What is Oxytocin?
Going into labour is like falling asleep… Labour is a different state of being, a state of being with a lot of similarities to sleep. For a start, they are both states that cannot be forced. They just happen! Sometimes when we least expect it. We cannot decide or control the moment when we fall asleep. We can also not decide or control the moment when we “fall into labour.” But we can make it difficult for both to happen easily and most effectively. Labour is like sleep because we need the same conditions to “fall into labour” as we need to “fall asleep.” We need to feel safe and warm and relaxed. We need to be in a place in which we feel comfortable, and we need to be free from pressure, anxiety or fear. Oxytocin When a woman is in labour she releases a hormone called oxytocin. Oxytocin is the hormone that makes the uterus contract during labour. It is also the hormone of love. Oxytocin is the hormone we release when we are enjoying a meal, or having a stimulating conversation. It is the hormone we release when we are making love and when we orgasm. It is the hormone that makes us feel in love, and it is the hormone that releases the milk when a mother is breastfeeding. Isn’t it amazing that it is the love hormone that brings the baby into the world? In hospitals synthetic oxytocin is often given to women. It has different names like Pitocin or Syntocinon. Synthetic oxytocin is given to make the mother’s uterus contract, which can help to birth the baby. But this synthetic oxytocin is not a love hormone. It is not like the oxytocin that is naturally secreted by the mother’s body. Synthetic oxytocin is just a hormone that contracts the uterus and helps to push the baby out. It is important that we know more about the effects and function of natural oxytocin, because when a labouring woman is under the effect of synthetic oxytocin she may have a decreased ability to produce natural oxytocin. How is synthetic oxytocin used? Synthetic oxytocin is used to induce a labour (this means starting a labour artificially) or to augment a labour (this means to speed up a labour that has stopped or slowed down). Synthetic oxytocin is also used for active management of the third stage of labour when the placenta is delivered (an injection of synthetic oxytocin is given to the mother to help deliver the placenta quickly). It is also used to stop a mother bleeding if she has a postpartum haemorrhage (when the mother’s uterus doesn’t contract after birth and she begins to bleed heavily). Induction These days it is very common for a woman to be induced to start her labour. She may be given many reasons for this: she may be over her due date, or her caregivers may be worried that her baby is getting too big, or that her baby is ill, or that she is ill. Augmentation When a woman is in labour, it is common for her labour to slow down or even to stop when she arrives in the hospital. There could be many reasons for this sudden slowing down of the labour: the lights are too bright, she is given a vaginal examination, a stranger enters the room, she is feeling watched or self-conscious, she is feeling rushed, cold or scared. Usually, if the labour doesn’t start up again after a certain amount of time, synthetic oxytocin will be used to get the labour...
Read MoreBeing on Call
Being on call… I was asked some time ago: If there was one thing you had known about becoming a midwife before you began training that you know now, would you still have chosen to become a midwife on call for home births? My answer was: “The realities of being on call.Knowing that I would be on call 24/7. That my phone would have to be charged and near me at all times!” I knew that attending home births and being on call would entail all of these when I chose to walk the path of midwifery and attending home births but the realities of it are quite different from any selfless fantasies one might have about it. Seeing the disappointed faces of my children as we turn around the moment we walk into the library or leave the beach, or miss a much loved extra-mural activity. Having to miss birthdays. Leaving for a birth on Christmas day. Missing New Year’s. Missing my very good friend’s wedding. Or feeling too tired to enjoy any of the above… And having that bloody phone so close to my head as I sleep and having to jump up and check EVERY SINGLE MESSAGE that pings its way into my world at all hours of the day. I curse at pointless emojis and kisses and notifications that I have won R500 000 from Coca-Coal via sms – I am trying to sleep! And having to check and answer every message and call even when you need to desperately sleep after two back to back births. Being on call means being available. 100% available. It means being willing, and able, to drop everything, no matter how important and valuable, to go and sit and just be at someone’s birth. If you want to practice a path of non-attachment then being an on-call midwife is it. I have had a nice break from being on call, teaching in Spain and Portugal in July. Being able to leave my phone in my caravan while I taught, or letting it die completely for a day or two was a rare treat. Now I am back in South Africa and life carries on. Being with my children. Four children. Homeschooling. Extra murals. Outings. Housework. Meetings. Teaching. Seeing clients. Walking on the beach. Life! And somehow I am supposed to drop everything and fit a birth into all of this? This busy, full, demanding life I have created for myself? And yet, somehow, when that phone rings or pings, and it is time to go – whether in the library, or the beach, or at breakfast, or more than likely, in the middle of the night, while it is raining and I am in the deepest sleep – time is somehow able suspend itself and I am able to make space for this woman birthing her baby. My mother was a midwife and her attending births was often more of a nuisance and an annoyance than fascinating to me while growing up. It meant that she would be tired and unavailable. But, it also meant, that when I fell pregnant, she dropped everything to be with me in labour and for the first time I saw how essential the work she did was for the woman in labour – her calm and presence held me through that experience and afterwards I thought, “This is the coolest job on the planet!” and wanted to be able to do just that for women in labour after that. But why do it? Why sacrifice family, children, friends? Is it worth it? It is. It really...
Read MoreThe Cape Town Midwifery and Birth Confernce
Have you ever been to the Cape Town Midwifery and Birth Conference? Well, if you haven’t and you are passionate about all things pregnancy and birth related, and live in, or near Cape Town (although people do travel from further afield to attend), you really really should come. What is the CT Midwifery and Birth Conference and what makes it particularly special? The conference began in 2013 when a bunch of women, got together and decided that they had had enough of the situation around birth in South Africa (the ridiculously high caesarean rates in the private sector and the abuse of labouring women in the public sector to name but a few). The CT Midwifery and Birth Conference was born and we were pleasantly surprised to find that many other people felt the same way and crowded little Erin Hall so that it was full to bursting! One midwife who attended said that the conference felt like a home birth. It is all about sharing and collaboration. It is about hearing the stories of all of those invested and affected in the services provided. Mothers. Fathers. Families. Midwives. Doctors. Doulas. Birth Activists. Lactation Consultants. All those affected and invested – especially those on the receiving end. The next conference (our third) will take place on the 30 – 31st of October 2015 at the Observatory Community Centre. For more info and for the full programme and list of speakers, have a look here: Cape Town Midwifery and Birth Conference official website And here is the direct link if you want to book your ticket: Get your tickets...
Read MoreMy Book now Available as Paperback and for Kindle on Amazon
In 2010, my sister in law Ellie asked me to attend the birth of her first child in Edinburgh. I was most honoured by this request and, of course agreed immediately. I was reading a lot of Michel Odent’s articles at the time, and was feeling very inspired by them, and began doing some research on what his thoughts and feelings were around doulas – I was pleasantly surprised to find that he had done lots of writing on the subject AND offered a doula course of his own! My heart raced as I realised that he was offering a course for three days before I was due to be with Ellie! Talk about synchronicity! So, after ten years of pretty much being a full-time breastfeeding, stay at home, homeschooling mother, I travelled to the UK and attended Michel and Liliana’s Paramana doula course in London. How do I describe the experience? Well, first of all, I was late! I got lost on my way there and arrived to a circle of about twenty women and Michel Odent (so weird to see someone so familiar in the flesh for the first time). They had all just finished their introductions. I was asked to say who I was and where I was from. As I said, “South Africa,” everyone roared with laughter and I got a fright. Seems there was a person from each humanly inhabited continent besides Africa present. For the next three days I said nothing much, I just wrote and wrote and wrote – the feeling was like a lightbulb had gone in my brain and my soul was being washed with a soothing balm. Everything shared and said made so much sense, I wanted to be able to share it with the world! Back home and I recommended Michel Odent’s books to everyone but his flowery writing and tendency to go off on tangents more often than not confused people. “Why is he advocating for polygamous and polyandrous communities?” Someone asked me after I had lent her a copy of Birth and Breastfeeding. Had he? ! I thought. “Why is he going on about cats?” someone else asked. “Why is he going on about leaving women alone while labouring? That would totally freak me out!” Clearly the message I was trying to bring across was not necessarily coming across – how could I let people know the essence of what he was saying? The parts they really needed to know? And so, slowly, the seeds for The Basic Needs of a Woman in Labour, were sown. It was in 2011, nearly a year later, when I was asked to attend the birth of Paula, who lives on a farm near Nieu – Bethesda in the Eastern Cape, that I had the chance to finally gather and summarise my thoughts on the subject. I travelled there with my family and it was whilst sitting in a little cottage in the semi-desert of the Karoo, waiting for Paula’s birth, that The Basic Needs of a Woman in Labour was written. I sent the finished copy to Liliana and Michel, who both were very happy with it and even asked if they could use it to give to the students of their doula course. Since then, it has been sold to interested people all over the world and all pretty much through word of mouth. I have given it to medical students and left it lying around hospitals in the hope that a mother, or a midwife or doctor would find it and find the information useful. I give a copy...
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...
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