Our report is attached on our Doula services. This documents our findings and provides some evidence for the use of Doulas in the perinatal period.
Spoon theory is usually spoken about in relation to those with Chronic illness, such as fibromyalgia, ME, migraines.
It is the theory that a person has so many “spoons” to use in a day and that some tasks take more spoons than others. So, getting dressed may take one spoon whereas the school run may take three.
And that once spoons are used then fatigue and other symptoms take over and the person is “down” for a period.
I think this can also be transferred to new parenting. It’s well known that a lack of sleep impacts upon physical and mental functioning and new parents are lacking in sleep. However, new parents can become quite resilient to the lack of sleep.
Lots of new parents report feeling guilty for not being able to do everything they feel they should be able to. But everyone has an amount of spoons. Maybe you have 10 spoons a day, take a couple off for a bad nights sleep, and you can see how everyone has limits. This is ok and healthy.
Some days you may have more spoons so can do more and other days are depleted. Parenting isn’t always easy and takes energy.
If we think about everyone having a level of spoons then we can begin to understand why some days seem better than others and how we can accept a day where things aren’t happeningZ
Some days have more spoons, some days have more stressors, some people have more spoons.
What takes your spoons?
What gives you spoons?
Over the lockdown I have been watching some old DVDs of family moments.
I’ve gone back to being pregnant with my eldest (age 19, 15 years ago) and through his baby days and beyond.
Looking back at the times when he was a baby/toddler I felt a pang of sadness. I wanted to scoop me up and tell me it would all be OK!
It took about 6 months to fully hit but I suffered from deep depression and anxiety for a good while after. Even watching his first Christmas video I feel the anxiety coursing through as if I was back there. She’s still me, the 20yr old new mum is still part of me and she always will be. She has shaped who I am today, I doubt Snowdrop would exist had I not gone through those times.
These old memories have been very much present in my mind and body when watching those times. Those memories shape things I do today too, I can feel anxious in certain situations and will react in ways I remember doing then, the feeling of dread making me want to run. Sometimes I do, and that’s ok.. I’ve had a lot of therapy over the years and continue with these feelings coming up (even therapists have their own stuff to deal with).
Watching these films have shown me that I have come along way and also acknowledge just how ill I was.
I say I want to scoop her up but then what would I actually say?
I know “it’ll all be ok” wouldn’t mean much to 20yr old me. She’d scoff.
What would I say?
I had zero confidence or self worth then. So maybe id need to hear, “you’ve got this.”
What would you say to a younger you if you could? Hard isn’t it.
I think holding or simply a hand on shoulder would be enough. Knowing it’s ok to cry, be angry etc.
Those old feelings have definitely risen during lockdown. I think because I’m those times 15years ago my illness made me lockdown. Walking out the front door would give me an actual panic attack and now I’m forced in to some extent.
Supporting new mothers going through similar situations I am aware of similarities and also the vast differences we can experience. I suppose I’d want to be more kind to myself as many mothers I support find helps. Just being there and riding the waves.
I can now see those black moments do not last. There may be fleeting moments but they do not last and the black days can become fewer and manageable.
Watching these DVDs has shown me (reminded me), that people can go through some tough times and grow amazingly and that hindsight is a wonderful thing.
Reminds me of this quote,
“Forgive yourself for not having the foresight to know now what seems so obvious in hindsight.”
I can see this maybe developing into a series of posts.
Having watched and participated in a few twitter discussions recently between mums and professionals I’ve been thinking.
Can we ever really not be coercive in language?
With health professionals (I’ll include doulas and Counsellors within that label) we strive to give information that’s the best for the individual. As Doulas we are not bound by the stricter policies that are within the NHS but we do have to be careful that we provide evidence based information.
I think there’s a problem in that in itself. “Evidence”, by its very nature, is biased. There’s always an element of researcher bias in studies. A good researcher will eliminate that as much as possible but it still exists.
When giving information out there’s also an element of bias. I’ve witnessed it far too many times a health professional giving one side of evidence and this is not enough for informed choice. Informed choice being when a person makes a decision for themselves (autonomy) with all the benefits and risks for every option available. I know myself that I have my own views on what’s best for myself, yet that is not the same for everyone.
For instance, one particular Twitter conversation/topic I’ve been following recently is around breastfeeding. Some suggesting that the benefits of breastfeeding are negligible in a country such as the UK. I have read the research around this and it seems fairly solid, however, over the last 15 years I’ve read a lot more telling me the benefits of breastfeeding far outweigh benefits of formula. I’ve always questioned that this doesn’t take into account the individuals. The benefits for one family is not the same for all. However, the health benefits of breastfeeding, without other factors, do outweigh those of formula. For instance formula does not have living immunoglobulins (the part of the immune system that helps fight diseases and infection).
An example I often remember is when I supported, as a Doula, two families who worked in NICU. One wanted all the drugs possible and to be in an obstetric unit. The other wanted a possible home birth. Both said they were choosing this because of their experiences in work. To me, I thought that was a fairly stark example as to what’s best for one is not always what another will choose for themselves. Medicine and health care should never be a one size fits all approach.
Back to the twitter topics around breastfeeding and I am reminded that maternal mental health is majorly important, not only to the mother but also to the baby and wider family. Successful breastfeeding may be important to mental health to one but being told “it’s ok to formula feed” could be of huge importance to another and, actually, for that family the benefits of formula could outweigh the benefits of breastfeeding. As a big advocate for breastfeeding and also mental health of new parents, it is definitely important to remember this.
There should still be better support around breastfeeding but I do feel that there should be more around mental wellbeing of new families. I think there’s better support for breastfeeding than there is for mental health currently in the UK, although this could vary in different areas. If we support better mental health care then this should include infant feeding and the relationships within this. It’s widely known that oxytocin if a hormone that helps with bonding and mental health (amongst other things, such as orgasm) and this is needed for breastfeeding. So simply biology would conclude that breastfeeding increases oxytocin and therefore is good for mental health. However, some have a negative feeling around oxytocin. There are theories about the “dark side” of oxytocin in particular in relation to trauma survivors and how the brain learns that oxytocin feeling can also be linked to not so pleasant experiences. In those who haven’t really experienced oxytocic feelings (there is some research that many women have not ever experienced an orgasm) then it’s also said that the feeling could be a little bit scary as any new thing is. So, it definitely isn’t a once size fits all.
Perhaps, currently in the UK, the risks to the whole family of current levels of mental health support outweigh the risks for the current level of breastfeeding support. It may be safe to say that the level of breastfeeding support for families is better that the level of mental health support. I’d suggest that is actually the case local to me where we’ve Gold standard BFI.
Giving a bottle of formula or expressed milk is not a fix to mental health for many but I do acknowledge that for some, to be told it’s ok to not breastfeed may be of huge importance. The pressure put on new mums is huge and detrimental in many ways. Society really should change this. (This is a whole other post!)
So, back to coercive language. Any policy, procedure, guideline, I would argue is coercive. They tend to require an outcome with certain ways to achieve. With little flexibility it can make it difficult for health care professionals to support, or inform, all choices. I’ve heard many say “I’m not allowed to tell you this but…” and actually that information/advice has been highly beneficial to the recipient.
I, myself, have been in trouble many times when I’ve worked in the NHS and other care services, from doing things “out of policy”, even though those professionals agreed that what I was doing was of benefit to the person. (Usually simply sitting and listening with a person who just wanted something simple.) The phrase, “against medical advice” is always a really manipulative one, I feel. “Against medical advice”, usually means against a policy, or even a personal belief. I have supported many women who choose to do things “against medical advice” and each one of those decisions has been from a place of being fully informed of all the angles, usually having only been given one side by those medical professionals and once the other evidence is presented the response is simply “well this is against medical advice.” There is a culture of power and authority seeming to come from medical professionals and that is very coercive in itself.
Let’s remember the authority should be with the woman and the family.
A sample track of a hypnobirthing track for confidence and fear release.
As the coronavirus pandemic hits everyone in the world, we, at Snowdrop Doula Community Interest Company, reflect on some on the things we are experiencing in supporting women and families as they navigate their pregnancy, birth and life with a newborn.
I support women and families through the perinatal period as a Psychotherapist and Doula. I also manage a team of paid Doulas and volunteers, working with all complexities and families that one can think of.
With the current global pandemic, the same concerns are being expressed by all who make contact. Women are concerned about their pregnancy and how safe it is to be going anywhere. New parents are concerned around going out of the house as, they feel, the baby could pick up the virus and become seriously ill. There appears to be a lot of confusion about the rules and each day this seems to change and cause further confusion. Women want reassurances and this does not seem to be available which heightens anxiety. As a Doula and psychotherapist, I am acutely aware of the impact of stress in pregnancy and the impact this can have on the family and the baby and supporting families through a stressful time where some stresses are currently unavoidable gives a new challenge for all. Many are finding that knowing they are not alone, and things cannot be changed, gives them a sense of acceptance and calmness. Which reminds me of the process of grief. It appears society is going through a period of collective grief. Perhaps mourning patterns of life and adapting to new patterns
Accepting things that you would not usually accept is an interesting concept, I find. Usually we would look at challenging policy that may not fit with own beliefs for birth and parenting. There seems to be a shift in that at the moment and families are accepting many things they would not normally. A concern here is that there seems to be a collective coercion. Which leads to an ethical question around is coercion ok in some instances?
With homebirths no longer being supported in many trusts, many families are either having to birth in hospital or opt for an unassisted birth. Neither of which are the preference of the family. Again, this is putting additional stress onto the family as they rethink the best for them. A professional reflection on this leads me to think about how much autonomy and choice families have in pregnancy, birth and parenting at any other time. Choices are always based upon the information we have at that time. If some options are removed how can a person choose that and therefore is full choice and autonomy ever, in reality, an option?
Locking down pregnant women for 12 weeks, as per government guidance as I write this, would normally seem hugely immoral and unethical. Yet society has now accepted this. Families have had autonomy removed in most things within the global pandemic and we accept that as “the greater good”. In conversations with families this felling of lack of control and autonomy is a common theme, they feel they cannot control their lives. Conversations, mostly, are around finding the little things they can remain in control of. Such as what they do in their own home. Goal settings and routine are things that families would like at this moment as it seems usual routines are stopped right now. Adjusting to the new normal.
In speaking with our Doula staff, we are having conversations around what is “essential support”. We can no longer support in hospital at birth. Staff are concerned how long this will last. Working with those who have requested Doula support for various reasons, they deem our service as essential. Both our own outcomes and research shows the huge difference a Doula can make to families. I would argue that Doulas and Counsellors/ psychotherapists are essential for many families and our families tell us we are. It seems we are temporarily essential to promote wellbeing in normal situations and even more so in unprecedented situations. To support in empowerment and resilience, or whatever word fits.
I have received messages from many other services (including those within the NHS) working with families that are disappointed in our service being limited at births and in the community at the moment and they feel this is an oversight as the stretched services struggle to cope usually anyway. We have made contact to offer ourselves under the volunteer scheme so families can remain supported. In the meantime, we have had interest in video support at births and have launched a national Doula Helpline to help with this. This is proving popular.
In my experiences in having daily conversations with families and staff working with families, there are common concerns. Concerns around autonomy and choice, own health, partners in the hospital. With choices and options now removed under policy and law there is a huge restriction on human autonomy under the thought of public health. Some conversations have been around removing he rights of some to protect others in a public health pandemic. There are no answers right now.
In usual circumstances it would be wise to seek to change things we are uncomfortable with. Some would argue that we should not simply accept anything we are uncomfortable with, ever. Right now, it seems that acceptance of the situation is bringing comfort to many and that is key. Informed choice can continue to be explored within the realms of current guidance, policy and law and families, and birth workers, can strive to find something within that that suits the induvial.
These are not usual times and we can continue to watch, challenge, reflect and choose what is best. We are all navigating new ways of working and new ways of being.
Importance of Self Care
As parents, as women, we seem to have a lot of pressure placed on us.
We’ve to be the mother raising the children and we’ve also to go and work.
Nothing ever seems good enough.
Stay home mum – lazy, not teaching work ethic
Working mum – not interested in child.
Men don’t seem to have this same pressure. They have different pressures.
This pressure can cause a range of emotions and feelings. Anxiety, worry, stress, sadness, depression, anger, frustration
All these feelings can leave you, tired, irritable, teary, fidgety. Even effecting your immune system, meaning you are ill often.
This can affect your menstrual cycle too, meaning your periods become irregular.
So if we do not take care of ourselves then we can struggle with taking care of other things in life as our health can begin to suffer too.
Taking care of yourself helps you to manage the pressures easier. Not feeling guilty in doing so too. (I know it’s taken me a long time to learn it’s ok to take some time for me, I still struggle with actually doing this)
What to do for self care?
Listen to music.
Spend a day in dressing gown.
Go for a walk/run.
Spend time with friends/loved ones.
Be on own for a short while.
Turn off phone.
All of these can be therapeutic and good for short periods. If they become a lot of the time this may be an issue too.
Like a pan on the hob, if you keep the heat there eventually it’ll boil over or even longer all the water will boil away completely. Sometimes the pan just needs taking off the heat.
Give yourself a break. It’s deserved.
Pick something to do for YOU right now! Even reading this is something for you! Well done. What else can you do for Self Care this week?
“Have you told You lately that You love You?”Unknown
Due to the success of our trailblazing projects and demand, we are launching three new streams to our Doula project.
We have an evidence based model of supporting families. Gaining recognition nationally for our work. We are trailblazers and continue to support women and families.
With all these streams you will become part of a nationally recognised, (BACP and ICO and NHS Information governance registration), not for profit Community Interest Company organisation supporting families. With endorsed training, policies and procedures, debriefing by qualified counsellor and birthworker, comprehensive staff and volunteer support, giving both worker and family piece of mind. We are the only Doula organisation in the country (possibly the world) to have this in place.
Doula support workers.
Firstly we are looking to train and recruit “Doula support workers” across the country.
These workers will be volunteers (with the potential for paid positions in the future) that commit to so many hours support women and families in group and one to one settings. You will support women and families alongside Doulas. You will not be required to be on call.
You will work within our Ethical Code and policies.
You will be trained with our CACHE Endorsed training.
There is a cost to the training, sliding scale due to household income and whether funding is available.
This is currently free for those living within BB postcodes.
Volunteer nanny worker
We are looking for volunteers to provide care for children whilst the mother is birthing in the hospital.
You will work with a Doula to provide holistic support to parents.
You will ideally have a childcare qualification or willing to train in Core Skills.
Hours will be as and when needed.
Potential for paid positions in the future.
Due to our success and the amount of requests we have received we now have the opportunity for Snowdrop branches to open across the country. This will give the option for funding support with access to our policies, software, research and knowledge and name. Due to different demographics within areas each area may work slightly differently. We have a procedure to follow for set up with regular audits. These audits help to ensure consistency across, protecting the families and workers.
There is a cost to this.
Funding can be accessed for this.
If you would like to be involved then please get in contact at email@example.com with subject matter “Doula support work”, “Nanny” and/or “new branch”.
I must admit, I am not a fan of “parenting guides”, especially sleep training books so I was quite tentative in reading this book. I was thinking “oh no! not another one!”
Imagine my surprise to find this book is nothing like any other “parenting guide”.
Sarah Ockwell-Smith provides the reader with recent research and evidence as to why
babies and children sleep in certain ways. This information alone could help a sleep deprived parent see things in a different way and help their family. Lightbulbs went off in my head as I read the research. As a doula I hear many stories and get asked many questions about “why won’t my baby sleep?” my answer is usually because his/her instincts are telling him/her to wake often and he/she needs you after being in your womb for 9 months. This book delves deeper into why this is so and the milestones in a babies sleep development. When you read this information it all suddenly becomes clear as to why babies sleep a certain way and why we adults struggle with this.
Trusting our instincts is something I often tell parents. “What does your gut tell you?” often this goes against all the parenting guides out there. Within The Gentle Sleep Book it talks of trusting instincts. I like this. Sarah Ockwell-Smith does give a routine but it isn’t prescriptive at all and she tells the reader to take only what you want. NO cry it out here! Simply how to move with your baby’s natural rhythm to get the best for you and your family.
“A mother doesn’t have to be perfect:in fact Winnicott says it is her imperfections that allow the child to become independent. she just has to be ‘good enough’.” Sarah Ockwell-Smith – The Gentle Sleep Book
This book will be one I recommend to people as its non-prescriptive and different to anything else about baby/child sleep. Finally a truly gentle sleep book!
I haven’t read anything else by Sarah Ockwell-Smith but I think I may now find copies and read.
Michelle Bromley – Snowdrop Doula Community Interest Company
This was first written some years ago as part of my Nurturing Birth course as i began my doula journey. I am copying it straight here for you all to read. Reading it back myself now i realise how much I have learnt in my journey and although I feel a little bit sad at some things I know that I made the right decisions at that time. I did find the experience empowering and had a positive experience although i may have moaned about it afterwards. I would not write it quite the same these days but this is how I remembered it then. Life is a journey.
Here you go…..
“My first child was born in 2005 naturally in hospital. I was 20 years old. I had a straight forward pregnancy with no sickness and the odd strange craving. Throughout the pregnancy I watched birth programs and read pregnancy and baby magazines. On reflection these are full of formula adverts and scare stories of birth. I knew I wanted a natural birth with little drugs and interventions. I went into labour on my due date and 15 hours labour I bought my wonderful son into the world. I used gas and air for most of the labour and also used a TENS machine and a bath. I did begin to ask for pethidine as I felt I could no longer cope. The midwife however seemed to take her time as she later said she believed in my capabilities and I am really grateful for her doing that as I would have possibly felt disappointed in myself if I had had the drug. My waters were broken (not sure on timings anymore) as I was becoming tired and I wasn’t dilating much. I was more than happy with this at that time. The midwife I had throughout the labour had to leave as her shift had finished and she had to get her own children. The student stayed. I got a new midwife who I wasn’t keen on, although it could have been my hormones (transition) and the amount of Gas and air I had inhaled. She was very stern on me laying off the G&A but I really didn’t want too. On reflection she had a point. Once I was ready to push I led on my back with feet up on another students hip. I was advised to be more upright as pushing wasn’t doing much. I was also screaming, which they advised me to focus energy elsewhere. I remember wanting to tell them where to shove there ideas. However I did calm the screaming and focus but i stayed on my back. Within 3 pushes my son was born. He was then placed on me, but not skin to skin, whilst the placenta was delivered. I had made the decision to have the syntocin injection. He wasn’t encouraged to breastfeed and I remember I had had a bath etc. before he was placed to breast.
I hadn’t come across many babies at this point so I felt lost. Instinct seemed to kick in overwhelmingly and I seemed to know what to do. Breastfeeding was somewhat of a problem to us. He had swallowed a lot of fluid so wasn’t really taking much at first and I felt it painful. The midwives wanted to see him feed but I struggled. The midwives tried to help but they were very hands on so I ended up going home none the wiser. I was getting up every 2 hours day and night to feed him and as I was told in the hospital those 10 minutes feeding is good I was putting him down after 10 minutes. Which I now know is not good practise. My nipples became very sore and cracked and the advice I received from health professionals was that he was gaining weight and the latch looked good. This left me feeling as I must just be me and still walking every 2 hours made me feel as though he was a hungry baby and I couldn’t satisfy him. One night I had a breakthrough and he slept 5 hour straight. I boasted to the midwife and was told that this was bad and I should wake him every four hours. I was back to feeling bad. Eventually at 3-4 weeks I mentioned to my health visitor that I was really struggling and I wanted to move to formula and she showed me how to make up formula safely. I remember I did not receive breastfeeding support at this point. I also note that I felt that formula was a natural progression and that it was weird to breastfeed older babies. I realise now that this was due to media and some peer influences.
I ended up with severe post natal depression after the birth of my eldest and was determined to not go through it again with any other children so I began to research more. This inevitably led me to come across the relation of lack of breastfeeding and post natal depression. “