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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​​"Your birth. Your body. Your baby. Your choice. Your way. Even when the shit hits the fan and you have to change your original plans."


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Do you want 1-on-1, 100% focused on YOU support during your pregnancy and birth? Do you want someone willing to listen who really HEARS YOU? How about a source of unbiased up to date information? Someone who doesn’t have a hidden agenda? Who trusts in, and believes, in you? Who doesn't pretend to be someone that they aren't? Someone who will give their all in supporting you to the best of their ability and beyond?
If your answer is a resounding YES!!! and you live on the North Side of Brisbane send a message TODAY to arrange a no obligation interview.​

​Most people will have never heard of it, some may have experienced it but not had a name to call it, some may think it’s just a crock of shit and that women (in general) should just be grateful that they are alive and have a healthy baby (assuming that the one who experienced Obstetric Violence actually did have a healthy baby which I do know for a fact isn’t always the case).

So what is it?

According the MidwivesVictoria1 blog maintained for the Midwives in Private Practice (MiPP) collective Obstetric violence is “the act of disregarding the authority and autonomy that women have over their own sexuality, their bodies, their babies and in their birth experiences.

It is also the act of disregarding the spontaneity, the positions, the rhythm and the times the labour requires in order to progress normally when there is no need for intervention.

It is also the act of disregarding the emotional needs of mother and baby throughout the whole [childbearing] process."

The World Health Organisation2 defines Obstetric Violence as “disrespectful, abusive or neglectful treatment during childbirth in facilities” and “included outright physical abuse, profound humiliation and verbal abuse, coercive or unconsented medical procedures (including sterilization), lack of confidentiality, failure to get fully informed consent, refusal to give pain medication, gross violations of privacy, refusal of admission to health facilities, neglecting women during childbirth to suffer life-threatening, avoidable complications, and detention of women and their newborns in facilities after childbirth due to an inability to pay.”

In addition Obstetric Violence also includes committing acts against the birthing person, including but not limited to medical intervention (both physical and via IV), without valid informed consent and verbal permission (after obtaining valid informed consent) to do so.

Obstetric Violence can also include holding a baby’s head inside the birth canal, performing a routine episiotomy without informed consent and against the birthing persons wishes, performing a caesarean against the birthing persons wishes (even if it puts the unborn baby at risk – the birthing person has the legal and human right to accept and/or refuse any and all medical treatment regardless of if it’s during childbirth or not), stitching up a perineal/vaginal/rectal/vulval tear without valid informed consent, denying a birthing persons request for specific procedures (hysterectomy or other sterilisation, delayed cord clamping, genetic testing for a known genetic disease within the family etc) and/or rejection of intervention (refusing ergometrine/syntocinon injection for delivery of the placenta, refusing a canula/IV, refusing internal examinations, refusing to be confined to the bed, refusing to use continuous fetal monitoring/CFM etc), giving the birthing person IV or intramuscular medication without valid informed consent, bullying/coercing/scaring/manipulating a birthing person into interventions that the birthing person otherwise would not have consented to (this also goes against the Human Rights laws and Australian law – Australia is also a cosignatory of the Human Rights laws meaning that they apply here and anything going against those laws is a violation of the Human Rights laws).

For some of these things it can be argued that they are lifesaving procedures – and while many of them can be for many women I am not talking about them right now (although some of them have involved violations of human rights too). The issue I am writing about here is to do with Obstetric Violence. Violence perpetrated against a birthing person that is either verbal or physical or even a combination of both.

If we take away the hospital/medical setting -  the gloves, the gowns, the masks, the lights and equipment, and transpose these abuses into any other setting, eg the cinema, the shopping center/mall, the car park, a private home, basically anywhere else except for in a hospital or other medical facility – everyone would be in an uproar, the perpetrator would be charged with assault, with physical abuse, with domestic violence or just simply for perpetrating violence against another person.
The media would be all over it, the general public would be screaming (well maybe not screaming exactly but at least calling loudly) for justice, if it just happened to be a native Australian who experienced it there would be a giant uproar and picketers would be barricading Parliament House demanding reforms and justice and changes to the law.
If it was a celebrity who experienced it there would be stories in every magazine, it would be known pretty much all over the world what had happened, and the court case would be all over the news.

But it is in a hospital setting, and because of that it’s “accepted”, it’s treated as “normal”. The birthing people who go through such a horrible experience are left to deal with on their own with very little support and sometimes even no support at all.

They don’t get any justice.

If they lodge a complaint with the hospital they may or may not get an insincere apology designed to cover the hospitals arse, the perpetrator may or may not get a slap on the wrist and will then most likely go straight back to doing the exact same thing to other birthing women.
If they lodge a complaint with the relevant regulatory authority they might see the perpetrator investigated, or they not see anything done at all.
If they contact the police they are normally told that “there’s nothing we can do”.
If they contact a lawyer they’re told “we can’t help you”.

Obstetric Violence is being perpetrated against birthing people every single day in hospitals everywhere and the victims have no recourse.

They get no justice for what was done to them.

They may get an insincere apology.

They get minimal help – and what little help they do get is usually limited to seeing a psychologist or counsellor to treat PTSD and/or depression caused by their experience.

Those who are creating awareness of Obstetric Violence, who are trying to bring into the public’s knowledge and sight so that something can be done, are usually those who have personally experienced it or who have personally witnessed it.

The victims of Obstetric Violence, those who have already experienced it, those who are experiencing it right now and those who will experience it in future, all need our help. We need something to be done right now.

OBSTETRIC VIOLENCE NEEDS TO BE STOPPED.
 
 
 
 
References:
1 - http://midwivesvictoria.blogspot.com.au/2014/03/definition-of-obstetric.html
2 - http://apps.who.int/iris/bitstream/handle/10665/134588/WHO_RHR_14.23_eng.pdf?sequence=1

Image courtesy of and Copyright FOOTPRINTS & RAINBOWS 2014

It doesn’t matter if it was an emergency caesarean or an elective caesarean, it was still a caesarean and a major abdominal surgery and it is essential that you look after yourself properly in the first 6 weeks after a caesarean, and that you look after yourself in general for the first 6 months after your caesarean.

When you’ve had a caesarean it can be hard to remember to take it easy and look after yourself properly – especially if you have older children that you need to look after.

When you had your caesarean the surgeon not only cut through the skin on your lower belly/bikini line horizontally (or possibly he did a vertical incision running up/down your belly instead of horizontally), but he or she also cut through the nerves located in the skin of your belly, either divided your lower abdominal muscles or cut through them (depending on if they were able to be stretched apart enough for the uterus to be pulled through or not), cut through the outer, middle and inner layers (including the muscle layers) of your uterus, cut through numerous blood vessels and nerve pathways, may have cut through some fluid drainage systems, cut through the tissue barriers that separate the various parts of the body (the fascia, and the peritoneum which is cut through twice during the procedure) and then stitched it all back together to make you as close to whole as possible again. The surgeon may have cut your uterus horizontally (transverse incision), or he/she may have cut it vertically (classical incision) or in a “J” or “inverted T” incision if a horizontal incision wasn’t an option at the time.

Major abdominal surgery like a caesarean takes 6 months to become 100% fully healed, and although the incisions themselves will be healed by 6 weeks post partum there is a lot of microscopic repairs that need the rest of those 6 months to be completed. If you had complications with your surgery or developed an infection in the incisions or in your uterus afterwards it can take longer than 6 months – sometimes in rare cases up to 2 years – for it to be completely healed.

During those 6 months there are many ways that you can take care of yourself. Not driving for those first 6 weeks is usually one of the first things that you are told – driving uses the abdominal and core muscles and can put strain on your incisions, you are also not covered by insurance during those first 6 weeks after a caesarean, and if you have an accident while driving during that time your incisions can reopen which can cause some serious complications.

One of the other things you are first told is that you cannot lift anything heavier than your new baby. If you have older children, for example toddlers, who like to be lifted up and held this can be difficult to do, and it is essential that you don’t lift them up in those first 6 weeks as in doing so you run the risk of your incisions reopening or causing further damage.

You need to rest as much as possible and get a good amount of quality sleep. The majority of healing a repair work within the body is done while you are sleeping, and you need quality sleep with at least 2 REM cycles (around 7-8 hours of sleep) every night in order for it to work efficiently. This can be difficult with a new baby who may wake up several times a night for a nappy change and/or a feed, so sleep whenever you can, sleep when baby is sleeping, and don’t stress about the housework, right now you need to focus on you and on healing your body, the housework can wait until later on when your partner (if you have one) is home or until the weekend. If you have older children at home it can be even more difficult to get enough sleep and sleeping when your new baby is asleep can be close to impossible. If you are in that predicament then it is time to ask for help – from family and friends that you trust who can help look after your children for an hour or two each day while you take a much needed nap - or time to send the older kids to day care one or two days a week to give you a break and time to catch up on sleep (and housework if you need to catch up on it as well).

You need to eat a healthy and well balanced diet. Your body stores many of the vitamins and minerals that it needs within it until they are needed. During pregnancy your baby takes nutrients from your body, even when you haven’t had enough of them during your daily food intake (in which case the baby takes them from your internal stores), and by the time your baby has arrived you may be running low on some essential vitamins and minerals like Vitamin D and Iron. If you choose to breastfeed these vitamins and minerals will be going into your breast milk for your baby as well, so it is essential to make sure that you are getting enough from your food (and in the case of Vitamin D, from sunlight. You produce the highest amount from exposure of the areas of skin between your lower ribs and the base of your neck, so wearing a shirt in the sun all the time while it is good for helping to prevent skin cancer it can greatly reduce the amount of Vitamin D that your body produces). Eat healthy foods with lots of carbohydrates, a reasonable amount of natural fat (you need this to help with energy) and protein. During the 6 months that it takes for abdominal surgery to fully heal ensure that you eat an increased amount of protein in your diet. Your uterus is made up of 3 layers of muscles, and the incision from the surgery did cut through part of your uterus. Muscles need protein to grow and to heal, so for those first 6 months after your caesarean make sure you eat more protein than normal to help your uterus heal well and to help reduce your risk of uterine rupture and other complications in any future pregnancies (while the risk of uterine rupture during labour is actually less than 0.5% after 1 caesarean and less than 1% after 3 cesareans it doesn’t only happen during labour, it can happen during pregnancy too, so if you strengthen your uterine muscles now, and continue a high protein diet during your next pregnancy your muscles will be stronger and your risk of rupture will be reduced).

Take care of your emotional health. This side of things can often be forgotten, and good emotional health is just as important as good physical health. If you aren’t emotionally healthy then that will affect the rest of your life and will also affect your baby and any other children you might have. If you experienced a traumatic delivery there are many people and groups who deal with that and can help you, for example in Victoria, Australia, there is now a Maternal Mental Health Service that has a section dealing specifically with Birth Trauma. There may be similar services in other states within Australia, and in other countries around the world.
If you are feeling down or just don’t feel right go and see your family doctor. If they brush off your concerns see someone else, because you may have a mild case of post partum depression (or something else might be going on) and you will need support. If you are having visuals of your child/ren or yourself being hurt (by you or someone else), combined with these feelings and are having dreams that are similar to the visuals as well go and seek help now.

Make time for you! I have mentioned this in several other blog posts, because it is very important and follows on from the above section on your emotional health.
You need to have something special that you do for yourself, without children, and without your partner, that makes you feel good and happy. Whether it’s going out to see a movie or meeting up with your friends, getting your hair done, taking up a hobby, going back to work (if that’s what makes you happy), whatever makes you happy go out and do it.
And don’t feel guilty about doing something for yourself, it makes for a happier mum, and by proxy it makes for happier kids and a happier home. Therefore by doing things for yourself as well you are making your home a much better place to live in.

Lastly, and most importantly, keep an eye on your physical health post caesarean, in particular the scar area for separation of the incision or signs of infection (more redness than is normal, puss, a foul odour, seepage that doesn’t look right etc) and your legs for signs of a blood clot (a bruise that cannot be explained that spreads quickly over a 12 hour period, and/or redness and/or pain and/or a localised area of swelling spreading in a meandering line across and/or up/down your leg). If you notice any of these things go and see your GP right away, if you notice all the symptoms of a blood clot go straight to your local Hospitals Emergency Department to get checked out.

Also keep an eye on your general physical health, if you develop a fever in the first 2 weeks post partum go and see your GP, especially if it is within 5 days of coming home from hospital. If your post partum bleeding suddenly increases and you are going through a maternity pad in an hour or less go straight to the emergency room to get checked out as it could be a sign of a post partum haemorrhage (contrary to most common knowledge in the mummy world haemorrhages can occur right up until your post partum bleeding ends anywhere between 2-10 weeks post partum). If you are having clots larger than the size of a 50 cent piece (or larger than the size of a golf ball) go and get checked out. If your post partum bleeding continues for longer than 10 weeks go and get checked out as well. If you are feeling run down then you may be overdoing things and it is time to slow down and take care of yourself for a while, because you are important and need to be healthy and in good health just as much as your baby is.

As always, feel free to share.

Jenna Edgley
Student Birth Doula
FOOTPRINTS & RAINBOWS

Recently I've come across quite a few articles and blog posts written by disgruntled mums blaming their Doulas for things not going right.

In some cases these mums have a right to be disgruntled - a couple of those so-called "doulas" were operating well outside of our scope of practice. Very scary for the mum who has never had the support of a good doula to read, and horrifying for the doulas who do their jobs well and stay within our scope of practice.

One of the prevalent things mentioned in these particular articles and blog posts describes doulas as "Airy Fairy Hippies who promote themselves as producers of births that are so good and wonderful that they are like rainbows and unicorns" (this is my take on the statements made in these articles and blogs and not the original wording, however the words "Airy Fairy Hippies" and "Rainbows and Unicorns" to describe Doulas all come straight from the blogs and articles themselves).

The biggest issue that I've found with these articles and posts is that these mums never "shopped around" for the right doula for them. They heard from a friend that there was a "great doula" in the area and upon meeting said doula they hired her on the spot. No questions asked, no mention of "meshing" between them and the doula and then lots of complaints in the blog/article about everything that the doula "did wrong" during mums pregnancy and labour.

Now I am not everyone, but I personally shop around for things that are important to ensure that I get "the best deal" or "the best fit". This applies to a service on my husband's car, and electrician to check the wiring in our house and a plumber to check the pipes. Most recently (and currently at this point in time) we are shopping around the various real estate agents in a bid to get the best price possible for our old house back in Morwell, Victoria.
You have to do the same with Doulas as well. Not every doula will be a match for every mum who contacts her and vice versa. You need to do your research and, unless there is only 1 doula in your area or none at all, you are guaranteed to have a variety of doulas in your area who would love to have the chance to meet you and see if you are a "good fit" together.

All doulas are different, some are the equivalent of the "Airy Fairy Hippies" described in the above mentioned blog posts and articles, others are serious and studious and stick to a strict schedule in their business practices. Some are male, many are female, some are bisexual, gay, lesbian or transsexual. Some have lots of kids, some only have 1 or 2, some adopt or foster, some don't have any kids at all for various reasons that are their own.
Some are "crunchy" parents who use gentle parenting techniques, others are strict parents. Some promote and only attend drug and intervention free births, others only support women who are having an elective cesarean,  while others support families who have lost their baby in utero or who will lose their baby soon after birth. Some doulas also support people who are dying from a terminal illness (these are called Full Spectrum Doulas). Doulas are all of these and more.

I myself never had a Doula for my own births, although now I wish I had, it would have made my births be much better experiences.
The picture at the top of this post is of me and my youngest child just minutes after she was born - my 2nd VBAC delivery after 55 hours of labour that could have been much shorter and far less traumatic if I'd had a Doula there to bolster my confidence and help me to find my voice. I look at this picture and I am filled with a mixture of happiness that my baby girl arrived safely, and sadness at how I was treated in the process of bringing her into the world and that I didn't have the extra support that I needed. Don't get me wrong, my husband was a fantastic support to me during labour, but there was only so much that he could do and he would have benefited from extra support as well.
As you can see I am a normal mum. I don't see myself as a "crunchy" mum or a strict mum. I am somewhere in the middle, I have to be with a child who has extra needs. I live my life day to day and plan ahead when needed. While I love the idea of natural drug and intervention free birth I know that that is not for everyone - I have not experienced it for myself either - and what worked for me won't necessarily work for everyone else. I devote my entire being to my clients, if they need me I am there ASAP to the point where I can leave my whole family in the lurch (lucky they support me wholeheartedly in my chosen profession and my kids are always excited to hear a new baby has been born). What I want out of your birth doesn't matter, all that matters is that you have the best birthing experience possible and I will support you and your decisions with my whole being. I cannot speak for you, but I can reassure you and tell you that you are doing an amazing job, whatever the outcome may be.

So as you can see we (including myself) are many and varied, but the one thing that brings us all together is the desire to provide extra emotional, physical and mental support to people going through the most important stages of our lives, whether it be bringing new life into the world or helping others on their journey out of this world. It is a very demanding job - we don't do this just for the money, we don't make millions of dollar's and many of us barely manage to put food on the table from what we earn once all of our expenses have been paid for - and not just anyone can do it. Quite often we burn out from everything that we put into our work and need to take reasonably regular breaks to rest and recharge before getting back into it again. We regularly attend marathon labours that last for over 24 hours (and in the case of the last birth I attended it was 53 hours lol and I only managed 3 hours of broken sleep somewhere in the middle because the adrenalin was still pumping). We are passionate, we love birth, we love being able to support people and feel blessed and honoured to be able to do this as a job. We are drawn to it like moths are drawn to a flame. Many of us (myself included) feel that we were born to do this and only this and anything that we did beforehand was only a stopgap measure until we found our true calling. Sometimes we end up with 2 or more clients going into labour at the same time. We cannot predict or control this, and on the rare occasions that it does happen we do everything that we can to either be at all births for as long as possible (sometimes we end up having to drive from one birth on the east side of the city/town to another birth on the west side, or north and south sides of the city/town, it is not ideal but we try to make it work) and if all else fails we try to arrange a back up doula to attend in our stead. This isn't ideal, but sometimes it has to happen.

What I am trying to say is that, no matter how much a friend or someone you know extols the benefits of a doula that they have personally hired or if they know somene who has hired a particular doula, you should always look around and make sure you mesh well with the doula that you decide to hire. This can sometimes mean having an interview meeting with 10 or more different doulas before you find the one that suits you the best. It will be worth it in the end as with the right doula even the most traumatic of labours can become something beautiful and special and be worth all of the pain that was involved at the time.

I have been lucky, I have become good friends with all of my clients, and they all had good outcomes even with things that came up during labour/birth, and we still talk regularly and share what our children are up to. We meshed so well that we were able to take the "client-doula" relationship further and will most likely remain friends for life. The best part is that we probably would never have met if they hadn't contacted me to ask if I could be their doula, and because of that I am truly blessed.
I know that in future I will be faced with clients who I don't mesh with or who don't mesh with me even if I do mesh with them, and that is OK.  It is part of the learning process and it is why I insist on an introductory meeting first to discuss things and see how well we get along. So please, please do your research before hiring a Doula! It will be more beneficial for you if you do.

As always, feel free to share :)

Jenna Edgley
Student Doula
FOOTPRINTS & RAINBOWS