Good posture (illustrated)

Found this very simple to understand illustration about posture in pregnancy from Farley Chiro. This is why I keep stressing for good balance and posture starting early in pregnancy.. or better, start now! Remember, 3 important principles for an easier birth (by spinningbabies.com): Balance, Gravity & Movement.

Invest in some money to see a chiropractor during pregnancy to align your body, or to learn general good tips about posture. InsyaAllah, it will be very worth it!

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A Saturday with Spinning Babies – easier childbirth with fetal positioning


I had a tough month of March. It was a true test to my work as a doula, but at the same time it was also a gift. Alhamdulillah I am now fully recovered.

Anyway, a couple of weeks ago, I attended a very useful workshop conducted by Gail Tully of Spininngbabies.com fame at Liverpool Women’s Hospital. In our doula community, we rely heavily on her website to help us in our work. Her website helps pregnant mothers deal with a misaligned/disproportioned reproductive system that may be causing pain or discomfort during pregnancy and birth. Pregnancy shouldn’t be uncomfortable and shouldn’t cause pain, numbness or soreness. If it does, then there is a good reason why the body is shouting for help. You will need to do something about it… and quickly too, or else it might have a possible unwanted outcome on how your labour works out later. Ideally, a good labour would mean gradual progress from less intense to more intense in a systematic manner. However, too many times do we hear of labours that stop halfway, or that the intensity doesn’t progress, etc. Her works also include useful positioning/exercises to help mothers have an easier and more comfortable labour/birth with help on how to get stalled labours going or how to help turn babies in a bad position back to a good one (which is what is causing labours to stall or be painful in the first place).


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My main take away from this workshop is that I must understand and accept that mothers in the future will face a lot more challenges in their pregnancy and labour, and it is not their fault. Why is this so? It is due to the way we live our lives now. You’ve all probably heard of the saying “orang dulu-dulu senang je nak beranak” (“our ancestors birthed without problems”), and this is true, but it doesn’t mean that just because they had it easy, we would too. Now, we don’t work on our hands and knees, we seldom sit on the floor anymore, we slouch a lot, we sit in a motor vehicle to get us around, etc. There are so many other examples of how modern technology reduces our mobility and the need to stay upright and balanced (the 3 main recipes for an easier pregnancy and birth). All these habits may displace the optimal foetal positioning that would be ideal for a comfortable pregnancy & birth. Human beings are meant to be upright, mobile and balanced. Not sitting down on an office chair all day, only to go home sitting slouchily on bus or car seat. So what do we need to do? We need to do extra help for ourselves… from the start.. or even before we get pregnant! Thankfully, spinningbabies.com has all sorts of information that will suit everyone.

So the 3 principles of spinningbabies.com are:
1) Balance
2) Gravity
3) Movement

What do we balance? Not only the joints of the pelvis, but also the muscles, fascia and ligaments of the entire reproductive system. If your body is balanced, you should not feel pain/sore/numbness in one side.  Make your daily actions (eg: sitting, walking, using computer, sleeping, washing etc) as balanced as possible. If you tend to use more of your right muscles for instance, now is the time to work those left muscles too.
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Imagine an egg balanced on two elastic bands as in this picture. That egg is your uterus and the two elastic bands are your uterine muscles. Gail says in her website: “Sometimes the uterine ligaments are not equal on each side of the body. If one side has shortened ligaments the entire lower uterine segment can have a twist in it. This effect is not uncommon among women who twist to do their work (massage therapists, nurses, chiropractors, etc.) or who hold a child on one hip frequently. A twist in the cervical ligaments can put the lower uterine segment into a slight twist which reduces the room for the baby to have a good head-down position. The baby may remain breech, posterior, or come down asynclitic.”

Activities to help increase balance: Rebozo technique and the Forward-leaning inversion

When we have balance, having gravity and movement will now greatly help in foetal positioning or for labour progress. Gail mentions that exercises like yoga, walking, swimming, stretches, dancing, pelvic tilts will only work better after doing the balancing activities mentioned above.

If you are a pregnant mum or hoping to get pregnant in the future, I really urge you to have a look at the superb website spinningbabies.com. It will give you an insight on how babies spin/rotate and the mechanisms that take place in doing so. MasyaAllah how grand is Allah’s design!

Gail Tully also provides useful tips on how to help a breech baby turn head down, how to engage baby in labour, and lots more! It is so amazing what she has done all these years to help mothers have an easier pregnancy and birth. Alhamdulillah I am so blessed to have met her!

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Gail Tully & Doula Hanani


If you have any questions to ask me about this workshop, you can send me a message over at my Yaqyn Birth page. 🙂

Can doulas work remotely?

If you hadn’t known yet, I am not living in Singapore at the moment. From Sept this year, to Sept next year (2012), I will be in a lovely place known as Leeds in the UK. DH is pursuing his studies at the Uni. of Leeds and brought me and DS along. 😀

Settling down had been easy, Alhamdulillah, thanks to our previous experience in Aus and NZ. This time round we’re wiser; we didn’t bring the whole house with us. I’ve made a lot of lovely friends, mostly Malaysian postgrads also from the university, and they have been very kind in helping us get the hang of things in Leeds.

Work-wise: my doula work from Singapore came with me to the UK and I’m very happy to announce that not one, not two, not three, but *four* of my mothers had a great birth experience with me as their ‘remote doula’. Watsapp is an amazing invention! Now, I had actually recommended them to get a different doula who can support them in Sg, but they reported that they had more confidence in me even though I’ll be far away. Alhamdulillah! *big smile* (I don’t recommend this though, for a guaranteed better experience, it is recommended that you get a doula in your country who can come to you and give you back massages and see you face to face, etc).

I told my mothers that “for every inch of confidence that you have in me, you must place the same amount of confidence in your birthing body and allow your baby to birth with zero or minimal medical intervention”. They listened and laboured in the comforts of their home with their DHs till the very last moments and spent just a short time in the hospital before they birthed! One first time mother was even ready to push as soon as she reached the hospital doors! SubhanaAllah, when they later told me their birth stories, I couldn’t help feeling their joy and almost feeling like I was there with them. But no, all the hard work and 100% credits go to the mother and her DH, for she had faith and confidence, and trusted her body to give birth exactly as she willed. All I did was to add that extra push of confidence to empower her. And Alhamdulillah, job done!

So you see, you *can* overcome your labour contractions at home yourself (or with DH) if you would learn to trust that Allah has designed your body for this amazing thing called childbirth. If you have had a healthy pregnancy, there is no need to panic when labour starts… you will be prepared… *breathe deep*…. and you will know how to take them in stride… *move your hips*… one contractions at a time… *visualise your baby coming down the birth canal*… and before you know it, your baby will be in your hands!

I’ve started a facebook page because I like to post links from other gentle birth sites, so please click ‘like’ and join me there. At the same time, I will also try to post updates here from time to time.

So what do you think? Can a remote doula work as effectively as a personal doula who comes to you? My honest opinion is she can’t, a ‘live’ doula can do so much more, ie: give you massages, give your DH a break, remind you to hydrate yourself, remind you to breathe, relax, loosen, to drink, to pee, etc. But if all you need is a little ‘push’ or confidence booster via watsapp, then I’ll always be here to help!

Warmly,
The Sg doula in UK

What Is A Doula and What Do Doulas Do?

(article from Bellybelly.com.au. For the original article, click here)

The word ‘doula’ (pronounced ‘doo-la’) is a Greek word meaning ‘woman servant or caregiver’. More recently, it refers to someone who offers emotional and physical support to a woman and her partner before, during and after childbirth. A doula (also known as a birth attendant) believes in ‘mothering the mother’, enabling a woman to have the most satisfying experience that she can, from pregnancy and into motherhood. This type of support allows the whole family to relax and enjoy the experience too.

Despite doulas being fairly unheard of in Australia, they have been actively supporting women for a very long time and are fast growing in popularity, as a result of positive word of mouth and the need for increased support. In fact looking at google statistics recently, searches on the word ‘doula’ are at its highest yet from 2004 to 2011.

Doulas are trained and experienced in childbirth and are usually mothers themselves. They have a good knowledge and awareness of female physiology, but a Doula does not support the mother in a medical role – that is the job of the midwife or doctor. She works on the basis of keeping birth normal and empowering, and should the birth become complicated and require medical assistance, a doula will still remain by your side and help in any way she can. She also does not make decisions for those she supports, but she assists them through the decision making process and provides balanced information so the couple can make their own choices.

Many women consider doulas to be a must for those giving birth in a hospital, due to the modern medicalisation of birth – unnecessary inductions are skyrocketing and 1 in 3 babies are now born by caesarean section (and yes, one of those interventions readily results in the other – its no coincidence). In Australia, some hospitals have caesarean section rates as high as 50% or more. This is a terribly high statistic, well above World Health Organisation recommendations of 10-15% – which makes us amongst the highest in the world. Given the long term emotional and physical effects this can have on the mother, her partner and baby, a doula to me is like an ‘insurance policy’ – which can help protect you from a disempowering experience. With a doula, you know that someone is always on YOUR team, holding the space for you and your family.

A doula works in birth centres, private and public hospitals and at homebirths in conjunction with midwives – but never as the sole carer at birth. Birthing without a midwife or doctor present is known as free-birthing however BellyBelly recommends birth with at a qualified midwife or doctor.

There are two types of doulas, birth doulas and post-natal doulas, with many doulas performing both roles. The difference is that the role of the post-natal doula is to nurture the mother at home after childbirth. This may include further breastfeeding support, light home duties, massage, emotional and physical support for the mother and so on. Post-natal doulas are particularly in demand as support for new mothers has reduced in modern society. Needless to say, studies show that post-natal doulas make a huge impact on the well-being of mothers.

The Promise Of A Doula

1. You cannot hurt my feelings in labour
2. I won’t lie to you in labour
3. I will do everything in my power so you do not suffer
4. I will help you to feel safe
5. I cannot speak for you; but I will make sure that you have a voice and I will make sure you are heard

What Are The Proven Benefits Of A Doula?

A recent review of many studies from around the world have concluded that a doula’s support is more effective than hospital staff, friends or family. You can read the review here.

Studies consistently demonstrate very impressive benefits for the mother, father and baby, including:

  • 50% less caesarean sections
  • Reduction in the use of forceps by 40%
  • 60% less requests for epidurals
  • 40% reduction in the use of synthetic oxytocin for inductions or augmentations
  • 30% reduction in use of pain medication
  • 25% reduction in labour length
  • Increased rates of breastfeeding at 6 weeks post-partum (51% vs 29%)
  • Higher self-esteem (74% vs 59%), less anxiety (28% vs 40%) and less depression (10% vs 23%) at 6 weeks post-partum

These are not misprints! The benefits are significant. Most of the women in the studies were accompanied by male partners, however study results show that women who had the support of a male partner and a doula fared best, for example, the caesarean rate of women supported by both a male partner and a doula was significantly lower (15.4%) than the caesarean rate for women supported only by their partners (24.4%). The studies also clearly show the positive benefits of doula support occur regardless of a woman’s economic status or whether or not they were privately insured. Its simply about having the right support with you at birth.

What About The Woman’s Partner – Does a Doula Replace Them?

According to the studies (and from personal observations in births I have attended) rather than reducing a partner’s participation in the birth process, a doula’s support complements and reinforces their role. Partners feel more enthusiastic and that their contribution to the labour and birth was meaningful and helpful. I often find when partners have a visual on how to support a woman i.e. watching me support her, they feel more confident and relaxing having seen some ideas to try themselves. In the studies, not only did partners report higher levels of satisfaction after the birth, but mothers reported feeling more satisfied with their partners role at birth too.

What Will My Ob/Hospital/Midwife Say If I Have a Doula?

More obstetricians and midwives are becoming aware of the doula as they become more popular; most are very supportive or are not bothered by a doula – in fact obstetricians and doulas rarely cross paths. If they do, it’s often for a very short time, during the birth.

In a recent birth I attended, a student midwife told me that they were currently doing a unit on birth support in her studies, and she was very impressed about the benefits and outcomes achieved with women who have doulas.

There is the occasional story I hear about some obstetricians not wanting a woman to have a doula present, however ultimately it is your own choice and decision as to the level of care you receive. An obstetrician is not present for you throughout most of the labour, only if you need intervention or to catch the baby (if they make it!). So continuous support from a known carer is crucial while you labour – because what happens during the labour can affect the outcome. It also is very telling about the sort of care you may receive at the birth if your Obstetrician is not open to you looking for ways to help reduce your chances of interventions. If your doctor is not supportive of you making choices, decisions and avoiding intervention, you may end up feel unsupported and disempowered in labour.

What Training Do Doulas Receive?

In Australia, there are several ways a Doula can train, through courses conducted by very experienced Doulas – some of which are also midwives, doctors and educators. Again, this is not medical training – doulas are trained in professional birth support. As part of a doula’s training, she may be required to read certain materials, attend several births (as an unpaid trainee), write assignments/reports, attend birth education classes and other requirements. If you are interested in becoming a Doula, see our BellyBelly article, Doula Training In Australia. (Doulahanani: In Singapore, you can train as a doula with Foutrimesters or Parentlink)

What Do Couples Think of Doulas?

Check out this short video on YouTube featuring couples talking about doulas:

Here are a few short testimonials from Australian couples who have used professional birth support:

“A very special thank-you… You made such a difference at the birth for us both, encouraging me when it all seemed too hard and helped me achieve the birth that has given our little girl the best start in life. Thanks for sharing this special time with us. I hope our paths cross again. You are a beautiful person with much to give the world.” — Catherine & Jason

“Thank-you for helping us achieve a wonderful birth experience. I felt safe and far more relaxed knowing I had the right support. Everything went exactly as I wished for with minimum intervention and stress¦ I feel sooooo grateful that we had such a great outcome. I am sure it is even helping me get through these difficult first months. I now know I CAN get through anything with determination, knowledge and support! — Meredith & Chris

“Wow I’m still in shock when I think about that long labour and the fantastic result – it was sooo worth it. I truly know that I couldn’t have done it without you – that is a fact. You are amazing and are truly made for the job – I really can’t thank you enough.” — Bronte & Michael – 2006

References and Recommended Reading

1. Klaus M, Kennell J, Berkowitz G, Klaus P. Maternal assistance in support and labor: Father, nurse, midwife, or doula. Clin Cons Obstet and Gyn 1992; 4:211-17.

2. The Doula Advantage, Rachel Gurevich, Prima Publishing 2003

3. The Doula Book, Marshall H. Klaus, M.D., John H. Kennell, M.D., and Phyllis H. Klaus, C.S.W., M.F.T. Da Capo Press, 2002

4. Sosa R, Kennell J, Klaus M, Robertson S, Urrutia J. The effect of a supportive companion on perinatal problems, length of labor, and mother-infant interaction. N Engl J Med 1980; 303(11):597-600.

Kelly Winder is a birth attendant (aka doula), the creator of BellyBelly and mum to two beautiful children. Become a fan of BellyBelly on Facebook or add Kelly as a friend (frequently adding articles and stories). You can also follow BellyBelly on Twitter.

Disclaimer: Doulahanani did not write this article. This article is from bellybelly.com.au

Of the Rebozo technique and our traditional midwives

Last week, I attended a very useful doula sharing session at Fourtrimesters. Doula Catherine shared some useful tricks she learnt from a birth conference she attended in Cairns last year. We took turns practising it on each other. What do you get when you combine 10 sister doulas practising labour techniques on each other – lots of fun and laughter of course!

It wasn’t my first time hearing about the Rebozo technique, but it was definitely my first time trying it first hand. It didn’t strike me at first how familiar this is all supposed to be to me – that my own Malay traditional midwives practised this since 100 years ago. I didn’t realise this until I asked my next client if she would be willing to let me try it on her. Her immediate sms reply – “Is it like lenggang perut?”

Lenggang perut or swinging the belly has been a traditional practise in some clusters of our Malay community, typically the Javanese. Like the Rebozo technique, it makes use of a long piece of cloth or shawl (the mexicans used rebozos, the javanese used batik cloth) and when placed under the lying mother’s bottom or hip area, the cloth extends like two long arms. The midwife or doula will stand over the mother and pull the cloth right and left to swing the belly.

How is this helpful?
This technique can be done throughout pregnancy to encourage optimal feotal positioning. It is also useful to turn a posterior baby if done during late pregnancy.

The modern Rebozo (click on pic for original source)

vs The traditional batik cloth

2nd Breastfeeding Basics Workshop

Thank you sis Hidayati for organising this again~

“Dear beloved sisters,

Back by popular demand! A 3hr workshop on breastfeeding basics for our sisters, by our sisters, specifically pregnant mothers or new mothers just learning to breastfeed.

When? Next Saturday 5 Mar 2011!
…11am – 3pm
Breastfeeding Basics Workshop by Doula Hanani

What?
Intro & Welcome
Myths abt Breastfeeding
Why breastfeed? & other facts
How breastfeeding works (practical exercise, using balloons or you can also bring your own baby sized doll/teddy)
Breastfeeding problems
Q&A

What to bring?
It will be a potluck lunch so if you can manage, bring something simple and healthy! Fruits, sandwiches, salad and finger food are some ideas. But in small quantities (for 5pax) pls, so there won’t be wastage.

Please RSVP for the workshop, or indicate interest if you are not sure you can make it yet 🙂 We do this on a voluntary basis and we need a min of 8 mothers to run the workshop so please please indicate interest quickly if you are a pregnant or new mom interested in learning about breastfeeding. You can also bring your mother/helper (Malay-speaking ok), but lets keep this ladies only so we can freely exchange our questions etc.

Hope to see you! And please pass the word around esp to other pregnant mommies you know!”

Waterbirthing suite @ NUH

As promised, here are pictures of room 12 in NUH, the only room there with a tub for waterbirth.

Rightfully I’m not sure if I’m allowed to upload these pics up, but I believe this will help to publicise their waterbirth suite, so should be okay right? Will take them down when NUH contacts me! 🙂

The waterbirth tub

Room 12 - The room with the waterbirth facilities

View of tub from bed

December Daze

I’ve been on a doula hiatus for December because am in the midst of ‘doula-ing’ for another big event come January – my brother’s wedding. I did just one ‘phone-doula’ (a new term I coined for doulaing over the phone) because this client’s hospital wouldn’t give me clearance until I got my certification in paper. Alhamdulillah it went well and she was in established labour for only 1 hr! I don’t really like to doula over the phone because I don’t get to do much and I get very frustrated about it, lol! So I’ll make sure I’ll get my paper cert before I get called to that hospital again, InsyaAllah. At the same time, I am also making several friendly visits this month to new mums who need a hand or two to help them in breastfeeding.

Some quick updates that made me a very happy doula!:

1) One of my bfeeding class participants is successfully bfeeding after a c-section. I was very happy when she told me how empowered she felt that she changed her gynae at the very last min (>36 wks!!) just so she could have a chance to (at least) try to naturally deliver her breech baby. Her 1st gynae did not give her this chance and insisted she opt for elective c-sect. See how much impact a little gesture from your gynae can make on you even though the outcome (c-sect) is the same anyway.

2) I found a fellow Muslim and hijab-ed doula based in Kuala Lumpur!! So if you’re living in Malaysia and hoping to get a doula, leave me your contact details and I’ll get Nadine Ghows to get in touch with you 🙂

Stay tuned for my next update! I will be posting pictures of the waterbirth tub in NUH. 🙂