Once all the home study elements and workshop requirements are complete the women who take part in the certification submit a final project before a one to one session with their facilitator. A last piece of work that brings together their learning and development so far. This can take any form they wish; written, spoken word, art or craft. The piece must incorporate the following elements: the importance of birth, where the woman fits in this picture, choice, support, integrity and love. Enjoy these samples of work – we think they are quite incredible.
“It’s such a wonderful experience, to find people of your tribe…They don’t have to be from your culture. When people are grounded in their bodies, in their lives, then you feel so connected in our deeper layers. And cultural difference just brings more colours to that experience. Thank you all!”
The day after I finished my Doula training
I went for a swim.
I was tired, so I swam lazily up and down for a few laps
then sat in the Jacuzzi,
feeling the warm jets of water soothe my back, and my legs, and my shoulders.
The training had tired me, more than I expected, but yet I also felt strangely elated, as though I’d given birth to something in myself-
something that was worthwhile, something valuable.
I lay back and closed my eyes for a while
then went in to the changing room
There were probably ten women in the room,
dressing or undressing.
Naked, our bodies on display,
we stood or sat,
rubbed cream into our skin,
combed our hair,
applied deodorant and makeup,
or changed from everyday clothes
Some of this little band of chance-met strangers
were very young, blossoming into womanhood,
full of hope and promise and joy to come.
No lines marked their faces, no stretch marks marred their sculpted bellies
and their breasts were firm and tilted upwards.
One was pregnant, her heavy belly resting on her thighs,
as she sat toweling her long, dark hair.
Her breasts were veined, engorged, ready for their purpose,
her nipples darkened.
She looked proud and happy
as she reached for her shoes,
smiling ruefully as she clumsily pulled her socks on.
“I’ll be glad when this is over,”
We wished her luck,
and a safe delivery.
Two were very old,
maybe in their late eighties, maybe even ninety.
They were friends, it was easy to see,
as they laughed and joked as the pulled on voluminous underpants
and shapeless vests.
The skin in their legs sagged and wrinkled
like old stockings
and their hair was thin.
And I was there,
Not young, far more than middle aged,
but not yet too old, I hope,
although my hair is white
and my body not what it used to be,
but still not too bad
I think to myself
maybe just wishfully.
And so we stand around,
then go our separate ways.
Sometimes with a smile,
and a cheerful goodbye,
sometimes too wrapped in our own world
to pay much attention to the others.
But maybe a goddess sees us,
bestowing a blessing on us,
we who are all sisters under the skin,
all mysteriously, marvelously female,
with wombs and breasts
And hearts to love.
Birthkeeping and the Refugee Crisis
‘Doing what we can’
Red Tent Doulas
One day a terrible fire broke out in a forest – a huge woodland was suddenly engulfed by a raging wild fire. Frightened, all the animals fled their homes and ran out of the forest. As they came to the edge of a stream they stopped to watch the fire and they were feeling very discouraged and powerless. They were all bemoaning the destruction of their homes. Every one of them thought there was nothing they could do about the fire, except for one little hummingbird.
This particular hummingbird decided it would do something. It swooped into the stream and picked up a few drops of water and went into the forest and put them on the fire. Then it went back to the stream and did it again, and it kept going back, again and again and again. All the other animals watched in disbelief; some tried to discourage the hummingbird with comments like, “Don’t bother, it is too much, you are too little, your wings will burn, your beak is too tiny, it’s only a drop, you can’t put out this fire.”
And as the animals stood around disparaging the little bird’s efforts, the bird noticed how hopeless and forlorn they looked. Then one of the animals shouted out and challenged the hummingbird in a mocking voice, “What do you think you are doing?”
And the hummingbird, without wasting time or losing a beat, looked back and said, “I am doing what I can.”
In the last 3 years I have worked continuously with grassroots charities involved in the refugee crisis, initially with those working in Calais and Northern France and more recently those local to the South-East of England. As my youngest child (now 3) is getting older I am also returning more to my work as a pregnancy shiatsu practitioner and last year I started my doula training – a path which has called me for many years.
As these threads of my work come together, it felt appropriate to write about what pregnant women face as refugees both during their travels and upon their arrival in (in this instance) the UK. There are many practical ways that we as birthkeepers can be part of meeting the needs of this particularly vulnerable community and I’d like to share information I have gathered along the way. I hope it is both interesting and a useful resource.
What keeps arising as I observe others and myself is the need to be acutely aware of our limits as individuals. Even if we worked tirelessly every day for years, the effects of what we do would feel like – and probably are – a drop in the ocean. This can be in the very least disheartening and in my opinion is definitely a contributing factor to the high levels of burn-out experienced in both jobs. The key learning I’ve seen amongst colleagues (and an ongoing practice for me personally) is remembering that our small actions do make a difference. This and the power of working together is something I am continually reminded of and inspired by. I work alongside a wonderful group in Brighton called the Hummingbird Project. They named their organisation after the fable above and its message is one I hold through my daily work.
“Be faithful in small things because it is in them that your strength lies” Mother Teresa
The current situation of human migration is unprecedented (1). Across the world there are incredible grassroots organisations which have grown in response to the current refugee crisis. Everyone involved in this work is passionate and driven to do their utmost to help. Almost no-one I have met has had previous experience of working with a humanitarian charity. They are just ordinary people now doing extraordinary things. I’ve met baristas turned political campaigners, film-makers, chefs, CEOs, actors, knitters, engineers, builders, dentists, pensioners, students – all using whatever skills they have to support some of the world’s most vulnerable people. Through my work with refugee organisations (2) and as a mama who works with expectant mamas, my attention kept returning to the experiences of pregnant and newly-birthed refugee women. I am not alone in this, there are dozens of wonderful midwives, doulas, breastfeeding supporters and doctors in many countries doing what they can to create safe conditions for women to birth and nurture their babies. There is a section of links at the end should you be interested in reading more or getting involved (3).
The extent of trauma these women experience is unspeakable. Not just the trauma of living in war-torn countries but, in some ways more gut-wrenching and depressing, the trauma of their journeys away from these countries – their journey to a ‘place of safety’. I am involved in co-ordinating practical and emotional support for women newly arrived in the UK, many of whom arrive heavily pregnant. They have endured a lot. Not only the dangerous journey many of you will have seen glimpses of on TV (4)– overfull boats, smugglers, freezing treks across Southern Europe, police brutality, trafficking as only part of the story – but their arrival in an entirely new country, a new culture whilst hormonal and full with baby. They arrive at their goal, the place where everything would be ok, a new life – only to find that it is still hard. As well as the mothers, I keep seeing these babies, born in to a traumatised generation and it is difficult not to be disillusioned and grief-wracked at what humanity is doing to itself. Through our work as doulas we have seen and felt, intimately and deeply, the importance of how a mama is able to birth: both the impact on her and her baby and the ripples into her surrounding circle. Creating environments of choice and peace for these families as they bring the next generation into the world is crucially important.
“By the way – Angels of Peace – Please don’t give up!” Robin Lim
The story of support for pregnant and newly-birthed women changes along their journeys. Many spend time in Greece – a financially poor country, but one which seems to have a particularly proactive and nurturing approach to all aspects of the crisis including its treatment of pregnant mums. There are established organisations such as Amurtel who support exclusively women, children and families and the UK branch of LLL has been supporting LLL Greece for a long time. Some places are more aware importance of safe infant feeding than others. Despite initial resistance, a 100% breastfeeding rate was successfully re-established at camps in Moria with the support of specialist infant feeding groups, while closer to home unfortunately there are different stories. British doula and breastfeeding counsellor Maddie McMahon wrote about the challenges in working in the camp in Dunkirk, Northern France (5), a place where refugees arrive from many backgrounds. Despite international guidelines from UNHCR and Save the Children there was a significant absence of safe infant feeding protocol and a lot of antipathy towards the incoming breastfeeding team. As there was a clean water supply, there was some complacency regarding sterilising despite incredibly unsanitary conditions. I was involved in co-ordinating support for the Women’s Centre at this time and it was extremely difficult knowing that babies’ lives were being put at risk on a daily basis. It’s tough work, and while we can be happy that one mum feels supported and informed that breastfeeding is safer for her baby or sterile conditions for formula preparation are temporarily available, for me this is only part of the story. Another aspect is also about knowing which battles to fight and where to let go and place your energies elsewhere, a place where your skills can be received and optimised. In my opinion when working with such a large-scale crisis this is vital in keeping the work sustainable, mentally and physically.
The culture of doula work in this country is primarily that of working one to one with women with occasional group gatherings – what I have perceived in refugee work is the absolute necessity of community collaboration, both for the women and birthworkers. For doulas having a network of fellows workers would provide emotional and practical support. For female refugees, enabling the connections within their community is vital in combatting the primary issue of isolation. Many women in camps are too afraid to leave their tents, ever. Even to go to the toilet. Projects such as exclusive Women and Children’s centres are vital in providing safe spaces. We are in the unique position of being able meet different needs to the medical organisations and this facilitation of safe space can certainly be another aspect of our work as doulas.
“Empathy is the starting point of creating a community and taking action. It is the impetus for creating change” Max Carver
As women arrive in the UK there are council-run services targeted to support pregnant asylum seekers, however many of these struggle to truly provide the support needed due to a combination of factors which broadly fall into two categories: a lack of funds for crucial aspects (eg translators) and a lack of knowledge of the significant cultural differences. The impact on the women is to compound the isolation she feels – they will arrive in the UK, be placed in a detention centre, have a visit from a midwife (either with or without a translator – this is also stressful for the service providers) and until two years ago they may have been relocated multiple times across the country during the last few weeks of pregnancy (6). We all know mums who move house at nine months pregnant, then laugh at themselves about how stressful it was. The key difference in this situation, obviously, is that of choice. Whilst there may be (sadly not always) compassion in individual interactions the refugee mother receives, there is never any choice. In where they live, where they birth, the clothes they wear, often even the food they eat. What I have observed is a lot of (well-intentioned) ‘giving’ from charitable groups. Whilst this is gratefully received, I believe the most powerful action you can take if you are working with a newly-arrived pregnant lady is to offer situations where she has choice. This can be really, really simple: ‘Shall we take the stairs or the lift?’ ‘Shall we have tea inside or outside?’ I was recently face-painting at an event and was struck by the subtle but powerful shift in the energy of a woman shrugging ‘I don’t mind what I have’ to quietly saying ‘I like red’. There is often initially a deep sense of disempowerment and resignation, but dig a little and you’ll soon find the remarkable resilience and desire to fight for the wellbeing of her baby. Don’t underestimate the power a few simple, positive experiences can have on a woman’s confidence to assert her choices when it comes to birthing her baby.
An Eritrean mum who now has a delightful 5 month old baby gave this feedback about having informal weekly meetings with a female volunteer up to (and after) her birth: ‘Meeting J made my day happy. I was sad and scared on my own. I worry about my baby. To start I am shy and not talking but J is very kind. We go out from the centre to drink tea and eat cake. I like it! J tell me how the hospital is here in UK. My husband not want to be in my birth, in my country father is not coming into the birth. J tells me it is ok that my (female) friend can come to hospital. When I having my baby I miss my mum… I scared but my friend tell me it is ok and when my baby comes I so so happy he is safe now. J visit me and (baby) M and bring me cake. Everything is very good now.’
My observation is that many official services would benefit hugely from the opportunity to liaise with volunteers who have on the ground experience of what the refugees’ journeys and lives have been like up to this point. This would enable them to offer more appropriate and effective support, in particular through having information about the specific needs which arise from trauma. Feedback from local groups (LGBTQ and youth support) who have actively welcomed refugees and asylum seekers shows that both current users and service providers often feel overwhelmed by the scale of trauma they are presented with and have requested more training in this area.
“The paradox of trauma is that is has both the power to destroy and the power to transform and resurrect” Peter A. Levine
City of Sanctuary (7) is an organisation which supports groups across the UK which actively promotes and provides welcome and support to the refugee and asylum-seeking community. There are various streams which link across the country; education and health being two. Leeds was the first pioneer project of the Maternity Stream. In each of the cities involved (most based in the Yorkshire/Humber area) projects have been initiated with a core of peer befrienders from the refugee community. Once the service has been established and proven to show good practice and progress in three core principles (8) these projects receive a Sanctuary Award.
I work alongside the Brighton branch (Sanctuary on Sea) and am in the early stages of establishing a Birthkeeping Project in Brighton which will lead to the development of a Sussex Maternity Stream. The services planned for the early phase of the project stem from the experiences and feedback of women who have experienced arriving pregnant and subsequently given birth in the UK. The main themes which arose were isolation from their own community (compounded if their English was limited) and not understanding the medical processes (eg of induction) they experienced. It is important to take into consideration that many of these women have experienced violence and/or sexual violence either in their home country or during their travels and provide appropriate support. There is a huge need for volunteers in this area.
The Birthkeeping Project has a volunteer bank of peer befrienders, a health visitor, a breastfeeding counsellor, midwives and doulas. The aim is to provide the opportunity to access ante-natal information and social connection, birth support, early post-natal and breast-feeding support and longer term social support. I am liaising with other teams from Maternity Streams – The Refugee Council, local BME orgs, HVs, community midwives and doula groups are also good points of contact if you are interested in initiating a group such as this.
The initial phase of the project will start with a regular series of pre-natal groups with the aim of giving space for women to connect with each other. I have observed that a simple approach is often most effective: allowing the connections to naturally develop from our shared experience, in this case our shared experiences as women. Encouraging women who have been settled in the UK for some time to support newer arrivals as informal doulas (health befrienders) and to affirm the women’s rights to express what is natural in their culture as well as offering information to enable them to go forward and make informed choices within this healthcare system. By creating the conditions – written translations and translators; an informal and women-only setting; moving our bodies (through yoga (9), dancing, hand massage); drinking tea – these things allow the thawing of isolation and the space for emergence into connection and expression, all of which will have a positive impact on the well-being of mum and baby.
Following on from this, we are building a beautiful network of birth-workers who are able to offer ongoing support nearer to and through labour and the immediate post-natal period and another group of volunteers who will continue to maintain this support by facilitating further post-natal groups. There is an already an established art group, cooking group, writing and birth-story projects all for mums (and babies). All of these groups can be tailored to the specific needs of the refugee community.
“Caring for myself is not self-indulgence it is self-preservation, and that is an act of political warfare” Audre Lorde
This work can easily becoming overwhelming. Many wonderful volunteers burn out, badly. They can’t do everything, they can’t save everyone – often these are sensitive people who get little if no training and end up experiencing a lot of vicarious trauma. I can see the same with many birthworkers. What can we do to make our work sustainable? And nourishing? And joyful? How to balance the energy of fire and drive and a desire to change the world with keeping it real? I currently get on average 3 nights of unbroken sleep per month (reality of having young kids) – self-care has to be up there as a priority. In the bigger picture, the NHS is in crisis, meaning that maternity services are stretched (an understatement) and care is not always optimal despite best efforts. And all this is before we even scratch the surface of the toxic culture of birthing that we currently live in – doctors, midwives and women themselves are often so far away from their instincts of being able to tune into and trust the natural process of labour that the results are sometimes horrendous birthing scenarios which can be traumatic for all those involved. Whilst of course this isn’t always the case, it certainly isn’t all clary sage, oms and orgasmic homebirths – in fact, I am in wonder when it is, given everything that is needed to create those conditions! As humans we need to be mindful of the challenges of reality and, amidst the work we do, look after ourselves. Get enough sleep, regularly nurture our souls and find the joy and nourishment in the essence of doula work: the service and the love. Whilst serving and love ourselves at the same time. For me this is a daily practice and a work in progress, as I imagine it is for many of us ☺(10)
So – we do what we can! We connect deeply with our own truth and knowledge in whatever way has integrity for us – an ancestral connection from our own family lineage, a spiritual practice, practical techniques and learning from courses attended, being deeply and fully with nature and the earth while we work to optimise any situation we work in. We use our wisdom to allow the space at transition times, whether it is birth, death or any time in between. There are some things we ‘don’t do’ as doulas. I feel strongly that one thing we can do is gently create the conditions that provide the woman with as much choice as possible to birth HER birth, whatever her environment or backstory. I am extremely fortunate to be in a position where I am able to advocate for my rights and choices. I am fortunate that I have had access to therapies when I have most needed them. But every woman has a right to a safe, fear-mongering-free and undisturbed birth which, however it then unfolds, she will know belonged to her and her precious baby. As birthkeepers we are privileged to have the opportunity to help protect this space. This work is needed. Globally and vitally, needed.
Beyond a wholesome discipline, be gentle with yourself.
You are a child of the universe no less than the trees and the stars;
you have a right to be here. And whether or not it is clear to you,
no doubt the universe is unfolding as it should.
1)‘Human Flow’ is a fantastic film by Ai WeiWei documenting the current state of human migration across the globe https://www.humanflow.com/
3) Links to organisations supporting women and babies abroad:
A blog about one doula’s experience of volunteering with Amurtel: http://www.youniquepostnatal.co.uk/blog/4594069694/Supporting-Refugees-in-Greece-as-a-Postnatal-Doula-Jan-2018—Naomi-Kemeny/11276475
4) ‘Exodus’ (first shown on iPlayer) is a documentary filmed by refugees as they make their journey into and across Europe https://www.imdb.com/title/tt5808940/
5) This is the account of her first visit. The Birthhub site has the other blog entries on infant feeding as well. https://thebirthhub.co.uk/2016/11/15/not-animals-day-dunkirk-refugee-camp/
6) Maternity Action campaign hard politically to make these changes – in 2016 Home Office guidance on dispersal (relocation) of pregnant asylum seekers was rewritten due to their work: “Working in partnership with the Refugee Council, we ran a three year campaign resulting in a comprehensive rewriting of the Home Office guidance on dispersal of asylum seeking women during pregnancy. Women are now much less likely to be moved in the late stages of pregnancy and to experience multiple moves in the lead up to the birth.” https://www.maternityaction.org.uk/
7) City of Sanctuary website, you can search the Maternity Stream for more information: https://cityofsanctuary.org/
8) Maternity Stream’s three core principles to demonstrate good practice:
LEARN, EMBED and SHARE: Learn about pregnant asylum seeking and refugee women, their experiences of asylum, the challenges of living in the UK and their subsequent health and social care needs. Ensure women are aware of the service or support group and how and why to access it.
- Invite an asylum seeker or refugee along to your team meeting to share her story of pregnancy, birth and motherhood in the UK.
- View the Maternity Stream film at your work/group (the film is available to view on our website here)
- Encourage the women you support to speak to others in their situation about why and how to access maternity care
- Undertake a group session with the women you support to explore their experiences and correct any misunderstandings about how maternity care works in the UK
Embed positive action
- Produce resources that are not reliant on the ability to read and write in English
- Hold regular group meetings with the women you support to continue the learning process for all involved
- Develop guidelines or care pathways to inform your work.
- Create new volunteer roles for asylum seeking and refugee women
- Monitor and evaluate best practice in your work
Share best practice with maternity services and local voluntary sector organisations
9) This is a great example of a local yoga project set up specifically for female refugees and asylum seekers: http://www.bnhc.co.uk/images/stories/pdfs/yogafinalfeb2016.pdf
10) Stephanie Dawn puts it brilliantly:
‘We must ask ourselves: “What do I need in this moment?” Then we must reach out! ..We must become excellent at calibrating our own needs. No-one can do this for us. Practicing excellent self-care for ourselves is where it’s at!..Are we truly caring for ourself? Are we being loving to ourself? Are we offering ourselves as much love as we are willing to give to another? I invite you to cultivate your selfcare/self love muscle. Give to yourself in unprecedented ways.’
‘On Becoming a Birth Angel’ from ‘Eat Pray Doula’ by Robin Lim
My role as a doula in birth and beyond, reflects all of the female life cycles; the archetypes of Maiden, Mother, Crone.
I embody the Maiden with my need for more knowledge and experience of birth and breastfeeding. Here, my creative juices flow; I am vibrant and energetic..As Maiden, I hope to inspire women to know their own power, strength, and endless beauty.
I am hopeful, joyful, and playful..dancing through birth, singing to uplift.
I embody the Mother with warm, loving care this nurturing care facilitates women and families to learn and to know themselves. As they find their footing, my gentle encouragement offers them a hand when needed.
I mother the Mother so that she feels safe, and held, and seen for who she is, as she rises up and becomes a new self day-by-day, moment-by-moment, breath-by-breath.
I stoke the hearth of the home (loving the mother); with nourishment and love, I hold her hand encouraging and remaining by her side as she births her baby and her new self.
As Mother, I am protector, gatekeeper of this woman’s precious space, ensuring that in that moment when she has to journey inside, that she need not concern with anything but turning inwards as she opens to birth her baby. And after, I guard that space all the same, so that she can rest and heal.
I have known the great depths of suffering, in which I have sat, and waited for the difficulties to pass. And in waiting for the passing, I have known my breath through fear, and sadness, and grief but most of all..being with not knowing.
Through making friends with Being with Not Knowing, the Crone was born.
She often sits silent, listening to everything; listening out to hear the true words of people’s hearts.
When I am the Crone, I am a medicine woman, with the wisdom to know when the great medicine of silence is needed.
Here, I am patient, and know that birth is sacred, and it knows no time, the body knows no stages..it just seamlessly breaths in and breaths out, contracts and releases.
In this moment, I am mindful and aware; I recognise the turning of the tide and sit strong by her side.
As the Crone I am always listening deeply, throughout the great journey of pregnancy, birth, and the early postnatal days. I listen with my ears and my heart, so that I know when I am needed and when I am not. I also have the wisdom to know my and other’s boundaries, and I respect them deeply.
How Holy a privilege it is to be invited into these sacred moments; moments to be revered and respected.. So I pack my songs, my joy, my playfulness, my encouragement and loving warmth, my patience and my medicine of quiet, and I set off to be Companion (not Guide) on a magical journey….Where will we go?
HELPED are those who are content to be themselves; they will never lack mystery in their lives and the joys of self-discovery will be constant.
HELPED are those who love the entire cosmos rather than their own tiny country, city, or farm, for to them will be shown the unbroken web of life and the meaning of infinity.
HELPED are those who live in quietness, knowing neither brand name nor fad; they shall live every day as if in eternity, and each moment shall be as full as it is long.
HELPED are those who love others unsplit off from their faults; to them will be given clarity of vision. HELPED are those who create anything at all, for they shall relive the thrill of their own conception, and realize an partnership in the creation of the Universe that keeps them responsible and cheerful.
HELPED are those who love the Earth, their mother, and who willingly suffer that she may not die; in their grief over her pain they will weep rivers of blood, and in their joy in her lively response to love, they will converse with the trees.
HELPED are those whose ever act is a prayer for harmony in the Universe, for they are the restorers of balance to our planet. To them will be given the insight that every good act done anywhere in the cosmos welcomes the life of an animal or a child.
HELPED are those who risk themselves for others’ sakes; to them will be given increasing opportunities for ever greater risks. Theirs will be a vision of the word in which no one’s gift is despised or lost.
HELPED are those who strive to give up their anger; their reward will be that in any confrontation their first thoughts will never be of violence or of war.
HELPED are those whose every act is a prayer for peace; on them depends the future of the world.
HELPED are those who forgive; their reward shall be forgiveness of every evil done to them. It will be in their power, therefore, to envision the new Earth.
HELPED are those who are shown the existence of the Creator’s magic in the Universe; they shall experience delight and astonishment without ceasing.
HELPED are those who laugh with a pure heart; theirs will be the company of the jolly righteous.
HELPED are those who love all the colors of all the human beings, as they love all the colors of the animals and plants; none of their children, nor any of their ancestors, nor any parts of themselves, shall be hidden from them.
HELPED are those who love the lesbian, the gay, and the straight, as they love the sun, the moon, and the stars. None of their children, nor any of their ancestors, nor any parts of themselves, shall be hidden from them.
HELPED are those who love the broken and the whole; none of their children, nor any of their ancestors, nor any parts of themselves, shall be hidden from them.
HELPED are those who do not join mobs; theirs shall be the understanding that to attack in anger is to murder in confusion.
HELPED are those who find the courage to do at least one small thing each day to help the existence of another–plant, animal, river, or human being. They shall be joined by a multitude of the timid.
HELPED are those who lose their fear of death; theirs is the power to envision the future in a blade of grass.
HELPED are those who love and actively support the diversity of life; they shall be secure in their differences.
HELPED are those who KNOW.
Odent talks about medical advancement being ready for the, ‘post electronic age’ (Odent, 2003, Clearview) but people aren’t. This is so true. We’ve been kyboshed into a subservient society, and ego has got in the way. We aren’t looking at the common history of birth, but the ‘heroic’ male dominated, hospitalisation of it. As can be seen through reading The Birthkeepers (Robinson), and more terrifyingly, Birth Crisis (Kitzsinger), birth has become dominated by a system of theory, and logic. Neither of which necessarily aid or support the ‘normal birth’, in which a woman finds an inner guide which, is intrinsic, and instinctively led. In fact, the ‘normal birth’ (one, at home with no intervention) is now something that is treated with fear and trepidation by many NHS staff. Sadly, our world of litigation has to shoulder some of the blame, too.
The results of these things butting heads are, women losing their right to a peaceful, contented and safe birth.
We pump birth situations full of adrenaline and stop the beautiful love hormones that need to be at work. The trauma caused by a ‘bad’ birth is vastly ignored by the NHS and the definition of trauma is lost in the, ‘one size fits all’ care we are receiving. Far too often, we hear of the professional advice rhetoric spouted as, ‘what did you expect?’ and ‘well you’ve just become a new mum, it is hard.’ Women’s self evolutions are being blocked by their loss of birthing, ‘the way nature intended’ (that can mean a variety of things to different people). The untold damage caused by interventions seems to be forgotten about by the experts, who are trusted with our lives, the moment we are physically repaired.
I have found myself, frequently, sat in situations with groups of women and more have ‘bad’ birth stories than good, or normal. This raised the question to me about what on earth was going on, and (as well as ensuring women don’t go through what I did) what could I do to help it?
It seems crazy that, something women have been doing since the beginning of time, is now a narrative of trauma and horror. There is no doubting, that birth can be horrific and dangerous, but the nature of living, is that the life can end. There is also, no doubting, that in the past, many women and babies didn’t survive because technology and medicine hadn’t advanced, but there still seems to be so little known. When reading The Red Tent (Diament), it struck me, when the protagonist talks about her Aunt’s midwifery and her own midwifery experiences, that, yes, there may have been losses but there was far less trauma when there were survivals. Is this due to the women centric nature of the whole process of birthing? Yes, I believe so.
Lack of information on choice, coercion (often with kindness), naivety and fear are the ruling classes in this birthing context. These things count for both clinicians and mums, and I was one of them. A doula is the person there to offer the choice, with love and complete respect. To ask the family to consider why, or what, or how. To ask the questions, due to the fault of the system, clinicians can’t or don’t have time to. I don’t believe that any midwife, nurse, or doctor goes into their role without wanting to do good, and it saddens me, for some, that gets lost or forgotten, by red tape and criteria, along the way. Someone said to me recently, you need to be well to go into hospital. How true. I am sure, most hospital staff would be saddened by this.
So, where is my place within birth? The answer,I believe, deep down, is nowhere, unless explicitly summoned by the mother (or partner where appropriate). The birth of a child is about the mother and her baby; if I am privileged enough to be invited into that space, as I have been deemed by the mother as a support, then my place is on the periphery. My place within the birth is to ‘serve’ the mother, and partner if necessary, and ensure there space is held in the way they desire for the birth of their child. I should not be ‘part’ of the birth, but the person there to facilitate what the mother wants and how she wants it, based on her informed decisions. My most important phrase should always be, ‘how do you feel about that?’ Her feelings and wishes, are my priority.
Additionally, I have been struck by images of mothers being on their own after a baby is born, and everyone else busied by the product of the labour (whether that is baby, paperwork, tidying etc). She is isolated and in need of care. Again, she is my priority, with that important question, ‘how do you feel?’ After birth, once everything is deemed to have returned to normal, my priority is her- how do you feel? The answer to these questions will determine my place in birth.
We seem to be in desperate need, not just in birth, to take a step back and look at ourselves. Our ancestors hold the answers to our need to birth our children in the way that stops the, frightening, statistic of one in 10 women suffering from PND (PANDAS), or the links between lack of colostrum in the early stages and later life depression (Odent), or the scary studies on addiction as a result of birth trauma. Medicine and technology are wonderful and life saving, I owe my life to a blood transfusion, but we are jumping too quickly to them. As is illustrated through Gaskin’s reflections, the stories and ‘midwives manual’ in Spiritual Midwifery, we need some knowledge about birthing, but much of it comes from ourselves.
Estes, shows us we have this in our make up by the collections she shares in her book, Women Who Run with Wolves, we have an ancestral knowledge, that as a mass, we seem to be ignoring. We need to heal our sex, and part of doing that is reclaiming birth and the knowledge of birth. Women need to show up in their power and stand together, not breaking each other down. With love we can redefine women to be the warriors they are, and that isn’t in a violent and aggressive sense, it is strength, intuition, and comradery.
Bramble Angela O'Brien
Growing up in Ireland in the 80’s and 90’s was fun for the most part. Yes, the “troubles” were still ongoing and unemployment was high but for the most part life was normal. No when I say normal, I mean normal for me. That may not be your normal or Joe, next door’s normal. My families normal was hushed family secrets, unspoken rules, forbidden words and copious amounts of Irish stew.
As a child I remember families getting bigger but never thinking to ask how, never really wondering how all the little people were finding their way to my friends or neighbours houses, that is until one found its way to my house!
I was 11 and had just come home from school on a Wednesday afternoon. Everything seemed ‘normal’ until I opened the living room door and my mother was sitting there holding a baby. At first, I looked around the room for the owner of the baby but the only people in the room were me, my father, my mother and the baby. My two younger brothers subsequently barged through the door a few short minutes later. That’s when the realisation hit me that it was, in fact, our baby. I did not dare to ask about the how’s or when’s. We just carried on with our normal family routine.
It was years later when I found out I was pregnant myself that I began you think about all this again. Mainly because I really struggled to announce my pregnancy to my mother. I was actually afraid to use the word pregnant, as this had been one of those forbidden words, along with sex, vagina, penis, anus, gay and lesbian. I could only tell her I was ‘expecting’ which seems completely alien to me now 13 years on. Struggling with that announcement brought back all the childhood memories I had stored as fine. Like the covering up of pregnant bellies, the whisperings of pregnancy announcements like it was a swear word, and the basic lies we were told as children, if we were lucky. Generally as children we were shielded from life, it was thought that it was better to find out these things when you got older. The problem being when we got older we were not equipped to deal with such experiences. So ,as my two younger brothers spiralled out of control when they realised they were different from all the other boys because they did not know how to cope with their feelings or emotions I could not process my emotions or feelings and really struggled as young girl entering womanhood on my own as it felt, becoming a women or a man was just not discussed at home.
As I progressed in my pregnancy I read a lot of book and articles, based mainly in Britain and America and had a lot of amazing expectations. My reality was very different indeed. I had no basic choices. Information was extremely limited to which hospital you could go to. There was a lingering feeling of disgraced young girls on the maternity wards and it was heart-breaking. Heart-breaking that in 2005 a young society appearing to be at the forefront of developed countries was still in fact stuck in the 50’s and 60’s ruthless Church ruled Ireland.
Since 2005 I have researched and read and sourced all manner of resources to confirm that pregnancy and birth should be celebrated and the woman should be made to feel special and celebrated. Women were made, whether it be by science or God, to grown and birth human babies. Our anatomy supports this. Our hormones support this. Our emotions and our brains are wired to support this process. I find myself asking the question then, why in 2018 are we still working on reforming/improving maternity services to support women and their babies in a way that is actually woman-centred.
I am lucky to have experienced maternity services that are supportive, to a point. Many of my family and friends have never experienced that and may never still. I have learned to offer support to those I know through love and kindness. I have learned to work through my family history in order to go forward in a supportive role. I am aware of my limits on this journey in so far as my hopes for a woman are unimportant to her and ultimately will not facilitate me to support her effectively.
My journey as a Doula has encouraged me to look around and learn from all cultures, to take into account a woman’s beliefs and values and to recognise when I cannot support someone. My goal as a doula is not to ensure a woman chooses a normal physiological birth at all cost but to ensure she is provided with relevant, evidence-based information in order to choose a birth path that is right for her, her baby and her family. All birth, however it occurs, is truly magical and empowering and so it should be celebrated as such.
I feel I have been on this journey for a lifetime but only just recently recognised my purpose. I know and hope I will continue to learn from the wise words of the many wonderful doulas that have preceded me and of course all the beautiful women I hope to work with.
It is said that good can come from bad.
As I reflected on my birthing experiences in my mature age, I was filled with a sadness, and a subsequent yearning to help young mothers to enjoy their experience of pregnancy, birthing and their babymoon and to share my great capacity for love with them.
And so my longing and determination to become a Doula was ‘born’.
Despite my birth experiences not being satisfying for me, I enjoyed my pregnancies and did not stop being thankful that I was bringing new souls into being. I described the feeling after my Caesarean births as ‘post-natal euphoria’. You see, I had thought that I would not be able to become a mother. I was separated from my babies initially after birth but, despite this, I went on to successfully breastfeed, for 2 years in the case of two of my triplet sons. I know that the difficulties I overcame with this art are a blessing as I will be able to empathise with and support any mothers feeling challenged.
I bring to the Doula world my experience of supporting adults and young people in my career as a Pastoral Assistant Headteacher in a multicultural secondary school. I have learnt to listen well above all, not to judge, to consider other viewpoints, to be sensitive to a vast range of cultures and religions, to help make peace between people and to smooth their path in life. Following this career, I have absorbed the wisdom found in the Essential reading list of Red Tent Doulas as well as researching further and I shall build upon this foundation to give me the skills needed to become a successful Doula.
In order to be able to fully understand and meet the individual needs of the pregnant ladies I will, God–willing, meet and grow to love, I shall always be aware of their religious, spiritual and cultural needs. As a starting point for this work I should like to research and discover the ways of the Muslim Community and the Orthodox Jewish Community.
Pregnancy and Birth in the Muslim Tradition
Muslims are told to show continuous gratitude for birthing children as it is a direct blessing from Allah. A child is like the fruit of a tree which brings a man and woman closer to each other.
Mothers are held in greater respect than fathers. It is narrated that the Prophet was asked: ‘Which of the parents has a higher status?’ The Prophet replied, ‘The one who for nine months kept you between her two sides, and then brought you into the world and gave you milk from her breasts’.
In fact, during her pregnancy, a woman has the status of a person who fasts, prays in the night or fights for Allah with her life. As she is birthing Allah gives her an immeasurable reward and when she finishes breastfeeding an angel tells her that all her minor deeds are forgiven. In a woman loses her life whilst birthing her child, on the Day of Judgement Allah will raise her from her grave pure and with no account of sins.
During pregnancy all thoughts and actions of the mother must be in accordance with Islam. The father must help her to maintain a healthy spirit. He must keep himself informed about the changes she will undergo and meet her emotional needs. He must help to create a warm home environment to aid the baby’s development. The baby will be a source of benefit not only to the immediate family but to society as a whole.
To keep mother and baby healthy in body and spirit certain foods are recommended to the Muslim mother during pregnancy. The reasons for these foods are lengthy so I shall indicate their source in the notes (1) below. Of course the mother must not consume anything ‘haram’ and she should get plenty of fresh air. The important foods include: breast of animal meat, chicory, dates, figs, olive oil, pomegranates, quince, watermelon, milk, almonds, peaches, bran rice and lentils to name but a few.
There are certain acts to undertake to ensure the health and good character of the child. A mother should try to be in ‘Wudu’ (2) especially when eating. She should give charity and stay away from sin and bad people. The Qu’ran should be recited and she should listen to scholars speaking. She should perform all required religious acts. She should perform Ghusl Jumuah (3) on 40 Fridays and pray Salat-al-Layl (4) a minimum of 40 times.
For mental well-being she should try to have positive thoughts, to not get angry, to prevent worrying about the pregnancy and trust in Allah at all times. She should not look in the mirror at night but should gaze upon pious people and beautiful natural scenes. She must speak to the unborn baby to increase the close bond and should choose a good Muslim name for him/her before birth.
By the time of the birthing a woman should have prepared for the birth both mentally and physically. She should be well informed of the processes she will go through to prevent fear (this is where a Doula can offer pre-labour support).
She should recite Surat al-Inshiqaq (5) out aloud or in her head at the start of labour. Pleasant smelling things should surround the mother and she can drink saffron syrup and eat high-energy foods. She should relax her mouth. She should recite the recommended Du-as for delivery.
- From Marriage to Parenthood the Heavenly Path. Chapters 6 and 7-available on Al-Islam.org
- Wudu= the purifying such as washing hands and nose etc, known to observant Muslims
- The whole body is rubbed and covered with water whilst intending to remove impurities.
- The night prayer
- The 84th chapter of the Qu’ran in which the splitting asunder of the Heavens is mentioned.
The Orthodox Jewish way in pregnancy and birth.
Judaism teaches that God is the source of all life and blessing. A Jewish mother and father wait with longing to see the baby that is a gift from God, created in partnership with the parents. The baby is the fruit of love between two humans.
The months of pregnancy are a very precious time. The attitude, spiritual wellbeing, behaviour and nutritional choices of the mother have a profound effect on the fetus. A pregnant woman should be surrounded by a positive and calm environment. Anger and anxiety should be avoided and so the mother should inform herself fully on her pregnancy and prepare herself physically and spiritually for the birth and post-partum period.
The sages encourage the mother to increase good deeds to others as well as taking good care of herself. She should attend synagogue services as much as possible, pray, attend Torah (1) study classes and recite psalms. She should take care to give extra charity as this has benefits for the developing child. The father and mother should increase their recitation of psalms and the father should recite psalm 20 before going to bed.
The mezuzahs (2) on the doorposts of Jewish homes should be inspected to ensure that the holy writings are intact as it is believed that these keep the inhabitants of the house safe; this includes the unborn child.
The food that a mother eats nourishes her baby and so she should be careful to eat nutritious foods adhering to a balanced healthy diet and to only eat kosher items. The Jewish calendar contains some fast days but if a Rabbi rules that the mother may not fast (based on a doctor’s advice) then she must not refrain from eating but eat small quantities of food frequently throughout the fast day. Jewish Law states that life is of top priority and laws must be set aside to preserve it.
The Jewish mother is encouraged to make every mouthful count for the benefit of the baby and herself. This is not the time for dieting. Eating high quality food and breastfeeding will support the health of the child throughout life. Sugar, margarine, refined oils and white flour are to be avoided. Adequate protein should be consumed from fish, eggs and some meat and poultry. Wholegrains and plenty of vegetables and fruit should be consumed and plenty of fresh water. Milk, yoghurt, nuts, seaweed and seeds in addition will help to ensure good health throughout pregnancy and lactation. Alcohol should be avoided with grape juice used when needed for religious purposes such as celebrating the Sabbath.
There are some pregnancy and birth-related customs which are practised by many Jews. For example the father will be asked to open the ark (3) in the synagogue containing the Torah scrolls during the ninth month of pregnancy. The Zohar (4) says ‘When the congregation takes out the Torah scroll, the Heavenly Gates of Mercy are opened and God’s love is aroused.’ The father hopefully elicits God’s blessing that the womb will open easily like the ark and the birth will be without complications. A pregnant woman should endeavour to be exposed to holy sights and sounds. She should for example avoid hearing gossip, slander and unsavoury talk. Where possible she should not look at non-kosher animals; a visit to the zoo can wait! In many communities pregnant women do not visit cemeteries to avoid negative emotions. Some hold that women should avoid having a fright which may lead to miscarriage so pregnant woman avoid barking dogs or even stepping on nail clippings. There is an ancient custom for the pregnant woman to sew a sash for a Torah scroll. This is then used on the scroll a boy reads from at his Bar Mitzvah (5) and on the scroll he reads from before his wedding.
During birth it is customary to have a copy of psalm 121 to hand and the father will have a selection of appropriate psalms to recite during the second stage of labour.
An important aspect of Jewish law needs to be understood as some medical professionals may be concerned about the father is not helping the mother by rubbing her back or even holding her hand during labour. The laws of marriage provide for a 12 day period of abstinence from all physical contact each month (during the moon time and for seven days afterwards). At the end of this period physical relationships resume and many state that this enhances the marriage. Once the labouring mother has had a ‘show’ or the amniotic sac has broken this law comes into effect and a Doula or other attendant will be needed to provide any massage or physical support.
It is usual for the community to be overjoyed at the birth of a child and to be very caring of the new mother. The wider community will provide meals for the family for several weeks postpartum so that the mother may rest. The new baby is welcomed with special prayers asking for God’s blessing for the whole family in the synagogue.
- The written Jewish law consisting of the first 5 books of the Bible.
- Small scrolls fixed to the doorposts of Jewish homes and buildings containing holy writings.
- The cupboard with an everlasting light above in which the scrolls of the law (Torah scrolls) are kept.
- The foundational work in the literature of Jewish mystical thought known as Kabbalah.
- The ceremony when a boy reaches 13 years old, the time of his religious maturity.