Moved over to main website blog:Begin your pelvic floor rehab

Hi to all the wonderful families connecting with Doulacare Ireland. My name is Louise Murphy and I’m a doula and a physiotherapist specialising in pelvic health. 

With the current Covid19 emergency, I’m really conscious that many women in Ireland at the moment won’t have access to pelvic health physiotherapy. This is obviously particularly difficult if you have an acute issue like a large tear after your baby's birth or urinary or bowel leakage or urgency.

So I wanted to reach out to share some tips on how to manage these problems and begin your pelvic floor rehab. 

1. Try not to panic. Not getting to your physiotherapist immediately doesn’t mean that things will necessarily get worse or never improve. If you have a lot of urgency or urge incontinence (leaking as you rush to the toilet), going to the toilet regularly (about every 2 hours) is advisable. This makes sure that the bladder isn’t over filling and overflowing.

2. Keep any stitches dry and clean. Don’t apply anything to them except water. Rinse the area or sit in a shallow bath after using the toilet and gently pat the area dry.

3. For the dreaded bowel movements:

   1. Take advantage of the gastrocolic reflex. This reflex means you’re most likely to have a bowel movement if you go to the toilet half an hour after breakfast, regardless whether you feel an urge or not. Try to make this part of your routine.

   2. Take your time. We all know how it is with a new baby – we run into the bathroom, sit down and push out the pee as fast as we can to get back to our (usually crying) as quickly as possible. So I want you to take your baby with you. Maybe in a bouncer or moses basket or even in a wrap if you have to. Aim to spend 5-7 minutes sitting on the toilet to allow things to happen.

   3. Use the correct position on the toilet. We are designed so that our bowels empty best in a squatting position so feet up on a stool, lean forwards, elbows on knees and entertain your baby, read a book or just enjoy some quiet time!

   4. Use your hand wrapped in tissue to support any stitches if it hurts to them to empty the bowel. 

   5. Take any laxative prescribes for you, hydrate well and eat healthily.

4. Start some pelvic floor rehab. I usually start this by making sure my patients can breathe well and have some awareness of their pelvic floor muscles and what they’re doing. This sounds simple but many, many people find this bit the most difficult part of their rehab. 

Breathing

So make sure that you can do:

• Upper chest breathing – hand on your upper chest and breathe in so that your chest rises towards your chin.

• Lateral (rib) breathing – hand on the ribs on each side and breathe in so that your hands move outwards on your ribs.

• Abdominal breathing – one hand on your chest and one on your tummy. Breathe in and concentrate on allowing your tummy to move outwards while minimising movement in your chest.

If you learn better from observing, just pop the different types of breathing into YouTube and lots of demo videos will come up. 

Practice these different types of breathing in different positions – lying, sitting, standing and practice being more mindful about how you normally breathe. 

Awareness

Once you’ve got the breathing mastered and can do it without having to concentrate too much, I normally move my patients on to working on their awareness. So while practicing your different types of breathing, pay attention to what’s happening with the pelvic floor. 

Just paying attention to begin with. At first you might not really notice anything but stick with it. 

Look out for:

• What the pelvic floor feels like when you breathe in.

• What it feels like when you breathe out.

• What are your tummy muscles doing?

• What’s your bum up to? Nothing? Tightening? Relaxed?

Ideally, we want you to be able to feel a subtle release of the pelvic floor as you breathe in and a gentle (not conscious) tighten or lift as you breathe out.

If you’re aware of this happening, you’re ready to move on to co-ordination.

This is pretty simple but takes practice. So: 

• Breathe in slowly

• Begin to breathe out

• Add a gentle pelvic floor squeeze as you continue to breathe out

• Release

You should be able to feel the squeeze and also the release. If you can’t feel the release, let you a little sooner as your muscle may not yet be strong enough to hold for the full breath out. 

Repeat this 5-10 times a few times a day. If you can, make your squeeze a little bit smaller with each repetition. This improves your control and sensation and reduces squeezing of the other muscles around the area which we want to keep to a minimum.

If you’ve got as far as this, you’re doing great! Keep working on these exercises in different positions and improving your control and sensation. 

If you’re struggling, please don’t feel alone. I’m available through Doulacare Ireland for a chat and will get back to you as soon as I possibly can. There are some online resources available to you that might also help and I’m linking to them below.

My online course: https://mindingmums.teachable.com/p/resetting-your-pelvic-floor (Coupon Code MARCH2020 for 30% off)

Free online Womens Health After Motherhood course:

https://www.futurelearn.com/courses/womens-health-after-motherhood

Videos from the Rotunda Physiotherapy Department:

https://rotunda.ie/knowledgebase/physiotherapy/

This link is about constipation and while you might not necessarily be constipated, a lot of the same information applies:

https://www.evidentlycochrane.net/feet-up-constipation/

Some information about dealing with bladder urgency:

https://www.ucsfhealth.org/education/bladder-training

Some physiotherapists are also doing virtual consultations for clients so chevk in with your local physio to see if they’re able to facilitate this for you. 

Good luck, 

Louise x

Many thanks to Louise for putting this blog together. You can read more about the support Louise offers here https://www.doulacare.ie/louise-murphy

A Wonderful Partnership with Irish Life Health

Did you know DoulaCare Ireland have an exclusive partnership with Irish Life Health? 

At DoulaCare Ireland we offer true continuity of care and our focus is supporting families as they transition into parenthood. This is not always an easy journey, but it is one that can be fulfilling beyond words. We support women and their partners throughout pregnancy. We offer continuous support during labour and birth (home and hospital birth).  We will wipe your brow when hot, keep you calm and focused. We support your partner to feel in control offering them tips and tricks too. We stay by your side, after birth. We go to your home. We nurture you as you find your new normal We cook home cooked meals, catch up on laundry, keep the house running so as new parents our clients can slow down and enjoy those early days. We offer evidence based information. We are an independent support person, without the same emotional attachment a family member can have - meaning unbiased care. We pass on years of knowledge around pregnancy, birth and parenting. Helping our clients to make informed decisions about their care and that of their baby/babies.

We don’t want our clients to. drift through their pregnancy, unsure of their options and frightened of their birth.

We don’t want our clients to muddle through in a sleep deprived fog in those early weeks of parenting.

We want them to feel supported, heard and validated.

We want them to feel cared for, safe and confident.

We ensure our clients thrive in every aspect of this journey, not just survive! 

We chose to partner with Irish Life Health for their forward thinking and family centred plans. They have a huge focus on well being (physical, emotional and mental) which we felt sits with our own ethos. What makes Irish Life Health different to other insurers is that their support doesn’t end when you leave hospital. They know that becoming a parent is a life-changing journey that goes far beyond your hospital stay. Their benefits are there to support you emotionally and physically every step of the way.

Irish Life Health can help you access the support you need for whatever stage you’re at on your parenting journey. They have created an incredible Maternity and Parenting Path package. With DoulaCare Ireland you can now claim up to €200 off Birth Doula support plus up to 18 hours Postpartum Doula support in your home to set you up for success!* 

This is all available exclusively with DoulaCare Ireland. Irish Life Health only work with our Doula Agency.  Why choose Doulacare Ireland above an independent doula? 

Because DoulaCare Ireland are a professional national doula agency. 

• Our doulas are the only doulas in the country that are Garda vetted for their role. 

• All of our doulas carry insurance. 

• All of our doulas are trained by a reputable organisation. 

• All of our doulas attend a minimum of 3 CPD days per year.

• All of our doulas have access to mentorship & counselling sessions if required.

• All of our doulas have opportunity to debrief.

• All of our doulas sign up to a code of ethics.

• All of our doulas know their scope and practice within this at all times.

• All of our doulas are passionate and caring. 

• Mary and Jen are two of the most experienced doulas in their fields and bring that knowledge and support to our doulas and to our clients.

Our Doulacare Ireland national team

But there is more! Irish Life Health are offering their members support in many areas to ensure they have a positive parenting experience. You may be entitled to healthy meals delivered to your door with Gourmet Fuel. A midwife visit in your home. Access to the GentleBirth App https://www.gentlebirth.com A beautiful food hamper. Some home cleaning hours. Access to mental health supports with Nurture Health, another of our working partnerships. They are a nationwide counselling service specialising in the care of parents from fertility issues, conception, and pregnancy right through to postpartum and parenting. You can find out more on their website https://nurturehealth.ie/about-us/ You could have access to a Dietician or Nutritionist Consultation. You could have some Acupuncture sessions or take yoga or pilates classes and so much more!

We are delighted to be a part of this amazing care. We feel parents in Ireland are under so much pressure to get it all right when pregnant, partners are expected to know how to support a Mum during labour (without ever having been near a labour room before). We are expected to just  ‘bounce back’ to ‘normal life’ after having a baby. The big secret no one tells you is you will have to adjust to a new normal. This can take some time. With all of the outlines supports, parents can do this without feeling like they are losing control. Every pregnancy is unique. Every birth experience is unique. Everyone parents in their own way to meet the needs of their unique baby. Babies do not pop out with a manual. New parents have to find what works, one day at a time. Our doulas will be right there, offering encouragement and support every step of the way. 

Any questions?

Please give `Irish Life Health Customer Care team a call on 1890 714 444 or email heretohelp@irishlifehealth.ie to check your plan and see what you may be entitled to!

You can read more about some of these fantastic benefits here

https://www.irishlifehealth.ie/the-parenting-path/redeeming-maternity-benefits

https://www.irishlifehealth.ie/the-parenting-path/the-big-day

For direct enquiries about our benefits with Irish Life Health pop us an email irishlife.health@doulacare.ie or

info@doulacare.ie for general enquiries

*Each policy plan is unique so you can check with their customer care team if your policy is covered or you can make amendments to ensure it is included

Mothering a baby who has Down Syndrome

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My name is Gillian Phelan. I was invited by Doulacare Ireland to talk a little bit about my daughter Elliah who was born with Down Syndrome and my experience with all that comes with it, and also what we are doing to help her develop at as normal a rate as possible.

Firstly a little back story... Elliah is my first child, born thanks to IVF (after many failed attempts and surgeries) in October 2018. I had an excellent pregnancy up to 34 weeks when my placenta rather suddenly shut down leading to a real emergency c-section. A movie-worthy dramatic scene. But that’s a story for another time.

Baby had to be taken to Special Care because she was small (4lbs), but breathing on her own and otherwise doing pretty well. As soon as I saw her I said to myself that her eyes looked ‘Down Syndromey’... Tests went off and we waited and waited and waited... Every day the consultants were hopeful that the results would be back “tomorrow”, or “ by the end of the week”. There really was a doubt in our minds. Some of our nurses said they didn’t think she had it. Others were less sure. Her eyes were literally the only tell tale - she didn’t have any of the other signs on the checklist. It took 17 days for the diagnosis to come back from Crumlin - 10 minutes up the road from The Coombe where we were. It was confirmed that Elliah has Trisomy 21 - which means that she has a third copy of her 21st chromosome. Nobody knows why it happens, but in 1 out of 800 births it just does.

So we were told what is to be expected of our daughter, and quite honestly, from the get-go it seemed very limited. We were being told not to expect much. That there isn’t much hope that she be independent or have a fulfilling life in the usual sense. Well, I absolutely reject that. Their limitations, not ours. Putting a child in a box labeled ‘limited’ will only encourage them to be just that. This is not acceptable for me. Additional needs or not, each child develops at a different rate, and faces their own individual challenges.

Needless to say, once the initial settling in period had passed, we looked into alternative therapies to help ‘wake up’ her senses so to speak. Basically we were interested in anything that would help bridge the gap between herself and other babies of the same age. Our goal will always be that she be as close as possible to doing the things that her peers are doing. Whether that be sitting up unassisted, crawling, walking, talking and all those other key achievements down the line. We are linked up with St Michaels House in Ballymun now and everyone is great. They do a fantastic job, they really do. But relying on that one Physio or Speech therapist visit a month and going one morning a week to the pool just isn’t enough. Physical and mental development go hand in hand, and we have now found a set of daily stimulation exercises that work for us and are giving good results.

We travelled to France to meet with an ex Montessori teacher who has a 5 year old daughter with DS. She has become an alternative consultant on all things DS, and sees families to build a personalised program for their children. Her daughters name is Marie, and she is quite exceptional. Her speech and motor skills are pretty much those of an average child of her age. She is at the same level as all her friends and attending mainstream school without a Special Needs Assistant. Emmanuelle started out with her solid Montessori background and has done extensive research and training to complement that. She saw Elliah over 2 days and gave us a program to follow based on her particular strengths and weaknesses.

We were highly recommended to read Glenn Domans (horribly entitled) book ‘How smart is your baby?’ Domans research stretched over 40 years and he worked with thousands of children and their families - for the most part the babies and children in his studies had brain damage, not DS. Specific exercises and hyper-stimulation techniques are used to override the problem and wake up the affected senses. Now I’m not going to lie, some of this stuff is totally counter intuitive for the mother of a small baby, but his results really do speak for themselves. So after reading the book, and seeing Emmanuelle in France, we had a specially adapted exercise and stimulation plan for our baby.

We have built her a crawling ramp to encourage as much movement on her tummy as possible. Children with DS tend to have issues with their muscle tone, so strengthening those all important neck and back muscles is vital.

We also had to ditch the traditional play mat which was not at all adapted to her needs. It has been replaced with a large gym mat - exactly like the ones we used to have in school (the navy blue yokes).

We also have a Dayvia light which is on constantly during her sessions. The very bright light is recommended for sensory stimulation of course, but also for helping with the distinction between day and night. Not to mention luminotherapy in our dark winter months.

The last ‘big’ thing we invested in after reading the research is an electromagnetic machine called an Earth Pulse. Designed to help athletes and Racehorses recuperate better, it emits a field adapted to the individuals needs so their rest is optimised and thus their performance enhanced. During their testing process they realised that all of the people partaking in the trial who had thyroid issues gradually stopped needing to take their medication. This is a key factor in DS. Our expert in France insists that ALL children with Down Syndrome have an issue with their thyroid. Even if a blood test says it’s functioning, ie producing satisfactory levels of thyroxin, there are no further tests done to check if that thyroxin is doing its job as it should in the cells. It really is one of those things where you believe it or you don’t. We thought that we have nothing to lose and a whole lot to gain. It’s been a few weeks now and Elliah is definitely more alert, more interested in her surroundings, more of a sparkle in her eye. She’s even sitting up in her highchair which is a big milestone and around the same time as an averagely developing baby.

Emmanuelle has been using the machine under Maries bed for a couple of years now and she insists that she started to see a difference in her capacities after a few weeks. Since we seem to have a similar timeline, I’m certainly inclined to agree.

It’s a lot. It’s very time consuming. But seeing Elliah improve every day is all the motivation I need

(I’ll have a shower when she’s 2 🤪) I’m also exclusively pumping which doesn’t help time-wise, but that’s my choice. It’s not a chore though. Elliah is not a burden. We feel as much love, and pride as any other parents. DS comes with the innate capacity to truly be oneself. To find joy in the simplest of things and to love without conditions or judgement. She is funny and sassy and an absolute ray of sunshine. I simply cannot imagine life without her smile.

Hopefully we are putting in place a foundation that will help our daughter be her best self and have more choices in her future. We will at least know that we gave it everything we had.

Well done if you’ve gotten to the end of this post 😂

What we wouldn’t do for our kids.

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A response to Barbara Ellen’s “Meghan Markle’s home birth should not blind us to the risks for most women” published on The Guardian, 13th April 2019.

A response to Barbara Ellen’s “Meghan Markle’s home birth should not blind us to the risks for most women” published on The Guardian, 13th April 2019.

I am deeply disappointed in The Guardian for publishing Barbara Ellen’s ill-informed, fear-mongering article on the dangers of Meghan Markle’s decision for a home birth in influencing us, common plebeian women, who couldn’t possibly have a safe home birth without the royal treatment she will receive.

Based on research and reliable medical evidence, the World Health Organization (WHO) states “It has never been scientifically proven that the hospital is a safer place than the home for a woman who has had an uncomplicated pregnancy to have her baby.” No evidence that the hospital is safer for uncomplicated, low-risk pregnancies. You can also find, on the NHS website, information regarding revised guidelines issued by NICE (National Institute for Health and Care Excellence) which “recommended that women with low risk of complications in childbirth should be encouraged to either give birth at home or at a midwife-led unit.” The HSE, here in Ireland, also states that “research shows that a planned home birth is an acceptable and safe alternative to a planned hospital birth,” again, for healthy women with uncomplicated pregnancies. The HSE itself offers a homebirth scheme as one of its maternity care options, as does the NHS.

I could stop here. But I won’t.

I’m offended personally by the assumption that we, common women, wouldn’t carefully plan a home birth, or any kind of birth for that matter, as we have learned to do so from horrific hospital experiences. Anyone who has been listening to Joe Duffy lately would know all about that.

Among the inaccurate information contained in the article, I’d like to clarify a few:

• Homebirths are not attended by one midwife, but two. That’s how it works under HSE guidelines. Besides, with a midwife, at home, you get continuity of care, which hospitals fail to provide due to the way they are structured. This continuous care, provided by one person who you have come to know and trust, is associated with shorter labors and lower rates of intervention; hence the ever-growing popularity of birth doulas (in all birth settings; hospital, birth center, home, etc).

• When women who are giving birth at home need to transfer to the hospital, they don’t get there by “any means possible”; they use an ambulance service which has already been notified of the start of their labor and has coordinates to their home.

• The article mentions the “risks to most women”, which is also untrue as high-risk complications occur in less than 15% of all pregnancies, as stated by UC San Francisco Health.

Furthermore, if Barbara knew anything about the physiology of childbirth (because yes, newsflash: it’s a physiological process, not necessarily a “serious, bloody business”, as she hauntingly states), she would understand that in fact “splashing about in a birthing pool […] surrounded by Jo Malone candles […] and Enya on Spotify” makes an enormous difference to the progress of labor and can be the crucial difference between a straight-forward, uncomplicated delivery and a cesarean.

Our Co-owner Mary Tighe seen supporting her doula client during a home birth

That is because the physiology of childbirth is dependent on intricate, sophisticated hormonal dynamics. The driver’s seat is taken by oxytocin. They give you a synthetic version of said hormone in the hospital to start or augment labor. They also give it to you to facilitate the delivery of the placenta and to prevent hemorrhage. Oxytocin also aids in bonding with baby and the start of breastfeeding, both of which the synthetic version can’t do, by the way. But how is oxytocin brought about naturally then? Well, it’s the hormone of love and intimacy. So it’s raised through touch, massage, kissing, being in a safe, quiet, intimate place, with dimmed lights and privacy, with freedom to move around, have some water, eat something if you so wish; with no strangers walking in and out, asking a million questions, poking and probing at you. And for some people that might very well be a warm tub of water or shower, surrounded by candles, with Enya on Spotify. Delivering a baby is much more like making a baby than we seem to want to recognize. So, the answer is: whatever floats your boat, as long as it’s a safe option for you. Feel safer in a hospital? Then by all means, have a hospital birth! Have a complication that may require medical attention? Again, the hospital is probably a safer option for you. But this commonplace, ignorant discourse demonizing something you obviously know very little about is unacceptable. As a woman, I find that adding even more fear to this process, which can be a beautifully empowering one, is unacceptable. It’s like bullying women, more than they already are in this “serious, bloody business”.

There are various, researched techniques, or methods, that can attest to the efficacy of supporting this hormonal interplay, as they usually translate into calmer, quicker labors, with less unnecessary intervention (which means less risks for mother and baby), and better memories to cherish forever, because you will. forever. remember. that day. They are the likes of Lamaze, HypnoBirthing, and Ireland’s very own GentleBirth techniques, devising an informed birth plan, or hiring a birth companion, such as a doula, all of which work to empower and support the laboring woman and her baby, her feelings and desires, and in turn, this miraculous hormonal process.

You might wonder how you may benefit from having a doula, a hired birth companion, at a home birth, like Meghan is said to be doing. Doula support might indeed look a bit differently at home, because they can focus on you and your partner completely, and not have to deal with the hospital environment. They arrive before your midwife and are by your side the entire time. It gets to a point sometimes where midwives actually need to rest, to make sure they are well able to identify your medical needs, while a doula, in quite a different mindset, will still stand by you. Additionally, should you transfer to the hospital, they will accompany you and provide invaluable continuity of care. 

General areas in which doulas focus their support include: emotional and psychological preparation, guidance, and ease; physical comfort, positioning, and nurturing touch; supporting you in your confidence, decision-making, learning, gathering information and understanding your preferences. Although doulas and midwives both value those components as part of a satisfying birth, doulas get to focus on them entirely, while midwives are tending to clinical tasks. So together, at home, they are a wonderfully powerful team.

Of all the fashionable trends out there, I think this would be an absolutely lovely one to get informed about—and yes, if it’s a suitable option for you and your specific circumstances, maybe even follow.

Anita Petry

Birth and Postpartum Doula with DoulaCare Ireland

Member of the Doula Association of Ireland

Originally from Brazil, Anita now lives in Dublin with her husband David.

The Irish Maternity System - Birth Trauma (Joe Duffy stories)

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DoulaCare Ireland have (like many others in Ireland) been listening to the stories that have been shared by families in Ireland on the Joe Duffy show over the last week. They have made very emotional listening at times. Unfortunately as doulas and childbirth educators we have been privy to similar stories over the years from women who have reached out to us, looking for someone to talk to. To know that women finally have a public platform to share their stories and to truly be heard is one of the positives to come out of the show. 

At DoulaCare Ireland we support clients nationwide, and of course some will have had past birth trauma. These women and their families often feel they cannot speak about their experiences or they will be treated badly on subsequent pregnancies. Those who do speak out often feel they are brushed aside or their trauma is belittled by hospital staff. 

There is very little support within our maternity service for those who have had challenging birth experiences and need someone to talk to. Many of these women often apologise for feeling upset about their experience. After all, they have a healthy baby. Shouldn’t they be OK with how things went? Everyone else seems to think they should be grateful that all is well with baby and move on. But just because you are thrilled to have a healthy baby doesn’t mean you don’t get to grieve for the birth you had hoped to have. It is OK to be upset at how you were treated during your pregnancy and labour. It is such a vulnerable time in a woman’s life and while we may be nervous about the unknown, most of us don’t think that this will be compounded by being spoken to harshly or mistreated by the people we are supposed to trust. 

At DoulaCare Ireland we work closely with other supportive organisations and refer our clients to available services. 

If you have an experience (negative or positive) within the HSE care you can leave your feedback on their site called Your Service Your Say. This information does get reviewed and will be brought to the person in question. 

https://www2.hse.ie/services/your-service-your-say/your-service-your-say.html

We feel it is important to highlight the fantastic work that AIMS Ireland have done since 2007. They are campaigners for safe and respectful maternity care for the women of Ireland and they work tirelessly on a voluntary basis to do so. If you need advice or supports please do contact them on www.aimsireland.ie

We are also proud partners with Nurture Health, who are a national counselling service. They specialise in the care of women and their families during pregnancy and the postnatal period. They have counsellors nationwide who offer space and time to women who have traumatic experiences or have postpartum mood disorders. Irene, the CEO, always ensures their clients are seen quickly and matches them with the best counsellor for their needs www.nurturehealth.ie (and some of your hours may be covered by health insurance - Irish Life Health for example, offer hours with Nurture Health through their Parenting Path packages for new families.)

Some women find it helpful to get their notes from the hospital. They can be requested by writing into the Freedom of Information Officer in the hospital attended, with Name, Date of Birth and any other relevant details. The applicant must mention that they are requesting their notes under the Freedom Of Information Act in order to receive them free of charge. They will write back  with a standard letter saying they will give a response within 28 days, before sending on the notes on. If desired and the Mum feels able to do so they can then request to meet with the Head of Midwifery or with your Obstetrician to have a review of your notes (AIMS Ireland also offer this option). 

Many of the stories shared over the last week have mentioned women being alone and frightened or not understanding what was happening. With DoulaCare Ireland these situations never arise. With our agency model, each client has their chosen doula but also a back up doula. They also have the support of our full team of 35 doulas - all fully Garda Vetted. This means no matter how long a labour and birth lasts (4 day induction for example) our clients will have constant support from a known doula. They also have the knowledge and experience of 35 doulas to tap into at any point. We have women with diverse backgrounds in our team, from women health physiotherapist, midwives, nurses, yoga instructors, antenatal educators and much more. While our role is not to speak for you during labour we are there to help facilitate conversations between client and their health care provider, encouraging the Mum to ask questions if it looks like there is a lack of understanding on their part. 

Doula support is scientifically proven to reduce traumatic experiences and postnatal mood disorders. A Cochrane Review 2017 showed:

Women who had doula support were:

• more likely to have spontaneous birth

• more likely to have shorter labour

• less likely to use pain medication

• less likely to have Caesarean birth

• baby less likely to have low Agpars

• Lower levels of Postpartum Mood Disorders

Women who had doula support had:

• 31% decrease in use of Pitocin

• 28% decrease in Caesarean

• 12% increase in Spontaneous Vaginal Delivery

• 9% decrease in use of pain relief med.

• 14% decrease in baby going to SCBU

• 34% decrease in risk of being dissatisfied after birth

We welcome the discussions on Joe Duffy show and thank the team in RTE for opening up the space for these women to share their story and finally be heard. It is shocking how many women have experienced trauma and remain silent. We hope that women will be able to find their voice, to speak up for their rights and to get the support they deserve. We also hope that those working in the maternity system listen and work to implement change. It must be hard for anyone who works in this area who actively supports and cares for women in kind and compassionate ways to hear these stories, as this is not how they would ever treat anyone in labour themselves. However, the myriad of stories from all over the country show that there is a systemic approach to treating women that needs to be addressed and changed for things to improve. 

Sharing these stories is the first big step. Well done to every single woman/partner/supporter who has spoken out. Your strength will be a part in driving change for all the women and their families who will be entering into the Irish maternity system. 

We are here to support all women and their families. Get in touch if you need compassionate care postnatally to help you recover from a traumatic experience, or if you are embarking on a subsequent pregnancy. Your voice will be heard.

info@doulacare.ie

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So Meghan Markle hired a Doula? What is that? Part 2

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So Meghan Markle has hired a doula and everyone is buzzing “what is a doula anyway?” Part 2.

There are two main types of doula. A Birth Doula and a Postpartum Doula. There are also Doulas who specialise in supporting families through loss and other niche areas

In this blog we will focus on Postpartum Doula support.

In times past (and indeed today in many cultures around the world) parents were not sent home from hospital with a new baby and expected to know what to do and manage on their own. We would have had the support of families, neighbours, friends - minding us, feeding us, helping us adjust to the changes in our lives and allowing the new Mum to rest and recover from birth and support her during the first few weeks of life with a small baby. Today we are often lacking this support and just expected to cope. People do call in to visit but don’t think to bring a cooked meal for the Mum, let her rest, load the dishwasher or ask how she is doing. The focus is often on the baby and the Mum is just expected to get on with it. However, we are not hardwired to manage in this way. We need the support of others in those first few weeks and months and in lieu of support from our community the postpartum doula can step in and offer this support.

A Postpartum Doula begins work with their client as soon as they book in. For some, this is during pregnancy (the forward planners!) and for others this is after baby is born. If it is during pregnancy, your doula will help you to prepare for your new arrival and the huge shift your life will take. If it is after birth, your doula will slot right in to your new routine (even if you don’t think there is any form of routine) As with Birth Doula support, your Postpartum Doula comes with many layers of support. We help you to debrief and process your birth experience. We nurture you while you recover from birth and find your new normal. We help your older children adjust to having a new dynamic in the family. We support your partner, adjusting to their new role and debriefing their own experiences. We offer knowledge, encouragement, information and support every step of the way - as each new day brings new challenges. Above all, we help you to savour the good moments between the chaos :)

Knowledge: Doulas are information junkies. We love reading, attending study days and growing our knowledge base. In DoulaCare Ireland all our Doulas must attend at least three CPD days per year. - which ensures the building of knowledge as evidence changes and new research is undertaken. We also learn from every interaction, with each individual client. We bring that knowledge base to you when you come home with your new baby. No matter what comes up, with your recovery after birth or your babies needs - chances are we have seen it before (or we know who to call if not).

Encouragement: Anyone who has had a baby, knows that surreal feeling of being left in charge of this new tiny human. Many parents feel “they are not seriously letting me home alone with this baby? I don’t even know how to bath him or tell if he is hungry” Don’t fear. It is normal to feel that way. The truth is no parent has the answers. Babies don’t come out with an instruction manual. We all learn on the job! The great thing is, with your Postpartum Doula by your side - you have a calm presence helping you every step of the way. So nothing feels overwhelming. You and your baby learn together, with a helping hand from your Doula.

Information: To new parents this is invaluable. The number one question we get asked… “Is this normal?” Rest assured, your Doula will have all the latest evidence and research at hand to help you make informed decisions when the fog of parenting clouds your brain. It can be hard to process information when you are recovering from birth and haven’t slept more than an hour in 2 weeks. Your Doula will give you the information you need in bite sized chunks so you can fully process it as required. She would also be delighted to tuck you up in bed, with clean sheets, after a hot shower and home cooked meal - and after a nice nap it is easier to think more clearly and have perspective on the changes in your life!

Hands-on tips and tricks: A Postpartum Doula passes on all the parenting tips and tricks they have picked up through their training and working experience. They help you to simplify your daily life. Sometimes it’s a gentle suggestion on where to keep the changing table, that you hadn’t thought of (like having a second one in that corner downstairs to save you running up and down the stairs 20 times a day) Sometimes it is demonstrating different methods of helping baby to get wind up - which can be a tricky skill to master.

Partners: Partners are often Doulas biggest champions! We help them to feel involved every step of the way. In parenting, it can be helping them to figure out how to put a baby grow on baby (which way is up? Are these the arms? We all know how hard it can be to get a new baby dressed!) It can be explaining the hormonal rollercoaster women ride after giving birth and to expect highs and lows. It can be a listening ear for them to debrief or to gush about their beautiful new son or daughter. Sometimes it is offering gentle suggestions to help them adjust to their new role and see what part they can play in supporting their partner and adjusting to their own new role.

With DoulaCare Ireland you have a full team of support. Each client is matched with the perfect doula for their needs. In the bigger contracts (100+ hours) you will usually have two doulas offering support. You have the opportunity to meet both beforehand. Both doulas will know your parenting style and wishes. This means that if for any reason your doula needs to change your scheduled hours you have the option of your second doula covering so you are never alone! Our co-owners Jen and Mary are always on hand too. We offer phone and email support to our clients and our doulas so no question is ever left unanswered.

We know from neuroscience that our brains are not hardwired to manage on our own in those first few weeks of adjusting to life with a new baby. All so often when we arrive at a new Mums house, they disclose that they feel they are doing something wrong as they struggle to cope. So few of us talk about how hard it is, that many are left feeling not good enough. The postpartum doula steps in to fill the gap. We are there to build confidence and make those first few weeks a positive memory for years to come - in other words to help a family thrive and not just survive the early days of parenting

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Meghan Markle has hired a doula, what is that? Part 1

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So Meghan Markle has hired a doula and everyone is buzzing “what is a doula anyway?” Part 1.

There are two main types of doula. A Birth Doula and a Postpartum Doula. There are also Doulas who specialise in supporting families through loss and other niche areas

In this blog we will focus on Birth Doula support. 

A Birth Doula begins work with their client during pregnancy. Supporting them throughout pregnancy, labour and birth. We don’t clock out at 8pm. We are there by our clients side every step of the way. Offering continuity of care throughout pregnancy, labour, birth and postpartum. We then visit our clients at home, offering support with all those early parenting questions.. We offer knowledge, encouragement, information and hands on tips and tricks of the trade. 

Knowledge: We help our clients to understand their chosen place of birth (most commonly a hospital) policies.We compare the different hospitals policies, statistics and what the National Clinical Guidelines say. We also chat about International Guidelines and help our clients to make informed decisions about their care. We also cover the physical process of labour and birth and common things that come up. We can assist our clients to create their birth preferences for their unique journey. After baby arrives we share all the latest evidence on infant care, recovery after birth and anything else you’re wondering about too!

Encouragement: We build up our clients. A huge part of our role is to help our clients (the birthing mother and her partner) to feel confident. We are like their coach or cheerleader from the sidelines, reminding them of all the skills they have gained throughout their pregnancy and the strength they have within. This does not stop once baby arrives. We build you up again after birth and remind you of that strength and knowledge.

Information: Apart from the mentioned topics, doulas also answer any questions that happen to arise with each client. It may be they read an article online and wonder does that happen in Ireland? Or they are told they have a condition (such as gestational diabetes GD) and would like information to help them feel informed and confident on how best to manage it.

Hands on tips and tricks: Doulas are not afraid to get in there and help out. During pregnancy we show our clients different massages, counter pressure and comfort measure to help during labour. We teach these skills to the birth partner so they feel fully involved in the process. On the day of labour often doulas and partners work really well together - tagging in and out (counter pressure can be really tiring after a few hours!) This support continues on into parenting. From showing you how to change and dress a newborn (which is surprisingly tricky at first) to helping you find a comfortable position to feed in - your doula will be right there. 

Partners: Partners are often Doulas biggest champions! We help them to feel involved every step of the way. Partners often say things like “I didn’t know what to do to help my wife” or “I felt like a spare tool in a scary unknown setting” but with a Doula supporting them - they have a full tool kit to draw from. They also get encouragement and a helping hand along the way. After they become a Dad/Mam we are still there. Helping them to adjust to their new role and offering guidance on how best to support you.

With DoulaCare Ireland you have a full team of support. Each client is matched with two doulas. You have your primary doula and your back up doula. You have the opportunity to meet both. Both doulas will know your birth preferences and wishes. This means that if for any reason your doula needs to take a break (such as a long birth, where your doula may need to grab some sleep), you have the option of your back up doula joining you so you are never alone! Our co-owners Jen and Mary are always on hand too. We offer phone and email support to our clients and our doulas so no question is ever left unanswered.

In next weeks blog we will discuss Postpartum Doula support.

Until then… Doula Jen x

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Postnatal Depression, when love doesn’t come as a thunderbolt.

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Postnatal Depression, when love doesn’t come as a thunderbolt.

I was 21, and diagnosed with Poly Cystic Ovarian Syndrome (PCOS), on a hot June day, in the consultants room, in a Cork hospital. One minute I was worrying about my parent's car being clamped, and the next minute I was being told,  if I was ever going to have kids, do it now in my early 20s. He closed the folder and stood up, as I sank into the chair. Fast forward to 23, going out with my husband, and about four weeks into the relationship, the clock now ticking so loudly, I sit him down and tell him. In September 2011, my daughter was born. Five years after my PCOS diagnosis. A greyness descended, initial happiness replaced with fears, thoughts, overwhelming feelings. My brain telling me that I’m not good enough for her. My husband was beaming, but my heart was breaking, because, after five years of hoping, wishing, endless sticks to wee on, I didn’t get that thunderbolt. I was in shock. 

I stayed in the hospital for four days, because I didn’t want to go home until I felt ‘right’ . That thunderbolt didn’t come. Over the following days and weeks, I lied to friends and family who were enamoured by her. I was staying awake all night, afraid, and dreading the moment she would need me again. Would she be better with someone else as her mammy? I envied my husband's love for her. I envied how happy he was. I loved her, but felt that I wasn’t enough for her. What if she didn’t like me? Friends kept telling me how lucky we were to have a happy, healthy baby. I didn’t feel lucky, I felt guilty, ashamed that I wasn’t enjoying the baby I had longed for. I was lucky to find a breastfeeding support group,  that allowed me to cry, talk openly, and not be judged. It became my lifeline. I found Kathy Kendall-Tackett's book, The Hidden Feelings of Motherhood, and it was eye opening, and reassuring. Dr Andrew Mayers from Bournemouth University, has done some interesting research about partners developing postpartum depression too.

I had heard some myths about PND , and medication, and I had fears about asking for help. What if they take her off me? What if, what if, what if? I became numb, and comfortable in my numbness. I hit rock bottom in 2016, when my neighbour passed away suddenly. A few days later, at my doctor's for something else, I broke down. He gave me some options, and I chose a referral for counselling. It was amazing. A weight lifted. The shame and guilt could be put down. I could breathe. 

I now work as a postpartum Doula, with Doula Care Ireland. One client described me as “a wonderful calm presence amidst the chaos" .I am not a health care professional. I am not there to tell you what to do. I give you the information,  and allow you to make an informed choice that works for you and your family. There is no one magic cure for PND, but , with calm, clear, informative support you can begin your journey out of the greyness. I am continuously working on being the best version of myself, and it is a continuous process. Sometimes I see glimpses of how I felt, in my clients, and it reminds me that the process of being mentally well, is something we need to keep working on.

Written by one of our doulas Dee Burke. You can fins out more about Dee and the support she offers here https://www.doulacare.ie/dee-burke-1/

If you or someone you know is suffering with a postpartum mood disorder these resources may help

https://www.nurturecharity.org

http://www.pnd.ie

https://www.cuidiu.ie/httpwwwcuidiucomsupports_parenthood_postnatal

https://www.hse.ie/eng/services/list/4/mentalhealth/mother-and-infant-health/#Finally,%20support%20services%20for%20those%20with%20Poatnatal%20Depression

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