It’s on a blog called Babywearing Downunder. Here’s the link:

http://baby-carriers-downunder.com/2009/02/10/babywearing-and-post-natal-depression/

We could probably talk more than we usually do in HypnoBirthing courses about the postnatal benefits of Hypnobirthing. In my courses I always show clients a simple self-hypnosis technique, a quick and easy way to relax yourself in all kinds of situations.
But the truth is, all Hypnobirthing techniques set you up for the ability to become relaxed and calm in any time of your life. Think of Hypnobirthing as not simply a way to be more calm in labour. It is also part of your strategy to protect yourself against postnatal depression.

Next time you stub your toe on the corner of a chest of drawers, try doing your surge breathing as you get over the pain! See how much better that is? Hypnobirthing helps in all kinds of situations.

Importantly, the art of relaxation which comes with regular Hypnobirthing practice reduces tension and increases endorphins. Using the same techniques on a regular basis could help keep away the main risk factors of postnatal depression.

That sense of well-being and relaxation which my clients report after a session is just as beneficial while struggling with a fretful baby.

Of course Hypnobirthing is no substitute for medication where that is clearly needed. But combined with other aspects of care such as:

• getting outside regularly for some gentle exercise,
• seeing friends,
• eating well
• sleeping when the baby sleeps instead of trying to do chores
• talking openly with partner or other family members about your feelings

Please add Hypnobirthing to your list as a valuable tool not to be forgotten the day after your baby is born. It will stand you in good stead for years to come.

Here are a few ideas:

• When breastfeeding, close your eyes and do “calm breathing” for a few minutes.
• When your baby has gone to sleep, lie down immediately and relax each part of your body in turn…remember the jaw and tongue!
• When your baby is crying and fretful, do surge breathing and think of relaxing face, shoulders, hands just as you learned to do in Hypnobirthing.
• Try the self-hypnosis exercise if you are finding it hard to get to sleep.
• What about affirmations? Could a few positive thoughts on your bathroom mirror help you through the bad days?

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Along with every other professional with even the smallest interest in childbirth, I’ve been glued lately to the BBC’s wonderful “Call the Midwife” on Sunday evenings. It’s a cut above other historical dramas, because so many of the storylines are based on the true-life recollections of the late Jennifer Worth, who accurately depicted life in the poorest parts of 50s London in her three-volume series of memoirs – as opposed to being stitched together by modern-day script editors trying to tickle the tastes and feed the expectations of today’s viewers.

In particular the series blows apart the media-invented battle lines of childbirth with which we are all too familiar. You know – the never-ending battle between natural childbirth “fanatics” and “breastfeeding Nazis” versus “too posh to push” Victoria Beckham wannabes and yummy mummies. These stereotypes, like all stereotypes, don’t exist.

Instead we see how complicated the arguments around birth are. The undisputed heroines of the series are the brave, well-trained and resourceful midwives and nuns of the (fictional) community of St Nonnatus. Hard-working, disciplined and cheerful yet always kind, these women remind us of all the best female virtues, and especially of what a great profession midwifery is. They shine lights of good sense and learning into homes without disempowering the people they find there.

Yet even they have entrenched views that are not, strictly speaking, evidence-based. Regular viewers will have noticed women labouring on their backs in every episode: midwives of the era were pointlessly strict about women maintaining the “delivery position” with legs akimbo.

In last Sunday’s episode (3 February) we saw an eccentric pair of twins pitting their belief in herbalism against modern obstetrics. The pregnant one of the twins is discovered by the midwives labouring upright in a birthing chair and in semi-darkness. The midwives promptly switch on the lights and order her off to her bed – to lie on her back like all the other women.

Nowadays, well-trained midwives in the UK, especially those with experience of home births or births in birthing centres where an epidural isn’t the norm, might do the exact opposite. Finding a woman labouring on her back – the most uncomfortable position, and the least useful for labour – they might well gently suggest she gets off the bed and “mobilises”, which is midwife-speak for walking about the room, leaning on things.

This simple move can transform what feels like an unending misery into something effective where the woman feels she can work with her contractions instead of against them. Birthing stools are now standard equipment in our maternity units. Yet the 1950s midwives of Call the Midwife are horrified by the birthing chair – a “contraption” with, to their eyes, the air of an instrument of medieval torture rather than the simple, supportive technique of using gravity to help labour which it really is.

The best midwives might also suggest that, with the woman’s permission, the lights in the room could be dimmed – because they know that the stimulant of bright light activates adrenaline and thus works against the production of oxytocin. Nicholas Culpeper, the seventeenth-century herbalist referenced in the episode, knew from observation that women labour more effectively in darkness, but since his day, doctors had entered the birthing room en masse with their forceps, requiring light to see by, and the old midwives’ knowledge was unlearned. Once it was accepted that childbirth needed bright light, nobody tried doing it the other way…until research into oxytocin proved that Culpeper was right.

Which is why we suggest to our hypnobirthing clients that as well as practising deep relaxation to reduce adrenaline and tension, they avoid stimulation from bright lights and loud noise (especially inane chatter!). A good midwife can work by torchlight, I’ve been told! And while many mums are comfortable on their backs or lying on their sides, many others prefer to lean forwards over a birthing ball and can maintain their relaxation in this position. But you know what? What really matters is what the woman feels is right for her – it’s our job to make sure she has all the possibilities within reach.

This blog post was written for www.motherandchild.co.uk and can also be found there.

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Meanwhile I found myself in tears the night before I went to collect him, mourning my carefree life when I could make an appointment to teach or see a client without having to arrange puppy-sitting. At least with a new baby, I said to myself self-pityingly, it is not usual to have to hand over a wad of notes as well. At least, not initially.

I’m feeling a bond with my clients as never before. After all, it’s over 15 years since I had a new baby and Merlin the cockapoo is doing his job already in giving me a real-time reminder of the stress new parents go through adjusting to their “new normal”.

When you get a new puppy the mass of contradictory advice on tap is astonishing.  Put him in a crate – no, don’t put him in a crate until later, or never. Put the crate in the kitchen – no, put it by your bed. Wake up once a night to take him out to do a wee – no, wake up every 2 hours…every 3 hours…whenever he cries. Use puppy pads – don’t use puppy pads. Use paper – don’t use paper. Take him outside to do his business – no, don’t bother to take him outside until he’s older. Get him used to the lead from day 1 – no, he’s far too young for a lead until he’s 12 weeks old. Later on there comes the great feeding debates: kibble or not? Stick with ordinary dog food or succumb to the raw feeding advocates – as determined, logical and uncompromising a lot as many breastfeeding advocates I’ve met –  and go BARF?

At least all the experts seem united in preferring positive training – praising for things done as desired, as opposed to punishing things done wrong – which is heartening.  And just as with a baby, all the anxiety just melts away when I watch his little tail wagging as he scoffs down his puppy food or, as he is right now, when he is innocently fast asleep in his crate. Welcome to the world, Merlin the cockapoo.

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Of course, every mother is a world expert on HER baby and what she experienced in her own birth is totally her own. And how women give birth really does affect what happens afterwards. So when I caught sight of this tweet from Ms Allsopp, retweeted by a Twitter friend: “There’s nothing like a new baby. It matters not a jot how it was born” I really felt a sharp intake of breath coming up.

She also, on Twitter the same day, said the NCT was “bollocks”, said that parents who went to the classes were “misinformed and scared”, that they didn’t mention C-sections (how out of date is that?)

The tweet I’ve quotd in this headline came in response to a dad who was actually sticking up for his NCT teacher because her course – like mine – included a session looking at what having a C-section would be like, and whose partner had had one 2 days before. Ms Allsopp may have not quite intended the blanket dismissal which was implicit in “it matters not a jot how it was born”. But that’s how it came across.

If she had a moment she might have a think about some facts that show how the process of giving birth does matter to lots and lots of women. Because not all women are the same.

What about the babies who end up in SCBU with breathing difficulties after a caesarean that could have been avoided with patience, support and midwifery skills if these had been brought into the room alongside drugs, clockwatching and fear? Does it not matter how they were born?

What about the babies of the mothers who are feeling disempowered and without any trust of their own bodies, feeling like beached, bruised whales after a string of interventions they never intended to have? Does not not matter how they were born?

What about the babies of the mothers who are isolated, feeling alone, exhausted and confused, with no group of other new mums to pop round and suggest a trip to the park – does it really not matter how they were born?

Ms Allsopp’s fiercest criticism is for the NCT, for whom I am a teacher. She says we don’t address people’s dissatisfaction with classes.

NCT classes can – and I think it’s pretty rare – be disappointing. You can’t plan who is in your group; you might have a teacher having a bad patch, or one who is feeling stale, or one who just does not fit with you.  But NCT classes can also be very, very positive, informative and supportive and in surveys 58% of parents rate them as “excellent”. I pointed out to Kirstie Allsopp on Twitter that no other organisation assesses and reviews teachers as much as the NCT.  I suggested that she might try having post-programme reunions after her TV series, where people who had tried out her craft ideas could come back and tell her that her ideas didn’t work. (Because that’s what NCT ANTs do. I’ve got 2 PN reunions coming up this month. It is scary.)

It was when I told her, tongue foolishly in cheek, that I was planning to ask the NCT head office to get a lawyer to look at her tweets as they seemed to me to be bordering on the libellous, all hell broke loose and I had hate-tweets from Kirstie’s fans all bloody day.

Well, I did feel extremely miffed and put out. Some journalists and broadcasters seem to think it is a permanent open season on NCT teachers – who are mainly lowly paid, part-time workers, mums all, trying to help and support new parents through the process. Remember Kate Muir describing the NCT as “the lie factory” in her Guardian column?

My NCT clients pay a lot for classes (though they are supposed to ask for a discount if the full fee is a problem, I suspect few do). So they deserve a really good antenatal course. I’m very much aware of that. We all try very hard to meet often wildly differing needs – hypnobirthers and ECs in the same class being the norm round my way – and differing experience levels.

I normally, if the class format allows, ask the class to set out what they want to get from the course at the first session.  Birth and parenting is a big subject – it’s hard to cover it perfectly in 14 hours and many teachers have even less time.  When I get “suggestions for improvement” from my clients I sit down and look at the next month’s course to work out how I can make it better. While I was training, one of my clients pointed out that I hadn’t done much about induction, yet several in the class had inductions – so I ‘ve bashed on about induction from all angles ever since. But it is impossible to please everyone all the time.

Perhaps there are teachers out there who are refusing to teach about caesearean, or who won’t talk to someone who had an emergency CS, or who won’t mention pain relief drugs, as the people who tweet to Kirstie Allsopp claim. I haven’t observed any of these allegedly biased classes – and I can’t imagine any NCT teacher “not wanting to talk to” a woman who’d had an emergency CS. But there you go – these are the experiences Kirstie hears about. She tweeted to me that I should read these tweets, which I did, and I tweeted back that she should also read the positive comments from very happy NCT parents being sent to Belinda Phipps, the NCT CEO.

What I suspect, after my bruising day on Twitter, is that there are a lot of parents out there whose expectations were not met, who have decided to blame the NCT for it. Oh, and some of them are really foul-mouthed, and say things to me on Twitter which they would never say to my face.  What a total waste of time.

On the plus side there was a surprising number of tweets from people most of whom I don’t even know, just being kind and supportive, for no reason other than their own good nature.

All the same, in future I am going to restrict my Twitter activity to #inamayquotes and promoting my classes!

Postscript:

Belinda Phipps, the NCT CEO, has been a total brick, she has told me I have “nothing to apologise for” though I seem to have kept the Kirstie Allsopp attacks alive long after their sell-by date.

Meanwhile the very next day the Daily Telegraph has a story claiming the NCT is “considering legal action” against KA. This just isn’t true – and it just can’t be squeezed out of my one tweet!

After talking with Belinda, I rang the reporter who did it – annoyingly he’s on his day off until Sunday and I spoke to his colleague to explain I wasn’t speaking for the NCT but was self-employed, teaching under licence. The conversation then went something like this:

DT reporter: So if you don’t represent the NCT, why are you complaining?

Me: Because your colleague has given the impression that I do speak for the NCT as a body.

DT reporter, evidently thinking himself extremely clever: “Well, in that case, we would only be interested in a complaint from the body that’s been misrepresented.

Me: Well, I will pass that on to Belinda Phipps. Silence while I try to find Belinda’s email address – and fail, and offer him the general NCT number.

DT reporter: Well, if you can get the NCT CEO to contact us herself it might make a nice follow-up story.

At which point I said goodbye and put the phone down. “Follow up story” = “string the story out for another few days” and I don’t really want to give Kirstie Allsopp the satisfaction.

I used to work as an education correspondent for the Daily Telegraph. If I’d done such a shoddy piece of reporting as this, not even bothering to make a short phone call, I’d have been in real trouble.

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Unfunny joke: How do you tell a mother from a non-mother? Make them sneeze and see what happens.

Well, it turns out this idea, that a vaginal birth messes up your pelvic floor, is yet another myth…probably (I speculate) deriving from the days of American “twilight labour” when drugged women were tied to beds and had babies pulled from their supine bodies with forceps as a matter of routine. (I am not exaggerating.)

The real truth is: risk factors increasing likelihood of stress urinary incontinence (SUI) include having an epidural (Thanks, Transition to Parenthood) having a forceps or assisted delivery, inadequate attention paid to emptying the bladder so that the urethra is stretched (I’m always banging on about this in classes) and THE PREGNANCY ITSELF.

Let’s look at this research from Spain which you can find with the following reference:

Arrue M; Diez-Itza I; Ibanez L; et al Factors involved in the persistence of stress urinary incontinence from pregnancy to 2 years post partum. International Journal of Gynecology and Obstetrics, vol 115, no 3, December 2011, pp 256-259.

OBJECTIVE: To identify factors involved in the persistence of stress urinary incontinence (SUI) from pregnancy to 2 years post partum.

METHOD: In a longitudinal study at Donostia Hospital, San Sebastián, Spain, 458 primigravid women were recruited from April to October 2007. SUI was diagnosed via the 2002 International Continence Society definition. Severity was assessed via the Incontinence Severity Index, and impact on quality of life via the International Consultation on Incontinence Questionnaire. Means (Student t test and analysis of variance) and percentages (÷(2) and Fisher exact tests) were compared, and multiple logistic regression analysis was performed with variables that were significant or close to significant in a univariate analysis (P<0.2). [I know, I don't really understand this bit either.}

RESULTS: Among 272 eligible women attending follow-up at 2 years post partum, 26 (9.5%) women reported persistent SUI since pregnancy. Incontinence severity was slight or moderate in most cases and the impact on quality of life was low. A higher body mass index (BMI) in pregnant women at term was the only factor found to be associated with persistent SUI (odds ratio 1.19; 95% confidence interval 1.08-1.32).

CONCLUSION: Higher BMI in pregnant women at term was an independent risk factor for the persistence of SUI from pregnancy to 2 years post partum.

Spain has a pretty high reputation for encouraging epidurals and a poor reputation for encouraging active birthing methods and yet even here the fact of high BMI was the jumping-out independent risk factor for SUI. In other words, the more weight pressing down on the pelvic floor the more likely the mum is to suffer stress incontinence after the birth. Which is interesting as it suggests that it is the pregnancy itself which puts the strain on the pelvic floor - not the method of delivery. If you want a baby and you want to keep your firm pelvic floor muscles, get on with those Kegel exercises!

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Comparing the odds of postpartum haemorrhage in planned home birth against planned hospital birth:

results of an observational study of over 500,000 maternities in the UK

Abstract (provisional)

Background

The aim of this study is to compare the odds of postpartum haemorrhage among women   who opt for home birth against the odds of postpartum haemorrhage for those who plan   a hospital birth. It is an observational study involving secondary analysis of maternity   records, using binary logistic regression modelling. The data relate to pregnancies   that received maternity care from one of fifteen hospitals in the former North West   Thames Regional Health Authority Area in England, and which resulted in a live or   stillbirth in the years 1988–2000 inclusive, excluding ‘high-risk’ pregnancies, unplanned   home births, pre-term births, elective Caesareans and medical inductions.

Results

Even after adjustment for known confounders such as parity, the odds of postpartum   haemorrhage (>=1000ml of blood lost) are significantly higher if a hospital birth   is intended than if a home birth is intended (odds ratio 2.5, 95% confidence interval   1.7 to 3.8). The ‘home birth’ group included women who were transferred to hospital   during labour or shortly after birth.

Conclusions

Women and their partners should be advised that the risk of PPH is higher among births   planned to take place in hospital compared to births planned to take place at home,   but that further research is needed to understand (a) whether the same pattern applies   to the more life-threatening categories of PPH, and (b) why hospital birth is associated   with increased odds of PPH. If it is due to the way in which labour is managed in   hospital, changes should be made to practices which compromise the safety of labouring   women.

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At last! The research study we have all been waiting for.

This is the abstract of a study I’ve just read about thanks to MIDIRS and the NCT library service: I reproduce it here without further comment….

Potential effects of chocolate on human pregnancy: a randomized controlled trial. di Renzo GC; Brillo E; Romanelli M; et al, (2012). The Journal of Maternal-Fetal and Neonatal Medicine , vol 25, no 10, October 2012, pp 1560-1867.

Objective: This trial was undertaken to evaluate the effects of high-cocoa-content chocolate supplementation in pregnancy on several haematochemical and clinical parameters. The study had as reference population the pregnant women requesting an obstetric control at Outpatient Clinic of Obstetrics and Gynaecology of the S. Maria della Misericordia University Hospital, Perugia, Italy. Candidates who participated in this study were all Caucasian women aged 18-40 years, who had a single gestation pregnancy between 11th + 0 and 13th + 0 week gestational age. Methods: We conducted a single-center randomized controlled trial. The pregnant women selected were randomized into Group A, which received daily doses of 30 g of chocolate (70% cocoa), and Group B, which was free to increase their diet with other foods. Results: Ninety women were randomized. Significant difference was found between the two groups for diastolic blood pressure (p = 0.05), systolic (p < 0.0001) and levels of liver enzymes, with values lower in Group A than in Group B. Total cholesterol levels and weight gain in Group A did not increase more than in Group B. Conclusions: A modest daily intake of high-cocoa-content chocolate contributes to reduce blood pressure, glycemic and liver pattern during pregnancy without affecting the weight gain.

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• professional drivers such as taxi drivers
• Craftspeople
• Builders, decorators etc though these in my experience prefer Kiss FM, very loud
• Parents at home looking after children.

When Woman’s Hour started it was aimed at the last of these groups because most women with children were indeed at home, getting on with chores around the house with the radio on. It was radio for ironing, basically. At some point quite early on in my life Woman’s Hour got all itchy and feminist, and felt that there was something infra dig about ironing. Its editors and producers secretly didn’t think much of women without paid jobs and it irked them to think that these flimsy mimsy retrogressive throwbacks formed their main audience. So it reduced down to a bare minimum any acknowledgement of the fact that its listeners were – most of them quite happily – fishing Duplo bricks out of the loo.  For years now, Woman’s Hour has been a way of half-hearing Jenny Murray debating consciousness-raising with some academic who, if she needed such services, paid another woman to fish Duplo bricks out of her loo, while you yourself fished bricks out of your own loo. After all, any mother who is not fishing Duplo bricks out of the loo is out walking in the park, or has a job which probably does not permit the luxury of listening to Woman’s Hour. In the latter case, she may well be on the way to becoming a Woman of Power and Influence. And by the nature of her daily routine, she doesn’t listen to Woman’s Hour.

Now the programme is asking its listeners to nominate its top 100 Women of Power and Influence. You see where I am going here, don’t you? The programme makers are looking for names of women who, by the very nature of what they do, don’t listen to Woman’s Hour, and if you nominated someone who just raised her own children and did it pretty well, they would laugh at you. I can’t help finding this only mildly amusing. I have always liked being at home with my children, and I have always thought it was a very important job, but the hardest part of it was becoming a non-person, a person of absolutely no Power, let alone Influence, whatsoever, except over the poor little mites who by accident of birth ended up in my care.

So far the programme has interviewed a lot of people about influential women: politicians, campaigners, women in the City, in the “boardroom”, all those places where Power and Influence are supposed to reside. Yet for mothers – which is most women -among the most influential people in their lives are those who advised them at the time they gave birth to their children. The obstetricians, the midwives, the health visitors – these people have a million tiny little nudges of influence in the way we birth, and the way we raise our children. Our parenting of the next generation starts then, and the influences under which we come during that whole vulnerable, shell-off period of our lives are extremely important.

With this thought in mind I very much hope to see some woman on the final list of 100 who has something to do with birth and midwifery -  preferably one of the pioneers of home birth, active birth and informed choice in maternity services. I am thinking of Janet Balaskas, perhaps, founder of the Active Birth Centre and, with Wendy Savage, a pioneer of the simple demand that we be allowed to labour in whatever position we choose; or Sheila Kitzinger, whose books changed the way many people thought of birth. Or Marjorie Tew, whose study of home birth safety turned upside down the lazy assumptions that doctors and hospitals always know better than women themselves what is good for them. Or perhaps Cathy Warwick, head of the Royal College of Midwives? Or a more local name – Annabel Bryant, who has changed the birthing experience at one of my local huge maternity units greatly for the better? What about Maggie Howell of NatalHypnotherapy? Katharine Graves, who founded the UK Hypnobirthing Association? Beverley Beech, chair of AIMS?

I am appealing to all my friends and colleagues to put foward any name they like to the list – just please make it someone who works in childbirth and midwifery. You can do so at this web address:

http://www.bbc.co.uk/radio4/features/womans-hour/power-list/

…or via Twitter using the hashtag #whpowerlist.

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I have worked as a doula for many women like Felicia Boots. Wealthy, beautiful, sweet and determined to be the best possible mothers in the world. Women who have gamely transferred their whole lives, tiny children and all, to this big, old, ugly, lonely, rain-swept city of London and thus put thousands of miles between themselves and the Mom and Pop whose comfort and warmth cannot be replaced by any number of lavender-scented hours of “pampering” in the local “Day Spa”.

Felicia’s is a dreadful story which throws harsh light on how powerful and destructive postnatal depression can be. It’s briefly told: This lovely mum of two gave up her antidepressants because she was worried that the drugs could harm her breastfed baby. She then spiralled downwards (court reports say) into what looks more like puerperal psychosis than postpartum depression and developed delusions that her children would be taken from her. She then took the lives of her two little children.

Let’s get one thing absolutely straight: this was not a story about breastfeeding and depression - it was a story about depression. I am interested in how this was reported and the results are mostly encouraging – but not entirely.

When I saw the headline in the Telegraph yesterday it highlighted the connection “Postnatal depression” and “breastfeeding” very aggressively. I went online today and found that this had been toned down.

The Sun referred to breastfeeding quite far down the story, commendably not sensationalising its connection with the depression aspect:

“She was prescribed antidepressants but had not been taking them after becoming  convinced the babies would be taken away from her because of the effects of  the drugs on her breast milk.”

The absence of an explanatory note for readers to the effect that research indicates that the “effects of the drugs” would not hurt the baby is to be regretted. I know Sun stories have to be short but there was room for this.

Many other news outlets played down the breastfeeding aspect and avoided headlines on the lines we would have feared  – hooray! Maybe a message is getting through to some of our friends in the media!

But The Times, which seems to be fighting hard for the coveted title of the World’s Most Anti-Baby Newspaper, had to have something to put in its regular Anti-Baby Supplement (commonly called T2) so it not only pumped up the breastfeeding angle but followed with a front page trail for a feature article the next day (1 November):

“How safe is breastfmilk? The truth about depression and breastfeeding”

The message we take from this headline is that breastmilk may well be unsafe and that there is a connection between it and depression, right?

So let’s turn to the article. Emotive headline “Love, drugs and breastfeeding”.

The article by Peta Bee contrives to build up the breastfeeding/depression connection while at the same time pretending to disclaim it. She begins by describing Felicia Boots’ “fears” of affecting her children with antidepressant drugs as “misguided” then launches into her real agenda:

“Yet were her concerns, shared by many women prescribed medication during and after pregnancy, really that irrational?” (my italics.)

The short answer to this question is Yes, they were. But Peta Bee has space to fill so we get the full works on how there is “insufficient reliable data” on the effect of minute trace elements in breastmilk; how heavy metals are found in breastmilk; how experts are vague about advice on alcohol intake while breastfeeding; padded out with some information from Australia which “found that children who are solely breastfed for the first six months of their lives, as is recommended in the UK, are at a 1.5 times higher risk of developing a nut allergy”. Point one: sole breastfeeding for 6 months is a global recommendation, not just a recommendation in the UK. Point two: nut allergy is still mysterious and the diet of the women studied is not mentioned. Then Bee goes on to say that “most worryingly” breastmilk “tends to attract heavy metals and other environmental contaminants such as poluttion adn chemicals from paint thinners, dry-cleaning fluids, wood preservatives, air fresheners and cosmetics”.  “It sounds terrifying enough to turn any new mother to the formula bottle. But should she?” By now we are just two paragraphs from the end of the article. Most readers don’t get this far but will have skimmed through and spotted the words “Breastmilk” and “paint thinners” fast enough along with the obligatory sniping at:

…the unequivocal “breast is best” mantra places presure on [women] to persist, even when breastfeeding is difficult or painful.

Does it really, Peta? Do you have any proof of that?

Ah yes:

 ”More than 95 per cent of women with postnatal depression or postnatal anxiety who were questioned by the Australian mental health charity, beyondblue, last year said difficulties with breastfeeding and resulting guilt had contributed to their illness.”

Blame the breastfeeding, then. Not the inadequate breastfeeding support. Not the fact that most of these women were trying to do something they’d never seen anybody else do in their lives…

Bee gives over one paragraph to remarks from Pat O’Brien, an obstetrician at UCH in London to the effect that the environmental toxins in breastmilk are no more than the levels in the environment babies exist in. The final paragraph, squeezed down at the bottom of the second page, concludes:

For any woman who fears her breast milk might be “contaminated”, the overwhelming medical advice is that there is little to be concerned about. “It is easy to isolate these factors so that they become unnecessarily worrying,” O’Brien says. “Breast milk will not put your baby at risk and we really should not become too paranoid about evidence to the contrary.”

After the front page scare headline, the article headline, who would have thought it, eh?

There is a huge omission in this article which makes me feel very angry with my old employer: no comparison is made AT ALL between breastmilk and formula milk. The reader is allowed, even invited, to assume that formula must be as safe, even SAFER, THAN BREAST MILK.

Yes, amazingly, there is a winner from the reporting of this tragic story:  The formula manufacturers.

And The Times’ take on this story is right in the middle of Baby Milk Action’s “Nestle-Free Week” campaign. Coincidence? Dear heaven, I hope so.

Opinions about anti-depressants and breastfeeding do vary quite a lot. While her own paper’s medical advisor Dr Mark Porter lists it as one of the “safest of the new generation”, the respected mental health charity MIND mentions Sertraline, to take one example, among anti-depressants of questionable effect on breastfed babies. It’s a minefield out there and it’s easy to see how Felicia Boots could become frightened. And where things are vague, women are more likely to take away from opinions such as Dr Porter’s conclusion: “If a woman still can’t be convinced [that using antidepressants in breastfeeding is safe] then I would prefer she stopped breastfeeding than came off her medication” the message “STOP BREASTFEEDING”.

My gripe: Today in The Times we have a whole double page spread about negative aspects of breastfeeding with not ONE SINGLE negative aspect of formula feeding EVEN MENTIONED. Sorry about the italics but the more I think about it the crosser I feel…

I would like to read just ONE, just ONE feature in The Times which actually talks about breastfeeding positively – the rush of oxytocin, the feeling of well-being, the convenience and the sheer pleasure of it for lots of women – instead of the obligatory side-swipe at its “difficulty” and “pain”. Wouldn’t you?

And I would love to be sure that Peta Bee did not get any helpful advice for her article from Nestle. Wouldn’t you?

The post The Felicia Boots tragedy – guess who will benefit? appeared first on Birth Hypnosis.

• Alternative comedy, a range of styles used by comedians and writers in the 1980s
• Alternative culture, a variety of subcultures existing along the fringes of mainstream culture
• Alternative dispute resolution, processes and techniques outside the traditional mainstream of jurisprudence
• Alternative fashion, for example Gothic fashion, Punk fashion, Fetish fashion
• Alternative lifestyle, a lifestyle that is not within the cultural norm
• Alternative media, media practices falling outside the mainstreams of corporate communication
• Alternative medicine, healing practice that does not fall within the realm of conventional medicine

Outside the mainstream; non-traditional; not conventional…these are all attributes of anything which is dubbed “alternative”, and the implication is always that there is a mainstream from which the alternative diverges. “Mainstream”! That’s such a nice safe word. Anything mainstream must surely be safe…especially compared with anything alternative, which hints at a flirtation with danger. Anything that is the “norm” must be more reliable, more effective, than what is “alternative”.

As a Hypnobirthing teacher I am always intrigued by how powerful certain words are in the conversations we have with mothers about their birthing. Take the positions women labour and birth in, for example.

It has been demonstrated over and over again that upright, forward and open positions in labour and birth utilise gravity, are more comfortable for the woman, improve blood flow to the uterus, and allow the pelvis to expand and mobilise to give the baby room to pass through. On every single count except one – the comfort of the attendant – “UFO” positions in labour are superior to being flat on your back on a bed.

Lying flat on your back or even semi-sitting on a bed is uncomfortable, exerts nwanted pressure on the blood vessels supplying the hard-working uterus, and traps the pelvis against the bed below it so that the tailbone cannot move outwards in the classic “rhombus of Michaelis” shape. The “beached whale” supine position is fraught with danger, risking a longer and more exhausting labour. Yet it remains the first position most people think of when they imagine a woman giving birth and still the vast majority of women find themselves birthing in this position.

We birth educators are always banging on about this. For example, take a look at the excellent NCT leaflet on positions for labour and birth here – it does not feature or suggest any supine positions:

NCT_Positions_labour_birth_PDF

No, not even as “alternatives”.

The supine birthing position, especially where a woman’s legs are raised up and fastened into braces called “lithotomy stirrups”, should in my view be designated as truly “alternative”.   It should only be used in extreme, unnatural, artificially created situations – where a woman has an epidural, for example (and even then there may be easier positions for her) or where there is a genuine medical emergency which justifies using instruments to help the baby out. The “McRoberts manoeuvre” used where a baby appears to be at risk of shoulder dystocia involves turning the mother over onto her back and pulling her knees right back towards her shoulders - it often works. (So does the “Gaskin Manoeuvre” which is basically the McRoberts turned upside down.)

Yes, looking back at the Wikipedia list of alternative cultural elements you can see that we should definitely re-name the lithotomy position as “alternative”.  Like alternative medicine, it’s not proven. Like alternative fashion, it has fetishistic aspects. And like alternative comedy, it belongs in the 1980s, not to today.

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