Tag Archives: Birth activism

Unplanned Cesarean Birth. A warrior’s path.

tor-019.jpgCaesarean birth is not everyones first choice when planning the type of birth we’d like. For many women it is the very last type of birth they’d opt for. So when we are faced with our least favourite choice, the thing we’d worked so hard to avoid, our worst fear, what do we do? How can we cope with the disappointment of a birth that’s so far away from the birth that we’d dreamed of that it resembles a nightmare? What went so dreadfully wrong, and who can we blame for this travesty? As a midwife and mother who’s first baby was born by unplanned caesarean I’d like to explore these questions further.

A less than ideal birth?

Why does a less than ideal birth have to mean less-than? Could our less than ideal birth leave us feeling less than complete? If our bodies apparently failed to give birth, or we didn’t get to do the things we’d planned to do when greeting our babies, is there a sense of failure? I certainly remember feeling that my body had failed to birth my first child, and that I’d somehow failed to be there for her immediately after birth. These are very common but totally irrational thoughts as we try to make sense of how our plans went so wrong. There must be someone to blame, and that someone must be me. But our brains must be so confused at this time, as I was obviously not slacking by needing a life-saving caesarean, then haemorrhaging and being unconscious for hours after. Where does that self-blame come from? Wherever it comes from it is misplaced in the case of unplanned caesarean.

How can we even think that we are to blame for things going wrong? I can joke about it now, as it’s approaching 23 years since my baby and I nearly died. I can see rationally that my caesarean was a life-saving measure, and that my daughter shows no signs of the early neglect she may have suffered. But do you know what? It still hurts to think of those lost hours when we were not together.

Best laid plans

Like many women I’d prepared for a homebirth, but of course I knew as a midwife that anything could happen. It just wouldn’t happen to me, as I was so well prepared. I watched all my plans evaporate when labour didn’t progress and I transferred to hospital for analgesia and augmentation. A catalogue of nightmarish scenarios ensued, and my baby was found to be presenting by the brow (forehead, instead of the back of the head coming down first). Of course trying to force a malpositioned baby through a pelvis for hours is never a good idea, so my body haemorrhaged after my caesarean and I was returned to surgery. Postnatal depression inevitably ensued, marring a majority of our first year together. It just didn’t make sense. I’d done everything so right. How could it go so wrong?

 Are birth plans worth the paper they’re written on?

I’m not sure one can actually plan a birth, knowing that birth is inherently unpredictable. I think writing a birth plan is a good exercise in looking at and discussing your birth preferences with your birth partner. It can also be a useful communication aid for your midwife to read whilst you are busy birthing and not able to fully express your wishes. Beyond this it is of very limited value. If you do write your birth preferences down please just write on just one side of A4 paper, use bullet points, and try not to be too outcome orientated. What I mean by this is do not write “I am having a homebirth, vaginal birth” etc as these are never guaranteed. Its fine to write “I hope I’ll have a homebirth” or “I’d prefer x to y if I require pain relief” or how you’d like to spend the first moments with your baby if possible. Please do keep it short though, as I’ve heard doctors joke that women with long, inflexible birthplans are bound to need medical interventions! So plan all you like, but your baby may have an entirely different plan of it’s own. I do believe that all babies do their best to come out the way we have planned, but some get stuck, some run out of energy, and if left to a natural conclusion some babies and women would not survive the birth process. Nature doesn’t always get it right despite our best efforts, and timely caesarean surgery saves lives.

Less of a birth=less than a woman?

Why should we feel “less than” if we’ve accepted life saving surgery, albeit unwillingly? As a midwife I see so many different types of birth, and not one has more worth than another. All women are strong, beautiful and powerful in their birthing. This transformational state has equal value whether it is long or short, painful or ecstatic, vaginal or abdominal, surgical or physiological. Each birth brings forth a baby as well as the birth of new parents who need to start their parenting journey in an empowered way. It is a true rite of passage, where we are presented with obstacles and challenges, so we can discover how courageous and strong we really are. When women are well supported in their births they get to see their strengths and triumphs, and start their journey to parenthood in a joyful way. Without support and explanation they may be left feeling disappointed or even traumatised by such an unplanned outcome.

So how can we lessen the impact of unplanned caesareans and enable women to feel strong and empowered in their birthing? It’s important to have continuity of midwife, or a doula if possible. Research has shown that continuity of carer leads to better outcomes. Women can empower themselves by learning assertiveness phrases and asking for everything to be explained, so they are in charge of the decision making. They can organise 2 good birth supporters, who will support their choices, and be able to help practically as well as emotionally after an unplanned outcome. Women will need opportunity to debrief their birth with their care provider after unplanned caesarean. And as care providers we have a duty to help women understand and integrate their birth experiences. Unfortunately most women don’t have continuity of midwifery care, but all midwives and doulas can help a woman after unplanned caesarean birth. We can do this by listening, by witnessing their story without interrupting, then by answering their questions. We can believe them and validate their experiences, letting them know they made the best choices possible (being a professional means putting aside our personal opinions). We can congratulate them on their intuition, bravery, endurance etc, for giving it everything they had and then some, because of course every woman does. Don’t forget to mention her beauty and dignity in birthing, her graceful acceptance of the inevitable, and big up her support team too.

That woman is a birth warrior, she has done battle with nature and her worst fears, she has bravely laid her body down on the theatre table and has said “cut me open for the sake of my child’ risking her own life to save her unborn baby. She then returns from her battle triumphantly holding her reward, her baby, and should be welcomed home as a returning Hero. How can this warrior’s birth ever be seen as less than?

Conclusion

As a midwife I’ve had the pleasure to see empowering and ecstatic, planned and unplanned caesareans. I have personally had a vbac so also know the joy of vaginal birthing too. All births are great opportunities for us to grow and become more than we ever thought possible. This is a process of growth not lessening, so let’s treat it as such, and celebrate all birthing women as the birthing Goddesses they are.

Microbirth Premier film screening in Glastonbury

The Premier screening of Toni Harman’s new film will be shown globally on 20th September 2014.
Following the successful screening of her previous film “Freedom for Birth” last year, I am pleased to be able to share her new film in Glastonbury.

“Microbirth” is a new feature-length documentary looking at birth in a whole new way; through the lens of a microscope. Investigating the latest scientific research, the film reveals how we give birth impacts the lifelong health of our children and potentially could even affect the future of humanity.

View a trailer here: http://microbirth.com

Recent population studies have shown babies born by Caesarean have approximately a 20% increased risk of developing asthma, 20% increased risk of developing type 1 diabetes, a similar risk with obesity and slightly smaller increases in gastro-intestinal conditions like Crohn’s disease or celiac disease. All of these conditions are linked to the immune system.

“Microbirth” explores several possible plausible explanations. One hypothesis is that if normal vaginal birth is interfered with or bypassed completely because of Caesarean birth, this could alter the “seeding of the baby’s microbiome”, the critical transfer of bacteria from mother to baby at birth. Scientists suggest this could lead to the baby’s immune system not developing to its full potential. Another hypothesis is the actual process of vaginal birth, including the cocktail of hormones produced during labour, could profoundly affect the baby’s immune regulation and metabolism.

The film’s co-director Toni Harman says, “Caesarean Sections are essential and often are life-saving. However, up until now, no-one has really looked into the long-term impact. This emerging research is painting an alarming picture in terms of future health across populations. There may even be repercussions for the future of humanity. And yet, up until now, I don’t hear any alarm bells ringing.”

Join us on 20th September 2014

In Glastonbury Town Hall , Magdalene street, Glastonbury, BA6 9EL

From  7pm to 9pm for the film premier, followed by after film discussion.

Tickets £5. All proceeds will be donated to Towards tomorrow Together  Registered charity number 1151022.

Parking close by. Disabled access. Refreshments available.

Contact me for further details on 0799247462 or email joy@birthjoy.co.uk


Radical Midwifery on the Road

?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????According to the Association of Radical Midwives (ARM)  “In the mid 70s, the majority of pregnant women in UK had labour induced by artificial rupture of membranes (ARM) around the date they were “due”. These initials were used when the group needed a name, using the dictionary definition of “radical”, (roots, origins, basics, etc.) which aptly described the basic midwifery skills which they hoped to revive.”

In this spirit I offer a grass roots midwifery information service to women. I am an Independent Midwife, and as such I provide total midwifery care for women and their families, but the numbers I care for are small, and every woman needs good information. I’ve always served women by giving free information by telephone, and running a local ARM group, but again the numbers are limited, and so is my time. But I feel a huge need to pass on my knowledge of maternity rights and choices to women who may not even know that they have a choice.

Am I saying that the NHS is not giving women enough information or choice? No.

Am I saying women are unable to find out this information for themselves?  Certainly not.

Pregnant women just don’t know what they don’t know. First – time mums may, or may not have read widely, they may, or may not have a relationship with a known NHS midwife, and the midwife may be too short of time, experience or knowledge herself to be able to help each individual.  Without adequate information about choices in pregnancy the woman may feel she has no choice, and if things don’t go to plan, she may feel things were done to her without her fully informed consent. Feeling disempowered or not understanding why things were done to you in childbirth, can contribute to postnatal depression. After a poor experience women often look for further information and support to prevent the same happening in subsequent pregnancies.

2541987300_7cf0e2543a_mAs an Independent midwife many of my clients come seeking truly unbiased midwifery information, so they can feel empowered in their current pregnancy. Some have suffered previous birth trauma and wish to avoid similar happening again. But why wait until the second or subsequent pregnancy to get a positive birth experience? The first experience of birth is likely to be the most challenging, so it is important that we as midwives know how to serve you best. Unless you tell us what would help, or hinder you in labour, we will not know. Unless you know your rights and the choices available to you, you will not be able to instruct us in providing the right kind of care for you.

This is where writing birth preferences comes in useful. As an NHS midwife I would meet someone (often for the first time) in labour, and have to discuss all the pros and cons of different birth choices. I  don’t mind explaining at all, but Labour is not the right time to be engaging the thinking part of a woman’s brain!

  • Educate yourselves, know your rights and choices before labour starts.
  • Write your birth preferences down. Discuss them with your birth supporters before labour, and share them with your midwife when labour is underway.
  • If you don’t know why a course of treatment or an intervention is being suggested then please ask.
  • If you don’t understand or don’t like the answer then ask someone else.

The Association for the Improvement in Maternity Services (AIMS) are a great resource for anyone having difficulty getting support for their birth choices. AIMS have a booklet entitled “Am I Allowed?” and all over it’s cover it has the word YES. Nothing can be done to you without your informed consent. If it has not been explained to you fully, you cannot make an informed choice. Please buy this book if nothing else (order from website, under “publications”).

Read also Mary Cronk’s assertiveness phrases and practice them in front of a mirror.

Birth Rights is a new organisation founded by a human rights lawyer. The website contains useful fact sheets on rights in childbirth.

The birth bus
The birth bus

 

If you live local to me then find out when I am next holding a midwifery clinic in my Birth Bus (campervan). I park at various locations locally, to give information and answer queries about rights and choices. Just text or email me for dates and venues. These do vary according to my midwifery caseload.

Remember that knowledge is power, and you don’t know what you don’t know- BUT you can always find out and ask WHY?

 

 

 

Mary Cronk’s Assertiveness Phrases

Following on from my “Am I Allowed post” I phoned my dear friend and former colleague Mary Cronk. As well as a good chat with each other, I obtained her permission to post her assertiveness phrases. She re-quoted the phrases that I know by heart, and have recommended to many women. I had the pleasure of working with Mary Cronk for 5 years as an Independent Midwife, and a further 2 as co-teacher of “Once More Unto The Breech” workshops. She is a true Midwife and has spent her life helping women achieve positive birth experiences.

joy and mary307710_251788671525311_932911360_nMary Cronk is an expert in breech birth who has shared the skills of breech birth with midwives and doctors across the United kingdom. She was awarded a MBE for her services to women.

See Mary in action here: Mary

You may find these phrases useful, particularly if told that you are “not allowed” to have your baby at home, or you “have to” be induced, etc.

“I am sure that many others will explain your absolute right to refuse any procedure for any or no reason. The law, and good practice is quite clear. A sensible person will listen carefully to any explanations to why a procedure is proposed, and then should she choose not to have XY or Z she just says no or no thank you. The “allowing” is done by YOU. An asssertive approach is worth cultivating. You may care to commit the following phrases to memory and practice them frequently in front of a mirror. Continue reading Mary Cronk’s Assertiveness Phrases

The Third International Breech Birth Conference. Washington DC November 2012

Robin Guy
Heads Up breech birth conference

I was lucky enough to be invited to lead a workshop at this years International Breech birth conference.

My qualifications are that I have been lucky to work with Breech birth expert Mary Cronk MBE as an Independent midwife. We attended several breech births together and thus I started to learn breech birth skills. Our midwifery clients alowed us to take photos of their births for teaching purposes, and these have further added to our knowledge as we studied the many and varied ways breech babies are born.

My workshop was entitled “Arse Backwards” as my journey to learning breech birth skills started with the most unusual births. A double footling, a foot then knee, a foot and extended leg, VBAC breech birth – all at home, were marvelous to attend and record, to share with other health professionals and women expecting breech presenting babies. Unfortunately I do not have permission to share these photos on-line which is why Mary Cronk and I travel the country (and abroad) sharing the stories and skills of breech birth.

My presentation told the story of how I learnt breechbirth skills, and how important it is to share these skills with others, to give women the option of skilled birth attendants at their breech birth. I took along video footage of Mary Cronk sharing her wisdom which was very well received.

I also learnt a tremendous amount at this conference which will aid me in the future care of women planning spontaneous breech birth.

I hope to have time to write up the highlights, but until then check out the brilliant Rixa Freeze’s blog

Association of Radical Midwives monthly discussion group.

This is a local group for the support of peaceful pregnancy, birth and parenting. Hosted by Joy Horner, radical midwife, mum, lecturer and some day writer. Inspired by the Freedom For Birth film I am determined to impart information about human rights in childbirth, facilitate discussions, and to support women on their journeys to parenthood. You don’t have to be a midwife, a radical, or a female to attend. All those with an interested in women’s rights and experiences in pregnancy and childbirth are welcomed. These stimulating monthly discussion groups are designed to encourage experience sharing and debate, accompanied by tea and cake. All welcome. Donations for refreshments welcomed as 50% given to local charity Towards Tomorrow Together.

2013 Meetings at my house 7:30pm-9:30pm:

Thursday 8th August – Birth rights and choices.

Tuessday 3rd September – Waterbirth evening.

Thursday 3rd October – Postponed due to midwifery commitments.

Thursday 7th November – Am I allowed? how to get the best from your pregnancy, birth and postnatal care experiences.

Thursday 5th December – Blissful, ecstatic or orgasmic birth?

Please phone or text 07939247462 prior to attending the meeting to confirm date and location details. I am a practicing midwife so there is a chance I would have to reschedule a meeting if attending a birth.

Please note that although children are welcome they are your responsibility at all times, as I do have free-roaming teenagers, lurcher and elderly cats.

The Association of Radical Midwives are midwives, student midwives and others in the UK committed to improving the maternity care provided by the NHS. We strongly believe that all women have the right to a service tailored more closely to their needs, and a sympathetic attitude on the part of their professional attendants.

We are primarily a support group for people having difficulty in getting or giving  sympathetic, personalised midwifery care, and those who wish to provide good care. A few of us are working independently outside the NHS, in order to offer a more woman-centred,one-to-one, style of practice, which at present is not widely available within NHS maternity services.

In the mid 70s, the majority of pregnant women in UK had labour induced by artificial rupture of membranes (ARM) around the date they were “due”. These initials were used when the group needed a name, using the dictionary definition of “radical”, (roots, origins, basics, etc.) which aptly described the basic midwifery skills which they hoped to revive.

Held in our homes in Somerset, the group meet monthly to share skills and knowlege to empower women to have the best possible maternity care experience. Phone me or e-mail me at joy@birthjoy.co.uk for details of the next meeting.

Freedom For Birth Film Premier

FREEDOM FOR BIRTH – GLOBAL FILM LAUNCH

GIVES BIRTH TO THE  MOTHER’S REVOLUTION

Glastonbury film premier on Thursday 20th September 2012. was a resounding success! we filled 40 seats and had people sitting on the floor! £100 each was raised for The red tent project and The White ribbon Alliance, A lively discussion followed lead by our panel of experts Jenn Hodge (doula and service user), Kate Woods (doula and doula trainer), Eleanor Copp (midwife and hypnotherapist), and myself Joy Horner.

We watched the new documentary that reframes childbirth as the most pressing global Human Rights issue today is launching with hundreds of premieres all over the world on the same day, Thursday 20th September.

Freedom For Birth is a 60 minute campaigning documentary featuring a Who’s Who of leading birth experts and international Human Rights lawyers all calling for radical change
to the world’s maternity systems.

Hermine Hayes-Klein, US lawyer and organiser of the recent Human Rights in Childbirth Conference at the Hague, the Netherlands says, “the way that childbirth is being managed in many countries around the world is deeply problematic. Millions of pregnant women are pushed into hospitals, pushed onto their back and cut open. They are subject to unnecessary pharmaceutical and surgical interventions that their care providers openly
admit to imposing on them for reasons of finance and convenience. Women around the world are waking up to the fact that childbirth doesn’t have to be like this and it shouldn’t. Disrespect and abuse are not the necessary price of safety”.

Made by British filmmakers Toni Harman and Alex Wakeford, Freedom For Birth film tells the story of an Hungarian midwife Agnes Gereb who has been jailed for supporting women giving birth at home. One of the home birth mothers supported by Ms Gereb decided to take a stand.

When pregnant with her second child, Anna Ternovsky took her country to the European Court of Human Rights and won a landmark case that has major implications for childbirth around the world.

Toni Harman, one of the filmmakers says, “the Ternovsky vs Hungary ruling at the European Court of Human Rights in 2010 means that now in Europe, every birthing woman has the legal right to decide where and how she gives birth. And across the world, it means that if a woman feels like her Human Rights are being violated because her birth choices are not being fully supported, she could use the power of the law to protect those rights. With the release of “Freedom For Birth”, we hope millions of women become aware
of their legal rights and so our film has the potential to spark a revolution in maternity care across the world. In fact, we are calling this the Mothers’ Revolution.”

Ms. Hayes-Klein concludes, “Freedom For Birth” holds the answer to changing the system. Birth will change when women realise they have a right to meaningful support for childbirth and claim that right. Birth will change when women stand up against the abuses that are currently suffered in such high numbers and say, No More.”

A local screening of Freedom For Birth will take place at:

Glastonbury Town Hall, Magdelene street, Glastonbury,
Somerset. BA6 9EL www.glastonbury.gov.uk

On 20th September at 7-9pm

Tickets £4 in advance or £5 on the door (concessions available). All profits to the local Red Tent Project and The White Ribbon Alliance charity.

With after film discussion with panel of local
experts including midwives, doulas and service users.

Organised by local midwife and birth advocate Joy Horner.

Freedom for birth film ticket

 

Additional information about Freedom For Birth can be found on the website: http://freedomforbirth.com

The filmmakers are aiming for 1,000 screenings happening across the world on Thursday 20th September, 2012. The countries with confirmed screenings include the UK, Germany, France, Denmark, Spain, Greece, Italy, Norway, the Netherlands, Austria, Poland, Croatia,
Slovenia, Slovakia, Belgium, Hungary, Israel, Sweden, Finland, Iceland, Russia, Iceland, USA, Canada, Mexico, Colombia, Brazil, Australia, Malaysia and New Zealand.

Each screening is being organised by local birth campaigners.

The film has been selected for screening in the Cambridge Film Festival on 20th September. http://www.cambridgefilmfestival.org.uk/

Toni Harman and Alex Wakeford are a filmmaking couple who have set up a cross-media global film project called One World Birth to provide educational videos featuring the world’s leading birth experts  http://oneworldbirth.net

Freedom For Birth is Harman and Wakeford’s third documentary film about birth. They were inspired to make films about following their own difficult birth of their daughter four years ago. A cascade of interventions in their birth led to an emergency
caesarean section.

Contact Information:

Toni Harman, Producer/Director, Freedom For Birth info@altofilms.com +44 (0) 1273 747837 Website: http://freedomforbirth.com

High resolution still images available on request.


Copyright and the sharing of information

After an awkward issue arose between some midwifery colleagues over use of each other’s materials without consent I was prompted to write this page.

I believe all information is knowledge, knowledge is power and therefore should be shared to empower women. All information contained in this blog is my original work, from knowledge amassed throughout my midwifery career. I have worked very hard and am proud of the work I have done, so have marked photos, artwork and text as copyright Birth Joy Ltd(c). When I have used someone else’s material I will credit them in the text. I respectfully request that you do likewise. Please pass on information from my website but please remember to quote the origins of your information out of respect.

Photos are copyright to the photographer. I am very lucky that when I’ve taken birth photos, some women have given me permission to use these for teaching purposes, others have let me use their photos on my website. Some have allowed me to share with other midwives and one allowed publication in a midwifery text book. Many women have not, and I respect their right to do so.

For more information on copyright see this useful website.

Da a Luz

Vanessa Brooks at Buddafields 2011

Just returned from a wonderful week in Spain. I met the wonderful Vanessa Brooks for the first time this year, and offered to share my experiences of breech births with her in Spain.

Unfortunately I was only able to spend 24hrs at the Midwives Rock workshop, as my family had accompanied me and were eager to do other holiday activities.
I taught at Da a Luz for 5 hours on the Saturday. I shared my experiences and knowledge that breech birth is unusual but not abnormal, and breech babies can be born vaginally as well as by caesarean. Although Breech birth is a variation of the normal I also taught that breech birth carries some additional risks for the baby however he is born, so careful monitoring of the progress of labour and baby’s well-being is essential.
It was a real pleasure to work with Vanessa and to meet Adela Stockton and all the other wonderful birth workers.
I look forward to teaching with Vanessa again in June 2012 in Brighton UK.

Had a wonderfully nourishing time with Vanessa and other like-minded birth workers in the summer of 2012! We talked about birth of the placenta, control of bleeding, orgasmic birth and so much more. Then it was my turn to contribute alongside Marta Orbis and Vanessa Brooks teaching about breech births and difficult births. Can’t wait to work with Vanessa again next year. xxx

 


Delayed cord clamping is a much kinder transition for the newborn baby

Cutting the baby’s umbilical cord is a ritual repeated unthinkingly by many doctors and midwives every day. Please educate yourself about the potential harm that could be caused for the baby by doing this.

In the 1980’s I was taught to feel for the umbilical cord around the baby’s neck, once the head was born, and to cut it if it was tight to facilitate delivery. I realise there were so many things wrong with this practice now. What if we cut a cord and then have a shoulder dystocia? We have effectively cut the baby’s lifeline. I don’t think many practitioners do this now. I certainly do not feel for nuchal cords as babies can be born, even when the cord is tight. The somersault manouver  can be used to keep baby close to the mother whilst the cord is untangled.

The brilliant midwife thinking blog highlights the dangers of premature cord clamping if a baby needs help to start breathing. Basically when the baby is born a significant amount of his blood is still in the placenta. After birth that blood is needed to perfuse the baby’s respiritory system, enabling him to transition to breathing air for the first time. If a baby is slow to breathe but has a good heatbeat he is still receiving oxygenated blood through his cord if it remains intact.

Some women like to keep the cord intact in the form of a lotus birth. Aida’s birth and lotus birth was filmed, and illustrates how not cutting the baby’s cord helps when her baby needs help to start breathing.

Here is a 7 minute film with good, common sense advice about not cutting baby’s cord immediately after birth. This film has brief images of a woman’s breast and nipple as she is with her newborn baby as his cord is cut and as he crawls to the breast to self-attachment. This process, called Self-Attachment and/or Breast Crawl is becoming known now as a very critical part of human development that has been disrupted by modern, medicalized birth. Click to view: We can be much kinder

Penny Simkin gives a visual aid teaching session on the subject of how much of baby’s blood is still in the placenta if we cut the cord too soon after birth. here

Robim Lim explains the importance of not clamping or cutting a newborn’s umbilical cord here:
https://www.youtube.com/watch?v=SwvRUrn0p90&feature=player_embedded