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Use the form on the right to contact Kelly (The Modern Doula).

0430227114

If you are looking for birth support, or Perth area placenta encapsulation in the Perth, Peel and Hills regions I can help. Kelly Evans - The Modern Doula 

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News + Notes

News & Notes from Kelly Evans (The Modern Doula) on pregnancy and giving birth in Perth, Western Australia.

Filtering by Category: Birth Planning

5 Ways To Splurge On Yourself In Pregnancy/Birth

Kelly Evans

So this baby is happening! You are so excited and want to give this baby the best. What do you buy? Many women get carried away preparing the nest, buying clothes for the baby, setting up a nursery and so on that they forget the most important thing - to look after themselves~!

Here are my Top 5 Ways To Splurge On Your Pregnancy/Birth.

1. Hire an Independent Midwife!

If you are in Perth - here is a list of Midwives that operate Independently (that means that they are not acting as employees of the hospital but are employed by you directly). This is hands down the best way to ensure the Continuity Of Care that we all know helps women get the birth they really want.

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What to pack in your hospital bag for a homebirth

Kelly Evans

Now nobody planning a homebirth really wants to consider that they may need a hospital bag. I see it as having a dual purpose. Of course should you need to go to hospital for whatever reason, its there and its ready (think Girl Scout).. but also if your partner or your doula or midwife needs to get you something - having everything in one place makes it so much easier to find.

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5 Reasons A Mumma Who Is Facing Medical Induction Needs A Doula

Kelly Evans

Even when you think its too late to get doula support it really isn't.

Just like you - I have been there. I remember vividly being told that my baby needed to be born early. Which absolutely did not fit with the notion in my head that I was still 3 weeks away from 40 weeks (as you can guess mentally I wasn't ready).

I also remember feeling so confused and scared when they said it was an emergency induction and my baby needed to be born now... but then the hospital got busy and I was told I would have to wait until tomorrow. Like what the actual? I needed someone to explain why, but the staff were all quite busy. In fact I waited an hour for someone to enter my room to tell me what was going on, to reassure to me, to tell me where I could get a drink of water.. but noone.
 

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5 Things You Need To Know About The Birth Confidence Game (aka Bait and Switch)

Kelly Evans

The Confidence Game in birth is alive and well. I'm writing this blog post in response to an email from a client. Up until now this client has received total support and confidence from their caregiver regarding their ability to give birth naturally. It has always been a valid option for them.

Today when they went to a regular, scheduled hospital appointment, they faced a different person to last time. A person who through their 'counselling' instilled the first seed of doubt in their choices. A person who made it clear that they held the medical degree.

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How To Rock Your Next Birth After Trauma (+ Create Your Own Battle Magic And Find Fillory)

Kelly Evans

With your first birth you may have had a 'what will be, will be' attitude (or not). This time around you find yourself like Alice in The Magicians. Alice is a magician who knows that she has the power to beat the beast. She is the only one with the power to attempt it. 

She and her lover use probability magic to determine their best chance to beat the beast, and the answer is to visit Fillory. Fillory is a magical land filled with talking animals and other magical beasts. It is a land of abundance.

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The Three Words That Mark The Transition Into Motherhood (That No Expectant First Time Mumma Ever Wants To Say)

Kelly Evans

I can't do that' was the reply from one lovely Mumma. 'Why not?' I asked with curiosity. 'It's not what we do in our culture is it?' she said. She was so right and I was so grateful for her pointing out the obvious.

It left me on the one hand saddened, knowing that as culture we expect women to DO IT ALL. In the movies they pop on a dress, heels and cook a three course meal two days after baby is born to entertain all the guests, in a sparkling clean, spotless kitchen.

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What Are Your Odds Of Having A Waterbirth At Rockingham Hospital?

Kelly Evans

If you live in the local area you will know that if you're baby is on it's way - Rockingham Hospital is the closest hospital to go to. What Are Your Odds Of Having A WaterBirth In Rockingham Hospital?

If you are a local you will have heard the rumours (yep they are true) that there is only one birth pool there (to be shared amongst the 5 labour and delivery rooms).

So to begin with you have a 20% chance of getting a waterbirth (unless they are too busy and women are labouring in other rooms - in which case your odds just dropped further). One pool... 10 women in labour (10% chance of accessing the birth pool).

Who Is Supporting You When It's Time To Push?

If you are labouring in the birth pool (because you were lucky enough to get in there), you will have a beautiful midwife with you the whole time.

However, when the time comes to push if you are in that pool in Rockingham Hospital you must:

  • STOP..
  • Hold that baby in (hah like we really have a choice)
  • Climb out (have you ever tried to move with your legs spread and a watermelon inserted in your vagina)
  • and push that baby out safely on land.

Those of us who are in the industry know that this is the point where women who are strong and knowledgeable and supported refuse to leave the birth pool (unless they choose to).

Who Is Supporting The Midwife?

It's far to easy to blame the midwife but we know that the hospital policy does not support her.

I have heard of midwives turning a blind eye to these women who refuse to leave the birth pool when pushing.

I have also been witness to a birth where the midwife told the woman that she would lose her job if the pushing woman didn't get out to have her baby (which may be true who knows?)..

Sadly the Hospital Policy does not support midwives to allow waterbirth.

Is This A Battle You Really Want To Fight In Labour?

My point is this is not the battlefield... when you are ready to push your baby out is no time to be having a debate about the pro's and con's of waterbirth (as opposed to immersion during labour).

Research shows that having this kind of discussion at that point in labour is counterproductive and can result in a drop in hormone levels needed to birth (due to an increase in fear hormones) and increased length of pushing stage (it's simple fight or flight stuff).

What Is The Solution? 

The solution is a change in policy to allow women to BIRTH their babies in the water at Rockingham Hospital (and any other state hospital where there is a birthing pool). You can help!!!!

Please take the time to sign our petition to the Minister to get change underway now and increase the odds of having a waterbirth at Rockingham Hospital!

https://www.change.org/p/hon-dr-kim-hames-waterbirth-allowed-in-wa-public-hospitals-now/

So, if you don't want to sit there wondering if you could have done things differently, if you want to learn what ALL your options are, and how to take charge of your birth, let's talk.

Contact me to set up a complimentary Better Birth Chat for those women who are ready to get the birth they really want.

 

G is for Gestational Diabetes

Kelly Evans

Gestational Diabetes (also known as Gestational Diabetes Mellitus) is a type of diabetes that some women get when they are pregnant. According to Diabetes Australia "between 3% to 8% of pregnant women will develop gestational diabetes around the 24th to 28th week of pregnancy, however, some may be earlier". SCREENING FOR GESTATIONAL DIABETES

The recommended screening test for GDM is performed at 26-28 weeks' gestation (according to RANZCOG Management Guidelines) SHOULD I TAKE THE TEST?

Clients often ask me whether they think they should do the test... and the answer is that is entirely up to you. However, you may want to consider it if you meet one of the risk factors that have been identified. These include: 

  • Previous GDM
  • Previously elevated blood glucose level
  • Ethnicity: south and southeast Asian, Aboriginal, Pacific Islander, Maori, Middle Eastern, non-Caucasian African
  • Age ≥40 years
  • Family history of diabetes mellitus (first degree relative with diabetes mellitus or a sister with GDM)
  • Obesity, especially BMI >35 kg/m2
  • Previous macrosomia (baby with birth weight >4 500 g or >90th percentile)
  • Polycystic ovarian syndrome
  • Medications: corticosteroids, antipsychotics

WHAT HAPPENS IF I HAVE GD AND I DON'T TAKE THE TEST?

According to the RANZCOG Guidelines:

Although there is no evidence that perinatal mortality is increased in pregnancies with treated GDM, some studies have shown perinatal mortality to be increased in untreated GDM.

GDM is associated with increased perinatal morbidity, the characteristics of which are the same as for infants of mothers with overt diabetes (eg, macrosomia, neonatal hypoglycaemia, hyperbilirubinaemia, respiratory distress syndrome).

Reference: Hod M, Merlob P, Friedman S, et al. Gestational diabetes mellitus: a survey of perinatal complications in the 1980s. Diabetes 1991; 40 (Suppl 2): 74-78.

WHY ARE THERE MORE WOMEN GETTING GD LATELY?

One problem that I hear a lot about lately, is mentioned here in August 2013 Australian Family Physician website: http://www.familypracticenews.com/single-view/ultrasound-diagnosis-of-fetal-macrosomia-found-inaccurate/36fa34152d.html

- that is there are currently two sets of diagnostic criteria in use for diagnosing GD. The revised guidelines will increase the number of pregnant women diagnosed with GD by a staggering 50%! This translates to the prevalence of GDM being likely to increase to around 12–14% with the new diagnostic criteria.

PREVENTING A GD DIAGNOSIS

If you are looking to prevent a GD diagnosis you might want to check out Gloria Lemay's article 'Helping your client avoid a Gestational Diabetes diagnosis': http://wisewomanwayofbirth.com/helping-your-client-avoid-a-gestational-diabetes-diagnosis/

WHAT ARE THE RECOMMENDATIONS FOR DELIVERY WHEN YOU HAVE GD?

Whilst the RANZCOG Guidelines for Timing of Delivery state:

  • Delivery before full term is not indicated unless there is evidence of macrosomia, polyhydramnios, poor metabolic control or other obstetric indications (eg, pre-eclampsia or intrauterine growth retardation).

My experience has been that the few women that I have met who have been diagnosed with GD and been treated for it, were then subject to increased pressure to undergo induction and/or where told things that led them to believe that their bodies were not capable of birthing their babies (due to them being too large) and that a caesarian birth would be necessary.

If you are interested to know how an ultrasound diagnosis of big baby can be wrong - the following article may be of interest: http://www.familypracticenews.com/single-view/ultrasound-diagnosis-of-fetal-macrosomia-found-inaccurate/36fa34152d.html

For more about 'big babies' more here on Evidence Based Birth: http://evidencebasedbirth.com/does-gestational-diabetes-always-mean-a-big-baby-and-induction/

With the increased number of women being diagnosed with GD you can see the flow on effect - that an increasing number of women are being subject to a cascade of interventions, and increasingly ending up with caesarian section births.

Don't get me wrong some times c-section birth is very necessary and life saving - but for the Mum for subsequently finds out that she was bamboozled into an elective c-s that was unnecessary the impact on her mental health can be devastating. With psychiatric illness is the leading cause of maternal death in Australia - the inference is clear - we need to do everything we can to ensure that women in labour are making truly informed choices based on accurate information.

So for those women who are wanting to know whether to take the test - in the end the choice is up to you. You need to be aware of both the risks and the consequences of a positive diagnosis. You also need to be prepared that you may have a fight on your hands to achieve a natural hospital birth without fear.

For more information on GD screening, our local Community Midwifery Program has a fact sheet titled: Screening for Gestational Diabetes (http://www.cmwa.net.au/_literature_88952/CMP_Info_Sheet_-_Screening_for_Gestational_Diabetes) that provides a succinct summary of information that may help you decide. In the end it your body, your baby and your choice.

IF YOU ALREADY HAVE GESTATIONAL DIABETES

If you have already been diagnosed with GD the following articles may help:

and finally you need to read this: Birth without fear: The truth about gestational diabetes and why it's not your fault http://birthwithoutfearblog.com/2013/06/24/the-truth-about-gestational-diabetes-and-why-its-not-your-fault/