Alice's blog...

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  1. A lovely doula testimonial, just in today! Well done to Lian, Paul and little Sebastian - have a safe trip back to Zimbabwe :)

    "We came home from Zimbabwe to have our first child as we wanted to be somewhere we felt safe and supported. Our hope, should all go well, was to have a water birth at home but whatever happened we decided we wanted to have the support of a doula to either facilitate the most natural birth possible or to help us navigate 'the system' should anything go awry.

    From day one (week 35 for us!) Alice was reassuring and supportive, she provided the hypnobirthing course as part of her doula services and this really helped with our relaxation and mindset especially in the weeks to come!

    As our due-date came and went and the days ticked by there was a creeping realisation that we may not be getting the homebirth we were hoping for. At term + 12 we were asked to consider an induction... Alice came straight to our house when we called and helped us discuss our options - we really felt that there was no judgement but having her there as a knowledgeable and impartial facilitator enabled us to be happy with our decision to go in for monitoring but not automatically agree to an induction at that point.

    Unfortunately a scan at term +15 indicated that fluid levels were very low and so with this added risk factor we agreed to an induction. Alice agreed to attend us in hospital as the syntocinon drip was set up and at this point it was wonderful to have a familiar face amidst a sea of strangers (I have to note that the care we received at Treliske from the antenatal and delivery teams was nothing but wonderful).

    Sebastian was born, happy and healthy, but with a rather large accompaniment of meconium on the 30th May at term + 18!

    In the hospital environment, in what became a highly medicalised birth, we felt that Alice's continued presence during labour was not necessary, although we were able to use the hypnobirthing techniques she had taught us to help remain calm and positive about what was happening.

    But in the days that followed, including a somewhat stressful time on the postnatal ward (we felt rather 'bullied' and then neglected by the staff there, with the exception of a wonderful maternity support worker), we relied very heavily on her continued support. She was available to us on the phone at all times and visited us twice once we returned home. To 'de-brief' with her was invaluable and I think, alongside the wonderful support of our family, was responsible for such an easy time adjusting to life with a newborn - 3 weeks in and we seem to have escaped the 'baby blues' completely!

    We already know that all being well we'd like another member of our family quite soon - we would definitely return to Cornwall to have another baby and would be calling on Alice yet again! It would be wonderful if no.2 comes of their own accord and we get the natural home birth we would like, but nothing in this world can really be planned and especially not labour - being well supported by Alice through the journey made coming to terms with a change of plan so much easier."

  2. It's been a busy few weeks of doula appointments and teaching hypnobirthing home workshops here in Cornwall...

    I was also asked by a new mummy to encapsulate her baby's placenta for consumption!

    placenta encapsulation in CornwallHere's the finished product after being steamed, dehydrated, ground and popped into vegetarian capsules. Around 80-150 pills are normally yielded. This placenta was quite wee, but there's 62 capsules in there - enough for at least 10 days postpartum.

    There's a lack of clinical research controlling for the placebo effect, but anecdotally many mums swear by this... Believing the pills to increase milk supply and keep them balanced and upbeat
    . Mum says:


    "My milk's going really good after 5 days and baby being 8 weeks early. I really feel its helping yay! 😊"

  3. hypnobirthing amazon mp3


    I've just checked out if I have any reviews for my 'Positive Birth Preparation' MP3 on Amazon. Since they started selling it in September last year I've had 63 sales and three reviews... All five star!


    "This is a Great track to take you through labour from start to finish . I would recommend it to any woman preparing for labour."

    "Great track and for a small price under a pound! Can't really go wrong with the relaxation techniques. Yet to use it through actual birthing, only on prep so far."

    "My friend recommended this to me as she said it always helped her to sleep and she was always asleep before it had finished. She was right. I have real trouble sleeping and obviously with pregnancy this is exacerbated. I find this really helps. Made me a little emotional at first if I'm honest but really does do the trick and I'm very glad I got it and for the price, well it's amazing."



  4. After a birth I attended recently where a well-meaning midwife exclaimed to my mum:

    "You did so well, you didn't need a doula!"

    I felt compelled to add the following to my doula page...

    "It's a challenge to exactly conceptualise a doula's role... and just like you, we're all different! Some believe in 'mothering the mother', others believe in teaching and empowering parents to 'do it themselves'. But wherever a doula finds herself along that continuum (and she's adaptable depending on your needs), she offers neutral information, guidance and non-judgemental support to the whole family, at all times, no matter how your baby is born.

    I like to work with you and your chosen birth partner extensively during the antenatal period. I offer highly regarded hypnobirthing tuition and resources, and we fully explore the birth process, your rights, choices, how to communicate effectively with care-providers, early baby care and more. I've been described by parents as their 'go-to person'.

    Subsequently, by the time of the birth my families are very well prepared, relaxed, confident and require little (if any) intensive 'hand-holding'. I work alongside your birth partner in maintaining an optimal space and ensuring that your care remains woman-centred. If you're coping well my presence is simply familiar, reassuring, quietly encouraging and low-key.


    "The guide is self-effacing and scanty of words. When her task is accomplished and things have been completed, the people say "We ourselves have achieved it!"

    (Tao Teh Ching)


  5. Much in the news today about recent British Medical Journal published research on homebirth safety for mothers.

    The study sample included 150,000 low-risk women who gave birth in the Netherlands between 2004-2006.

    For women expecting their first babies, their risk of being admitted to intensive care or needing a large blood transfusion was pretty similar for planned homebirths vs planned hospital births:

    2.3 per 1000 vs 3.1 per 1000 (respective safety 99.77% vs 99.69%)

    For women who had given birth before, their risk of postpartum haemorrhage was significantly less following planned homebirths vs planned hospital births:

    19.6 per 1000 vs 37.6 per 1000 (respective safety 98.04% vs 96.24%)

    Ank de Jonge, midwife and senior researcher on the study said:

    "This comes from a good risk selection system, good transport in place and well-trained midwives."

    In response, Dr Tony Falconer, President of the Royal College of Obstetricians and Gynaecologists said:

    "The rate of home birth in the UK is low (2.4%) in comparison to the Netherlands (20%) where the proximity to specialist services with short transfer times is the norm.

    "The same advantages are not always available across the UK, so the safety of home birth has to be considered in the context of the availability of local services."

    In contrast, Cathy Warwick, chief executive of the Royal College of Midwives welcomed the research, saying that the choice of homebirth should be promoted and available to all low-risk women, but often low staffing levels mean many women who wanted a homebirth are denied that right.

    The Birthplace in England study published 2011 also found benefits of homebirth for mothers, namely a reduced 10% risk of having medical interventions for those who planned a homebirth, compared to a 40% risk of such for those who planned a hospital birth.

    I've certainly known of families who have, when told on the phone that "there are no midwives available for your homebirth" have insisted upon midwives attending, for personal preference and also valid safety reasons, e.g.

    "I will not be putting myself and my baby at increased risk of giving birth in hospital"

    - and, sure enough, midwives are 'found' somehow... But not everyone knows that they can decline transfer or would feel comfortable doing so.

    But this research is good news :)

  6. Feel free to copy or adapt the following for your birth preferences document if you'e planning a caesarean birth. There are no right or wrong choices, but the following is provided as food for thought. You can totally own this birth!

    Your preferences should be fully discussed with your care providers during pregnancy, and this plan also serves to remind them on the day.

    Some expectant parents who are planning vaginal births choose to staple a 'just in case' caesarean plan to their birth preferences too...


    Birth Preferences...

    Thanks for being part of our baby's birth! The following preferences assume that all is well. If anything changes please keep me fully informed. I plan to be an active participant in my baby's birth:

    • IV to be placed in my left arm (non-dominant side)
    • Our own birth music to be played in theatre
    • Please help us to have a calm, quiet, respectful atmosphere
    • Gown and ECG to be arranged to allow for skin-to-skin
    • Ask me if I'd like the drapes lowered to see my baby being born
    • Please birth my baby from my body as slowly and calmly as possible
    • Please wait for my baby to begin breathing before clamping the cord
    • Place my baby on my chest ASAP
    • At any times I am not holding my baby, my birth partner will do so
    • Do not announce our baby's gender- we want to discover this ourselves
    • Our baby is to receive oral / injection of vitamin K
    • We will / will not be keeping our baby's placenta


    Positive caesarean tips


    Positive c-section

    These photographs are from the birth of our youngest Oska who was born via c-section in July 2010. The one on the right is a photograph Jay took of me watching Oska being checked over and wrapped up before being brought back for our first snuggles. This was such a huge moment for me as we lost a baby before getting pregnant with Oska and I spent the whole pregnancy in fear ... Seeing him out of me, hearing him crying was the most blissfully relaxing moment, just complete and utter joy. The photo on the left I took of Jay having his first cuddle with Oska whilst I was still being stitched up ... I'm pretty sure the mws/OBs thought I had lost my mind ... still worth every odd look to see forever how tenderly your partner is even after being a seasoned daddy of four! :)

    Bekkie, Bambino Art Photography
    , UK Birth Photographer,

     



  7. For those of you wanting to see more natural births, and more of Virginia after last night's 'Home Delivery'  documentary!

    Amy is seen practicing HypnoBirthing® The Mongan Method. This is a method I have trained in and used for a while, but I share the same particular reservations about the approach as Virginia, which is partly why I have moved on to develop my own approach to hypnobirthing.

    These films are produced by Berny Bos and shown on her fantastic online birth channel MyBirth.tv






  8. Highly recommended watching! Put this in your diaries...

    ITV1 will be screening 'Home Delivery' at primetime on Thurs 21st March 2013. This program was made in conjunction with Kent independent midwife Virginia Howes, who wanted to show how different birth can be to the dramatic births and patriarchal outdated practice often depicted on shows like C4's 'One Born Every Minute'.

    The show follows the births of three women who planned their homebirths with Virginia. Some require assistance, but this promises to be a realistic look at birth rather than dramatisation and scaremongering.

    Here's the ITV1 synopsis:

    "50 years ago 30% of women gave birth at home, now it’s less than 3%.

    Up and down the country a rare event is taking place, women are going against convention and having their babies at home. With privileged and intimate access to homes across the UK, we follow the magical moment when independent midwife Virginia, brings new life into the world.

    We follow Virginia’s unpredictable and exciting life as she races to make sure she arrives in time – before the baby does. And meet three incredible women who are going against convention and saying 'no' to a hospital birth and instead, choosing to labour in their living rooms"
     
    Please spread the word! If there are enough viewers and support for the show perhaps there will be more commissioned. The media has a huge influence in how our culture perceives childbirth...

  9. Limitations... This is a small sample of women who chose to practice hypnobirthing. Data is included from all women who judged themselves to have practiced 'enough' or 'extensively' by the onset of labour. Women practiced in different ways. Data is excluded from those experiencing rare complications that typically affect just 0.5% to 3% of babies nationally.

    Results... The following bar charts display results as percentages

     Hypnobirthing outcomes Cornwall
    vbac rate hypnobirthing
     hypnobirthing pain relief statistics

    *If births involving syntocinon for induction or augmentation are excluded, the epidural rate was 0%

    homebirth rate hypnobirthingu
    hypnobirthing results Cornwall



  10. I walk along holding your 2-year-old hand, basking in
    the glow of our magical relationship.

    Suddenly I feel a kick from within, as if to remind me
    that our time alone is limited. And I wonder: how
    could I ever love another child as I love you?

    Then he is born, and I watch you. I watch the pain you
    feel at having to share me as you've never shared me
    before. I hear you telling me in your own way, Please
    love only me. And I hear myself telling you in
    mine, I can't, knowing, in fact, that I never can
    again.

    You cry. I cry with you. I almost see our new baby as
    an intruder on the precious relationship we once
    shared. A relationship we can never quite have again.

    But then, barely noticing, I find myself attached to
    that new being, and feeling almost guilty. I'm afraid
    to let you see me enjoying him - as though I am
    betraying you.

    But then I notice your resentment change, first to
    curiosity, then to protectiveness, finally to genuine
    affection.

    More days pass, and we are settling into a new
    routine. The memory of days with just the two of us is
    fading fast. But something else is replacing those
    wonderful times we shared, just we two.

    There are new times - only now, we are three.

    I watch the love between you grow, the way you look at
    each other, touch each other. I watch how he adores
    you - as I have for so long. I see how excited you are
    by each of his new accomplishments.

    And I begin to realise that I haven't taken something
    from you, I've given something to you. I notice that I
    am no longer afraid to share my love openly with both
    of you.

    I find that my love for each of you is as different as
    you are, but equally strong.

    And my question is finally answered, to my amazement.
    Yes, I can love another child as much as I love you -
    only differently.

    And although I realise that you may have to share my
    time, I now know you'll never share my love. There's
    enough of that for both of you - you each have your
    own supply.

    I love you - both.
    And I thank you both for blessing my life.


    Author unknown


    Expecting a sibling poem
  11. The Hospital Episode Statistics Maternity data set for 2011/12 was released a couple of days ago. Royal Cornwall Hospitals NHS Trust seems to perform better than other England trusts on average:

    • 18.6% total caesarean rate vs 25%
    • 8.3% elective caesarean rate vs 10%
    • 10.3% emergency caesarean rate vs 15%
    • 12% ventouse/forceps delivery rate vs 13%
    • 19.1% of women delivered their babies in an entirely midwifery-led setting vs 10.7%
    • 51.2% of women gave birth 'unassisted' (meaning without medical intervention) vs 45.5%
  12. Nobody really knows the origin or meaning behind Sheela-Na-Gig figures. They've been discovered all over Europe, usually in places like churches and castles.

    There's a theory that some may have been used as 'birthing stones' by women in labour... Perhaps for visualisation and affirmation!

    Maybe I could make some...


    sheela-na-gig

  13. For the next twenty years the seaside town of Ilfracombe will play host to 'Verity', Damien Hirst's 70 foot statue of a pregnant woman brandishing a sword. Half her torso is presented in an anatomical style revealing her sleeping baby within. Verity, meaning 'truth' in Italian, represents a  “modern allegory of truth and justice."

    damienhirtsveritystatueproposalinengland1_0

    hirstverity_0


    The local council has received 100 plus complaints from local residents, brandishing the statue outrageous, immoral, bizarre, obscene, offensive, disgusting, distasteful, embarrassing, grotesque, disrespectful, insensitive, inappropriate, a monstrosity, tasteless, ugly, vulgar and not in good taste.


    How divorced are we as a society from the realities of being human?! My favourite comment on Verity, on a Facebook thread, simply says:

    "She is a fertility Goddess. Oh we forgot about her. We thought cars were more important. She is awesome."


    Verity reminds me of something written in a Guardian article I was sent by a friend and former client yesterday. Frances Harrison, on the relationship between being a mother and war correspondant, contemplates how:

    "As a mother, I found it harder to fathom the extraordinary cruelty otherwise gentle people are capable of in wars. At night in Sri Lanka, I would sit under the ceiling fan and rock my tiny baby to sleep in my arms, haunted by the stories I reported by day: tales of torture, mass graves and the agony of the missing fighters' mothers who never received a corpse to mourn. Both sides reeled out casualty statistics like cricket scores, forgetting the people they talked about were once someone's baby, loved and protected. It made it hard to get excited about the military hardware side of war – it didn't matter much if it was a T56 or AK-47 that did the killing. In the male-dominated world of foreign reporting I never admitted it, but motherhood did bring a new perspective to the story."



    Verity also reminds me that as childbearing women we are powerful, amazing and strong. How striking is the contrast between this and the mainstream perception of pregnant women as delicate, vulnerable and stupid? Similar to Marianne Williamson's poem:

    "Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness that most frightens us. We ask ourselves, Who am I to be brilliant, gorgeous, talented, fabulous? Actually, who are you not to be?..."

  14. In the year 2009/2010, 8.3% of women giving birth at Royal Cornwall Hospital (Treliske) had an elective caesarean section (NHS Information Centre).

    The reasons for choosing a caesarean are varied. For those experiencing a 'low risk' pregnancy and labour, intervention-free, vaginal birth is normally the most advantageous way for a baby to be born (Enkin 2000).

    For those who require help - for either physical or unresolved psychological reasons, scheduled caesarean birth from 39 weeks can also be a low risk option, according to Dr Anthony Falconer, Royal College of Obstetrics and Gynaecology President:

    "Recent advances in medical science have made the procedure much safer and for most women the complications of this operation are low" (press statement 2011).


    Pregnant women should be offered evidence-based information and support to enable them to make informed decisions about childbirth.

    Recently updated national NICE guidelines state that women who haven't had any problems in their pregnancy, having a first, planned caesarean birth, may be at an increased risk of experiencing the following, compared to if they had a planned vaginal birth:


      - baby admitted to neonatal intensive care: 13.9% vs 6.3%
      - hysterectomy caused by postpartum haemorrhage: 0.03% vs 0.01%
      - cardiac arrest: 0.19% vs 0.03%
      - longer hospital stay: 3.96 days vs 2.56 days


    (Nice clinical guideline 132, published November 2011)

  15. I just stumbled across this interesting short piece on Youtube... Fascinating to see how similar the depictions of childbirth are... All strong, upright women. My favourite quote from this:

    "Every woman has something of the goddess inside her."



  16.  

    Location  Type
    Births per year

    Normal birth rate* Induction rate

    Caesarean rate

    Instrumental delivery rate Epidural available? Birth pool provided?
    Royal Cornwall Hospital (Treliske) Consultant-led 3700 38.5% 22.4% 22.2% 13.5% Yes No
    Penrice Birthing Centre Midwifery-led 350 95.9% <2%     No Yes
    Helston Birth Unit Midwifery-led 60 >91%       No Yes
    St Mary's Hospital (Isles of Scilly) Midwifery-led 4         No No
    Homebirth Midwifery-led 182         No No buy/hire


    *A normal birth is one that avoids the following, according to the Maternity Care Working Party:

    • induction of labour (with prostaglandins, oxytocics or ARM)
    • epidural or spinal
    • general anaesthetic
    • forceps or ventouse
    • caesarean section
    • episiotomy


    The table doesn't cover local data on the intervention rates (induction, instrumental delivery, caesarean etc) of births that transferred into hospital from a midwifery-led setting.
    However, recent data from all NHS trusts in England found that women planning a birth in a freestanding MLU experienced a 17% intervention rate, and women planning a homebirth experienced a 10% intervention rate (compared to those who planned a hospital birth, who experienced an average 40% intervention rate).


    2011 data provided by Birth Choice UK, Dr Foster Health and the Birthplace in England study

  17. A large study published in 2011 compared death and injury rates for the babies of 64,538 low risk women giving birth in a variety of settings in England between April 2008 and April 2010.

    The women planned births either at home or in midwifery-led birth units (like Penrice / Helston) or in consultant-led hospitals (like Treliske).

    • Birth was found to be very safe with over 99% of babies having good outcomes wherever their mothers planned to give birth

    • For women not expecting their first baby, there was no difference in outcomes wherever they planned to give birth

    • For first time mothers, births planned at hospital were safe for babies 99.57% of the time, and births planned at home were safe for babies 99.07% of the time. The authors state this small difference is unexplained, but asserted that homebirth is still safe for first time mothers

    • It's also interesting to note that women planning a hospital birth experienced a 40% medical intervention rate (e.g caesarean, forceps, ventouse) compared to those who planned births at a freestanding midwifery-led unit (17%) and those who planned a homebirth (10%)

     

    Treliske labour wardResearch link:

    Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study BMJ 2011;343:d7400