Dating Scans: A comfort or crime?

Over this year I am doulaing for 4 women who are enjoying their first pregnancies, and all planning to give birth at home.  Each one of them was very sure of her dates when she had her last period and some were sure of ovulation.  All of these 4 women were told at dating scans around 12 weeks gestation that the scans were more accurate than their own dates that they had charted.  Each one of these women have been given a date of 40 weeks which is actually around 39 weeks or 38 weeks of pregnancy.

I was quite shocked by this so decided to throw the question out to the homebirth group that I facilitate.  The response was quick – 2 women emailed me to say their recorded due dates were a week earlier than their own calculations and several other women shared their unhappiness at dates not corresponding to their own knowledge.  I asked all the women expecting a subsequent baby that I was doulaing for and many of those were given expected due dates earlier than expected.

Now we only have to go over the see to France, a neighboring Country, to find a system of determining gestation of pregnancy between 41 and 43 weeks.  At least that gives some leeway if a dating scan is so far from the reality.

http://www.frenchmamma.com/2011/07/how-to-calculate-your-pregnancy-due-date-in-france/

This has led to much reflection. ……

Firstly, I ask: What is happening here?

Women who are aware of their own bodies, who chart their cycles, are being undermined.  Instinct and intuition is being written off at the start of pregnancy.  Women are being taught that the healthcare provider knows best.

Women with healthy pregnancies and beautifully nurtured growing babies are being told their babies are at risk, due to postdates, with a higher chance of stillbirth.  Induction is offered between 41 and 42 weeks, a membrane sweep is offered at 40 weeks.  Often a pregnancy based on the woman’s own cycle is not even at the 40 week mark.  This is a human rights issue.

Women planning to have their babies out of hospital, at home or at a birth centre (for the lucky few who live near a birth centre that is not closing down) are being told this choice is not allowed, and are often told their babies will die.  Women having planned home births and aware of the risks associated with birth in a hospital are going into hospitals reluctantly, consumed with stress, and often surrender to the procedures they had planned to avoid by planning home births or births at MLU (midwife led units).  This is a feminist issue.

There are many worthy articles about the risks of induction, see The Thinking Midwife

http://midwifethinking.com/2010/09/16/induction-of-labour-balancing-risks/

Or look at the AIMS booklet:

http://www.aims.org.uk/pubs3.htm

My other question is what does this do for the self-esteem of women and the future of birth?

Women are being brainwashed into the lie that their bodies do not spontaneously go into labour.  Natural birth then becomes a myth under this belief.

‘’Considering that induction of labor brings with it some important risk factors, perhaps induction isn’t quite so seductive after all. Five of the documented risks include:

1)    abnormal fetal heart rate[1]

2)    baby being admitted to the neonatal intensive care unit (NICU)[2]

3)    use of forceps or vacuum extraction[3]

4)    prematurity, jaundice and breastfeeding difficulties[4]

5)    cesarean[1] [5],[6],[7]’’ ( http://www.scienceandsensibility.org/?tag=risks-of-induction)

Breastfeeding has become harder as a result, with infants struggling to latch on after drugs have crossed the placenta. (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1595228/)

Women are starting their journeys as mothers DONE IN!  Exhausted, physically, emotionally and spiritually.

What can we do about this?

Women need support to access more knowledge in their first 12 weeks of pregnancy.

By this statement, I guess I am raising awareness of our cultural tendency to keep the pregnancy quiet in case of miscarriage.  As a woman who has birthed a baby not ready for this world, at 12.5 weeks, I can say that support at this time is crucial.  So women need to connect with other women, we need strength in our voices and strength at times of sadness and challenge.  I see this happening all around me with Red Tent movements happening across the UK.  In particular, around Yorkshire from where I am writing.  CONNECT, CONGREGATE and CARE.  Share stories of your monthly cycles, dreams and build that strength that we are capable of giving as womyn.

Consider whether you want to have a dating scan?  If you know your cycle, stay with it.  Trust that age-old wisdom that has been the voice of reason through a million years of mammalian birth.  Get the information regarding the safety of ultrasounds.

Ask yourself what an ultrasound will give you.

Yes, you will get a picture of your baby, but does this scan at this moment tell you what will be happening tomorrow?

Does this scan tell you on what day your baby will feel ready to embark on their journey into the world?

Will this scan give you confidence in your knowledge you have been handed by your ancestors?

Come on women, stand up and use that voice from within with confidence and strength.

 

References

[1] http://www.ajog.org/article/0002-9378(95)91415-3/abstract

 

[2]http://journals.lww.com/greenjournal/Abstract/2000/08000/Forty_Weeks_and_Beyond__Pregnancy_Outcomes_by_Week.26.aspx

[3] http://aje.oxfordjournals.org/content/153/2/103.full

[4] http://www.marchofdimes.com/pregnancy/vaginalbirth_inducing.html

[5] http://www.ncbi.nlm.nih.gov/pubmed/20027037

[6] http://www.aafp.org/afp/20000215/tips/39.html

[7] http://www.ncbi.nlm.nih.gov/pubmed/10511367

Secret Diary of A Doula

secret diary

It was Christmas Eve and of course, my kids took ages to get to sleep, so I snuggled in next to my youngest and she soon drifted off.  I retired early to bed after Father Christmas had visited the kids, of course!  No glass of wine this year as I am on call for a woman called Mary expecting her first baby.  My husband stayed up watching a movie whilst I retired to bed.

I couldn’t sleep that night and I was up a few times.  The phone rang at 4.50am; it was Glen, Mary’s Partner:

“Hi it’s Glen, Mary is in labour and contractions are pretty intense.”

I take a few minutes to wake up and walk through to another room (at this point the whole family are in our family bed).  “HI Glen, How often are Mary’s surges?”  I ask.

“Well they are not regular but she said she had a show and they started 2 hours ago” He replied.

My tired brain has kicked into action, not regular, intense; hmm is she in early labour?  Whilst I was thinking, I could hear Mary in the background and asked if she could speak.  Glen asked and I heard her push the phone away and moan through another surge.  She sounded consumed with her labour so I said I would go around.  Mary and Glen live close.  Sometimes I am a birth doula for a woman who lives an hour away, but usually I am no more than 30 minutes in distance.  I washed my face and my husband got out of bed and asked what was happening.  Arrrgh I thought, it is Christmas day.  By now, it was just after 5am and my kids usually wake between 6 and 7 on a good day.  We made a decision whether to wake them and decided it was much more important to see Mum and open some presents before I left.

Typically, they took ages to wake.  We all went downstairs and my husband made an open fire it was so cosy.  The kids were so excited that Father Christmas had been and left a stocking filled with gifts.  I had my cup of tea whilst the present opening ritual was in progress.  Then we let them each open a present from us.  My eldest got the star wars Lego set he had hoped for and my littlest got a balance bike. They were so happy and excited that Father Christmas had been.

By this point, it was 5.40am and I left the house smiling with joy.  Isn’t Christmas magical!  Halfway down the road, I realised I had left Mary’s birth plan at home so phoned my husband to see if he would run out with it.

It cannot be easy being married to a birth doula as sometimes you cannot plan a holiday or a party comes and your wife isn’t there.  We share the care of our children together.  Therefore, if I get called out he comes home.  I work with one or two women a month so it works in our family.

Outside, it was pitch black and the roads were dead.  It was deathly cold and ice lay over the ground.  On leaving the house, I started to get excited.  Mary is having her baby boy (she knew) at home on Christmas day.  It took less than 5 minutes to get to the house.  Again, the street was quiet and no cars were about.  A light shone through the window softly but I could not hear a sound.  I tried the door and had to knock because it was locked.

Glen came running down and opened with a smile and a slightly nervous look, let’s face it.  Who would not be nervous?  He was mid pool set up, and said ‘I have managed to calm her down.’  I smiled and whispered ‘where is she?’

He pointed up the stairs to the room she had set up to labour in. She had been relaxing to hypnobirthing CD’s in the room and using it as her quiet space.  I had met with Mary, Glen and her sister less than a week earlier to do a 2nd birth preparation session. Her sister had hoped to be there at the birth but was away with family.  Mary had been busy leading up to her baby’s arrival and she had looked forward to her two quiet days alone with Glen before the family festivities kicked in.

I quietly entered the room so as not to disturb.  Mary was leaning over her bed with her eyes shut.  She was a little panicked that she had been fighting a cold for the last few days and she may not have the energy to give birth.  I hugged her and assured her she was doing really well.  She spoke few words but I got the gist that she had had a show the night before and slept a little but not a lot and then had been vomiting and going to the loo.  This is all quite normal in early labour.  What wasn’t so normal for early labour was that Mary said she had pain in her bum.  After an hour and a half, she said she felt pushy and started to ask for reassurance.  “He is coming he is coming’ She asked alongside “Is this really it, is he coming?’  I realised that she was in transition at this point and this was confirmed when she cried “ I can’t do this anymore’.  I asked if she wanted me to call her Midwife.  Mary nodded.

At births if I ask questions, it has to be necessary and they need to be short and require a yes or no answer.  This is easy to do when you have met with someone a few times and know what they want and need.  Whilst this was happening, Glen tried filling the pool, which was missing the right adaptor.  This was something we had to keep secret from Mary so as not to stress her. She had also planned to use a tens machine but on the day she did not need it (good job as the pads for the tens were not yet purchased). Mary had wanted me to use her homeopathy kit, which I gave her pulsatilla, because she felt sick and had been weepy.  They really helped.

The midwives arrived and helped Glen with the pool.  At times Mary really started to get upset with others talking around her.  When in labour your senses can be really heightened. Everyone quietened when asked and Mary got ready to come downstairs to her birth pool.

I do love it when a labouring woman gets into a hot tub and always sighs as all the pressure starts to feel less.  We were all quiet for the next half hour or so and Glen stayed close to Mary as she accepted all the surges that pushed her baby down.  Mary had chosen to have no vaginal examinations because she thought it might disturb the natural flow.  This meant at times she asked for reassurance and we all confirmed she was labouring beautifully.  The Midwives and I stayed out of sight and Glen was wanted within eye contact. I put her hypnobabies music on.  At one point Mary laughed as she said she felt her baby moved down through the pelvis.  Mary was completely in control and did not fight what her body was doing but stayed calm and relaxed.  She did not push her baby out.  She breathed and panted under her own instruction and out wriggled her son’s head. He turned a few times and the Midwife helped him out as he couldn’t decide which way his shoulders needed to slip through. Out through the water the Midwife lifted Glen and Mary’s son, Ryden. Mary moved over him, as the cord was still intact.  She was in tears and so moved, as was Glen.  Glen put his hand over Ryden’s back and they connected as a family.  No rush and just quiet.  Mary held Ryden close and he suckled at her breast.  Not long after, Mary’s Community Midwife came by and another went back to delivery suite.  Homebirths usually have 2 midwives available.  Mary was delighted to see her Community Midwife and she was the best person to sit with her,  the placenta came.  It can take a while for a placenta to come out and a woman needs the same quiet, darkness and privacy as she does through labour.

Glen and I (mostly Glen) made tea and emptied the pool.  I gathered the dirty clothes to wash at my house because Mary and Glen had had problems with their washer over the week.  Mary got into bed after the placenta was out. Ryden is a natural with breastfeeding.

Mary snuggled in close to her son and fed him again.  I made toast and fed her whilst she breastfed.  She looked radiant and beautiful.  She was so elated with the birth she had had.  When we had met 4 months earlier, Mary had made reference to being too old to have her baby at home.  I asked her a little more and she realised that she really wanted a birth out of hospital more than in.  I met her alongside another doula Rachel from www.Mothernurturedoulas.com.

I left the new family at about 12.30pm and got home to my family.

“Mama” Cried my littlest and “Mummy, can we open more presents now” Said my eldest.

That was my Christmas!!  What an inspiring and uplifting day.  Women and men are really quite amazing!!

Jacquie’s Hero Journey

After going through a long journey to conceive we were met with a lot of resistance when I informed people I was thinking of having a home birth. I soon came to learn that this negative energy was born from ignorance and I felt more and more confident in our decision. We decided with it being our first birth and not knowing anyone else who’d had a home birth we would really like the experience and expertise of a doula and soon came across Hannah. From the moment we met I knew Hannah was the doula for us. My husband and I having polar opposite characters in many ways, Hannah just seemed to compliment our ‘team’.

I had a show on my due date but didn’t start with surges until 5 days later. It was a Friday night and within a couple of hours they were getting quite intense. I sent my husband off to bed as I had a feeling he would need his energy. I laboured through the night with my hypnobirthing cd and little physical mantra on repeat! The surges got closer and closer together, by the morning they were coming every 3-4 minutes so I woke my husband and he decided to call Hannah.

Hannah quickly arrived and started to make preparations along with my husband. Shortly after, the first team of midwives arrived, I felt like I was getting an urge to push so agreed to being checked. The midwife told me I was 2cm dilated and that the baby was back to back which would explain slow progress and the urge to push.

I found the whole process of the internal check completely crushing; being brought out of my “safe place”, engaging my cognitive brain, the pain of the check and then being overcome with feelings of sadness that I hadn’t made ‘good progress’.

I had a bit of a melt down but Hannah and my husband managed to regain some peace and calm again and we decided to try and get some rest but the rushes were all consuming so Hannah suggested getting into the pool for a bit of relief. Oh the wonderful, wonderful feeling of getting into that warm pool for the first time!! It was heaven!

After this point things get really muggy in my brain but I spent most of the day split between the pool and the toilet which became almost a safe haven.

Things got really tough at times, usually just after an internal check, I tried to have faith in my body but I did doubt it at times I have to confess. I had a few mental hurdles where I thought I just couldn’t carry on like that for hours and hours, the thing I found hardest was not being able to rest throughout the whole experience, but with the help of my husband and Hannah I regained faith that each time that I could do it.

After the last check when I was told I was almost there I went into the bathroom and did some serious squatting, and at last I could feel the baby’s head. And that was such a blissfully euphoric moment!! What a sight I must have looked, I came waddling out of the bathroom totally naked, hand between my legs, trying to run down the stairs shouting joyously, “I can feel the head! I can feel the head! She’s coming! At last she’s coming!!” Haha!

I got back in the pool with my husband and the midwife came in and said that they were concerned about the baby’s heart rate; it had dropped initially and then had risen. They wanted to give me an hour and if she hadn’t made an appearance by then they wanted to transfer me to hospital. This had such a negative impact on me as suddenly I felt like I was racing against the clock and I got a bit panicky, I stopped following what my body was telling me and was pushing when my body didn’t tell me to. It didn’t do me any good and the baby’s heart rate started to go up (the midwife was now checking her heartbeat every 5 minutes). My husband and Hannah tried to calm me down and explained that the reason the baby’s heart rate was going up because I wasn’t getting enough oxygen to her. I was so intent on pushing I was forgetting to breathe! But they talked me through my breathing and sure enough her heart rate dropped again. However the midwife at this point said that they strongly suggested we transferred to hospital as it had been an hour and they were concerned.

This was another invaluable moment of having Hannah’s presence; she gave us the confidence to trust in our instincts to stay put and helped us communicate this to the midwives.

Once we’d made that decision I felt a renewed sense of calm and confidence again and sure enough within what felt like 10 minutes she started to make an appearance. I was physically shattered by this point and it took so so much energy but we did and eventually out she came. My husband caught her and placed her in my arms. I cannot put into words that feeling, without doubt the happiest moment of my life.

We were then left, thanks to Hannah’s request, for 10 minutes to spend some time together just the 3 of us. This time was just magical and I feel so lucky that we have that to look back on and cherish, a moment which may often be missed out on in other situations.

The midwives returned, my husband cut the cord and I delivered the placenta on my sofa after one more easy push.

She was born at 00.24 on the Sunday, May 1st.

It was just perfect and I wouldn’t change a thing. I feel like a new woman, more confident and so utterly empowered by my very wonderful body! (Quite the change from the girl who thought of her body as ‘broken’)

I would so highly recommend having a doula and Hannah was just wonderful, she kept us both fed and watered, sounds simple but food and drink were the last things on my mind but I don’t think I would have managed without those energy boosts. She kept me calm and helped me regain my trust in my body when I had moments of doubt. She was wonderful at managing the midwives, we had 3 shift changes, so many people in and out, but she kept them quiet and at a distance in the kitchen! She was invaluable when it came to decision making, she gave us the confidence to trust our instincts.

She knew how to create the perfect calming atmosphere and was always a step ahead in arranging the perfect journey.

In short Hannah helped us have the best day of our lives and have the most magical start to family life.

A Local York Doula

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I am Hannah, mum of three, a York doula and I am passionate about encouraging women in confidence to have a peaceful gentle birth. I recently was awarded a ‘Making a Difference Award 2015″ by Healthwatch York. A big achievement in my career.

For everyone there will be a local doula with whom you have a warm rapport and this will be someone who believes you can birth in your chosen way. I may be this person so please make contact and we can arrange an informal chat. I have attended births at birth centres, hospitals and at home. A number of women have had VBAC’s and a few have had home water births after a previous caesarean (HWBAC).

I am  to work specifically with trauma prior to giving birth through the means of debriefing and Reiki (Reiki I and II qualified). This will be an addition or separate to the normal doula work.

“A doula is my eyes is another experienced mother, with a skill of reflecting all expertise  and wisdom back to the mother and awakening the confidence in her inner mother within.” Hannah Robertson on doulas in ‘The Mother Magazine’

“There is power that comes to women when they give birth. They don’t ask for it, it simply invades them. Accumulates like clouds on the horizon and passes through, carrying the child with it.” Sheryl Feldman

Doulas can inspire confidence, provide reliable continuity, emotional and practical support in most situations. For the most part I have been chosen by first time parents choosing home birth with the NHS, mothers who have previously experienced a traumatic birth,

mothers who have had caesareans and are planning VBAC. I work with you at your own pace to debrief previous experiences of which may impact on the birth and parenting of your new child. This involves giving you knowledge based on research so you are making informed decisions, and being there for you unconditionally. Doulas are not just for mums but they provide a great deal of support to partners and men who have needs of support as well.

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“Birth is a rite of passage of women. Their journey should be honored, their rights should be fiercely protected, and their stories should be shared.” – Marcie Macari

“Birth is not only about making babies. Birth is about making mothers ~ strong, competent, capable mothers who trust themselves and know their inner strength.” – Barbara Katz Rothman