Labour and Childbirth… some of my thoughts

I am a true believer in all women having the labours they want and want to experience, some want it all natural, with a doula, birth coach, midwife, whale music, water birth, hypnobirthing, some want all the drugs available, an epidural at the first contraction and some choose an elective caesarean section. One of my personal favourites was the Entonox or Gas and air as it was called in layman terms. I am not sure how widely used this is in Canada.

My role when I was a midwife was not to judge but to support what each individual client wants and needs. women also need to understand that sometimes, things don’t go to plan and many did come in with a birth plan.  Another one of my roles was to monitor the mother’s and baby’s wellbeing whilst in labour and watching the progress in labour, trying not to think about the medical model of labour, but keeping it tucked in the back of my mind. In my 6 years as a practising midwife in the UK, I have attended a variety of births, normal cephalic, high risk, breech presentation, premature labour, twins, quadruplets, the sad stillbirths the late terminations for abnormalities and many more… of course I did not experience everything and I still have a lot to learn when I gave midwifery up after my 2nd child was born and I felt I could not do a good job as a midwife as I was constantly sleep deprived and my children and family always came first. I felt I did not have much left to give women and their families going through such an amazing time, and so decided leave the profession. 

Childbirth is still something that can only be deemed normal in retrospect. We really cannot predict that everything will go as planned.  We sincerely hope that a normal and healthy pregnancy will result in a smooth labour and birth of a healthy baby but occasionally, babies do get distressed or labour does not progress for reasons like there may be cephalopelvic disproportion. It could even be something like the umbilical cord having wrapped itself inconveniently round the baby’s neck, the baby’s body, and the baby get distressed with each contraction. Whatever the cause, we don’t want these things to happen but they sometimes do. We have a duty to educate women about these possible events, not to scare them but to prepare them for things that may go awry. This way, if any of these events happen, then they will not be so traumatized or shocked and feel like the perfect labour and birth was denied them, or they were robbed of the wonderful experience of a normal birth.

I feel sometimes like my friend Katie Clinton puts childbirth is portrayed as the 2 extremes of the serene amazing natural birth (which does happen) and the horrific ones where everything appears to have gone wrong. In reality, most people fall in between these two extremes.

Finally, another friend has shared her experience of childbirth and parenthood, and I especially like the bit at the end where she says, I have had 12 years to experience being a mum, it’s not all about the labour or birth, it’s so much more.

LK Koay posted this on one of my posts

Suyin, fr young I saw how childbirth was being portrayed on tv and I grew up being afraid of all the pain, screaming and the propped up legs. To me, it’s painful, messy and unglamorous. I almost didn’t want kids! 

When I got pregnant, I cried. Tears of fear. When the 1st child’s due date loomed near, I told my doc n hubby that I want it as painless as possible n I wanted C-sect. 

On the day my water bag broke, the 1st request I made after the hospital settled me in a labour room was…. “where’s the anaesthetist? I don’t want to feel pain!”. When I realised the pain I felt wasn’t a stomach ache from wanting to visit the loo, I panicked even further that the most important person has yet to arrive! And I’m not talking abt the obstetrician! Anyway… overall birth experiences I had were wonderful. I felt almost no pain and I didn’t go thru what I saw depicted on tv. I had good birth experiences if you ask me. I wasn’t traumatised. I’m glad I did it the way I want, rather than what I should have done because others do it naturally to feel ‘how it feels like to be a mother’. I had so far 12 years to feel how it feels like to be mom anyway. 

Laid Back Breastfeeding AKA Biological Nurturing

Recently I discussed this method of breastfeeding to a new mum who was having a few problems with obtaining a good latch resulting in sore nipples. She was pretty sceptical and because I was the only person amongst all the health care professionals she had encountered since the birth of her baby, including nurses and a lactation consultant, who had mentioned it she was mulling it over. In the meantime, I had suggested side feeding, which seemed to be the best bet for a good latch. After going to the 2nd Lactation Consultant a week later, who convinced her it was worth a go, she tried it whilst with the lactation consultant and found that it was a great way of getting the baby to latch. She came home, tried to replicate the experience and did not succeed, she went back to cross-cradle hold and side feeding. Baby was having the most success with a good latch in the lying sideways position.

When I visited the next day and we we talking about how things went with the IBCLC, she said that she wanted to give the laid back method another go, and would I help her to achieve this. I said of course I could and we set on an adventure, baby, mum, dad and I. We undressed baby, placed baby on mum and watched in amazement as baby made her way to the breast. She had some assistance from mum who placed her within the vicinity of a nipple and she appeared to do the rest. How wonderful, baby led breastfeeding and attachment. Admittedly mum had to be careful that baby did not clamp down too hard on the healing nipples, by directing the breast towards baby’s wide open mouth, but it was minimal assistance as opposed to having had to bring baby to her breast as in all the other positions and methods that had been used previously. Mum too felt more relaxed and comfortable, bringing her arm down to support baby’s head as in a modified cradle position. Mum said the laid back position she was in also reduced the back and shoulder strain she had experienced previously in the more traditional feeding positions. Success.

The first time I heard about biological nurturing was when I attended  CAPPA lactation educator’s training, being delivered by Attie Sandink IBCLC extrodinaire. I had been a midwife in the UK and practised for 6 years, till the year 2000 and a nurse after that until 2009, and never once had I heard about laid back breastfeeding.  The DVDs were amazing to watch but to see it for oneself live is the best thing ever. For this I can thank my current clients. Dr S Colson brought this method to us and we should teach all new mums about it.

Here is a link to an article by By Nancy Mohrbacher, IBCLC, FILCA about biological nurturing. 

https://breastfeedingusa.org/content/article/some-ins-and-outs-laid-back-breastfeeding

 Here’s a link to Suzanne Coulson’s video on Biological Nurturing

http://www.biologicalnurturing.com/video/bn3clip.html

Yet another link to Dr S Colson’s work and words

http://www.midwiferytoday.com/articles/biologicalnurturing.asp

Lactation Cookies Doing the Doula Style

I decided to make some of these for the mum I am looking after at the moment, as baby wasn’t putting on weight and the IBCLC diagnosed a problem with mum’s milk supply.  I got the main gist of the recipe from Housepoet’s Famous Lactation Boosting Oatmeal, Chocolate Chip and Flaxseed cookies… but added my own twist to it as this is what I normally do to recipes.  I  tend to alter recipes to suit my needs and I decided to add some dried apricots and cranberries to the recipe as dried apricots are a good source of iron.  I also did this because I wasn’t sure how the brewer’s yeast would taste as I had smelled it and wanted something to mask the rather distinct flavour it may give.  I had made some choc chip, oatmeal and cranberry cookies for this mum before and she really liked them so thought the cranberries would be a good idea to add.  Dark chocolate is also a good source of iron but I am not sure how much dark chocolate there is in the semi-sweet dark choc chips. In addition, I also altered the amount of flour used to make a softer cookie.

So, my lactation cookies contains all the vital milk producing ingredients… oatmeal, flaxseed meal, brewers yeast but also has a few lovely tasting bits in them.

Lactation Cookies Doing the Doula Style (makes about 80 small cookies)

1 cup butter, you can use margarine if wished

1 coup brown sugar

1/2 cup white sugar

4 tbsp water

2 tbsp flaxseed meal ( available from health food shops and bulk barn, I went to bulk barn)

2 large eggs

1 tsp vanilla essence

1 and 3/4 cup flour, or if using wholemeal 1 and 1/4 cups

1 tsp baking powder

1/2 tsp cinnamon powder

3 cups rolled oats, I used thick cut

1 cup choc chips

2 oz dried apricots, snipped into small bits

1/2 cup dried and sweetened cranberries

2 tbsps brewers yeast. No substitutions, has to be brewers yeast. Be generous and I got this from bulk barn too

Method

Preheat oven to 375 F. Line 2 baking sheets with parchment paper

Mix together the flaxseed meal and water and set aside for 3-5 minutes. Cream the butter and sugars. Add the eggs one at a time. Mix well, add the flaxseed meal mixture and vanilla. Beat well. Whisk together the dry ingredients except the oatmeal, chic chips and dried fruit. Add dried ingredients to butter mix, stir in oats, chic chips and dried fruit.

Drop cookie size blobs onto baking sheet, I used 2 teaspoons to do this, cookies will expand a bit due to baking powder. Bake 8-12 minutes depending on size of cookies.

I made about 80 cookies with this recipe.

They tasted quite nice, soft and slightly chewy. I was generous with the yeast and so my normal food tasters weren’t too keen on them but the mum I gave them too really likes them. So, now to see if they work!

 

 

 

Me, Mitchell and Jasmine at the Westonbirt Aboretum, Wiltshire

This was taken some years back and is my profile picture on the CAPPA website, someone chose to interview me because of this picture. Images can make a huge impact on one’s decision making processes.

Sleep Sack

A crocheted sleep sack to use inlace of a swaddle… it allows baby to move freely, it will not cover the baby’s head and cause overheating.

Baby Whisperer Part 2

This name was given to me by 2 sets of parents recently. I happen to turn up for work and their babies just happen to be going through a fractious phase. I step in, say hello, and offer to have baby and, voila… baby calms down and quietens.  The parents stare at me in disbelief and awe, which I am almost unaware of. Then they say, “What did you do?” Or, “How did you do that?”  In all honesty, I don’t know myself, but I have some theories to explain what is happening.  I am penning this right of the top of my head and it’s by no means evidence based. It may be interesting to explore the evidence in support some of my techniques for settling babies… I guess that will be in Baby Whisperer Part 3.

The early days of parenthood are wonderful and amazing times. It can also be a time of stress and these precious miracles called babies are very adept at feeling the stress their parents feel.  So, my theory is that when I take over from them, being the calm, confident postpartum doula that I am, the babies sense this too, and calms down, as the stress around them has been removed.

Once the babies are clam and quiet, stop crying and fussing, the stress levels in their parents drop too, so that when I hand the babies back to them, all is calm and great.

Now, in the back of my mind, I see a potential drawback. I want to empower my clients to become confident parents. I don’t want to be the only one who can calm their fractious baby. So, I explain to them about the stresses of the early days of parenthood and discuss ways of dealing with these stresses and anxieties. It’s a huge learning curve becoming a parent for the first time and of course they are going to be anxious and have a lot of concerns and questions.

Why do babies cry?  Babies cry primarily because it’s their only means of communicating with us until they learn how to talk.  And it is our duty as ‘Sherlock Holmes’ parents to decipher what that crying means. They are trying to communicate to us that they may be hungry, they may have  wet or soiled their diaper, they may have gas or they may have been startled. It may even be too quiet for them.  They are not used to being left alone, after all, they have spent the last 40 weeks in their mother’s uterus listening to the swishing, pulsating of the placenta and their mother’s heartbeat. Not to mention all that borborygmi! They can also hear mum’s voice and that of others all through their watery world of amniotic fluid.

And so they are born. All of a sudden their noisy world becomes a relatively quiet one. It must take a bit of getting used to. Maybe this is why white noise machines seem to be a must thing to have these days, though I must admit I did not have one for my children. I co-slept with them, and I guess that having us close to them comforted them enough to negate the need for any white noise.

So, in order to calm a baby, go through the list of why she/he may be crying, one by one until you solve the mystery. Eventually, you’ll get used to baby’s cries and reactions, and discover the reason fairly easily. In the early days though, going through the list mentally in your head may help. If baby is rooting – opening her mouth as though searching for a breast – feed her. If she has been fed, and is not settling, burp her, check her diaper and maybe check if she needs topping up.  Swaddling is going out of fashion and there have been some recent recommendations by the Ontario Nurses Association advising against swaddling.  The following link is just one write-up of many written about the new guidelines.

http://www.canadapress.org/health/2014/03/05/new-guidelines-reopen-great-swaddling-debate/

Bearing this in mind, I do not advise my clients to swaddle their babies, if they decide to do so, I advise them of the risks so they can make their own informed decision.

In conclusion, I don’t think I am a baby whisperer nor do I profess to be one. I am an enabler and educator. There are many ways of settling a baby and it may seem like a mystery but if you go through the possible reasons as to why a baby may be unhappy, you’ll soon discover the cause and solve the problem. It’s all about learning,  learning to be confident parents and babies learning to communicate with their parents.

 

 

You’re the baby whisperer!

Just a quick entry as I am due at work in 8 minutes. Just wanted to pen this down and write more about this later when I have a bit more time. I have been called this twice by clients recently… It’s a great compliment but I tell my clients that it’s not what I set out to be!  And if indeed I am a baby whisperer than I will impart these skills to my clients so they too become their baby’s baby whisperer.

Anyhow, will return to this in due course… more to follow. Got to dash now.

The Importance of Clarity

A costly lesson learnt today and it’s to do with clarity….. make sure both parties understand and agree on what is going to happen so there are no disappointments on either side, or misunderstandings! Short but sweet…..

A new testimonial

I have been a postpartum doula  based in Thornhill for the last year. After practising as a nurse and a midwife in the UK for 19 years, we took a leap of faith as a family and moved to Trinidad and Tobago to work and live for 2 years. We had a wonderful 10 months out there before we were told we were being transferred to Toronto, Canada. Another move, another adventure.

I was hoping to be able to nurse here in Canada but for various reasons this was not meant to be.  This turned out to be a blessing in disguise as it gave me the opportunity to try out a few occupations I have often wondered about.  In my nursing days, when things got me down at work, usually due to stresses from workload, staff shortages and disagreeable managers, I would say to myself… “I should just go and stack shelves in Sainsbury’s than deal with all this stress!”  Now was my chance. I could venture outside nursing and see how non nurses fared.  I did a short stint working at a McDonald’s 5 minutes walk away from home, working the dreaded night shift. Then found a job at a local pharmacy who were willing to take me on as a pharmacy assistant, even though I had no previous pharmacy or retail experience. They provided me on the job training. It helped that I was a nurse prescriber as I knew mostly what all the drugs and medications were for.  This lead to another pharmacy job which I am just about to leave after being there for 2 years.

The work I was doing was ok, it paid just above minimal wage, provided me with a little job satisfaction but something was missing. I was missing out the caring element. I did care for the customers at the pharmacy, but closer personal care that you get from  being in the caring profession was missing from my life. I had to find something else that would fill this gap. I have a wealth of knowledge and skills that were under-utilized, and I wanted to to change this.

I scoured through the internet, talked to some friends who were nurses and midwives in the UK but were now  doing something else here in Canada and wondered what I could do. Being very interested in women’s health and the promotion of breastfeeding, I stumbled on the profession of the Doula. I thought I could possibly do that, it would let me use my skills in a non-clinical way and better still be supporting mums and their families with a precious new addition to their lives.

I researched the various doula trainings available and decided to train with CAPPA. I was familiar with them as I had been a volunteer at the Mamatoto Birthing Centre in Trinidad, and they were a worldwide recognized organization, plus I loved their ‘Vision’ and philosophy. The rest is history and now I am about to embark on being a postpartum doula full- time.

This brings me back to my title. I have created a web site to support my doula business and to promote it, how much that is happening, I don’t really know, but I had wanted to tweak a few things on it and discovered that one of my recent clients had posted a testimonial on there for me.  And here it is…..

“My husband and I are the type of people who like to do everything ourselves. But when my second daughter arrived with a big appetite and a distaste for sleeping, it finally became apparent that we needed some professional help. It really eased our minds after learning about Su Yin’s background in nursing and midwifery. We were overjoyed that she turned out to be a warm, easy-going and knowledgeable person whom both my children adore. It was one of the best decisions I’ve made to have her in our children’s lives.”

Qin

Second time mom

I have been meaning to blog about my doing the doula and now seemed like a good time to share this positive testimonial.  My website address is :-

http://cherryblossomdoula.webs.com

My Facebook page is

https://www.facebook.com/DoulaSuyin

If you’re a tweeter, my twitter username is @doulasuyin