So Meghan Markle hired a Doula? What is that? Part 2

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So Meghan Markle has hired a doula and everyone is buzzing “what is a doula anyway?” Part 2.

There are two main types of doula. A Birth Doula and a Postpartum Doula. There are also Doulas who specialise in supporting families through loss and other niche areas

In this blog we will focus on Postpartum Doula support.

In times past (and indeed today in many cultures around the world) parents were not sent home from hospital with a new baby and expected to know what to do and manage on their own. We would have had the support of families, neighbours, friends - minding us, feeding us, helping us adjust to the changes in our lives and allowing the new Mum to rest and recover from birth and support her during the first few weeks of life with a small baby. Today we are often lacking this support and just expected to cope. People do call in to visit but don’t think to bring a cooked meal for the Mum, let her rest, load the dishwasher or ask how she is doing. The focus is often on the baby and the Mum is just expected to get on with it. However, we are not hardwired to manage in this way. We need the support of others in those first few weeks and months and in lieu of support from our community the postpartum doula can step in and offer this support.

A Postpartum Doula begins work with their client as soon as they book in. For some, this is during pregnancy (the forward planners!) and for others this is after baby is born. If it is during pregnancy, your doula will help you to prepare for your new arrival and the huge shift your life will take. If it is after birth, your doula will slot right in to your new routine (even if you don’t think there is any form of routine) As with Birth Doula support, your Postpartum Doula comes with many layers of support. We help you to debrief and process your birth experience. We nurture you while you recover from birth and find your new normal. We help your older children adjust to having a new dynamic in the family. We support your partner, adjusting to their new role and debriefing their own experiences. We offer knowledge, encouragement, information and support every step of the way - as each new day brings new challenges. Above all, we help you to savour the good moments between the chaos :)

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Knowledge: Doulas are information junkies. We love reading, attending study days and growing our knowledge base. In DoulaCare Ireland all our Doulas must attend at least three CPD days per year. - which ensures the building of knowledge as evidence changes and new research is undertaken. We also learn from every interaction, with each individual client. We bring that knowledge base to you when you come home with your new baby. No matter what comes up, with your recovery after birth or your babies needs - chances are we have seen it before (or we know who to call if not).

Encouragement: Anyone who has had a baby, knows that surreal feeling of being left in charge of this new tiny human. Many parents feel “they are not seriously letting me home alone with this baby? I don’t even know how to bath him or tell if he is hungry” Don’t fear. It is normal to feel that way. The truth is no parent has the answers. Babies don’t come out with an instruction manual. We all learn on the job! The great thing is, with your Postpartum Doula by your side - you have a calm presence helping you every step of the way. So nothing feels overwhelming. You and your baby learn together, with a helping hand from your Doula.

Information: To new parents this is invaluable. The number one question we get asked… “Is this normal?” Rest assured, your Doula will have all the latest evidence and research at hand to help you make informed decisions when the fog of parenting clouds your brain. It can be hard to process information when you are recovering from birth and haven’t slept more than an hour in 2 weeks. Your Doula will give you the information you need in bite sized chunks so you can fully process it as required. She would also be delighted to tuck you up in bed, with clean sheets, after a hot shower and home cooked meal - and after a nice nap it is easier to think more clearly and have perspective on the changes in your life!

Hands-on tips and tricks: A Postpartum Doula passes on all the parenting tips and tricks they have picked up through their training and working experience. They help you to simplify your daily life. Sometimes it’s a gentle suggestion on where to keep the changing table, that you hadn’t thought of (like having a second one in that corner downstairs to save you running up and down the stairs 20 times a day) Sometimes it is demonstrating different methods of helping baby to get wind up - which can be a tricky skill to master.

Partners: Partners are often Doulas biggest champions! We help them to feel involved every step of the way. In parenting, it can be helping them to figure out how to put a baby grow on baby (which way is up? Are these the arms? We all know how hard it can be to get a new baby dressed!) It can be explaining the hormonal rollercoaster women ride after giving birth and to expect highs and lows. It can be a listening ear for them to debrief or to gush about their beautiful new son or daughter. Sometimes it is offering gentle suggestions to help them adjust to their new role and see what part they can play in supporting their partner and adjusting to their own new role.

With DoulaCare Ireland you have a full team of support. Each client is matched with the perfect doula for their needs. In the bigger contracts (100+ hours) you will usually have two doulas offering support. You have the opportunity to meet both beforehand. Both doulas will know your parenting style and wishes. This means that if for any reason your doula needs to change your scheduled hours you have the option of your second doula covering so you are never alone! Our co-owners Jen and Mary are always on hand too. We offer phone and email support to our clients and our doulas so no question is ever left unanswered.

We know from neuroscience that our brains are not hardwired to manage on our own in those first few weeks of adjusting to life with a new baby. All so often when we arrive at a new Mums house, they disclose that they feel they are doing something wrong as they struggle to cope. So few of us talk about how hard it is, that many are left feeling not good enough. The postpartum doula steps in to fill the gap. We are there to build confidence and make those first few weeks a positive memory for years to come - in other words to help a family thrive and not just survive the early days of parenting


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Meghan Markle has hired a doula, what is that? Part 1

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So Meghan Markle has hired a doula and everyone is buzzing “what is a doula anyway?” Part 1.

There are two main types of doula. A Birth Doula and a Postpartum Doula. There are also Doulas who specialise in supporting families through loss and other niche areas


In this blog we will focus on Birth Doula support. 


A Birth Doula begins work with their client during pregnancy. Supporting them throughout pregnancy, labour and birth. We don’t clock out at 8pm. We are there by our clients side every step of the way. Offering continuity of care throughout pregnancy, labour, birth and postpartum. We then visit our clients at home, offering support with all those early parenting questions.. We offer knowledge, encouragement, information and hands on tips and tricks of the trade. 


Knowledge: We help our clients to understand their chosen place of birth (most commonly a hospital) policies.We compare the different hospitals policies, statistics and what the National Clinical Guidelines say. We also chat about International Guidelines and help our clients to make informed decisions about their care. We also cover the physical process of labour and birth and common things that come up. We can assist our clients to create their birth preferences for their unique journey. After baby arrives we share all the latest evidence on infant care, recovery after birth and anything else you’re wondering about too!

doula pregnancy support




Encouragement: We build up our clients. A huge part of our role is to help our clients (the birthing mother and her partner) to feel confident. We are like their coach or cheerleader from the sidelines, reminding them of all the skills they have gained throughout their pregnancy and the strength they have within. This does not stop once baby arrives. We build you up again after birth and remind you of that strength and knowledge.


Information: Apart from the mentioned topics, doulas also answer any questions that happen to arise with each client. It may be they read an article online and wonder does that happen in Ireland? Or they are told they have a condition (such as gestational diabetes GD) and would like information to help them feel informed and confident on how best to manage it.



Hands on tips and tricks: Doulas are not afraid to get in there and help out. During pregnancy we show our clients different massages, counter pressure and comfort measure to help during labour. We teach these skills to the birth partner so they feel fully involved in the process. On the day of labour often doulas and partners work really well together - tagging in and out (counter pressure can be really tiring after a few hours!) This support continues on into parenting. From showing you how to change and dress a newborn (which is surprisingly tricky at first) to helping you find a comfortable position to feed in - your doula will be right there. 

doula birth support



Partners: Partners are often Doulas biggest champions! We help them to feel involved every step of the way. Partners often say things like “I didn’t know what to do to help my wife” or “I felt like a spare tool in a scary unknown setting” but with a Doula supporting them - they have a full tool kit to draw from. They also get encouragement and a helping hand along the way. After they become a Dad/Mam we are still there. Helping them to adjust to their new role and offering guidance on how best to support you.



With DoulaCare Ireland you have a full team of support. Each client is matched with two doulas. You have your primary doula and your back up doula. You have the opportunity to meet both. Both doulas will know your birth preferences and wishes. This means that if for any reason your doula needs to take a break (such as a long birth, where your doula may need to grab some sleep), you have the option of your back up doula joining you so you are never alone! Our co-owners Jen and Mary are always on hand too. We offer phone and email support to our clients and our doulas so no question is ever left unanswered.

In next weeks blog we will discuss Postpartum Doula support.

Until then… Doula Jen x

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VBAC Mothers are real!



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Hi I am here…a real life, breathing VBAC mum :) 

So many of our DoulaCare Ireland clients do not believe that VBAC’s actually happen in Ireland. Well as a doula I have supported them, as an antenatal educator I have taught parents about them and earlier this year I experienced a VBAC personally.

My beautiful baby daughter Kayla Rose (a bit of a social media celebrity now) arrived in a whirlwind on 25th March 2018. I had an intervention free VBAC, supported by my husband, doula and midwife (an obstetrician was there also but I have very vague memories of her as she was not my focus) 

As Kayla’s birthday starts to draw closer, I have started to write my birth story. I will upload it in two parts (its a long story even though the birth itself was fast) That will give you all a full run through of my VBAC.

Before labour began I was admitted to hospital at 38 weeks for polyhydraminos (too much amniotic fluid) and baby in an unstable lie. Kayla was lying diagonally across my tummy. This meant there was a high risk of cord prolapse if my waters released. So after weighing up all my options, the pros & cons I decided to stay in hospital. (see my pregnancy blogs and our social media posts during March 2018 for videos/updates etc) You can also look back through my weekly pregnancy blogs ;)

There was lots of talk about elective caesarean but I held firm that I would like to try for a VBAC. I was confident in my body’s ability to birth my baby. There was a lot of negotiation and I found being informed about my options really helped in these situations. I knew the benefits and risks and studies that were done around vaginal birth after caesarean and also repeat caesareans. I was never against caesarean. I knew it was one option and if that ended up being the case I was ok with it, once I was listened to. My main priority was always to have a safe birth BUT I also wanted to have a positive experience. I found having doula support a great advantage as I had someone that I could bounce my thoughts and feelings off, who was non-judgemental and impartial and made a great sounding board for me. They supported me as I mourned the birth I wanted (to labour at home before going into hospital), and help prepare me for my change in circumstances. The brain training techniques in the GentleBirth app also helped me keep my focus and stay calm as things changed for me.

During my pregnancy I did all I could to empower myself. I worked on my physical and mental health. Over the 9 months I worked on building a positive mindset. preparing my husband to be my advocate. I armed myself with great support, in the shape of my informed husband and my wonderful Doula. I took time for self care. I had regular reflexology, used aromatherapy, had shiatsu, realigned my pelvis with chiropractic treatments, listened to daily affirmations, GentleBirth tracks and had a vision board. I knew my VBAC wasn’t going to just land in my lap. I had to take ownership and prepare for it.

I stayed really positive and used my time on the antenatal ward to focus my mind and prepare my body. I went into spontaneous labour just as I was going to bed on the 24th of March. I did consent to having the CTG, even though I had originally felt I did not want it (more detail to come in my birth story) However I was clear that I chose my own position and moved with my body.

Kayla Rose entered the world at 4.17am, the night the clocks went forward. So my labour lasted less than 3 hours. She was 8lbs 2oz, at 38+6 gestation. 

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I escaped with only a small 1st degree tear and no abnormal blood loss. 

I did it!




Jen with baby kayla enjoying skin to skin,surrounded by love with (hubby paul taking the photo), midwife jo (rotunda) and doula mim.

Jen with baby kayla enjoying skin to skin,surrounded by love with (hubby paul taking the photo), midwife jo (rotunda) and doula mim.

It was such a high and I was so proud of myself. I haven’t really spoken about that high much. There was complications after, as Kayla was born with an undiagnosed cleft palate and Pierre Robin Sequence but that was not connected to our VBAC. My moment of euphoria only lasted a second before we realised something was wrong with our baby.

So after a bit of my story…. I experienced a VBAC in an Irish maternity hospital. Yes at times during my pregnancy I felt like there was a huge spotlight over my head. Yes I had to negotiate and be firm at times. Yes I had a wobble myself during labour, when I had a burning sensation across my scar but I did it. The evidence says many more woman can safely do it too. 

Preparing for a VBAC can definitely be a rollercoaster and support is crucial. Most people (including health care providers) just assumed I would be having a repeat Caesarean. I knew VBAC was safe, I was aware of the evidence and for me it was the option I hoped for.

There is a lot of misinformation out there about VBAC birth. You will hear care providers tell people that they can have a VBAC but only labour for so many hours as it is dangerous for the scar (not evidence based), or they cannot go over 40 weeks in case the scar ruptures (not evidence based), or because it has only been 2 years since their last baby their scar may be too weak (not evidence based)…you get the picture!!! So in order to have a successful VBAC you do need to prepare yourself. Below I have listed some of my top tips for anyone hoping for a VBAC.


What are my top tips?

Empower yourself with knowledge and the latest evidence.

Educate yourself and your partner so they are also aware and can advocate for you if needed.

Get yourself a Doula!

Take an independent childbirth class - a Cuidiu antenatal class or a GentleBirth workshop, or a VBAC specific workshop (also given by an independent provider).

Try to be under midwifery led care if possible.

Peer support is hugely helpful. The VBAC in Ireland Facebook group is a great support network of Mums who have tried for a VBAC, or are trying (LINK)

Don’t be afraid to ask questions at appointments (bring a notebook if it helps)

Know you have the right to decline any option of care once you understand the benefits and risks (a caesarean, a CTG trace, an induction and so on)

Remember to use BRAIN as a tool when discussing your options (both for you and your baby)

Example:

What are the BENEFITS of a repeat caesarean?

What are the RISKS of a repeat caesarean?

What are the ALTERNATIVES?

What does my gut INSTINCT say? Need more INFORMATION?

What happens if I do NOTHING for now and wait to make a decision?

Remember DoulaCare Ireland are here to support you through your VBAC. Ask us questions, gain information & support but above all, gain the skills to make informed decisions for your individual situation. 

I wish you luck on your journey. Whatever the outcome, what is important is that you have a positive experience - at the centre of that is making informed decisions and feeling supported. 



Doula Jen x



Some Further reading :

http://aimsireland.ie/vaginal-birth-after-caesarean-vbac/

https://www.hse.ie/eng/services/list/3/acutehospitals/hospitals/cavanmonaghan/maternity-services/consultant-led-care/maternityvaginalbirth%20aftercaesarean.pdf

https://www.rcm.org.uk/tags/vbac

https://www.rcog.org.uk/globalassets/documents/guidelines/gtg_45.pdf

https://evidencebasedbirth.com/topfive/

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Moved over to main website blog:Care and Recovery After a Caesarean Birth.

Care and Recovery After a Caesarean Birth.

You have a brand-new baby — and you also just had surgery. Whether you knew you would have a caesarean birth or not, dealing with both at the same time can be rough. Here are some helpful tips to get your recovery and parenting journey off to a great start. 

 

 

Keep on top of the pain medication!

Expect the caesarean incision to hurt for a while. The medicine used in the epidural/spinal ease pain immediately after birth. After they wear off, you’ll be given oral anti-inflammatory medication or suppositories. There are options for these medications that don’t interfere with breastfeeding, so take them. If you can keep pain at bay, it’s unlikely to get out of control. But if you let it go, it’ll hit you like a ton of bricks. It is important to mind yourself during your recovery.

Many new mothers get tummy cramps after birth. These are called "after pains" and are similar to early contractions. They are your uterus’s way of shrinking to its original size. Sometimes having that incision will make it more intense for you. Also know that breastfeeding can trigger those cramps and make them feel a little more intense. As crazy as it sounds, this is actually a positive thing! Breastfeeding releases oxytocin which will assist your uterus to shrink back down the way nature intended. Talk to your doctor or a lactation consultant if you’re having severe pain or other problems breastfeeding. Or remember your doula is always at the other end of the phone.

 

 

Move at your own pace!

You probably won't feel up to walking the room rocking your new baby straight away after birth, but you should be able to get out of bed and walk around within a day. You obviously have to wait for the epidural or spinal medications to wear off fully but you also may need extra time to regain your energy. Once the catheter is removed (it emptied your bladder so it wouldn’t be damaged during delivery), you’ll be able to get out of bed. Take those first few days at your own pace (often similar to a 100 year old tortoise).

Moving around allows normal body functions to get back to normal, as well as decreasing the chance of complications from your surgery. For example, walking even small amounts helps to avoid constipation. It can also lower the risk factor of forming a blood clot. Plus as hard as it seems, you will feel better if you go and brush your teeth or take a shower. Slowly and with help!

Of course, you’re not expected to get up and go for a 10k run anytime soon but it is recommended to gradually increase the amount of activity you do from around two weeks postpartum. That can mean starting by walking around the garden and gradually going longer distances and becoming more active. Increase the intensity around six weeks postpartum. By that time, you will be due your 6 week check with your GP, who will let you know if you are ok to drive and answer any questions you have. Take it at your own pace, follow what your body is telling you.

Get help lifting baby

I know - All you want to do is lift that gorgeous baby up and cuddle her, but you’re always better to ask for help. It could be painful or difficult shortly after surgery. This is normal, and pain medication, as well as a hand from your partner, doula or a nurse, will help. Lifting a baby out of the crib may be a challenge, but sitting and holding a baby in your bed or a chair and nursing isn’t. So go ahead and breastfeed your baby, but ask for assistance from the nurses or your partner during your hospital stay.

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Eat lots of fibre

Constipation can be an issue for women after caesarean birth. Gas also gets backed up. This can be uncomfortable in the obvious ways but in surprising ones as well, like shoulder pain. If your bowels are distended, they can irritate the diaphragm, and that can be a referred pain that goes to the shoulders.

Don't be shy,  speak to your care provider about laxatives and anti-gas meds if required. Remember to eat fiber-rich foods like fruits and vegetables, drink lots of water, and move around as much as possible. And don’t be shy — let that gas pass.

 

postpartum fiber diet

 

Care for your incision

In the shower, let the water run on the wound (don’t scrub). Try not to use soap on the area. Once you are done you can pat it dry. If your skin folds over the incision, put a cloth pad on it to keep it from getting sweaty. Your nurse will check it regularly to make sure everything is healing well and may put a dressing on for protection.

Look out for signs of infection, if any develop call your care provider:

  • High Tempature

  • Skin around the incision turns red

  • Oozing green or pus-coloured liquid

  • Incision becomes hard or painful

Self care is vital!

So now you are a mam with a round-the-clock new responsibility. It can be easy to get distracted with your adorable new baby and push your body too far. It is important for both you and baby that you recover quickly. You can help speed recovery by eating a balanced diet, getting as much rest as you can and start gentle exercising once you get the go-ahead from your doctor. Don’t be afraid to ask for help so you can get some extra sleep, take a long shower or eat a full meal. (see my blog on ‘Self Care’) 

 

 

I wish you the best of luck with your birth experience.

Doula Jen x

 

Jen Crawford,

CO-OWNER DoulaCare Ireland

www.doulacare.ie