Hats we Wear !!!

Roles we play :
Iattended a CAPPA conference in may, 2004. In one of the sessions we attended we did a fun activity. Each of us made a paper hat... all kinds of hats. Then the organisers put a few on their heads and ran down the aisles trying to balance them.
Recently a friend asked about the roles various people played in birth, and I was reminded of the hats we wear. Here is what I thought works in birth rooms.
1. The doctor's role is primarily to look at the things that may go wrong. That's what they train for. In any case they have crisis check list, and they are the safety net to circumvent the items on that list. However, over a period of time defensive medicine has become a routine.

2. The doula role is that of support but there is a thin line of what the doula sees as support and what the mother sees as support. Therefore, it is very essential to be informative, have discussion before labour begins. There may be a time for a doula where the mother may want an intervention, much against the belief of the doula but focusing on the goal...

support ..unconditional

The care giver may be a midwife ... in which case the welfare of the baby and mom then lie in her purview.

3. If there is a hypnobirthing practitioner involved...like a childbirth educator they have no active participation role in childbirth. Their work is to educate, facilitate discussion, protect the moms' evolution of birth philosophy. Note, I said protect, even as educators we cannot force our opinion on them. Even when we know something to be right it may still not be right for everyone...

It a complex situation yet simple in premise. Each one of us are a link but its her birth.

So an important step is to reflect what our boundaries are... all boundaries are dynamic and self imposed. There isn't a clear cut line ever. Also reflect on the role and significance of the role of others. For example : as a hypnobirth practitioner I may say in my class that the hospital staff can assist with Hypnobirth by making no mention of pain. But do I take the responsibility of educating the hospital? What happens when I have more than 5 couples in a class who are going to different hospitals? Does this responsibility now lie on the expectant couple in my class? Will they add this to their birth preference? The educator may not meet every doctor how ever she can say, when you are discussing this with your doctor, I will be happy to be with you for one visit/ speak on the phone/ have a handout explaining about Hypnobirthing in detail for the doctors consumption

As a doula do I support Hypnobirthing philosophy? Am I involved prenatally? More communication in the mom - doula- educator triad. Can the doula take the responsibility of being with the mom while she presents her birth preferences... and does the make want her to take charge to protect the environment at the hospital... or will her birth companion do that? many subtle undertones here as well

To what extent the doctor regard her wishes. Considering the circumstances around every birth, think will this doctor stay with what she/he has intellectually agreed or if faced with stressful moment revert back to his medical training. We have understood the mind enough to know that long term memory will override. that's why change is slow and seeing is believing... seeing over many many birth.

I have faced these dilemmas for many years now and reflective practice is a powerful tool for growth here. Change can be best made from within. Confronting people with what wasn't done will make them defensive and less likely to change.If every one closes up there are even lesser opportunity for SEEING IS BELIEVING to work. Define and reflecting on our roles will make us define our responsibilities and make us aware of what more we could have done.Also cuts out the blame game creating harmony. Acknowledging what ever progress will motivate everyone.

The most important part is ... how the birth mother her birth... ITS STILL HER BIRTH. If she is happy lets share the happiness and take this experience to share and grow.

Val Staples in an interview as a doula :

http://www.wsfa.com/Global/category.asp?C=91650&nav=menu33_2_2

Hypnobirth in Mumbai

The following birthstory has been told by Kasia Wierzbicka. She can reached on email at kasiawierzbi@gmail.com

"Ever since I started teaching yoga to pregnant women I felt it's very special to have this opportunity to be able to contribute something to both of them, the mother, and the baby and I believed that both of them can really benefit in many ways. But ever since I heard about HypnoBirthing I got even more enthusiastic, because this time also father was involved in the process, and they became complete, loving family, working together in harmony for better future…I was always admiring pregnant women moving slowly, and gracefully, with a beautiful glow on their faces .When I met Jaipali, she was exactly this type of mom! I was very happy to have her in my first HypnoBirthig class. She came with her mom, since her husband was in USA, but he was planning to come back to have baby with her. So we decided she will attend first 2 sessions by herself, and once Ashok is back we will do extra class for him, and he will join the last 2 sessions. They were both very eager to do this program, since Jaipali's first baby was breach, even though she was preparing for natural birth from the beginning, she ended up with c-section. She said "I wish I have known about HypnoBirthing then, I would know what to do". It was all in USA 3 years ago. So this time she decided to do all that is possible to be in sink with her body and her baby and have natural birth. She was very relaxed and calm about it, having totally positive approach form the very beginning. Practice of yoga and transidental meditation helped her throughout last few years, and it really came handy now because she could slip into her deep relaxation very easily! The only obstacle was her doctor, which was known for high rate of cesarean section, offered her routine episiotomy and the menu full of interventions, which she wasn't interested at…. There was only one choice, to look for knew doctor, that will give her a chance to birth her second baby naturally, despite being Vback as they call it in medical terms. I recommended her Dr Amit, with whom I did HypnoBirthing course. I also advised her to use a midwife to have more support and confidence. Selecting the right care providers is 70% of the success in achieving natural birth! As long as mother isn't relaxed and trusting in the environment where she is giving birth it might be much more difficult and obstacles might come. It's a natural defense system of the mother and the child…

We went through our HypnoBirthing sessions beautifully. There was one more couple in the class, and once it got over I felt I will ask Jaipali, if she would like me to come to her birth. She said yes. On Tuesday 18th I was thinking about Jaipali so I just called dr Amit to tell him I will also come to the hospital, and he says she is already admitted! So I just rushed there, and I met both parents smiling, relaxed as usual. It seamed like it was just the beginning, so I said I will go home, change and come back, but in few hours we realized that they were labor warm ups, so they returned home. Then finally on 22nd of November I got a call at 3am, that this time it was for real! So I quickly pack my old cd player, our HypnoBirhting scripts and rush.

When I entered Ashok was giving Jaipali light touch massage and they were going through the surges together so beautifully! I started to read HypnoBirthing scripts to her so she went deeply into her body and connected to her baby. Hours were passing, but none of us felt time. The surges were closer, and closer. Lina, the midwife joined us after 2 hours, and Dr Amit came around 7am. Jaipali was either on her side breathing through the surges, later standing up by her bed and in supported squat with Ashok against the wall. At the last stage she decided to lie down on her back. We elevated her upper body with pillows. Ashok and Lina were by her sides giving all the support she needed and I was behind, by her head whispering in her ears HypnoBirthing scripts. By the 8:30 baby came! We learnt it was really big 3.77kg, that's why it took some time, but it was worth it! Mom needed 1 stitch, since she had only small tear. We were all so happy!

After the birth many reflections come…Would it be easer for her to birth in some other position with the help of gravity….It would be good to have some light music (my old cd player refused to work)….But now it all feels fine. Family is happy, baby was so alert and breast fed immediately! The father looked ecstatic and said that every dad should be there by their wife's side and witness their baby coming into this world! Jaipali admitted during her birth and after, that HypnoBirthig scripts and relaxations really helped her and the thought of taking any sort of pain killer hasn't even crossed her mind!

It was amazing to witness the miracle of giving life and I will definitely attend more births as a doula and HypnoBirthing practitioner to support more families in that beautiful journey! " - Kasia

More on BIG birth

Saloni and Vasant were in my childbirth class when I travelled to Mumbai to do the Hypnobirthing workshop with Sarojini. As we went through our 4 days together I felt that these were THE people to benefit from hypnobirthing.

To begin with they believed that birth was natural. It took me a while to decide how best to approach/offer them to consider a hypnobirthing class. So I offered my class without charge, primarily because I wanted to get a feel of how the classes would work in real. Also I told them that I totally believed in the philosophy of Hypnobirthing so any short comings were my own. The next big hurdle was to get the book and CD quickly. They ordered on Amazon and her mom carried it from USA.

We began in earnest. I studied each module many times and practised each topic each week before the class. By the second class they were into hypnobirthing. Vasant was very involved by now. At one point when we discussed listing of fears, he said "my biggest fear is that what will I do when she is in pain".

The EDD was sometime around end Oct, we decided not to go by dates. Also they had decided not to have many ultra sounds. They were also keen to use water for labour and we were set to give birth. Couple of times Vasant sent me an SMS that said ... she is having mild surges so we are going to do relaxation and sleep. Lots of practise, and there never seemed any sense of panic or urgency. The doctor was on board with this as well.

Saloni went for a routine check on the 3rd morning. The doctor did and internal and found her 1 finger dilated and asked her if she was ok with a sweep. Saloni agreed. By noon she was having mild surges, and was at a friend's place near the hospital but decided to go back home and wait and watch. I met them at home at about 3 pm that afternoon. She had eaten sandwiches and was relaxing. As I sat with her the surges seemed to get closer so we decided to go to the hospital.

En route things slowed down again. Upon reaching the hospital she was checked and was fully effaced and had dilated a wee bit more. There after we were on our own with periodic checks for the fetal heart rate. Vasant was taking video clips and at some point Saloni said.. I am confused if this is IT. With all the experience of start and stop she was joking about not being responsible if it stopped again. The doctor said she was definitely in labour.

Around 7 in the evening we decided to get out of the hospital for a bit. So we went out for dinner to a nearby G K I market restaurant. She wanted to eat her favourite sandwich at Cafe Turtle, just like they did after the Saturday class each week. There was a lot of joking and fun about this. Of course she could tell the surges... she did feel some thing. It was amazing to be laughing and sharing this time. Vasant recorded every detail of the food and other things... memories from the day of the birth.

I had a feeling things would get more intense after the food and the moon. At 10pm she was something between 2 and 3 cm, but I could feel labour getting stronger. The staff at the hospital felt it was too early and very slow but somehow I felt things were moving fine. I didn't think we could categorise. I felt more tuned to her feeling than findings. She started to talk of warm bath or shower. So first she took a shower and said that the surges felt different in the warm water. I knew she was ready to move to the warm tub. The doctor left the decision entirely up to us. However, some of the staff felt it may be too early. As soon as she went into the water, she visibly dropped down and the very next surge was longer and stronger, and she slipped into a trance there after. we had dimmed the lights and some soothing music was in the back ground, Vasant was whispering the hypno prompts to her and at one point it seemed that I was intruding on a really intimate moment. The gentleness of it all was overwhelming.

In the water she would spread her legs really wide and lean on the side of the tub and relax. She moved in and out of the tub a couple of times and sitting on a birth stool at one point her membranes released. She was already breathing the baby down by 3:30 am and soon after that she was ready to push. A junior doctor tried to organise the pushing but she tuned out and went with what she felt. The baby emerged slowly supported by her doctor's hands and as she held her baby the father cut the cord. Later when the baby was weighed .. they did it four times. No one could believe he was a 3.95 kg baby, the mom had a superficial tear.

Doc and I shared a cup of celebration tea and acknowledged...

had there been an ultrasound...

we would have an idea of the weight of the baby...

considering it was biggish ...

maybe we wouldn't have waited,

definitely not used water

and definitely had an episiotomy bigger and deeper than the tear,

and this would be the best case scenario.

And here the one thought I had was`"That's a lot of divine coincidences"

Her I was a doula, the childbirth educator, the hypnobirthing practitioner, friend, stand in sister, everything, nothing. I felt deeply connected to her as if i was in labour too and at some point I made some suggestions which were only in the realm of the above coincidences, and I didn't make them thinking, I felt the need to make them.

As we were sharing the birth together both the parents felt that it couldn't have been more perfect. To answer my question if this is what they had thought it would be like... they said this is what they hoped it would be.

I hope this is really a positive inspiration for all and I am sure all of us would be happy to answer any questions the reader may have

BIG BIRTH

Baby boy born to Saloni and Vasant, born Nov 4th, 2008, at 4:39:20 am. Wt 3.95 kg

Hypnobirthing mom, water baby, euphoric doula

I am at loss of words, but I feel that I do have to acknowledge that this was an amazing birth for me. At this moment, just hours after birth and fewer hours of sleep, I cannot put into words all that I experienced; the mundane and the sublime . And perhaps I would never be able to put into words however it is important that I say

"This one was BIG."

(pun intended)

Inspiration Birthing From Within

Laxmi met me when she was almost due and was absolutely not thinking about giving birth. Don't get me wrong ....
Laxmi was pregnant and almost completing her 9th month
Laxmi was a well educated modern woman with a great job
Laxmi loved her baby a lot

Only, all this time did not think about the actual birth. Infact, she made an effort not to think about it at all.

It was around this time I met Laxmi.

Like may other women she was scared of the word labour and birth.

Somewhere along the line fiction has become greater than fact. Women think birth is painful and full of peril. It is something they have to grit their teeth and suffer to become mothers. Nature revels in fertility... yet for humans it makes the birth so painful. Do we really think that nature does not want humans to have babies? Is it possible that after eons of evolution and adaptation nature wants the most intellegent of its species to perish? Doesn't make sense.

After a couple of meetings ... in a session inspired by BFW.. ... Laxmi created



In her own words...
this is a picture of her and the baby, the baby is snug at the breast, and she is fine with the pregnancy and the birth. The whole mom and baby scene is in a glass ball, with golden flakes that float down when the ball is shaken.

Laxmi did well in her labour and had a normal birth

The age of fear

We are in the age of fear. I am not talking about the terrorists and stuff. I am talking about every day mundane, routine life.

We are afraid...

I am not advocating that we shouldnt be cautious, neither am I saying that being careful, or planning, or taking charge is wrong. I am saying we are afraid, despite caution, knowledge, being careful, being in charge... we are even afraid of being afraid.

Birth is about faith

Birth is about faith in nature... your intrinsic nature as a woman

Birth is about faith in your relationship... both with the father and the child

Birth is about faith in wisdom of your body... and the wisdom of the baby about to be born

Birth is about faith in you strength... both at birth and when you stand between the world and the child you love.

Birth is about faith in people who you chose to care for you.... could be your doctor, doula, or dai.

Birth is about faith.

Isn't being afraid the exact opposite of faith. It would seem that the idea of faith and trust would be reinforced by information and knowledge, cemented by caring families standing by the moms' side. However time and again I meet fear.

There is nothing to fear but fear itself

Fear is a self fulfilling prophecy that holds us back from doing what we can do. And we can chage this world of fear if only we can give our children the legacy of faith by living it at the most intense, life altering, out of control moment of our lives. With deep reverence for all those mothers who believed in their strength at the most vulnerable moment. Faith

Hypnobirthing

I have recently attended a Hypnobirthing practioners training workshop, which I can say I am partly responsible for happening at all. And despite all the flip flops and the change of location was a wonderful experience. Sometimes we cannot make sense of the puzzles pieces we are holding on to... from the BIG PICTURE puzzle the the "powers to be" have the vision of. I was holding on to traffic snarls and waterlogging and hotel booking and flight times.... and nothing was making sense. Yet it was an incredible learning experience both in and out of the classes. Met some good people, and bonded with some who I already knew. Missed all the deeper level work... I was too deep too quick, (but as Sarojini said, something was listening; I bow to her wisdom) though personally I think all I did was make a huge dent into 12 years of sleep depreivation.
Vented some of the "things are not good" around birth feeling accumalated for many years, and appreciated how good the Doc I worked with was. How much she has supported my growth and changed I was getting fixed in "not good" ideas.
Hurray ! to hypnobirthing and all those wonderful people whose energies were significant to my learning, and to Sarojini, who offered us knowledge and nurtured our growth, hurray to new associations, and biggest Cheers!!!! to the new twists in the path I call my life

Hip Hip Hurray !!!!!!

Hypnobirthing Workshop, 7th to 10th August 2008, Mulund, Mumbai

A valuable lesson

The labour started slow and easy and thats how she took it .... slow and easy. When she called me to say she was having mild discomfort for the whole day, I wasn't in the most receptive moods. Yes, we doulas can have a bad day. I think I said lets see through the night if it picks up. All I wanted was the day to end. When I woke the next morning, she was my first thought. I waited for a decent hour (could not wait beyond 7:30 am) before sending her a message.

She was definetely in labour and it was slow and easy all night. We talked when the hour got more decent at about 9, she was heading for the hospital. This time I suggested if it was early she should go back home. Less than two hours later I got another call from the father to be letting me know that she was going to be in the hospital. I knew I was in this birth from that first waking moment. I wanted to be there.

As I reached the hospital she was 5 cms, active labour, back ache and sleepy....

Before I knew it I had her striding a high back chair resting her head, with a hot water bottle at her back and getting her to eat something. We were going to have a baby.

For me time stops at births, so the minutes, hours cease to matter. Many a sips of water, and deep breaths, trips to the bathroom, arm and back rub downs later.... one contraction, the sound of that breath changed. A nurse said dont make any sounds and the mom was moaning and bearing down. And all I could think was ...the bags are intact.

I know that was I felt at that time was completely different from what the parents felt, I also know what I felt at the time was just as powerful as what the new parents felt. I hope I was able to bring something more to their birth as their birth brought to my life.

I learnt a very valuable lesson as I walked out of this birth:

Your faith is tested at many points in life and it is that very faith that takes you through each of those tests.

Whats the Scene!

J was in my childbirth class. When I saw her smile the first time I thought that she packed a big punch in a small packet. For her labour started and stopped at its own pace building gently. When I saw her the morning of birth she was all set for the hard work. She wanted to try water to see if it would help her. We had talked of labour, and possibilities and I think she had an open mind. She was in and out of the tub many times, she ate and drank, walked and moved. At one point she put her hand really low on her belly and I asked her jokingly what she was doing.

"मैं देख रही हूँ की scene क्या है !?!"

Her sense of humour was her strength. The labour stayed strong ... however for may reason which is her story to tell, she was looking at a C sec after 18 hours of labour. We gave them a little privacy to talk about it. Her mom was there for support as well. I knew there was a sense of disappointment and helplessness but what was so amazing about this little mom was her response. She said that she had experienced labour and now it looked the baby was saying its time to be born.
Despite the hard work put in, and the disappointment J was going to give birth to her baby. I was wonderful the moment of her baby's birth was still joyful for her. As I stood beside the couple, I could see them connect as many new parents do when they hear their bay cry for the first time.
As I took the baby to her right after they brought her to the room... the baby latched on. Maybe that what made the birth more real to her.

This birth, her sense of humour and positivity are driving force for me to to keep going on my path। Also this experience would not be complete without acknowledging the fact that the father laboured just as much as the mom and was with her bit of the way. The new parents shared their news with friends and family as........."Hi! we have been blessed with a bouncing baby girl last evening, all of 3.4 kg; had a C section after 24 hours of labour in both land and water !"

Doula !?!

A lot of times when people ask me what I do,....I am a childbirth educator and a doula. Equal number of people scoff at the childbirth educator bit (more about that later) as the say a dou...what!
A DOULA
The word doula comes from Greece and refers to a woman of service.
A doula accompanies a woman in labor to provide physical, emotional, and educational support for a more satisfying birth experience. She does not perform clinical tasks such as fetal heart rate monitoring, nor does she make medical diagnoses. A doula will helps the labouring woman make decisions by providing information and support, but will not make decisions for her.

Studies have found that birth companions, of which doulas are one type, offer numerous benefits both to the mother and child. Women with support have a reduction in the duration of labor, less use of pain relief medications, lower rates of operative vaginal delivery, and in many studies a reduction in caesarian deliveries. Newborns in supported births have lower rates of fetal distress and fewer are admitted to neonatal intensive care units. In addition, one study found that 6 weeks after delivery, a greater proportion of doula-supported women, compared to a control group, were breastfeeding, and these women reported greater self-esteem, less depression, and a higher regard for their babies and their ability to care for them. These results are similar to findings that support from a female relative during childbirth has similar effects.
One study found doula support without childbirth classes to be more helpful than childbirth classes alone, as measured by levels of emotional distress and self-esteem evaluated at an interview 4 months after birth. In particular, it was noted that women in the doula-supported group reported their infants as less fussy than the group attending childbirth class without any doula support.

CNN did a neat story on doulas.
http://edition.cnn.com/2007/HEALTH/08/06/hm.doulas/index.html
I am a doula, its an honour to be a woman of service and part of birth