Why 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 MoreEvery Mother Matters
About a year ago a young mother, pregnant and living under a bridge, went into labour. She was a sex worker and we can only assume she stayed under the bridge to birth her baby because she was afraid to go to the hospital to birth her baby. I don’t know. Sadly, the baby got stuck and both the mother and her baby died. Dudu from SWEAT (Sex Workers Education and Advocacy Taskforce) phoned me when she and a group of other mothers were returning from their friend and colleague’s funeral. “We must do this training Ruth!” she said. I had some time ago been invited to help facilitate some of the SWEAT Mothers of the Future meetings and there we had shared our birth stories and chatted about pregnancy and other reproductive issues. Mothers shared how they were slapped and hit and shouted at by nurses and midwives for being uncooperative. They felt they were stigmatised for the work they do whilst giving birth. They often felt unsupported. Three or four mothers shared their stories of birthing at home with no assistance when labour had gone more quickly than expected and how different and empowering and different those experiences were. We talked about how the mothers in this group could be of better support for one another and we eventually decided that perhaps a doula training would be a good idea. As part the Compassionate Birth Project, we envision the option of a doula for every labouring mother and initially we thought that our job was to train doulas who could be employed by facilities so that any mother arriving in labour could gain access to a doula. But the SWEAT Mothers of the Future have decided for themselves that what they want to do is ensure that there are doulas within their own networks and communities. Fellow mothers who understand each other and who have walked similar paths. Makes total sense. Dudu is a real visionary and she has plans to roll out this doula training to sex worker mothers countrywide. I like how she thinks. Yesterday, Robyn Sheldon and I started our training with five beautiful souls who made the journey from their various dwellings, catching buses and taxis to get there. They have made the commitment to be part of this training for the next week. Yesterday one of the mothers said: “ If I understand it correctly, to be a doula I need to be able to let go of everything and to just be there for the mother. To be able to fill her with positive energy.” Couldn’t have said it better myself…the perfect definition of the...
Read MoreWhat is a Safe Birth?
What is a safe birth? We have made such fine advances. Birth is now very safe. And it becomes safer the quicker we can do a caesar and the younger we can rescue a premature baby. It really is incredible what we are able to do nowadays. And the focus is on that. To ensure that a birth is safe. Safe for the mother. Safe for they baby. They are alive. Because that is the most important. That they are alive. Of course, that is the most important. I think we can all agree on that. But is it? Or have we gone way, way, way over to one side, in one direction and forgotten about balance? Firstly, birth is never, and can never be 100% safe. Let’s face that. Scary. But oh so true. We want it to be. We so, so want it to be. Of course. But is that everything? Do we take away everything else to ensure it? Is that safe? What is a safe birth? Is a safe birth a birth where we ensure mother and baby are alive? Or is it one where a mother feels held and safe and looked after and cared for so that she can feel capable and able to hold and look after and care for her baby. Make her baby feel safe. She is the mother after all. The one who takes care of this child. Not us. We walk away. How do we ensure a balance of both worlds? A safe birth. Safe. Alive. Well. And a feeling of safety. Not traumatised and violated. But whole. Trusting. Empowered. And...
Read MoreThis is Marthe and she had a Home Birth…
When Marthe was eighteen years old and newly married, she went into labour one Cape Town spring morning. She was living down the road from her Aunty Maggie and Aunty Martha’s house and the two busy body aunties came to see if the pains the expectant mother was complaining about were indeed the pains of labour, they were there to keep the nervous young husband at bay, and to send a young boy to summon the midwife. The local midwife soon arrived on her bicycle and stayed with young Marthe for three days before deciding to send the young woman off to Groote Schuur hospital. The labour was taking too long and the baby was not coming. The midwife was concerned. After three days of labour and after being transferred to the hospital, Marthe gave birth to a skinny little baby girl. The doctors were baffled as to why the tiny girl had taken so long to come. Eighteen months later, Marthe was in labour again. Again she was at home, and again the local midwife joined her. This time the labour seemed to be progressing smoothly and soon Marthe began bearing down. By some strange twist of fate, the house across the road caught alight. While Marthe easily heaved out a large ten-pound baby girl, a woman died as the house opposite burnt to the ground. (Birth and death walked side by side down that road that day…) Marthe was my grandmother and the large baby girl was my mother. Marthe was pregnant again three years later, and she gave birth easily, at home, attended by a midwife, to another girl. Smaller this time. Life went on and many things changed, especially my grandparents’ social status and when my grandmother fell pregnant in her thirties it was only natural, that this laatlammetjie(1) birth would take place in a hospital, under the care of the best doctors that money could buy. It was years later, when my grandmother was hard of hearing, and cataracts had begun to form in her eyes, that I took her along to a birth film festival I had organised in Cape Town at the Labia theatre. On the drive home, she divulged her birthing stories to me, and she admitted that giving birth at home, had been for her first prize and that paying all that money to have her baby “delivered” in a hospital had been a disappointment. After watching these beautiful birthing films that night, she had only one regret. She would have liked to have had a water birth! * (1) Afrikaans: a child born many years after his or her siblings * My grandmother died in France two years ago, whilst on holiday with my aunts. She had been quite ill and been a given a short time to live so she took herself and her daughters off on one last holiday and shopping spree before she passed away in Nice. She was cremated and has been at rest in a crematorium in Nice. This week my aunts bring her back to Cape Town where she will be buried, alongside my grandfather (who passed away over twenty years ago). Rest in Peace Jiajia, and welcome...
Read MoreBirth and Death
Birth and Death. Two words we do not like to see together. To put them together makes us feel uncomfortable. Birth is about life. The beginning and emergence of a new existence. It is about newness. The beginning. What do we associate with birth? Love. Light. Joy. Life. A new beginning. Who wants to think about death at a time of birth? Death is about illness and sadness and loss. It does not evoke beauty and joy. It is something we try to avoid. Death is so final. It is something we do not wish to associate with birth. But in my experience, birth and death seem infinitely intertwined. The feelings the two evoke are so similar. One brings intense sadness and a sense of loss, and the other brings intense joy, but both have the same underlying feeling of being wide open and vulnerable and confused. Both need nurturing and safety. Both bring on a sense of being in an altered state, a state of being in touch with something greater and more infinite than ourselves. Both bring things into perspective, make clear what is important, valuable, precious to us. Both make life incredibly tangible and real. This week it will be eight years since my mother, my sister, and my stepfather were all killed in a car accident. When I lost so many members of my family, the feelings that came up, were so very similar to the times when I had given birth. The intense pain, the vulnerability and the incredible lightness and insight into the life process. And the feeling of being on the threshold of something… My friend Caitlyn visited me some time after the accident, and while I lay curled up on my sofa feeling sad, she folded laundry and brought me soup. Some time later, she told me that she had been at a loss as to what to do in that situation. She drew on her experience of attending births and thought that she would do what she would do for someone who had just given birth. I remember how grounding and comforting the familiarity of that simple gesture was. It did not take away the rawness of the pain I was experiencing, but it did provide a safe space for me to experience it in. These days, I spend a lot of time attending births. I wipe sweaty brows with a cool cloth, I breathe with women, I hold them, I move with them. I am there. I am witness to this incredibly vulnerable state, this time that can reach a point where it feels like she is looking death in the face. I am there to create a feeling of safety, to remind them that they are going through this process to bring forth...
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