Birth First Aid: Roots, Trust, and Preparedness
We are three weeks away from starting the next cycle of the Birth First Aid for Mother and Baby and I find myself wanting to speak to where this course actually comes from. Not in terms of curriculum or structure, but in terms of roots. From the age of 8, I was raised in a rural, mountainous part of South Africa, far from towns, hospitals, and easy access to help. We lived without electricity or hot water, and “making a plan” was simply part of daily life. My mother, a farmer and a self-taught rural traditional midwife, was my first teacher. Part of her work revolved around growing herbs, preparing natural medicines, and offering care to the local community. Birth happened quietly, often in the background of everyday life. Sometimes in the middle of the night, and then life simply went on. To be honest, it wasn’t something we, as children, paid close attention to. It was simply part of the landscape we grew up in. Women trusted my mother to sit with them while they birthed their babies, and this trust felt natural and unremarkable at the time. Birth wasn’t feared. It was accepted as a normal part of life. My mother had a still, calm, and deeply accepting presence. The women she supported often spoke of her quiet nature and her healing hands. And although much of this was absorbed unconsciously, it shaped something fundamental in me: a sense that birth, when held with trust and respect, usually unfolds as it should. Later, as a birth attendant myself, I experienced those rare situations where a baby struggled to breathe, a mother lost more blood than expected, or a birth asked something extra of those present. These moments taught me that preparedness does not need to mean fear, and that calm, grounded response is very different from panic. This understanding was later deepened through my work teaching Helping Babies Breathe and Helping Mothers Survive in African hospital settings. These experiences reinforced that even in moments of urgency, calm presence and simple, well-understood responses matter more than fear-driven reaction. This is the soil from which the Birth First Aid course that I now offer grew. The course is not about anticipating disaster or turning birth into a clinical event. It is about cultivating steadiness, discernment, and confidence. Knowing when to trust the process, and knowing how to respond when gentle, respectful support is needed. Birth isn’t about fear. It’s about trust. And when we hold birth with trust, and pair it with simple, well-understood first aid skills, we create safer, more held spaces for mothers and babies, without unnecessary intervention. If this way of approaching birth speaks to you, you’re warmly invited to read more about the course and its upcoming cycle...
Read MoreWhy Birth First Aid?
The First Time I Ever Resuscitated a Baby on my own I remember the first time I had to resuscitate a baby on my own. It had been a fairly average first labour. It started in the middle of the night and trotted along into the new day. The mother was surprised at the intensity of the surges but she rode them quietly and stoically. The emergence of the baby was slow and as her mother crouched, she was born gently onto the floor onto a soft pile of towels. Some mothers scoop their babies up immediately, while others take their time, looking, smelling, and touching. Still, others need to take their time, first processing the enormity of the event before being able to look and engage. As long as the space is warm and the mother and baby are left undisturbed all are variations of normal. In this case, the mother was slow to interact with her baby, I believe she was initially taken aback at the sight of her newborn. It became evident that this baby was not responding after being born, not showing much muscle tone and not breathing. Helping Babies Breathe I had recently been trained in the Helping Babies Breathe (HBB) programme as a facilitator through Operation Smile and worked as a volunteer for some of their educational missions in Africa. What I love about this programme is its simplicity: its focus on normal birth, preparedness, its understanding for working in low-resourced and out-of-hospital settings, as well as the all important MotherBaby needs like skin-to-skin and not cutting the umbilical cord. As a skilled birth attendant, you make a difference In the HBB programme, we are taught that the majority of babies are totally fine at birth and require little more than skin-to-skin contact with their mother – but that around 10% require gentle assistance in transitioning from womb life. These are some of the skills we will be focusing on in the upcoming Birth First Aid series of workshops that I will be offering for the month of November. Extreme neonatal resuscitation is rare in healthy pregnancies and births and usually is an indicator of some other underlying issue. Why Birth First Aid? If we are attending births on a regular basis, especially when a birth is left to unfold as it should, we come into contact with the beauty and simplicity that is birth and we receive the regular imprint that birth works and that birth is safe. But every once in a while, nature throws us a curve ball, and in the same way as we expect someone who works with children to be prepared if a child chokes, we want to be prepared for those rare times when a mother or baby does require assistance. In the case of the birth I was describing at the beginning of this post/letter – it felt clear that this baby was struggling. Muscle memory from my HBB training kicked in, and with her cord still attached and intact, between her mother’s legs on the floor, we worked together to gently remind her that she needed to breathe. And she did… I invite you to join us We will be gathering weekly for the month of November on these dates: 2, 9, 16, and 23 November 2022 via zoom from 11am – 2pm SAST (GMT+2) COST: 130 Euro / 130 USD / 1250 ZAR All sessions will be recorded and made available to you for one month after the call For more information or to book your place please email me at truemidwife@gmail.com What we will cover over...
Read MoreThere is hope…
Two weeks ago I came back home to South Africa after a full and busy tour of teaching and presenting in various countries in Europe. I don’t think I quite realised what I had signed myself up for when I said yes to all the commitments I had made but for three weeks I ended up either teaching or travelling every single day. This was my itinerary: 14-15 May, Additional Skills and Information Session Weekend for Doulas at DO-UM in Istanbul, Turkey 17-18 May, Helping Babies Breathe and other obstetric emergencies for home birth at Da a Luz, in the Alpujarras, Spain 20-24 May, An Introductory Course to Midwifery at Vale dos Homens, Portugal 26-31 May, book launch of Italian translation of my book, The Basic Needs of a Woman in Labour, in Rome and various towns on the island of Sardinia. I flew to Istanbul mid May to teach doulas and student doulas at DO-UM, a space run by Nur (the first ever doula in Turkey) and Sima. These two doulas are pioneering and bearing the torch of birth through education and birth attendance in Turkey. Turkey has a rising caesarian rate which matches our own here in the private sector in South Africa. The majority of births are attended by doctors and most end in caesarans. But DO-UM and other places are trying to shift this by offering doula courses, as well as childbirth classes for expectant couples. Then I went on to Spain where I spent two days teaching the last workshop of Da a Luz Midwifery School’s second year in operation. The school, is the vision and idea of Vanessa Brooks, a British home birth midwife residing in Spain. It is still a work in progress but what I have seen in visiting the place twice in the last two years, is that it is coming together very nicely, and growing as a course which supports women in choosing the path to true midwifery. Students sign up for a year’s apprenticeship and have the added challenge of having to provide completely for themselves in terms of accommodation (living in tents, vans, yurts, caravans, and one student even building herself a little cob hut), living off the grid and living communally. The school building, is slowly being built and has gone from being a pile of stones to taking on a majestic presence of its own. I look forward to seeing it when it is done but for now, classes still take place mainly outdoors, on rugs, on the grass, under the olive tree. I am very inspired by what Vanessa is doing at Da a Luz because we all know that there is something lacking in midwifery training nowadays, and that is often a lack of trust of the birthing process. Da a Luz aims to instil a sense of confidence and faith in birth. Last year I taught the Helping Babies Breathe course to a group of doulas in Portugal. After that course, there were numerous requests to build on that and for me to provide a longer, more detailed course, exploring some of the skills of midwifery. Hence,An Introductory Course to Midwifery was born. At the beautiful venue at Vale dos Homens we spent five days discussing, exploring and mostly laughing our way through basic midwifery skills, sharing birth stories and discussing what birth and midwifery meant to us. You can see more pictures from the course on the True Midwifery FaceBook page. After the course in Portugal I had to catch a plane to Rome where the Italian translation of my book, The Basic Needs of a Woman...
Read MoreAdvanced Doula Workshop in Portugal
Alex and I connected for the first time around nine years ago and the reason we connected was around birth and midwifery. We are not quite sure where and when it was that we first heard of one another but I do remember hearing via various whispered sources about this brave young French woman who was living very simply on a very isolated farm in the Eastern Cape, South Africa, and who had chosen to give give birth unassisted to her first baby. (You can read the story of Alex’s second birth, also a free birth, outdoors in the Eastern Cape, here). Alex and I first chatted online. I was pregnant with my third child. We discussed our births and shared our dreams of one day becoming midwives. Alex was the first person to ever tell me about Lotus Birth and highly recommended I try this for my next birth. I imagined birthing in a room filled with scented flowers, visualising myself opening like a flower for the sun to birth my baby. I have to admit, I was slightly disappointed to find out that all a Lotus Birth required was not cutting the cord of the baby and waiting the 5-7 days for the cord to naturally fall off. Alex, along with her husband Yan, and their good friend Ole, pioneered the intentional community Khula Dhamma, initially founded on Vipassana principles. Over the years, our families met regularly, both in Cape Town and at Khula Dhamma and needless to say, Alex and my conversation would steer towards birth and midwifery. We shared our stories and experiences and always, we strongly resonated regarding birth and our implicit trust in women’s abilities to unlock (when given the opportunity) something deep and powerful within themselves. Four years ago, Alex and her family left South Africa and lived in Brazil for two years before finally settling in Portugal. Alex has been inviting me to come and visit for a long time and when she heard I was going to teach in Spain she invited me to come and teach some of the doulas in her area too. So after my ten-day teaching stint at De-a-luz in Spain, I traveled on three busses to the Algarve in Portugal. So this last weekend, doulas from Portugal came and we discussed mostly our experience of birth(amazing how birth-y people never seem to tire of this subject!), spoke about creating the optimal environment for a a fetus ejection reflex and physiological birth, and learned some skills around resuscitating babies as well as some basic but essential obstetric emergency skills. The question was asked as to why these would be skills a doula should learn since a doula’s role is to provide non-medical support to the mother. The answer is quite simple: The World Health Organisation states that one million babies die each year from birth asphyxia (an inability to breathe at birth) and recommends that every birth have an attendant skilled in neonatal resuscitation. If you are attending births regularly, you may find yourself in a situation where a baby is not breathing, or where a mother is bleeding more than usual, or has a prolapsed cord…You may be alone with her, or you may be at a home birth with a midwife, or driving in a car, or even be in a hospital. You may be the only one who can deal with that situation right then and there before the mother and baby can be transported to hospital, or you may need to assist, or you may just need to support a mother and her family during...
Read MoreHelping Babies Breathe
Helping Babies Breathe (HBB) is an initiative of the American Academy of Paediatrics and the World Health Organisation. It is a programme that has been implemented to ensure that every birth attendant is skilled in the basics of neonatal resuscitation as part of one of the five 2015 Millennium Goals (to reduce infant mortality). Apparently, in Countries where this programme has been implemented, governments have found a decrease of up to 25% in neonatal deaths. Helping Babies Breathe is a neonatal resuscitation curriculum for resource-limited circumstances. It was developed on the premise that assessment at birth and simple newborn care are things that every baby deserves. The initial steps taught in HBB can save lives and give a much better start to many babies who struggle to breathe at birth. The focus is to meet the needs of every baby born. Helping Babies Breathe emphasises skilled attendants at birth, assessment of every baby, skin to skin contact with mother, delayed cord clamping, temperature support, stimulation to breathe, and assisted ventilation as needed, all within “The Golden Minute” after birth. Midwife Marianne Littlejohn and myself are trained as teachers and trainers of HBB and volunteer for Operation Smile and have thus far taught midwives, doctors, NICU staff, nurses, doulas, birth attendants, mothers, fathers, and interested people these basic but life saving skills. We have been privileged to teach all over South Africa, as well as in Malawi and Kenya. Plans are also afoot for us to teach in the DRC and Lesotho, as well as continuing to teach in South Africa. This last week I taught the skills to a group of peers, WOMBS doulas and CPM Mandi Busson at friend and colleague Lana Petersen‘s home. I must admit to feeling slightly intimidated, teaching friends and colleagues but this fell away very quickly as stories were shared and we acted out various scenarios from precipitous unplanned home births to water births. What I love about the HBB programme is its emphasis on normal birth – that it reiterates that approximately 90% of all births are straightforward and that it teaches as its introduction how to facilitate that: Skin to skin, delayed cord clamping, breastfeeding, etc and that even when a baby needs help to breathe, that every step is take to ensure that that mother and baby bond and cycle is not broken. Here are some pictures from this week’s course. We had so much fun acting out the various scenarios that plans are afoot for some fun birth theatre sports, possibly to be presented at this year’s Cape Town Midwifery and Birth Conference. If you would like to host or attend a Helping Babies Breathe course, please contact...
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