informed-choice

Doula Care for a C-section

Mon, 06 May 2013 16:34:31 +0100

There is no other major surgery of it's kind where you will be handed a newborn baby immediately afterwards and expected to care for it, and there are very few other major surgeries where you will be wide-awake and fully conscious of what is taking place.

A c-section is a very remarkable and sometimes overwhelming experience for both the mother and the father, so having a familiar, caring presence with you during surgery can offer immense relief to both parents. While many medical professionals question the need for doula support during an elective c-section, for the reasons already stated above it becomes somewhat of a "no brainer" when you think about it.

When an unscheduled (aka "emergency") c-section becomes necessary, the mother may still have some time during which she is required to continue coping with a difficult labour and so a doula is able to keep her going until pain relief can be administered. The pre-admission area can also be quite busy and add to the stress of the father - especially in the event that things have not gone according to expectation. This can also be a time of disappointment at some unexpected twists and turns in the path - and I see part of my job as giving both parents a chance to express their feelings since, as a doula, I've spent a great deal of time fully trying to understand their hopes for such an important day in their lives. Providing that calm, reassuring presence during this time, and allowing parents to express fears, concerns and worries about surgery need to be addressed right at that moment - and no other person present is usually in a position to do this.

Once in theatre, your doctor and other medical team members around you will be focused on their own tasks. It can give both the mother and father a huge amount of relief to have someone truly focused on their well-being and immediately able to answer any questions about all the strange sensations that go along with surgery.

Having had a c-section myself, I remember clearly how vulnerable I felt laying naked on the operating table with so many people around me - all of them very busy! My partner was with me but was equally helpless to understand what was going on or explain it - and while my wonderful doctor was busy with her work, she was hardly in a position to really offer support over the top of the screen and from behind a surgical mask (which made hearing anything she said almost impossible).

I was surprised to realise just how much of what was going on that I could actually feel, and I could even still manage to move my toes despite the spinal anesthesia. There was a lot of tugging and movement, along with a big drop in my blood pressure, and perhaps the oddest sensation was when a great deal of pressure was applied to my stomach but I only felt the pressure up towards my shoulders. I was quite terrified at this point!

When providing doula care to someone during a c-section, I am continuously checking in with the mother as to what she's feeling. For the father, I make sure he's not feeling too overwhelmed by all that's going on - especially if he's someone who is a bit squeamish around blood (which is about 95% of the Dad's I've met so far). Some fathers who are particularly squeamish have chosen not to go into theatre at all and are relieved that someone close to the mother can still support her.

Once the baby is born, it's now the Dad's job to go with him or her to the resus area where the peadiatrician will do a variety of tests and ensure that the baby is beginning to breath well. Without a doula, the mother is often forgotten about to some extent, and most of the time she is unable to see her baby or know exactly how things are going. The doctor will be busy removing the placenta and then beginning the approx. 45min process of closing up the incision.

This is a great time to have a doula there to be able to have a better view of how the baby is doing and to let the mother know. I also make sure to take photos of whats happening to the baby and then show them to the mother right away, so that she can still feel connected and part of the process. This offers a great deal of reassurance to the mother!

Should all be well with the baby s/he can be brought to the mother and placed on her chest. Should there be a problem, the father will accompany the baby to nursery and the doula will stay with the mother.

When the baby stays with the mother, having a doula can mean that skin to skin with the baby is possible the moment they arrive in the recovery area, and that breastfeeding can begin. This may be one of the most difficult positions in which to try and breastfeed, but ensuring that latching takes place within the first hour can make a huge difference in future success as it's when the baby is most primed to do it. Although difficult, the positive reassurance from a doula can help make the mother feel much more adequate despite how challenging things can be at that moment.

Should there have been a need to take the baby to the nursery for further observation, having a doula to go and enquire on behalf of the mother can speed up the process of reuniting them. In the very least, it gives the mother a voice in a place where she can't be (but so desperately longs to) and her doula can also then return as soon as possible to give her an update on what is taking place. Sometimes it is through the doula that the baby can still join the mother in her room by wheeling in the incubator, so the mother can see and touch her baby in the very least.

In most cases a doula will simply be helping the mother get settled into her room, and adjusting feeding positions to try and get breastfeeding going. Other jobs might be organising something to drink for the mother, or the father, and taking a few family photos.

Obviously the role of a doula extends far beyond the birth itself, as a doula will continue to visit the mother both in hospital and then later at home. She can offer a helping hand with other breastfeeding issues that may come up, keeping an eye on the third day blues (to avoid Post Natal Depression) and sometimes to help with the first bath or to answer questions about any newborn skin issues.

As you can see, there is still a huge amount of value that a doula can provide during a c-section - both before and after!

All photo credits to Joann Stokes Photography

Natural C-section

Mon, 12 Nov 2012 07:17:27 +0100

You may have longed and hoped for a natural birth, but fate had something else in store and an elective c-section has become the fabulous life-saving technology it was always intended to be! While you can be glad of this option to delivery your baby safely, you may mourn the loss of a powerful natural birth and some of the benefits it offers, such as immediate skin to skin and delayed cord clamping. How can you bring these special elements into an elective c-section?

Enter the Natural C-Section

This method of delivery differs from a routine c-section in that it allows the mother to

see her baby being born
have immediate skin to skin
delayed cord clamping for the baby
breastfeed as soon as possible

Send this video to your care provider in order to advocate for a "Natural C-Section" for the birth of your baby

Natural Induction of Labour

Sat, 13 Oct 2012 19:50:25 +0100

In this guide to the natural induction of labour, I will go through methods that are often recommended from innocuous suggestion of eat certain foods to more extreme methods in the form of castor oil.

The first thing which can help you determine if any kind of induction will be successful is to know your Bishop Score. You would need a doctor or midwife to assess what your score is, but you should have a score of above 8 for an induction to have a good chance of success.

Pineapple

Pineapple which contains an enzyme called Bromelain which has been scientifically shown to have various medicinal properties, but the induction of labour is not one of them. This is simply because there aren’t a huge number of studies on the use of eating pineapple as a way of inducing labour, but many women have given anecdotal evidence of it’s efficacy. Bromelain is thought to act very much like prostaglandin in preparing the cervix for labour.

How to take it:

Only fresh Pineapple contains Bromelain, and it is found most concentrated in the stem (that hard crunchy bit in the middle). It is best to buy a whole pineapple and to cut it open and eat immediately to get the most Bromelain, as the enzymes are reduced once the fruit is cut. Canned, pre-cut or cooked pineapple will not contain the enzymes needed for induction to be successful.

One of the other downsides is that in order to get enough Bromelain for this method to work, it is estimated that one would need to eat approximately 7 pineapples.

Evening Primrose Oil (EPO)

Evening Primrose Oil is high in the omega 6 fatty acid gammalinolenic acid (GLA), which is readily converted in the body to prostaglandin E1. This is what the cervix needs in order to ripen and for labour to begin.

How to take it

EPO can be taken from 37 weeks gestation, either orally or vaginally. It is best to do so under the supervision of a homeopathic doctor, so as to ensure that you are a good candidate as they are not without risk.

Contraindications

If you are on medication for schizophrenia
Should be avoided by epileptics as it mayexacerbate a certain type of temporal lobe epilepsy.
Should be avoided if you have a bleeding disorder

Safety

· Some studies have shown that women taking oral EPO have a higher risk of complications during labour and the need for intervention

Oral evening primrose oil: its effect on length of pregnancy and selected intrapartum outcomes in low-risk nulliparous women. - Study

Sexual Intimacy

Not only is this a great way to keep a couple bonded during the pregnancy, it’s a great stress reliever and certain things can actually promote labour. Orgasms in the mother help simulate the uterus to start contracting, prostaglandins are found in semen which help the cervix ripen, and nipple stimulation can also help the uterus to begin contracting.

Walking

Walking is a great way to start labour as it allows the baby’s head to stimulate the cervix in order to trigger contractions. Some people advise walking on uneven group and perhaps including going up a flight of stairs in order to help with the cervical stimulation.

Spicy Foods

Spicy food such as a hot curry is thought to help bring on contractions. Essentially how this works is that the hot curry can cause mild diarrhea that in turn can him stimulate the uterus to contract. The bowel and uterus are closely connected and the hormones that cause the bowel to move can have the same effect on the uterus.

Acupuncture / Acupressure

In order to have your labour induced by this method, it is best to see a trained professional for the best results. This is one of the only natural methods where there have also been clinical trails that have shown that acupuncture may stimulate the start of labour.

How it works

Acupuncture is an area of Traditional Chinese Medicine that focuses on the energy meridians of the body. By stimulation certain points in a meridian it can cause change in the flow of chi and help the body to work more effectively.

The Acupuncturist will place very thin needles into various points of the body and then stimulate them by moving the needles. The patient will then lie for some time with the needles in place. It is not usually a painful procedure but you may be aware of a “zing” sensation when the needles are inserted or moved.

Cape Town

I recommend Arnold Erasmus for acupuncture treatments and he has successfully helped many clients – from turning breeches to induction of labour.

Contact him via his website – Lao Kung

Castor Oil

Some controversy surrounds the use of Castor Oil as a method of inducing labour, with critics claiming that it is likely to cause distress in the baby (passing merconium), however there are no studies available to support this claim. It is a method that has been widely used within midwifery over many years with lots of anecdotal evidence of its safety as a labour inducer.

How it works

In 2012 it was discovered that the reason castor oil works to cause contractions was because of ricinoleic acid activating prostaglandin EP₃ receptors in the uterus.

Castor Oil was primarily used as a laxative and it was thought that the upset stomach was what triggered contractions. We now know that Castor Oil itself has a direct effect on the uterus. (Castor oil induces laxation and uterus contraction via ricinoleic acid activating prostaglandin EP₃ receptors – study)

How to take it

You need to take approximately one tablespoonful of Castor Oil. It has a rather vile taste so it is best to mix it with something that you drink down quickly. The most popular ways to take it are mixed with orange juice or as part of a smoothie.

This video is an example of someone doing a successful castor oil induction

The following are “semi-natural” methods of labour induction in that they don’t involve medication/chemicals in order to get labour started. They are, however, medical intervention that needs to be done by a qualified medical professional.

Stretch and Sweep

Also known as “Sweeping the Membranes” is when a midwife or doctor performs a cervical check, but during this he or she will attempt to separate the membrane of the amniotic sac from the wall of the uterus. During this process the cervix is also stretched out slightly. It can be rather uncomfortable procedure but has a good chance of success and is definitely a good first option if you are faced with needing a chemical induction as a next step.

Foley Catheter

This involved placing a deflated foley catheter through the cervix into the uterus. A foley catheter has a double lumen which allows a bubble at the tip to be inflated with air or water. This kind of catheter is normally used for the bladder when the catheter needs to stay in place. In this case it is being placed in the uterus and then inflated with water so that it pushes against the cervix in order to encourage the cervix to soften. It may also be gently pulled on in order to provide enough pressure against the cervix. Often if this method does not start labour, the cervix can be a lot more favorable if a chemical induction is needed.

Induction of Labour - the new c-section?

Sun, 30 Oct 2011 19:59:53 +0100

These days women in South Africa have become a lot more clued up on the high c-section rate and the benefits of opting for a natural birth. Studies done internationally have shown that the saying "Too posh to push" may have been somewhat of a myth and that many women were instead being pressured by their care provider to opt for a c-section, rather than choosing it themselves from the outset. Certainly in South Africa, women have become much more informed on the subject and will be choosing to "try for a natural birth" with many finding their doctor to be supportive, in the early part of pregnancy at least.

While women have become more vocal in their wishes to have a natural birth and the media has drawn attention to the pressure they come under by doctors to choose a c-section, this seems to have started a new trend of the 38 week induction. Instead of doctors urging the women to have a c-section, they instead compromise by offering an induction at 38 weeks so that the mother still feels that she is being given the option to try for a natural birth, but often she doesn't know that for most women the chance of the induction failing is almost certain - leaving her with no choice but to have a c-section.

With everything we do there is a risk, and it is up to us what risks we are the most comfortable with for any given choice. There are obviously risks involved with induction of labour at any stage of pregnancy (whether pre- or post- due date) and it's up to the individual to decide of the risks associated with induction outweigh the risks of continuing to be pregnant.

1. The risk of the induction resulting in a c-section be required is significant

A research study by Ehrenthal et al. (2010) found an increased c-section rate of 20% for women being induced with their first baby. They concluded that: “Labor induction is significantly associated with a cesarean delivery among nulliparous women at term… reducing the use of elective labor induction may lead to decreased rates of cesarean delivery for a population.” Another study by Selo-Ojeme et al (2010) found induction increased the chance of a c-section by 3 for first time mothers.

2. The need for medical pain relief is higher

Induced labour is not the same as going into labour naturally and studies have shown that it can be much more painful than a natural labour. The drugs used in an induction of labour do not trigger the same responses in the brain that cause a rush of pain-relieving hormones to be released into the blood stream. In a natural labour, a womans own endorphins are released in response to pain. Endorphins as a painkiller are much more powerful than morphine. Twenty different types of endorphins have been discovered in the nervous system. One of the endorphins, beta-endorphin, is 18-50 times more effective than morphine , while another, called dynorphin, is over 500 times stronger.

This means that a first time mother is up to 3 times more likely to request an epidural for pain relief. The risks of epidural then also apply meaning she is more likely to need an assisted delivery - such as forceps, vacuum or a c-section.

3. The risk of Fetal Distress is higher

The drugs used for an induction of labour are much more powerful than those in a natural labour. The hormones of labour also moderate each other, for example, if the mother is feeling a huge amount of pain then more endorphins will be released - or if the baby is not in the correct position, this lack of correct stimulation will cause the contractions not to get stronger until the position is changed. With an induction, the drugs are blindly forcing the body to labour and the drip can not react to any messages the baby or other hormones in the mothers system may be trying to communicate. The first time a problem will be picked up is when the baby goes into distress. This is also why babies born from an induced labour are also more likely to need resuscitation, NICU care and have lower APGAR scores.

A baby who is being born at 38 weeks also has the risk that the due date may have been incorrect and is therefore younger than 38 weeks. A baby born before 38 weeks will be more likely to have comprimised breathing and need special care in NICU.

4. The risk of major maternal complications is higher

When a Pitocin drip is used to induce labour it increases the chance of hyperstimulation of the uterus. This means that the muscles of the uterus are being over-worked and once the baby is born there is a much higher risk of Post-Partum Hemorrhage (excessive bleeding after birth). If the uterus has become overstimulated it will be very tired and unable to adequately contract, thereby sealing off the open blood vessels at the site where the placenta was attached. After a non-induced labour, if such bleeding occurred an injection of a similar drug would be given to assist in contracting the uterus. If Pitocin has already being used then other stronger drugs may be required, or in an absolute worst case senario a hysterectomy would be done or the bleeding could result in the death of the mother.

Perspective

While these risks are present for any induction, it's important to look at the reason why it may be necessary. If a mother is sure of her due date and the baby is most definitely overdue and showing signs of less movement or dips in heart rate, then an induction would by far outweigh the risks of continuing to wait for labour to occur naturally.

The best thing to do if you are being pressured to have an induction at 38 weeks is to ask for more information about what your Bishop Score is. This will help you to know if there is any chance that the induction will be successful or if it will be more beneficial to wait until your body is more ready to go into labour.

The Bishop Score

Bishop score is a pre-labour scoring system to assist in predicting whether induction of labour will be required. The total score is achieved by assessing the following five components on vaginal examination: The Bishop score grades patients who would be most likely to achieve a successful induction. The duration of labor is inversely correlated with the Bishop score; a score that exceeds 8 describes the patient most likely to achieve a successful vaginal birth.

**Bishop score**
Parameter\Score	0	1	2	3	Description
Position	Posterior	Intermediate	Anterior	-	The position of the cervix varies between individual women. As the anatomical location of the vagina is actually downward facing, anterior and posteriorlocations relatively describe the upper and lower borders of the vagina. The anterior position is better aligned with the uterus, and therefore there is an increased likelihood of spontaneous delivery.
Consistency	Firm	Intermediate	Soft	-	In primigravid women the cervix is typically tougher and resistant to stretching, much like a balloon that has not been previously inflated. Furthermore, in young women the cervix is more resilient than in older women. With subsequent vaginal deliveries the cervix becomes less rigid and allows for easier dilation at term.
Effacement	0-30%	31-50%	51-80%	>80%	Effacement is a measure of stretch already present in the cervix. It is analogous to stretching a rubber band; as the rubber band is stretched further, it becomes thinner. This is affected by individual variation and previous surgery such as loop excision for cervical dysplasia or cancer.
Dilation	0 cm	1–2 cm	3–4 cm	>5 cm	Dilation is a measure of the diameter of the stretched cervix. It complements effacement, and is usually the most important indicator of progression through the first stage of labour.
Fetal station	-3	-2	-1, 0	+1, +2	Fetal station describes the position in of the fetus' head in relation to the distance from the ischial spines, which can be palpated deep inside the posterior vagina (approximately 8–10 cm) as a bony protrusion. Negative numbers indicate that the head is further inside, above the ischial spines.

If your Bishop Score is lower than 8 then it is unlikely that induction will be successful.

Using a Birth Stool

Sun, 30 Oct 2011 18:22:24 +0100

A birth stool is a great addition to your options when having an active birth. It's probably one of the oldest birth tools around, as even the Goddess Isis is depicted in ancient carvings as giving birth on a birth chair, or stool.

In fact, the modern origin of giving birth in the Lithotomy Position (ie. flat on back, legs apart) was the result of a certain King who found it to be the optimal position for his mistresses to give birth in for his viewing pleasure. As the role of birth moved from being the realm of women and midwives to that of the male doctor it was used for the doctors benefit only.

Before this, all depictions of women giving birth have been ones of them in upright positions that normally involve squatting or kneeling. Not only does this position allow some help from gravity but prevents the full force of the babies head being directly on the perineum and therefore reduces the chance of severe tearing.

A birth stool helps the woman maintain a squatting position, without having to support all her weight on her legs. Her partner or Doula can also sit behind her in order to provide something for her to lean against and rest between contractions.

You can hire your own birth stool from BirthWorks - http://www.birthworks.co.za .

Here is a great video that shows how a birth stool can be used during birth:

Dianatal Obstetric Gel

Sun, 30 Oct 2011 14:02:05 +0100

This Obstetric Gel is now available in South Africa. It is essentially a lubricant for the birth canal and has been found to assist in easing childbirth and protecting against damage to the perineum.

More information can be found on their website. In order to use this during your birth in a South African hospital you just need to speak to your Gynecologist or Midwife who will be able to obtain it for you.

Early Signs of Pregnancy

Thu, 28 Oct 2010 13:52:23 +0100

What are the earliest signs of pregnancy?

The early signs of pregnancy can often be difficult to detect, and can often be confused with certain illnesses as the symptoms are rather general.

The most obvious and accurate sign of pregnancy is a missed menstrual period, but many women would like to know if they are pregnant even before this. Here are some tips for seeing early signs of pregnancy.

Swollen, tender breasts

The hormonal changes in very early pregnancy cause the breasts, and nipples, to become tender and sometimes sore. You might notice this small change in breast size very early on, and perhaps a few of veins (if they are visable) may seem more apparent.

Spotting

This might occur shortly after ovulation and once fertilization has occurred. Bleeding at this time is also known as implantation bleeding as it is when the egg begins to implant in the uterus. Some women have mistaken this for an early, light period without knowing that they are indeed pregnant.

Temperature

If you are trying to fall pregnant, you may be able to see when conception occurs due to a rise in body temperature. In order to use this as a predictor you would need to have a good idea what your normal body temperature is.

Sense of Smell

Some women notice that their sense of smell is heightened very soon after falling pregnant. They will be extra sensitive to both good and bad smells as a result.

Nausea and Dizziness

These are two signs which are common side effects of pregnancy but are not always present from conception. They are generally a result of the changing hormone levels in your bloodstream and would only become high enough to cause side effects approximately two weeks following conception.

Early Pregnancy Tests

When you are unsure of the early signs of pregnancy being correct, you can also do an early pregnancy test up to three days before your period is due.

Remember that with a pregnancy test there can be false negative results, but not a false positive. This means that if you get even the faintest line indicating a postive test, then it means you are pregnant!

The Most Effective Drug to Have in Labour!

Mon, 25 Oct 2010 17:52:21 +0100

This Miracle Drug is shown to have the following effects:

50% reduction in the caesarean rate
25% shorter labor
60% reduction in epidural requests
40% reduction in oxytocin use
30% reduction in analgesia use
40% reduction in forceps delivery

The are no contraindications
There are no side effects
It is 100% safe to use by all women

This miracle does not come in a bottle or a box though. It comes in the form of a woman called a Doula! She is a trained, professional, labour companion who will support you during pregnancy, birth and beyond with emotional support, informational support and even physical support during your labour.

A doula does not replace your husband or other birth partners, and research has shown that women who have had positive birth experiences have had the ideal combination of a doula and another birth partner. A doula also provides the other birth partner with support so that s/he can also take a break and the mother is never left alone.

While a doula does not do any nursing or other medical techniques, she has indepth knowledge about them and can help you with information in order to make informed choices during labour. She can also make suggestions about how to help speed up a slow labour, or what other positions you can try if you are uncomfortable.

Even if you are planning a c-section, a doula can be an invaluable resource to help look after you and your partner during surgery and then help you with breastfeeding and comfort measures following the surgery.

BirthWays is a team of WOMBS Accredited Doulas who work in and around Cape Town!

Read more about us here.

Looking for a doula in other areas? Visit WOMBS for a national database.

Or phone the National Call Centre on 0860-410 032

How to choose a hospital for childbirth

Sun, 17 Oct 2010 09:27:06 +0100

When autumn comes to New Mexico, the aroma of green chile being roasted fills the air. Locals buy big burlap sacks of chile which are poured into a big drum that turns over a fire until the chile is charred (which then allows the skin to be peeled off).

Chile is mild, medium, hot, or very hot! Locals know enough to ask, “How hot is your chile?”

One day a newcomer to New Mexico stopped at the Grocery Emporium on Girard Boulevard and bought a bag of roasted Chile. The aroma made her mouth water all the way home. Using her chile, she prepared a traditional New Mexican dinner. A few bites into the meal, her eyes began to water and her tongue burned painfully.

The following day she marched up to the chile roaster and began complaining that the chile he sold her was too hot. “Look lady,” he replied, “I just roast and sell chile. If you don’t like your chile hot, you should have asked me about it!” (from Birthing From Within, by Pam England and Rob Horowitz)

So what do YOU think this has to do with birth?

Many of us will will have certain things we’d like to have or do during pregnancy and childbirth, some people write a birth plan and others just have a vague wishlist of what they would and wouldn’t like to do. The birth plan or wish list might contain things like:

- no interventions unless they are absolutely necessary

- to use breathing techniques or gas and air for pain relief

- my husband and mother to be with me

- to hold my baby straight after he or she is born

- to breastfeed my baby and have him or her in the room with me

Other vague ideas you might have in the back of your mind during labour might be things like

- I might like to take a bath during labour

- I think I might like to be squatting when I give birth

- I’ll drink water and apple juice to keep my energy up

Just like the lady and her chile, with the idea of having a delicious meal that wouldn’t blow the roof of her head off and clear her sinuses like never before, she was doomed to disappointment before she even took the first step.

Hospitals too are selling a product, and there is often some very fine print that stipulates certain protocols that are in direct opposition to what you might be planning or wishing for. It’s important to know what you’re buying so you don’t discover at the point of being in labour that your hospital is only in the business of selling extra-hot chile when your preference is for ultra-mild! (hows that for a mixed metaphor? Ha!)

When we choose to buy something as like a car, we ALWAYS explore our options, read up on different makes and models, test drive a variety of cars and really weigh up all the different options available so we get something that suits our needs and our pocket too.

When you think of something as important as the day your baby arrives in the world, shouldn’t we be exploring ALL our options too?

I can honestly say I know nothing about cars. I can differentiate between the different types according to size and colour, but that’s about it! I can totally understand how parents can find exploring all their care options for birth quite daunting, as it can be a huge learning curve. That’s a lot like me trying to choose what car to buy. While I’d love to be able to walk into a car dealership and tell them what kind of car I’d like to be driving, they’re only going to sell me one of theirs and not suggest the dealership across the street instead!

Some hospitals offer their own childbirth classes but there is something important to remember about those classes. If a hospital expects women to lie flat on their backs with feet in stirrups when it comes time to deliver they aren’t going to give you information on alternative positions or giving birth in water. That’s not part of the product they are selling, so there is no reason why they should inform you of other versions of the product that are available elsewhere.

You might have seen some of those adverts for insurance options where a third party website will get you quotes and options for cover from a variety of places. This is the kind of approach we need for childbirth. We need to seek out a classes that aren’t helping sell a specific product, but rather give us all the available options.

It’s also one of the frustrating things most Doula’s encounter quite a bit. We see women who would really like to have a natural birth and be free to move around as they feel comfortable and be free to birth as they please. Then they go and choose an obstetrician as their primary care-giver who works in a hospital with a c-section rate that is over 80%. To use the car metaphor again, that’s like wanting to buy a cheap and economic car but going to a high end car dealership to buy it. When the mother is asked why, she can give a variety of reasons but the doula knows deep down that what this mother believes to be true about birth is very different to what she says she says she wants.

The Birthing From Within classes that I give are about helping mothers discover what this truth is. I ask them directly - What is it that YOU need to know, or do, to give birth? This is a harder question than one might realise, because it leads you to the real crux of things – what do you believe is the truth about giving birth?

To discover what your truth is, just imagine someone saying the word “childbirth” and draw the first image that comes to mind - like you would in a game of pictionary. This immediate image is often created by these “truths” that we are both consciously and subconsciously influenced by.

In most cases I see pictures that resemble this:

It’s important to be aware of these images because once you are, you can strip away the preconceptions and truly start to look within the deepest parts of yourself to understand what birth is to you, and you alone.

Like life and death, birth is not something we plan but something that unfolds before us with many surprising twists and turns along the way. When you start exploring what you want and need to give birth, it’s about exploring options and then setting sail in a particular direction but not having a “lust for result” or caring too much about how to get to your final destination. What you do want to prepare for is the journey and for dealing with whatever unfolds.

This exploration is more than just about childbirth, it’s actually about learning more of who you are and even expands to other areas of your life. Everything becomes so much more of an adventure when you find harmony between having a goal and also being open to go with the flow of the present moment.

Like I now say – how you give birth is not whats important, it’s feeling loved, supported and cared for along the way and knowing that each step you took to get there was done in awareness through making informed choices.

South African Unassisted Homebirth

Wed, 13 Oct 2010 17:19:48 +0100

This is a beautiful story of an unassisted homebirth by a woman living in South Africa. It contains photo's and also the most fantastic video of the little boy following the birth, who is very alert and peaceful!

Unassisted Homebirth Story (this link will take you do a different website - please use your browser "back" button to return)