Debra Pascali Bonaro review

"I love Adela's book.

Gentle Birth Companion captures the heart, passion and sacred path that doulas hold in supporting women and their families through out time. The perfect blend of her-story with science , showing the doulas role and importance today as she helps us  re-discover the value of female companionship during childbirth.  If you are pregnant, thinking of hiring a doula,  becoming a doula or are involved in maternity care today, Adela's book is essential to help you reconnect the circle of support in childbirth that provides an essential ingredient for a safe, fulfilling birth experience."

Debra Pascali-Bonaro, Director of the documentary and Co-Author of Orgasmic Birth: Your Guide to a Safe, Satisfying and Pleasurable Birth Experience, DONA International Doula Trainer and Lamaze International Childbirth Educator www.debrapascalibonaro.com

 

Birth Stories

For many doulas, our journey begins with our own birth story. Our first experience of pregnancy, giving birth, breastfeeding, becoming a parent. Our first understanding of being part of our new family. And our first contact with the maternity care services. 

The quality of physical, emotional and social support that we have received during this time can make a huge impact on our experience of childbirth. And whether it has turned out as we hoped or expected, or whether it has confirmed our worst fears, it is nonetheless so often the trigger that starts us thinking about the idea of supporting other mothers through the same experience.

Listening to other women's birth stories is bread and butter to doulas therefore. It is the way we learn about and connect to the mothers and fathers we support. It forms the baseline upon which our relationship with our clients during this birth experience balances, it provides waymarkers and flashpoints. And allows for the unpacking of a whole heap of the grief, anger, fear, hurt and disappointment that can sometimes accompany the joys of holding our newborn.

We need to be strong, mindful and steady in order to weather the storm of some birth stories, as well as gentle and yeilding enough for the parents to know we are with them from our hearts. This can be tough, it can resonate with our own birth trauma or postnatal illness, and touch us in ways we never knew was possible. Not only can it connect us back to the circumstances surrounding the birth of our own babies, but also to our personal (unconscious) memories of our own birth.

It's useful for new doulas to be aware of the powerful and valuable impact that birth stories bring to their learning and preparation I feel. Not only does the novice hear about the physiology of natural birth and what happens when this is disturbed, but also it is an opportunity for her to begin to explore what it might mean to provide birth and postnatal support in practical and emotional terms within a safe setting.

To become humble, to begin to know a little of the amazing art of just being.

Running

I think I am starting to get the thing about running. 

I mean, if in theory you can still run marathons aged 101 (I bow down to you Mr Singh!), there must be something in it. 

The slap-slap of your feet like the in-out of your breath - its regular, its rhythmical, its hypnotic, its progressive towards an eventual conclusion, be this an end or merely a pause. 

Ian Cameron, Five Winds School

I have never been a runner, even in team sports at school I engineered my position as goalkeeper to avoid running. Yet I practised tai chi for 25 years, happy to sustain the stamina required for training without difficulty.

So why now?

Something to do with being overweight and fifty perhaps (and losing tai chi).  But recently I have been dipping my toe in, curious. Short jogs, downhill, just to see what its like. 

 

Don't get me wrong, its way too late to aspire to the mighty steps of Mo or Mr Bolt. Yet never too late to be inspired!

Even from these brief forays, I realise that while running, or in order to keep running, there is only the now. A focus on the present moment for what it is, for to stray from the sounds, the sensations in my body is to lose contact. And without that connection, I slide towards a gasping, wilting halt.

 

So it becomes like meditation, mindfulness, and I think the idea of that could keep me going back for more. 

Or is that what drives other folk to it too ...

Fresh views on doulaing

Up-to-date comment and discussion on the doula role: http://www.adelastockton.co.uk/content/published-articles

Latest news from our European doula community:

http://www.european-doula-network.org/doula/resources/articles-studies.php

Birth Mindfulness for Parents 1

Planning a natural birth?

 

Did you know that there are three key ways that you and your partner can prepare for the arrival of your baby, whether in hospital or at home, which may make a real difference to your chances of experiencing a gentle birth? 

Place – feeling safe and unobserved in your birth environment, free to move around and take up any position you want, can help your mind and body to stay focused and keep those essential labour hormones flowing. Rearrange the furniture, hang a ‘do not disturb’ sign on your door!

People – choosing attendants you trust to uphold your wishes for labour and birth is wise. Your supporters can protect your birth space by keeping questions and noise to a minimum, by banning strangers from the room. Enlist a doula (birth companion) as your advocate, she is there for your partner too!

Pain – establishing a unified attitude to the way you choose to work with your contractions, and making sure you have plenty of positive emotional support, can mean you are less likely to feel the need to request pain medication or an epidural. Write a clear birth plan, keep everyone informed!

An ‘undisturbed’ labour means you are more likely to enjoy a gentle birth. And a positive experience helps you, your baby and your family off to a good start.

Author of ‘Birth Space, Safe Place: emotional wellbeing through pregnancy and birth’ (Findhorn Press, 2009), former midwife Adela Stockton also provides doula courses (Mindful Doulas). For further information, see www.adelastockton.co.uk

Journey from Midwife to Doula - MAMA 2012

Several folk who were unable to attend the recent MAMA conference in Troon have asked if a recording was made of my presentation 'Journey from midwife to doula' - and if so, could they hear it.

Given that the session, shared with student midwife Debbie Gilmour who spoke about her 'Journey from doula to midwife', was small-fry in comparison to those of the keynote speakers such as Michel Odent and Ina May Gaskin, it did not (to my knowledge) attract enough attention to be recorded!

I did notice that at least three of our highheedjyun midwives plus our charismatic director of RCM Scotland were in the room however. That is in addition to the chair of Doula UK, a homebirther obstetrician, plenty of student midwives and a fair smattering of doulas too.  So I was happy!

And for those who might still be curious, here is a flavour of what I covered.

In the hope that questions from the audience would prove as valuable to the session as anything that Debbie or I presented, I did not dwell long on my story.

A synopsis of what I had brought into midwifery at the start of my 3 year direct entry training in Edinburgh in 1992, kicked things off - outlining an eight year career in TEFL working in Peru and Portugal, a background in naturopathic medicine and homeopathy, a long term commitment to the practice of tai chi and a fundamental belief in the powers of natural childbirth.

The kind of midwife I had aspired to be included those such as Jan Tritten, Ina May Gaskin and Mary Cronk with some Jannine Parvati Baker and the TBA mixed in. Although the truly awesome midwives I have worked with at grassroots level during my training and practice and post-midwifery have probably been the most influential.

Practising as a midwife in London then Stranraer, with an enlightening and humbling skills-sharing sabbatical with midwives at Marie Stopes Madagascar in 1997, I focused on building autonomy and promoting normality. Theatre or High Dependency were never my forte.

The turning point came in 2000, with the gentle undisturbed home waterbirth of my beautiful daughter, sensitively supported by my husband and community midwife. Returning a year later, to a big teaching hospital in Glasgow where I witnessed so many shocked mothers and angry babies, tragically put the nails in the midwifery coffin for me.

Perhaps fortuitously, it was at this time that I learned about doulas. And I began what was to become a long volunteering role with Doula UK.

I was also running independent holistic birth classes and providing homeopathy for childbirth. When my midwifery registration came up for renewal in 2003, I reluctantly let it lapse. I felt truly deeply sad, yet I knew it was the right thing to do: I could no longer sit on the fence. But I could still work 'with-women'.

A period of de-midwife-ing ensued, I learned to stop watching my back, to change my vocabulary - 'women birth' rather than 'are delivered' is my favourite! I reminded myself that mothers and fathers are consenting adults with the right to make their own decisions. I worked on developing supportive skills and letting go of advice-giving, and honed in on the idea of 'being' rather than 'doing'.
 

'Birth Place, Safe Place' was conceived as a handbag sized handbook for parents to dip into, to be inspired by ideas that they could follow up as they chose, promoting ways in which parents could help themselves towards a positive birth experience. And in 2007, I was instrumental in formalising our peer support group Scottish Doula Network. 

The Scottish doula 'training' programme had been led by our pioneering doula Lesley Ann Patrick until 2003, when I was lucky to have her hand it on to me. This I developed into the Mindful Doulas course we know today, I love doulaing new doulas!

More recently, 'Gentle Birth Companions' evolved as the first text on the UK doula movement, I wanted the world to know about our UK doula community and how we work, I also wanted to embrace our European sisters and the activities of the European DoulaNetwork.

A key part of my journey has been to offer some insight to the midwife-doula relationship, from my personal experience. I believe that with compassion and respect, careful communication and a commitment to building bridges, we can make it work well.

It may be useful for midwives to know that the benefits of doula support are greatest when she is not associated with the hospital (Hodnett et al. 2011). And I feel it is important for doulas to understand that, in certain circumstances, midwives may not be able to support a woman's choice because of fear of litigation.

A subsequent conversation with the experienced senior midwife who questioned my use of the word 'litigation', made me think that replacing it with 'being struck off' might work better. 

Yet, I wonder, doesn't it more or less amount to the same thing? Doesn't it mean that the midwife cannot work either way? To say nothing of all the grief, stigma and nasty politics. And it is certainly something that Denis Walsh refers to regularly.

Mary Ross-Davie's new research on Support in Labour and its effect on normal birth was flagged up, with a question posed regarding the recruitment of midwives in view of personality.

I consider the issue to be more about the prospective student midwife's attitude to birth, than her personal attributes. Does she consider birth to be a normal physiological event or a medical saga? And equally, about the kind of training and support she receives along the way.

In conclusion, we considered the words of Jan Tritten, Midwifery Today (2009/10):

“Birth is a Human Rights issue. Every mother and baby has the right to be treated with reverence and respect during the birth process, including pregnancy and beyond.” 

I was greatly moved by an about-to-qualify student midwife who came up to me afterwards almost in tears to ask if there was 'anything good' I could remember from being a midwife.

ADDENDUM

Later in the evening, a chance chat in the ladies toilet with our RCM director, gave me the opportunity to voice my (warmly met) feeling that having the opportunity to debrief her own birth experiences during the process of her midwifery training, in a supportive environment, could make a real difference to how a midwife goes on to support birthing women. 

Over the course of the MAMA conference I heard voices saying 'you can't change the system unless you work within it', and I understand where this thinking comes from. But I am not sure that I agree with it.

My feeling is that the real power to bring about change has to come from the women. As such, the role of emotional support should not be underestimated. If it gives women the self-empowerment to use their voice, does it matter whether it is provided by the midwife or the doula?

With our independent midwifery in such a critical position, it has perhaps never before been so important for ALL birth workers to stand together in the name of supporting mothers and their families.

Embracing the doula movement may be just what is needed to shake up the system. If it raises the profile of how emotional support can give women the voice they need to make maternity services meaningful for them, then surely its worth it?

For without being meaningful to birthing women, what is the point of being a midwife or indeed, the doula role?