The Irish Maternity System - Birth Trauma (Joe Duffy stories)

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DoulaCare Ireland have (like many others in Ireland) been listening to the stories that have been shared by families in Ireland on the Joe Duffy show over the last week. They have made very emotional listening at times. Unfortunately as doulas and childbirth educators we have been privy to similar stories over the years from women who have reached out to us, looking for someone to talk to. To know that women finally have a public platform to share their stories and to truly be heard is one of the positives to come out of the show. 



At DoulaCare Ireland we support clients nationwide, and of course some will have had past birth trauma. These women and their families often feel they cannot speak about their experiences or they will be treated badly on subsequent pregnancies. Those who do speak out often feel they are brushed aside or their trauma is belittled by hospital staff. 

woman calling about birth trauma


There is very little support within our maternity service for those who have had challenging birth experiences and need someone to talk to. Many of these women often apologise for feeling upset about their experience. After all, they have a healthy baby. Shouldn’t they be OK with how things went? Everyone else seems to think they should be grateful that all is well with baby and move on. But just because you are thrilled to have a healthy baby doesn’t mean you don’t get to grieve for the birth you had hoped to have. It is OK to be upset at how you were treated during your pregnancy and labour. It is such a vulnerable time in a woman’s life and while we may be nervous about the unknown, most of us don’t think that this will be compounded by being spoken to harshly or mistreated by the people we are supposed to trust. 


At DoulaCare Ireland we work closely with other supportive organisations and refer our clients to available services. 



If you have an experience (negative or positive) within the HSE care you can leave your feedback on their site called Your Service Your Say. This information does get reviewed and will be brought to the person in question. 

https://www2.hse.ie/services/your-service-your-say/your-service-your-say.html




We feel it is important to highlight the fantastic work that AIMS Ireland have done since 2007. They are campaigners for safe and respectful maternity care for the women of Ireland and they work tirelessly on a voluntary basis to do so. If you need advice or supports please do contact them on www.aimsireland.ie




We are also proud partners with Nurture Health, who are a national counselling service. They specialise in the care of women and their families during pregnancy and the postnatal period. They have counsellors nationwide who offer space and time to women who have traumatic experiences or have postpartum mood disorders. Irene, the CEO, always ensures their clients are seen quickly and matches them with the best counsellor for their needs www.nurturehealth.ie (and some of your hours may be covered by health insurance - Irish Life Health for example, offer hours with Nurture Health through their Parenting Path packages for new families.)



Some women find it helpful to get their notes from the hospital. They can be requested by writing into the Freedom of Information Officer in the hospital attended, with Name, Date of Birth and any other relevant details. The applicant must mention that they are requesting their notes under the Freedom Of Information Act in order to receive them free of charge. They will write back  with a standard letter saying they will give a response within 28 days, before sending on the notes on. If desired and the Mum feels able to do so they can then request to meet with the Head of Midwifery or with your Obstetrician to have a review of your notes (AIMS Ireland also offer this option). 



Many of the stories shared over the last week have mentioned women being alone and frightened or not understanding what was happening. With DoulaCare Ireland these situations never arise. With our agency model, each client has their chosen doula but also a back up doula. They also have the support of our full team of 35 doulas - all fully Garda Vetted. This means no matter how long a labour and birth lasts (4 day induction for example) our clients will have constant support from a known doula. They also have the knowledge and experience of 35 doulas to tap into at any point. We have women with diverse backgrounds in our team, from women health physiotherapist, midwives, nurses, yoga instructors, antenatal educators and much more. While our role is not to speak for you during labour we are there to help facilitate conversations between client and their health care provider, encouraging the Mum to ask questions if it looks like there is a lack of understanding on their part. 




Midwife doula woman birth



Doula support is scientifically proven to reduce traumatic experiences and postnatal mood disorders. A Cochrane Review 2017 showed:


Women who had doula support were:

  • more likely to have spontaneous birth

  • more likely to have shorter labour

  • less likely to use pain medication

  • less likely to have Caesarean birth

  • baby less likely to have low Agpars

  • Lower levels of Postpartum Mood Disorders


Women who had doula support had:

  • 31% decrease in use of Pitocin

  • 28% decrease in Caesarean

  • 12% increase in Spontaneous Vaginal Delivery

  • 9% decrease in use of pain relief med.

  • 14% decrease in baby going to SCBU

  • 34% decrease in risk of being dissatisfied after birth




We welcome the discussions on Joe Duffy show and thank the team in RTE for opening up the space for these women to share their story and finally be heard. It is shocking how many women have experienced trauma and remain silent. We hope that women will be able to find their voice, to speak up for their rights and to get the support they deserve. We also hope that those working in the maternity system listen and work to implement change. It must be hard for anyone who works in this area who actively supports and cares for women in kind and compassionate ways to hear these stories, as this is not how they would ever treat anyone in labour themselves. However, the myriad of stories from all over the country show that there is a systemic approach to treating women that needs to be addressed and changed for things to improve. 

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Sharing these stories is the first big step. Well done to every single woman/partner/supporter who has spoken out. Your strength will be a part in driving change for all the women and their families who will be entering into the Irish maternity system. 


We are here to support all women and their families. Get in touch if you need compassionate care postnatally to help you recover from a traumatic experience, or if you are embarking on a subsequent pregnancy. Your voice will be heard.

info@doulacare.ie



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Postnatal Depression, when love doesn’t come as a thunderbolt.

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Postnatal Depression, when love doesn’t come as a thunderbolt.

I was 21, and diagnosed with Poly Cystic Ovarian Syndrome (PCOS), on a hot June day, in the consultants room, in a Cork hospital. One minute I was worrying about my parent's car being clamped, and the next minute I was being told,  if I was ever going to have kids, do it now in my early 20s. He closed the folder and stood up, as I sank into the chair. Fast forward to 23, going out with my husband, and about four weeks into the relationship, the clock now ticking so loudly, I sit him down and tell him. In September 2011, my daughter was born. Five years after my PCOS diagnosis. A greyness descended, initial happiness replaced with fears, thoughts, overwhelming feelings. My brain telling me that I’m not good enough for her. My husband was beaming, but my heart was breaking, because, after five years of hoping, wishing, endless sticks to wee on, I didn’t get that thunderbolt. I was in shock. 

I stayed in the hospital for four days, because I didn’t want to go home until I felt ‘right’ . That thunderbolt didn’t come. Over the following days and weeks, I lied to friends and family who were enamoured by her. I was staying awake all night, afraid, and dreading the moment she would need me again. Would she be better with someone else as her mammy? I envied my husband's love for her. I envied how happy he was. I loved her, but felt that I wasn’t enough for her. What if she didn’t like me? Friends kept telling me how lucky we were to have a happy, healthy baby. I didn’t feel lucky, I felt guilty, ashamed that I wasn’t enjoying the baby I had longed for. I was lucky to find a breastfeeding support group,  that allowed me to cry, talk openly, and not be judged. It became my lifeline. I found Kathy Kendall-Tackett's book, The Hidden Feelings of Motherhood, and it was eye opening, and reassuring. Dr Andrew Mayers from Bournemouth University, has done some interesting research about partners developing postpartum depression too.

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I had heard some myths about PND , and medication, and I had fears about asking for help. What if they take her off me? What if, what if, what if? I became numb, and comfortable in my numbness. I hit rock bottom in 2016, when my neighbour passed away suddenly. A few days later, at my doctor's for something else, I broke down. He gave me some options, and I chose a referral for counselling. It was amazing. A weight lifted. The shame and guilt could be put down. I could breathe. 

I now work as a postpartum Doula, with Doula Care Ireland. One client described me as “a wonderful calm presence amidst the chaos" .I am not a health care professional. I am not there to tell you what to do. I give you the information,  and allow you to make an informed choice that works for you and your family. There is no one magic cure for PND, but , with calm, clear, informative support you can begin your journey out of the greyness. I am continuously working on being the best version of myself, and it is a continuous process. Sometimes I see glimpses of how I felt, in my clients, and it reminds me that the process of being mentally well, is something we need to keep working on.



Written by one of our doulas Dee Burke. You can fins out more about Dee and the support she offers here https://www.doulacare.ie/dee-burke-1/


If you or someone you know is suffering with a postpartum mood disorder these resources may help


https://www.nurturecharity.org


http://www.pnd.ie


https://www.cuidiu.ie/httpwwwcuidiucomsupports_parenthood_postnatal


https://www.hse.ie/eng/services/list/4/mentalhealth/mother-and-infant-health/#Finally,%20support%20services%20for%20those%20with%20Poatnatal%20Depression


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Things are not always as they seem on Social Media!

Things Are not Always as They Seem on Social

Media!

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Things aren’t always as they seem!

 

Social media like Facebook portrays an image of happiness and beauty. Everyone full of smiles, surrounded by friends and family, women with perfect make up, children looking sweet, even their house looks clean and decorated so beautifully in the background!

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I have sat with so many parents who feel inferior and genuinely upset when they compare their life to their Facebook or Instagram friends (some of whom they may never have actually met in real life!) 

 

Well guess what? No one has a perfect life. Who do you know that told you about their toddler having a massive melt down on the floor of the super market?  It’s happened to us all! Now ask yourself this, have you ever seen them post a photo of said event? The probable answer is of course no. They may even have got through that hiccup in their day and gone on to post a video that evening of their little one singing a sing, full of smiles. This often leaves us all thinking “Look there is Sally’s little girl singing, she is so sweet. Why are my kids such terrors? I can’t even bring them to the shops to get milk and bread without a melt down!”

 

Social media is where people document their happy moments. It is well thought out before anyone posts a photo. They will find the clean corner of their house, hold the camera to its most flattering angle, nudge their partner to smile or do silly faces to coax a smile from their little ones. It is where we can look back and say “That was a brilliant day” or “Look how much my baby has grown since then!”

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I encourage you all to enjoy social media, like Facebook and take inspiration from others. See another twin Mum getting out to a play group? Never thought you could? Maybe that was the photo you needed to see to give it a go ☺ 

 

Social media is a great way to stay connected to people, get peer support and find out about local resources. Remember to take off the rose tinted glasses and see behind the staged scenes of family photos. Reality is that there was probably shouting or bribery (or both) to get everyone in and smiling. If we capture that moment we can feel proud posting it, banking that moment in time for the future. 

 

So your life isn’t perfect, your kids are a pain in the backside most of the time, your house is a mess and your partner is a nightmare. Whose isn’t? Feel comfort in knowing we are all in the same boat ☺ Reach out to friends to chat. Go to peer support groups. Have a moan, then have a cup of tea and a biscuit, take a deep breath and enjoy the rest of your day.

 

Because even if your life isn’t perfect, you will never have this moment again. Your little ones will never be at this stage again. Sometimes the days can feel endless but the weeks disappear so quickly so savour every precious moment and breath through the hard ones.

 

Doula Jen xx


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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.

mother baby

 

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