Tag Archives: Birth

25 Oct

Book Review: Why Doulas Matter, by Maddie McMahon

I love that near the beginning of Why Doulas Matter, MM points out that “on one level, doulas do not matter.” The invisible but steadfast presence of a doula, and how much difference she can make to the experience of birth, is the most important lesson this book can teach you.

This is a book about what doulas do and how they do it, and it also tells you what they are thinking about while they’re doing it. Maddie’s voice comes through very clearly, and unlike other books in the Why It Matters series, this one is far more personal than political. One exception to this is her mini-rant about the politics of breastfeeding, where the most passionate passion of a very passionate woman is clearly revealed.

Why Doulas Matter contains much useful information about birth and breastfeeding, woven into chapters about labour, meeting your baby, breastfeeding, and the postnatal period. One thing I felt was missing was a little more history of women supporting women during childbirth, setting the question of why doulas matter in the context of the 21st Century western world.

This book would be particularly useful for people thinking about what sort of support they might need during and after birth, whether or not that support comes from a doula. It would also be useful for both new and experienced doulas who want to reflect on their role. It answers all the questions you might have about doulas, and much more.

[Disclaimer: I was sent a free review copy of Why Doulas Matter by the publishers Pinter & Martin. You can get a copy here, with 10% discount using the offer code SPROGCAST at the checkout].

09 Sep

Book Review: Birth In Focus by Becky Reed

IMG_20160909_133611 What I love the most about this book is all the different perspectives. We have a collection of personal stories and photographs, mainly – inevitably – of births that take place at home. There are births in water, breech births, twins and a caesarean; and the stories are told both by midwife Becky Reed and by the mother, and then in several cases also by the partner, a sibling, and even a grandmother. It gives such a fascinating, colourful, and relentlessly positive picture of birth, in all its amazing variety.

The stories are then used to illustrate and provide anecdotal evidence for the final chapter, which all too briefly explores the theory of normalizing birth, giving a good overview of relevant research, and a great introduction to the subject for parents-to-be and birth professionals alike.

This is a book that is both useful and beautiful, and therefore it has a place in every home!

[Disclosure: I received a free review copy of Birth In Focus from the publisher Pinter & Martin. Order yours here, currently with free delivery and 10% off if you use the code SPROGCAST at the checkout]

01 Jun

Book review: The Secrets of Birth, by Kicki Hansard

The Secrets of Birth is a book born out of Kicki Hansard‘s extensive experience of supporting birthing women. This book is intended for pregnant women, and aims to reveal five secrets that will help them during birth and the transition to motherhood.

The five secrets can be sorted into two main themes: the first three tell us that childbirth is a normal physiological process, and the last two that becoming a mother is a major personal transformation. This is useful and interesting information, and Hansard covers important topics including straightforward birth, hormones, skin to skin, and the benefits of a calm, safe environment, very effectively.

She goes on to discuss the transformational process of birth, a time when women have “nowhere to hide,” (p72) and a great opportunity for growth. I would have liked to read about this in greater detail, as few books (Naomi Stadlen excepted) seem to focus on this except in the most superficial way.

Hansard obviously has a wealth of experience with women in the birthplace, however this comes across as being a fairly small section of society, since the first chapter discusses at some length the pros and cons of engaging a private obstetrician; and of course the majority of her experience refers to her own clientele, a self-selecting group of people who hired a doula. There are several parts of the book which read like a manifesto about the state of birth in the UK, which may not be generally useful for expectant parents. The language and concepts discussed are more appropriate for birth professionals. One could argue that this subject matter needs to be more widely talked about (but one cannot then argue, for example, that the NCT is “too academic” (p16) in their approach).

I am always wary of birth professionals who appear to set themselves up in opposition to other birth professionals, and some of Hansard’s secrets seem to imply distrust of obstetricians (p12), midwives (p15), hypnobirthing (p38), and even the father as birth partner (p32). While much of the book is based in the author’s experience and personal opinion, there are some well-referenced and useful points, and good signposting to a range of sources. The short section on natural caesarean is one of the book’s highlights. The final chapters consist mostly of birth stories, supporting the various points made earlier in the book.

While The Secrets of Birth is probably not the first book I would offer a pregnant woman, I think it would be a very interesting read for doulas in training, or anyone supporting a birth or a new mother.

[Disclosure: Kicki sent me a review copy of her book – thanks!]

29 Feb

Maternity Review: Informed Choice and Personalised Care

Yesterday’s publication of the 2016 Maternity Review, glossily titled “Better Births,” gave rise to a mixed response in the press. The 126 page document is a fascinating compilation of statistics and feedback gathered from parents and health professionals, much of which tells an all-too-familiar tale about disconnected care, conflicting advice, families feeling unsupported, and midwives and other health professionals working within the confines of a complex high-pressure environment.

The main recommendations of the report were:

  • Personalised care, with genuine choice, informed by unbiased information;
  • Continuity of carer;
  • Safer care, with professionals working together across boundaries, and a culture of safety, with rapid and transparent investigation of mistakes;
  • Better perinatal mental healthcare;
  • Community hubs so that women can access a range of care from different professionals, including local midwifery practices;
  • Reform of the payment system for maternity services.

Mainstream media were quick to focus on the proposal that women should have a £3000 budget and a choice of birth places and carers. The Times describes this as women being “handed £3000 by the NHS,” a scenario which seems as unlikely as its tone seems dismissive of women’s abilities to think straight if presented with such quantities of money.

In what I will call the “birth press,” the response was more mixed, with much applause for the focus on personalised care, continuity of carer, and genuine informed choice. Doula and founder of Birthrights Rebecca Schiller wrote in The Guardian of her expectation of “the inevitable barrage of scepticism about whether we can handle the weight of responsibility for our own health.”

Jane Merrick in The Independent immediately obliged:

Do all expectant mothers really want personalised care plans, as proposed by the National Maternity Review? […] Although there is no cost to the individual, placing the burden on mothers, with a price tag attached, is yet more pressure and yet another thing for pregnant women to worry about.

There was a widespread response that, since homebirth is generally cheaper than birth in a hospital, the focus on cost efficiencies would see health professionals encouraging more homebirths, even, according to Kim Thomas, author of Birth Trauma, when this is not clinically appropriate. Many birth workers will be reading this with a raised eyebrow; experience suggests that the interests of the baby always trump the interests of the mother, and it would take a huge change of culture for homebirth to be routinely recommended even when it is clinically appropriate.

Another undercurrent in the response among the birthy people is that the report, and particularly the recommendation of the birth budget, opens up the door to privatisation of maternity care, as well as the use of NHS funds for non-evidenced forms of care. The report itself tells us that parents want to be able to make informed decisions:

Many women expressed frustration over receiving conflicting advice from different healthcare professionals throughout their care. Women and their families told us they need to be able to access
appropriate information to enable them to make genuinely informed decisions about their care and where to give birth. They wanted information to be evidence-based and available to them in a range of
formats, including online.

What this report is calling for is a huge cultural upheaval, as well as a change to the infrastructure of birth in the UK. To be able to offer genuine choice of birth place, we would need more midwife-led birth units and more midwives able to support homebirths. Health professionals across the board would need training to bring about a shared knowledge of the evidence base as well as an understanding of the different perspectives they bring to maternity care. I think perhaps the body of the NHS may be willing, but the purse strings are held too tightly by people who do not have this knowledge or understanding.

Cross-posted from Huffington Post.

25 Feb

Why are twins double trouble?

From conception onwards, having twins seems to raise the bar. Through pregnancy and birth, mothers having twins are viewed as twice as delicate, with their precious double burden, placing a pressure on babies and parents that impacts on the birth as well as the early days and weeks of the babies’ lives.

Google “having twins is” and autofill offers the options of “hard” “so hard” “a blessing” and “a nightmare.” It must be difficult to focus on the blessing when society is so hell-bent on telling you you’re in for double trouble. “The way the majority of people turned my twin pregnancy into a negative really surprised me,” says mother of twins Jen. Another mum Mally adds “It makes you feel incredibly isolated. People are incredibly arrogant to think that they are much better off with ‘just the one’ (at a time).”

Having twins is increasingly common in the UK, partly because the overall birthrate is increasing, and medical advances means that more twins survive when born prematurely. In addition, women tend to wait a little longer to have babies, and over the age of 30 the likelihood of releasing multiple eggs, and therefore having twins, increases. Assisted conception through IVF and fertility drugs is another contributing factor. And more twin pregnancies means more opportunity for little old ladies to hover over your bump or your pushchair, giving advice and telling you what hard work it’s all going to be.

Kate, who has triplets, says: “Apparently it’s perfectly fine for the first question out of the gate to be ‘are they natural?’ Or ‘How were they conceived?’. What difference does it make? But it always feels like a loaded question to me.” It is loaded: with the assumption that you couldn’t have managed this all by yourself, and therefore that you cannot possibly birth, feed, or generally manage these babies all by yourself.

Most mothers who are having twins give birth to healthy babies. Some complications are more common in twin pregnancies, and modern medical practices mean monitoring for high blood pressure (a sign of pre-eclampsia), gestational diabetes and anaemia, all of which can usually be managed. For the babies, the complications that are likely to arise are a result of prematurity or low birth weight.

Giving birth to twins without medical professionals hovering around like cats on hot bricks seems unlikely. Even in the most uncomplicated twins pregnancy, it can be a challenge to avoid being channelled down the high-risk route and straight into theatre for a c-section. The effect of this is that skills and confidence in giving birth to twins without intervention are gradually eroded, and this is self-perpetuating.

I had the lady serving me in the post office say ‘twins? Poor you!’ the other week. I was so shocked I just stared at her. She then said ‘so you’re done now then’. I thought about her comments all day and got more and more upset. (Marie-Claire)

Once the babies arrive, the focus switches to all the things you surely cannot manage to do with two babies: breastfeed, sleep, get out of the house, retain your sanity. Most of the time I talk to singleton mums who tell me that all of those things are difficult; I’m not convinced that they are twice as difficult with twins, and one thing I know is that twins mums are a little better at recruiting the help they need. Life with any number of new babies can be hard work, and it’s hard to define “more” sleep-deprived when you’re as sleep-deprived as it seems possible to be.

Society needs to stop feeling sorry for mothers of twins; it’s a judgement they probably don’t need, and they get twice as much of it.

Thanks to members of Reading & District Twins Plus Club for their input. We’re talking about having twins in the next episode of Sprogcast.
Cross-posted from Huffington Post.

28 Jan

Book Review: The Hypnobirthing Book, by Katharine Graves

Hypnobirthing is something I think I understand, without ever having read much about it. As a general topic, the background theory of pain and fear was one of the first truly “birthy” things I learned about; and this book offers a clear explanation of how that works, as well as the impact of language on a birthing mother’s state of mind. The whole thing is mind-blowingly logical, and Katharine Graves sets out the case beautifully.

I enjoy the writing style, which is, for me, the ideal combination of gentle and no-nonsense. I particularly like the author’s suggestion that if something she suggests seems wrong or sits uncomfortably, to research it and then, if you still want to, reject it: a good strategy for informed decision-making.

The Hypnobirthing Book covers the physiology of birth, the importance of the birth environment, and strategies for getting into a helpful mental and emotional place to cope with the experience of birth. These include many practical things such as relaxation scripts, as well as some strong advice about a woman’s rights during childbirth. As such it is quite an all-encompassing read and I would recommend it to anyone supporting women during birth or teaching parents-to-be about birth, as well as to pregnant women themselves.

As with most largely sensible books about birth, there is the usual dip into alternative therapy, which if it worked would be called therapy. If you have a skeptical nature, just skip this bit, as the rest of the book is superbly useful: clear, direct, and comprehensive.

15 Oct

Book Review: Whoosh! by Katie Brooke

This is an appealing little book, chunky and colourful, with some useful informatoin tucked into its bright pages. It might be intended as a way for a woman to tell her partner she’s pregnant, or to share some basic ideas about how the partner might support her in labour. Full of sweet cartoons, this would also be a great format to tell a child about a sibling on the way (or how about one for grandparents; I foresee a whole range of these!).

I liked the spaces for personalisation and can imagine a couple filling it in together; what a nice way to think about birth planning. I felt it could benefit from a little more substance to make it more of a handy pocket guide, but there is no denying its cuteness.

You can get your copy of Whoosh! from the publisher Pinter & Martin, currently priced at £9.99. Disclosure: they sent me a free copy.

25 Sep

Book Review: Men, Love & Birth by Mark Harris

I have been waiting to get my hands on this book for some time! Mark is my co-presenter on Sprogcast and the last few months have seen him working hard to get the book finished. I’ve seen and heard snippets of it, and I have been intrigued.

Billed as “The book about being present at birth that your pregnant lover wants you to read,” this book is aimed predominantly at men as fathers-to-be and as birth partners. Mark has filled it with explanations of how we relate to people and the world around us, how hormones work for and against us during birth, and what actually happens during the birthing process. As such, it’s a useful read for anyone working in birth, as it does offer some refreshing perspectives.

Mark is garrulous in person and his chatty style comes across well on the page, successfully combining a grounded and down-to-earth approach with occasional forays into “new age wank” [p109], which some readers might find off-putting. I’d recommend sticking with it, as Mark acknowledges that it is hard to find more grounded language with which to discuss the interplay of hormones and energies between a man and a woman in the birth room. I forgive Mark his occasional generalisations about gender roles in the home, as they do make sense in the context of the book; but I wonder how readers would respond if it was a woman writing that “birth has been hijacked by men.” [p56]

The book sets out to give you “the tools to keep you grounded when adrenaline wants to sweep you off your feet;” [p36] and really does achieve that. Chapter two explains the role of hormones and suggests subtle ways to elevate levels of oxytocin; much of this advice is useful for relationships in general, and not just in this specific context. Chapter three advises men about looking after themselves, and the two chapters of dialogue between Mark and a group of men are packed with information, coping strategies, and advice about how to relate to midwives. Mark himself is an experienced midwife and can be considered an authority on this matter!

Chapter seven on breastfeeding is spot-on in terms of the accurate information offered, and covers a fair bit of political ground too. It is sad that NCT Breastfeeding Counsellors are not mentioned as an excellent source of support, and I felt it would be useful to include the helpline numbers, as in my experience, it is very often new fathers who call the line seeking help on their partners’ behalf.

Men, Love & Birth is humorous, practical, and pitched at just the right level for men who want to figure out what their role is in birth and early parenthood. It’s also rather saucy in places.

Disclosure 1: I was sent a free review copy of Men, Love & Birth by Pinter and Martin Publishers. To order your own copy with a 25% discount, just follow the link and use the discount code KH25 at the checkout.
Disclosure 2: You can’t not like Mark. I’d recommend going on one of his super workshops.

13 Feb

“I knew I only wanted her as my doula.”

After a difficult, highly medically intervened birth with my first son, I wanted a different experience and had read that Doulas have a high success rate in low intervention births.

I knew Karen after the birth of my first child as she had supported me with breast feeding issues. We have stayed in contact and I knew I only wanted her as my doula.

Karen was there throughout, offering calm and rational support to me and my partner. She reminded me that I didn’t want an epidural and timed and monitored all of my contractions as I never made it to the delivery suite I was not really monitored by NHS medical staff. I think if Karen hadn’t been there, there would have been more supervision and intervention by the ‘professionals’

Immediately after giving birth, Karen helped to get my baby onto my breast, but then she stepped back and let me and my partner enjoy our first few moments with our new baby.
Karen seems to have a sixth sense about when we needed her.

I found my labour to be a much calmer experience where I genuinely felt in control.

Karen is one of the calmest people I have ever met which is why I wanted her at the birth of my second child, She is also an experienced post natal doula and breast feeding counsellor so I knew she could meet a variety of mine and my families needs.
She has a professional but warm approach and I felt completely comfortable around her from the first day I met her. She has a very gentle approach to children and we share many values and beliefs around families which I think helps, but I also know she is not judgemental in any way.

– Helen, December 2014

13 Nov

Birth Plan Prompt Sheet

Birth planning is a vague science; some birth workers now refer to “birth preferences” instead, and some prefer to avoid this sort of planning altogether. I’ve found a few resources online including this comprehensive tool from the NHS, and cobbled together a list of prompts so that my clients and I can go through it together and make something that is completely tailored to their needs. I’ll be taking several copies with me to the birth!

Birth Plan

Early labour – where?

Where to give birth – MLU/delivery suite/pool etc

Who do I want to be with me?

Equipment I plan to take with me

Intermittent/continual monitoring of baby during labour

Keeping active during labour

Positions to adopt

Trainee midwives/doctors in the room

Immediate skin to skin

Pain relief preferences

Episiotomy

Third stage – active/managed

Breastfeeding

Vitamin K

Any special requirements