Weekend babies on the NHS

 

I woke up this morning and as is my habit, tuned into LBC.  I like to keep up with what the great British public are thinking about and medicate my homesickness for London.  This mornings birth news story was repeated over and over again. A discussion began about what can make birth safer. I asked a non-birth world friend (already a parent three times over) how they would feel if they were having a baby now and they came across this article “……frightened….like I would want to do the impossible and try and keep the baby in if it was coming on the weekend……” of course – this is a reasonable response to hearing that one in six baby deaths during birth at the weekend in England could be avoided.  Tuesday is the safest day.  So what will happen now with parents?

Tuesdays will be over run and I can imagine many women deciding not to turn up at the weekend if they can avoid it and maybe if they can’t too.  Not turning up when they are worried about their baby, not wanting to have an induction on a Friday, if they burst their amniotic sac of fluid, if they would ordinarily be ready but staying home that extra night in fear.  Fear we know is an adrenalin producer. Adrenalin we know is a direct inhibitor of oxytocin which is our love hormone.  Physiologically we need oxytocin to make our cells contract to open the womb for our baby to get out.  We are designed so well – this means if something frightening happens we can stop giving birth and deal with it.  It’s troublesome to not be able to produce it in abundance because you are freaking out your baby is coming on a Saturday night.

This was no small study – it can be found in its entirety here.  Imperial college London analysed 1.3 million births and found that babies were 7% more likely to die during birth or in the first week of life if born on a Saturday or Sunday. Infections after birth were 6% higher and the chance of the baby suffering an injury was also 6% higher.  Researchers found clear evidence of poor care and this was not due to a lack of senior doctors either.

So what can we do as mothers and fathers to counterbalance this?  Carefully considering your place of birth is a really good place to start.  What will be safest for you? Where will you feel safest? What is their reputation? You can often find feedback sections for maternity units on their websites and we are also in the fortunate position that we have an independent organisation that collates figures and facts called Which? You can find them here. The Birthplace Study has found that home and birth centres are generally safest for most women – even high risk – you can read more about that here.  My experience supporting at births over the years reflects this.  At home you have two midwives dedicated to caring for you and your baby and they can go nowhere else – they are with you constantly once you call.  We imagine that labour wards with doctors, equipment, theatres and medication will solve all manner of ills and there is no doubt at all that they can be very useful when needed but with all of those technologies come a further degree of risk – seemingly we are frequently introducing this risk to women and babies without having the staff to monitor as closely as needed or indeed the capacity for surgery that is needed once those higher risks manifest.

Also thinking about who you may choose to have with you can make a real difference. Having another woman with you who has given birth before has been known to greatly reduce risk. It significantly reduces the chance of c-section, instrumental delivery, induction, epidural and ups the chances of breastfeeding – this all lowers risk considerably.  Have a look at this piece of research here. I had my sister with me for my babies but this may also be your yoga teacher or someone who does this professionally like a doula. You can read more about doulas and find one near you here.  Doulas are fantastic at lowering risk. Why? They are on constant watch to make sure you have all that you need and sometimes its the doula who spots the clinical risk when the professionals haven’t. This is a very controversial issue as it is most definitely out of their scope of practice but what are you supposed to do when you can see blood pooling under an increasingly pale woman and the midwife is tapping away on the computer in the corner? When you see your maternity notes being handed to another woman who’s going in for her antenatal appointment? When a woman is convinced she is having a stroke and no one is listening to her? (I spoke with three midwives before a doctor arrived about 45 minutes later to check out the patient) When a baby is actually coming out and both mum and dad are saying this and the midwife is still asking who the GP is whilst again tapping information into a computer while dad is shocked and trying to catch? (in this case mum was a doctor). When syntocinon (a hard-hitting synthetic version of the  hormone associated with greater risk) is clearly going into a womans tissues rather than her blood supply and her hand is swelling and swelling? These are all real life situations I have personally witnessed and I could go on before I even begin to add in all the others I have heard of as a mentor.  This isn’t an attack on midwives and doctors – I’ve seen and know many who do a fabulous job at doing their absolute best to keep everyone safe and loved.  It seems to me that these over sights are often the result of a HUGE amount of bureaucracy and policies and procedures and machinery to read and attend to before you can fully concentrate on the mother.  We know that their is a problem with listening – this article here helps you to understand that. We are currently spending millions in the NHS on the Compassionate Listening programme. Alongside serious staffing issues which are clearly much more to do with not funding enough midwifery posts to deliver the standard of care that keeps everyone safe and supported including the midwives and much less to do with a shortage of midwives.

Something needs to change. My first thoughts when I heard this headline this morning were that this would generate a whole lot of unhelpful fear and stress. With some reflection I think what it also does is open up the discussion that when we are overworked and over stressed we cannot work safely and we need to be having that discussion over and over until something changes. It’s just the human condition. Now this is out in the open we can begin walking towards change one step at a time keeping mothers, babies and staff loved, safe and happy.

nicola mahdiyyah goodall is a revert muslim who grew up with hip hop based in edinburgh, scotland and london, england. she works with women trying and mainly succeeding to build circles of knowledge and community primarily with birth. read more about her and find out how to access her services here. she is now also part of a new doula collective in london called birth in the city launching 2016 – watch this space!

she is also the director of wysewomen publishing and facilitates wysewomen workshops and red tent doula courses.

 

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Birthing with Sisters

Birthing with sisters

 

“When someone else speaks of a similar experience, it can evoke the memory and bring back the feelings, which restores the experience. Only if we speak from personal experience does this happen. This is why we need words for women‘s mysteries, which, like everything else that is of women, seems to require that one woman at a time birth what she knows. We serve as midwives to each other‘s consciousness“.

Jean Shinoda Bolen  

“Crossing to Avalon”

 

On a quite afternoon, as Scotland’s weather seems to show it’s magic with mist and rain. We were drinking tea in Nicola’s kitchen and talking about womanhood, sisterhood, birthing and life.

 

Me: Nicola, tell me, about your doula journey, how did you get to this point where you are now? How did you become a doula? I know you may have talked a hundred times about it, but maybe some new angle…

Nicola: Well It‘s really good to think about it every time. I have a very fortunate set of circumstances. I came to have my children in this community where everybody seems to have babies at the same age as me. My sister was there with me and had already started her family, and my family. Nobody was really bothered, they had their babies easily. I was really fortunate, because I had never thought how frightening it could be.

Me: So you were not damaged?

Nicola: Yes, I think I wasn’t  (laughing). I was protected. All the bad things that I was told, It just didn’t sink in. I don’t know why, maybe that’s the way I am. I never expect things to go wrong. I am upset with people when things go wrong, but I get more upset about the brutality of bad treatment. When the midwife comes sometimes it is just the government health program, it’s not midwifery. It becomes a tick box exercise, like  OK “I had you in the hospital”, “Ok, I am filling out my notes”, “Ok, I am going”. No words like “Hurray, you have a baby, it’s great” or “how you guys doing?”, “how do you feel about it”.

Me: Working through all these years, do you think this attitude changes?

Nicola: I think they don’t have time and resources to practise true holistic midwifery. I think it is getting worse, because they are under more pressure now. When I had my first baby twenty years ago and I had named midwife, I really connected with her. I will never forget her. She caught my baby and  I was told to go to the postnatal ward at 1 o’clock in the morning, and my husband is going home. I was in my early twenties. She obviously saw my face and she told me “I am going to take you there”. She took me upstairs and she sat at my bed for about 2 hours drinking tea with me. This is extraordinary in our health service. This is never happening in our local hospital today. No midwife is coming and sitting with you. It’s just not going to happen, because they are so overstretched. It would be like disappearing from their job for two hours.

Me: This is the thing, that amazes me all the time, how birth is related to initiation. This is such an intense experience and you are very vulnerable at that moment. If you get stuck in there, it can be so damaging and painful, and you will have to walk a long way to heal these wounds. It seems like a lot of women are carrying birth traumas in our time.

Nicola: It’s shedding. You have to shed. My last daughter is in puberty and she is in this hormonal “I am angry”, “I am crying”, “I don’t know what’s wrong”.  I gave her a cuddle and said “we are really lucky that we have this shedding, that you can shake all the things that you have to shake off to become a woman”. We have this before every cycle. In our bodies we have to shake off, to prepare for a possible new baby. It’s  happening in the menopause, in your wise age. A lot of women are really angry having premenstrual stress, or they don’t know why they are so angry when they are pregnant. Its very important to go through it, not to be medicated, to have somebody with you who knows about this. It’s sad, that most people don’t have that.  

Me: I think we are coming to this question, how would you explain, what you do as a doula?

Nicola: I had to think for a long time about this. I decided, that a doula should be the ultimate faith bearer. She always believes everything will be ok – in an almost worshipping way. Even if something happens, it’s still going to be ok. You believe, that woman will walk through whatever she will have to walk through. It can be hard, but eventually it will be all right. You have to be the person with your feet on the ground. You have to give them love. You have to really give them love.

Me: It seems, that doula work is so related to the shamanistic way. You go through something, that seems like chaos. The shaman tells you, that’s the principle of life, that’s how it works. Suddenly everything clears out. It’s like Jung would say, in every chaos, there is a cosmos.

Nicola: I think, that midwives were shamans. You still find midwives around the world creating ritual and ceremonies. I was talking to one Native American guy, who used to be in a difficult place, but now he is helping the young people when they are in the same situation as he was. He is using traditional ceremonies and rituals. When I asked him what he does for a living, his answer was: “I am healing the next seven generations and the previous seven generations”. He is saying, that the good birth, and a good birhkeeper is also doing the same thing. If you have a good birth, you are healing seven generations back and seven generations in front. So the good birth keepers are shamans, and these are authentic ones.

Me: It reminds me that when I was pregnant, everybody was expecting that I will give birth the same way as my mum and grandmother did. It’s such a powerful feeling, when you go the different way, when you have the opportunity to experience, to relate to these powerful events in a different way. It’s something like healing in your mother line and you can pass something different to your daughter.  

Nicola: Oh yes, it’s such a powerful healing, that you can change that pattern, you can break it, you can almost break the spell. I had a talk with one woman. She was expecting her second baby. Her first baby was stuck in some way, when she was pushing. It was the same when her mum was giving birth, and her grandmother too. So yes, it might be something physiological, but it might also be some psychological pattern. She has to think about it and discuss it with her daughter. To work something out.

Me: Do you see any changes in relation to birth in the women that you are helping?

Nicola: No…Well it’s more popular now. They are and will always be women, who are giving birth. There are more people, who realise that the national health service is broken and that there is a lot of things missing, and there is some danger in that struggling system. I had one woman, and she was so badly mismanaged, from the medical point of view, they created so much more risk for her, she may have been better birthing in her room on her own.

Sometimes I think, that you have to hit the wall, to jump back. Something like that is happening in our hospitals.

Me: In my country Lithuania, we saw, how dads came to the birthing room. Now it seems normal and is encouraged even by staff. But doulas are something new and a lot of rejection is going on. I hear a question – why do you need other person? If you have the father at the birth.

Nicola: Women were having other woman come and be around them when they had babies. When they started to go to the hospital eventually somebody said, you can’t bring your mother anymore, because they are getting in the way. So it’s natural for women to be with other women during birth.

I have seen much research, that showed, when a doula is present, the father is more relaxed and active during birth.

It’s really important to remember the history, how fathers get into birthing room. We campaigned  for men to come to the birthing room to protect their woman, because they were so violated and brutalized. Now this is the cultural interpretation, that you are there as a man, and this is bonding, watching your child being born and supporting your woman. But it’s not how it started. In hospital everybody is listening all the time to see if something will go wrong – they listen to the babies heart beats, they check her blood pressure, everything around is geared for something going wrong. Usually when something goes wrong or risky, dad will listen to midwife, of course. The subtext is that you have to listen, otherwise your wife and baby will be in danger. So they always act to keep their child and mother alive and well. This is natural and very healthy. For dad to go what his wife would say and not what implied risk from health care provider would be radical.. So that’s why doula should be there in the first place. She is someone different, saying like me, everything will be all right. You have choice – this is your decision.

Me: I think women bring different things to birth. It brings a lot of things in our life too. I want to ask you about sisterhood. I have this impression that more and more women are gathering, sharing their experiences, talking and appreciating their womanhood. How do you see those things?,

Nicola: Well, I think this is a natural part of society and the problem is, that we destroyed our society. We’ve gone from the village to the town, to the city and we lost the community. This is an unnatural way and a lot of problems come from there, like the epidemic we have of depressed women, who are basically drug addicts with prozac and the like. I saw my mum taking everything from the doctor, pharmacy and everything she could get her hands on to deal with her difficult unsupported  situation. What we do with our older ladies here? We treat them so badly and make them so lonely that we have another epidemic of mentally ill older women and then we put them in the care home. Its awful. I need these women – my children need these women – this should be the easiest and most appreciated stage of our life. The natural and healing way for women is to go together.

Me: I am reading this extraordinary book about “Dreaming sisters” by Diane Bell where she studies Aboriginal women’s lives from a woman’s perspective. A women has this big house, where old women, widows, lonely women live there. The wise women are in charge. You can go there, just to sit with other women, to spend time, to get help, support, to live there. They have their rituals, celebrations. It made me feel, that this is the way how women become strong and secure. You have all the time this sisters, where you can find help, support and peace.

Nicola: Yes, it’s so true. That’s natural human behaviour. This is Fitra, the Arabic word and it’s so true. Fitra is our inner nature or our code that we are born with. Like a baby knows where to find a breast.  You feel this in your body. You respond to those kind of things, because that’s how we are supposed to live.

Me: There was a lot of devaluation in women’s relationship. It felt like it’s ok to be in the family and the relationship are important and respected there. But when women go out with their friends, society sees it like shallow time – gossiping, shopping and pink fluffy stuff.

Nicola: Yes, I think we really have to stand up for that and say “what’s wrong with women getting together?”. We have to be that person that stand’s up and says “grey hair is beautiful, old age is not ugly, that’s the sign that I went too far”. Every other culture in the world appreciates it as wisdom, beauty, knowledge. You have to be the renegade. One of my teacher says, that you can tell the renegade by the arrows in his back. I am looking forward to being a grandmother and having grandchildren, everybody is running away from this among my peers. But I am getting shot on that, because it’s not an easily understandable thing in our culture right now. So we need more people standing up and saying “shoot me down, I don’t care, but I believe…”

Me: I’ve noticed, that men started to appreciate those women gatherings too.

Nicola: Definitely. It’s really good for a man to have a strong woman with a good circle of friends. This is the problem with the common structure, if we don’t have it, we put everything on the men – they have to be the mum, the aunty, friend, lover, husband and so on. It’s impossible for one man to carry all these roles.

Me: I think womens circles are very important when you have your baby. Those Australian aborigines can’t understand how woman in our society with a little baby is living alone in those flats-cages and sometimes spends all day long alone.

Nicola: Yes, and I think it breaks a lot of them.

Me: I want to ask you about postnatal support. It seems, that a lot of things are happening to prepare women for birth, but the postnatal period seems a little bit more left out. What do you think?

Nicola: I think postnatal support should be just as important. We have to undo a lot of miseducation, for example about breastfeeding, it used to be understood that the bottle is safer, easier. We have to get the basics. We have to talk more about the rest period after birth. We have to spread the news, to talk, that this is going to be better for you, you will be happier, you will have calmer baby, you all will get together as a family.

Me: In old cultures they have this ceremony after birth. In Lithuania the women went to sauna, and after that it was the celebration to welcome her to the society. How do you think, what’s the meaning of that?

Nicola: It’s very important to honour your transitions as human beings. We do really badly in this area. We are not honouring toddler’s, teenagers, we do nothing for menopausal women, we do very little for parents. We have some baby showers but little of any depth.

Me: But sometimes it seems like more for present, then for spirit.

Nicola: Exactly, empty. I think it is really important for women, after doing such a big job, to be acknowledged, to celebrate this with close ones, to hear, that “we are here for you”, “you are fantastic”, “here is food”, “we are here to help you”, listening to her grandmothers stories with their babies is really important, this is giving everything that they need.

Me: What do you think the most important thing for taking care of women postnatal?

Nicola: I like to cook. Because I believe, that with cooking you can really nourish people.

Me: Yes, one of the most vivid memories most people have are their mums cooking, all these tastes, smells, warmth. It nourishes not only your body, but the soul too.

Nicola: Yes, the food is really important. It makes a good environment to hang out, to talk. This is very natural way.

Me: I’ve noticed, when you are doing some kinds of work like cooking, grass picking, sewing, the talk goes very smoothly and very deep. It’s like healing.

Nicola: This is relative, I think, to different brain activity. It’s like meditation, knitting and something like that. You busy your hands and it’s related to your brain. We need that more.

So lot’s of talking.  The feedback that I get, the good doula does a lot of listening. I always say to doulas, that you have to go in like the best mother that she could have. So you are not judgmental, you are encouraging her. Of course you can be firm if you feel that. But loving and caring is the most important thing. “Go take the bath, I will be with the baby”, “I will wash your hair”, “I will make soup for you”…

​Me: It’s so good to listen to that.

Nicola: Yes, I know. I would like to have that. We all need that and we all should have that.

​Me: What are the happiest moments for you as a doula?

Nicola: Well …seeing parents happy in their bed with a baby, having had the birth that they wanted, appreciating the impact that made on their lives. That’s the happiest moments. It’s such a good start. My best moments are after VBAC birth. When a woman had a caesarean the first time, and she is told that her body doesn’t work properly, you are broken, you are useless. When you love her, prepare her, give hope and trust her and being there, when she gives birth vaginally and saying “I am not broken at all, I can give birth” This is so empowering and a healing experience, to have a normal birth after caesarean trauma. You can transfer it to your life. In a broader sense.

It helps us believe, that we can do a lot of things, if we want. It‘s really powerful. Birth does that, for growing women in society.

Postpartum and Healthy Boundaries

Some women are extremely lucky in having their own mom come for visits soon after the birth of the  baby and it’s awesome to have an extra set of hands around the house when you have this new bundle of joy in your arms. Except when it isn’t so awesome. Moms mean well. They usually do. But sometimes they forget why they are visiting and good intentions can turn into screaming matches and lots of tears over your baby’s cute little head.  Those of us who are so fortunate to have moms and mothers-in-laws coming to help during postpartum, even though they can sometimes drive us a little crazy, can benefit a great deal from the help and love of an older wise woman can offer. However, it is good to establish good boundaries so that yours and theirs high expectations mixed with your postpartum exhaustion and new mom insecurities do not turn into a disaster.
The more clarity you have about who you are, what you want, where you beliefs come from, the clearer and stronger your boundaries will be. So, we begin by asking ourselves some basic questions.  Do I have a clear idea of what I need after the baby arrives? Are these ideas mine, or are they influenced by what my culture, family and society at large have told me? Do I agree with this at a visceral level? How strong is my sense of self? How do I feel about asking for what I want and need?

I suggest an inventory of your influences, your feelings and your sense of self to discover what needs to be strengthened, changed, harnessed and cherished. After will give you a short list of suggestions you can discuss ahead of time with a loving mom or mother-in-law visiting you in the postpartum period.

STEP ONE: INFLUENCES

Think of your family and/or community’s way of doing things; is that in conflict with your own beliefs and desires? Some people believe you should not pick up your baby as soon as she cries, some believe that babies need to be fed on a schedule. Some cultures believe babies should be dressed, no matter the temperature with hats, gloves, socks and heavy blankets, even indoors.  In some cultures mom is not allowed to go out of the house for 30 days, and the list goes on. Ask yourself if the community around you, whether your own family or your peer group, encouraged you to change your attitudes, values, or behavior in order to conform to what they refer to as the norm?  Has your mother or mother-in-law already spoken to you about where the baby should sleep, shared her feeding experience? Remember that many older women have been unsupported by a system lacking in breastfeeding skills, and have either being told they had not enough milk, or that formula was better. Remember that trying to tell them that what they did was wrong will only create malaise.

BOTTOM LINE

Peer pressure is a phenomenon we have all experienced in our lives at one point or another. Peers can be your community, friends or family, and even your partner. To please them and be accepted by the group, we might have done or do something that is not in line with our desires. How successfully you handle peer pressure depends a great deal on how you feel about yourself and your place in the world. Do you feel you have a right to speak up and stand for what you want? Are you afraid that if your opinion differs too much from those around you, you will be excluded and isolated?

The most useful approach to have your desires respected is not going on a tirade about how you are right and they are wrong. Conflict never works and never, ever changes the other person’s mind about any issue.  One of the most successful approaches I have seen has been to ask for their support instead of telling them why they are wrong. Having a difficult, yet clarifying conversation ahead of time can go a long way to a peaceful and supported postpartum experience.  Tell, whomever is coming to help you, that there will be ways you care for your child they might not agree with, but that you’d really appreciate their support and compassion in allowing you to learn on your own about your baby.  Yes, you might make mistakes, explain, but they will be your mistakes and you are so excited to trying out your ideas and follow your gut feelings.  You also want to make sure they feel appreciated, so do tell them how valuable their presence will be, especially in helping out with food and house tending. If anyone in your family cannot hear you or support you, then make sure to tell them that for the first few weeks you prefer to be alone with your baby, to build up your milk supply and recuperate from the birth. Be loving, express your acknowledgment of how difficult this might be for an eager grandmother, but appeal to her memories of her first few weeks with her child. The clearer you are with what you need help with, and what you prefer not to hear, the better.  Sometimes we assume people can read our mind and know our preferences, however most people are not that psychic.

STEP TWO: FEELINGS

Think of your childhood and try to remember those times and places where your feelings were either ignored or abused.

Example: a client came in to see me after planning a VBAC and I asked her about her feelings. She said, “No matter what happened in my life my mom always told me how to feel, I can still hear her say to me, ‘There is no reason to cry, stop getting upset at something so silly, why aren’t you happy, you should be grateful.’ It seemed I had no right to have my own feelings. So I learned to look at her to see how I was feeling about anything and everything. During labor I was not even aware I had chosen a strong female doctor. I kept looking at her to see how I should feel and behave during my labor. She ended up making all the decisions for me. She said my labor was taking too long, my baby was probably too big and I needed a cesarean. I know that did not feel right to me. I had been in labor for only ten hours and I thought I was doing great. But I just believed her when she said I was probably too tired to even push this baby out and I probably just wanted him out of me. So I agreed and had a cesarean, and my baby was a 7.6lb healthy boy. She looked at him and pronounced him lazy because he wanted to sleep and not breastfeed in recovery. I can’t say I have a good memory of my son’s first breath.”

BOTTOM LINE

Sometimes, people don’t realize that they’re crossing your boundaries when it comes to telling you how to feel or not feel. Most moms don’t even realize what they are doing, in fact many of us are either doing our best or we believe we do what we do for our daughter’s own good. It is up to you to realize you might be stuck in a familiar pattern of people telling you how you feel vs. figuring it out for yourself.

To break away first, you must tune in to, embrace, and understand you own feelings. It seems simple, but if you have relied on someone else to tell you what you think and feel this will take some work. Something as simple as saying “ouch” when someone has said something that has hurt you is a start to expressing your feelings in a non aggressive way.  In postpartum your feelings will be all over the map, thanks to the hormonal readjustment you will feel blue more often, vulnerable, exhausted and at times scared and anxious.  Learning some specific tools before the baby comes that can help you express what you feel in a non-confrontational manner will go a long way in being able to ask for your needs to be met. Sometimes a simple “I am tired now, and feel like a cuddle with my new baby, can we talk about this later?” can shut a busy mouth.  I have written an article called   Baby Blues or Opening the Heart, about the feelings that surface during the postpartum period, it is important to understand this very delicate psychological phenomenon that touches all women once the baby has arrived.

STEP THREE: SELF

Think about how you feel about yourself. Many people think that they don’t deserve to set boundaries in the first place. Their low self-esteem makes them unable to have an opinion or make a decision. They often hide behind phrases like, “Anything you want is fine with me. If the doctor is comfortable this way then I guess we should just do that,” and “Don’t worry about me all I care about is a healthy baby.” A fun way to gauge where your self-esteem is at, is doing the following quiz truthfully. Answer the following questions with true or false:

  1. Other people are not better off or more fortunate than me
  2. I accept myself as I am and am happy with myself
  3. I enjoy socializing
  4. I deserve love and respect
  5. I feel valued and needed
  6. I don’t need others to tell me I have done a good job
  7. Being myself is important
  8. I make friends easily
  9. I can accept criticism without feeling put down
  10. I admit my mistakes openly
  11. I never hide my true feelings
  12. I always speak up for myself and put my views across
  13. I am a happy, carefree person
  14. I don’t worry what others think of my views
  15. I don’t need others’ approval to feel good
  16. I don’t feel guilty about doing or saying what I want
  17. Test score at the bottom

BOTTOM LINE

To build your self-esteem and your right to want what you deserve and desire, start small. Remember all your accomplishments and make a collage with mementos that remind you of what you have already accomplished in the past, and all the things you are proud of. Use photographs of a recital from when you were young, a trophy you won at a little league competition, a business card from a job you really loved, or a paper from school you are particularly fond of. Just don’t say you can’t remember anything. I know there is something, even the smallest thing is important. Make sure it is something YOU accomplished on your own.

Make a list of your most recent accomplishments; even the ones you think are insignificant. Each completed task, regardless of how small, is a building blocks towards a more confident you. Create an image of yourself as the confident and self-assured person you aspire to become. Do something that scares you, even if it is starting a conversation with strangers while in line at the groceries. You’ll learn to talk to the most difficult people this way. Do something you are good at. Set small goals. If your goal today is to do the laundry and take a walk and you accomplish it, put a mark on your list of accomplishments, you’ll feel a lot better about yourself. Beware not to try to overachieve and set yourself up for failure. START SMALL.

Help others feel good about themselves. When you help other people feel better about themselves and like themselves more, it will make you feel good about yourself. Write positive affirmations about yourself and repeat them. Recite them in front of a mirror. This is hard but very effective. Last but not least: stop comparing yourself to other people. Low-self esteem stems from the feeling of being inferior.

These are only three small steps to stronger boundaries and a stronger self-esteem. Learning to set boundaries is a vital part of learning to communicate in a direct and honest manner. It is impossible to have a healthy relationship with someone who has no boundaries, with someone who cannot communicate directly, and honestly; especially if that somebody is you. Learning how to set boundaries is a necessary step in learning to be a friend to yourselves. It is your responsibility to take care of yourselves – to protect yourselves when it is necessary. It is impossible to learn to love yourselves without owning your rights and responsibilities as co-creators of your life. We need to be able to tell other people when they are acting in ways that are not acceptable to us, but we can only do it if we have compassion for where we come from, consideration for our own feelings and self-esteem. After all we teach our children how to have healthy boundaries by example, so you are not just doing this to help yourself you are doing this for your baby.

Here is the list we promised at the beginning of the article. You can add to and share with anyone coming to help you after the baby is born:

  • You will need food, 3 meals and 2 snacks each day. Enlist as many friends and relatives for this.  People will ask if there is anything they can do…SAY YES. Consider setting up a page for your family on a great website called com where people can go and schedule themselves to bring you food and they can also see what you have been eating.  Sometimes asking for people to bring food might mean having 5 pounds of lasagna brought to you with great intentions.  Be specific about likes and dislikes, allergies etc.  People need directions and welcome them, especially if they know you have loved their meals.
  • Laundry, it is amazing how much laundry a little one can generate. Be sure to post a list of detergents you buy regularly and tape it to the washing machine.  We all have different preferences and a message written is a lot better than an explanation as to why you choose a more expensive but environmentally friendly soap.
  • If you have pets they need walking. Pets in particular are in need of extra attention once the little ones come, so enlist someone or a few people to come and walk and cuddle your pets.
  • Do you have plants that need attending? There are a lot of people who live in apartments who would love to hang out in your garden and feel the dirt under their fingers, you will make them happy and your weeds and veggies will be happy for it.
  • House cleaning, if you already have someone to help around the house see if you can afford to double her/his time for the first few weeks. If you have always cleaned yourself, than ask mom or someone else to come and help. A clean house makes a postpartum experience feel like a vacation in a hotel…with room service
  • Many grandmas love to hold the baby a lot. I have seen loving, good intentions grandmas come over hog the baby while the new mom ends up catering to them. DO NOT ALLOW THIS. Baby needs skin to skin so you can produce milk and you want to enjoy your baby. However, once a day why not ask mom to hold baby so you can go take a shower or even a short walk. Compromises always work for everyone involved.
  • If you can hire a postpartum doula, she can help you with more than house chores and food, she can reassure you of your own choices, offer breastfeeding support and a caring and compassionate hear.

Add to this list what is important to you.  If you do this before the baby comes you can really feel prepared, loved and pampered by the most important person in this equation YOU.

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TEST SCORE: Total number of TRUE answers you gave, EACH ONE POINT:
15-16 Points – You have a high level of self esteem!
12-14 Points – Not bad, but there is room for you to improve
8-11 Points – Low self esteem is holding you back
Below 8 Points – Your esteem is drastically low!

Giuditta Tornetta is a birth and postpartum doula, mother of two, author of the best-seller Painless Childbirth: An Empowering Journey Through Pregnancy and Birth, and Conversations With The Womb.  Together with Robin Lim and Nicola Goodall she facilitates a postpartum certification program in Bali each year called Loving the Mother.  While Giuditta is best known as a writer, workshop leader and a doula, she is also a passionate voice for women. She founded the Joy In Birthing Foundation  a non-profit organization of committed, community oriented professional doulas, dedicated to helping families through pregnancy, birth and the postpartum period. The foundation serves women in the foster care system, homeless shelters and juvenile detention center.

this post was  written by the gorgeous Giuditta Tornetta – read more about her here

this blog is part of the #postnatalrevolution in honour of sheila kitzinger passing on to the light.

wysewomen workshops hold a very popular motherwarming workshop at different locations all around the country – themotherwarming workshop looks at different ways to keep mum, baby and family healthy in the immediate postnatal period –  find local dates near you here

wysewomen are also involved in loving the mother – a week long journey for women to develop love for the mother.

having a postnatal doula can support you during your babymoon – find out more here and here