Fearless birth!

I consider myself to be a well experienced doula having supported almost 100 births here in NI.  These have all been different births, ranging from very medicalised caesarean births in theatre, to unassisted home births, and everything else in between!

It came as no surprise when I was contacted by a young mum who was moving to the province to be with her partner, saying she was pregnant and looking for the support of a doula.  She mentioned she was looking into home birthing her first baby, and I sent her some information on the maternity services available in NI together with regional guidelines on home birth.  We exchanged a few messages and emails, and arranged to meet up for a casual chat and cuppa when she arrived.

As soon as I met this couple, I was mesmerised by their confidence and trust in each other, to choose the birthing path that was right for them.  Their plan to home birth was actually unassisted, wild, freebirth.  This means that they chose not to have any antenatal care, nor have any midwives present at the birth. I have to say I absolutely loved their matter-of-fact attitude that birth is such a natural event, and something they had considered for a while and would do together to bring their precious wee baby into the world.  It’s not for everyone, but I knew I wanted to be their doula and share in their innate knowledge and wisdom, and their faith in Mother Nature that everything would be as it should. 

To say I was delighted when they hired me is an understatement!  They said they chose me as they wanted to have an experienced doula, and a mother figure to be with them on their birthing journey, as they didn’t have any family close by. I was flattered.  We made such a great team and it felt like all the jigsaw pieces fitted together!  I could easily tell by our conversations that they had thoroughly done their research to make informed decisions.  This was important to me as their doula, as they were choosing to birth outside of guidelines. As a Doula UK doula, there are guidelines on supporting unassisted birth, which I shared with them so they knew exactly my role as their doula.

Mum was well into her pregnancy when we first met, around 7 months, and they also decided to do a full HypnoBirthing course with me as well.  This gave us lots of opportunity to get to know each other and build up a strong, trusting connection.  When I was with them, I could feel their enthusiasm and their wisdom each over me. I felt as if I was bursting with excitement and fully invested in their choices.  However, as a doula, I do hear of some births not going to plan and sometimes a teeny bit of fear would creep over me.  I devoured videos on breech birth, looked into evidence based information on shoulder dystocia, meconium and postpartum bleeding. But all I had to do to regain my full confidence once again was to be with this beautiful couple. They had such a connection with their unborn baby, that I could hardly wait for the birth!

I did highlight to them that sometimes problems arose around registering the birth if there were no midwives present at the actual birth, and if mum had not seen a GP or midwife antenatally.  We did some research, and coincidentally I was also researching this topic via AIMS helpline, specifically around the process here in NI.  I suggested that they inform the Head of Midwifery in their local Trust of their intention to freebirth, and from that we had a lovely zoom call with the deputy Head of Midwifery, where mum lovingly showed off her bump!

They made it clear that it wasn’t worthwhile talking about what if things went wrong, as they didn’t want to bring any fear into their space to disturb their trust and belief in physiological birth.  They did tell me they would appreciate my knowledge and experience if they thought they needed to call an ambulance, and I was content with that.

When the time came for baby to begin their birthing journey, mum texted me early in the morning to say that today was the day.   When I look back, I have to be honest and say that from that moment on, I never once thought about anything going wrong with the birth, it was just pure joy and excitement.  I spent the day with them as they progressed through the trials and tribulations of early labour, and having a spa day in the pool!  Mum was so intuitive, letting us know what was happening to her body and to her baby during the whole birthing journey. We celebrated every hallmark along the way, ate and drank tea, and read HypnoBirthing scripts. I took loads of photos on mum’s phone as she had requested, and remained a steady presence offering gentle reassurance.  

In the evening they were both tired and I knew they needed some time on their own to try and get some rest, so I suggested that I go home, knowing they could call me back at any time.  I left around 8.30pm saying that I would hear from them during the night.

Sure enough, dad called me at 4am to return to their home.  Mum was well into the rhythm of labour and was finding it really difficult to get comfortable.  She had been spending a lot of time finding solace in her little bathroom, but she really wanted to rest. So we got the pool ready (again!) and mum made herself as comfortable as she could, resting her head over the edge of the pool for a couple of hours whilst dad had a sleep on the nest he had made on the kitchen floor. 

Just before mum decided to get out of the pool to go to the toilet, she thought she felt her waters going.  So I emptied the pool while mum  laboured on the toilet and on the kitchen floor with dad holding her.  Mum was becoming more vocal and her breathing was starting to change and I instinctively knew her baby was moving down into her pelvis.  I stayed out of the way, discreetly taking photos, quietly whispering reassuring words and relishing the  true beauty of their undisturbed, instinctive,  physiological birth. Once the pool was ready again, mum got back in and within a couple of hours, she gently and calmly birthed her baby in the water at 12.30pm – a healthy bonny boy! Dad had held mum, showered her with his strength and confidence in her ability to birth their baby. I managed to catch it all on video for them to watch later. We could see the moulding of baby’s head as mum and baby had worked together for hours to birth when the time was just right. The placenta easily came away just 14 minutes after the birth.  It was such an emotional journey and I got to witness the pure strength and belief in this wonderful couple! 

The new wee family of 3 moved into the bathroom, so mum could relax with her baby in a lovely warm bath.  I left them on their own so I could start tidying up, and they took time to gaze at their new son and enjoy the golden hour together.  A wee while later, they said they were happy for me to head on home as they were all feeling good.  They knew to keep an eye on mum’s bleeding, and baby’s feeding, and were intending to head to bed together for some well-earned rest, once they had done the burning of the cord ceremony.

This wild, freebirth was like a massive breath of fresh air for me, amidst a crippled maternity system of increasing medicalised births which are robbing families of pure raw physiological birthing experiences. I know I want more of this awesome couple in my life!

Pregnancy Massage

If there’s one thing I love about being a doula, is meeting and working alongside other birth professionals, such as midwives, doulas, pregnancy yogis, aromatherapists, reflexologists, chiropractors, masseurs, doctors, breastfeeding consultants, physios, fitness gurus, and so on. There is so much support out there for pregnant mums and pregnant people in our community, but sometimes it’s difficult to find the help or support you need. This is why networking is so important.

I’ve been very lucky to meet some pretty amazing people since I’ve become a doula, and I feel very grateful to know so many professionals to signpost my clients to if needed.

One of my favourite contacts is midwife Nicole Schlogel, who runs her own aromatherapy for pregnancy and baby positioning clinic in Lisburn, including a vegan pregnancy coaching program. Many of my clients benefit enormously from a pregnancy massage in the last semester, not only for relaxation purposes but potentially for making more room in the pelvis to help baby get into optimal position for birth. So I was absolutely delighted to receive a Happy New Year message from Nicole, also gifting me a ‘pregnancy massage’, just so I know what my clients are enjoying, when I signpost them her way! The massage was truly blissful, and Nicole used aromatherapy to set the scene, and even gave me the wee bottle of oil she used for the massage. She really has magic hands, so soft and wise, knowing exactly what spot needs that wee bit more of attention. I loved my pregnancy massage, even though I’m not pregnant! I felt totally spoilt and extremely relaxed, and isn’t that just what most pregnant mummies and people want to feel as they prepare to meet their precious wee baba! I certainly will continue to thoroughly recommend Nicole, and if you don’t believe me, I suggest you give it a go!

Find out more about Nicole and her practice at https://www.thepregnantvegan.com/

Becoming a doula: my story

Anne trained as a doula with Nurturing Birth in June 2015. Since then, she’s been a full time doula based in Northern Ireland.

Are you primarily a birth or postnatal doula? 

I love doing both birth and postnatal doulaing, but the demand seems to be primarily for birth doulas here in Northern Ireland. We’re working on that!

When did you first hear about doulas?

About 10 years ago, I was living in Eastern Europe and whileI was there I came across an article about doulas in a women’s magazine. It seemed so idyllic and made so much sense to have someone you could trust to guide and reassure new parents throughout pregnancy, birth and the early days with a newborn.  I decided that it’s what I would like to do when I returned to Northern Ireland, or when I retire.  I would have loved to have had a doula at my births and postnatally, but unfortunately I didn’t know about them 30 years ago!

What were you doing before you trained as a doula?

I had been living overseas for almost 30 years and was looking forward to returning home. My 3 children are all grown up and whilst I had done various jobs whilst travelling, I now felt that it was my time to do something on my terms, something that I felt passionate about. I’ve always worked or volunteered in the social care sector, and in fact was a family support volunteer with a local charity, https://www.tinylife.org.uk/ when I was doing the Nurturing Birth doula training. My working career spanned from the bank, administration in public and private hospitals and international schools overseas, childminding, disability development management, support work at homeless drop in centre and eventually to the best job in the world – being a doula!

Had you been at any births before training to be a doula?

Yes, I supported my sister at her second birth many years ago and was completely blown away to see my niece enter this world, especially as the midwives had already left the room when her wee head started to crown. I felt very fortunate to get a glimpse of a natural birth, with baby deciding when it was the right time to be born. As a result of that experience I looked into training as a midwife but then we moved to live overseas for almost 30 years… I’m a firm believer in everything happening for a reason and I now know that I was never meant to be a midwife.

What made you decide to train as a doula?

We were planning to return to UK to live and after having done various jobs for many years, due to moving around, I decided to look again at training to be a midwife. I sought advice from a midwife friend who was a senior lecturer in midwifery, about doing the degree, and we also talked about doula training.  

There were not many doulas in Northern Ireland, and as I love a challenge I decided to do the doula training first and then see if I should look more into the midwifery degree. However, the more I delved into being a doula and looked at the various training courses, the more I could relate to becoming a doula rather than a midwife. Honestly, as soon as I commenced the Nurturing Birth doula training, I felt like I’d found my true calling! I just wished I had discovered this path earlier in my life.

I’ve always been fascinated by birth and babies, loving the mystery and magic that surrounds this life-changing event.  It would have been pure bliss to have had a doula at my births, especially my first when I laboured most of the time on my own.  I can also appreciate the need for postnatal support for various reasons, but especially if the family don’t have any other support at all with a newborn.  I came away from that course full of enthusiasm for birth, feeling that everyone should know what we were taught at the course.  After all, birth is such an important and exciting life-changing event in most people’s lives.  

What do you love most about being a doula? 

So many things!

It’s the best job ever! 

I’ve always been a ‘people person’ and thrive on caring for others. Being a doula takes this to another level.  I love meeting new families, taking time to get to know them and growing our relationship together. It really feels amazing when a family I’ve been supporting is confident and knowledgeable about labour and birth, and the fire lights in my belly when they make informed decisions about their own birthing journey.  It sounds very clichéd, but it really is an honour to be with a family as they prepare to meet their precious wee baby, to support their pregnancy journey, and then to be with them throughout labour and birth.  There’s nothing quite like it in the world, witnessing the birth of a baby!    There is laughter, joy and tears, all surrounded by excitement and anticipation.

My beautiful granny is my inspiration.  She was in her 30s before she had the first of 6 children, including a first breech birth followed by a premature birth, all born at home and all breastfed until 9 months old.  She also supported other labouring mummies in her neighbourhood, because that’s what women did in those days, until the doctor arrived! A doula before her time!

What do you find challenging about being a doula?

There are a couple of things that I personally find challenging being a doula. It’s tough sometimes to say goodbye to families, especially when you became a part of their precious pregnancy and birthing journey. But supporting families to feel empowered and confident is all part of my role, so saying goodbye is also a sign of success – so I keep telling myself!

The other thing that I find really challenging is the lack of knowledge and awareness there is generally on what a doula’s role is, not only in society but also in the maternity services. This is something I’ve been working on for the past 6 years, trying to raise awareness about doulas.  Since the pandemic it has really become even more evident that our role is misunderstood, and our importance to our client has been underestimated. It is vital for everyone who is managing maternity services to remember that it’s the woman or birthing person’s choice to have a doula, and therefore we are an essential part of their birth team.

What do you want from the future/where do you see doulaing taking you?

A couple of years ago I started a podcast (Let’s doula it!) to raise awareness about doulaing in NI, which has proved to be a great success!  So, I will continue will that. I’m also a founder of the first doula collective in NI (https://www.doulasni.co.uk/) and I absolutely love working with other like-minded doulas! We are able to combine our expertise and specialities to offer a wide, specialised service tailored to the individual family’s requirements.  There has never been a better reason to work together since the pandemic! Doulas need doulas!

I’m also actively involved with Doula UK. I cherish supporting other doulas and seeing them blossom into amazing professionals.  

In the future I’d love to see doulas recognised as much more than birth partners, as a vital part of the woman’s or birthing person’s birthing team. I really enjoy building relationships with midwives and obstetricians, demonstrating how we complement each other and provide families with the care and respect they deserve. 

I know I’m very lucky to have found my calling, and to be able to go where life leads me on this amazing doula journey!

Is there anything else you’d like to add?

Just in case I never have enough to do, I also volunteer for AIMS on the campaigns team! I feel that to campaign for any improvement to maternity services is always worthwhile 🙂


Anne Glover’s Nurturing Birth Directory Entry is here: https://nurturingbirthdirectory.com/doulas/united-kingdom/county-antrim/belfast/anne-glover/

Anne’s email: anne@motherdoula.com

Anne’s Doula Group website: https://www.doulasni.co.uk/

Instagram: annehypnodoula

Instagram: doulasni

Facebook: Doula Anne Glover (https://www.facebook.com/doulaanneg)

Facebook: HypnoBirthing Anne Glover (https://www.facebook.com/HypnoBirthingAnneGloverNI)

HIV+ birth and breastfeeding

A few years ago I was a doula for a young mum who had expressed a great desire to breastfeed her second child, something she was denied with her first child based solely on the grounds that she was HIV+. Here in Northern Ireland, doctors consider the risks of HIV+ and breastfeeding to exceed the risks of formula feeding. The stance remains that considering we live in a developed country and there is access to safe water and sterilisers, the policy is that HIV+ mothers should be advised to formula feed as it eliminates all risk to the child. Breastfeeding was signed off as contraindicated in this mum’s maternity notes!

I’d like to share some recent revolutionary and ground breaking progress regarding HIV+ mothers and successful breastfeeding in Northern Ireland.

The key issues were to present the most recent research and evidence regarding HIV and  breastfeeding, so we could confidently approach the local medical team to request their support and guidance for this particular HIV+ mum to successfully breastfeed with no risk to her baby.

HIV Facts and Pregnancy and Breastfeeding

Obviously the main risk is the transmission of HIV from mother to baby. This can be by vertical transmission from mother to baby if the baby comes into contact with mum’s blood or bodily fluids, and through breastfeeding.  The biggest risk for vertical transmission is the mother’s viral load – a measure of how much HIV is in the blood. Anti-retro viral therapy (ART) is taken to reduce the viral load to ‘undetectable’, giving a risk factor of zero. HIV is present in breast milk just like the viral load in blood.  The risk of infection is there because the virus in the milk could pass through the lining of the baby’s stomach. Therefore if a HIV+ mother chooses to breastfeed, breastfeeding has to be exclusive up to 6 months old. If anything else passes the baby’s lips it threatens the impermeability of the gut wall and increases the chances of the virus passing into the bloodstream.

In this particular case, mum’s personal circumstances consider her to be ‘low risk’ mainly due to a consistently undetectable viral load for many years. 

Progress

My first point of contact was Maddie McMahon, who was able to signpost us directly to Pamela Morrison, a specialist in HIV and breastfeeding.  Maddie and fellow Doula UK members also signposted me to the various weblinks as shown at the end of this blog, which proved invaluable. I continued with my research into HIV, and started to read the many articles and links from Pamela.  What a steep learning curve, but utterly fascinating!

Meanwhile mum culminated all the latest information, research and evidence from Pamela, which she needed to discuss with her midwifery team, obstetrician, paediatrician and specialist GUM consultant. She also finalised a birth plan which detailed clearly her wishes and plans for this birth, which she shared with her medical team. We both knew it was going to be hard work and a bit of a struggle, but the medics soon realised mum was serious and committed in her desire to breastfeed.

What made a difference

  1. Mum had been HIV+ for more than 10 years with no risk factors, and was meticulous with her medication.   She never missed a single appointment, and was on the same combination ART (anti-retro viral therapy) for years, achieving a consistently undetectable VL (viral load) long before and during pregnancy.
  2. Lab agreed to turn round any of mum’s VL tests within 3 days instead of 3 weeks to support the level of monitoring requested by her medical team – without this support the GUM specialist probably would not have agreed to oversee breastfeeding at all.
  3. Having the most up to date research and evidence on HIV+ and breastfeeding to enable a full discussion with the medical team early on in the pregnancy.
  4. Addressing breastfeeding issues, potential problems and preventive measures, and being equipped with knowledge on mastitis, sore/bleeding nipples, home pasteurisation. Awareness of local support, eg hospital grade pump,  breastfeeding counsellor, health visitors.
  5. GUM specialist can over rule other HCPs.  Luckily this mum’s GUM specialist had 4 EBF babies of his own although he could not support breastfeeding as a matter of course.  The interpretation of the BHIVA guidance led him to conclude that formula feeding remains the first choice feeding option for HIV+ women in NI under his care, for clinical and ethical reasons.   However he wrote a letter of instruction to all the medical teams involved after taking time to seek appropriate professional advice from another specialist consultant in London. He explained that he had to take a very detailed look at into patient history covering all clinical aspects, including routine test results, allergic reactions, toxicity, resistance to drugs, compliance, responsibility, attendance to clinic and existing knowledge and expectation of HIV+ and breastfeeding. GUM specialist and Paediatrician met to discuss all options and made a decision on the best course of action.

Result!

✔Obstetrician wrote in the maternity notes that mum wished to have a water birth and breastfeed, including that she had researched feeding in depth.

✔Paediatrician wrote in her maternity notes that mum wishes to breastfeed and he supports her decision (massive step plus a humongous success for mum).

✔GUM specialist took time to seek professional advice from another specialist consultant in London.

✔ Health visitor reassured mum that they would be looking out for her and would support her and help with technique to ensure optimal latch.

✔ Midwifery team assessed the birthing pool and deemed it safe for water birth without concern of cross infection.

✔NI revolutionary and groundbreaking for HIV + mothers. One of the first HIV+ mum to successfully breastfeed in NI.

✔It has forced the local maternity hospital to produce their own guidance on HIV+ and breastfeeding for the first time.

✔Mum has completed feedback for her paediatrician regarding his practice and he has mentioned that this journey will be the foundations of protocol for future breastfeeding

Supporting a triplet birth

Well, can you imagine the excitement of receiving an enquiry to be a birth doula to triplets! Of course I contacted the mum straight away for a chat and to arrange an informal visit. Then reality hit! I knew that having another doula on board would be a great asset – so many babies and not enough hands… I called the mum again to chat about having another doula and she was interested. So then I contacted my colleague, Sara Benetti to ask if she was interested and really I knew it would be a no-brainer! Sara has experience of twins natural birth and I just knew she was the perfect partner as we often work together offering shared care and back up for each other. So Sara and I met with the parents of the triplets and we were hired by the end of our visit!

We had a great first antenatal meeting with the parents, discovering how the triplets were a huge surprise for the family. It was not an assisted (IVF) pregnancy and the odds of naturally conceiving triplets are in the region of one to few millions; additionally only one out of 6,000 to 8,000 triplet pregnancies is spontaneous.
We were so excited especially as the parents were planning a natural birth for their babies, possibly in water. We supported them by talking through their options, their birth plan, negotiation around mum’s care and what they were and were not willing to accept in terms of interventions. As soon as we left the meeting, we drew up an on-call rota as mum was nearly 30 weeks and 35 weeks is considered full term for triplets. This worked well for everyone involved as both Sara and I had some holidays booked, but it also gave mum and dad peace of mind that at least one of us would be around if the babies decided to make an early appearance.

However it all worked out so well in the end. Even though the parents were very keen for a natural birth, at the same time they were fine with a highly monitored pregnancy and agreed to induction as soon as there were signs that one of the identical twins was not growing as much as the other. Both Sara and I were available when mum went into hospital at 35+2 for ARM to get labour started. Labour progressed quite quickly and twin 1 swam into this world at tea time, followed half an hour later by twin 2 on dry land and breech. Half an hour later baby 3 burst into this world, again breech. All babies were fit and healthy and paediatrics who were standing outside the door, were stood down. Having 2 doulas was a dream, as when the babies were born and placed with dad for skin to skin, one doula remained with mum for reassurance, and the other doula supported dad and took some videos and photos.

It really was one of the most incredible experiences of all of our lives, including the consultant and midwives, especially mum and dad, and of course for Sara and myself. Full credit to mum, who really is an amazing goddess, a very quiet labourer who likes to be left alone! It was amazing to see the identical twins being born, followed by the biggest baby, all fraternal.

We kept in contact with mum during her stay in hospital and visited her when she returned home. Luckily I was able to continue to support the family on a weekly basis as a Family Support Volunteer with a local charity, Tinylife (until the covid-19 pandemic).

Parents: “Having the support of doulas for a multiples pregnancy was very important to us as we strove to have a natural birth with minimal interventions.”

A wee postnote to say it was not all was smooth sailing… some of the hospital staff were not overly keen on two doulas being present, but we did our homework and contacted the Head of Delivery Suite ahead of time, for reassurance that our presence would be acceptable.

Pinch me!

It’s three years since I began this amazing doula journey, and 35 births later plus supporting an additional 6 families postnatally, I am still in awe of the magic of birth and how the presence of a tiny wee baby can affect each and every one of us.  No matter how much preparation goes into coping with pregnancy, labour, birth and bringing baby home, I still see the jubilation and nervous mixture of raw emotion when baby meets mummy and daddy in those early days. I love it!  I feel so very privileged to offer support at this precious, intimate, life-changing event and I will never tire of doing so.

And this leads me on to why I have had my head in the clouds this past weekend.  I humbly received an award for ‘Doula of Distinction’ at the NI Positive Birth Conference in Belfast amidst many of my birthing heros.  Check it out! Not only the headline presenters, but so many strong, fierce mummies together with health professionals and volunteers all endeavouring to improve the perinatal experience for families in Northern Ireland. Wow! It was truly amazing, inspirational, emotional, raw – a bit like birth really.

Playing the waiting game..

One of the many lovely things about being a doula is waiting on receiving a call or text from your client to say she thinks she might be in labour.  Sometimes it’s completely out of the blue when baby decides to make an early arrival, or usually it’s when mum has gone past her guess date and she is beginning to think that baby will never come!  I completely empathise with the parents once mum reaches the magical ‘guess date’, and then one day passes, another day and perhaps even a week….or two!  It can feel overwhelming as the family try to be patient and chilled, but really they are so excited at the prospect of meeting their wee baby that it’s difficult to keep emotions under control.  Seriously, how many times can you clean your house or keep filling up the freezer!  Just one more time!

As a doula, I am experiencing similar anticipation.  I often think to myself, if I just tidy this cupboard that I keep meaning to, then I’ll get the call……or if I just run a wee bit faster, then I’ll get the call…you get the drift!  Of course it doesn’t matter how many cupboards I clean, or how fast I run, the baby will come when it’s time.  I know that, but it doesn’t stop me from thinking like that as I play the waiting game too!