A letter to my head of midwifery

Hi HOM, 

As mentioned, I am writing to you regarding my birth choices and preferences. I want to ensure these are addressed prior to my estimated due date so we can work together effectively from a place of understanding.

Human rights law gives individuals the right to enjoy a private and family life. This means I have the right to choose who supports me during pregnancy and birth, and in the days following birth and my chosen birth place.

Firstly my perceived risk is due to having a caesarean birth previously. Due to PROM I was induced which resulted in a caesarean. Prior to the cascade of interventions my waters were clear and I was fit and well showing no signs of infection or concerns for babies welfare. Had I been presented with the research at the time to make an informed choice I would have chosen to stay at home and wait, unless concerns arose.

For this pregnancy, all is currently well with the pregnancy and no other perceived risks other than the previous caesarean and a perceived risk of scar rupture. It was a lower transverse incision, the evidence suggests the risk of this is 0.22% and so I am willing to take the 99.78% chance that this won’t happen to me. My background in tissue viability assures me that I have a healed well and allowed enough recovery minimise the risk further again. I discussed this with the obstetrician and I understood him to respect my choices and has hopefully emailed you with the outcome of our discussion. I have asked that unless something comes up in the pregnancy that this is not revisited as I feel there is nothing more to say. 

As a Trust I feel you need to consider the harm the restrictions of the home birth policy may cause as I appreciate restrictions can be put in place, especially around winter pressures. Research in this area has repeatedly demonstrated the benefits of being supported by loved ones and companions of choice during pregnancy and birth. I appreciate staffing may not facilitate a home birth however should no one be available I will be remaining at home with the support of my husband, family and Doula unless I feel the need to come into hospital due to any concerns that I may encounter.

I know questions will be raised around my preferences to not be monitored in labour and declining Vaginal examinations. I would like to make it clear I am informed in my choices and that to achieve the birth that I need to heal from my previous experience these choices need to be respected.

There is no research to date examining whether the practice of fetal heart rate auscultation improves outcomes, or the optimal frequency of auscultation and therefore unless I request it, I do not want to be pressured into monitoring of any kind.

Also to add, the idea that the cervix can tell a midwife about my progress in labour is underpinned by an incorrect understanding of birth physiology. Childbirth physiology is complex and I strongly believe that being left undisturbed optimises my birth experience, mentally, physically and spiritually. I've done a lot of Dr Rachel Reeds lessons in reclaiming childbirth and witnessed firsthand birth unfold beautifully without interruption so the belief that my instinct will prevail is strong and this is what we should be guided by.

I understand that I may need to make alternative decisions during my birth. I want us to work together to make sure I fully understand my options so I can make an informed decision however understanding my above preferences will make this easier and as a result I am confident that my birth will progress without complication.

A lot of self discovery and research has gone into creating my birth preferences which is why I know this is the best chance for me having a birth without trauma or complication.

It is also important to note that once baby has arrived, I do not want the immediate time to be disturbed unless I request it. The only hands touching the baby will be that of my own, my husband and possibly my daughter if she is awake. I do not require active management of the placenta and it is through my own experience that I wish for patience with its arrival as it often seems to come at approximately 90minutes after birth of baby, of course each individual is different. I would also like to keep my placenta. We will be using a cord tie and cutting the cord as a family once the cord is white and non pulsating.

I appreciate their is a lot here that your policy’s may not be supportive of however I am hoping that any midwives involved will be excited about the prospect of a true physiological birth and supporting me by hopefully having to do nothing but sit, listen and wait. I will have refreshments readily available. I also hope that having all of this documented on my health care record can facilitate this further again and reduce any anxieties around protecting NMC registration. I want the midwives to feel relaxed in supporting these choices that do not fall within their usual practice. 

I look forward to your response and chatting through this with you.

Yours sincerely,

Leanne

I’m having another baby

So with a heart that's about fit to burst with love we are so excited to share that baby number 2 is in the way and expected January 2024.

I have my last client due in the fall AKA pumpkin baby and I will then be on wind down with self care and family time. I will also still be running baby massage until Christmas.

I am also facilitating Alex of the @the_original_birth_connection wonderful Doula training for the North West & Scotland so I won't be quiet on here and if you sign up to OBC training I will see you in the new year, possibly with a little babe in arms.

I know the question will be asked "is the doula hiring a doula?' And the answer is Yes! I'm classed as birthing outside of guidance due to having my first born via caesarean and planning for a HBAC and although I am happy to advocate for myself I feel my husband will benefit from an impartial expert to execute my birth preferences should they need to. It takes the pressure off him massively and those good hormones will just flow better.

I won't be sharing everything but I will be sharing a lot via my social media so expect doula content, personal journey updates, community, baby massage content and just general stuff that alligns with who I am and what I believe in.

Lots of love

Leanne x

Homeopathy in Pregnancy & Childbirth

Harnessing the power of nature is Pregnancy, Childbirth & Postpartum.

Earlier this week I didn’t a little course for Birth Workers in the use of Homeopathy and it’s used for pregnancy, birth and post partum.

I love exploring alternative ways to support my clients. Having an overview of any considerations clients wants to explore is a useful tool. It’s also useful on a personal level for my health and that of my families.

I am very interested in a more gentle and natural approach. I love seeing how different methods work for different people. Because that’s the point isn’t it. We are all different and it’s not a one size fits all!

Homeopathy treats each person as a unique individual with the aim of stimulating their own natural healing ability. Medicine is selected with the aim of triggering the body’s natural system of healing.

Did you know?!

Homeopathy is the second largest system of medicine in the world today, as recognised by the World Health Organisation (WHO). Two hundred  years of practice, research and trials means Homeopathy is perfectly safe. Unlike  some conventional drugs, homeopathic medicines are non-addictive and have no dangerous side-effects making it safe to use for babies,  children and pregnant or breastfeeding women.

Homeopathy doesn’t interfere with conventional medicine and should be seen as a complementary treatment, not as an alternative. For me, it is something I am going to utilise for my family as a first line treatment before turning to more traditional medicine from the GP.

Homeopathy can be a useful tool in pregnancy, labour and post partum.

Some examples include.

Pregnancy:

Nausea & Vomiting

Cramps

Headaches

Sciatica

Labour:

Fear/Anxiety

Can give you a little nudge into labour post 40 weeks

Can support physiological 3rd stage of labour

Post Partum

Emotional Trauma/Shock

Soft Tissue Healing

Hormone balancing

Wound Healing

Nerve pains

Physical Exhaustion

Please get in touch if you would like to discuss with me how homeopathy can help you. I use Helios Childbirth Kit linked here.

*remember to notify your health care provider of any alternative medicines you wish to explore* not medical advice*

A Safe Space

It is important to know Doula Diary is a safe and non judgemental space!

This comes from me, being a human being and learning everyday about challenges we all face. This is a very open, wearing my heart on my sleeve kind of post. One I feel some of you will relate to and understand, and why I want to share.

I love my life, everything I have dreamed of has come true…is true. I’m living my dream. It’s not perfect but it’s what makes me happy. It’s a balancing act to juggle happiness, finance, home, work, family, life and as I grow and learn more about myself I understand more.

I have a roof over my head, a healthy body (granted I could do with more sleep and my body aches from time to time) a healthy family, supportive friends, an understanding husband, 2 wonderful dogs and the best clients who really make my work fulfilling.

So when it comes to that time of the month where as a women I bleed. Things get a little foggy. I get irritable, lack motivation and need space and time away from my family. The balancing act becomes overwhelming.

Did you know this is perfectly normal and valid for so many. Now my husband always worries as I naturally become distant. I’m reserving my energy. It’s hard work raising a spirited toddler who’s navigating her own emotions. To support my daughter with this it all starts and ends with me. Now I find it so so difficult to maintain this patience at this time of the month. I have to breathe and collect myself. Easier to do if I’ve had some headspace and filled my cup.

My husband asked me what he can do to help as he isn’t ‘Intuitive’ when it comes to stuff like this. I could have cried. I try to explain that it’s not him , our daughter or our life together. It’s my hormones, it’s my emotions, it’s who I am and always have been. Once upon a time it would have manifested so differently but now I have people who depend on me. But I still need space, and that is what he can do to help. Take our daughter and give me some space.

I may seem like a little bit of an ‘expert’ around birth. I’m not, I’m always learning, same with parenting. It’s a learning journey which we do better when we do it together and share. We have highs, we have lows.

Each Parent, baby and child is different and so is the journey. It will never be the same. So I want you to know that my inbox is always open if you need to splurge into a message how you are feeling. Do not worry about any typos, auto corrections (these can be quite funny and humour is powerful) or grammar. I don’t, it doesn’t matter in the grand scheme of things.

Pop me a little heart in the comments if you ever feel the same, or have anything to add. I would like to show my husband it’s not just me. I appreciate those of you who are pregnant won’t have a cycle right now but that feeling of being overwhelmed may still speak to you.

Lots of love

Leanne x

Reconnecting To Yourself In Pregnancy

Connection is our birth right, but it’s in danger. More and more we are finding ourselves in our heads losing the connection to our own bodies. Education and society also keeps us in our heads, and this is at the expense of our bodily instinct & wisdom.

Reconnecting to yourself and your body when your pregnant can be so empowering. Simple adjustments in your day to day can create new habits which will strengthen the connection to your body, which many of us have lost along the way. Rediscovering this skill and learning to reconnect to yourself in pregnancy is also a great tool to take forward into your labour and your journey as a parent.

With that I just wanted to share a couple of things that anyone can do to reconnect with their bodies.

Pilates and similar embodied arts like yoga is often described as the Dance of Breath a Movement which beautifully sums up birth too. The breath helps centre us providing you with oxygen rich blood, gives us focus and can allow our mind to relax and our body open. Focusing on your breath has been shown to alter your brainwaves in a positive way, decrease stress hormones, blood pressure and increase oxygen levels and relaxation.

Practising movement with breath work in pregnancy prepares you beautifully for birthing your baby, whether that’s home birth, caesarean birth, hospital birth, whatever your choice, it will influence a more positive experience. Dancing through contractions has lots of benefits and can help baby descend into your pelvis. You can then take these skills you have learned forward to adjusting to life as a new parent. There will be times you will feel overwhelmed and centring yourself with your breath will help you clear your mind. Movement with your baby will soothe your baby, soothe you and support bonding.

Modern society is overwhelming, the constant juggling and expectation of more, so it is no wonder we are disconnected from ourselves. The above advice does not cover only pregnancy and about but moving forward into your role as a parent.

So with all of that said it is no surprise that at the top of my top five list for reconnecting to your body is.

How to reconnect to yourself in pregnancy

Dancing and movement

Dancing during the first stage of labour can decrease duration and intensity of pain. Instinctive movement can help your baby move down into the pelvis  and will divert attention away from any unwanted sensations. Dancing with your newborn is also a wonderful happy hormone release and the moment is incredibly soothing for your baby.

Slow down and be present

Remove yourself away from the noise, switch off technology and pay attention to what you are eating, how you are feeling, how the leaves are changing colour. Note how this makes you feel.

Go outside

Feel the sun, wind and rain on your skin. Blow away the cobwebs and clear your mind. Fill your lungs with the gorgeous fresh air and oxygenate your blood.

Question authority

Stay connected to your own genuine needs and desires by being in the body. Be your own guru and don’t feel guilty for taking the time you need to keep yourself well physically and mentally.

Be creative

Do more of what inspires you. Paint, make something, read, take a warm bath with your favourite treats. Do the things that you love but you never find time for – make the time. Feeding your soul opens you up to so much peace and joy.

Now it is important to note that equal measures of rest and movement are important. Tuning in to your body will help to find the right balance for you. Breath work can be a key tool and influencer in how we are feeling. When it comes to birthing your baby, if you are too much in your head or adrenaline is taking over it will disrupt the flow of oxytocin which is a key hormone in birth. Breath work & instinctive movement can break this process.

Nutrition, Wound Healing & Recovery

Nutrition plays an essential role in wound healing and care, and nutritional support needs to be considered a fundamental part of wound management. Poor nutrition before or during the healing process can delay healing and impair wound strength, making the wound more prone to breakdown.

For an adequate immune response, collagen synthesis and to transport oxygen to the wound, certain micronutrients are particularly important for wound healing (Munoz et al, 2020; Tuz and Mitchell, 2021).

These micronutrients include:

Vitamin C: fundamental for collagen formation and subsequent cross-linking, as well as the formation of new blood vessels (angiogenesis). Adequate Vitamin C levels will help strengthen the healing wound. Vitamin C deficiency has been found to impair wound healing and has also been associated with an increased risk of wound infection. Also helps Iron absorption.

Vitamin C is found mostly in fruit and vegetables, especially oranges, grapefruit, tomatoes, and leafy vegetables.

Zinc and copper: Found in small amounts in the body, it plays a role in wound healing. Zinc is involved in protein and collagen synthesis, and in tissue growth and healing. Zinc deficiency has been associated with delayed wound healing, reduced skin cell production and reduced wound strength.

Dietary zinc sources include red meat, fish and shellfish, milk products, poultry and eggs. Copper is found in highest amounts in protein foods like organ meats, shellfish, fish, nuts, and seeds as well as whole grains and chocolate.

Vitamin E: essential for optimal immune function and assists with healthy tissue formation

Vitamin E is found in plant-based oils, nuts, seeds, fruits, and vegetables.

Vitamin A: Increases the inflammatory response in wounds, stimulating collagen synthesis. Low vitamin A levels can result in delayed wound healing and susceptibility to infection. Serious stress or injury can cause an increase in vitamin A requirements. While the mechanisms of vitamin A in wound healing are still not well understood, it is clear that it plays an important role.

Vitamin A is found in milk, cheese, eggs, fish, dark green vegetables, oranges, red fruits and vegetables

Iron: is a mineral that provides oxygen to the site of the wound; therefore iron (haemoglobin) deficiency can impair healing. Iron deficiency can also result in impaired collagen production and strength of the wound.

The best sources of iron in the diet are red meat, offal, fish, eggs, wholemeal bread, dark green leafy vegetables, dried fruits, nuts and yeast extracts.

Protein: is essential for the maintenance and repair of body tissue. Low protein levels will cause a decrease in collagen development, slowing the wound healing process. Adequate protein levels will help achieve optimal wound healing rates. Overall energy intake is also important, because if energy needs aren’t met the body will use protein for energy rather than for wound healing.

Sources of protein include red and white meats, fish, eggs, liver, dairy products (milk, cheese, and yoghurt), soy beans, legumes, nuts and seeds

Healing Post Partum Bath Soak

Postpartum herbal soaks are a lovely, natural way to soothe tender, inflamed skin, heal tears, reduce hemorrhoids, and otherwise pamper yourself after you have your baby. I recommend a bath a day for no longer then 10 minutes to help soothe and heal your skin. It also offers you the opportunity for some much needed me time, medicine for mind & body.

I myself enjoyed a healing sitz bath after my daughter was born and I was recovering from an unplanned caesarean. After my initial dressing was removed from my caesarean site I would gently bathe then pat my wound dry with a clean towel. I would then apply some high waisted fresh cotton knickers (you don’t want anything rubbing on the scar line as this will aggregate the wound and could contribute to complications or delayed healing.

There are many variations of herbs that can be used. I have posted below a combination I like to to soothe tender perineal tissue, heal tears, episiotomies, promote caesarean scar healing and reduce inflammation, and even shrink hemorrhoids after a vaginal birth.

Preparing the bath is as simple as making a giant pot of tea, and the medicinal liquid can also be made into compresses if you are needing even more support for your perineum.

Red raspberry leaf is a super gentle yet effective herb that is a mineral-rich uterine tonic and a skin soother.

Herbs like chamomile, calendula, & witch hazel are antiseptic and great for increasing circulation to pelvic area.

Lavender has a relaxing floral scent. It promotes restfulness, and is antibacterial, antifungal, and an antioxidant.

Witch Hazel used for hemorrhoid relief and treatment is known for its anti-inflmmatory and healing properties.

Yarrow, Both the dried herb and flowers can be used with similar properties. Yarrow has wonderful antibacterial and antifungal compounds that are helpful in replenishing the interstinal flora. It is also helpful in stopping bleeding from haemorrhage.

Quantities.

* 1 cup or of Epsom Salt

* 1/4 cup of Red Rasperry Leaf

* 1/4 cup of Lavender

* 1/4 cup of Witch Hazel

* 1/4 cup of Yarrow

* 1/4 cup of Calendula

* 1/4 cup of Chamomile

Please note this is not medical advice.

Post Partum Bounce Back

We spend 9 months (ish) being treated like a goddess, then all of sudden your baby is here and you are expected to take a back seat.
Whats that all about? Along the way we have lost the gentle path of our postpartum recovery and we're not quite sure how that happened!

This bounce back approach to being a new mum can be really damaging, you know it isn’t real right? From the outside, we often only really see snapshots of someone else's life with a newborn looking like they have it together, however in reality, the lead up to that moment looked very different. Your postpartum time needs protecting, it is unique to you, your needs and what you need to facilitate your recovery.

What is postpartum recovery?

Postpartum recovery is the time after your birth and a time where you should be handled with care. Think of it as your recovery time!

But, in realities of today's modern world, how do you make sure YOU recover when looking after a newborn, while your hormones are recalibrating ? (I feel like I need to recover from that paragraph). Remembering my own experiences of that time after my birth was a complete shock to the system.

A lot of people, myself included, overlook the importance of preparing for postpartum time. We get ourselves so fixated on preparing for birth and the practicalities of looking after a newborn that we completely overlook our own emotional needs as a new mum.

Preparing to adjust to motherhood postpartum

Adjusting to everyday life after the birth of a baby has its challenges, especially if you’re a new mother. Although it’s important to care for your baby, you also have to take care of yourself.

You need to think about your postpartum body, the more you allow yourself to rest, the shorter and easier your recovery will be.
Simple right? So how do we rest with a new born baby, especially if we already have children? Here are a few tips to get you started:

• Know what to expect - learn about what to expect for your recovery so you can manage it effectively.
  Your body may look different, so why not do some research on vaginal birth recovery or caesarean birth recovery and learn how to take care of your perineum and how to manage constipation - trust me you want everything to flow.

• Make life as easy as possible for yourself - if like me, you hate clutter, trying to declutterduring your pregnancy and prepare for your house is super helpful. Babies breed clutter so creating as much space before they arrive goes a long way to the “tidy house, tidy mind” feeling.
  Now, I am no way saying that it will take away the clutter but the less stuff you have the less to clutter!I learnt the hard way that my house is not going to be the polished masterpiece I was once proud of pre-baby, but it is a happy home!Baskets are great for collecting items and having them in one place to sort out at a later date - your home will feel instantly tidier and calmer.Another great way of making life easier for yourself is to create 'stations' around your home; I’m talking baby changing stations, movie stations with snacks, drinks, books, so that when you sit down to watch a movie and relax, you have everything to hand so you don’t have to worry about getting back up again. This is especially useful for caesarean recovery and accommodating a breast feeding journey.When it comes to breastfeeding, if this is what you choose for yourself, remember that it is completely normal for newborns to be on your breast for what feels like 24/7. Babies instincts are usually pretty good but it is a learning curve for you both and little adjustments can make a big difference. You do not have to navigate this alone.

• Don't be afraid to ask for help - people will naturally want to visit you and your baby after the birth, so your home will be pretty busy for the first few weeks. However, visitors can inadvertently bring on more work for you and leave you feeling even more tired (welcome to the tired mums club!). The best kind of visitor is the one that, when they come round for dinner, they start clearing up after themselves, they offer to help with tidying and they make you feel comfortable. That is your person!
  If you can’t think of anyone that falls into this category, it's okay to ask help. And that goes for everything around the house, you'd be surprised at how much people actually WANT to help and have any excuse to spend time with your newborn baby !

Having said that, postpartum birth visits are one of my favourite aspects to being a Doula. I love nourishing the mother and leaving a sense of calm after my visits, it is very rewarding, and an honour to nurture a new parent whilst they navigate their postpartum journey.

So remember protecting your postpartum recovery is so important. Look after your mind and your body and be kind to yourself by celebrating the wins as they come, no matter how small they may be.

And most importantly, remember - you are incredible!

And Doula Diary was born…

Dear Doula Diary,

It all begins with an idea. Doula Diary was born following the birth of my daughter Olivia on the 13th August 2021 at Stoke Mandeville Hospital. On Wednesday 11th August1pm (ish)I had a trickle down my leg. Did my waters just break or had I peed myself? I genuinely wasn’t sure so I Googled it which wasn’t really helpful. I decided to see if labour would follow and carried on about my day. Nothing else happened. Thursday 12th August me and my husband decided I should speak with the midwife. My midwife told me to go to the hospital to get checked, without even questioning this I did as I was told and was checked. Little did I know at the time that this could be damaging to the natural progression of my labour and also would introduce infection. Without much thought, as I was hoping that The hospital staff would confirm that I would be welcoming my baby, they confirmed my waters had broken but they hadn’t “popped” completely. This is where the cascade of intervention began, I did not know it at the time and I would have done things so different if I had prepared myself differently. Due to the hospital protocol they wanted me to start on 4 hourly IV antibiotics as precaution (infection risk) and I was to be induced the following day. I thought this was over the top but I complied as I thought that they would know best, I put my trust in the service provider and not myself. Working for the NHS for the last 10 years I did not think this trust was misplaced. As I was working through a mixture of emotions I had to fight for my husband to be able to remain with me as they would not let me go home. We offered to pay for a hotel near by so we were close to the hospital, anything to not be separated. Eventually once the night staff had come on and the day staff had gone home they allowed my husband to stay and for us to finally get some rest. It was a very unsettled night and I was praying that labour would start spontaneously.

Friday 13th August cervix closed so to help things along I requested a pessary as the reading I had done had said this may help speed things along. I know better now but in the moment for my first birth I thought this would help my situation. 1st pessary inserted 01:30 and I tried to get some rest. Nothing happened (Surprise!). Later that morning at 12:15 I was checked and my cervix remained closed, I was very disheartened. Certainly know good hormones floating round my body at this stage. Before I was to be induced I took the opportunity to have a bath and then I was induced at 12:45 which was ticking along, I had a lot of nausea and vomiting throughout my pregnancy and I vomited again the morning of the induction. When the induction started I used a tens machine initially to manage any pain. I thought this worked well, I know that induced labours could be more painful and wanted to try and manage the pain as best as I could with limited drugs. When the induced contractions stepped up a level I had a practice with the gas and air. The consultant then came in to do a stretch and sweep and a hook to properly break my waters at 15:25 (this was brutal!) Crazy contractions minute apart minute in length started not long after this with babies heart rate raised! The consultant checked my Cervix and I was only 1.5cm. It was described to us that it was like trying to push a baby out of a keyhole on a closed door. I do not really recall much more other then some paper being placed in front of me and the health care staff “informing me” of the risks to a caesarean. It was too late, I had no choice, I was in pain, something was not right and my baby was in distress. I scribbled something that looked like my signature. With baby distressed, heart rate over 200 and everything a blur, it all happened so quickly and Jack (my husband) held my hand every step of the way. We were rushed to theatre, I had a Spinal block, urinary catheter inserted and a Cat 2 Caesarian Birth. The spinal block was very surreal and made me feel even more vulnerable when I already felt helpless.

Jack got to cut the cord and have a cuddle whilst they played some relaxing music and put me back together. The theatre staff were very lovely and tried to involve me and honour my wishes as much as possible. Olivia was born. Time: 18:41 on Friday 13th August weighing 7lbs 3oz. She was here and she was safe! I however, was broken. All I remember repeating whilst I was in theatre was that “this is everything I did not want!’ This is where the journey began to understand my own birth story, heal from it and find myself wanting to ensure your birth is in alignment with your vision and that you are prepared. Part of my recovery has been facilitated by becoming a Doula and finding a village of women and birthing people who have either a passion for birth rights and birth or have had their own birth trauma to deal with and found themselves wanting to make birth and postpartum the empowering and transformative experience that it should and can be, if we understand the physiological process of birth and have the confidence to trust our instincts. I can 100% support any birth providing that the mother understands their options and can make informed choices that is right for them. I am particularly passionate about first time Mum’s achieving ANY birth as long as it’s what they have chosen without coercion. I am also very passionate for second time Mum’s achieving vaginal birth after caesarean (VBAC) or home birth after caesarean (HBAC) as this is what I am aspiring for my next birth and I know with the right support around us we can achieve it!