From the Covid-19 pandemic & beyond – navigating Maternity ultra-sound scans.

TL:DR

  • All ultra-sounds in a non-complicated pregnancy are offered and not compulsory.
  • Whether you accept that offer or not is your choice!
  • If your partner is not able to accompany you in person to a scan or other clinic appointment, you can dial in with your partner or record the conversation.
  • You can feedback your experiences of your care during your pregnancy, fertility and post-natal journey via the Central Cheshire Maternity Voices partnership. (MVP)

There is no doubt that being able to see that monochromatic fuzzy outline of your baby on a screen whilst its still inside you, is an emotional and significant event. The miracle of pregnancy, combined with the non-invasive* application of scientific development is remarkable and one can be forgiven for saying, undeniably magical. Pregnant people and their families often describe it as the first time they “believed” that they were pregnant; that it was the start of a bonding process for fathers or partners; that it was an event in their pregnancy that they were most looking forward to, and so on. These feelings are real, valid, and understandable given the ubiquitous nature of scans. Occasionally the scanning experience is less anticipated and for some families is downright distressing; if anomalies are discovered or if the pregnant person has severe anxiety or fear of hospitals, for example.

Over the last 12 months, for various reasons and to varying degrees, as the Covid-19 pandemic waxed and waned and infection control procedures remain, pregnant people have often been denied the support of a significant person, to share their scan experience. If that experience is at the negative end of the scale, this can, and is causing emotional harm. There is, of course a need to balance the emotional and physical needs of an expectant person or couple with reducing the chances of Covid-19 infection to them and indeed the sonographers and support staff. At a recent Central Cheshire MVP meeting (Jan 2021) we were told that at that time, the sonographers department was running at about 70% due to their own sickness, self isolation requirements, childcare/home schooling and so on. The sonographers who do your maternity scans at Leighton maternity unit, also support the rest of the hospital. I understand the pressures and I’m sure you do, but understanding that doesn’t mean that you can’t feel stressed, angry, sad, or annoyed about the change in what you were hoping was going to be a positive experience.

I am writing this blog as a response to all of this uncertainty and change. I did some digging around the internet and found the NICE guidelines CG62 – Antenatal Care for Uncomplicated pregnancies. (emphasis my own) and by presenting this information to you I hope that you will be more able to manage your expectations, potential disappointment and preparedness for outcomes that may not be altogether positive, within the restrictions imposed as a result of the Covid-19 pandemic and beyond. It’s March 9th 2021 and the “reopening” of the country has begun, but it is realistic to assume that some level of infection control and protection will be required in maternity departments for some months to come.

A note on choice

While these scans (and many other tests and appointments) are routinely offered, and are included in such tomes as the NICE guidelines, that does not make them the law! The key words to remember are offer and choice.

Everything that happens to you in your pregnancy, birth and post-natal period (that isn’t an automatic function of your body – like contractions say) is your choice. It might be an obvious decision (to you), but it is still your choice. This is true of scans as well. You are offered scans, you think about the many factors which might influence your individual decision, and decide whether you take them up on their offer or not.

Nice Guideline CG62 – Antenatal Care for uncomplicated pregnancies

In the UK, the NICE guideline CG62 – describes two occasions when an Ultra-sound scan is offered**

  • Gestational age assessment (CG62; 1.2.6)- is offered between 10 weeks and 13 weeks & 6 days (as well as determining gestational age, this is also used to detect multiple pregnancies) If this scan happens before 14 weeks, an ultra-sound screening for Down’s Syndrome can also be offered. (Down’s Syndrome screening cannot be done by ultrasound after 14 weeks and should not be done at any time without consent)
  • Screening for fetal abnormalities (CG62; 1.7.1) – should be offered between 18 weeks and 20 weeks and 6 days this is commonly referred to as the 20 week or anomaly scan. The majority of pregnant people who have scans see healthy babies, because fetal abnormalities are rare, which leads me to believe that this is probably the reason why these scans have become synonymous with “seeing your baby for the first time” However the NICE guidelines specifically state:

At the first contact with a healthcare professional, women should be given information about the purpose and implications of the anomaly scan to enable them to make an informed choice as to whether or not to have the scan. 

NCG62 – 1.7.1.2 – emphasis my own

The Gestational Age Assessment.

A pregnancy is considered to be “term” between 37 and 42 weeks. If a baby is not born at 40 weeks (the EDD) the pregnant person is not overdue, merely still pregnant. I have blogged about this before – here and AIMS has some excellent information on Due Dates and accuracy of the various prediction methods here. (TL;DR: they’re not very accurate).

If you haven’t been aware of your pregnancy or booked in with maternity support before 13 weeks, it is unlikely that a dating scan will be helpful. It becomes less accurate as more weeks go by after 13 weeks. In these late booking in cases it is extraordinarily rare that multiple pregnancies (another reason for the dating scan offer) are not picked up through the usual schedule of regular appointments and conversations and checks with midwives, without the use of a scan at all.

If a pregnant person is sure of the dates of their last period, they may decide to decline the offer of this scan. It might be of more use in cases of irregular periods, or when recollection of menstruation dates is more fuzzy. Worth remembering though that a due date arrived at by this “10 week scan” is still an estimated due date (EDD) but anecdotally is likely to trump any dates calculated from the menstrual cycle information, even when those dates are certain. In some countries, dating scans are not offered unless there is doubt about the validity of the menstrual dates.

Declining the offer of this scan, may raise some eyebrows, and even generate some “feedback” but if you are informed and confident in your decision then remember that they are not compulsory. Declining or accepting this offer does not mean that you will decline or accept all offers. Situations and information can change and so do decisions.

The fetal abnormality scan

Screening for fetal abnormalities, whether by ultrasound or other method, is a sensitive and highly personal subject, families have their own approaches as to whether to accept these offers or not. “Seeing your baby”, “bonding with baby” and/or finding out the gender, are often happy consequences of this scan, but do not feature in the medical reasoning behind the offer.

There is nothing in the NICE guidelines, for example, about identifying the biological sex of your unborn baby, this is entirely optional and dependant on your Health Trust and the skills of your sonographer and your request to know, may be declined.

The NICE guidelines do say that the purpose of the scan is “to identify anomalies and allow:
reproductive choice
parents to prepare
managed birth in a specialist centre
Intrauterine therapy”

Whilst equipment and technical abilities are improving all the time, and more refined observations of fetal abnormalities are possible, it is still not possible to detect all the possible abnormalities that might occur, whilst your baby is still in utero. Humans survive in an infinite variety of forms and abilities, that’s one of the things that makes us so amazing.*** We also exist with different tolerances for ambiguity or control, so whether you want to be able to make a choice, prepare or undergo intrauterine therapy is your decision and yours alone, whether you have the scan or not.

Do Not Do Recommendation

The evidence does not support the routine use of ultrasound scanning after 24 weeks of gestation and therefore it should not be offered

https://www.nice.org.uk/donotdo/the-evidence-does-not-support-the-routine-use-of-ultrasound-scanning-after-24-weeks-of-gestation-and-therefore-it-should-not-be-offered

It might surprise some women and pregnant people to learn that not offering routine scans after 24 weeks is a thing. This is definitely worth knowing, if you are offered scans after this time and you have no other risk factors or concerns for needing one.

Navigating scans if restrictions are in place

Firstly – find out what ‘s happening locally. At Leighton maternity unit – as I type (March 2021), the following is the situation regarding support and attendance at pregnancy ultra-sound scans. I would expect this to be updated shortly, so will amend this post when the news breaks.

this was posted in January 2021, I would expect an update soon

This infographic obviously covers all maternity/covid restrictions locally, but in relation to scans, if you cannot or do not travel to the hospital by car, there are identified areas for partners and pregnant people to wait inside the hospital.

Secondly – know your rights. For example; if you do need to attend further for re-scans, or for any other purpose where a partner is not able to attend, you are able to video the scan and/or speak to your partner on the phone while you are in clinic.

This is a screen shot of a section of a page on Birthrights.org.uk – further hyperlinks below

Additionally, Birthrights, (a link that’s worth keeping in your pregnancy and birth resources) explain that maternity services should always consider exceptions, should review changes regularly, and provide reasonable adjustments for vulnerable communities such as those represented by disability, mental health, and Black and Ethnic minorities. Birthrights’ Covid-19 specific information where you can follow the link pictured above is here.

centralcheshiremvp@gmail.com

Thirdly – let the people who proved the services you have encountered know how they’re doing! If you have any feedback for local maternity services (Cheshire) in relation to the care you’ve received or been offered at any stage of your pregnancy or fertility journey, you can of course contact that service directly, but the Central Cheshire Maternity Voices Partnership (MVP)***** would also like to hear from you. They can take your feedback to the maternity care providers (anonymously if you wish) individually, via one of their monthly listening events, or at one of the quarterly meetings, to ensure that improvements are made or maintained.

*non-invasive but not necessarily completely harm less. https://www.aims.org.uk/journal/item/ultrasound-weighing-the-propaganda-against-the-facts
** offered not essential – up to the pregnant person to decide whether to have it or not.
*** Myself and Kate Blakemore the founder of Motherwell Cheshire, recorded an online discussion about our personal experiences of having babies with additional support needs. You can find this video here.
**** there are MVPs all across the country, if you are not using the services provided in or around Cheshire, you can find your local Partnership here.
***** I am the current vice chair of this group – so you could contact me as well if you wish.

Drawing in the lines

My reflections on my work and professional development over the first half of this year (2020) has had an unintentional theme. I didn’t even really notice it until some way in to lock down, but now that I have, with the help of my mentor and my own observations of the peaks and troughs of my own mental health, it’s really focused my mind and my actions.

The theme is Boundaries.

I work from home, self-employed in a predominately caring profession. As a Doula, I (during the normal course of events) have a low number of clients at any one time, and really get to know each one, personally and emotionally. I am for the period of time I’m working with them, their sounding board, emotional sponge and advocate. Occasionally as circumstances dictate, I also do all of that for their partners and families too. It’s brilliant, I absolutely adore it, but it can get a bit “leaky”. My clients’ concerns, worries, and problems can spill over in to my own personal life, when I spend time and energy I could be spending with my family on a client’s concerns. Some clients are more attached to me than others, and demand more of my time. I do what I can to meet their needs as individuals, but sometimes their need to be heard, intrudes on my own need for love and connection from my own family, or even just for rest and recuperation. By the same token, it’s important that my clients don’t feel discarded or ignored because of mine or my family’s needs.

I live with my semi-retired husband, two teenagers and a cat (two older children have left home, so they’re not in my immediate circle any more, but they are often on my mind) Until the Covid-19 lockdown, boundaries seemed to sort themselves out, and I didn’t think too much about it. The kids went to school, I did admin and meetings during those hours and family stuff in the evenings with the occasional phone call from an anxious client, which I was able to absorb.

My husband works 3-4 days a week from home, for a charity, also involved in delivering caring support services. He was often away from home for a couple of days each week, so would just set up his workspace wherever he fancied on the days when he was at home.

Then lockdown happened. My kids were home all the time, my husband is home all the time. I realise that I am not alone in this. His adhoc approach to work stations, had to stop, because the quantities of online meetings he now has, to replace the days he was away from home, would mean whatever room he’d chosen (often the kitchen) was off limits to everyone else for the duration – not at all sustainable. So we all set up shop in the dining room. Him, me, and the kids. Like an office. We were able to help the kids with their school work (which wasn’t often thank goodness) without being too diverted from our own work. We talked about our working days, made plans and we shut up shop at 5 o’clock or there abouts and walked away. Long, unplanned and convoluted client phone calls in the early evening, were no longer tolerable, the overlap made me stressed and anxious, in a way I’d never felt before.

In the initial lockdown, as with many other businesses, doula work disappeared overnight. Doulas were prevented by NHS trusts from entering birth spaces as a means of controlling virus spread. This restriction has continued for longer than is necessary (follow #butnotmaternity on the socials if you want more information) and I and many other doulas have become avid followers, interpreters and conduits of news, Maternity Unit updates and campaign actions. It might only be from the comfort of our own homes, but we carry the emotional burden of this work as well, whether we have clients on our books or not. In mental health terms alone, with the ongoing background levels of general Covid related anxt it’s really not sustainable without drawing lines, breaks and boundaries.

In September our kids went back to school and college, or one of them did. The other one, the college one, has a physical difference that requires additional support. It turns out that college didn’t (and still don’t some 8 weeks in to term) have anyone recruited to provide that support. It’s a long and tedious tale, that is for my personal blog, not my work one (boundaries see) but the upshot is that my time and emotional energy has been called on again to support them with their online studies, guide them through their own emotional response to the circumstance and harass the college to pull their bloody finger out. I can’t do that and offer unlimited support to people I do not have contracts with, so I’ve reduced my administrative working hours again. My husband still spends the majority of his time working from home, but because that involves plenty of online meetings, I’ve had to leave him in the dining room alone, so I can focus more readily in the hours I have allocated to my own work. We have updated my office space though.

These are the things I have done to draw the lines I need.

  • I have clear and defined “working” hours – now published on all my business contact points – emails, website, Facebook and contracts.
  • A separate phone and phone number for work things, which is switched OFF, not just silent outside of my standard hours – unless I’m on call, or something has been prearranged.
  • Separate accounts/pages for personal and work related social media shenanigans.
  • Content in my contracts, describing when and how clients can get in touch with me during and outside of the “on-call” period.
  • A clear structure to my day. With housework, gardening and leisure activities happen outside of my working hours, as a result I’m actually doing many more of the things, outside of my work that make my heart sing.

None of this is new, I know, caring and counselling professions have been dealing with this since forever, but it’s the first time for me, that I’ve noticed the effect of absent boundaries and had the assertiveness to fix it, and I’m not perfect. Leakage still happens, but I’m much more able to notice it and manage it appropriately. Doulas are amazing conduits of positive transformational change, but we can’t be all the things to all the people all of the time! Sometimes we need to take a leaf out of our own book, and that’s much easier to do when you know where the boundaries are.

Your Covid Birth Room

In normal circumstances, you might not give much thought to your birth room.

Maybe you’ve decided on a Home birth so your home is just where you’ll give birth, it always looks like that so no problem

The Midwife led Unit – a home from home you’ve been told – no need to think about it.

The Labour ward- you’re being cared for by a consultant so you’re expecting to give birth on the labour ward. You’ve had a look around and the rooms are a good size but hospital looking, and you’re accepting this location.

Yeah – so what? – why is My Birth Room so important anyway? Why Should I give any thought to how it looks, or feels or smells? or what I can see?

We’re not living in “normal” circumstances right now, just in case you hadn’t noticed! Birth centre rules and restrictions are changing all the time, sometimes favourably and predictably at other times not so much. The removal, or threat of removal, of some options like home birth or water births however temporary, can have an impact on your sense of control. Spending some time thinking about how you can influence your birthing space, even if it’s not going to be where you first planned to give birth or even considering how you might mitigate any last minute changes of plan, can go a long way to bringing the focus of the situation back to you and your baby. Here are some thoughts that might help.

But first a note on Oxytocin.

If you haven’t heard of it already – it’s the miracle hormone during pregnancy, labour and birth. There are others, but focusing on this one, brings all the other good things along with it! Good levels of it can keep labour going physiologically, reduce pain perception and gets your body ready for breastfeeding. It works on a feedback loop while you’re in labour – the action of the baby pushing on your cervix during a contraction produce more oxytocin which produces more contractions – honestly this is a good thing!

Oxytocin is a happy hormone. However it’s also a really shy one. It won’t come out to play under bright light or if you are feeling observed, nervous or scared, and it can be completely overshadowed by it’s hormonal big brother – adrenaline, which comes to play when you are feeling observed, nervous or scared. Funny that!

But still – why should I think about my birth room, what difference does it make?

In a bit of a throwback stylee, think Hygge. When your environment is comfortable and cosy, you feel good right? low lights, soft furnishings, nice smells, the presence of people you love. Think about how you relax when you return to your favourite space, after a stressful day, you might throw off your clothes, have a scented, warm bath with candles. Whatever floats your happy boat.

On the other hand how unhappy might you feel if you returned home after a stressful day when you’re having home repairs done. There’s scaffolding around your house, strange people climbing all over it looking in to your windows, the heating’s off and there’s no-where cosy and clean to relax in. The happy boat scenario, that feeling of calm, and peace is driven by Oxytocin, the latter – not so much.

romantic space

So your immediate, intimate environment can affect your Oxytocin levels and you can get even more of the good stuff by manipulating the environment of the room you’re in to remind you of your Hygge or happy place.

An analogy that is often used, is that the same sort of environment that facilitates romantic sex, will also facilitate a positive birth! All the elements of dim lights, nice smells, good food maybe, comfort, a lack of interruption will help. It’s not trivial.

In these Covid-19 times, it is more apparent than ever, that things change, often quickly, some times with little warning. In my local area at the height of the first wave, our Home Birth service was suspended, it was reinstated quite quickly but any or perception of inconsistency in the services available that might relate to your birth plan can cause feelings of concern and nerves, so now is the time to plan what you’re going to do instead.

Even if your birth is some months away and you’re hoping that any suspensions or restrictions will be lifted by then, it’s really worth thinking about all the possible scenarios that may play out when your time comes. How can you make your birth room as homely, as Hyygeyey (word of the day) and as Oxytocin rich as you can. These things apply without Covid-19 in the mix but, I think they’re even more important now. So here’s a list as a starter for 10!

A note on infection control – when you are allocated a room in a hospital or Midwife Led Unit to birth in, it is yours until your baby arrives, and will be cleaned well, before the next person arrives. Therefore anything you take from your home environment is OK for you to use. Your midwives and Healthcare Professionals will be using PPE, to protect themselves from possible infection, but it’s still a good idea to make sure your property is as clean as it can be, so cleaning and packing it before you need it is a good idea.

Here’s the list! Items that might need packing and/or purchasing are highlighted in bold.

1.Think about how you are going to transfer in to hospital. If you’ll be using your own car then get the person who will be driving you to practice the journey at different times of day. Consider using an app like Waze  so that you, the birthing person don’t have to worry about how you are getting there. Your transportation isn’t normally considered as part of your Birth Room set up, but it could be an element of your labour, so making it as stress free as possible is definitely the way to go. This is particularly important in relation to point 3.

2. Your birth room starts with the door, so whether you’re at home or in a health care setting, consider making a sign to let people know what you need from them. Here’s an example you can access and change to your requirements. Don’t forget to pack blue tac to attach it to the outside of your door if you’re not going to be at home.home birth in hospital

3. Stay at home – for as long as possible, the first stage of labour is when your Oxytocin production ramps up, but can be easily quenched by stress, change, fear, observation etc. If your home is part of your happy place, then labour at home for as long as you are comfortable. In the very early stages, you could try making a cake! The more established you are in labour, the less likely that the transfer and associated curfuffle when you arrive will affect your progress.

4. Think privacy. How much privacy you need is personal to you, but even if you’re a nudist, birth can be an exposing process. Midwives are aware of the need for privacy, of course, but on the whole, they don’t know you or your privacy needs. You may also find that your needs are different when you’re in labour than they are in your normal life. Midwife Led Units, are generally more flexible in how you set up the room, but Labour ward rooms can be moved around as well.

If you’re going to spend any time on the bed, consider moving it so that the foot end doesn’t point towards the door.

Protecting your privacy is an essential role for your birth partner – making sure the curtain that covers the entrance door is pulled all the way across for example. Make sure you talk to them about this, so they know it’s part of their role before you get there.This is your room for the duration, you can adjust things.

There may be occasions where your or your baby’s medical needs require access to monitoring equipment etc, but you can always negotiate a compromise and moving equipment around is usually always possible. You are the focus of this scenario not the health care professionals or the bed!

5. Think smells – Not everyone is sensitive to smell but they can be a powerful element in your Hygge/Oxytocin mission. Aromatherapy is becoming a more mainstream feature in Midwife Led Units at least, but if you don’t enjoy the smell of Lavender, a common essential oil used for relaxation in labour, you will need to think about your own preferences and supply your own sources of those smells.

You could bring your own oil blend in a small roller ball dispenser, to roll on your wrists, or your partner’s neck! on a pillow etc, or just bring perfume, febreze (!) whatever fragrance relaxes you and brings you feelings of calm, love, happiness or all three.

6.Think lighting – Most labour rooms have dimmable lighting, insist that the lights are dimmed. You can bring your own battery powered tea lights or fairy lights and consider going as dim as possible!

Assessment units, labour ward rooms, theatres and the corridors between them are generally much brighter, which can be disconcerting.  If you are comfortable with the sensory deprivation, consider packing an eye mask or sunglasses to mitigate the effect of that light on your Oxytocin/adrenaline production.

I have noticed that the ensuite shower rooms attached to labour rooms often have automatic lights that come on when someone enters the room. If the birth room is on a low level of lighting, this can be quite jarring. Shut the door! People entering your room from the corridor can create significant light pollution as well. This might be something you put on your sign, and make sure that your birth support is primed to manage.

7. Think activity. Being as active as you can be during labour, really helps with your progression, and getting baby in to a really great position for birth. Just because there’s a bed in the room, doesn’t mean you have to use it – well not as a bed anyway. All hospital beds go low, high, and bend in several places. So either push it to the side of the room to show your intent on as active a labour as possible or ask to adjust it so you can use it as a prop – maybe with the head end up, you can kneel on the bed and lean on the raised end. There are nearly endless possibilities. Most Midwife Led Units and Labour wards, have access to mats, birth balls and peanut balls. If they’re not in the room when you get there ask for them or during labour if you change your mind. It might be worth a call to the unit you expect to birth in though, to check availability, so you can bring your own if want to

Top tip – whether you provide your own or use a hospital provided birthing ball, it’s useful to take a hand pump, so you (your birth partner more likely) can pump up a squashy ball! – linking forward to the next point, dancing and/or singing to the music you bring can also be a great way to increase laughter, fun and oxytocin. Bring the party with you!

8. Think sounds – Hospitals, and Midwife Led Units are strange places for noise. Sometimes there are machines that go ping; staff chat in corridors, often not quietly and possibly directly outside your room; you might even be able to hear other women in labour. Whatever might be going on, the noises are not familiar and could be popping your birthing bubble! Sounds, like smells, can be a powerful conduit to your happy Oxytocin filled feelings. If you’re a music lover and you have tunes that generate those feelings, then put some work in to your playlist before hand and take it with you! Many units have facilities to play music (or hypnobirthing tracks) in the rooms, but taking a phone or portable speaker means that you will know how it works, and there won’t be any hassle getting the sounds going.

Some speakers have a light production aspect too, to link back to number 5. A little search on Spotify led me to this pre-loaded play list, and there are a couple of others there, if you need inspiration.

9. Think food – in spite of popular opinion, eating and drinking in labour is a good thing. Labour is hard work, and maintaining hydration and energy levels is important to get you to the end! I know from a “recent” experience (11th April) of supporting a hospital birth at Leighton Maternity unit, that they, at least provide a packed meal at various points in the day. These included a sandwich, a piece of fruit, a bag of crisps, a cake/biscuit and some orange juice. I, as the birth partner was offered a meal too. I don’t know what the current provision for any restrictive diets or food allergies is, but pre-covid experience suggests not much. So if you want something delicious and comforting to eat, especially if you have a specific dietary requirement I would strongly recommend taking your own food in. Small snack sized, easy to eat portions are ideal for you to grab a mouthful in between surges. Also take a drinking vessel that has an integral straw – it needs to be easy access, your birth partner might hold it for you or it might just be near you so you can turn your head and take a sip as and when – it seems a small thing, but having to drink out of a cup or a bottle without a straw can get quite tricky when you’re in the thick of it.

10. Think Comfort, Touch & colour – 3 things there – grouped together because I’ve run out of numbers! but this is where I’m asking you to think about what your room looks like. Hopefully, by now you’ll be imagining soft lighting, maybe some fairy lights, and there will be lots of space for you to move around. There might be birthing balls, a pool or large cushions on the floor, but things might still look a little sterile, and the sheets on the bed will be white, VERY white. You could take your own pillow (which will have the added advantage of carrying your smells from home), a colourful blanket or throw, that changes the feel of the room from hospital to bedroom. Maybe you’ve got something you made for yourself, or that someone made for you, that brings with it feelings of love and connection. It can both be seen and then used when your baby is born, and you’re skin to skin to keep you and your new bundle warm and together.

crochet
Are you comforted by things that feel soft? a soft fleecy throw, or your partner’s jumper/fleece (if circumstances keep them at home).Do you have other children? pictures of them that you can stick to the wall or a drip stand (remember the blu-tac in point 2?) can generate more oxytocin if you need some more. If you’ve been practicing hypnobirthing, you can also stick print outs of your favourite affirmations to your surroundings.

I have a bonus point for these Covid-19 times – think communication. If you and your birth partner are separated, or because of yours or their infection status you are unable to be together at all, or you had planned to have a doula as well, but infection control means they are currently not able to be there, you can still benefit from their support.

Take your mobile and video call them when your need is highest, continuously if the hospital has good wifi or you have a good data contract. You are allowed to use mobiles in hospitals, but remember to take your charger and a charged battery pack so you don’t lose contact when you need it the most. Remember the cables. These will also be helpful if you are transferred to the post-natal ward, as in most places, and Leighton is one of them, visitors are restricted outside of the birth locations.

Remember, babies are still being born, and you still have options and choices, even if they are within a slightly different framework. I hope that some of these suggestions will help you to make the best birth room you can have.

With love and blessings for a joyous and positive birthing experience.

Doulas are still working and able to support you, ante-natally, in labour and post-natally. If you’re thinking a doula can help you navigate your pregnancy, labour and post-natal period in and around Crewe & Nantwich, then you can contact me through my website, or on Facebook. Alternatively search for a doula in your area using the Doula UK Find a Doula page.

Now what?

It’s the 31st March 2020. In the UK we start our second week of Covid-19 related lockdown.

Since this new virus started getting people all riled up, I’ve started several blog posts, none of them are finished, words are not coming easily to me. Today I’m removing perfection from my blog writing goals and am just seeing where this will take me.

I’m a doula, because I KNOW, that connection and continuity heals things. In birth, in life, in death. It changes lives, it changes futures, it changes communities, it changes the world!  It has come as somewhat of a shock to me, to be confined to my home and to know that other doulas are similarly confined at a time when our work is so sorely needed. I may be one, but I am one of many; our army that heals the world one family at a time has, on the face of it, been stood down.

I do not need to write a post with information about what to do and where to do it, because someone, somewhere has already written it* and that in itself has been a problem for me. After the initial – well that’s buggered us up – phase of my response to the crisis, and I move in to the – Well what can I do? – I am overwhelmed by the sheer quantity of offers out there. I am perhaps smothered, my small voice, and my limited reach, insignificant in the overall scheme. The army is actually on the virtual move. It has caused some moments of panic that I will be left behind or maybe swept up.

stones - me

I am fortunate (in a way**) that I do not have any current clients on my books, I do not have to think quickly about how to support those particular women and their families, I have time on my side, and I have focus. Indeed I do not matter, I am part of a larger movement and proud to be so. My connection to that movement matters.

I have reached out to my wider family, my neighbours and my past clients offering support, shopping and a listening ear. I have volunteered to work in and around the maternity hospital when the need arises, I am part of a virtual Emergency Early Labour Support network, I continue to facilitate an online version of our Positive Birth Movement group,  and I am looking after myself, (our garden has never looked better!) I continue to read and learn both about the current situation but also more broadly, in order to develop what I do have to offer, whenever I am needed to offer it. I will stay safe and well. These things matter.

And this leads me to my final point. Fear is an evolutionary response, it keeps us alive in times of attack, but it should not rule us, even now, when we are actually under attack. Connection is what keeps us healthy. Connection to each other, (emotional connection works too) and connection to the universe. My connection (my calm & connected system) creates trust.

I trust that what I do makes a difference to individuals and the wider community.

I trust that I will be called upon when I am needed. 

I trust that I will be able to respond to that call when it comes, compassionately and fearlessly.

I trust that there will be an end, a change, a continuation. Of all the times that my work will be needed, it will be then.

Love and blessings to you all.

two hands holding a paper cut heart

*At this moment in time I recommend the following links, that do not overwhelm with conflicting information

The Royal College of Obstetricians and Gynacologists has a regularly updated page of information and advice relating to pregnancy and birth.

Evidence Based Birth – is an excellent resource for all things birth. It’s hosted in the U.S but is international in its reach. Covid-19 is of course also covered and they have an excellent Podcast.

If you need a doula, or think you might need one (they’re not just for birth!) then Doula UK has a great Find a Doula service that is location driven.

The New Scientist podcast is a general information source, but most importantly rooted in facts and current science. It also includes interesting sciencey updates on non Covid-19 related topics which I have found helps to keep perspective.

** unfortunately this means that I’m not earning any money! It is possible to buy me a virtual coffee though to keep my spirits up as it were! https://ko-fi.com/doulamelanie

 

 

Emails – are you waving or drowning?

De-cluttering isn’t just about having less physical stuff. It’s about releasing ANYTHING that doesn’t serve you, by being in your physical space and/or in your head space.

Email is one of those intangible things that can cause quite a lot of anxiety, and it’s one of those things like washing up that continually regenerates – annoying. If you’re one of the people who can exist happily with 3465673 emails in your inbox and you don’t worry about a single one of them, then this post is probably not of any use to you, but if the number of emails gives you palpitations or you find yourself avoiding dealing with any of them because of the sheer quantity – read on.

stressed person at computer

As well as personal anxiety, emails are a significant generator of greenhouse gasses – A new study published at the end of last year estimates “that if every adult in the UK cut back on ‘thank you’ emails, it could save 16,433 tonnes of carbon per year” (more information on that here) Companies like Microsoft are apparently continuously improving the carbon footprint of their online storage but less is always better!

These are some things that I have found helpful in managing my inboxes. Sharing in case these things might help you too.

Get Ready, preparation is key…

  • As well as an email account you will also need a way of scheduling any actions that might arise from your emails – phone apps are good – ToDoist is my list of choice but there are plenty of others or you might prefer an actual diary or bullet journalling. Once you’ve put the action in your list you can delete the email – no need to keep it as a reminder.
  • Consider having more than one email address – this might sound like I’m just adding to the problem, but I work from home so my work email and my home/personal emails can quickly become entangled. I have one address for work contacts and one for all the useful stuff I buy online and the occasional personal correspondence. Keep it simple though, 2 or 3 is probably ample.

  • Prioritise – I check and process my work email more regularly than the personal one.

  • Decide how often you want/can review your emails – use your “out of office” function to let your emailers know your timescales. If you’re worried about missing something actually important on the days when you’re not checking – include a contact phone number with instructions to call you if they’re not happy with a response in the timescales you’ve put down. Do this, no-one will call you, you therefore know that none of your emails are life-changingly urgent.

  • Set up a recurring action in your to-do list to process your emails and set a timer when you do it. Weekly works for me, although I often put it off a few days if I’m not in the mood, there are hardly any things that can’t wait a week, and if there are, then the person will call you or contact you in the way you’ve suggested to them in your “out of office” text. Weekly also leaves me with a manageable number of emails to go through – in the 10’s rather than the hundreds, and even then most of them are a quick delete.

  • Turn off the little email notification thingy on your phone, especially if it pings or flashes across your screen. You do not need this level of notification.

  • Set your emails to list oldest first. Every time you log in, you see the messages you’ve left, once you’re in control it’s easy enough to scroll down to the newest ones, but having them there in your view, reminds you to do something with them, even if it’s only to delete them.

checking emails on phone
those are not my legs

So you’ve decided what, where, when and how – now it’s time to take action

  • If you’re starting with an inbox of thousands. No judgement- set a timer on your phone for 30 minutes say – and just eat that electronic elephant one bite at a time.

  • Delete everything over 12 months old, as a start, if you find that easy, then try 6 months, 5 months, 4 months etc. If any of that starts to make you feel a bit panicky, pick your date and start there. Take it a step at a time, but delete delete delete.

  • Report junk emails as junk, but remember to empty your junk file every now and then.
  • Unsubscribe – you don’t need to do this every time, the delete button is very cathartic if you’re in a bit of a rush, but if you find yourself with a bit more head space, take a few seconds to find the unsubscribe link and then click on it. As a by note – always check the text in the “do you want us to contact you” sections on websites and the like. 9 times out of 10 it should be a no shouldn’t it? You do not need any marketing emails from organisations selling you stuff. If you actually need a thing, you’ll go and find it, you don’t need to keep those dubious discount emails just in case. We are bombarded with marketing gumpf on every internet forum we visit, be selective about the ones you keep in your inbox. Newsletters from lovely doulas might stay for example!

  • Delete all the emails you don’t need any more, including ones you’ve sent.
  • If you order things online. Delete the dispatch, confirmation etc emails when the thing has arrived. That information is on the originating website anyway. – eg amazon notifications that an item has been ordered, dispatched, with the courier, on the way, delivered. If you really want to know your item’s progress get the store app on your phone and set the notifications on there – they flash up and then they’re gone, you know what’s up, and there’s nothing left to action. I know this works with Amazon – I’m sure there are others that do this too.
  • You have given yourself some time to do this email malarchy – see point 4. So sit down and do the things that need doing. Then delete the email that’s finished with. In rare instances if you don’t quite have everything you need to complete a task, use the flag option and keep that email there to revisit next time you log in.
  • Organise – personally I find folders in my email accounts turn in to a big black hole, I have a few – things like “actions pending” but generally I forget to check them so they languish there until I do have a look and then most things are ancient and get deleted anyway.  If you’re the sort of person who likes a category though then file away, but really think before you move it. Does it need keeping? Is the information stored somewhere else? like on another person’s or organisation’s website? Can you save the information in a different way? If you have replied to an email, but you need to follow up if the person doesn’t respond back – put an action in your to do list/diary to check. Delete the email.
  • If you really need to keep an email for reference eg as a receipt for tax purposes, or evidence that you’ve done something or received something, consider saving it as a file on your computer and then delete it from your email folder.
  • Day to day – if you get sent emails in your day to day interaction with a website – password resets or survey verifications. Get in the habit of deleting that email as soon as you’ve done the necessary clicking and updating.
  • At the end of your scheduled session – Go to your trash folder and empty it. This will permanently delete the emails where they can no longer worry you any more.

In addition – now and then, in moments of downtime, like on the train, or waiting for the kids at school, I’ll have a quick scroll through on my phone to do some more deleting – the swipe delete action is fun!

If you’re in a business where you manage a mailing list, it can also make you think hard about how many emails/newsletters you might send!

Let me know how you get on. I’d love to see your before and afters – I’m off to empty my sent items folder, I appear to have emails in there from 2015! *blush face* and unsubscribe from Amazon order updates by email.

Full disclosure – as I hit publish on this post – I have 15 emails in my “home” email inbox and 27 (too many) in my “work” one

– we’re all a work in progress…

jumping person - freedom
enjoy the freedom!

One Minute Recommendation – WAZE

This is the first in a series I hope, of quick and to the point recommendations. Not many of us have got time to check out all the options out there for all the things we might need or want. My recommendations are based on my own personal experience of a product or service that I think might be of use to you as a pregnant person or new parent. If I’ve been given something to test and I do recommend it, I will tell you, but I cannot be bought! If it’s crap, pointless, or unnecessarily wasteful in my opinion, there won’t be a recommendation coming from me whether I was given it or not!

 

So first up, because I cannot praise it enough – I absolutely LOVE it – is the WAZE app.

I appreciate that this is not a new thing, and you’ve probably heard of it already, but bear with me on this. As a doula, I travel to places and addresses I often haven’t been to before to meet clients, and then I need to get back there again if they book me for follow ups and then in the quickest time possible for B Day! Waze is a brilliant app. It’s like a little traffic reporter pixie living in your phone, diverting you around roadblocks, accidents and traffic and re-routing you if something happens on the way. It has never let me down and has in fact directed me through some lovely parts of Cheshire that I otherwise would never have seen if I’d been stuck on the main roads, grumbling and fretting about being late.

If you’re pregnant and planning to birth in hospital, and you need to travel any distance to get there – then get the person who will be driving you to get the hospital programmed in as a favourite asap. When the time comes, you will get there in the quickest time possible and you’ll be able to update the hospital to your eta pretty accurately. Even if you think you know the way – use this app, in case something happens on the roads ahead of you while you’re en route.

 

The slight downside for my personal transport arrangements (BMW) is that the app does not sync to the car’s communication system completely, so there’s an extra step to adjust the settings in order to hear the Waze instructions and still be able to receive a call through the car if I need to while I’m driving to a client. Also you do need phone signal and data of course.

 

This recommendation is brought to you by my own discovery and useage over many months. Apologies if I’m preaching to the converted, but maybe there’s someone out there who doesn’t know about it yet!

 

I have not been asked to recommend this app, nor have I been paid to do so.

A picture of the Holmes Chapel viaduct taken from the field, with a grey brooding sky and bare shrubs in the foreground.
The Viaduct at Holmes Chapel – one of the landmarks I love to drive past on my WAZE journeys. Photocredit me

The Story of my bag

Doulas have bags, maybe not all of us, but all the ones I know, and they’re obviously the best kind!  Rather like Mary Poppins’ bag they are full of magic and tricks. Really they are just a grab bag full of simple caring things that can help the doula support a mum through labour and some self care items for the doula too.

It’s taken me a long time to find the right bag – I’m not sure I have yet, because the current incumbent has not been tested, but since my birthday this year (September), I have had this beauty.

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It’s from Wyatt & Jack –I’ve lusted after one for ages, and on top of that it’s made out of the bouncy castle Stone Henge “Sacrilege” that did the rounds in 2012 and I bounced on for my birthday that year – it’s flipping awesome and a limited edition. It’s also a really good size, waterproof, and strong. Check them out if you haven’t already!

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Such a bonkers thing and great to have had a go on it. It’s really cool that Wyatt & Jack have got hold of it now that it’s been decommissioned and that all that stuff isn’t going in to landfill, and I get to own a little bit of it!

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This is me and my daughter bouncing! It really was fun – I’m not laughing mercilessly at my daughter falling over!

Right so what’s in the bag?

I’m trying to keep my doula business waste-free. Hospitals or midwife attendants at home births generate enough waste  – understandably and hard to reduce because of sterility requirements and so on, I don’t want to add to that if I can help it though.

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From top left

  • Paleo bars from Aldi – high energy, high protein. Just two of these got me through an overnight birth not long ago, they might not be the only snack of choice for the future but they’re pretty good – apart from the individual plastic wrappings, will work on that one…
  • Box of tissues – for me or for my client – plastic free packaging from Greencane UK
  • A crocheted purple boob – more of a good luck charm than a need for a birth bag!
  • Empty spray bottle – has the potential to be filled with a water/essential oil mix for misting over a hot face or making a room smell nicer
  • Battery powered tea lights – not entirely waste free, the little batteries are not rechargeable, but naked flames are not considered good form in a hospital room, home births are a different kettle of fish all together though.
  • Essential oils – the one pictured is Clary Sage, but I might have any number of oils based on the scent preferences of my client. I’m not an aromatherapist, and am careful with the oils I offer and use them very sparingly after discussion with the client – it’s more about relaxation and comfort than any sort of properties at this stage in my doula development.
  • A coin purse – parking and vending machines – for me and/or my client.
  • A toiletries bag for me – contains toothbrush etc, deodorant, clean pants and washable pads,
  • A couple of wet bags for taking home any wet cloths
  • Warm non-slip socks – for me – I haven’t used them yet, but I hate having cold feet and I don’t like to wear heavy shoes while supporting a labouring person, so they are there just in case.
  • A washed bandana – one of the things that can be rinsed in cool water and tied on to a hot neck, or head. If the woman isn’t enjoying being touched during labour, this is a good hands off way to help her stay cool.
  • Another wash bag – with potentially useful things for Mum in – all new things, given to Mum if she needs to use them – hair ties, head bands, a comb that sort of thing.
  • A pile of new flannels – for coolness or warmth – depending on what the client needs. (Essential oils can be added to these too) These are all new with their labels, I do take them home after to wash and sanitise them, but then they get added to my home stock, rather than back in the doula bag. These I think were from Wilkos and are about 50p each.
  • all of that is sitting on a large woolly shawl thing, for me to snuggle under for naps, or for keeping Mum warm and cosy if she’s feeling a bit shivery.
  • Not pictured because I’ve taken it out, is my yoga eye mask – the heavy wheat filled ones. I have offered it to women who go in to the Midwife Assessment Unit (MAU) for any length of time, because it’s totally dark, and the weight can bring a much needed prompt to relax. I have also used it for me, when trying to catch 40 winks in a family room, while a client was in theatre for an unplanned caesarean. I’m hoping to make individual ones for future clients, so I don’t have to worry too much about washing my own one (although of course I will)

Things are added and removed according to an individual client’s preferences, needs and circumstances, but this is it at the moment, and I’m loving the bag itself. Bring on the next birth!

Waste free baby showers

I’ve been to a few baby showers now, and they seem to all have some things in common:

1 – A wonderful outpouring of love and support for the pregnant person and the new human they’re growing in their belly.

2 – So much stuff. Mostly in the form of presents for the baby – clothes mainly, and while it cannot be denied how exciting it is looking at, choosing and buying new baby clothes, they really don’t wear more than sleepsuits and vests for the first 12 weeks, apart from the occasional “outfit” for an outing or something, and you really can have too many blankets. Then the stuff is wrapped in more stuff, which can just end up in the bin.

3 – A lack of presents, in my opinion, specifically for the pregnant person, to honour them and support them in their transition to a new state of being.

4 – Cake

As well as these general thoughts, I’ve been thinking about Zero Waste week, which was the first week in September. I’ve finished thinking now, so here’s what my brain’s come up with for some alternative/waste free gifts for a Baby Shower.

1 – A Doula – well Gift vouchers for one anyway. It’s probably not a surprise, that this is top of my list, but really there is published evidence to show that Birth Doulas and Post-natal doulas are quite literally worth their weight in gold, but like gold, can appear to be costly– If you’re in the UK, Doula UK offer a Gift Voucher scheme, and while one person might not be able to fund a whole doula, many people can fund a small part of one – a few £20 gifts soon add up and even if a top up is required, a baby shower contribution can still represent a significant saving.

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gratuitous picture of me – with my own label

2 – Pay it Forward – Consider Donating some money to The Doula UK Access Fund on behalf of your friend. Like donating to charity instead of gifts at a wedding. The Access Fund aims to provide doulas to women who really have no way of paying for one themselves but would really benefit; refugees and other displaced people, survivors of trauma, and so on. Of course a charity close to the heart of the pregnant person would also be a suitable recipient of a Baby Shower collection.

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3 – A clean bundle of pre-loved baby clothes –  if you’ve had your own babies you’ll know that the clothes from the first 12 months of a baby’s life (and beyond really) just never wear out, they are not worn often enough. If you’re related to the pregnant person, you may even have some that might be considerwhite and blue textilesed family heirlooms – There are 2 sleep suits that have done the rounds of all of my children and my niece and nephew – I think they might have been passed on outside of the family now, but as well as reducing the impact on the planet, there is a lovely spiritual connection between all of the babies who have worn the same clothes, they are received with a “ooo it’s our turn”. If you don’t have your own children’s clothes to pass on – the NCT run really good nearly new baby sales, you’d be able to pick up some excellent quality items, not just clothes, from there. Try and pick gender neutral colours so that they can get passed on for every baby not just 50% of them.

4 – A meal rota.
brown fish fillet on white ceramic plateIt’s not a secret that the first 12 weeks of a baby’s life, require levels of stamina and often sleep deprivation never experienced before, together with recovering from labour and birth itself, and maybe also caring for other young children at the same time. It’s really important that the new parents are well nourished, and hydrated, at a time when they probably feel the least motivated to do so. You don’t have to offer to move in and cook all the family’s meals, but you could co-ordinate amongst your friends a meal rota, there are even websites like https://takethemameal.com/ that help you to do that easily. Maybe you can get the baby shower attendees to sign up to help while they’re supping prosecco or eating the cakes! Nothing like making the most of a captive audience.

5 – On the food theme – a supermarket delivery saver account – maybe for a year, would I think, be well received, The ability to get food ordered and then delivered, whenever it suits, rather than schlepping around the shop with a new born will save the new baby grower lots of stress.

6 – Washable nappies and a soaking bucket– this will need some co-ordination with the pregnant person, because if they’re not planning to use them it’s a wasteful gift in more ways than one. There’s no doubt that disposable nappies are an environmental nightmare and washable nappies are a more environmentally friendly alternative, but they can be expensive to purchase in the first instance. A gift of one or two or however many you can afford, will go a long way towards setting up this new family’s stock, that will last them for many years, used for later babies if that’s how their families develop or indeed be passed on. It’s a gift that keeps on giving.

7 – A stretchy wrap

babywearing
this is a ring sling actually – but a similar concept

this sounds like a new thing right? To add to the stuff that we’re trying to reduce. Well yes, but in my opinion of all the stuff that’s thrust on new families, a stretchy wrap has the potential to be the most useful. In those first few weeks babies need to be carried, a LOT, a wrap can help with that, helps to keep baby feel safe and warm and frees up the parents to do other things at the same time, if that’s their bag, saving backs and arms – you might be surprised how heavy a 7lb baby feels when you’ve been holding and nursing it all day. Wearing your baby is one of the very best bonding activities you can do, and the non-birthing partner can join in too. In answer to the new stuff thing well Little Possums have a pre-loved department at very reasonable prices, and as it happens very useful information about wraps and how to use them.[1] Also Congleton Sling Library – meet all over Cheshire and can talk you through options and suppliers if you need some face to face advice. If it was a toss up between the pram that does all the things and the wrap – I’d go for the wrap, every time.

8 – A paediatric First Aid Course – this might be a useful gift for grandparents as well. The Red Cross and St John’s Ambulance provide courses specifically aimed at parents at very reasonable prices. No-one wants to think about needing to perform brown and white bear plush toyCPR on their baby, but if the need arose, wouldn’t it be great if they had the skills to jump in to action. another gift that will keep on giving – the information will last a lifetime

9 – Books – pre-loved ones of course. This might sound a bit “cheap” but like the pre-loved baby clothes, passing on a much loved children’s book is a touching and personal gift, and In this case, if your own copy is too battered or too loved to part with, a new purchase will surely be an exception to the waste free rule, if you and your family loved reading it, you can be sure the new family will too.
photo of man and child reading book during daytime

10 – A book of promises – this is just limited by your imagination and motivation to support the new family – but it could be “I promise never to offer unsolicited advice” “I promise never to speak negatively about birth or post-natal bodies to you” “I promise to be cook you a meal” and so on.

 

That’s my almost waste free starter for 10  – can you think of any others? and if you’re inspired to gift any of these things at a baby shower you go to, please let me know  how they were received.

[1] Lots and lots of other websites and Youtube info for local support on wraps – you could ask a local doula for links to your local support services.

It’s a baby…

Yesterday morning in the early hours of the morning, the Duchess of Sussex gave birth to a baby boy, announced delightfully by her husband in the afternoon so clearly riding high on Oxytocin.

Obviously, rich woman has baby, father is happy is International news (more so than the UN report that 1m plant and animal species are close to extinction) and the rumour mill went in to overdrive speculating on the most intimate details of this couple’s transformation to a family unit.

Of course the speculation didn’t start with the birth, if you didn’t know that she was apparently planning a home birth, had allegedly hired a doula and wasn’t doing the photo call thing hours after birth – where have you been? None of this of course is actual proven fact. (Although we do now know that she hasn’t done the photocall thing!)

Take the doula situation for example, for a short, crazy time a Doula UK doula was named as The Duchess’s doula. Even her own mother believed the press over her – It was reported incorrectly (shock!) by a couple of papers that she had been seen visiting Kensington Palace and Clarence house, as evidence that it was her – when in fact, she was waiting in for the dishwasher repair man. You can read more about her having nothing to do with the royal birth here.

What this small piece of Meghan’s pregnancy and labour story reminds us, is that, in the absence of any actual truth; conjecture, fabrication and pure fantasy sell as many newspapers and generate as many spin off stories as if it were the truth. Why then would what we “know” about the Duchess’s plans and whether they’ve been “dashed” or not, be any different? Add to that, that the Daily Fail features large in the procreation of this non-news and I appear to have proved my point.

It matters not one iota what actually went down, but for what it’s worth, I think it highly unlikely that a hospital transfer  for a mid-labour complication (as has been reported in some places) would have seen a labouring woman, whoever she is, transferred from Windsor to London. It’s doable of course, but there are maternity units much closer, for an unforeseen difficulty. Much more likely that a transfer to the hospital of her choice, if that is what happened was actually in her plan, but that is, like the newspapers – conjecture.

We don’t know if she was induced (highly unlikely if she was at home), we don’t even know if she was actually overdue, the public were never told what her actual due date was. If she was, as I’ve seen reported, 41 and a bit weeks, she wasn’t overdue, even if Harry said she was. A baby is considered to be “at term” if it is born between 38 and 42 weeks, you’re not actually “overdue” until  42 weeks +1, a little bit more on this here. Then there’s the fact that only about half of all pregnant people will go into labour on their own by 40 weeks and 5 days (for first-time mothers) or 40 weeks and 3 days (for mothers who have given birth before). The other half will not. Meghan apparently fell in to the second half. No biggie.

The news media want us to be emotional about things, that’s what gets us hitting the keyboards and buying more papers. Says I, currently hitting the keyboard! but before you react, especially if you’re inclined to scorn, mock or otherwise belittle. Stop. Think. Remember the only facts we know for sure are that she has birthed her baby, and that they are well and happy.

Personally I would love to know Meghan’s birth story, but then I’m a bit of a birth story junky so that’s not a surprise, but until I’m invited to hear it, I’ll just stick with saying…

Congratulations Meghan and Harry, welcome earthside little one.

Blessings on this your Birth Day.

Now about those extinctions

My Doula year 2018

Sheelanagig by @Boannlambertartist

I am called to this Doula work from deep within my soul, the transformative effect of non-judgemental, consistent, exclusive support to women, is vastly underestimated in this patriarchal world of fast consumer living, from food to medicine. I truly believe that women should be supported, listened to, embraced and honoured during all of their transitions, from maiden to Mother, from Mother to Crone, and all the steps and stumbles along the way. Transformation and change on a small scale feeds the same on a global scale.

When I started writing this review, I thought that the list of my 2018 Doula accomplishments would be very short, and while it’s true, that in terms of clients, I’m counting them like the legs on Long John Silver (muppet Treasure Island reference there), it seems I have done quite a lot of groundwork. Shifting my focus and increasing awareness. Being a doula, for me, is not *just* about the individual clients I serve, it’s a way of living, a direction and a sustenance for me and for the wider communities I find myself in. Although it would be good to make some money in 2019!

2018 began with intent – to finally get my Doula show on the road, to that end early in the year, I found myself a mentor and so became an official mentored Birth and Post-natal doula with Doula UK

2018 also began with me volunteering to be a trustee for the Doula UK Access Fund Charity, (DAFC) a new charity, arising from DUKs existing Access fund, but with the ultimate aim of it becoming a stand alone charity. I attended our first meeting in February, and left as the Secretary of the trustees, not particularly as a result of a rush of selfless altruism, more as a result of there being a lack of volunteers and not wanting to be the Chair or the

me on my way to a DAFC meeting on a dark cold morning

treasurer! Anyway this set in motion some months of juggling priorities and 2 versions of the Charities application, with the (hopefully) final application to the Charities Commission being submitted in July. I had lots of input and help from the other trustees it must be said, I’m not claiming all the credit, but it did take up a great deal of my “doula” headspace for the first half of the year. As I type we are *still* waiting to hear back from the CC about that application and whether it needs adjusting (almost certainly) or whether it has passed (most unlikely but there’s always hope)

 

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After much badgering from me, which may or may not have had an effect. the first Maternity Voices Partnership meeting for Leighton Hospital happened in March. It was brought together by a member of staff at Leighton in the absence of an “official” MVP, was well attended by other interested parties as well as me! but unfortunately led to not much at all. The official group has been set up now, with its first meeting in November, which I couldn’t attend, and is still very much finding its feet. Nothing is ever wasted though and the benefit to me of attending the March meeting was meeting another Crewe based Doula – Bella, who has become a bit of a partner in crime as the year has progressed.

Later in March came the Doula UK Conference – the second one I’ve attended and well worth the cost and the travel to London, even getting temporarily misplaced in the dark, walking to my hotel, with a dead phone and therefore no map(!) did not detract from the learning, and all round community awesomeness that it represented. One of the top highlights for me was the “Wild, The birth Project” performance – so flipping moving, funny and brilliant, look out for a performance near you…(link)

Look at all the wonderful women – I’m in there somewhere – near the front I think – photo courtesy of www.doula.org.uk

About this time also picked up my first birth client who was due in August. She wanted a VBAC for this her second pregnancy and we seemed to get on quite well. I was incredibly excited, and a contract was signed. She was well versed in what she wanted and what it would take to get it, and I set myself to catching up with her reading! (see my Doula reading below)

May – was a first informal meeting of very local Doulas around Crewe, Nantwich and Sandbach, we drank tea and chatted about running a Meet the doula event, which is still to materialise how we imagined it then, but it was the start of a coming together and it’s lovely to be part of a local community of like minded people.

In the summer I came to a bit of an epiphany about my current day job. I’m a childminder and have been for 8 years. I have a lovely bunch of boys to look after aged from 1 to 6, and I have a pleasant workload through the week. Through the CC application process though, it became apparent that this work was not bringing me joy, infact, the background work required to maintain an Ofsted registration and the “Good” rating I have, was bringing me the absolute opposite. I became increasingly frustrated and angered at the time this took and how that time took me away from a) my family with not even the benefit of a passion realised and b) the ability to focus on and develop my doula business. This conflicted with the enjoyment I do get from the day to day interactions with the amazing small people, but in the summer after a particularly stressful Friday (my busiest day I must work on that!) it became clear that I needed to draw a line under it. I spoke to my husband who agreed with my plan straight away, that I would close the childminding business when my registration period ends at the end of October 2019. I told all my customers, who were all gratifyingly (for me) disappointed, and the exit strategy was put in to motion. I immediately felt a massive weight lifted, positivity returned and it became easier to make decisions about both businesses, knowing exactly (almost) where both of them were heading. Childminding has been an excellent way for me to earn the extra money our family needed whilst staying at home to ensure the care of our disabled daughter and our youngest son, it’s been entertaining and challenging, and I have plenty of transferable skills and knowledge to take with me in to the next chapter, but it’s played its part and now it’s time for it to bow out.

ime, I also took a step back from the paid and volunteer work I have done for Motherwell Cheshire. I am still supporting when I can and definitely cheering on from the sidelines but am moving more towards working with them as a doula, so for mutual business benefits, rather than as an administrator.

my lovely christmas gift from Motherwell Cheshire

July- I swam a mile in an outdoor lake – and raised just short of £400 for Motherwell Cheshire. The latter being a happy consequence of a long term item on my to do list. I haven’t kept it up as I might, but do plan to get back to it when the water warms up again. That said we were very lucky with the weather this summer!

me getting in a lake!

Late summer I signed up to the Doulavation course and continue to work my way through it. I can’t do it quickly, among other things, I’m still trying to work out in my own head what my unique offer is. I’m at the older end of the “new doula” spectrum and am relatively late to the study of all things attachment. A big regret of mine for example that I did not baby wear any of my beautiful babies.

I have felt inexperienced and a little bit “lost at sea” in this doula world but alongside that I have also realised in 2018 that I know stuff, I read, and I apply what I’ve read to all aspects of my life, from professional childcare, to managing a household, to living a sustainable life – I watch people who have set themselves up as “experts” and realise that I am at least as expert – I find it hard to understand that there are many people “out there” who do not know what I know and what I have can benefit them as much as it benefits me. I am realising that this is probably also true of my doula skills. As I explain in my “why I chose to be a doula” story – I know what to say! The doulavation course is splendid because it can be worked on in your own time and at any stage of your doula or birth worker journey. Its style and mission, works for me on building a business around my heart’s calling.

August came around, my client’s due date. As it turned out, I didn’t attend her birth, I suspect in retrospect that at some point she changed her mind. Her waters released the day before I went on call for her, which after she negotiated a 48 hour wait with her maternity provider ended with a Cat 3 caesarean birth, with her husband as her support. We met post-natally and she seemed happy with how her birth happened, but after another meeting some weeks later, our relationship ended on a sour note, due to a disagreement about payments. This was incredibly disappointing for me, on an emotional as well as financial level, but as is the way with these things, I have reflected and learnt and will adjust my operation to reduce the chances of something similar happening again. My confidence may have been knocked a little, but I do not and will not apologise for placing a monetary value on what I can offer.

August!- just the minor event of my step-daughter’s wedding to keep us busy and happy though!

Me and my boys (my daughter out of shot) getting emosh during the ceremony! photo credit http://www.bgsphotography.co.uk

 

In October my husband retired from the Police Service – this is a massive change for us as a family. Financially we are secure, and pretty much debt free – even the mortgage! This gives me the space I need to develop my business that might not make much money for a year or two, but also more importantly for me to let go of the reins of our household, for which I’ve been the majority holder for the best part of 12 years, for those times when I’m needed by another family.

He is going back to work in the summer of 2019 but part-time and almost infinitely more flexible than Police work. Much as there is adjustment required to get used to him being at home more of the time, and indeed for letting go of the aforementioned reins, he is my perfect consort and companion, for this role I call work, understanding the depth of what it means to me.

In November I became a joint facilitator of a positive birth movement (PBM) group in Crewe – even going so far as to offer my dining room for our initial meeting room. It’s a slow start but we remain committed to getting this off the ground in 2019.

Early in the same month I got my campaigning action on and reported our local Asda to Baby Milk Action for breaking UK law and the UNICEF code on Infant formula marketing. The offending display was changed and I joined Baby Milk Action!

I’ve been quite busy it turns out. I’m looking forward to 2019 very much, I hope you’ll be part of my journey too.

Doula blessings

Mel
The sustainable doula (trying this out for size)

 

PS: These are the doula books I’ve read this year, links to Goodread listings by clicking on the images…

My doula reading started late in the year, prompted largely, it must be said, by my client!