There 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 MoreMy Father Wasn’t at my Birth
My father wasn’t at my birth. My mother had hoped for and planned a home birth for my entrance into the world, but she was a single mother living in a communal house in Switzerland at the time. She was considered to be an older mother (She was 29 when she fell pregnant with me) and was advised against having a home birth by her doctor. The man of the house she was living in was also dead set against having her birth in his home – there was no way that African girl was going to squat down and birth in his house. My mother then found out about a natural birthing centre in the neighbouring canton of Graubünden, and while she drove to take a look at it and loved the pink rooms and the deep birthing pools and the midwives in attendance, there was no one who was willing and able to drive her there once she was in labour (which I have now worked out via Google maps is only 1 hour and 23 minutes away!). So she settled for the very fancy and exclusive private hospital at Stefanshorn. My father wasn’t at my birth. I was a planned pregnancy. Very much so. I was very much hoped for and wanted, but it was an unusual arrangement of sorts. I’ll let you in on a little secret. You see, my father was married to someone else when he met my mother and he stayed married to his first wife (my parents actually never married) while embarking on a relationship with my mother. My mother was a staunch feminist at the time and had all sorts of theories about different ways of having relationships and so they embarked on an ‘open relationship’ – which my father’s wife was actually rather reluctant about. So the plan was for my father to impregnate my mother and that she would be a single mother and that he would be a long distant parent and visit once a month or when time and travel allowed him. My father lived in England and in South Africa at the time. My father wasn’t at my birth. He was in England at the time, at home with his wife. My mother was admitted a week before her due date to be induced for no medical reason other than that her doctor was going to be away on holiday. She was admitted on my father’s wife’s birthday, which his wife always saw as a personal affront to her and made her resent my presence even more. My father wasn’t at my birth. A friend drove my mother to the hospital, but my mother was alone when she went into labour with me. I know that she laboured for twelve hours and that she had the latest in foetal heart monitoring technology strapped to her while she laboured. I know she laboured on her back. I also know that she held on to a little green Verdite statue. A little bust of an African woman. It had been given to her by a grateful woman my mother had counselled when my mother had volunteered as a rape counsellor in South Africa. I know that this little statue was a lifeline back to South Africa for my mother while she laboured. My father wasn’t at my birth. He was in England at the time, at home with his wife and while she hung out a load of wet laundry he snuck a call to my mother and shouted instructions on how to breathe through the heavy...
Read MoreThe First Time I Ever Witnessed a Fetus Ejection Reflex
The first time I ever witnessed a fetus ejection reflex was one summer’s night when I was attending a home birth as a doula. The first time mother was ten days past her estimated due date and there had been some pressure to induce. She had declined this intervention and made it clear that she would wait for her baby to come. She was a very petite woman and had already been warned by both her obstetrician and her midwife that more than likely, she would require a caesarean and that she should prepare herself mentally and emotionally for that eventuality. The baby hadn’t dropped into her pelvis at all, let alone engaged, her hips were tiny she was told, and she was already very much past her due date. Instead of these remarks squashing her plans and her confidence, they fueled her instinct to birth at home even more and she made it quite clear that she would prefer to be left alone until she went into labour. So, ten days after her due date, she let me know that her waters had broken but that she wasn’t yet experiencing any labour pains. She would let me know once things were happening but for now, she was just going to stay at home and wait and see. She would be in touch. Even though we only lived ten minutes from one another, we were separated by the Argus Cycle tour taking place that day, so even if I had wanted to get to her, I couldn’t have, and neither could anyone else, so she really could just be left undisturbed at home. At around 3 pm in the afternoon, once the roads were open and clear again, I made my way to her home at her request. She and her partner were sitting on the sofa when I got there and after greeting them I sat down on the sofa opposite them. I felt on the spot, they were looking expectantly at me, as if they were waiting for me to do something. She was experiencing the occasional contraction but it was definitely still very early labour and there was certainly not much that I could do! I excused myself and went to the loo, and once I was done, I ducked into the garden thinking, What do I do with myself now? I spotted a cat lying lazily in a spot of afternoon sun on the grass and I remembered Michel Odent saying something along the lines of: “If you are unsure of what to do with yourself at a birth, find a cat and copy what they do. Cats are the ideal birth attendants.” So yeah, I went and sat with the cat. She didn’t seem to mind too much that I was infringing on her bit of sunlight. At first, I sat a little stiffly, I felt awkward. But soon, her laziness rubbed off on me and eventually, I too was stretched out enjoying the last rays of afternoon sun. The mother came out into the garden and asked my advice on what she should do. I asked her what it was that she felt like doing. She said that she was tired and felt like resting and sleeping, so I said, “Well, why don’t you go and try to do that.” So off she went. And I stayed with the cat until the sun set. I snuck back inside the house (like a cat) and saw out of the corner of my eye the mother sitting cross-legged on the sofa, propped up by pillows, resting in between surges...
Read MoreNo Matter How Tired You are, Remember to Stay Mindful
Words echoed over and over again by stressed and exhausted 4th-year medical students yesterday during their Obstetric rotation OSCEs. A good reminder for a midwife who had had 3 hours sleep after a long labour and who had to sit through 4 hours of 50 students being examined on ‘Compassion.’ No Matter How Tired You are, Remember to Stay Mindful… That was the message that echoed over and over again and what kept me going through yesterday.
Read MoreSexual Abuse Triggers During Labour and Birth
I have started writing a book on creating a safe space for pregnant, labouring and birthing women who have been sexually abused. I don’t claim to be an expert on this very sensitive subject matter. Nor do I claim to have covered every aspect of it in this book. For a very comprehensive and thorough analysis on this subject matter please read When Survivors Give Birth: Understanding and Healing the Effects of Early Sexual Abuse in Childbearing Women by Penny Simkin and Phyllis Klaus. I am putting this book for numerous reasons. I am putting this book together because I live in a country where women are more likely to be raped than literate. A country where, according to the Medical Reasearch Council, one in three girls under the age of 18 has been sexually abused.The MRC’s study also states that by 2009, 40% of all victims who reported rape to the police were under 18 and 15% were under 12 years old.I am putting this book together because of my own personal experience. I am putting this book together because abuse is so prevalent in our birthing facilities. I am putting this book together because I see what a difference knowledge, skills and the correct language can make. I am putting this book together because of my mother. I am putting this book together for all the women out there who have, or will still some day, give birth. This book springs forth from a series of tutorials called Compassion tutorials started by midwife Robyn Sheldon. They are a series given to the 4th and 5th-year medical students at the University of Cape Town during their Obstetric and Gynaecology rotation. I teach these tutorials along with Robyn, Caitlyn Collins and Alexia van der Velde. We teach at Groote Schuur hospital, Mowbray Maternity hospital and New Somerset hospital. These tutorials were started to address the high incidents of abuse from caregivers towards women birthing in the labour wards. With the 4th years, we focus primarily on the concept of compassion in the context of the labour ward. Often students are rather traumatised from attending births and how women are treated and this is very much the focus discussion amongst meditation, learning skills when attending women in labour and understanding better the emotional and psychological aspects of labour and birth. These tutorials are usually well received and have been deemed a success. By the time the 5th years are in their gynaecology rotation, the students have hardened from their experiences, sometimes the Compassion tutorials fell a bit flat because they seemed not to deal with the real issues the students were faced with. One day, I decided to tackle the subject of compassion from the perspective of working with women who had been sexually abused. Something shifted. The feedback was very positive from the students. I have now been regularly speaking on the subject matter for the nearly two years. Over and over again I hear the words, “I wish I had had this information sooner – it will certainly change the way I work with women in the future.” That feedback is enough to make me want to spread this message far and wide. I will touch on two aspects of what I share with them here today: I emphasise the prevalence of sexual abuse in South African society. As mentioned previously, 1 in 3 girls will have experienced some form of sexual coercion before the age of 18. Let that sink in. These statistics made me think that we needed some sort of sexual abuse universal precautions in place...
Read MoreA Story of Surrogacy
I met her when she was pregnant with her fourth child and was planning her first home birth. I got to attend that birth as her doula – after three hospital births, this was a very different and empowering experience for her. She loved being pregnant and she loved giving birth but four children were enough for her and her family. She decided to take on being a surrogate mother – A woman who agrees to give birth to a child resulting from artificial insemination or the implantation of an already fertilised egg and who surrenders any parental rights to a third party. A big thing to decide to do but she felt very strongly that she wanted to do this for someone else. She met and carried the child for a single man. They became good friends and as she had trained as a doula as well, she was able to educate him on the options available in bringing his baby into the world. He went from wanting an elective caesarean for his child to attending hypnobirthing classes with her and planning a water birth in a hospital with midwives! I attended as her doula. She laboured well, but sadly, due to various circumstances, a cesarean became necessary. This mother who had birthed her babies (one of them breech) with no issues was suddenly wheeled to the theatre where for the first time, she underwent this operation. There was obviously a lot of emotional (and physical) recovery after this but she did say at one point that she felt that she felt that in order to be able to give the baby away, to not bond or attach herself to the baby, him being born via caesarean was necessary. A few years later, she chose to walk this road again with another couple, a couple who had lost their son in an accident. They were quite clear that they were taking no risks that their baby was to be born via elective caesarean. Again, I walked this path with her as her doula, and there was much processing about the previous birth and preparation for the imminent caesarean birth. One of the things she was able to request and implement was a ‘natural caesarean’. On the day of the caesarean, I fetched her from home. It was strange to be attending a birth that was scheduled – for both of us I think. We had planned to go for a walk together first. I took her to The Company’s Gardens and we walked and talked until we reached St.George’s Cathedral where we sat quietly for a while. Then we lit a candle each. Then we went to the hospital. I have to admit to it being one of the most beautiful, and dare I say, ‘holy’ caesarean births I have ever experienced. There was no idle chatter, everyone felt fully focused on this event – there was a real reverence for this gift that was being given. She even admitted that although she had been terrified of this second caesarean, it was actually a healing experience for her. She is now pregnant again for another couple. This time, it is twins! Again I will be attending as her doula and an obstetrician has agreed to assisting at a VBA2C (Vaginal Birth After 2 Caesareans) for twins. The parents are in agreement. We wait and see… Shared with...
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