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 MoreWhen you sit with a woman in labour, allow yourself to become soft…
Notice yourself. Your own breathing. Allow it to become deep. Allow it to become soft. When you sit with a woman in labour notice yourself. Your body. Your breathing. Sit quietly in a corner. Or lie down. Avert your gaze. Droop your head as though in prayer. Close your eyes as though in meditation or sleep. Or make your eyes soft soft soft and look at nothing on the ground. Allow your breath to become deep and expansive; fill your lungs, your rib cage, your entire being. Allow your breath to become deep and expansive like the waves of the ocean. In and out. In and out. Become so huge that your arms embrace the room, the world, the universe. Hold the woman in labour in an unseen embrace. Become so huge and expansive that you disappear into nothingness. Stay with your breath. Your softness. And the soft sighs and moans of the woman in...
Read MoreThe Fetus Ejection Reflex
One cannot help an involuntary process, the point is not to disturb it… If the labouring mother has had her basic needs met during the first stages of her labour, her body will prepare itself for something called the Fetus Ejection Reflex. What are the basic needs of a woman in labour? To feel safe To leave the thinking brain (the neo-cortex) switched off Silence Darkness or low lights Warmth Not feeling observed No adrenaline It is very important that the labouring mother has utmost privacy during this time, otherwise the fetus ejection reflex will not take place. How does it occur? When a fetus ejection reflex is about to take place, the mother will suddenly become fearful and will say things like: “I want to die!” or “Kill me!” It would be a mistake at this point to try to soothe or placate the mother with reassuring words. Soon after this there will be some very strong contractions. The labouring mother will suddenly be full of energy and she will want to be upright. The baby will be expelled in a few strong contractions. The Fetus Ejection Reflex is different from what we know as the second stage of labour, which is when the mother has to actively push the baby out. When a true fetus ejection reflex takes place, the likelihood of the mother tearing is very low and the placenta should only take a few minutes to separate. A fetus ejection reflex cannot take place if the basic needs of a woman in labour have not been met. Read more on the Fetus Ejection Reflex...
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 MoreMichel Odent Reviews my Book…
I asked Michel Odent to review my book, The Basic Needs of a Woman in Labour. Who is Michel Odent? Dr. Odent started his medical career as a surgeon and became involved in birth when he was put in charge of a hospital in Pithiviers, outside Paris. He soon realised that hospitals were not conducive to a woman in labour. They were too bright, sterile and uncomfortable and lacked privacy. He was the first person to introduce low beds (easier for a labouring woman to climb in and out of), dim lighting, beautiful home-like rooms, and eventually water as a form of pain relief, in a hospital setting. The hospital in Pithiviers was so successful that many people came specially to have their babies there. Dr. Odent was there from 1962 to 1985. He worked with six midwives and oversaw approximately 1000 births per year. The hospital’s maternity section had excellent statistics with low rates of intervention. He eventually moved to London and became a home birth midwife there. Again, he was able to make many interesting observations through his experience there. Later he founded the Primal Health Research Centre He works with a doula called Liliana Lammers. Together they run the Paramana Doula course in London. Liliana is a quiet and unassuming woman who holds an incredible strength in doing very little at a birth. She is able to hold a space with her presence alone, a quiet strength. She must make a woman feel very safe in labour. Through his many years (more than half a century) of attending births (around 15 000 births) in both hospitals and at home, Dr. Odent has come to the conclusion that a labouring woman needs not much more than to be left alone, simply to be attended to by a quiet, non-invasive and low profile midwife. The little 24 page booklet I wrote is a summary of what I have learned from attending Michel Odent and Liliana Lammer’s course in December 2010, by reading Michel’s books, and from my own experience and work with pregnant and labouring women. I received his feedback a few days ago…I am honoured and humbled by his feedback and it took me a few days to process the immensity of his review before I could bring myself to share it. Here it is: There are two important published documents about birth physiology and the basic needs of labouring women. The first one is an enormous book written thousands of years ago. In the very first pages of this bestseller, there are some lines suggesting an association between the consumption of the fruit of the tree of knowledge (translate knowing too much or having developed a powerful neocortex) and the difficulties of human birth. At the end of this book, we can read about the birth of a legendary man whose mission was to promote love. His mother found a strategy to overcome the human handicap: with humility she gave birth among non-human mammals, in a stable. The second document is the opposite of the first one in terms of size. It is a booklet by Ruth Ehrhrardt. To bring together what is important in such a small number of pages is a feat. I hope that, on the five continents, all pregnant women, midwives, doulas, doctors, etc. will take the time to assimilate the contents of this chef d’oeuvre: it will be a turning point in the history of childbirth and therefore in the history of mankind. – Michel Odent...
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