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

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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.

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.

 

H is for Hyperemesis Gravidarum

Kelly Evans

H is for HG The Modern Doula
H is for HG The Modern Doula

What is HG?

Hyperemesis Gravidarum (or HG) is every pregnant woman's worst nightmare. It's a bit like extreme vomiting, nausea, and weight loss and it's certainly more than a bit of morning sickness. Whilst most women experience some morning sickness in pregnancy, while HG is quite rare (some estimate 1 in 100 pregnanies). I know of a few pregnant women who have suffered through HG for their entire pregnancy.

What can I do if my pregnant friend has HG?

Part of the problem is others trying to be helpful and telling a Mumma to just eat ginger (let me tell you nothing repulsed me more than the smell of ginger when I was pregnant or dry biscuits for that matter). We need to start educating each other on HG and start being more empathetic and practical with our support (instead of offering solutions). So if you know someone suffering HG ask them what you can do to help. Acknowledge that you don't know exactly what they are going through but offer to provide practical assistance (assuming you know them well enough).

How do I know if it's HG or just morning sickness?

There are a few differences between the two. With morning sickness you sometimes have vomiting, with HG you get severe vomiting. Morning sickness generally settles down at about 12 weeks, whereas HG often continues (sometimes up until the moment of birth). HG often results in severe dehydration and you are unable to keep any food down (as opposed to morning sickness where you can usually keep some food down).

If you are thinking you may have HG there's a checklist you can download here that you can take to your care provider as well (Rhodes Index of Nausea, Vomiting and Retching).

Is there anything that will help cure HG?

If you think you are suffering from HG be sure to talk to your care provider. There are treatments available for the symptoms, though there's no known cure.  You may be given medication (your care provider will work with you to balance possible side effects with benefits).

If the medication doesn't help, or you get dehydrated you may need to go to hospital for treatment (although this sounds scary, you will feel alot better just by not being dehydrated and not nauseous).

What can I do if my loved one is suffering with HG right now?

There is a great printable brochure you can download from the HELPHER website: http://www.helpher.org/downloads/hg-loved-one-brochure.pdf which can help you to help your loved one through this really difficult time.

Further reading

If you want any further information on HG the HELPHER website is my go-to resource: http://www.helpher.org/
 

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 birth support 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.

Is Breastfeeding Really Welcome Here Pt 2? (Reply From The Melbourne Town Hall)

Kelly Evans

In my last post I explained about the horrible situation that left me in tears on the steps of the Melbourne Town Hall. Below is the reply from the City Of Melbourne who employ contractors to run the Town Hall. I'd love to know your thoughts. Have they gone far enough? Should the Melbourne Town Hall be made a Breastfeeding Welcome Here Venue? Is there anyone in Melbourne who would like to go feed their baby on the front steps and let me know if things really have changed or if this is just lip service!

Dear Ms Evans,

Further to my email to you on 10 June 2015 I can advise that the matter you raised with regards to your interaction with a staff member at The Melbourne Town Hall has been investigated.

The City of Melbourne fully supports the right (as set out by the Australian Human Rights Commission) of every child to be breastfed ‘anywhere, anytime’ and we are aware that it a child’s legal right to do so. I understand that this position was not made clear during your conversation with the doorman on the steps of the Town Hall and that you felt discouraged from feeding in this location. This matter has been discussed with the person you spoke with and while it is understood that no offence was intended, City of Melbourne’s position on breastfeeding has been emphasised with our Town Hall contractors, who employ the staff member in question.

I trust that this will result in a more sensitive and informed approach in any future interactions our contractors may have with breastfeeding mothers in this location. I apologise for the offence you suffered as a result of this interaction and thank you for bringing this matter to our attention.

I am pleased to hear that you enjoyed the Homebirth Australia conference at the Melbourne Town Hall and hope that you will visit again soon.

Kind regards,

Ian.

Ian Sumpter | Acting Manager | Customer Relations

Tips For Travelling In Bali With A Toddler

Kelly Evans

2015-04-28 17.25.20 I recently went on holiday to Bali and we took our son with us (15 months). I thought I would share some tips that I found made our trip a little bit - no actually ALOT easier.

What To Buy Before You Leave Australia

I was eternally grateful for the following items that we brought from home:

  • Naty Nappies - they don't even seem to sell these in Bali so we were so glad we bought heaps with us.
  • Wotnot Wipes - no sign of these for sale either.. BYO!
  • Probiotics - we bought Bioceuticals BabyBiotics with us (wrapped in an ice pack) and this seriously saved us all from the dreaded Bali Belly (yes we all had some Babybiotics at one stage).
  • Toddler Food - we took organic fruit purees and a few other packaged toddler food items with us. These were handy for snacks and what we didn't use we declared at Customs at the Airport on the way back through and were allowed to bring home.
  • Sanitary Protection - this is something that I didn't expect to need and boy I wish I had bought some from home. No sign of organic pads anywhere that I could see and good luck in buying a Juju Cup! Seriously BYO just in case.
  • US Dollars - you will need these at the airport to buy an Entry Visa (this is not included with your airfare so don't get confused)
  • Babywearing Equipment - We took a Bali Breeze and for that I am so happy we did. I still sweated in that carrying around a 12kg toddler in the heat but I still think that it beat trying to navigate a pram up and down the many stairs and narrow paths. I also found it quite reassuring having my son close all the time I didn't need to worry about his whereabouts.

What To Buy In Bali

  • Bottled water - buy a heap when you first get there. You are going to need it for rehydrating all the time as well as brushing teeth and many other uses you haven't even thought of yet. Don't trust tap water - ever. Just take bottles of water everywhere.
  • Clothes - the clothes over there are super affordable and designed for the local climate, so be sure to bring an empty suitcase and buy some locally made clothes. Even the coolest clothes I had brought with me from home did not compare to the cool local clothing.
  • A Massage - I had a totally amazing massage for about $15. Highly recommended.
  • Shoes - you can get some cheap shoes in Bali but beware the ultra-cheap runners - I have heard stories of them lasting one wear before starting to fall apart.

Have you travelled to Bali? Do you have any tips to share? I absolutely loved my time with the Balinese. It's a different lifestyle and such a different culture. Well worth a visit if you haven't been there.

 

Is Breastfeeding Really Welcome Here? (My Open Letter To The Melbourne Town Hall)

Kelly Evans

Dear Sir/Madam, To whom it may concern:

Firstly, I'd like to say thank you for the wonderful experience that was the Homebirth Australia Conference 2015! It was a beautiful venue and the catering was one of the best I have experienced.

I'd like to bring to your attention however an unfortunate incident that occurred on the steps of the Melbourne Town Hall on Sunday 31st May.

My son had just come to meet me for his lunch on that Sunday and his lunch happened to be breastmilk. Having breastfed two children (the first for 2 and a half years) and the second for 14 months so far, and having travelled around Australia and overseas and breastfed all the time, I have never had occasion to have to think about feeding my son. It just happens. He is hungry. I am usually pretty discreet about it anyway, he feeds and we are done.

Anyway on this occasion the gentleman on the door rushed up to me and said 'you can't do that here'. It actually took me a moment to understand what he was referring to.. So I said 'Yes I can'. He shook his head at me and ushered me to move and said 'No you can't do that here'.

I said 'But it's the law, I can feed anywhere'. He said 'There's a family room inside you'll have to go in there'. I shook my head I said 'but it's the Homebirth Conference' and turned my back on him, before sitting down on the steps.

He muttered more things under his breath about me needing to go inside, about me returning to the 3rd floor to feed and about it being 'culturally inappropriate', by which time I have managed to beckon one of the conference organisers over for support. Luckily she backed me up saying that of course I could feed my son there! He then acknowledged that he was from a different generation (?)

I felt very disconcerted by your doormans verbal tirade, I was left shaking and in tears by the end, all the while standing my ground, to feed my starving baby the breastmilk he needed. I couldn't concentrate at the conference after that and ended up leaving the building after that walking around in shock.

In Australian Federal Law breastfeeding is a right, not a privilege. Under the federal Sex Discrimination Act 1984 it is illegal in Australia to discriminate against a person either directly or indirectly on the grounds of breastfeeding. Babies can be breastfed anywhere and anytime. Your doorman should not have asked me to leave or move on the basis that I was breastfeeding. I should not have been sent to the toilet (aka family room). More information can be found here: https://www.breastfeeding.asn.au/bf-info/breastfeeding-and-law/legalright

I wasn't doing anything wrong and I was treated most unfairly by your staff member. I would like to know that your staff since this incident will receive proper training in the law, and how they should treat breastfeeding women. Perhaps you might even consider going one step further and becoming a Breastfeeding Welcome Here Venue with the Australian Breastfeeding Association: https://www.breastfeeding.asn.au/services/welcome

I look forward to hearing from you promptly regarding this matter, and I thank you once again for providing such a lovely conference venue. Kind regards,

Kelly Evans The Modern Doula

What to avoid when shopping for a maternity bra

Kelly Evans

How to choose a maternity bra One of the first things I noticed when I became pregnant was that my breasts were sore.

It wasn't long before I needed a new bra and as I found out there are a few things to look out for!

SIZE

You will probably find that you go through a few different bra sizes before your pregnancy and breastfeeding journey is over. So aim to get a maternity bra fitted for now, but know that you will probably need another few bra size upgrades (especially once your milk supply comes in). Now is not the time to make do with an ill-fitting bra - your breasts deserve the best.

NO UNDERWIRE? OR FLEXIWIRE?

It used to be that experts advised against wearing underwired bras. Now modern technology has design flexi-wire which is much safer for pregnancy/breastfeeding as it is more flexible.

The reason that the old style of underwire was not recommended was due to wire that digs into your breast tissue could harm the later development of your breast ducts causing blockages and very painful mastitis.

You can still get great support in wireless bras (even in larger sizes) so now the choice is yours.

DESIGN MATTERS

A few simple design flaws can ruin a comfortable bra. If you are looking at breastfeeding bras - always try out the release clips one handed. After all you will be holding a baby in the other hand.

Look for a wide band which can be more comfortable as it shouldn't dig in so much.

The more adjustable a bra is, the better it will continue to fit even as it gives with continued use and washing. There's nothing worse than a bra stretching and becoming too loose after a couple of washes.

BUY 2-3 BRAS

If you find a bra you really like - buy at least 2 of them so that you can alternate and wash. This is especially important after baby arrives as it is likely milk will leak and you will need to wash your bra more frequently.

START WITH A BREASTFEEDING BRA

Some people skip maternity bras (which don't have opening clasps) and go straight to a breastfeeding bra. That way they will have worn in and have a comfy bra all ready to go when baby arrives and they want that all important skin on skin.

The choice is up to you.

WHERE CAN I BUY A MATERNITY/BREASTFEEDING BRA?

Maternity/breastfeeding bras can feed found at:

 

Foods to avoid eating when pregnant

Kelly Evans

Being pregnant can make meal times tricky. It's hard enough for you as a pregnant woman to remember all the do's and dont's - but this is compounded when you need to eat out. So what are you meant to look out for - and what are the main foods to avoid and why? Here's a brief list!

Listeria

A rare but potentially severe illness caused by the Listeria monocytogenes bacteria.

Many pre-prepared or takeaway foods are considered high risk for Listeria, this occurs due to contamination with bacteria as part of the food preparation process and the bacteria continues to grow in the fridge.

Here are some of the most common foods to avoid when you are pregnant to avoid listeria (this list is not exhaustive):

  • pate
  • cold ready-to-eat chicken
  • manufactured ready-to-eat meats (including polony, ham and salami)
  • soft cheeses (including brie, camembert, fetta, ricotta)
  • pre-packed, pre-prepared or self-serve fruit or vegetable salads (this includes coleslaw, potato and other salads)
  • freshly squeezed fruit and vegetable juices
  • ready-to-eat cold, smoked or raw seafood, including smoked salmon, oysters, sashimi and cooked prawns
  • sushi
  • soft serve ice cream and thick shakes (you might want to check other iced drinks and milk shakes too)
  • tofu (both soft and hard types) and tempeh
  • unpasteurised milk and unpasteurised milk products
  • raw sprouts (including alfalfa, clover, radish, and mung bean). Bacteria can get into sprout seeds through cracks in the shell before the sprouts are grown. Once this occurs, these bacteria are nearly impossible to wash out. Sprouts grown in the home are also risky if eaten raw. Many outbreaks have been linked to contaminated seed. If pathogenic bacteria are present in or on the seed, they can grow to high levels during sprouting - even under clean conditions.

 

Methylmercury

Is a metal that can be found in certain fish which can be harmful to your unborn baby if you eat them. Mercury can reach the fish both through natural occurence as well as industrial pollution, which accumulates in our oceans. Bacteria in the water transforms the mercury chemically into methylmercury, which can be toxic.

Fish absorb methylmercury as they feed on other fish, however, larger fish that have lived longer have the highest levels of methylmercury because they've had more time to accumulate it. The following large fish pose the greatest risk to pregnant women who eat them regularly: 

  • Swordfish
  • Tilefish
  • King mackerel
  • Shark

It's okay to eat other cooked fish/seafood as long as you select a variety of other kinds while you're pregnant. You can eat up to 12 ounces (2 average meals) a week of a variety of fish and shellfish that are lower in mercury.

Five of the most commonly eaten fish that are low in mercury are:

  • shrimp
  • canned light tuna 
  • salmon 
  • pollock, and
  • catfish. 

Salmonella

A type of food poisoning caused by the salmonella bacterium found in the following foods TO AVOID (the following list is not exhaustive):

  • cake batter
  • raw cookie dough
  • raw eggs
  • raw or undercooked sprouts
  • undercooked eggs (cook until yolk is firm)
  • undercooked poultry and stuffing

Toxoplasmosis

Is another infection that can affect unborn babies. To reduce the risk thoroughly cook all meat, and ensure that salad and vegetables are thoroughly washed.

(Pregnant women should also avoid contact with cat faeces and should wear disposable gloves if handling cat litter. Hands should be washed after gardening or handling pets).

What are the symptoms of foodborne illness?

Symptoms vary, but in general, a person might get sick to their stomach, vomit, or have diarrhea. Sometimes foodborne illness is confused with the flu because the symptoms can be flu like with a fever, headache, and body aches.

What should I do if I suspect a foodborne illness?

If you are unwell contact your doctor, hospital or healthdirect Australia on 1800 022 222 (24 hours a day, seven days a week) as soon as possible.

 

Please note that this list is not exhaustive - but designed to give you a quick guide of foods to avoid when you are pregnant.

Sources:

Foods to avoid during pregnancy: http://www.foodsafety.gov/poisoning/risk/pregnant/chklist_pregnancy.html Listeria: http://www.public.health.wa.gov.au/2/402/2/listeria_infect.pm#A Methylmercury: http://www.fda.gov/Food/ResourcesForYou/HealthEducators/ucm083324.htm While you are pregnant - what is foodborne illness?: http://www.fda.gov/Food/ResourcesForYou/HealthEducators/ucm083316.htm

The post-baby conversation - the book you should read pre-baby

Kelly Evans

As part of my doula prenatal visits, I try to introduce discussions about the planned methods of parenting and who will do what. Most first time couples seem to dismiss the topic. I am sure that they believe they 'have it sorted'. What I find most interesting was recent conversations I had with friends, most of whom echoed the sentiments in the book 'The Post-Baby Conversation'.

This had me questioning why had none of us highly intelligent, strong, women had known enough (or been strong enough) to hold the 'post-baby conversation'. We clearly didn't 'have it sorted' yet!

Reading 'The post-baby conversation - What new parents need to say to each other' was a real memory jogger for me. It bought back painful memories of the period post-partum when I (like many other first time mothers) struggled with my new identity and my role in life.

Here are some excerpts from the book (for those of you with children already you may empathise):

'Motherhood strips us of our self-worth if we are not very careful and very strong... When we are not earning money and not engaging in the big wide world, when we spend our days feeling weary from the monotony of endless domesticity, it is hard to ask our 'hardworking' partner to give us a break, or to share the out of work tasks.

We become subservient beings, we make up excuses for our partner's lack of involvement, and we live with an unresolved fuzz about the privelege in our lives, on the one hand, and our demoted status on the other. If we don't value ourselves, we won't ask for equality.' (p14)

'What confronts many women post-baby is radically different from the dreamy picture of marital bliss and harmony we envisaged. First, the actual job is overwhelming. It is impossible to imagine, before you have a baby, how much work it will add to your life.

Second, our identity transforms - this can be more uncomfortable than giving birth. Becoming a mother means becoming a culturally infused icon..

Third, we lose our economic value and independence. That has a huge impact on most women. When we remember that the women's liberation movement has fought long and hard for women to be educated and to have the right to financial equality, it should come as no surprise that we feel demoted when we forego paid work.

Fourth, we lose our freedom - and discover the power of a basic human urge. We can now understand why wars have been fought for liberation.' (p19)

According to Osborne, 'most couples don't talk about who will do what post-baby, and as a result, most assume traditional roles. Kerrie James maintains that this model will ultimately lead to feelings of unfairness, and will cause the sense of inequality to rise dramatically.

The problem with the model that says he is financial provider and she looks after the house and kids is that his job is 40, 50, maybe 60 hours a week.

However, if it is the woman's responsibility to look after house and kids, she is on call 24 hours  a day. She can rarely have a sick day or a long lunch.' (p44) (that equates to 168 hours a week).

She goes on to suggest that to create equity 'couples actually write down all the tasks involved in looking after a baby... and all the household tasks, and then work out who will do what. Couples need to have a conversation about responsibility (being shared) and then a conversation about planning for how that will occur (who will do what, and when). (p 45)

She goes as far as to suggest that both parents work 9-5 and that childcare (including responsibility for everything child-related) be shared equally between both parents out of work hours.

Osborne states that 'The idea of having to re-fight the women's liberation war in your own living room is extremely confronting. Renegotiating your own status can be difficult, particularly if your partner does not take your concerns seriously...

The way out of this murky period is to find the strength to value ourselves and calmly ask for the things we need. While it is easy to blame men for doing very little, it's women themselves who need to change before a change will occur in men.' (pg 115)

I highly recommend this book - if you haven't seen it already (and particularly if you are planning for the birth of your first or even second child). Even if you have already had your baby, you may want to consider sharing this book with your partner. It's never too late to have the post-baby conversation.

You can buy this book online from here: http://www.amazon.com/gp/product/1877082783/ref=as_li_tf_il?ie=UTF8&camp=1789&creative=9325&creativeASIN=1877082783&linkCode=as2&tag=themoddou00-20  (affiliate link)

To receive your free Family Tasks Checklist (to supplement this book) click here

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/

Post-weaning energy slump!

Kelly Evans

The Modern Doula Post-weaning energy slump (not postpartum depression)

The post-weaning energy slump is how I describe feeling at the moment… I’m not the same me I have been for the past 2 and half years. My daughter recently weaned from me, due to reasons beyond my control and it's affecting me. I don’t have as much energy as usual, I am getting the odd headache, and huge muscle aches, and I just feel plain weird (I won't even go into how confused my breasts are)!

Yet when I Google 'weaning' all I seem to come across is articles linking weaning and post-partum depression. Thankfully I am not sad or depressed. But I am definitely feeling a dip in hormones making me not as sparkly as usual.

Google provided little relief so I decided to create my own prescription to feeling me again. I figure that part of the issue is the drop in Prolactin and oxytocin (breastfeeding hormones) post-weaning. Not much I can do about the Prolactin (short of having another child), so I have decided to work on upping my own oxytocin levels!

Having read numerous texts on oxytocin as well as attending Ancient postpartum tools and techniques for birth workers, I have decided on the following to help me ease myself out of weaning:

a) getting a massage (this is guaranteed to up the oxytocin levels)

b) getting together with some other Mums for some fun (getting a group together is another key)

c) taking some magnesium supplements (and taking it easy on myself while my muscles are still stiff and sore)

d) eating some chocolate! (just in case I need some extra magnesium - or so I tell myself lol).

I would love to hear from you - what have you done to ease the post-weaning energy slump>? Feel free to leave a comment on here or on Facebook!

 

F is for Feng Shui For Birth

Kelly Evans

This week we are looking at Feng Shui - in our A-Z of Birth & Early Parenting! You may have heard of Feng Shui - but did you know you can use Feng Shui at birth?

I recently attended a workshop with the lovely Faye Read of Feng Shui For Birth and I learnt some fascinating things!

FengShuiForBirth

 

I guess the important thing is to remember that whereever you are birthing, you need to create a Sacred Space and optimise your birthing environment.

Some simple ways to do this include:

  • Space clearing of the environment - to release any stuck energies that no longer serve us.
  • A physical declutter of the environment - this can be done even in a hospital room or birth suite.
  • Finding your position of power in the room
  • Minimising Electromagnetic Stress in the area
  • Placing a sign at the door to your birthing room

As your doula I can assist you to optimise your birthing environment by being a positive attendant and holding the space.

My doula kit includes tools like a Crystal Singing Bowl, Tibetan Tingsha Bells, Battery operated (hospital safe) tealight candles, Smudge Sticks and of course my support to help you clear the space/declutter the room.

If you want to learn more about Feng Shui for Birth , you can visit the Feng Shui For Birth website where you can download a free ebook 'Top 10 Feng Shui Tips for Birth'.

If you would like to get in touch, to see how I can help you with your birth, please contact me or call me on 0430 227 114.

E is for Elimination Communication

Kelly Evans

In our A-Z of Birth and Early Parenting E is for Elimination Communication.

What is Elimination Communication?

According to Sarah Buckley: 'Elimination Communication (EC)...is how most babies are brought up around the world. This ‘method’, which is so integral and so obvious in most cultures that it needs no name, involves the mother and baby becoming attuned and communicative so that the mother knows when the baby needs to eliminate- wee or poo.'

Baby_Elimination_Communication
Baby_Elimination_Communication

So basically by focussing on timing, signals, cueing, and intuition you learn to know when your baby wants to go to the toilet, and you take them to the toilet (and this can start from birth).

Why try Elimination Communication?

Not needing nappies most of the time is something I wish I had known about when my daughter was born! Imagine being so in tune with your baby that they can communicate with you when they need to go to the toilet... even before they can talk.

When you consider the environmental impact that each disposable nappy contains petroleum (a finite resource) amongst other materials, and that each used nappy goes to the rubbish dump - every disposable nappy not used can be appreciated.

According to ECSimplified:

Half the babies around the world are potty trained by 12 months (Pediatrics Magazine), yet in the United States, the average age is currently 3 years old (webMD)!

Of course there are disadvantages to using elimination communication. These include additional pressure at a time (especially for first time parents) when there is a lot to learn! There is always the potential to have too high expectations of yourself or your baby, and to be disappointed or even feel like a failure if you can't make it work. But attempted with the right mindset and being prepared to compromise and use nappies as often as required it can work for you.

I hope that this blog post inspires you to consider elimination communication as part of your post-partum planning.

photo credit: Kevin Conor Keller via photopincc

Birth Trauma is Real

Kelly Evans

Birth Trauma is Real

Birth Trauma is Real. As I sat the other day, scrolling through my Facebook Newsfeed, I came across this post from Yoni Love - Dana Laggett (pictured above). I was instantly glued. I clicked on Continue Reading, but then someone in the room was demanding my attention... but I didn't want to stop reading. Dana so succinctly put into words what so many women feel.

Her metaphor of birth trauma as like a tumor on her chest resonated with me.

Mama suddenly yelled “DON’T” or “NO” – I can’t remember which – and my heart started thumping quickly as I watched that disembodied glove continue its manipulation.

Suddenly all of the times that I had said no, and had it fall on deaf ears -all of the times that I had said “No” or “Don’t” rose from my chest to my throat and I choked on the words. My heart turned over with sickening thump.

Tears dripped onto the blanket that I clutched tightly around me as I waited for some sort of justice; surely it would be brought up in the recollection of this woman’s birth. This “birth assistant” would be spoken to, embarrassed; it would be acknowledged that both woman and infant had been violated – this would be part of the film.

But it wasn’t. And Mama felt good about her birth. There she was, a few weeks later, cheeks rosy and smile wide and honest. Her baby was bundled in her arms, perhaps breastfeeding, or simply being rocked and comforted. She told her birth story, but that word – “NO” – was left out somehow.

Her post about birth trauma is one of the reasons that I became a doula. I am pleased to say that personally I have never witnessed this happening at any birth that I have attended as a doula. It would be nice to think that I could keep my head in a bubble, and pretend that it wasn't happening in Western Australia but I know differently.

I know because sadly these events are still happening today (I hear new stories all the time - as women I talk to make a point of telling me), and yet we still don't feel like we can speak up about them in public.

I know because it happened to me. I will never forget my own birth screaming 'No' and being told

'That's right let it all out'.

Well I am speaking up! It is time that as women we reclaimed our rights. The right to birth where we feel safe! The right to be supported by safe (and qualified) caregivers! The right to have our sacred space protected (not invaded)! The right to be listened to (and heard)... The right to say No!

In the words of Dana:

'We need to stop closing our mouths and ears against these words and take back our births, for the sake of the memory of our bodies and those of our children and of their children and theirs.'

Please do take the time to read Dana's story, and if Birth Trauma is something that is affecting you - you can always call:

From the Heart WA's Helpline  - 1300 726 306 (6:00am – 4:00pm WA time, Mon-Fri) or
Lifeline - 131 114 (24 hours a day, 7 days a week),
"HELD" Supporting Families after their birth experiences http://www.birthtraumaaustralia.com/
or you can read more on Sheila Kitzinger's website or the Solace For Mothers website.

Prevention And Treatment Of Traumatic Childbirth: http://pattch.org/resource-guide/traumatic-births-and-ptsd-definition-and-statistics/

If you are planning a child or pregnant, please consider having a doula present at your birth, please contact me.

D is for Doula: The Essential Ingredient

Kelly Evans

Many people I meet often ask me 'So what is a doula and what does a doula do!' I try to keep it to a few sentences and I often say that a doula supports pregnant couples during labour and postpartum. However there is so much more to what doulas do.

DOULAS IN HISTORY

Throughout history, women have always been depicted as supporting birthing women. It is interesting to note the birthing process moving to a hospital setting and being watched over by (commonly male) doctors, is a fairly recent trend in history (in the last century).

 

WHY USE A DOULA

If you have read my story, you would know that one of the organisations I have trained with is DONA International. According to DONA:  'Numerous clinical studies have found that a doula’s presence at birth:

  • tends to result in shorter labors with fewer complications
  • reduces negative feelings about one’s childbirth experience
  • reduces the need for pitocin (a labour-inducing drug), forceps or vacuum extraction
  • reduces the requests for pain medication and epidurals, as well as the incidence of cesareans'

So you can see why there is a growing trend towards using a doula for labour support.

DOULA: THE ESSENTIAL INGREDIENT

DONA International have made this short video about Doulas called 'Doula: The Essential Ingredient' which talks about the origin and rationale of doula support:

If you have any questions about the services I provide, I would love to hear from you (you can message me on my Contact page).

Good on you James and Kimberley Van Der Beek!

Kelly Evans

Who's choice is it anyway? This was the question that came to my mind, after reading this article: James Van Der Beek’s Wife’s Scary Home Birth Wasn’t Worth the Risk (yes I was a Dawsons Creek fan and that's what caught my eye initially).

In today's world everyone seems to have an opinion of everything a pregnant Mum is supposed to do:

Eat this!

Don't eat that!

Sport is dangerous!

What annoyed me about this article is that here is a woman who instead of congratulating Kimberley (for the amazing feat that she performed especially in modern society) is busy questioning whether she should have the right to choose to birth where she wants.

I think it's time women starting working together, to support each others birth choices. According to Freedom for Birth:

"In many countries around the world, women are being denied the most basic human right of autonomy over their own bodies. They cannot choose how and where to give birth. Those that persist in their desire to have a normal, physiological birth are sometimes forced by judges to surrender to surgery or threatened with having their babies taken away by child welfare services.

In many countries, if a woman wants to have a home birth supported by a midwife, those midwives face criminal prosecution. Some midwives, like Ágnes Geréb in Hungary, are even imprisoned. Freedom for Birth calls for radical reform to the world’s maternity systems so that these Human Rights violations stop and women are afforded real choice as to how and where they give birth."

If you missed out on seeing Freedom for Birth, the free web version will be available in a week or so here: http://www.oneworldbirth.net/

As for Kimberley I loved what she had to say after her breech birth helped by a supportive Doctor (and I couldn't have said it better):

"I truly believe a woman should be able to plan to birth where and how she is most comfortable. In order to make such a decision, it’s crucial to have options."

As your doula I believe that this is your birth and it's your choice, and there should always be options...

Love Kelly

PS: Do you agree?

 

C is for Caesarean Birth

Kelly Evans

Perth is Australia's Caesarean Birth capital

According to The West today.

Not that there's anything wrong with that - if it's your informed choice - or it's medically necessarily.

The fact that the Western Australian Health Department has released WA Hospital Caesarean rates is to be commended. It's the first step into transparency around what you can expect at particular hospitals. However,

'The World Health Organization recommends that the caesarean section rate should not be higher than 10% to 15%'

(source World Health Organization. Appropriate technology for birth. Lancet 1985; 2: 436-7)

So the question remains, why are all these women giving birth this way. Are they all making informed choices?

rowan.simpson  Free Photos

 Research has found that there are risks of caesarean birth. According to the Coalition for Improving Maternity Services,

Risks of caesarean birth include:

  • Accidental surgical cuts to internal organs
  • Major infection
  • Emergency hysterectomy (because of uncontrollable bleeding)
  • Complications from anesthesia
  • Deep venous clots that can travel to the lungs (pulmonary embolism) and brain (stroke)Admission to intensive care

Potential Harms to Maternal Attachment and Breastfeeding

  • Women who have unplanned caesareans are more likely to have difficulties forming an attachment to their babies
  • Women who have caesareans are less likely to have their infants with them skin-to-skin (cradled naked against their bare chest) after the delivery. Babies who have skin-to-skin contact interact more with their mothers, stay warmer, and cry less. When skin-to-skin, babies are more likely to be breastfed early and well, and to be breastfed for longer. They may also be more likely to have a good early relationship with their mothers, but the evidence for this is not as strong.
  • Women are less likely to breastfeed.

So if you are planning a pregnancy, or you are pregnant -  educate yourself as best as you can about your care providers (including hospitals).

A good doula should be able to provide you with evidence-based information on your local options so that you can make truly informed decisions. They should also be able to prepare you and your partner for what happens when a Caesarean Birth is necessary - so that you feel fully prepared.

Working with a doula, you can tailor your birth plan, so that if a caesarean birth is necessary - you can still achieve some of your preferences such as choice of pain-relief drugs, immediate skin-to-skin with your baby, and so on. Having a doula can also help you create a home environment to promote bonding and breastfeeding post-partum.

If you have already had a caesarean birth, then you might want to consider contacting an organisation such as Birthrites, where you can meet other ladies who have had caesarean births, attend month get-togethers and give and receive support.

If you would like to discuss your pregnancy and birth choices, and whether or not a doula can help you achieve the birth of your dreams, please Contact me.

B is for Baby Wearing

Kelly Evans

B is for Baby Wearing in our A-Z of Birth and Early Parenting. Baby wearing is one of the principles of attachment parenting.

What is baby wearing?

Baby wearing is using a wrap, carrier or sling to carry your baby around.

Why wear your baby?

Benefits of baby wearing include:

  • Babys who are carried cry less - babies who are carried cry on average 43% less than those that are not 1 Happier babies equates to happier parents :)
  • Baby wearing means more sleep for the baby, which means more sleep for the parents (here's the hint = sleep while your baby sleeps if you can Mums and Dads)
  • Babies who are carried are more portable (it is easier to go to many places without the size restriction of a pram)! It also means you can take baby whatever the terrain.
  • Mums who wear their babies are able to do more - baby wearing gives them a free hand to cook, hang out washing - the only thing you can't do is have a shower! (you can get slings that are suitable for swimming though that tends to wake the baby).

Which wrap, sling or carrier should I get?

Often parents will buy or be given a wrap, carrier or sling before the baby is born. My personal suggestion is that you wait until after baby is born. All babies and parents are different - and it's funny how much the personality and likes and dislikes of the baby can affect the right choice for you both.

As a guide as soft, stretchy wrap like a Hug A Bub is great for a newborn (when often they are too small to safely fit into a structured carrier. After that a structured carrier like an Ergo, Manducca or Tula are all popular brands.

Where can I buy a wrap, sling or carrier?

There are a number of retailers wherever you are that sell endless varieties, styles and brands. The important thing at the moment is to ensure that it is not going cause hip displaysia or hip dislocation (the baby's hip coming out of its socket). Don't be fooled into thinking that just because it is for sale - it is safe.

The following diagram is from the International Hip Displaysia Institute and it explains quite well what to avoid.

HipDysplaysiaPreventionTheModernDoula
HipDysplaysiaPreventionTheModernDoula

Local to Perth, Karri Tree Lane sells a variety of wraps, carriers and slings (including rings to make your own slings).

Of course baby wearing is a part of The Modern Doula's pre-natal education (and is included with all birth and postpartum doula packages).

To enquire about having a doula at your birth or postpartum, please contact me.

(1) Hunziker UA, Barr RG.1986. “Increased carrying reduces infant crying: A randomised controlled trial.” Pediatrics 77:641-648 and Dr. Eckhard Bonnet (specialist in paediatrics, youth medicine, environmental medicine and sports medicine). 1998. Krankengymnastik 50 Jg No.8.

A is for Attachment Parenting

Kelly Evans

In our A-Z of Birth and early parenting - A is for Attachment Parenting. As a birth doula I consider it of vital importance to consider your parenting style early (preferably before your first is born). Many parents are surprised by this as often the topics of importance are taking leave, from work, baby showers, and parental leave/baby bonus. Some parents have been having conversations around the subject of parenting already. How you were parented affects your views on parenting.

Do you want to parent as your parents did?

Are you determined to be nothing like your parents?

If so do you have a vision for how this will look?

Do you have a plan or a framework for achieving this (particularly if you are planning to be different to your own parents)?

October is attachment parenting month

Personally and having studied with DONA International - I am a huge fan of the attachment parenting style as a parenting tool (note as a tool not a discipline).

The seven principles of attachment parenting are (thanks to Dr Sears):

  1. Birth bonding
  2. Breastfeeding
  3. Babywearing
  4. Bedding close to baby
  5. Belief in the language value of your baby's cry
  6. Beware of baby trainers
  7. Balance

If your current pregnancy planning ends at birth, then maybe it's time to have a chat with me - and start your post-partum planning.

The reality is that birth lasts for a few days, but parenting lasts for a lifetime! The time to set up a good foundation, in agreement with your partner is now!

Having a Soundbirth

Kelly Evans

I spent yesterday doing Soundbirth training with the lovely Nicole LLoyd. It was a fascinating day with a beautiful bunch of women. It was also a great reminder of the work that we do as doulas, and that in our society we have been conditioned to feel that we need permission to speak (much less sing, or tone). Some of us have been told, (some since we were children) that good kids are seen but not heard. In school you need to raise your hand and obtain permission before you speak, and so on.

So how is it that birthing Mum's are supposed to somehow have the knowledge and the confidence to make possibly the loudest noises of their life (well for some anyway) without someone there showing them the way!

This is where doulas come in! Having a Soundbirth trained doula - apart from the obvious support, information, advocacy and mediation - is having someone there in the birthing room with you - giving you full permission to get loud (and joining in so you don't feel alone or embarrassed). We can also encourage your partner to join in and get loud (if they want to).

How much easier is it to get loud in a group of loud people! Opening the throat is the key to opening your cervix (in fact they are made of the same tissue).

Contact me today if you would like to find out more about using sound at your birth.

The A-Z of Demystifying Birth and Early Parenting

Kelly Evans

Debunking fears and demystifying birth in Perth WA
Debunking fears and demystifying birth in Perth WA

Hi and welcome to my blog :)

Part of the fear that surrounds childbirth and early parenting is around the unknown.

When a women is pregnant both she and her partner are suddenly introduced to a new world of jargon, medical terminology and symbolism that she most likely has never heard of before.

As a DONA-trained doula - it is my role to provide evidence-based information so that parents and parents-to-be can make informed decisions.

Hence my A-Z of Demystifying birth and early parenting which starts next week. If you would like to read more, click on the Follow button below right to be notified of future blog posts!

If you have any special terms you would like demystified please contact me kelly (at) the moderndoula.com.au

xx Kelly