When you don't know a lot about birth except for what you've seen in the media or heard from well-meaning friends and relatives, it can seem big and scary at first.
I love working with clients who are keen to explore what a positive birth means for them, what the hurdles along the way might look like and how we can work through them together.
Even when Covid stopped me from being present in person to support clients in labour, Meg's story shows how the work we do together during pregnancy is invaluable. It is not just the pain coping strategies but also the more profound work of knowing what is important to you and advocating for it.
I value Meg's strength and determination and the support from her partner to get the information they needed to make decisions as individuals in the face of typical systemic behaviour.
Meg's Birth Story
When I first found out I was pregnant, I knew I wanted to soak in as much information as possible. I'm a control freak by nature and from what little I already knew, pregnancy and birth were so unpredictable.
Thank you so much to Meg and her family for sharing their story.
If heading into your birth confidently knowing how to advocate for yourself sounds like your jam, send me a message and we can get started with a package of prenatal sessions.
Free resources to get you on your way to a better birth:
10 Questions to Ask Your Care Provider
What is Informed Consent?
5 Birth Planning Tips
"I'm looking for a doula who is familiar with hypnobirthing" is a very common comment I see in many groups on social networks and get asked by potential clients. So am I familiar with hypnobirthing?
Heck yes I am! Here's a little info around my personal and professional experience:
Way back in 2006 when I was pregnant with my daughter, I took part in a self-hypnosis trial with Dr Allan Cyna (Consultant Anaesthetist) at the Women's & Children's Hospital in North Adelaide. We had 3 in-person hypnotherapy group sessions with Dr Cyna as well as CDs to take home and listen to. I remember very clearly how calm and relaxed I felt during my labour, to the point I was falling asleep in between contractions. I had been induced with gels and the OB breaking my waters so was a little apprehensive about it all but it was very straight forward. I then went on to use those skills during my next two births at home - one of which was 19 hours long!
Many of my doula clients have undertaken group hypnotherapy or calmbirth classes with one of the many providers here in Adelaide. As with all my clients, we talk about what they want for their birth. This includes any particular techniques they may have learnt or terminology they want used, for example using the word 'surges' instead of contractions'.
I have sat in on client's private hypnobirthing classes and gone through the learning with them and practiced the breathing and soft-touch techniques. I know for one particular client, these skills became essential during her 50 hour VBAC!
For further professional training, I have undertaken studies with the HypnoDoula course.
So yes, I am familiar with hypnobirthing and would love to support you through your pregnancy, labour and birth as your doula!
Read below for one of my client's hypnobirthing stories from January 2021.
Kate's hypnobirth with Elemental Beginnings
We first met Kelly in 2018 when we hired her as a Doula for the birth of our first son. From our very first meeting with her we felt incredibly comfortable and relaxed in her presence and we knew straight away she was exactly the type of support person we wanted and needed at the birth.
Kelly helped us clarify our birth preferences by making sure we understood the birthing process so we could make informed choices throughout. For our first baby we opted for a home birth, and Kelly supported us through 20 hours of labour at home before I was ultimately transferred to hospital due to some complications. She was a huge support to both myself and my husband throughout the long labour. I think he was particularly grateful to have an extra support person to tag team with. I was also grateful to have Kelly's support postpartum and she helped me navigate my disappointment that the birth had not gone exactly the way I had hoped.
When we found out I was pregnant with my second son in May last year, the first thing my husband said to me was "we will definitely get Kelly again won't we?". It really wasn't a question for either of us as we couldn't imagine doing it without her. We greeted Kelly back into our lives as a friend and once again, she helped us feel calm and supported in the lead up to the birth.
This time around we decided for a hospital birth from the outset. My labour progressed slowly and was manageable throughout the day. My husband was in regular contact with Kelly to keep her updated and we both felt reassured knowing she was ready and waiting for us when we needed her. Later that evening when things had progressed we asked her to come over. She arrived at our home, her usual unphased and calm self, using a soft voice and gentle touch. I used a TENS machine and utilised my learned hypnobirthing skills to remain 'in the zone', while Kelly and my husband supported me through each contraction.
Around an hour later I decided it was time to go to the hospital and Kelly rode with us (squeezed in the back of our car between two baby seats), offering words of support where needed, but just as much comfort in her silence. On arrival at the hospital ER, my husband dropped us at the door and left to park the car. I remember thinking how I would have been left alone at that time had we not had Kelly with us. I was so grateful to have her there, guiding me through admission and responding to some of the questions on my behalf so that I could remain focused on my labour and breathing.
It was a long walk from the emergency room to birthing and assessment, and Kelly was with me every step of the way, helping me block everything else out as I breathed through each contraction. I chose to walk as it felt the right thing to do at the time, so Kelly was left to fend off multiple offers of wheelchairs from concerned nurses and hospital staff as we walked the long corridors together. It felt so reassuring to know she was in my corner, helping me to trust my instincts and encouraging me to 'walk my baby out'.
My husband was already in the birthing suite waiting for us when we arrived. Kelly straight away raised the bed to the highest height so I could continue to stand and lean against it while she placed her hands on my hips and back for gentle support. Her experience means she know exactly the right things to do to help in the moment, with very little communication needed, meaning I could remain 'in the zone' for labour.
Soon after I decided to get into the bath and spent the next little while in the water in silence, breathing through each contraction and feeling my baby move down. Kelly continued to provide subtle support - whether it was occasionally wafting peppermint oil under my nose to help with nausea or placing an extra towel under my head, or gently reminding my husband to hit replay on the hypnobirthing affirmations track playing in the background.
Only two hours after arriving at the hospital, I breathed into my final contraction and pushed out my baby. The birth was exactly what I had hoped... A calm and beautifully supported experience.
Kelly's support did not end once our baby was born. She helped me breathe through the birth of my placenta and helped me with my first post-birth shower. I also required some minor stitches so she came with me to the room next door while my husband remained with our baby. I was more scared of the stitches than I had been at any time during my labour and for the first time needed pain relief. As I breathed in the gas deeply and squeezed her hand tightly, she offered continuous words of encouragement and support throughout the procedure. I was so incredibly grateful for her kind and caring presence during that time.
After such a beautiful birth, our baby experienced some unexpected breathing complications and ended up in neonatal special care for 12 days. This was an incredibly stressful and upsetting time for us but once again, Kelly was a continuous support for me throughout with texts and phone calls, offering a level of empathy and understanding I would not otherwise have had.
We are forever grateful for the friendship and support Kelly has provided to our family. If you are thinking about hiring a Doula, I cannot recommend Kelly enough. She is calm, kind, patient, genuine, knowledgeable and understanding - the perfect person to support you throughout your pregnancy and birth.
Thank you Kelly!
You might also like to read more about Kate's other birth from her husband Simon's perspective.
And how does a doula advocate for you?
When you choose to give birth within the system (through a public or private hospital or one of the homebirth programs), you must be aware that Obstetricians and Midwives will treat you according to the policies of their hospital and state. In South Australia, these are the Perinatal Practice Guidelines, and you can find a link to them at the end of this blog.
The government website states that "The statewide guidelines do not address all the elements of clinical practice and assume that clinicians are responsible for discussing care with consumers in an environment that is culturally appropriate to ensure informed decision-making and individualised care for pregnant women, mothers and their babies.
The emphasis on specific terms is mine. Because although the health departments mention this in their documents, women rarely receive wholly culturally appropriate, individualised care with a real opportunity for informed decision-making.
Let me share some examples.
Is it culturally appropriate care to tell a woman she can not have her placenta straight away for burial because part of a policy says that the hospital must stick it in a fridge for seven days, along with every other placenta born there that week? No.
Is it individualised care for a midwife to tell a woman that the last person she saw with higher blood pressure was induced straight away, so that is what she will need to do also? No.
Has the opportunity for informed decision making been given when a midwife performs a stretch and sweep while doing a cervical exam without asking the woman first? Just because the midwife wanted to "razz things up a bit" No.
Is a decision free from coercion when the unit manager storms into a woman's birth space without introduction, demanding to know why the labouring woman isn't consenting to a suggested course of action? No.
Is it individualised care for a midwife to tell a woman that she will not attend her birth if she doesn't consent to cervical checks, despite knowing the woman has a history of sexual abuse? No.
Has a woman given legally valid consent to have continuous monitoring if the OB only tells her that if she refuses, her baby could suffocate and they won't know about it until it is too late? No.
These aren't made-up scenarios.
My clients have disappointingly experienced them all and I have witnessed the majority of them.
So as your doula, what do I do in these types of situations? How do I advocate for you? It's a question I often get asked.
I know that these are all stressful situations which can interrupt the labour process, so my first action is to remind my client that she isn't alone in this - reassuring her with a touch, eye contact or even a smile to help her settle her nervous system as much as possible.
Depending on the situation and timing of the event, I might also do any of the following:
If you would like to learn more about what informed consent and refusal looks like, you can download the free handout below. Click on the picture to get your pdf and print it out. Hey, you could even take it with you to your appointments if your health professional needs a little reminder =)
Why knowing how you want to feel during childbirth is more important than what type of birth you want.
Vanessa and her family hired me to support them for the birth of their second baby with a planned VBAC (vaginal birth after caesarean).
As part of my prenatal visits with clients, I talk a lot about birth preferences. Birth preferences include what I call "checkbox items". You know, like the boxes you might tick on a form or birth plan template:
However, the birth preferences I want my clients to really focus and work on are how they want to feel during labour and birth and how they want to be treated. Feelings that are important to my clients often include phrases such as calm, respected, not pressured, informed etc.
We can't control (but can influence) how our bodies and our babies work during childbirth but we do have control over our actions and role. We can think about how we want the maternity provider we have chosen to treat us. We can determine the level of responsibility we are ready to claim in decision making and the actions we are willing to take to achieve these goals.
Because when the unpredictability of birth kicks in and clients have to adjust their checkbox items, we can still focus on these feelings and their values.
How can I change my checkbox items from a VBAC to a repeat caesarean while still feeling informed of what is happening to me and my baby, while still feeling respected, while keeping the environment calm and not rushed?
That’s where the magic lays in a positive birth.
"HOW the birth is conducted might be just as important as WHAT you do.... Positive communication and interactions throughout the birthing process significantly affect the woman’s experience, which in turn can affect both her mental and physical health, as well as her relationship with her baby postnatally."
Click here to read the whole article related to the above quote about the
importance of the language used by care providers in birth.
In Vanessa's own words
"I was worried (in fact, super scared) that I would have another birth where I walked away feeling like I didn’t have a very nice birthing experience. Hiring Kelly meant that I could work through many scenarios and know that I could put my mental health first and have others ‘checking in’ on my mental health. So as the birth didn’t end up being as I had planned, I came away from the birth this time in love with my new little human.
The most helpful thing was having someone who knows the system on my side. It was like having a very strong emotional pole to hold onto and to feel grounded the whole time. This was important for me as it meant I could be confident in my choices throughout the process. She was a sounding board throughout the birth.
I found the hospital system and birthing classes just gave a general overview of the birthing process but nothing was customised to me and my birthing situation (what happened the first time). This time around, with Kelly’s help, I felt like I had more knowledge so was able to ask deeper questions and research more to ensure I was happy with what was going on around me.
She was a great support for my partner who felt he had a better understanding of my situation too with both my physical and emotional needs. It’s great to have a professional person to looking out for me mentally and emotionally.
Although my birth didn’t go quite as planned (I was hoping for a VBAC but ended up with a RCS) I came away from the birth in my baby love bubble, something I didn’t experience first time round.
Because of this, Kelly is worth her weight in gold."
Vanessa & Baby Jett - Happy Valley
I have a bunch of books in my office that clients are welcome to borrow. Please let me know if you are interested in reading any of them. I do ask for a $20 fully refundable deposit for any item I lend out just in case they don't come back and I need to replace them =)
Click on the thumbnail to see the full cover and scroll through the other books
Prepare for an easier fourth trimester with these 25 Secrets From A Postnatal Doula!
Kelly Harper is the owner of Elemental Beginnings Doula & Placenta Services in Adelaide. She provides sleep consultancy, placenta encapsulation and doula services to families during pregnancy, birth and in their fourth trimester.