Go into any dedicated pregnancy or parenting support group and you’ll see posts regularly popping up asking about “natural” induction methods, ways of encouraging baby to be born earlier, ways to get yourself more dilated, more contractions (or stronger contractions), more quickly into labour etc etc etc...
Occasionally  you may see a comment stating that “natural” induction methods don’t work, or that baby is the one who initiates labour when he/she is fully ready to be born, but for the most part people comment with what they did regardless of if it appeared to work or not.

The truth is that they don’t actually work, 100% of the time these people who promote them went into labour afterwards BECAUSE their baby was actually ready to be born.

Current research shows that, in the absence of premature labour, that it is actually baby who initiates when he/she is physiologically ready (meaning fully mature and ready to live outside the womb) by releasing specific proteins from his/her lungs that tell the mothers body that it is time for birth. Prior to this the mothers body has been slowly preparing for the birth by building up its own hormone levels (and lowering the levels of those hormones that are not necessary for labour) so that when baby is ready labour can begin within a few hours or days.
What this means is that all of those “natural” induction methods and ways of supposedly making your body ready quicker are pretty much useless.

While they may make you feel like you are doing something constructive and proactive to help you really aren’t doing much – if anything – at all and the majority of the time they just leave you frustrated, tired, exhausted, upset, physically and emotionally drained and sometimes you are left feeling like your body is broken because nothing has worked, you’re still pregnant and no, or very little, progress has been made.

If none of those methods work, where does this leave you though?
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There are many other things that you can do instead which will prepare your body a lot better for your upcoming labour and birth:

• You can rest your body: with sleep, sitting down when your body tells you that it needs to sit and rest, reducing your current activity level (let’s face it, life in this day and age is normally hectic, especially when you have other children or are still working, and it can be hard to slow down but for your health reducing your workload, even a little bit, can help during these last days and/or weeks of pregnancy) by slowing down your busy everyday life to a somewhat reduced pace.
• Relaxing: not only what was mentioned above re rest, but also by doing things that leave you feeling relaxed and calm and ready to face whatever life will throw at you.
• Eating: not just eating for the sake of eating, but eating high energy (and good for you) foods that not only taste good but also give you that boost to your energy levels that you will need when labour begins. Contrary to popular belief foods that are healthy and “good for you” don’t have to taste like crap or be plain salad and meat, they can be really tasty and include all sorts of fruits, vegetables, grains (if you are gluten intolerant or have caeliacs there are other options available), dairy (there are non-dairy options available for those cannot or do not wish to consume it) and meat products (again there are non-meat options available for those who do not consume meat). Google “healthy high energy meal recipes” and a plethora of recipes and meal ideas will come up, some of them are so simple (and taste so good too) that even the worst home cook can make something palatable that tastes great and fills you up while providing energy and those much needed vitamins and minerals for your health.
• Hydrating: make sure that you are consuming enough fluids. The average person requires 1.5-2ltrs of water a day to remain healthy, there are many who don’t drink that much though and as a result are at higher risk of dehydration. Some beverages (for example those containing caffeine like tea, coffee and energy drinks) can have a diuretic affect making fluids pass through your body faster than normal, reducing the amount that your body absorbs as a result, so reducing your consumption of those beverages can be a good idea (note: I do not say stop consuming them completely, as a coffee and tea drinker myself I understand fully how much those types of drinks can sometimes be needed just to get through the day). If plain water is unpalatable for you (you can’t drink it plain for some reason) there are many flavour enhancers available on the market that you can use to flavour it with. Alternatively using a sparkling mineral water (with or without bubbles) and one of those flavours can be a good option as well, with the right flavouring the bubbly ones can taste like soft drink without having all the sugar that soft drink contains.
• Doing something that YOU enjoy: do something that you enjoy every single day, whether that’s going for a walk, doing something crafty, getting a manicure and/or pedicure, going shopping, doing a pregnancy safe workout, yoga, meeting up with friends for a coffee or day out away from the kids etc, just do it for you.
• Focus on your body and your baby: start listening to what your body and baby are telling you – is your body extra tired or run down? If so it’s telling you that it needs to rest. Is your gut instinct telling you that something isn’t quite right but you can’t really tell exactly what is it? Listen to it and get checked out – thoroughly. If your body is telling you that you need to get up and move then follow its instructions.
  When focusing on your baby pay attention to his/her normal movements throughout the day – when is he/she the most calm and quiet? When is he/she the most active? Under what circumstances do they change from active to calm and back again?  Is baby more or less active while you are moving? And is baby more or less active when you are resting/laying down? Does baby react to what you drink or eat?
  By becoming more in tune with your body and your baby you’ll be able to recognise, instinctively, when something isn’t right and act quickly to get it checked out (and don’t forget to push for a proper in-depth check up, not just CTG monitoring and palpation as both of those have been shown to not improve outcomes in pregnancy).

 
Lastly I would like to say that while these last few days/weeks can be some of the longest and most frustrating/draining of your life you only get to do this once with this baby – make the most of it and try to find ways to enjoy this time while baby is still inside you.

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Anyone who knows me well will know that I am a huge advocate for respectful, evidence based, consensual medical care. You would also know that I am hugely against inadequate medical care when medical care is absolutely necessary and INSANELY AGAINST biased and coercive based medical care.

If you didn’t know any of that, then congratulations! Now you know and I won’t have to say it all again later on.
Before I really get started on what this blog post is about though I’d like you all to picture something in your minds for me:

• A man goes to the emergency department of his local hospital at night for excruciating lower abdominal pain, non-stomach-bug-related vomiting and inability to walk without aid.
  The pain doesn't respond to any of the standard pain relief medication normally given when people present with severe (currently) unexplained pain – paracetamol and ibuprofen doesn’t work, the maximum doses of endone or buprenorphine doesn’t work. Usually when that happens the nurses consult with the on call registrar and stronger pain medications are ordered (morphine, fentanyl etc).
  The man gets to stay in the hospital for a couple of days or so days with regular morphine and/or fentanyl and/or every other strong pain relief available to try and get the pain under control while having in depth investigations to find out exactly what is causing the pain (by in depth I don’t just mean the standard urine and blood tests and maybe an ultrasound – I mean the full kit & caboodle testing to rule out everything from appendicitis to cancer to an obstructed bowel). The man walks out of the hospital with his pain under control and either a diagnosis or a referral to a specialist who can diagnose him.
  
  

Now I ask you to picture this:

• A woman with a pre-existing incurable and generally painful disease goes to the emergency department of her local hospital at night for excruciating lower abdominal pain, non-stomach-bug-related vomiting and inability to walk without aid.
  She is only given one endone every 4 hours and two paracetamol every 6 hours. When she tells the nurse that neither of those pain medications is helping at all she is given a heat pack and told “that will help” (what the nurse hasn’t been told is that the patient spent the previous 6 hours before rocking up at the hospital at home taking the buprenorphine she normally takes for severe pain related to her pre-existing disease with a heat pack so hot that it is burning the skin on her lower abdomen). Only the basic tests (urine, bloods and an ultrasound – a basic one that cannot pick up the disease that she has and has been proven in the past to not show serious things that were happening within her body) – are done and she’s left to suffer and cry alone in her bed on the ward while still in excruciating pain. After about 12-18 hours, and maybe in a rare case after a second overnight stay, she is sent home and told to “wait it out” as it is assumed to just be a 100 times nastier than normal flare up of her incurable condition – no in depth testing has been done, the pain is still not under control and the woman in question can barely walk let alone speak up for herself as she’s pushed out the automatic doors with no real help and told to see her GP in the morning, all so the hospital can make room for someone “who really needs the bed”.
  
  

After visualising both of those scenarios can you see the difference between the two? The differences between the tests that were done and the treatments that were given? In how both patients are cared for and the results that both received? In when and how they went home?

The man received better treatment, his pain with an unknown cause was taken much more seriously and given top priority to find out what was wrong, and he was given adequate pain relief and left the hospital with the pain in control and a plan in place.

The woman wasn’t given adequate treatment, was given inadequate pain relief, was brushed off and mostly ignored, and, potentially even more dangerously, her pain was solely attributed to a pre-existing condition with only minimal investigation done - what if it had been her appendix getting ready to burst? Or what if part of her bowel that wasn’t visible on ultrasound had ruptured? Or what if her fallopian tube and ovary had twisted right behind her uterus where it can’t be seen clearly and had gone into torsion which can result in the loss of an ovary if it isn’t picked up in less than 6 hours of onset and can be deadly if it is left untreated? All of these are valid concerns but sadly a lot of them are brushed off and ignored if there isn’t anything visible on an ultrasound or if the symptoms don’t exactly match what most doctors have been trained to recognise.

If you can’t tell already I’ll explain this now – there is HUGE inequality between how men and women (and this is not even going into how those who don’t associate as either are often treated!) are treated when it comes to the quality of the medical care given to them.

In some ways - and some places - we are still very much in the dark ages with how women experiencing reproductive, lower abdominal and pelvic issues are treated in hospital settings. This is not to say that there aren’t some wonderful care providers out there because there are, I’ve personally met some of them, but they are few and far in between and the chances of one of them being on duty when you end up in hospital are really slim.
You may think that these are just random scenarios created in the fertile darkness of my crazy mind but I must sadly inform you right now that this isn’t the case.

These scenarios are both based on very true stories – the inspiration for the man’s scenario came from a combination of my own husband’s experience and the experiences of random men who have shared their stories online, the woman’s scenario actually happened only this past week, and the woman’s scenario is also, I am very sad to report, the real life outcome that happens to hundreds of women every single day all around Australia.

When I randomly questioned a group of women (some who have children and some who don’t have children, some with a painful health condition and some without any known conditions at all) about the two scenarios above the answers were empathetic towards the woman’s scenario and many shared their own experiences.

• W- “It is like you have written the experiences of myself and my husband”
  
  
• Another, Anonymous, responded with – “The world is sexist as if a man says he is in pain he is surrounded by help but a woman has pain she is told to deal with it.”
  
  
• P says – “It's BECAUSE pain associated with women's reproductive organs is accepted as "normal".
  
  
• From B – “I'm a part of a huge Perth group and I honestly just saw a story like this on there, but it was a mental health thing. They kept the person in overnight but then said they assessed her and she wasn't deemed worthy of a bed and was discharged even though she went in with suicidal tenancies - yet someone else (male) posted their experiences with the same hospital in the same mental health unit and couldn't stop praising the hospital saying how great they were for him and how they must have been leaving something out for them to have kicked her out. Yet, when copious amounts of other women came along and said they experienced the same thing, said male 'joked' that men have it harder anyways which is why they're better looked after.
  I know it's not the same thing but in some aspects is because it shows that there are some discrepancies in care.
  I have seen this before myself and been a part of it. A few years ago, I presented to the ED with chest pains and numbness down my arm. I got taken in 2 hours later, put on an ECG machine and monitored for an hour maybe 2 before told I could go home. Given pills for the pain and dizziness I was feeling at the time too. Nothing worked and I felt so horrible and tired that while on the ECG machine, I fell asleep. Next morning, woke up and felt horrible and the pain wasn't gone but dulled down.
  A couple years later, XH goes to hospital with exactly the same as what I was feeling and ended up staying overnight and having all tests run on him under the sun (Luckily they did cause they found gall stones but still) and I remember just saying to him that he was get preferential treatment cause he was a male - little did I know how true it actually felt.”
  
  

Every single day in Australia women are treated as second class patients compared to their male counterparts and have their pain ignored, they are told to “suck it up”, that pain is “normal” (pain is not “normal”, even the scientific literature agrees that pain isn’t “normal” and is a symptom of an underlying issue that needs to be treated) and that we just need to live with it, to go and see a psychologist or therapist because it’s “all in our heads” and if we “fix our heads” the pain will “go away” (it won’t, physical pain can’t just be stopped by a psychologist or therapy, it needs adequate physical medical treatment and pain relief as well and even then it may not be “fixed”).
What can you do to change this? There are several things and I’ll outline them below.

• Contact your local members for parliament. By sending your local members for parliament letters outlining your anger at how women are treated in the healthcare system you can help to promote more awareness by making them aware. Not all of them will respond or take it seriously, but some will take action on it.
  
  
• If you or someone you know has been on the receiving end of this sort of treatment lodge a complaint with your local hospital. While most of the time you’ll only get a generic apology letter it is known that the more times that complaints are made, and the more people who kick up a huge stink about how they have been treated, the more that problems are taken seriously and the better the treatment will be for similar scenarios in the future.
  
  
• If you or someone you know are currently being treated inadequately in a hospital setting and located in QLD you can call 13HEALTH and quote “Ryan’s Rule” (you can find the details of Ryan’s Rule here - https://www.health.qld.gov.au/cairns_hinterland/html/ryan-home)
  
  
• If a specific doctor has treated you or someone you know like this you can lodge a complaint with the Medical Board (http://www.medicalboard.gov.au/~/link.aspx?_id=60F806737FE14B28AF314FB306B4BFBE&_z=z) and also with the Australian Medical Association (https://ama.com.au/tas/health-complaints)
  
  
• Share awareness amongst your friends, family and anyone else who will listen. Many won’t be interested and some may even ridicule you but there will be people who are receptive to what you have to say and will listen and take action themselves.
  
  
• Continue to advocate for yourself and those who rely on you for their care. If you don’t advocate for yourself you can’t change how you are treated. As part of advocating for yourself you can ban any practitioner from treating you or being in charge of your care and can request another practitioner if needed. You have the right to receive the best healthcare and treatment possible (and also to refuse any healthcare that you don’t want to have). The more people who advocate for better healthcare for themselves and others the more that Australia’s care providers will see how much people aren’t willing to put up with substandard treatment.
  
  

Lastly I want to say this – in order for the treatment of women in the healthcare system to be improved those who are in charge of our care need to be taught that we women are equal to and just as deserving of high quality medical treatment as our male counterparts who are also patients. They need to learn that our pain is real, that it exists physically and that a lack of adequate treatment is not only detrimental to our health and well-being (as women) but also to that of our families and friends too. Care providers need to take our pain seriously and provide adequate pain relief (not just minimal pain relief) and need to be educated on the various diseases and conditions that can cause it – not just the basic information from one paragraph in a medical text book but actual first hand information provided by a specialist in that particular field. They also need to respect us not only as fellow human beings but also as people who are intelligent, educated, able to recognise when something is wrong with our own bodies (it is our body after all and no one knows it better than ourselves) and able to make informed, intelligent and needed decisions for ourselves without being coerced, manipulated, forced or scared through fear mongering into making a decision that we otherwise wouldn’t make.

Today I took part in a discussion about obstetric violence and the doulas role when witnessing obstetric violence. It was very interesting and also sad, frustrating and made me a bit angry reading the personal experiences of going through obstetric violence from some of my fellow doulas, as well as the first hand witness accounts from those who has seen it done to their clients.
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Obstetric abuse is not new to me; I have been through it myself and know many others who have also been through it. Seeing it discussed openly and respectfully with suggestions of things that we (doulas) can do to help any of our clients who may be on the receiving end of it and hearing about the different ways that obstetric violence can be presented was very helpful and I know that I will be taking away much of what I have read and using it to help any of my future clients who may experience obstetric violence (I bloody well hope that none of them do!)

The biggest issue discussed was about many of those who experience obstetric violence AND have a doula supporting them while it is happening – specifically about the client blaming the doula for not stopping what happened and what we, as doulas who may be witness to this awful practice in the future, could potentially do to not only stop it from happening but also to potentially prevent it from happening at all. The one thing that I noticed most about this part of the discussion (and from a documentary that discussed women’s experiences of obstetric violence) was that the doula was often blamed for not stopping it, not preventing it, not fixing the problem.

Having personally experienced "birth rape" during the birth of my youngest child - I didn't have a doula during that birth and I did blame my husband for a LONG time afterwards (and still have some residual anger towards him that I have not yet been able to release, it has been nearly 6 years now and the long term negative effects of that experience still affect me to this day - I have forgiven my husband however, and I have no doubt at all that had I had a doula I would have blamed him/her for not protecting me instead of my husband) for not doing anything to stop what was being done to me (in his defence he truthfully had no idea what was going on and was focused on our baby who wasn't breathing yet and needed resuscitation). I blamed the person that I trusted the most during the most vulnerable moment of my life for not protecting ME, for not SAVING ME, for not ripping that fucking obstetric registrar away from me and ripping his damn head off. I still blamed the registrar for his actions, but most of my blame went to the person who was supposed to be my protector.

We as women who have experienced obstetric abuse still blame our care provider for what happened - that's obvious - but we also blame the person that we trusted most to protect us, either our partner, a family member/friend  or our doula (if we have one), because in our eyes they DID NOT protect us and they were supposed to.

Blame, choosing one person to blame for what happened, is (unfortunately for us) normal and is part of the grieving process, it's awful for us who are on the receiving end. And we are grieving after what happened to us – we are grieving for what should have been, grieving for the pain we have experienced that we shouldn’t have had to experience, grieving for everything that should have been perfect and right and instead went so very very fucking wrong.

WE the doulas become the scapegoats instead of the other support person (if there was one) just because of our presence in that room, WE become the ones who SHOULD have done more, SHOULD have been better, SHOULD have been able to FIX whatever was happening, SHOULD SHOULD SHOULD have done SOMETHING, ANYTHING to stop what was happening from happening in the first place. WE doulas are the ones who are trusted to protect our client, to keep our client safe, to tell our client what is happening and when. WE doulas are often expected to do more and be more than we actually are – like that old blog post about airy fairy doulas full of unicorns and rainbows from way back in 2014.

All that we as doulas are physically able to do in the birthing room is to tell our clients what is happening, speak up (out loud so that everyone present is aware of what we are saying) and ask our clients if they are ok with what is happening or if they wish for it to be stopped.

We cannot control what their care providers do.

We cannot physically stop their care providers without risking being charged with assault ourselves and as a result leaving our client alone, vulnerable and still in the hands of that care provider (here in Queensland, Australia we are now not "allowed" to even raise our voice in anger or frustration at a care providers actions, regardless of if we are in our role as a doula, as a patient or as the support person/advocate of a family member, without risking being potentially charged with abuse against that care provider ~ carries the risk of spending up to 14 years in jail if we are charged), we can do what we can within the limits of the current system wherever we are but we alone cannot change it, we can only create awareness and make sure that our clients know all of their options.

The harsh reality is that there isn't all that much that we doulas are able to do in the moment and we cannot stop all of it from happening. All we can do is support our client, inform them and their other support people, tell our clients if we see that something is being done without their consent and remind them that they can say NO and STOP and can kick their care provider out of their room if they don't stop what they are doing.

After the birth we can register complaints with the hospital and the relevant medical authority as witnesses of what occurred and we can provide a witness statement that our client can use for what we saw happen. We can support our client physically and mentally/emotionally and we can find suitable resources for our client so that our client can hopefully begin the process of healing, if not physically then at least mentally/emotionally.

It kills me inside that I cannot do more. I wish I could do more. I wish that I could save every single woman from experiencing anything like what I went through – I know that I can’t but the wish is still there – and all I want, more than anything else in this world, is to see those care providers who practice obstetric violence be appropriately punished for their actions and for all of the damage, pain and heartbreak that they have left in their wakes.

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Just a little end note:

-  If you or someone you know has experienced obstetric violence please lodge a complaint against the person who perpetrated that violence with both the hospital that it occurred in and also with the relevant regulatory authority for that persons profession.
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- If you or someone you know has experienced obstetric violence and is struggling mentally/emotionally please encourage them to seek help from a maternal mental health counsellor/psychologist with experience in treating complex PTSD caused by obstetric violence/birth trauma.

Recently I saw a question on a pregnancy and parenting page asking about being induced at 37 weeks for a “Big Baby” (estimated to be around 9ish pounds/4-4.5kg by 40 weeks). This particular mum-to-be didn’t feel comfortable with being induced then, and did say that, but was seeking advice and support that it was the right thing to do.
I did what I usually do, I advised of the risks, the benefits, that the estimated weight was not “Big” at all and many women birth babies even bigger than that vaginally and after spontaneous labour with no issues at all, and reassured the mum-to-be to follow her heart – in that if it didn’t feel right then tell her doctor that she didn’t want to be induced and would wait until baby decided to arrive on his/her own.

This kind of question is becoming more and more common these days, women being told they are having “Big Babies” estimated to be between 9 and 10pd (which isn’t “big” as such, it is just another variation of normal size) and will be induced between 37 and 38 weeks gestation because of that. These women are apparently not being given any choice in the matter, they are being told it WILL happen, that they NEED to be induced as if they don’t their baby will get stuck (shoulder dystocia) and die because it is too big to be born vaginally.

For the record, this is not evidence based medical practice, this is fear mongering and scare tactics and outright lying by medical professionals in order to get an expectant mother to do what THEY want her to do. A 9-10pd baby is not big, 11+ pounds is “big”. 9-13pd babies are born all around the world all the time without any issues when the mother is able to move around in whatever way she finds comfortable and as a result assist the baby in manoeuvring through the birth canal. In these cases there is no respect for a mother’s decision making, no allowing the woman’s body to do what it was made to do, preventing the natural physiological process of birth from occurring when the time is truly right and making women around the world afraid of a natural body process. To add to this a small baby is just as likely to get stuck as a larger baby if baby’s position and mothers position while birthing are not ideal. There are ways to prevent it and to reduce the chances of it happening, and early induction is not one of them and has a higher chance of shoulder dystocia by preventing the mother from adopting natural birthing positions due to the CTG monitoring and in many cases an epidural as well when the induced contractions become too much for the mother to bare and increasing the chances of baby being malpositioned when artificial rupture of the membranes (amniotic sac) is done as part of the standard practice of induction, traumatic physical and emotional intervention with the use of ventouse (vacuum), episiotomy, forceps and physical pressure on the mothers abdomen, and fetal distress from the induction itself resulting in either the above mentioned interventions or an emergency cesarean occurring.

But what I've mentioned just above is not what prompted this blog post. What prompted this is the lack of up to date knowledge in obstetricians and other mothers who were “fans” of this particular page and answered this particular question.
These “fans” were promoting induction at 37 weeks with no major risk factors or true need, stating that it was “term” and “baby would be fine”. This information is incorrect, not only have the WHO and ACoG, within the last 12 months, updated their guidelines of when “term”, “full term” and “post dates” are, but an induction at 37 weeks for no reason other than an ultrasound weight estimate (proven to be inaccurate in the majority of cases) shows that baby is measuring larger than average. The new guidelines state that “term” is now from 39 weeks to 39+6 weeks after recent research showing that a lot of important brain development occurs in-utero between 37 and 39 weeks and babies who stay in longer have less physical issues than babies born before 39 weeks gestations (eg feeding issues, regulating of body temperature issues etc), “full term” is now from 40 weeks to 42 weeks gestation, and “post dates” is now from 42+1 weeks onwards.

What does this mean for pregnancy and birth and going past 41 weeks gestation? Well frankly it means that every woman should now have a much higher chance of being able to go into labour naturally when their baby and body are really ready without the need to be induced, whether it is at 37 weeks that their baby decides that he or she is ready, or at 43 weeks, AS LONG AS all obstetricians and doctors follow the ACoG and WHO guidelines, which unfortunately for all of us women is not the case. Sadly most obstetricians and doctors do not follow these guidelines, they follow their own guidelines and the hospitals outdated policies on “management” of pregnancy and labour. And “management” it is, they are “managing” us like animals, inducing when they want, cutting us open when they want, giving us medication when they want, telling us what we can and can’t do, scaring us and putting the fear of death into us, only telling us what they want us to know and not what we need to know, essentially taking away our basic human rights and preventing us from making our own truly informed choices and decisions by not providing all of the information and only telling us what they want us to hear.
There are of course exceptions to this, there are some wonderful and truly amazing obstetricians and doctors out there who treat women with respect and dignity that they deserve and do everything that they can to inform women of ALL of the risks and benefits, accept a woman’s choices without trying to change her mind, support her unconditionally in those choices and go out of their way to try and give the woman the birth that she desires. They are few and far between, a dozen or so in every state, a few hundred or so in every country out of a hundred thousand or more obstetricians and doctors around the world that are trained in high risk pregnancy and birth.

“So what?” You might say, “They are trained in pregnancy and birth, they know what they are doing.” Yes, they are trained, in “HIGH RISK” pregnancy and birth, the types of pregnancies that might be dangerous for mum and/or baby. They are NOT trained in natural physiological childbirth, they are not trained in the kind of birth that does not need drugs to make it start, that does not need intervention or constant monitoring, that does not result in a mother on her back in a bed unable or "not allowed" to get up and move around and physically help her baby to get into a better position for birth, they are not trained in allowing a woman’s body to do what it was made to do and treat every woman the same as if they have the same risks as every other woman. Every woman, every body and every baby are different with different risks and different needs, we do not all fit into same mold (eg not everyone has a 12 hour or less labour just as not every woman has a very long 55+ hour labour), but obstetricians and doctors are trained to fit everyone into the same mold with the same risks regardless our own individual risk factors, body shapes, histories, abilities and needs.

How can we change this? How can we make pregnancy and birth an individual thing again? How can we make obstetricians treat us with the respect and dignity that we deserve? How can we make them respect our decisions and choices without trying to scare us or bully us into what they want us to do? The answer is that every woman and every man must make the decision to stand up for themselves and their partner, to say NO, to make obstetricians and doctors understand that it is NOT a medical professionals or hospitals decision to make on when a baby comes into the world, to make obstetricians and doctors stop scaring women with generalised risks and outright lies, to make the maternity system in whatever country you live in stop and listen and change its policies for the benefit of ALL women, to make pregnancy and birth about the woman once again and not about the medical side of things. Women everywhere need to take their bodies back, to make sure that everyone knows that SHE makes the decisions regarding HER body and HER baby, and that hospitals, obstetricians and doctors are NOT the ones to make the decisions. Even in a life or death situation the mother has the right to decide what is to be done and should be given the chance to do so, even if there is only a minute available for her to make that decision that will affect her and her family for the rest of their lives, she should be the one to decide, not someone else who doesn’t have to live with the consequences.

So there you have it. We live in a medicalised world that is slowly trying to remove all natural bodily autonomy from women, that is trying to stop women from being able to choose if she has an induction or cesarean or waits until her baby and body decide that it is the right time, a world where women are being scared and bullied into inductions and cesareans instead of being given the right information and support to make a truly informed decision over their bodies and method of birth, a world where women are ridiculed for their decisions, denied good care, denied the right support that they need and are traumatised on a regular basis when they are in the most vulnerable state and position.

Can you imagine a world where women are supported personally in a way that fits their individual needs and wants and are empowered in the process? Can you see a world where a woman is able to choose whenever she wants if she has a home birth, an unassisted birth, a hospital birth, an induction or a cesarean without being judged, ridiculed or traumatised in the process? Where she is truly informed about the risks and benefits of every procedure instead of only informed that  the medical professional feels is all she needs to know? Where she can birth however she wants without being lied to or scared by medical professionals? Where she can trust those who are caring for her and supporting her to give her the power to make her own decisions regardless of where she lives, her body shape, her previous history, or what she looks like? I can, I can see that world, our world can become that world. If we all worked together to make changes, if we all supported one another in our individual decisions regardless of what they are, we can create that world and make it ours.

Jenna Edgley
Student Birth Doula
Placenta Encapsulator
FOOTPRINTS & RAINBOWS

(***Quick note, yes it is ideal to be able to quit smoking before or as soon as possible after you find out you are pregnant, but for many who do smoke it is extremely difficult and some people do find it impossible to quit smoking, this post is not meant to give people an excuse not to quit smoking, it is designed to help those who genuinely have not been able to quit smoking for whatever reasons, and hopefully help them to cut down and eventually quit on their own when they are ready to do it.***)

Smoking during pregnancy. We all know it’s bad for our health and bad for our unborn baby’s health. So what happens if you are unable to quit when you find out that you are pregnant?

Rather than go into all the bad things that can happen I am going to tell you 10 things that you can do to reduce your risks while you are still smoking and will hopefully allow you to cut down gradually and eventually quit smoking on your own, in your own time, when you are well and truly ready to finally throw that packet of smokes/tobacco away for good, and if you aren’t ready yet then that is ok as well. It takes time to quit and may involve many attempts at quitting in the process. The more times you try to quit the easier it will be when you do eventually stop smoking, and you will have a better chance at quitting for good because you will already know what works and what doesn’t work for you.


1. Set yourself a limit of how many cigarettes that you can smoke a day for each week of your pregnancy. If you are used to smoking a pack a day (20 or more) start with the number that you would smoke on an average day and reduce that number by 1 smoke a day for each week or fortnight, eg 1 week or fortnight you will smoke 20 a day, the next week or fortnight you will reduce it to 19 a day and so on. If you found out you were pregnant at 4-5 weeks gestation and you smoke 25 cigarettes a day and choose to drop one a week then by the time you reach 25 weeks pregnant you could potentially only be smoking 5 cigarettes a day – not too bad in my opinion, and that means that by the time your baby is born you could potentially have managed to be down to only 1 smoke a day each week or may even have managed to kick the cigarettes for good!

2. Take care of yourself. While cigarettes aren’t good for your health there are other things that you can do to make yourself healthier while still smoking. Moderate exercise and eating healthy good quality foods are 2 things that you can do. Pampering yourself each time you manage to drop 1 cigarette, by treating yourself to a manicure/pedicure, a facial, a massage or a movie, you can make yourself feel good and reduce your stress levels, and by rewarding yourself each time you reduce your daily number of cigarettes that you smoke you are one step closer to being able to successfully quit. Each time you have a cigarette you are rewarding the nerve centers in the brain that have become addicted to the nicotine, so by rewarding yourself when you don’t have one you are slowly transferring the reward addiction across to something healthier, and better for you.

3. Don’t use junk food as a reward for not smoking! It is easy to do and it tastes good at the time but it isn’t good for your body either. Instead of rewarding yourself with junk food reward yourself with something healthy that you really like – for example a healthy food, like a fruit, that you really like but it is a seasonal item and to buy it when it isn’t readily available costs a lot more so you don’t normally buy it, instead of buying junk food spend that extra bit of money on that fruit. Your baby and your body will thank you for it.

4. Don’t beat yourself up if you have a bad day and smoke more than you had planned to. Shit happens, and sometimes we need to something like that to make ourselves feel better. Just start again the next day and do some things to make yourself feel good for each smoke you don’t have after that.

5. Talk to your family doctor or Obstetrician. They may be able to suggest some ways to help you either to cut down or to make yourself healthier even though you are smoking, or they may be able to refer you to someone that you can talk to who can provide advice for you. Sometimes we have underlying reasons for our smoking that can make it extremely difficult to quit, and talking to someone, even if it is a therapist or psychologist, can help us to acknowledge those issues which can pave the way to a healthier and happier you and may even help you to start the journey to quitting smoking.

6. Drink plenty of fluids. Smoking can cause snoring and constant coughing which can affect your hydration in a negative way. Drink 2-3 litres of water a day to make sure that you stay well hydrated and to prevent dehydration. If you struggle to drink plain water then try adding a small amount of low sugar cordial (one cap full) or a small amount of fresh fruit juice (50ml maximum) to your water for a bit of flavouring.

7. If your partner or other people living with you smoke ask them to smoke outside and away from you. It is well known that when you are around others who are smoking then you are more likely to smoke as well, and it is bad for a baby’s health to be exposed to cigarette smoke in the home so this is good preparation for when the baby arrives. Ask them to support you in this, tell them that it is important to you and make sure that they abide by it. If they refuse to abide by it then make sure that you stay away from them when they are smoking.

8. Set a goal for what you will do with the money that you will save. Setting a goal can help a lot when you are trying to cut down or quit smoking. If you normally smoked a pack (20 or more) a day but you are aiming to be smoking only 5 or 10 a day (or even less) by the time baby is born you have the potential to save quite a bit of money by the time your baby arrives. If you are spending an average of $100 a week on cigarettes and manage to get down to only smoking half of what you used to you will be saving $50 a week. If you get to that point by the time you are 20 weeks pregnant then you potentially have another 20 weeks to go where you will be saving $50 a week, over the full 20 weeks that amounts to a total of $1,000 that you have in your pocket! If you put that $50 a week into a savings account then by the end of your pregnancy that could pay for a lot of nappies, wipes, formula and other items, or you could use it to pay for a holiday or to pay out some debts. It gives you something to look forward to and can make you feel good about yourself to see the amount of money in your savings account getting bigger each week.

9. Take it 1 day at a time. It is very hard to cut down and even harder to quit smoking, and any other addiction as well. If you don’t succeed one day then start again the next day. You will find that the days that you succeed in cutting down start to happen more often until eventually you succeed in cutting down every time you put your plans into action. It may take a while, but eventually you will get there.

10. Don’t give up! It is so easy to give up when things are hard or difficult to do, but it is the worst thing that you can do, for both yourself and your baby. As said in an earlier section, if you fail one day then start again the next day, and the next day, and the next day. Keep trying and you will eventually succeed. It takes hard work to achieve something that you really want and you will feel really good about yourself if you keep at it and make it work. Find a buddy that you can talk to when you are having a bad day or week, it can be your partner, a close friend, or someone online that you don’t actually know in person but trust enough to talk to on a regular basis. Talking to someone can help a lot on those bad days and can help you to pick yourself up and try again.


“If you fail, don’t give up and walk away. Pick yourself up, brush yourself off, straighten your back and shoulders, lift your head up and try again. Keep trying until you succeed. It may take a thousand tries but there will come that last time when you get it right and it will be worth it all.”


Jenna Edgley
Student Birth Doula
FOOTPRINTS & RAINBOWS