What is Closing the Bones?

Closing the Bones is a traditional South American postnatal ritual, given to mothers within hours of giving birth. It can also be given days, weeks or even years after birth and still have amazing benefits. The mother is rocked, massaged, soothed, physically and emotionally supported with the manta and soothed from head to toe.

IMG_3135

Why do mothers need it?

In our culture there is little to honor the mother and the amazing work her body has done in creating a new life. It is common to give gifts for the new baby, but rarely is the mother herself and the hard work her body has achieved is acknowledged!

IMG_3124When we look at other cultures around the world, it is common that new mothers are cared for and nurtured so that they may in turn nurture their new baby. The postpartum period of 40 days is often recognised as a time when mothers are vulnerable and need support to regain their strength.  Traditional practices may heal the body after the intense work it does during pregnancy and birth, as well as allow rest and relaxation enabling the body to recuperate. Special foods or some type of body work may be given such as massage or binding with cloth.

 

Towards the end of pregnancy joints soften and become more flexible. During birth the pelvis physically opens so that the baby can be born. It is important that the pelvis realigns correctly otherwise this can lead to pelvic instability; the pelvis supports the weight of the spine and head and can be the seat of unresolved trauma.

Closing the Bones is about physically closing the pelvis again: the massage part of the treatment cleans, renews and moves fluids and hormones, stimulates the immune system and helps tone muscle and tissue. The massage also has osteopathic benefits – tension in the lumbar spine is released (this area is subjected to a lot of pressure during pregnancy); helps remove bladder and uterus tension caused by compression on the bladder and suspensory ligaments of the uterus, improves function for the sacro-iliac joint,   enables the pubic bone to move back into position and helps to loosen gluteal attachments and fascia. Fascia is a tissue that encompasses the whole body and can tighten with stress.

The ritual of Closing the Bones also has an emotional benefit. Many women who have received it have spoken of how they felt a release of emotions that had been held since they had given birth or from their experiences of becoming a mother.

The ritual begins by ‘rocking’ the pelvis using a manta (also known as rebozo in mexico) followed by a complex abdomen and pelvic girdle massage using a warming oil and then finishing by tightly wrapping the hips with the manta.

The mother is then left to rest for a short time and to enjoy the comforting feeling of her hips being held in this way and her emotion to flow in a safe and supported way.

What do mums say about their Closing the Bones ritual?

“Sarah gave me a ‘closing the bones’ massage three weeks after having Austin and it was a wonderful experience. She created a calm and relaxing atmosphere and really put me at ease. Her touch was warm and gentle, whilst the rebozo wrapping felt strong and supportive. My hips felt amazing after struggling with pain through most of my pregnancy. I highly recommend this postnatal massage, a chance to think about your body at this time of adjustment.” Becky, mum of four 

A Closing the Bones treatment can be a wonderful gift for a new mother; it can also be helpful even years after a birth when the mother feels she has unresolved emotions. Please visit my website here for more details and how to book your treatment.

IMG_3134

Advertisements

Two important dates for women around the world, both in the month of March – International women’s  Day (8th March) and World Doula week from the 22nd March.

To celebrate Women’s Day locally, Taunton Area Unite Community, produced a display of ‘postcards’ with nominations for inspirational women – both locally known and worldy famous, British and International. Nominees included Dr. Helen Sharman, the first Briton in space, to Debra Searle, the first person to row solo across the Atlantic. Some women were nominated for their politics and passion for human rights such as Aung Sang Suu Kyi, who initiated a non-violent movement for democracy, and Malala Yousafzei an advocate for girls right to be educated. Local nominees included a GP, Dr. Catherine Lewis, who works hard to dedicate time to all her patients, midwife Kate Hopwood who provided much needed support to her nominee, and Frederica Smith a local councillor and campaigner and founder of RAFT (Refugee Aid From Taunton) which sends aid to refugees all over the world.

Behind all the nominees is passion, commitment, drive and strength. When I am working as a doula, it is the strength of women that is most apparent to me. Women’s physical strength to cope with their labour and the challenges it often brings, but also their emotional strength to ride the highs and lows that birth and postnatal life bring.

I was very much humbled to be included in this display. My nominee put my name forward because of my commitment to providing birth, breastfeeding and postnatal support in my community. Behind my commitment lies my passion for supporting parents – I want every mother to feel confident in herself to birth her baby, and in turn parents to feel confident in caring for their baby and able to make decisions that are right for their family.

You can see the digital version of the display here

World Doula Week begins on March 22nd. After a conversation between myself and some of my doula sisters, we developed an idea to celebrate the week with a patchwork quilt. We took our inspiration from Ina May Gaskin’s idea ‘Safe Motherhood quilt‘ which is a commemoration of women who have died from pregnancy related causes. With time not on our side (!) we decided to create a virtual quilt made up of photos of doulas, and even developed our own collective noun – a cuddle of doulas! As our patchwork grew, so did we as a visual collective force of women who are united in supporting and enabling women and their families through pregnancy, birth and beyond.

You can see the ‘quilt’ here

Breastfeeding Support

Recently, an article in the Lancet reported that the UK has some of the lowest breastfeeding rates in the world.
So why are more mothers not breastfeeding? Breastfeeding is the natural way to feed a baby – mothers have been feeding their babies in this way since mankind began – it can’t be that hard can it?
Or can it?
In 2010, 81% of mothers initiated breastfeeding at birth. After one week, the breastfeeding rate drops to 69%, and to just 55% at six weeks. At six months, just over a third of babies are still receiving breastmilk. Exclusive breastfeeding rates (i.e. just breastfeeding with no use of formula or solid foods) are even lower. The world Health Organisation (WHO) recommends exclusive breastfeeding for the first six months of life, and continuing to breastfeed into the second year of life and beyond. The Infant feeding Survey also tells us that the majority of mothers who gave up breastfeeding in the first few weeks would have liked to continue breastfeeding for longer.
So what is happening? It seems that mothers want to breastfeed but are not enabled to do so. Here are some of the key issues that mothers discuss at the breastfeeding drop-in group that I run.

Am I doing it right?

Some of the problems cited as causing mothers to stop breastfeeding are sore nipples and insufficient milk. Often, when a mother has become sore when breastfeeding, it can be due to the way that baby is latched. The latch is how the baby attaches to the breast to feed – there are many factors that can affect the latch but possibly most common is the positioning of the baby whilst feeding. There are a variety of positions to use, and in the early weeks with a new baby it is a case of experimenting to find what is most comfortable for mum and baby. You can find more information on positions to try here
Once your baby is latched you can look for signs of a good latch such as baby’s head tilted back slightly, mouth open wide, chin tucked into breast, cheeks full and rounded, and more of the areola (darker area around nipple) visible above rather than below mouth – see here for more info.
Ultimately feeding should be comfortable for mum and baby should be drinking (you may hear swallowing and see movement at your baby’s temple as he/she feeds)

How do I know if my baby is getting enough?

It can hard to feel confident as a new parent. Often when a breastfeeding mum encounters difficulties with her baby, it is her ability to produce enough milk, or milk that is of a good enough quality that is questioned. However our bodies are really very good at providing exactly what our baby needs, and contrary to popular belief, breastfeeding mums do not need to eat a specific diet, nor drink vast quantities of fluids to maintain a good milk supply (see here)
In fact the best way to ensure a good milk supply is to follow babies cues for feeding, and to feed for as long as, and as frequently as baby requires. Babies may cue for a feed for reasons other than just milk – it is comfort, reassurance and love all rolled into one. Feeds may not have a regular pattern, certainly in the early days, but a baby needs to feed 8-10 times in 24 hours to be able to receive enough milk.

As your baby feeds, your body is stimulated to make more milk. In fact our bodies make milk 24 hours a day; the rate increases whilst the baby is at the breast so a mother will not run out of milk if she is feeding according to her baby’s cues. It is very normal for babies to cluster feed, often in the evenings. Babies also go through growth spurts when they will feed frequently for a few days – this stimulates the mum to produce more milk to meet the baby’s increased needs. It takes a few days for our body to catch up with what our baby is doing, which is why the baby may seem unsettled until the milk production increases.
One way to tell if your baby is getting enough milk is to look at nappy contents. A baby who is under a week old should wee and poo every day. After this, some babies will poo less frequently, and some breastfed babies can go many days before passing a poo. Have a look here for more information.

I find it hard to position my baby

Babies need to learn to breastfeed, just as mums do. A wonderful way to learn together is to enjoy some skin to skin time. Babies love this contact with mums (it is equally important for babies to have skin to skin time with dads too). When you are in skin to skin contact your body produces lots of oxytocin, the hormone that drives breastfeeding, and also promotes bonding. Your baby’s oxytocin level also increases which helps them feel calm and relaxed, which in turn helps them to follow through on their own reflexes to breastfeed.

If breastfeeding is not going as smoothly as hoped, enjoying skin to skin time, in a relaxed position with your baby on top of your body so that you are tummy to tummy, can help take the stress out of breastfeeding and allow mum and baby to enjoy just being together. Have a look here for more information about using this position to help breastfeeding.

I need help!

Support plays a major part in a woman’s ability to establish and continue breastfeeding. Dads can be the first line of that necessary support. Dads can provide emotional support (telling her she is doing a great job and how proud he is of her) as well as practical support (simple measures such as making a snack or a drink for her whilst she is feeding can help the mum feel comfortable and able to keep breastfeeding). Sometimes it is the Dad who thinks to reach out for further support – ringing the midwife or health visitor, or a breastfeeding counsellor. It is very difficult to know what is normal when you have never experienced something, and new parents often have many questions concerning their care for their new baby. No health practitioner minds being asked such questions – and no question is too silly to ask.
Support groups can be a valuable source of information, and equally important, allow new parents to meet others who are very often going through similar experiences. This can enable the new parent to feel more relaxed knowing that what they are experiencing is common, and in turn may feel more confident in being able to meet their baby’s needs. I run a breastfeeding drop-in group at Cannington, Somerset and the mums often say how helpful it is to come along and chat with other breastfeeding mums. They enjoy the group describing it as ‘warm and welcoming’; that they ‘feel listened to’ and that support and information they receive is ‘very helpful’. One mother wrote ‘the Breastfeeding drop-in has been an oasis for us – somewhere to go for a hot cup of tea and be able to chat to other like minded mums’. Another wrote ‘If I had not had the support in feeding my two children I could not have continued’. Another mum said ‘the group was like a haven – I got a lot of benefit from the group for tips on sleeping’.

Support and information may also be sought from midwives, maternity care assistants, breastfeeding counsellors (try NCT, ABM or La Leche League) or lactation consultants, through telephone helplines, or breastfeeding clinics. To find your local breastfeeding group, you could ask your health visitor or midwife, or phone one of the national helplines listed below:

  • NCT 0300 330 0700
  • La Leche League 0845 120 2918
  • ABM 0300 330 5453

In this article I have only covered a small selection of tips that may be helpful to you whilst breastfeeding – if breastfeeding is proving a challenge or you feel that you are struggling, then please get the information and support to enable you to continue to feed for as long as you and your baby wish.

#myNCTstory

I first encountered NCT when I signed up for their antenatal classes when I was pregnant with our first child in 2001. Little did I imagine at that point that being involved with this amazing charity would eventually lead to me developing a career that has taken me in directions that I would never have thought possible.
The NCT Antenatal classes provided me with information and support and enabled me to develop confidence in myself and my ability to birth and breastfeed. At a time when none of our friends were having children, our NCT class introduced us to other local parents-to-be and we all formed a close bond through the mutual support that we provided for each other when our babies were born.
By the time I was having our second child, some of my other friends had started families of their own. They turned to me as an ‘experienced mum’, for breastfeeding support. Although I had breastfed my first and second child, I felt I wanted to be able to have the background knowledge and training to offer one to one support to other mothers. I decided to train as an NCT breastfeeding counsellor. I discovered that I loved the NCT style of facilitation, and the course content which covered breastfeeding knowledge, counselling skills and adult learning theory and practice all fuelled my passion for supporting new parents.
I qualified as an NCT breastfeeding counsellor in 2010. Part of my new role was to facilitate the breastfeeding session of an NCT antenatal course. I have to admit I was not looking forward to it – I have never been a particularly confident person, and certainly never relished the thought of standing up in front of a group and talking. However I found I really enjoyed the sessions, and from the feedback that I received it seemed that the parents enjoyed them too.
I live in rural area of Somerset, and felt very aware of the limited services for anyone in my area, but especially new mothers. There was no local breastfeeding support, so when I heard that a new children’s centre was to be built in the next village, I contacted the area manager and requested a meeting (something else that I never imagined I would do!) I put forward my idea of having a local breastfeeding drop-in group, and the manager appointed me – to run one locally and two more in the Bridgwater area. Three years later, the contract had to be terminated due to funding cuts, but I was determined to keep a group going. I applied to Awards for All, and in January 2014 I was able to open the Cannington Baby Cafe. The word spread about what mums could gain from attending such a group – warm, friendly, non-judgemental breastfeeding support and information (all values at the core of NCT). Mums travelled from across Somerset to attend the group where they could meet other mums and importantly, enjoy a hot drink! Sadly the funding ran out a year later, but since then I have secured another group to re-open as an NCT drop-in, and also to fund some training for peer supporters who will be able to help support the group as the attendance has grown.
Today I continue to facilitate the group and breastfeeding classes. Last year I qualified with the NCT to facilitate their new antenatal course, ‘Essentials’ and I have loved being able to work with parents through such an important time in their life. It was a desire to offer more support in the antenatal and early postnatal period that also led me to train as a NCT doula. Today I work as an independent doula, but my training and the support I received whilst attending the NCT course was exemplary.
Supporting people in their journey to parenthood my passion – my training and my work with NCT has led me down many new paths, given me new skills and so much more confidence in myself and working with other professionals.
And the best part of all is how many wonderful parents I have had the privilege to work with, at what is often their most vulnerable, challenging, exhausting, rewarding and exciting time of their life.

Baby Cafe launches in Cannington, Somerset, UK

Aside

On the 13th January 2014, local breastfeeding mums gathered at Cannington United Reform Church for the opening of the newest Baby Cafe. We were joined by local health visitors and midwives, the MP for Bridgwater Ian Liddell-Grainger and the councillor for Cannington, Ian Dyer. All enjoyed meeting and chatting over lovely refreshments including a beautiful celebration cake made for the event by my good friend (and one of the mums from my original breastfeeding group) Emma Chillingworth of Rainbow Bakes. Everyone was very impressed and supportive of the new group.

I applied for and received a grant of £5000 from Awards for All to set up the Baby Cafe, and I was delighted to see so many mums attending. I am well aware that support is one of the key factors in enabling mums to establish and keep breastfeeding – new mums gain confidence and support, meeting other mums in a friendly and welcoming atmosphere, and I am there each week to offer one to one breastfeeding support or information. We also have a selection of books that are available to borrow, as well as useful leaflets and DVDs covering breastfeeding and related baby topics such as weaning and sleep.

The Baby Cafe charity, established in the UK in 2000, coordinates a network of breastfeeding drop-in centres and other services to support breastfeeding mothers across the UK and other parts of the world – there are now groups as far afield as the Channel Islands, Mexico, New Zealand, Singapore and the United States!

Baby Cafe drop-ins support 7,800 mums annually – in total mothers make 30,500 visits to Baby cafe drop-ins , with the drop-ins offering  7,500 hours of support annually. Baby Cafes are run by health professionals such as midwives, health visitors, or lactation consultants. They may also be run by healthcare practioners e.g. nursery nurse or maternity support worker, or by breastfeeding counsellors. The most common reason for attending Baby Cafe drop-ins is for the social support gained from being with other breastfeeding mums. Close behind are the specific issues for which mums seek professional  support (sleep issues, starting solids, expressing milk and milk supply issues)

99% of mums surveyed find their Baby Cafe drop-in ‘very helpful’ or ‘helpful’

 All pregnant and breastfeeding mums are welcome to drop in at any time during opening hours. Partners are welcome too. Cannington baby Cafe runs every Monday except bank holidays, 10.30am-12pm at Cannington United Reform Church, high Street Cannington.

Contact me through my website at www.sarahharcombedoula.co.uk or see http://www.thebabycafe.org/ for more details

Image  Image

Image

Knitting and doulas – a yarn of pattern, rhythm and relaxation.

Last month I attended a hospital birth. In the weeks before the due date the mother-to-be and I met several times and discussed what she felt she may need to make her birth comfortable. These included suggestions of relaxation techniques – visualisations and ways to focus on releasing tension. We also discussed massage or touch – did she like firm or gentle touch, on her back, feet, or hands? We talked about music, positions for birth, and the practicalities of the support I could offer.

A few weeks after our last antenatal meeting, the mum called me to let me know her labour was beginning. Once she felt her labour was beginning to settle into a pattern, she rang again to ask me to make my way to meet her at the hospital. When I arrived she was very happy sitting on her birthing ball in the early stages of labour. The atmosphere in the room felt relaxed and happy as I chatted with the mum and dad to be.  

As her labour progressed, the mother became more and more inward focussed and I felt confident that she was finding her own rhythms and ways to concentrate on what her body was telling her to do. Our chatter ceased as the mum fell silent through each contraction as the sensation demanded more of her attention. I had brought some knitting with me and after two false starts of the pattern, I got into a rhythm myself, of knitting a baby hat. I found that knitting had exactly the effect I had read about – instead of focussing solely on the mother, I could relax and focus on my knitting. Perhaps this sounds a little odd – surely doulas are meant to ‘be there’ for the labouring mother, by her side, supporting her physically or emotionally, not getting on with a craft project! However, knitting can have a much deeper effect than just creating a piece of clothing….

The French birth expert, Michel Odent wrote of a renowned midwife, Giselle,  who often knitted at births she attended. In his article ‘Knitting needles, cameras and fetal monitors’ (1996), he focussed on Giselle’s knowledge of physiology of birth and the importance of privacy and darkness for a woman in labour. He wrote how a woman may feel less observed by a midwife whose attention appears to be focussed on knitting. Odent still talks today of the importance of labouring women having privacy and not being watched.

Odent later wrote how repetitive tasks are an effective means of reducing tension. Labouring women can be particularly sensitive to atmospheres or feelings within a room – if those around her are stressed or anxious the mother may pick up on these feelings and in turn become anxious herself. Anxiety and fear produce adrenalin  – this hormone counteracts the effect of the hormone oxytocin, which drives labour. The converse is also true – if the atmosphere in the room is one of calm, then the mother is more likely to feel relaxed, allowing the free flow of oxytocin and her labour to progress.

Odent suggested that if a woman is aware that her midwife is knitting, then she may feel reassured that all must be well with her labour and that the midwife is not worried about what is happening. Knitting helps to keep adrenaline levels low, creating a relaxing sense of security all round.

When I knit, my mind can clear of the chaos of the day and I can become almost meditative as I relax into the rhythm of the clicking of the needles. When in labour, women need to be able to switch off the ‘thinking’ part of their brain and tap into their instinctive thoughts to guide them through their work of bringing their baby into the world. Many women find a rhythm or a routine to help them focus, yet relax, and in this way I feel I share a connection with the mother.

I hope that the baby’s hat that I completed is a reminder for the mother of how strong she was in labour, how her mind and body carried her through her labour, how she was able to use a rhythm to keep relaxed and focussed and – perhaps – how my relaxed state empowered her to have the birth she wanted. 

Face of Birth

Last week I attended the Bridgwater Positive Birth movement’s screening of the film ‘Face of Birth’. This is a documentary looking at our human rights as women, to chose where, when and with whom we give birth. The film focuses on birth in Australia, and the stories of women who had chosen to birth at home, but also looks at birth on a global scale. It features interviews with some of the worlds top childbirth experts – Michel Odent, Sheila Kitzinger and Ina May Gaskin to name a few.

What struck me was the power of their emotions surrounding their stories, even though for some their children were now adults. Our births are an experience that remains with us for life. Research has shown that if women do not have a positive birth their confidence in mothering their new baby can also be undermined – mothers are less likely to breastfeed and are more likely to suffer postnatal depression.

The important message that is conveyed by this film is that women need those choices and to feel empowered in their birth so that they can have that positive experience. In the film the UK was portrayed as a country where there are more choices surrounding birth – here we are still cared for by midwives rather than doctors during our pregnancy and birth, and home births are an option whereas in some countries it is not supported.

I wonder, how did you feel about your birth? Did you feel that you had autonomy surrounding your choices? Have you been left with a sense of empowerment and fulfillment?

Do visit the page http://www.faceofbirth.com/index.html for lots more info and interviews