Hindrances to Natural Birth #52 : Tickets

Image courtesy of Arvind Balaraman / FreeDigitalPhotos.net

I'm pretty sure that if I were to ask you about some of the top hindrances to natural birth, 'tickets' would not be high on your list. Pitocin, lithotomy position, hospitals, a medical model of care, our culture of fear around birth: these are all pretty obvious. But I believe some of the real hindrances to natural birth may be somewhat more banal.

Labour is a shifty thing sometimes. One of the hormones that keep labour going - oxytocin - is considered to be a 'shy' hormone. It is not easily released under pressure. It is the hormone most intricately involved in lovemaking and released during orgasm. It is also the hormone that causes 'let down' or a fast flow of milk when breastfeeding. In short, oxytocin is the hormone of love, labour and lactation. 

Couples struggling to get pregnant who have to do the 'baby dance' on a particular day or even at a particular time will often attest that being 'forced' to make love on schedule kind of kills the vibe. 

Let's take it a bit further. Imagine you are in the middle of lovemaking and someone knocks on the door, peeks around it, and switches on the main light, just to check how you're doing. Are you there yet? Shall we check to see how far you've got to go? It seems to be taking some time. If you're not done in x amount of time we may need to help you along. I'll be back shortly. As you were. Toodles! 

Vibe. Officially. Dead.

Now that sounds ridiculous when applied to lovemaking, but the same hormone, oxytocin, is what induces and keeps labour going. 

So imagine: you are at the end of your pregnancy and your mom has booked her ticket from across the country, or across the globe, for the day before your expiration due date. She only has three weeks off work. The pressure is on. The clock is ticking.   

The thing is, when a pregnant mom has a perceived time limit within the labour process, her body is far less likely to release sufficient oxytocin to keep labour going effectively. On a larger scale, when a mom feels under pressure to go into labour to begin with, it actually makes it much harder for her to do so. 

And so she starts looking at induction options. Inductions can be helpful when there is a genuine medical need for them, but often then lead to a cascade of interventions as illustrated below.

There is lots I could say about inductions that would give some evidence for the diagram above - but that is a whole other post on its own! Let's rather look at some solutions to avoiding inductions altogether. Firstly, let people know that 'estimated due dates' are just that, estimates - there is about a 4-6 week window of 'normal'. I've got another post in this series looking at the notion of due dates as a hindrance to natural birth. I'll link to it here once it's up.


I know you get better prices if you book tickets long before the time and I know grannies-to-be would love to be around at the when babies are born - but I would really encourage you to find a way to not have time pressure around the time of your birth, especially if you are aiming to have a natural or low intervention birth.

Do you have creative ideas on how to avoid time pressure around your labour day? Please share them with us!

The doula as a witness

I love that I learn from every single birth I have the privilege to attend. Each family and each birth requires different things from me - different words, different actions, different energies. Part of the skill in being a doula is knowing when to use which words, actions and energies. 

At times I stand by as a quiet presence, at other times I am in constant contact. Some moms prefer silence, while others want distraction. I rub feet, hands, hips, legs, backs and shoulders, I stroke hair,  I whisper encouragement, I turn down the lights, I turn up the heat, I fill the pool, I bring cool washcloths, I hold the space, I keep everyone fed and watered - doing my best to remove any hindrances to the birthing mother. 

I do all these things, but I feel they are all secondary to my role as a witness.   Of anyone involved in the birth process this one is almost unique to doulas. Partners are present but the birth is their own birth experience too. The midwife, the nurse, the doctor - they have their own responsibilities that often involve papers, numbers and tools - they have additional concerns that I don't have to carry. I am able to be there - truly present - with all my energy and attention focused on the birthing mom. I know midwives who choose to be fully present with the birthing mother, but these are rare.

And so I often get to see the things that others don't. I witness a birthing mother glowing serenely through yet another wave; the gentle interactions between a mom and her partner; the dad's face as he marvels at what he and his partner accomplished. I witness the mother's triumph as her dreams and expectations are clothed in flesh.

I am there for the disappointments too. I witness the moment when the gynae orders a second caesarean section after a long battle for a VBAC. I am there when her wishes are disregarded and her body violated with impunity by those with greater authority than me. 

In those moments something in the depth of me rages.  I don't dispute the medical justification for their actions, but too often there is little to no acknowledgement of her desires, her struggles, her strength, her autonomy, her personhood. 

Something in me rebels at the idea of being complicit in a system that routinely disregards evidence-based care in favour of convenience, that favours policy over personhood.

While this system rolls on, someone has to mop up the emotional fallout after institution has done its work. While there is little I can do on my own to improve the care women get while giving birth in our birthing institutions, I can bring empathy - the ability to sense, understand and share the feelings of another - because I was there.  

So to all my doula moms, thank you for the privilege of allowing me to witness your journey...

I was there when you believed you couldn't go any further but you did anyway. I was there when you felt your body would split itself apart but you kept it together. I was there when you found and accessed that primal power deep inside. I was there when you pushed past exhaustion. I was there when your hopes were shattered, when your deepest healing was won, when your darkest moments were met, and overcome. 

I saw what you did. 

Your triumph. Your power. Your vulnerability. Your pain. 

I saw it all.

And I want you to know: you are magnificent, you are fierce, you are breathtaking. 

I know because I was there, and I remember. 

Mother's Blessing - Alternative Baby Shower!

A group of women stuff their mouths and try to outdo each other's horror stories. They play some games that may or may not involve chunks of chocolate cake floating in a potty full of orange cordial and watch the mom open a mountain of gifts and pretend to be ecstatic about yet another pack of wet wipes while everyone makes comments about how the pile she already has will last her less than a week. Ha ha. 

'There must be more to it than this!'

Have you ever felt that way at a baby shower? 

So what if there was an alternative? What if we could create a space for women to come together to celebrate motherhood and to honour and encourage the mom-to-be? If that sounds like something you might like, then you will love the idea of a Mother's Blessing! 

I have had the opportunity to organize two Mother's Blessings for friends of mine and both have been very well received - even by the more conservative, less hippy-dippy ladies attending!

Usually a Mother's Blessing will be attended by a close circle of female friends and relatives. The idea is to create a safe space for the mom to share her fears and doubts, and for the women present to share their stories.  

The shape a Mother's Blessing might take:

• General Introduction - It is helpful to introduce the idea of a Mother's Blessing so that the women have an idea of what to expect. I usually mention that many women experience having a child as more life changing than getting married and we really should honour that rite of passage. It is a joyful but challenging time. When you get married, you know who you are getting, because you chose them! But when you have a child there is much more uncertainty involved. Women spend so much time comparing and competing that it is important to set aside time to honour and encourage and let the mother know that she is not alone, that she has a circle of women around her who will support her in this transition.

• Personal Introductions - Have each woman introduce herself and perhaps mention how she is connected to the mother if the group is large. Women can also introduce themselves as a link in a lineage of women - mine would be, 'I am Leigh, mother of Amelia and Eloise, daughter of Tracey, grand-daughter of Nancy, great-grand-daughter of Betty.' There is something special about seeing yourself as a link in a chain of women giving birth through the ages. 

As a side note: Something I find fascinating is that by the time a girl-baby has reached 20 weeks gestation she already has all her eggs! So when you are pregnant with a girl you are also carrying half the DNA of your grandchildren! So half of me was already present in Nancy's womb all those years ago... Doesn't that give you goosebumps?

• Pampering - There are a few things you can do to make the mother feel special. Here it helps to have some inside knowledge of what the mom enjoys. It may be an Epsom salts foot bath with some pregnancy-friendly essential oils for one mom, for another it may be a hand massage or a head massage - again just make sure that the person doing these is aware of the guidelines for massaging pregnant ladies. Someone close to the mother can brush her hair for her, ready for her flower crown...

To make this flower crown on the right I used florist tape - that green stuff that is stretchy but not very sticky. Start winding around one or two flowers and every 2cm or so add another flower and keep winding and adding flowers until you reach the right size and join them in the same way as would add another flower.

• Beads - Each woman attending brings a bead or trinket to be strung onto a necklace or bracelet for the mom to wear in labour, or just to wear for fun. Some also bring beads for the baby as well. At the most recent Mother Blessing I organized we asked each woman to bring a bead that signified something about the mom for them - and we also supplied a varied selection of beads for those who didn't have a chance to get one before the time! So, for example, a clear bead with a gold core could signify that you see the mom as transparent in her dealings with people, and that you believe she has a heart of gold. This is also good if there are ladies who can't be there - they can send a bead and a message and still be included! In the image below, a guest strung Tara's necklace on the spot so she could wear it straight away.

• Encouragement - The idea of being a mom can be very overwhelming. I think it is important to remind the mother of qualities she already possesses that will help her in her parenting journey. So, as each woman gives her bead, she can tell the mother something she has seen in her character that will help her in her parenting journey. For example, the one mother I organised a blessing for had spent some time with my children and I was always impressed at how she treated them with patience and kindness and respected their individuality - so I reminded her of a time where I had seen her do that. This idea is also relevant for subsequent Mother's Blessing (i.e. for 2nd and 3rd babies) - the women can tell the mother about things they admire about her parenting.

Further ideas:

• Foot washing - Recently I organised a Mother's Blessing for a doula client so I washed her feet as a symbol of how I would serve her in her labour, and also on behalf of the women around her who had committed to serve and support her through this life transition.
• Candles - Each guest can bring a candle for the mom to light while in labour, or alternatively, the host can supply candles that each guest can take home to light when they hear the mom is in labour. 
• Henna - If there is someone in the mother's circle of friends and relatives who is handy with that kind of thing it can be really lovely to have the mother's belly decorated with henna. Each lady attending could have a henna motif done on a hand or a foot as well if there is time.
• Belly cast - A belly cast is a lovely way to remember a pregnancy and a great way to get everyone involved. The mother may not be totally comfortable with having everyone coming into contact with her naked torso, so a bikini or smooth bra can help, or the belly cast could be done before the time and decorated at the Mother's Blessing. Click here for my belly cast tutorial.

String - Towards the end of the blessing time it is a lovely gesture of unity to have the attendees stand in a circle and each put one hand in the circle. A ball of yarn is then passed around and each woman wraps it twice around her wrist and passes it on to the next lady. The yarn is then cut and each lady can knot the yarn around her own wrist to be worn as a reminder of the pregnant mother. The string is then cut when the mother goes into labour. For those women for whom this is not something they would do, I have offered to braid the string onto a keyring or onto a zipper as a bag tag - anywhere that they will see often. 

• Food - In this day and age I think it is not out of the bounds of good manners to ask close family and friends to bring a plate of eats to share. You could specify sweet or savoury on the invite to get a reasonable balance. 
• Flags or quilts or stones - At a Mother's Blessing I organised recently we made a strip of bunting in the colours of the nursery (see image on the right). We then had guests write single words or short phrases in fabric marker on the individual flags so that one day when mom was having a hard time she could look up at the bunting and see what all her friends had wished for her and be encouraged. No one can be sad while looking at bunting! Sometimes guests use fabric markers to write on pre-cut quilt pieces than can then be made into a quilt or playmat for the baby. Alternatively, you could provide river stones that guests then write their words on.
• Quotes and Poems - Each guest can read out a quote or poem about motherhood, and then write it in a blank book provided so that the mother can read them afterwards.
• Freezer Stash - A great idea is to get some of the mother's baking pans and casserole dishes before the time and have them available for the attendees to take home. Then at some stage before or after the baby is born they can bring the mother's own dish back - full of yummy food of course! This certainly saves the mother the inconvenience of having to return baking dishes when she is trying to focus on her baby. Alternatively have attendees who are willing to provide meals write their names on a list to be contacted when the time comes. 
• Positive Birth Stories - Moms can share their positive birth stories, or if their stories were not so positive, they can share how they overcame difficulties they experienced along the way.

Some tips if you are organizing:

• Be sensitive - As much as a Mother's Blessing is for the mother, be sensitive to the women attending the event when planning. Not everyone wants to smooth wet plaster strips across another woman's naked breasts! But, having said that, don't underestimate how far women will go to show their love for the mom-to-be!
• Pick and Choose - There are so many lovely things to do at a Mother's Blessing that it may be hard to choose - but things often take longer than you think so don't feel you have to include absolutely every idea. Try to choose those that the mother would appreciate most and leave some ideas for future pregnancies! 
• Enjoy yourself too - So often event organisers are so concerned that everything must be perfect that they forget to enjoy themselves. Don't let that happen to you! There is no 'perfect' Mother's Blessing anyway, so go with the flow!

If you like the idea of a Mother's Blessing please do share this far and wide - if you hover over any of the images you will see a 'Pin It' button - feel free to use it!

For the sake of future moms, let's start an alternative baby shower revolution!!! 

'Two Cent Pearls' presents...

'Two Cent Pearls' is me adding my two cents to the cacophony of voices on the InterWeb, in the hope that some may find some pearls of wisdom...

So if you ever wanted to match a face, voice and some crazy eyebrows and weird facial expressions to a name, now is your chance. At the moment I am recording them on my built in webcam, with a desk lamp for light and a mini microphone for sound, but as time goes on and I get better at this I'm trusting that the quality of video will match the quality of the words spoken...

So here is my introductory video:

And my first 'feature' - 'Your Body is not a Lemon' which includes some musings on a quote by Ina May Gaskin from her book 'Ina May's Guide to Childbirth.' (Getting clever with adding some tchoons!)

Please share these videos if you like what I have to say, and even if you don't necessarily like it, but it got you thinking. Also, subscribe to my channel if you would like to stay up to date with new posts! You can find a link to it here: 'Two Cent Pearls' YouTube Channel

Feedback is always welcome! And if there is anything you would like me to talk about, please do let me know!

Until next time, please do remember:

Keep Calm and use your BRAIN!

This little acronym - BRAIN - is a powerful tool to increase your chances of getting evidence based care. So here goes - your care provider suggests a procedure, such as a stretch and sweep, or an induction, or even an internal exam at 38 weeks, or an episiotomy, or even a Cesarean birth - what do you do?

Sometimes medical decisions are based on outdated policy, financial or convenience factors rather than on what is best for mom and baby. Many parents are not sure how to question their care providers in a way that opens doors of communication rather than slamming them shut. The BRAIN acronym facilitates discussion in a non-threatening way.

What this really all boils down to is making sure that you are making informed choices and giving informed consent. This is a tricky field legally, and particularly in the area of labour and birth where there is a huge emotional component involved and families feel particularly vulnerable. 

Just remember, no one is allowed to do an internal exam or 'adjust' your cervix without your consent - if your care provider asks to do an internal exam and you give permission, and are informed afterwards that your cervix was manipulated or your membranes stripped - that is not informed consent and that is a violation of your patient autonomy. 

Furthermore, no one can inject you with anything or put anything in your drip, or cut into your flesh at any point without your informed consent - and if someone is busy doing something, an internal exam for example, and you say - STOP - you have withdrawn your consent and that person is required to stop what they are doing and withdraw their hand. 

You may be asked to sign a blanket consent when you are admitted to hospital (if you are birthing in hospital) - please read through it and discuss whatever you are concerned about. Perhaps you could get a copy before the time. It really is worth it! I have heard too many stories of women lying in bed for the duration of their labour because they believed that was just how it's done and didn't know they could request otherwise. Or women coerced into unnecessary inductions because of the doctor's leave schedule. For a first time mom, inducing labour drastically increases chances of having a Cesarean birth. If women truly knew the risks of the procedures they are apparently consenting to I think our phenomenally high Cesarean birth rate in our private hospitals would be a thing of the past.

There is much more I could say about this, but you get the idea. When in doubt, use your BRAIN!

Just so you know, I actually have a website dedicated to helping parents make informed choices along their birthing journey. Click here: http://www.giving-birth-naturally.net

When have you used the BRAIN acronym before? Please tell us!

Alternatively, was there a time you would have used the BRAIN acronym had you known about it? Tell us your story!

Private Birthing Venue!

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You will have a midwife and her assistant devoted to your care for the duration of your labour and birth. All essential equipment is provided. 

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Birthing suites come complete with double or queen size beds,

including free accommodation for partners and siblings.

You can even bring your pets!

• No set menus or meal times - you decide when and what you eat.
• You decide who may visit, and when they may visit.
• You will be able to sleep while your baby sleeps. No one will wake you at 5am to check your pulse, and your sleep will not be disturbed by the sounds of babies not your own. 

Get all of this for less than half the cost of a natural birth at a private hospital!

Yes, you guessed it, 

GIVE BIRTH AT HOME!

So yes, while I know that not every can or wants to give birth at home, I just thought it was funny that we pay so much to get a home-like birthing environment.

Belly Cast Tutorial

In it's curing spot, before refining and reinforcing.
Such a beautiful belly!

One of my kind doula moms, Candace, agreed to be my crash test dummy guinea pig in my attempts to make a belly cast. I'm considering the possibility of including belly casting as a service for my doula moms or anyone else who wants one for that matter, so I thought some practice would be a good idea!

I'm not a complete newbie when it comes to the art of working with Plaster of Paris; I majored in sculpture at varsity so PoP did feature at some point! I just don't remember it being quite that messy... I digress.

The basic idea behind belly casting is that you put Plaster of Paris bandages all over mom's belly and whatever else she wants casted  (breasts / thighs etc). Once the plaster sets it pops off and once it has cured you can reinforce, sand and paint it and hang it in your baby's nursery or anywhere you want to show off you beautiful belly! You'll need at least one person other than the mom, but having two people working seemed to work well for us. What we didn't take into account was trying to take pictures with plastery hands, so you'll need another helper if you want pics.

So here is how we did the belly casting:

What you need before you start:

From the left: Plastic wrap / Gloves / Vaseline /
Baby Wipes for mom afterwards /
6 rolls of PoP bandage in 2 widths.

• A belly attached to a willing volunteer
• A drop sheet (we cut up some rubbish bags - it's messier than you think!)
• A chair (we used a sturdy coffee table so mom could lean back on one arm)
• Something to smear on said belly to prevent plaster from sticking and causing unwanted nipple waxing Petroleum Jelly is what we used.
• Plaster of Paris Rolls - We used 10cm wide by 4.6m long. 4-6 rolls should be enough. You can get different widths if you like.
• Plaster of Paris Powder - for smoothing and reinforcing
• Flat container with water - warm water sets quicker, cold water sets slower - we just stuck with room temperature! Warm water not recommended!
• Large sharp scissors - I used kitchen scissors
• Hole Puncher - For punching holes in the cast so you can hang it
• Plastic or Latex Gloves - Check for latex allergies  Non-sterile is fine. You could use those gloves like the ones you get in hair dye kits, but I find them a bit clumsy for fine work.



Mom's Throne =
Sturdy Coffee Table
+ Cushion + Plastic

• Plastic wrap if mom doesn't want her nipples to show or if she wants the cast to go over the pubic area. Alternatively you could get those handy disposable paper undies from the discount chemist.
• A bottle of red wine and some jazz on the go - And perhaps some smelly candles depending on the time of day.

Try to make sure you really have everything ready before you start! Otherwise you will end up with white hand prints all over your kitchen. True story...

Before you start: Some considerations

• Decide how big / extensive you want the cast to be. Just belly? Belly and boobs? Belly, boobs and thighs? One shoulder? One or two or no hands on the belly? Just remember that you can't take the cast too far around the body - you want to be able to get out once it's set!
• Pick a position. Most of the time women choose sitting positions - if mom is at all prone to feeling faint or dizzy then standing is not recommended! Changing positions while casting is also not recommended. Make sure her spot is comfortable!
• Cut the rolls of plaster into 30cm lengths, with a couple of shorter ones for more detailed areas - especially if you are including a hand. Square pieces are great for nipples and belly buttons.
• Have a shallow bowl of water ready. Tap water should be fine. Cold water will cause the plaster to set slower, while warm water will speed setting.
• Lay your drop sheets down - and make sure there is space for your water tray quite close to the mom.



A spot for the cast to cure once you're done.
What? It looks like you just rolled up some
newspaper and piled it up on a  chair cushion!
Um, er, yeah, that's exactly what I did.

• Prepare a spot to put the cast to cure once you're done. We used a chair cushion with a stack of bunched newspaper to help maintain the shape while it cured. 

Ready to start?

Double Triple check that mama has had a pee in the last two minutes. You'll need her to sit still for a good half hour so make sure she's been fed and watered too.

My volunteers were Candace and her partner, Mat. I was going to be their doula at their upcoming birth so doing the belly cast was quite a good icebreaker in terms of being in each other's space.

About to pop... Candace and the Cast!

Ok, so once you're ready to start it's time for mom to get undressed. Make sure the room is warm enough / cool enough and that she doesn't feel too exposed. If you're doing a belly cast at a baby shower, just make sure there isn't a chance of Great Uncle Ned walking in on the process.

First you need a lubricant of some kind so that the plaster doesn't stick to the skin and give an unwanted nipple wax. If you're using latex gloves, don't put them on yet! The Vaseline will eat them up. I think you need something pretty sticky i.e. not olive oil. You are not trying to rub it into the skin, but make sure it forms a layer on the skin - like those chaps who do ice water swimming covered in a layer of Vaseline. I'd really like to find a natural alternative to petroleum jelly though, I just didn't have a chance this time. You could also wrap mom in some cling wrap, although you do lose detail that way.

Once the smearing is done the smearer can make sure his/her hands are wiped clean of the lubricant and put gloves on. I guess gloves are not absolutely necessary if you don't want to use them - the plaster will eventually come off your hands. But that's entirely up to you.

So being the good doula, I got Mat to smear the Vaseline all over the casting area and once Candace was sufficiently greased, we took one last sip of red wine and got working. You'll need to work quite quickly from here! 


 Take your strips of plaster bandage one by one, zip them through the water (i.e. don't soak them) and lay them down on mom's belly.

• As you lay the strips and smooth them you will see how the plaster fills in the gaps in the bandage.
• Use the square pieces for the nipples and belly button so you can get reasonably good detail. Again, Mat was happy to oblige. Try not to put too many layers over these areas to keep as much detail as possible.
• Lay the strips in different directions for greatest strength. and ensure everything is covered in at least two layers. 
• Keep going until everything is well covered. Make sure to reinforce the edges and corners and try to make the edges even, but it's not a train smash if they aren't - you can sort that out later.



From the other side

• At the end we smoothed the whole cast over with some plaster paste made with 2 parts PoP powder to 1 part water.

• Mom will feel the cast get warm - Don't Panic! That is what the plaster does as it sets... She will start to feel it popping off as it hardens anyway so it should come off pretty easily after about 20-30 minutes after you lay the first strip. 

Put the cast down in its curing spot and give mom some wipes to take care of the worst of the vaseline, then help her get to a bath or shower to clean the rest off. She may need a loo break. 

Then you clean up...

24-48 hours later

The cast needs 24-48 hours to cure completely so make sure it is well supported. Now you can smooth some of those edges and do some finishing off. 

With this cast I trimmed any rough edges with kitchen scissors and took strips of plaster and reinforced all the edges i.e. laying the strip along the edge and folding it over. I also reinforced the internal points of weakness - the crease under the bust and the space between the breasts. 

Top of the cast with rough edges

Trimmed with kitchen scissors and reinforced with plaster strips.

If you hold the cast up the the light you will see if there are any weak spots. You can also fill in with a little bit of plaster paste where necessary. 

Hopefully you can see the reinforcing here! This is looking from the inside.
 It is reinforced all along the edge,  in the crease of the bust and in the space between the breasts. 

I then used a hole punch to make holes to hang the cast - once I had reinforced the spots where the holes would be. 

Hole punch...

You can sand the cast quite smooth if you like.

Once it is as you want it you can seal it with something called gesso; you can get it at most art shops. You can also paint it with acrylic paints, or write on it with permanent marker - it really is up to you!

I'll add a pic of Candace and her belly cast when they are reunited...

So tell us, what would you do with your belly cast?