and babies reducing risk through audits and confidential enquiries) report 2018 which found Asian mothers twice as likely to die and black mothers 5 x as likely to die during childbirth than white women. We discuss the problem of viewing women as ‘other’ and the impact of true listening. With a plea to you watching to check inside to see if you are guilty of either fault so you can bring yourself gently back to open hearted listening to the human being in front of you
26.30 Brings us to cultural safety
28.40 The blind spot that assumes there is a level playing field that fuels defensive reactions when confronted by any women asking for more ( respect , time, etc) and in particular women of colour. We also talk of the importance of understanding the defensive reaction and moving beyond it back to the heart and humanity.
30.46 Takeaway wisdom - You don’t have to birth like they do on one born every minute! - or any other film or any other person.
32.19 Takeaway wisdom 2. Use your voice to insist on help. You matter and your voice matters. Take some time to enquire what you truly want and need and ask for it.
Find Lorna at Birmingham Doula where she offers Doula services including postnatal doula services, hypnobirthing and Mizan Therapy.
The Passion and Possibilities in Birth Interivew Series showcases the who's how's and why's of creating a community of support around you as you prepare and create your best birth experience. Intended to inspire you and open you to new and old ideas there are 11 different birth profesisonals sharing their passion and wisdom. We kick off here with experienced independent midwife Janie Al Alawi.
Watch the video or listen to the audio only version below the video. If you are limited for time use the notes underneath to skip to what most interests.
Janie Al Alawi discovered her passion for midwifery during a 4 week placement to the Jessop Hospital for Women during her nursing training that she completed in 1985. It was here she returned to become a 'Jessop girl' with 18 month training to become a midwife. She experienced labour ward and community midwifery before moving to Abu Dhabi in 1990 to the Corniche Hospital. 12 years, 4 different jobs including the busy delivery suite where 100,000 babies were born annually, Janie returned to the Uk to work as a community midwife. where she remained untili 2014. 2014 saw her creating acorn birth services as an independent midwife.
4.10 Janie describes why she loves midwifery so much -"Being a midwife for Janie is not a job it is something in you".
5.41 All about The Pinard.
This is the long trumpet that you see my husband using to listen into my baby's heartbeat, under supervision of Janie. Janie explains why she loves this traditional tool and why it is still useful today even though we have hand held dopplers and technological aids to listen in.
6.40 The difference between working for the NHS and working indpendently.
9.32 All about choice and the mantra " guidelines not tramlines" when arranging your birth plan with your care providers.
10.30 Why you are the expert in your own birth. The importance of communication especially listening to the woman, the mother. REmember 'The customer is always right' is the mindset to cultivate.
12.44 Billy the dog. A midwife's faithful companioni. He remained off screen but present so here is a little picture of the bundle of mischief.
13.30 Why the presentation and interpretation of data is a problem with induction research and what Janie would like to see change ( We mention Sophie Messager who as a scientist and birth educator has also written eloquently on this subject Check out this blog on induction )
15.31 Why sweeps are the bane of Janie's life and her water slide analogy to help you understand and choose.
20.15 As a population we are healthier than ever so why are we having so many more problems? Discussing the need to trust women and their bodies, with a special mention of big babies as an example of how planting fears that weren't there can affect you.
23.30 What Janie would like to see women doing to prepare for the birth of their child- including slowing down in the third trimester particularly. How she sees 'wired babies' when the mother hasn't slowed down, babies reflecting their mothers state of being.
26.40 Janie shares some tales from her travels to other cultures including the Emiratesand Angola where she witnessed the elder traditional midwives working alongside her in the hospital and mothers being looked after round the clockin the postnatal period.
31.44 Discussing easy to implement tips and techniques to support baby into the best position inlabour including using the stairs and the racing start.
33.30 A saddening tale of how quickly traditional skills and home birth/active birth preference were lost in the Emirates as an overmedicalised model took over in this nation which today sees 50% c sectoins. On her first visit she used 1 epidural in 12 years and very low c-section rates so the change is astonishing and quick. Janies mission and passion (one of many!) is to bring back home birth to th Emirates.
40.27 How you speak to a woman in pregnancy and birth will stay with her for life- so be mindful. And a reminder that YOU are superwoman! As Janie describes how she is still excited at every birth after 31 years as a midwife.
43 The heartbreak Janie feels when women are only given one option when there is almost always more choice than that. ( Check out this blog for more skills on how to get offered the choices available )
44 Mary Cronk Exclusive! Midwives on a mission of mercy. Janie shares a story from a trailblazing midwife who has done much to support women's choices in childbirth and to preserve skills such as birthing a breech baby.
You can read about her legacy here .
46 Some women need some help with some labours, BUT this help is the last line not first line as women can do this and have been for 1000s of years.
I spent a lot of time preparing for the birth of my first child. Trawling the internet, ordering books to read and in-depth emotional clearing work. Somehow I still managed to leave some gaps. Some of these gaps are quite funny now- New born poo colour for example…! I actually thought as the thick treacly meconium gave way to bright yellow mush that it was all due to the lovely meal cooked by my husband I’d eaten the night before coming out somehow in my milk. (His African sauce was made with Palm Oil which is bright orange and solid at room temperature, liquid when heated and permanently stains everything it comes into contact with bright yellow.)
Some of the gaps in my knowledge caused me some temporary concern and added stress and I hope that this post will save some of you from the same needless worries that I experienced.
So here goes, in no particular order, I wish that I had known:-
I did kind of know that due dates are just an indication and that there is some question over the accuracy of the 40 week marker in the first place. ( See bottom of post for useful links on gestation length and EDD calculation.) I also knew that most first time mothers give birth at around 41 weeks. I just thought that would be the same for me. So at 38 plus 5 and contemplating the mammoth task of mounting the stairs I felt a wave of despair at the thought I could have another four weeks and how would I cope. It never occurred to me that this – plus the furious house cleaning- could be an indication that I wouldn’t have to wait that long...
At 39 weeks exactly, I waved my parents out of the door on Good Friday Evening and we all joked how they would be back soon enough. I shut the door and felt the first cramps. Oh…! I nearly called them back in but thought, "It’s probably Braxton Hicks, I’ve not had any of those yet…."
Takeaway Number 1: Listen to your body and be prepared.
Those first ‘Braxton Hicks’ were very low down, dull aches across where my uterus would be were I not pregnant. They felt like period pains. I watched the wild thought fly across my awareness that maybe something was wrong. I was expecting big waves of contractions right across my lovely big belly. I think I was forgetting about a gradual progression of labour and expecting to be thrown right into the most intense labour sensations from the get go.
Still I did at least do something right here. I checked out the panicked thoughts, reassured myself that I was all good and as it was nearly 11pm, I went to bed. It was a restless night that felt like one big contraction but I got a decent amount of sleep in between. I woke at 9 am when I could not ignore that I was in labour any longer as they were now close to 5 minutes apart.
Takeaway Number 2: Connect with the sensations in your body and enjoy the knowledge your body is working for you and get rest while you can.
Another one of those fleeting thoughts that had my heart rate racing. I knew to expect a plug shaped piece of tissue. And there was no mistaking the plug when it arrived. It was, well like my bathroom plug same shape and size and quite solid. Despite the name I wasn’t expecting it to be so pluglike. But somehow I hadn't expected a little gush of blood.
I breathed through the panic and my fears of looking stupid and rang my midwife. She was wonderful and suggested I put a pad on and check the amount of blood then call her back. Great advice and as I put the phone down I realised I was not bleeding any more beyond the couple of drops that had spread out on my clothes and looked much more than they actually were. Thanking my mind once more for its extreme caution in wanting to keep me safe I relaxed again.
I will quickly add that you may not get an obvious plug like I did. Some women lose the plug weeks before labour starts and some like me during my second son's birth, never know if they lost it down the toilet without realising or some time in labour as they never see it and there are all kinds of variations in between.
Takeaway Number 3: Slow down and breathe. Ring your midwife and ask even if you feel stupid.
So useful to know! It really does feel like that. Another unexpected surprise. The pressure of the baby taking up the space in your body causes you both to feel like the baby is coming out of your bottom and for you to actually evacuate your bowels for real. So yes both these are great signs that your baby is on the way and good things to know in advance.
Takeaway Number 4: Expect to poo, and know it's a good sign.
I believed that I needed to be examined at least once, found to be the magic ten cm and given permission to push. I knew I was going to follow my body regardless of numbers, I just thought that was the system and I would have to go along with it. I have since learned that I could have said no to the one examination I did have. It was so clear to all around that I was in labour and doing well, an examination wasn’t necessary. I didn't really want one, I just thought I had to.
Here I have to say my midwife was wonderful. She asked permission, asked if I had had one before ( I hadn’t) and was totally gentle so I could hardly feel it. She then pronounced me 8 cm. Although I would have refused had it been clear to me this was an optional intervention, this announcement actually helped dispel the worry that I had called her out too early and was going to look stupid when she said sorry you are not in labour yet!
Finally I want to really stress that vaginal examinations are a choice and you are the one with the power to choose what is right for you. I was aware that they only tell you what is going on in that moment and that can change. I knew that birth is not linear despite the (mostly male created (charts that imply a certain progression per hour. I had heard many anecdotes of women I know personally and their friends or family who had nearly given birth in triage as labour progressed so quickly. I knew all this but at the time did not know I could make my own choice. Some women find them reassuring as I did in this example. Others prefer not to know and there is a danger of feeling discouraged if you have laboured for a while without any corresponding increase in openness. This seeming lack of change on its own does not mean that nothing is happening. Again listening and communicating with your own body will help you decide what you need.
As for me in this birth story, the official confirmation that I was truly in labour and pretty far on was like a load lifted. I got back up and onto my knees on the floor, for the final stages of opening my body. For that 8 cm was moving pretty fast now, I was not on any arbitrary linear timescale. I had no idea what timescale I was on as I was moving deep into the labour trance world and nothing made much sense any more. There was just one more hesitation on my part.
Takeaway Number 5: You have the power to choose what support you need. You can say no to vaginal examinations.
Not if your body is spontaneously pushing even as you concentrate on relaxing deeply and going with the flow of the birthing energy. Try stopping that life force. That kind of pushing is impossible to stop.
Sometimes women are told they must wait until they get to ten centimetres, whereas in some cultures women are told to start pushing from the first contractions and push all the way through labour. I have always been confused by these seeming contradictions and the lack of trust implied in the process and the woman and baby giving birth. (Check the end of the post for more information on pushing before 10 cm) i
In the mean time there I was on my knees, head buried in the couch, swaying, when I felt my body begin to push. "Oh," I thought, "I am only 8 cm? Will I be in trouble? Should I tell her?" I lifted my head just long enough to say tentatively, "my body wants to push now." "You just go with what your body wants to do," my midwife replied gently. AAhh so good. The last worry smoothed away with just those few words. I dropped my head into the sofa again and let everything go.
Takeaway Number 6: Spontaneous Pushing is impossible to stop or control but can feel fantastic. Trust your body.
(A small aside- if you are a community midwife who attended a home birth on Easter Saturday in Handsworth and you recognise this story. Thank you. You were so lovely. You always asked permission, explained and exuded a quiet confidence and respect that was catching. I would love to hear from you if you ever read this- I cannot remember your name.)
I felt my son come right up between my legs during the contraction. As I relaxed into the quiet space I felt him move straight back again. With the next contraction, he surged forwards enthusiastically, then fell back again as it subsided. Now as I write and remember this rhythm I am reminded of the sea, gentle waves that lap the shore and the water trickling back to the ocean. It was exactly like that. It serves a purpose, I believe, to soften and prepare your body. Your baby is also an active partner in the birth and needs to rotate himself into position as he comes out.
My son was gearing up for his final exit where he would shoot accross the pool as I sat up to see him. What I would do differently if I could go back would be to have more patience and really enjoy this part. There was no pain as I floated in my pool. It was a fabulous opportunity to connect with my son, reassure him all was well and to take his time rather than question in my head if that was normal or not.
Takeaway Number 7: Be patient and take your time as you start to crown. A bit of to and fro is normal and may help.
We were so in love with our new son that we didn’t get out of the pool. Unfortunately, the room was colder than we would have liked due to an unforeseen heating problem and I started to feel chilly. The midwives had been filling in their paperwork and hadn’t realised we were getting cold. It was easily rectified with some warm towels, dressing gown and blanket but we came close to needing a transfer for a cold baby.
What I did learn with this experience is just how amazing we women are. I may have been blissfully unaware of the temperature of my serene baby but my body knew differently. As my husband and midwives wrapped us in a bundle I started to sweat. The only comparable heat I have experienced is during a fever. My body became a furnace and heated my baby so fast that my lovely midwife wondered if she had made a mistake taking his temperature. I know, as did my body that she didn’t and my birthing story ended happily with the midwives leaving to sleep as my husband and I remained resting on our sofa enjoying our baby as he took his first feed.
So there you have it. 8 tips from the birth story of my first son. I hope you find them useful. If you have any of your own to share, please comment and let me know.
If you enjoyed a quick glimpse into the birth story of my son you can read the complete story along with 12 other wonderful water birth tales in this book. Click image to buy from Amazon.
Below are links to some articles that you may find useful related to the points raised in this post.
Women's gestation can vary by up to 5 weeks-Article in the Independent
Article on pushing with an anterior cervical lip by Midwife Thinking.