Going into my first birth as a mother I was so excited!

My requested (or rather demanded!) induction for my estimated 41 weeks and 3 days gestation, just 4 days before Christmas Day, had been approved.

My OB was someone that I considered to be the perfect care provider for me (and in hindsight she was, and had only grudgingly approved the induction for before 42 weeks – which is such a rarity these days!)

The hospital I had chosen to birth at was 40 minutes or so away from the home we had just bought in September, but that was all good because we had family and friends near it and a guaranteed place to stay for a couple of days after I was discharged before heading home to start our new life as family of 3.

I’d read every single pregnancy and birth book I could get my hands on locally, and had Googled the heck out of everything I could about vaginal birth – that was my goal of course!

I was going to have the perfect drug free labour.

It was going to only last maybe 24 hours at most.

Everything was going to go perfectly and nothing was going to go wrong – it couldn’t go wrong!

I was excited to finally meet our son.

And then the induction started.

The gel took 3 doses + the tape to get me from 0 dilated and 0% effaced to 1cm dilated and something effaced (even now, over 11 years later I still don’t know how much effacement had happened) between 7pm on the 21st and 9am on the 22nd of December, syntocinon was started around 9:30am that day after my waters were broken.

Cue a long, tiring, extremely painful induced labour that saw me very quickly getting an epidural – that slipped out of place late at night on the 22nd and left me with permanent nerve damage to the nerves where they joined my spinal cord – and then finally making it to 9cm dilated at 9am on the 23rd, and fully dilated and starting to, ineffectively, push shortly afterwards.

After somewhere between 2-3 hours of pushing and my son starting to have heart decels that were slow to recover once the syntocin-induced contractions had ended it was decided that a caesarean would be the best option – not by me though, I had adamantly refused it repeatedly, it was decided by my OB who went to my now husband and told him that if a caesarean wasn’t done our baby and myself would both die (and oh how ironic it was that she said that, because one of the anaesthetic medications in the spinal nearly did kill me while they were stitching me up!)

It was agreed that they would try the ventousse (vacuum) briefly in theatre, technically they were only meant to try it 3 times in total but I distinctly remember through my exhausted fugue the surgeon attaching it to my sons head at least 6 or 7 times before giving up.

The caesarean was, initially, very straight forward. I felt the tugging, the pulling, but did not feel any pain, and I was terrified and shaking and it all felt extremely surreal – like it was happening to someone else and I was looking in from the outside.

I saw my son briefly as they held him up over the blue drape before they whisked him over to the heated table to clean him up. He cried the moment he was out, then promptly pee’d on the surgeon. I got to touch his cheek briefly after he was cleaned and wrapped up before he and my husband were taken away to the nursery (there was no skin-on-skin in theatre back then) and shortly after that I nearly died.

My vision went black and I remember trying to tell the anaesthetist that I couldn’t breathe a few times before he finally heard me and then I lost consciousness.

My blood pressure had bottomed out while I was being stitched up. I was later told that they were worried that they’d have to do full CPR before they were able to get it back up. Not the kind of thing you really want to hear right after you’ve woken up after having major surgery. I was also told that I’d never be able to give birth vaginally, that my pelvis was “too small and the wrong shape” for vaginal birth. I’d need caesareans forever afterwards and they would not “allow” me to have more than 3 caesareans at most.

I eventually recovered – 6 whole long months of pain before I reached my “new” normal.

At around 3 months postpartum I threw myself into planning my next birth. My next birth HAD to be better than what I had gone through with my first, the whole experience of an emergency caesarean had traumatised me so greatly that just the thought of needing another one left me anxious and feeling very panicky.

I found out that vaginal birth after caesarean (VBAC) WAS an option for me, that the “diagnosis” of my pelvis being too small and the wrong shape (cephalo-pelvic disproportion, or CPD) was so rare that it only affected 2% of the population in the western world and could not be diagnosed from just one birth alone or even during a caesarean.

I aimed to have a VBAC, even when I was diagnosed with whooping cough at 16 weeks gestation and then gestational diabetes at 30 weeks and put on insulin at 35 weeks I still aimed for a VBAC. That was my plan, my goal, my whole reason for living while battling undiagnosed PND – resulting from that first unplanned caesarean birth - during my next pregnancy.

Did I have a VBAC?

I sure as hell did! 4 hours & 43 minutes of labour, no syntocin, induced at my request solely by having my waters broken, only 20 minutes of pushing. My 2nd child was born vaginally at 40+2 and was my smallest child at what, to me at least, seemed a teeny tiny 8pd/3.65kg (my son was 8pd 3, 3.774kg, when born at 41+5).

And it was how my first birth should have been and wasn’t.

It was healing.

It was how I’d always imagined my births would go.

I was respected. I was supported.

I made all the choices and decisions myself and none of them were taken out of my hands and made by anyone else.
It was how birth should be for everyone – respectful, caring, supportive and following the birthing persons lead.

I had picked a new supportive care provider (not my original OB who had travelled to Tibet for volunteer work by then) who respected my wishes, who didn’t push anything on me, who left all decisions in my hands and who treated me respectfully as a human being with thoughts, feelings, knowledge and the ability to make the right choices for me and my baby.

Like with my first birth I didn’t have a written birth plan, but this time I did have a plan that I had discussed many times with my care provider so that I knew, and could trust, that he was on board and supportive of what I wanted.
I sit here typing this all out now, remembering my first and second births as my 2nd child’s 9th birthday approaches, March 30th, thinking about the long journey that I had along the way.

And I am also thinking of all the mothers who were left disappointed, feeling broken, had their choices and bodily autonomy taken from them during their own births, like mine was during my 1st and 3rd births.

I remember why I entered into this field of doula work, birth work, and why it means so much to me.

I remember the student midwife who supported me so well during my 1st birth even when everything went to crap, and the other student midwife who supported me during my 2nd birth - I only remember her first name, Elise, because it is my 2nd child’s name as well, and though I had picked that name out many many years before I saw it as a good omen that the student midwife who supported me the way that I, as a doula, would have wanted to be supported from another doula bore the same name (MANY MANY THANKS TO YOU ELISE! I always wanted to thank you in person afterwards and wasn’t able to, I hope that you will see this one day and will know how very grateful I was, and still am, for your support during my first VBAC).

I also find myself wishing that more women, more birthing people, were able to experience the kind of respectful support and care that I was given during my 2nd pregnancy and birth.

As both a mother and a doula I have become somewhat jaded towards obstetricians over the years – I have experienced disrespectful and outright abusive care and treatment as a birthing person (#metoo #sayNOtoobstetricabuse), and I have witnessed, oh so many damn times, the way that many care providers act and speak in order to make their patients do what they want them to do – and yes, I have reported those who needed reporting. I have had to bite my tongue so many times – it’s not my job to argue with a care provider in the exam rooms, my job is to support and educate the person I am supporting so that she can do that herself if she wishes to! – until I’m outside and able to let loose those condemning words that I’ve held inside.

BUT...

I have also witnessed amazing, respectful care, just like what I had received from the obstetrician that I chose for my 2nd birth, too. And while it isn’t often that I witness it, it still gives me hope. There are still respectful care providers out there.

They might be few and far between, the proverbial Unicorns of the Obstetric world, but they DO exist.
Their rarity is part of the reason why I do what I do.

Why I have chosen to support women, to support birthing people, to support new and growing families.
I have, as a mother, been on both ends of the spectrum of hospital based maternity care and also right in the middle of that spectrum too – I have received respectful care, received completely average care and received bloody awful care – and that gives me something unique that my clients can and do benefit from. I have that knowledge learned from experience of what birth usually is in a hospital setting, what it could be, what it can be and also what it’s like when it’s really fucking crap.

Have you been on the receiving end or amazing care? Or have you been on the receiving end of pretty average or really bloody awful care?
​
I’d love to hear from you, and if you are willing to share your birth story/stories I would love to be able to post it on this blog so that others can see them, read them and gain hope from them.

Re-bo-what-now?!

I know you're likely thinking "what the fuck is this shite?" (or something along those lines).

Let's start with a little bit of background history so you can see what I'm going on about:
"The rebozo is a wonderful tool originating in South America (including Mexico, Guatemala and other South American Countries), it is used as an all-in-one garment, a wrap, a head covering, a provider of shade from the sun, a blanket, a baby & shopping carrier, a tool for comfort measures during pregnancy, labour and birth, a massage tool, and much more.
While the original rebozo’s themselves were made before the Spanish invaded they were somewhat different to what they are like now, not only because they were made on a different type of loom but also because they were not used as a hair cover. After the introduction of a new type of loom by the Spanish and the native women being forced to cover their heads/hair with a cloth – as was the fashion in Spain and many other European countries at the time – the rebozo, and this hair cover, were amalgamated into one item by the innovative and resourceful native South Americans, creating the rebozo that we now know of. 
Traditional midwives in Mexico use it for anything from helping to move the baby into a better position in the womb before and during birth and to assist with bringing the uterus back down to its normal size after birth (often via belly binding), comfort measures to aid mothers as they work through their labour contractions, as an aid in traditional remedies and therapies, massage and so much more.
We can be very thankful that these traditional midwives have trained other people in their use, and that those people have also trained yet more people in how to safely use them too, allowing many in the wider world to know and be able to utilise the rebozo as a tool for assisting birthing people as they bring their babies into the world. We who teach and use the rebozo thank them for gifting us with this knowledge, for gifting us with the rebozo, so that we might help, teach and support others better and more easily and hopefully aid in improving birth in the process."
​
OK, now that we've got the brief background history part out of the way lets get down to business!

As a rebozo practitioner my job is to teach YOU (only if YOU want to be taught, of course!) how to use a rebozo safely, regardless of if you are the birthing person yourself or the partner/support person of the birthing person, so that you don't go and do something stupid that you later regret with it.

​Now, that being said, not everyone wants to use a rebozo or can see, just from looking at it, what kind of benefit it might have for their pregnancy and/or birth.

For the partners & support people: What if I told you that the rebozo would help to reduce the strain that you WILL put on your neck, back, hands, arms and shoulders? Yep, that's right, in many instances the rebozo gets used instead of your arms, your shoulders, your back etc.
Sounds pretty awesome, and believe me, it is, after 24 hours of supporting someone through their labour you will be very very thankful for being able to use the rebozo to help!

For the birthing people: What if I told you that the rebozo could lift up your belly up enough to help reduce some of the weight of baby at your front and on your bladder? Or that it could be used to ease some types of hip and pelvic pain? Or that it could help to reduce the pressure that your pregnancy might put on your back? Or that it could help with relaxing your neck, that you and your partner/support person could use it to help you get up out of chairs, up off the floor and even out of bed, more easily? Or that, with the use of tennis balls and a wooden spoon (yes I really do mean a WOODEN SPOON!) we can use the rebozo to help reduce the pain of back labour?

The rebozo can help you with all of these and more and I can teach you how to do it.

​Enquire now to find out more!

Check out the Victorian class dates and times below (QLD/Brisbane dates will be put up after I get back from Victoria at the end of April!) and sign up via the Eventbrite links - I look forward to seeing you all there!

​Rebozo For Comfort Measures Classes


Date & Time: 4th & 15th April 2020, 11am to 2pm
Location: Koo Wee Rup (exact location still to be arranged - hoping to book with the Masonic Lodge within the next 2 weeks)
Cost:
Class ONLY - $200 per couple/birthing person & support people
Class + Rebozo to keep - $300 per couple/birthing person & support people
Birthworkers (Students & other) - $150 each
 
Classes will last for approximately 3 hours - 2 hours of class with around 1 hour for lunch (sandwich platter lunch included, coffee & tea will be available too!) and chatter in the middle. Babies are welcome however there will not be childcare facilities available so you will either need to arrange care for older children or have someone with you who can care for them while you are doing the class.

Rebozo's can be purchased separately prior to the class or during the class for $140 each incl postage (all rebozo's pre-ordered will be sent via Express Post prior to April for arrival before the classes start), and there will be some available for purchase on the day, and you can arrange to pick up a preordered rebozo on the day too!

April 4th - This class I will be donating 25% of all the fees received (from both registration & rebozo sales) to Our Haven Wildlife Shelter to assist them in saving, feeding and helping orphaned Joey's from the fire affected areas and greater surrounds.
They are registered with the ACNC (Charities Commission) and endorsed as a DGR so all donations are tax deductible.
To donate separately:
NAME: Our Haven Wildlife Shelter
ADDRESS: 26 Haven Way, Golden Beach, Victoria, 3851, Australia
BSB: 633000
Account number: 152037628
SWIFT NO: BENDAU3B
 
April 15th - This class I will be donating 25% of all the fees received (from both registration & rebozo sales) to the Gippsland Emergency Relief Fund to assist them in helping those who are affected by emergency situations like fires and flooding in the Gippsland region.
 
To donate separately:
Visit HERE for full donation details.
 
TO REGISTER:
April 4th: SIGN UP HERE - Use the early bird discount code EARLYBIRD2 by March 15th to get 20% off your class and/or pre-purchase rebozo!
April 15th: SIGN UP HERE - Use the early bird discount code EARLYBIRD2020 by March 15th to get 20% off your class and/or pre-purchase rebozo!"

Rebozo For Comfort Measures Classes


Date & Time: 8th (Morwell) & 20th (Tecoma) of  April 2020, 11am to 2pm
Locations:
Morwell – CoAbility Space, 215 Princes Highway, Morwell, VIC, 3840 – On street parking or free parking at the back of the building
 Tecoma – CoAbility Space, 5/1563-1565 Burwood Highway, Tecoma, VIC, 3160 – free all day parking around the back
Cost:
Class ONLY - $200 per couple/birthing person & support people
Class + Rebozo to keep - $300 per couple/birthing person & support people
Birth Workers (students & other) Class ONLY - $150 each
 
At this stage we only have room for a maximum of 30 registrations for each class.
 
Classes will last for approximately 3 hours - 2 hours of class with around 1 hour for lunch (sandwich platter lunch included) and chatter in the middle. Babies are welcome however there will not be childcare facilities available so you will either need to arrange care for older children or have someone with you who can care for them while you are doing the class.
Rebozo's can be purchased separately prior to the class or during the class for $140 each incl postage (pre-ordered rebozo's can be sent via Express Post prior to April for arrival before the classes start or can be collected on the day).

April 8th - This class I will be donating 25% of all the fees received (from both registration & rebozo sales) to Our Haven Wildlife Shelter to assist them in saving, feeding and helping orphaned Joey's from the fire affected areas and greater surrounds.
They are registered with the ACNC (Charities Commission) and endorsed as a DGR so all donations are tax deductible.

To donate separately:
NAME: Our Haven Wildlife Shelter
ADDRESS: 26 Haven Way, Golden Beach, Victoria, 3851, Australia
BSB: 633000
​Account number: 152037628
SWIFT NO: BENDAU3B
 
April 20th - This class I will be donating 25% of all the fees received (from both registration & rebozo sales) to Gippsland Emergency Relief Fund to assist them in helping those who are affected by emergency situations like fires and flooding in the Gippsland region.

To donate separately:
Visit HERE for full donation details.
 
TO REGISTER:
April 8th: SIGN UP HERE - Use the early bird discount code EARLYBIRD2 by March 15th to get 20% off your class and/or pre-purchase rebozo!
April 20th: SIGN UP HERE - Use the early bird discount code EARLYBIRD2020 by March 15th to get 20% off your class and/or pre-purchase rebozo!

Whether it’s your 1st child or your 15th child birth can be a scary and even nerve-wracking experience for dads-to-be.

You love your partner, and you’re worried for her.

You’re likely nervous about what could happen, what could go wrong, and what the birth itself will be like – potentially you’re even nervous about how you will cope as a father too.

And you’re also likely trying very hard not to let her know just how much it is affecting you because, culturally, you are expected to be strong and brave and to be able to keep it all together for her.

Your partner is going through a life-changing experience as she gives birth – AND SO ARE YOU!

The biggest difference between you both, within that birthing room, is that no one is there to support you as well.
Everyone is there is there supporting your partner – even you!
​
Who will support you?
A doula certainly can.

Who will support you as you support your partner?
A doula certainly can.

Who will help you as you help her?
A doula is more than capable of helping you so that you can help her.

Who will be able to get things for you when you are otherwise occupied with what your partner wants and needs from you?
A doula can get you whatever you need, allowing you to stay with your partner and support her.

Who will be able to take over your support role when you need a break, a rest?
This is what a doula does, we don’t take your role away from you, we’re like the backup option – quietly supporting from the background and only stepping in when needed.

Who will bring you food and drink when you are hungry and thirsty but can’t physically leave your partner because she needs YOU?
A doula will happily do this for you – you need to eat and drink too!

Who will wipe the sweat from your forehead when your hands are both busy applying yet another hip squeeze in the middle of a contraction, or providing counter pressure for back labour, or holding your partner up as she relaxes back into you as a contraction ends?
A doula can do this for you.

There’s a common misconception in the general community that doulas are only there to support the mother herself, and are there to replace the supportive role of the father/partner/other support people.
This is most certainly NOT TRUE!

While, as a doula, our role is most often that of supporting the mother during her birth it also encompasses so many other things as well, and supporting the mother can mean so many different things too.

Sometimes supporting the mother means supporting the father, her partner or husband, or another support person, as THEY support her.

Sometimes it means just staying on the other end of the phone, calmly speaking to dad  and bringing him down from a panic attack because contractions have started and he has, in his panic, forgotten what to do.

Sometimes it means giving dad a short crash course in childbirth education at the prenatal meetings, because he has no clue what happens and quite frankly just the thought of a baby’s head coming out of his partners vagina makes him feel woozy and scares the living crap out of him.

Sometimes it means just quietly reassuring dad, in a quiet moment between his partners contractions, that he’s a doing a great job.

As a doula I do not replace you. I work beside you and help you to support her. I support you so you can better support her. I guide you when you need guidance. I help and aid you when you need aid and help. I share my knowledge and skills with you so that you can know what is happening and when, and how to help your partner.
I assist you to be the best support person that you can possibly be for your partner as she brings your baby into the world.

Dads, I know it’s hard to accept extra help and support sometimes, and I know it’s hard to hear and accept your partner wanting someone else, that isn’t just you, in the birthing room with her as she births your child.
We, the doulas, are here for you too.

We are a tool for both you and your partner to utilise as and if and when needed, to help you both have the best birthing experience possible.

Use us well, and use us the way that is right for both of you, and your partner will thank you for it.

Doulas are there for you too.

Spontaneous Labour? Physiological Labour? Augmentation? Induction? Elective Cesarean? Emergency Cesarean?
 
What are they?

Spontaneous labour is labour that begins on its own, meaning that it is not started with induction drugs or a foley bulb/cooks catheter, it is the final culmination of your bodies hormones reaching a level that is individual to you combined with your baby signalling to your body by way of proteins that are released from his or her lungs that then travel to the placenta where they tell your uterus that baby is ready and your uterus then sends signals to your brain that tell your brain that it is time for labour to begin. Spontaneous labour can be augmented with syntocinon  (a labour inducing drug made from synthetic oxytocin which acts similar to but is not the same as the naturally occurring oxytocin in your body) and, in the case of premature labour, can sometimes be stopped with drugs that are designed to relax the uterine muscles and stop contractions (it does not always work however).

Physiological labour is spontaneous labour without any interventions (meaning no drugs, no augmentation, no induction etc and usually no internal examinations as they can sometimes disrupt the physiological process). With the way that our hospital based maternity system is designed this natural labour (it is a completely natural process) is usually only now occurring in rare scenarios – births before arrival (garage, side of the road, hospital car park or entrance way), in some birthing centre births (not all birthing centres are devoid of interventions though they do usually keep them to a minimum) and also in most planned homebirths.

Augmentation is usually used when a spontaneously started labour is going slower than a care provider would like it to go (as a doula and childbirth educator I will stress here that regardless of what a care provider prefers it is still your body and your baby and your birth and you can refuse augmentation if you wish to do so, it is always your choice). Syntocinon is used to make contractions stronger and closer together with the idea that it will speed up labour time (this may or may not be true, it is individual to everyone). There are risks involved with the use of syntocinon however so ask your care provider or doula to go through them with you so you can make an informed decision on if this is the right option for you. Augmentation can also be done when an induced labour, where syntocinon is not yet being used, is slowing down or stopping in order to get contractions going again.

Induction of labour is where labour is induced instead of allowing it to occur spontaneously. Induction usually follows the same general guidelines and which methods are used can depend on if there is any prior dilation of the cervix and what the hospital you are birthing at considers to be normal policy. In general if there is no prior dilation of the cervix a ripening agent will usually be used – like cervadil or misoprostal (both carry risks so please ask your care provider to talk through the benefits and risks of both of these drugs).

Cervical softening  could then be followed by either artificial rupture of the membranes (ARoM) or a foley bulb catheter/cooks catheter to increase dilation (which would then usually be followed by ARoM), this is then usually followed by syntocinon delivered at a steady but increasing rate via an IV drip. Syntocinon also has risks so please ensure that you ask your care provider to talk you through them.

When dilation has already begun prior to the induction ARoM is usually done followed by syntocinon.
Sometimes the cervical softening agents or the foley bulb/cooks catheter or ARoM are all that is needed to get labour going and in these instances syntocinon is not normally used unless labour starts to slow down and augmentation is needed.

Elective caesarean is a caesarean that is usually electively chosen and done before labour has even begun – sometimes labour will begin beforehand and in these circumstances it can be called an emergent elective caesarean (meaning it’s not an emergency, yet, but labour has already begun which means it is classed as an emergency – yes that doesn’t really make much sense but it is how it works in most hospitals). Most (meaning over half) elective caesareans are chosen without any complications indicating that a caesarean is needed and are purely the personal choice of the birthing person – this is perfectly OK, I want to make that very clear. While elective caesareans are considered to be safer than emergency ones they are still major surgery and major surgery carries risks. Prior to scheduling an elective caesarean your care provider should be talking through with you all of these potential risks – not just for the surgery itself but also for any future pregnancies too – so that you can make an informed decision about your mode of birth. If your care provider does not discuss this with you please make sure that they do – ask lots of questions, and ask to see the research.

Emergency caesarean carries many of the same risks as an elective one though usually has a few other risks related to the speed in which they can need to be done. Many emergency caesareans these days are done for reasons that aren’t a true emergency YET but could potentially become one quickly, some are also done solely because a care provider thinks that a birthing person has been in labour for “too long” (usually after 24 or more hours of labour which can be a very normal length of labour for some women) or a birthing person has not dilated beyond a certain point in 3 or more hours (from a physiological standpoint this is very normal and not an actual emergency situation, it just means that the fundus is doing some very hard work that doesn’t involve dilation and likely also indicates that the birthing person needs both food and sleep for energy before more dilation will occur).
 
 
Why should I think about them?

Thinking about your birthing options is important, it helps you to decide which option is the best one for you and your baby and can help you to learn more about what is involved. Getting you thinking before your birth is important, because during labour you may not be able to think clearly and having to make decisions while you are having contractions can potentially disrupt the labour process and make it harder for you to cope with labour.
When you know what you want ahead of time, and have already thought about all of your options and decided on both your main birthing plan and your backup birthing plans (the ones for if your circumstances change) then you don’t have to think as much during labour and there’s less interruptions – you can tell your care providers and partner to refer to your birthing plans first and then go on from there.
 
What if I need an emergency caesarean?

Hopefully you will have investigated this option prior to labour. Most first time mothers, and even many second, third, and so on, time mothers don’t actively think about this option until it comes up unless they have been exposed to the scenario before (either from their own previous birth or from friends, family and acquaintances who have been through it before.  I know for me as a first time mother an emergency caesarean was so far off my radar that I didn’t even look into it, or learn what was involved, and when it became the only option I was still refusing it and saying no while I was being wheeled into theatre because it wasn’t what I had wanted and I knew nothing about what was involved other than that I would be cut open and my baby pulled out of me.

Research!

Learning as much as you can about every option is one of the key’s to having a better birthing experience. You don’t have to know every single nitty gritty little detail about how it is done but knowing the basics can help you to feel more comfortable with what is happening. An emergency situation is almost always scary for the mother, her support people and even for her care providers, so being able to remain somewhat calm and knowing what will happen during the procedure can make it that little bit less scary for you.
 
What if an elective caesarean is offered to me?

This is your personal choice, always. You can consider an elective caesarean, and you can accept or refuse it at any time, and you can even change your mind at any time. You don’t have to make a decision right away and you can tell your care provider that you need time to think it over first.

Ask lots of questions – why is this being offered to me? What are the perceived benefits for me and my baby? What are the risks for me and my baby, not just during this surgery but also in future pregnancies? Are there any alternative options available to me? Do I need to make a decision right now (meaning is it actually an emergency or just a care provider preference?) or can I wait until I’m closer to my estimated due date before making a final decision? If I can’t wait longer before deciding, why? What if I change my mind later on and don’t want to go through with it? Will you support me in my choice if I do decide to not go through with it?

Regardless of what a care providers preference is in regards to your birth you are the one in charge, and you are the one who gets to decide how you birth, regardless of what is happening and what potential benefits or risks are involved.
 
Which option is, in the absence of any complications, safer for me?

From a physiological standpoint, and in the absence of any life threatening complications a spontaneous labour resulting in a vaginal birth is the overall safest option. In some situations an elective caesarean birth may be safer FOR your baby but would have additional risks for you that a vaginal birth does not have.

We need to remember that just a risk of something happening isn’t an immediate life threatening complication so it doesn’t count in this particular scenario (and should only be one minor consideration when making a decision about how you want to birth, combined with the benefits, other potential risks that might be involved, other options and their benefits and risks and your own personal wants, needs and choices) – risks have a place but they are generalised towards the entire population and not towards you as a unique person, and your own individual risk factors, which are separate from the general populations overall risk factors though they do make up one very small percentage of those general risks, often either aren’t taken into account or are considered to be far more important in the moment of making decisions than they actually are.

The risk of uterine rupture for a vbac is a good example of a risk being blown out of proportion, yes there is a risk (0.2% to 0.7% for vaginal births after up to 2 cesareans with an average risk of 0.5% - or 1 in 200, this risk applies to all of a pregnancy and not just to labour alone though it is often promoted as just a risk of labour itself) but the risk itself is quite small when compared to the risks for the mother, both during the surgery and later on in subsequent pregnancies, of a repeat caesarean, yet a repeat caesarean is often offered and even pushed on women who are thinking of having a vbac because of this one risk even though statistically a vbac is much safer for the mother and only slightly less safer (overall based on general risk factors, the vast majority of families who vbac have no problems at all despite not having had a repeat cesarean) for the baby than a repeat caesarean. This is why research, and choosing a supportive care provider are so important, so that you can know the risks, and the benefits, and make the right decision for you and your baby with the support of a care provider who will help you to achieve your goal and will only recommend a caesarean when it is really needed (*hint* most care providers don’t do this, but there are a few wonderful ones out there who do, finding these “unicorn” care providers is often the hardest part of the whole process of planning for a vaginal birth after a cesarean!)

Ask yourself – how do the benefits and risks of this particular option apply to me?
What other options are available to me?
What are their benefits and risks as well?
What do I want?
How does what I want apply to my options?
What could prevent me from birthing the way that I want?
And what can I do to minimise that thing that could prevent me so that I can increase my chances of birthing in the way that I want?
What are my care providers preferences and how do they apply to me?
Do my care providers preferences override my own wants, needs, wishes and rights?
How would my care provider react if I chose something that he/she did not approve of?
Am I comfortable with my care providers reaction?
Am I comfortable in only doing what my care provider says or do I prefer and/or feel more comfortable in doing my own thing?
Do I feel fear or worry or concern when I think about going against my care providers wishes or preferences?
If yes why - why are my care providers wishes and/or preferences more important to me than my own even when they aren’t what I want or what I feel comfortable with?

Regardless of how you choose to give birth make sure that you know what is involved and what your options are, because the more you know, the better prepared you will be, and the easier it will be for you to make informed decisions.
 
 

​I will never be the perfect doula for every single birthing person.

It's simply impossible for me, a human being just like you with all of my own faults and uniqueness and differences, to be absolutely perfect for everyone else regardless of their own faults, differences and uniqueness.

And that is ok.

It is why I offer no-obligation interviews FIRST before someone hires me, to make sure that I am a good fit for my clients, that I am the right doula for my clients, that they feel comfortable with me and the style of support that I offer as a doula.

This usually doesn't get to happen with backup clients, the clients that I'm called out to support on behalf of a colleague who is unable to stay at a birth, or unable to make it to a birth, for whatever reason.

These clients are another doulas clients, not my clients, I'm just there to help when it is needed.

They fit well, mesh well, feel comfortable with that doula that they chose and I'm a secondary emergency replacement that they may never have met before and have no experience with and it can be awkward, it can be difficult.
I try my best to support them well in the way that I 'feel' (from observing their body language) that they need but I don't always get it right, I don't always read a cue the right way or get the right spot with counter pressure, or say the right words, or sometimes I might suggest something that I think might help but they don't want anything to do with it and may feel upset or angry that I suggested it. They don't always tell me what they need either. It's hard, but I really do try my best.

For both of us it can feel like we've been thrown in at the really deep end of a diving pool without a floaty to keep our heads above the water. We're both trying to get through it, the mother is trying to birth her baby, her partner or another support person is trying to support her in whatever way she needs, and I, or any other backup doula, am trying to read cues and provide support when it's needed as it's needed and sometimes we get it wrong or because we're not their chosen doula what we do provide feels wrong to them.

I want to say that that is ok.
And it's ok to tell the backup doula to leave.
It's ok to say that you're not a good match and it's not working.
I also want to say please speak up too if you need/want something and the backup, or even your chosen doula, isn't doing it.
​We can't read minds, we don't always know what you need or want just by looking at you, by observing you. Sometimes we need to be told what you want or need before we can do it. We're human just like you and we can, and do, make mistakes, get things wrong.

I want to thank a particular mum, for whom I was the backup doula, for her honest feedback. Even though I had been expecting it it still felt brutal, but I can cope with that and learn from it. I did my best and tried so hard to provide good support, it just wasn't the right kind of support you needed, *I* just wasn't the right support person for you.
Thank you.
For being so honest.
For confirming what I have been thinking, and condemning myself for, for the past month and a half.
For being true to yourself and what you actually needed and didn't get and not just saying "weeeeellllll, she was ok I guess, I wouldn't hire her again but she was probably ok" when what you might have really wanted to do was slap me and scream in my face.
Thank you for saying you weren't happy with me so that I can make changes, not only in how I provide support as a backup doula but also so that I can now put things in place to work with my colleagues and meet with their clients before the birth so we can, hopefully, know ahead of time if I'm not the right backup to be called in for that particular client.
You're an amazing person, and it was an honor to be able to provide what support I could for you even though we weren't the right fit.
​Thank you, thank you, thank you for everything.