Category: Relax Into Birth Hypnobirthing

Podcast – Episode 2: Tracy and Ryan’s Birth Story

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Tracy shares her birth story… Listen to the podcast above, or watch her tell it below.

Dr Tracy Flowers (of Médecins Sans Frontières) shares her birth story. Here’s an excerpt… “”As a doctor, I always imagined I would want a caesar, but then I fell pregnant and everything changed. There’s no doubt that the Relax Into Birth course and the preparation really made it such a wonderful event for us. We went into the birth feeling confident, calm and peaceful despite doing all this through Covid-19. Relax Into Birth helped me to normalise birth through daily listening to the hypnobirthing tracks. When I was in labour, I used the tools I had learnt about breathing, relaxation and visualisation, which all helped me keep calm. The surges felt so manageable and the techniques helped us both so much,” says Tracy.

Her husband Ryan Flowers, adds; “As a very inexperienced dad, the course gave me ultimate confidence and preparedness for the birth. I found the partner tracks handy, which helped me know what was to come and I enjoyed learning massage techniques too. I also used the course as a resource I could go back to anytime. Speaking to other dads who hadn’t done the
Relax Into Birth course, I realised they had quite a different mindset on birth than me.”

Polycystic Ovarian Syndrome: A lifestyle-related disease?

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Polycystic Ovarian Syndrome (PCOS) is common in South African women and affects about one in 10 women globally. It is caused by a complex imbalance of hormones in the ovaries.  Charlene Yared West spoke to Life Kingsbury endocrinologist, Dr Jocelyn Hellig and gynaecologist Dr Philip Zinn to find out more about this condition. 

So what is PCOS?

In a woman’s body, the ovaries release eggs each month as part of a healthy menstrual cycle.  However, with PCOS the egg is not released as easily, which leads to irregular ovulation and menstruation and can impact fertility. “The ovaries are described as polycystic because there is an excess of the fluid-filled, egg-containing sacs called follicles, all of a similar size, when seen on an ultrasound image,” says Dr Zinn. “This excess occurs due to disturbance of the growth of follicles – to the size required for ovulation.”

It’s all about the hormones… or is it? 

Dr Hellig explains that the exact cause of PCOS is unknown. “There is no one singular factor which causes PCOS. It is considered to be a complex trait arising from the interaction of genetic and environmental factors, usually first presenting when mature gonadotropin levels (hormones essential for reproduction)are achieved at puberty. It occurs naturally in primates as well as humans,” she says. “The disorder arises clinically by the presence of two out of three criteria: irregular periods or the absence of ovulation, features of high androgen levels (acne or excess hair growth) and a certain appearance of polycystic ovaries on ultrasound,” she says. 

You could be predisposed to PCOS if…

  • You have insulin resistance.
  • You have Type 2 diabetes.
  • You have unhealthy eating habits.
  • You do not exercise regularly.
  • You are overweight or obese.

Trying to fall pregnant?

If you are trying to fall pregnant, but it is proving difficult, PCOS might be the culprit, says Dr Zinn. “Many women are unaware that they even have PCOS until they start trying to have a baby. Once they start treatment and their symptoms are managed, then their chances of conceiving are increased.”

QUIZ: ✓Tick the boxes below to see if you might have symptoms of PCOS

  •  Irregular menstrual cycle 
  • Thinning hair or hair loss on the scalp (male-pattern baldness).
  • Acne on the face, back and chest. 
  • Too much hair on the face or areas where men usually have hair (hirsutism affects up to 70% of women with PCOS). 
  • Weight gain and difficulty losing weight. 
  • Darkening of skin pigmentation, along the neck, groin and under the breasts. 
  • Skin tags in the armpits or neck area. 

How is PCOS diagnosed? 

“If you think you have PCOS, make an appointment with your gynaecologist. There is no single test to diagnose PCOS, but we take your medical history and can conduct a physical exam with a pelvic ultrasound and do some blood tests,” says Dr Zinn.  Dr Hellig adds: “Of utmost importance is that PCOS is a diagnosis of exclusion and it is important for your medical professional to look for other causes of your symptoms before ascribing it to PCOS.”

  • Physical exam: Checks your blood pressure, BMI and waist size. Also checking for extra hair on the body, skin discolouration, hair loss and any other signs of excess testosterone such as an enlarged clitoris. It is important to exclude other health conditions. 
  • Pelvic ultrasound: A sonogram will examine the lining of the uterus and check the ovaries for the polycystic features. 
  • Blood tests: To check your androgen hormone levels, as well as other hormone checks, including your thyroid. 

Can I be cured from PCOS?

8Dr Hellig explains that there is no cure for PCOS, but symptoms can be effectively managed and therefore treated. “We take into account if you want to conceive, your risk of long-term health problems, especially diabetes and cardiovascular disease, and will help formulate an effective treatment plan through lifestyle changes and medication where necessary,” she says. 

What can I do to alleviate my symptoms?

Dr Hellig and Dr Zinn agree on the following steps that women can take to treat PCOS: 

  • Lose weight: This will help to stabilise your blood glucose levels and alleviate insulin resistance. Even a 5 – 10% loss in body weight can improve your chances of conceiving. 
  • Remove hair: Using facial hair removal creams, laser hair removal or electrolysis. Medication is not very effective for permanent hair removal. 
  • Hormonal birth control for women not wanting to conceive: Can help to regulate  menstruation cycles, stabilise weight, improve acne and reduce new hair growth on face and body. 
  • Anti-androgen medicines: Although not safe for pregnancy, can help reduce PCOS symptoms. 
  • Metformin: A drug used to treat type 2 diabetes and may help some women with PCOS symptoms in certain circumstances. 

Do you have the pregnancy glow?

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In pregnancy, your skin can exude a truly healthy glow because of a combination of factors, such as greater blood volume, which can give the cheeks a flushed look and more sebum on the skin, which can make the skin shine. While every woman experiences hormone changes in pregnancy, not every woman will get that pregnancy glow. It is well-documented that pregnancy brings with it a whole new set of skin concerns – not just the most common of problems, namely stretchmarks. Charlene Yared West spoke to Life Fourways Hospital Gynaecologist, Dr Abigail Lukhaimane, Life Mercantile Hospital Dermatologist, Dr Zinzi Limba and Genesis Maternity Clinic Maternity Coach & Spa owner, Tsholo Bless, to find out more about skin conditions in pregnancy.

Acne-oh-no!

What is it? “Acne is very common in pregnancy, especially in the first and second trimesters and in some cases can be quite severe. When your hormones settle by the third trimester it can subside for most women, but this is not always the case” says Dr Abigail Lukhaimane. “I do my best to reassure moms that it is a natural , cosmetic condition and that it will get better when hormones stabilise.” 

Primary cause: Dr Zinzi Limba explains that increased levels of androgen hormones, believed to be important for cervical ripening at full term, as well as for maintaining a healthy pregnancy, can cause acne. 

What can you do? “Managing acne in pregnancy can be tricky because many prescriptions and over the counter treatments are contraindicated for pregnancy and can cause birth defects,” says Dr Limba.  She encourages moms to talk to their doctor to plot the best and safest way forward before taking any acne treatment. 

Tsholo Bless recommends some easy drug-free options for managing zit outbreaks:

  • When washing your face, use an oil-free, alcohol-free cleanser, limiting washes to twice a day. Avoid over-cleansing as this stimulates the oil glands in the skin to produce more oil.
  • Change your pillowcases often – use cotton pillow cases which encourage the skin to breathe.
  • Keep your hands away from your face so that you do not spread bacteria from your fingers to your face. This goes for your mobile phone too – a device dripping in bacteria, even on the best days!
  • Avoid the temptation to squeeze or pop your pimples, as this can cause re-infection and scarring.
  • If you have clogged pores, treat yourself to a professional salon facial.

Chloasma: The Mask of pregnancy

Dr Lukhaimane explains that chloasma, also known as melasma, is a common skin problem where the condition causes dark, discoloured patches on your skin (hyperpigmentation).  Most common on the forehead, nose, cheeks and chin.  According to the American Academy of Dermatology, 90% of people who develop this condition are women.
Primary cause: “Estrogen and progesterone sensitivity often accompany this condition and can trigger it,” says Dr Lukhaimane. “Usually it is self-limiting and will fade after the pregnancy. Sun exposure can also predispose melasma. In addition, darker skinned people are more at risk than those with fair skin.” 

How do I know I have it? A visual exam of the area is often enough for your care provider to diagnose it, says Dr Limba. “However, dermatologists can perform a bed-side test using a Wood’s Lamp – a special kind of light that allows the doctor to check for any bacterial and fungal infections to determine how many layers of skin the melasma has affected.”

Living with melasma: Not all cases clear up with treatment, but there are methods of behavioural changes that can help minimise the worsening of the condition.  “Visit your doctor to discuss prescription options that are safe to use for pregnancy,” says Tsholo.

  • Use Paraben-free makeup if you are self-conscious to cover up areas of discolouration.
  • Wear Sunscreen containing Titanium Dioxide & Zinc Oxide – every day!
  • Wear a wide-brimmed hat and protective clothing when you are out and about in the sunshine.
  • Seek out support groups for your condition.

The Pregnancy Line

The pregnancy line is also known as linea nigra and is a normal and natural part of pregnancy. It is brown and darker than the skin tone of the woman and is a vertical line running down the middle of the belly, between the belly button and the pubis, explains Dr Lukhaimane. 

Primary cause: “It is understood that the linea nigra and the darkening around the nipples is caused by the hormones estrogen and progesterone, which stimulate the production of melanin, the pigment which darkens and tans the skin in pregnancy,” says Dr Limba. 

Does it fade? After pregnancy and birth  it goes away on it’s own – you do not need treatment. 

Stretchmarks? You earned your stripes mama! 

“Stretchmarks are very common in pregnancy, affecting about 8 out of 10 women –  and do not cause harm to the mother or baby, but can cause itching on the area for some women,” says Dr Lukhaimane. 

Primary cause: Dr Limba explains that skin is highly adaptable and can stretch and contract, but during pregnancy, the skin does not have enough time to adjust, which causes the skin to tear, which in turns results in a scar that forms – and this is known as a stretchmark. 

Who gets stretchmarks? “Lighter skinned women often get pink stretchmarks forming, while darker skinned women will have lighter stretchmarks than the surrounding skin area.  Stretchmarks can occur anywhere; on the hips, thighs, belly breasts, lower back and buttocks,” says Dr Limba. 

Treatment: Tsholo says that there is no absolute treatment for stretchmarks, but that women can be comforted to know that they will fade into paler scars and sometimes become less noticeable, but will not go away completely. “The best advice would be to make sure that you keep the skin well nourished and a cream or oil made from plant oils rich in Omega 3,6, & 9 can be very useful. A study published in International Journal of Molecular Sciences by T.Lin et al showed that the topical application of some plant oils can have anti-inflammatory and skin barrier repair effects. This also means that the itching is reduced. So it is wise to seek information from your skincare therapist,” she adds. 

TOP TIPS

Sunscreen is imperative. 

When pregnant, all medication should be cleared by your physician / gynaecologist. 

Healing from incontinence

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Urinary incontinence is common in pregnancy and is reported by about 60 percent of women. For these women, the severity of their condition can increase during the course of their pregnancy, especially peaking in the second and third trimesters. Of these women who experience incontinence in pregnancy, 70 percent go on to resolve the condition postpartum – and within the first year, the prevalence of incontinence drops down to 11 to 23 percent. Dr Bongi Makhubo, obstetrician gynaecologist from Life Anncron in Klerksdorp sheds more light on the topic. 

Early incontinence is normal

Pregnancy can affect the normal way your urethra relaxes and contracts and many women, particularly those who had a vaginal birth, can experience incontinence after childbirth. “The pubic and pelvic muscles and the anal sphincter can be injured in up to 40-80% of births and so, leaking a little bit after birthing your baby vaginally is quite within the normal range, but it is not normal if it lasts for months afterwards,” says Dr Makhubo. “Directly after birth, using a thick maternity pad helps to absorb the leaks, but once you have stopped bleeding and incontinence persists, you might need a specialist appointment to discuss the problem further.” 

Stress incontinence is also quite common in new mothers and affects roughly a third of women in the first year after birth. Stress incontinence leaks happen when the mother laughs, coughs, sneezes or goes for a run. Lifting heavy things can also cause these leaks,  which are due to increased intra-abdominal pressure and a defective urethral support or closure.

<FACT BOX>What causes incontinence after birth? Dr Makhubo shares the facts: 

  • Weakening of the pelvic floor muscles or injury to the nerves supplying the structures of the pelvic floor, due to a prolonged or difficult labour. 
  • Carrying a bigger than normal baby in utero, leading to difficulty in delivering or stretching and compression of the pelvic floor.
  • High levels of elastin, a hormone which allows for more stretching of the skin and connective tissue, can cause prolapse and in turn, incontinence (as opposed to collagen, which is decreased during pregnancy).  
  • Assisted delivery, especially with the use of forceps. Research shows that there is less injury and urinary incontinence noted with the use of ventouse in comparison. 
  • Maternal age; the higher the age the higher the association with urinary incontinence.
  • Parity; incontinence is more common with parous women, however of note is that the highest risk of incontinence is with the first delivery, then 10% risk increase with each subsequent birth.
  • Vaginal delivery definitely predisposes women to a higher risk of incontinence and most women will be incontinent for a few weeks; however most will be normal within a year.

What can help?

“Pelvic floor muscle training or kegels exercise are by far the best way to combat the problem postpartum, although the research differs as to how much of the exercises should be done. However, these can be done anywhere, and one way to remember to do them is to pick an anchor which will remind you to do them. For example, when stopping at a robot or boiling the kettle: each time you do one of these activities, do some pelvic floor exercises too,” says Dr Makhubo. 

She suggests that physiotherapy can also help in some cases. “A physiotherapist will give you cones or a pessary that can be used to squeeze and strengthen the pelvic floor muscle.” Dr Makhubo also encourages lifestyle modifications, such as drinking less coffee and alcolhol and stopping smoking. Decreasing BMI can also help improve incontinence issues. “If lifestyle modifications have been made and incontinence persists, then medical treatments can be offered,” she says. “The last resort is surgery.”

Medical treatment and surgical options

  • Medication:
    • Estrogen creams, duloxetene and even botox can help to alleviate incontinence. 
  • Medical devices:
    • A vaginal pessary, which can be used for prolapses. It is a ring-like device and acts as a support for the bladder. A disposable urethral insert may also be prescribed and serves as a leakage barrier. 
  • Bulking agents:
    • Bulking agents are injected into the urethra to help plump up the tissues where urine is released from the bladder and help to hold it in. 
  • Surgery: The underlying principle of surgery is to support the urethra, so that the bladder can work effectively. 
    • “Retropubic urethropexy ( Burch’s Colposuspension ) is used most common surgery for this condition. It is an abdominal procedure, where the pubocervical fascia is attached to a copper ligament or to the pubic symphysis (pelvic bone),” explains Dr Makhubo. “This helps lift the anterior vaginal wall and tissues surrounding the urethra and bladder, which helps to alleviate incontinence. 
    • Slings: There are various kinds of slings and they are all made of mesh. The use of mesh has been approved by the FDA and the South African Urogynaecology Society endorses and supports the use of this method for incontinence. A ‘hammock’ is created using mesh and tissue to support your urethra and can be done under local anaethesia.
      • Pubovaginal slings, mid-urethral slings, mini-slings and micro-slings are used as a means to help incontinence, but implanting mesh where it is needed, in and around the urethra. These range from being quite invasive to non-invasive. Your care provider will help you decide on the best approach for you. 

Healing… after miscarriage

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Miscarriage is the most common type of pregnancy loss and according to the American College of Obstetricians and Gynaecologists, 10-25% of all recognised pregnancies end in miscarriage and about 80% of all pregnancy loss occurs in the first trimester. Unrecognised pregnancies, which are also known as ‘chemical pregnancies’ account for 50-75% of all miscarriages, where the pregnancy is lost shortly after implantation, where bleeding occurs around the time of the woman’s expected period. Charlene Yared West unpacked the topic with Dr Francis Maleka from Life Mercantile Hospital. “In short, miscarriage is more common than we think,” he says. 

Why does miscarriage happen?
“Not every miscarriage has a clear cut reason and often the cause isn’t identified. Women will ask themselves why – and often blame themselves, but the truth is, there is very little you can do to prevent a miscarriage,” says Dr Maleka. Reasons include chromosomal abnormality, hormonal problems, infections, maternal health problems, maternal age, maternal trauma, lifestyle (smoking, drugs, malnutrition) and implantation of the egg that does not occur properly. “Things that do not cause miscarriage are sex, working outside of the home and moderate exercise,” he adds. 

Men – the forgotten grievers

Women are the ones who have to cope physically and emotionally after the loss of a baby. Often, the grief men experience goes unacknowledged. According to research carried out in 2014 by Dr Petra Boynton at the University College London, dads said they felt happy, excited, thrilled or delighted about the pregnancy before the miscarriage – and 55% of those men had already picked out a name for the baby. After the loss, many fathers reacted with feelings of sadness (85%), grief (63%) and shock (58%), but nearly a quarter didn’t share their feelings with their partner, usually for fear of upsetting her more or saying the wrong thing. “I encourage couples to talk about what happened and also to see a therapist if they find it difficult to access those emotions,” says Dr Maleka.

Getting pregnant after miscarriage

Deciding to have another baby after miscarriage can cause mixed emotions for both parents. “On one hand they want a baby, but the next time around is often fraught with fear of another loss. We have to pay special attention to the next pregnancy even more carefully,” says Dr Maleka. Parents may choose to delay falling pregnant again due to surgery from the miscarriage, a delay in menstrual cycles, genetic testing and autopsy reports, and emotional issues and readiness. “Seek support from family and friends, as well as your doctor or midwife and professional support groups, to help you heal after miscarriage,” he says. “Remember that you are still grieving the loss of your baby while attempting to get pregnant again. Be gentle on yourself.” 

A case study: “How I moved forward”

We fell pregnant for the first time in 2011 and were so excited. We decided not to wait until the 12 week time period to share our news with friends and family – as for us, a life is a life and we told everybody! I had all the pregnancy symptoms; sore breasts and bouts of nausea. Then I was at work one day and started bleeding heavily. The doctor confirmed the miscarriage and we were distraught. I was so heartbroken and this heaviness weighed down on me for weeks. My husband and I went away on a relationship workshop weekend camp and for me that was the turning point. The camp was situated in a beautiful place in nature, which brought me a lot of comfort. There was also a small chapel there that my husband and I would visit. In the quiet of this tranquil place, I came to the realisation that I had to give her a name as I sensed she was a girl and that I needed to somehow name her. So, we named her Faith and I think just the act of giving her a name gave me such a sense of relief. I was much better afterwards and  fell pregnant soon after… and gave my baby the second name of Faith, so that I would never forget the first little life that came to me. I think a lot of people after miscarriage tend to want to close it off and not talk about it – and try their best to forget about it. I somehow embraced the experience as painful as that was and named her, letting myself to feel the loss that occurred. This is what gave me closure. We have two daughters now, but have never forgotten baby Faith.  

Own your birth: Why you need a birth plan

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The birth plan: a tool pioneered by childbirth activist and midwife, Sheila Kitzinger in the 1970s, who believed that women and not their caregivers, should be the focus of childbirth and be able to advocate for themselves with this document, which detailed their wishes for the delivery. In the wake of birth plans, the Better Births Initiative was formulated as a way of educating caregivers on the general care of women in labour. The initiative was also rolled out in South Africa and expected to be adopted by all hospitals by 2015. Amongst the guidelines, it encourages respect, privacy and companionship for women in labour, pointing out that women should be able to labour and birth in whatever position they feel most comfortable, with as many birth companions as they choose to have. By Charlene Yared West. 

Birth plans inform and educate 

“Birth plans have become common practice now, as expectant mothers are more informed about their birth choices,” says Marié van Heerden, midwife and hospital manager at Genesis Maternity Clinic. “It is a good exercise for each expectant parent to inform themselves of their options through compiling a birth plan, so that they understand what they can expect, as well as benefit and risk of procedures and medication – and know where they can make certain choices. This applies to any type of birth, whether it is for a natural or planned caesarean section.” Laura Sayce, doula and lactation consultant at Genesis agrees; “I help my clients to compile their birth plans as a way of helping them make informed decisions. It also encourages them to do their own research into each element of the birth and then to make choices based on this information.” 

What should a birth plan include? 

According to a research paper Birth Plans, the good, the bad and the future by J.Lothian (2006), the focus of birth plans should be to answer three patient-focused questions: What will I do to stay confident and feel safe? What will I do to find comfort in response to my contractions? Who will support me through labour, and what will I need from them? “I encourage all my patients to write out their birth preferences and to make copies of it, one of which is placed into their file at the hospital and extra copies for the hospital midwife on duty for the day they go into labour,” says Dr Sean Drew, gynaecologist-obstetrician at Life Hilton Hospital. “It helps everyone onto the same page about what the parent’s intentions are for the birth, but it must also leave room for what happens in the event of having to resort to ‘plan b’ option, which is often not detailed in the plan, but should be.” Dr Drew explains that as medical professionals, their first obligation is to the safe and healthy delivery of baby and mother. “First we want to ensure life, then we can look at incorporating all the ‘quality of life’ elements from the birth plan. This is not to say we don’t observe what is written in the document. It is quite the opposite. We do try to fulfil the mother’s wishes to the best of our ability, within our scope of practice.”

Most important birth plan elements

Life Hospitals aim to work in an evidence-based way. Sister van Heerden points out that it is helpful to speak to your care provider and to do a hospital tour, so that you have a clearer insight into how the births are conducted at the hospital you have selected to birth at. “Once you have done that, you are ready to write your birth plan. There are so many templates on the internet, but here are some important factors to include,”: 

  • Labour and birth: freedom to eat and drink in labour, play music, dance, make labour sounds without inhibition, use aromatherapy oils (safe for labour and birth), have freedom to move into any position and birth in any position on the floor, or the bath or the bed. A mother should be allowed access to a doula or birth companion of her choice, who will provide non-medical pain relief options, including hypnobirthing, massage and general encouragement. Delayed cord clamping after the baby has emerged to allow for all the baby’s blood to be drained from the placenta to the baby. 
  • First hour: Uninterrupted, immediate skin-to-skin contact with the mother or the father (if the mom is unable to). Assistance with the first latch if requested, otherwise the baby should be allowed time to attempt a breast crawl. Weighing and measuring to be done after the first hour of bonding for the family. No separation of mother and baby unless absolutely medically necessary. 
  • Postnatal: Rooming in with your baby, no formula unless there is informed consent of the mother, provision of pain relief if medically necessary and assistance with breastfeeding. 
  • Plan B: In the event of an unexpected caesarean, there are still choices. The mother can request immediate skin-to-skin with the baby in the theatre after the initial checks by the paediatrician and no separation unless medically necessary. Early initiation and assistance with the first latch. If the baby has to go to the neonatal ICU, then the father may accompany the baby. 

What are the roles of each of the professionals present at a birth? 

  • Obstetrician-Gynaecologist: A medical doctor who is the primary caregiver for your birth and there to deliver the baby when it is time to push the baby out. He/She may also conduct vaginal examinations during labour, but this is more often performed by the hospital midwife on duty. It is also the role of the doctor to perform the caesarean sections either scheduled or emergency. 
  • Hospital Midwife: The hospital midwife performs nursing duties during labour and ensures the medical needs of mother and baby are taken care of by checking foetal heart rate, mother’s well being,blood pressure and other medical checks. She/he may also conduct the vaginal examinations, under the instruction of the primary caregiver, the doctor. In private hospitals in South Africa, the baby is delivered by the doctor and not by the midwife, unless the baby is born before the doctor’s arrival at the birth. The midwives at Life Healthcare hospitals are however trained to conduct normal deliveries. In government hospitals, the hospital midwives are permitted to conduct deliveries. 
  • Independent Midwife: She/he fulfils the same role as the hospital midwife, but may also deliver the baby and call on the obstetrician-gynaecologist in the event of an emergency. Independent midwives may also conduct homebirths, hospital births on low risk pregnant women, with confirmation and back up of a supporting gynaecologist-obstetricians. 
  • Doula: A doula is employed privately by the parents themselves and works independently of the hospital. She is non-medical and is there for the mother’s physical and emotional support throughout the labour process. She may not advocate on the mother’s behalf to her caregivers. Research supports the use of a doula for a more empowered and positive birth experience, no matter what turn the birth takes, whether the baby is born vaginally or abdominally.   
  • Anaesthetist: The anaesthetist is called in if the mother requests an epidural during labour and is also there for caesarean births to administer the spinal block and for ensuring adequate pain relief after the caesarean. 
  • Paediatrician: The paediatrician is called in after natural births to check on the wellbeing of the baby. They are also present during caesarean sections to ensure the health of the baby. 
  • Lactation consultant: Although the mother receives breastfeeding advice and assistance from the midwives in the maternity unit of the hospital, a lactation consultant is extremely helpful to ensure long-term breastfeeding success. 

Ruwarashe’s Birth Story

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Ruwa was nervous at our first meeting. Soft-spoken, she asked about my role as a doula for her birth. I walked with her in pregnancy and birth and when she went into labour, I met her at the hospital. Her birth changed everything. She was shown how powerful her birthing body was and that she could do anything. Here is her story of the birth of her son…

My name is Ruwarashe and I am 21-years-old and I come from Zimbabwe. I’m currently studying at UCT. I became pregnant in September 2018. Pregnancy was going to be a hard journey for me, as I didn’t understand anything about birth and even worse, I was a long way from home where I had friends and family to guide and support me. In Cape Town, I have little support. So many people recommended I get a doula, especially since I felt quite isolated in Cape Town without my family near. 

Choosing a doula for me was so important, because I needed someone compassionate and soft and when I went onto Charlene’s website, I knew she was the doula who would understand my fear and confusion of becoming a mother. ( I hadn’t even met her in person yet, but I just knew.) 

I remember I wasn’t sure if I was going to have anyone close to me at my birth, because my family and fiancé stayed so far away… And I had so many fears of becoming a new Student  mom. Charlene reminded me that she was going to be there for me – and that I would be ok, no matter what turn it took. She said this at our first meeting.

Charlene engaged with me every week reminding me to trust the process of the journey I was on, offering me her kind support along the way. I was at school from 8am to 5pm everyday and I was at school until I was 9 months pregnant.

She also made sure we were able to meet close by to where I lived, as I did not have a car. She did this without hesitation – and it was so kind of her. When I felt low, I would message her and we would chat and she would encourage me to keep my faith and to be strong. 
I think what especially helped were the Relax Into Birth visualisation tracks. Listening to them regularly helped me realise that birth wasn’t just an event, it was a process – a beautiful process… Finally I was learning to trust the process – and trusting myself to do it! I felt strong enough to birth my baby boy. The strength seemed to come from within me. A deep knowing. 

The Relax Into Birth classes made me realise I wasn’t just doing a duty a woman is required to do; no! My body was giving life to a soul, another human being. Although it was about birth, it also somehow helped me establish what type of mom I was going to be to my little boy. 

When I finally went into labour, the emotional support for me and my fiancé was tremendous! She always made sure I was as comfortable as I could be in those circumstances. When it was time for me to deliver, I remember I was very tired – and our doula Charlene never once wavered, always trying ways to help energise me and encourage me to bring my son down to earth.

During my visits to the doctor, I was told we had to schedule an induction, because they didn’t want me going over my due date, which was the 26th of May. I wasn’t so sure I wanted an induction considering the potential complications. It was really not what I wanted.

In my 39th week, I went for cervix check to prepare for my induction. I was notified that soon I was going to be in labour – and that it was likely I would not need an induction. On Thursday 23 May, my waters broke as I was going to bed. I remember I kept my calm. I took an Uber with my fiance who had arrived from Zimbabwe, even though my contractions hadn’t kicked in properly yet. I didn’t want to stay at home after that because I didn’t want to be under pressure to rush to the hospital when it became necessary. I didn’t want something dramatic! Charlene did join us at the hospital when my contractions got regular and intense. She was there the whole time and I held onto her. She created such a calming environment in such a tense situation. I remember I had moved 1 cm in 4 hours and all I wanted was an epidural. I asked the nurses for an epidural, but was refused by them, saying it was too early to administer. In the face of that, my doula encouraged me to keep going and to stay strong as I was birthing my angel.

We used other forms of natural pain relief. We used the shower and we counted together and breathed together and finally at 7 am they decided to insert a dose of prostaglandin gel to help my cervix open. Once that was given to me, five minutes later I was standing to go poo in the toilet and another five minutes later I was walking myself to the tub in the delivery room. During that walk I definitely felt my baby was coming! I got into the tub for a few minutes and notified both my fiancé and Charlene that the baby was indeed coming.

The delivery room not prepared by the hospital staff (as they didn’t expect me to push so soon), they quickly put me on the bed, and there was my baby crowning! They quickly set up the room as I involuntarily pushed him out. A few pushes and I had birthed my baby.

My birth taught me to trust my body and trust my baby. I have never felt as strong or as empowered as I did in those first days. I was blessed to have such a positive, empowered birthing.

Pip’s Birth Story

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Hailing from New Zealand, I had never met Pip in person, but she was referred to the Relax Into Birth Hypnobirthing course by a dear South African friend of hers, who had also completed the course a few years earlier. She was so excited to share her story with me after she had given birth, because the techniques had been so helpful. Here is her letter to me after her birth.

Dear Charlene,
I just wanted to give you an update on how I have been doing and let you know our little baby girl “Niamh” arrived safely with us in hospital at 10.07am on the 8th May 2020 at 6 Ib 15 oz and we are all doing great! I am sorry I haven’t been in contact sooner – I just wanted to sit down when I had some time to fill you in properly. I have emailed you because if I sent you a voice over on whats app I would be in tears!

Just to give you some background on myself, I had extreme anxiety about labour for as long as I can remember and this soon got worse when I became pregnant. To give you an example I had previously passed out from getting cervical smears done and I am just not good with that kind of stuff! – ironic really considering I am a horse vet! 

You couldn’t have come at a better time for me as the anxiety was getting the better of me as time progressed. I remember around 26 weeks in tears at my midwife appointment feeling completely overwhelmed and not knowing what to expect.  I spoke to my dear friend Felicity Meek who put me in touch with you. As soon as I started listening to your affirmations and then doing your course from around 33 weeks my mind set started to change and I began to relax ! Your course allowed me to understand the process but in a way that wasn’t scary but beautiful, something to look forward and that my body was going to do it! I had no idea how powerful hypnobirthing could be but it was the best thing I could have done to prepare myself ! I can not thank you enough Charlene – you are incredible and what an amazing birthing experience you and your course have given me.


Now for the gorey details………… well there aren’t any! Haha! I went into latent labour on the 4th May ( my due date) with mild contractions every 10-20 mins for about 20 seconds in length on / off through to the 7th May when the contractions gradually got stronger and longer. I had a “Show” over this time too which I admit did freak me out a bit but I had your voice saying “Show time!” in my head which helped to ground me and stop me panicking. 
I laboured at home for as long as possible and made a wonderful area in my sitting room with candles, diffuser with lavender oil, exercise ball, cushions, fairy lights etc …. with my husband, 2 dogs and my favourite movies on.

It was really beautiful and my husband was absolutely amazing using some of your massage techniques on my lower back and making sure I was eating/drinking. I used a water colour painting of a lotus flower to remember your affirmations and a colour card to look at to help me focus on the rainbow breathing technique. During contractions I would also think about your lovely knitted uterus which helped me visualise and understand what mine was doing!

 By the 7th May from 6pm the contractions got stronger and lasted longer until  I was getting contractions every 3-4 minutes lasting a minute by midnight –  I was in/out of the bath at this point which helped a lot. 

We made our way to the hospital at this point and got screened at the entrance for COVID-19. We entered the maternity ward and the corridors were lined with pastel balloons and fairy lights which was wonderful! I was examined (I was apprehensive about the examination) and found to be 8 cm dilated. My waters broke at this point – I was delighted thinking ” not long to go now!”

I went into a bath  and my husband and midwife set up some led candles and my affirmation cards. I stayed in the bath from about 2 am to 6 am . I was examined a few times and found to be 10 cm by 4 am but my contractions started to get weaker and further apart. I got out of the bath and tried sitting on a squatting stool but that didn’t really bring things on.

Up to this point everything was 100 % perfect but I started to feel anxious and willing for more intense contractions! I was examined by an Obstetrician  at 6.30 am – he was astounded that I had no pain relief and I remember the midwife saying proudly “she’s using hypnobirthing!” The obstetrician confirmed with the midwife that all was well with baby and there was no reason why she shouldn’t come through my pelvis.

It was discussed with me to go on a Pitocin drip to get contractions going. My platelets were low so it was not recommended to have an epidural, but I remember feeling so exhausted and the thought of pain relief sounded good! Your affirmations grounded me through this process and helped me focus and I just continued to breath, eyes closed and I just went into myself. Once the drip was in and monitor put on baby head I was allowed go on 4’s on the bed. The contractions came – I took gas as I found them heaps stronger than my own ones but I could tell we were making great progress.  I remember feeling my baby head turn and pop through my cervix. An incredibly visceral and alive feeling I had – I think I shouted out “Fecking hell!!!” and “How close are we now?”

Then I felt the wee burn feeling and I remember thinking “We are nearly there!” My midwife got me on my back at this point, one of my legs was wrapped around her neck. I couldn’t believe how much pushing I had to do along with the contractions. She got me to really push with my breath. At this point I remember taps going on and her telling me try not to push at the moment. She was putting hot flannels on me. Then the last contraction came and she warned me she may give me an episiotomy (I didn’t care at that point !) but she didn’t  have to  in the end and Niamh’s head came out followed shortly by the rest of her and up she went onto my chest – total magic!!!

My husband Josh cut the cord and she stayed on my chest for an hour.  I got a small superficial tear that was stitched (about an inch or so long), but that was it. I passed the afterbirth and I remember the umbilical cord some how slid up between my bum cheeks and I said “Guys – the cord is giving me a wedgey!” , then I proceeded to wiggle around on the bed trying to pull it out. 

I walked out of the delivery room an hour later feeling completely elated and so proud of myself. I had a beautiful and empowering birth experience and when one of my fears of having interventions occurred I was able to process and deal with it thanks to you and your course. 

So Charlene, I can not thank you enough. Every first time mum should be doing this as it has honestly helped me beyond belief. I really think it should be offered to all expectant mums at their first midwife/doctors appointment. A huge thank you from the bottom of my heart.
Love from Pip.

Want to find out more about Relax Into Birth Hypnobirthing? Enjoy a more comfortable, empowered birth and click below to enroll and find out more. Relax Into Birth is an Online Birth Preparation Course, of international standard, teaching women and their partners Hypnobirthing techniques and deep relaxation methods for a more comfortable and manageable birth experience at home or at hospital, for natural or caeasarean birth.

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Petra’s Birth Story

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Petra is a very strong mama who I met when she was pregnant with her first baby. Firm and determined, she never gave up all through her two birth experiences. It was lovely getting to know her as a mama also living in the Valley and this is the story of her second birth, where she attempted a VBAC. Thank you Petra for sharing your story!

I met Charlene in 2015 while pregnant with our first. My husband and I attended her hypnobirthing antenatal course. We were very keen on a natural birth and even changed service providers from a doctor to a midwife after doing a lot of research and weighing up all our options.

Unfortunately, our baby had other plans and presented in Frank breech, which is a breech position with the legs extended straight up towards the head. We were told by our supporting gynae that there was no chance of a natural delivery, and so we ended up scheduling a c-section. Our baby had other plans again: I went into labour the night before the c-section date, and our daughter was born by emergency caesarean at 03:30 in the morning.

3 ½ years later we found out that we were expecting again and to our delight our gynae suggested a vbac without us even asking. We agreed that this would be our preferred birth option, provided that everything was favourable. 

I have a deep desire inside of me to birth my babies, and not just be delivered of them, which is why I felt somewhat “left out” with the c-section birth of our first child. And this time around I was determined to make sure that this baby would not be positioned in breech!

The pregnancy progressed well, without any complications and our baby turned head down and stayed head down – I was so thrilled!

We decided to make contact with Charlene for a refresher course, and chose her as our doula, to ensure that we have someone by our side who knows her way around natural birth.

At this point I need to mention that I turned 43 about 5 weeks before the birth of this baby and, whilst I feel much younger than this, my gynae would not allow me to go over 40 weeks for possible age-related complications. This means we have a scheduled c-section booking in case I don’t go into labour by that time. He also tells us that I cannot be induced, because it is a vbac, but he can rupture membranes for me the day before the booking, which might induce labour. If that doesn’t work, then I will have to stay in hospital overnight and have the c-section the next morning.

Week 38 has me seeing a midwife for a stretch and sweep. She tells me that my cervix is 1-2cm dilated and my body is definitely preparing to go into labour. Yay!

Week 39 and my gynae does another stretch and sweep, telling my husband that our weekend plans might just be in jeopardy. Great! Monday comes without any signs of labour and the booked section day is Wednesday. Oh no! We have a final check-up with the gynae, and he tells me to check into hospital at 3pm the following day so he can attempt to start my labour by rupturing the membranes. This being a vbac, we also agree that if there is foetal distress at any stage or if I start bleeding (which can be a sign of uterine scar rupture) then we will change plan and do an emergency caesarean.

Tuesday 21 May – the day before our c-section booking
I wake up feeling calm. Too calm! Not a surge in sight. I chat to Charlene and she suggests that I ask the gynae if we can check in earlier, so that I have a better chance of not labouring through the night.

So there I am at 13h00 hooked up to the CTG, listening to Charlene’s birth affirmations and waiting to have my membranes ruptured. 

The procedure is successful, my water breaks and an hour later labour has started, and I am having regular surges roughly 5 minutes apart.

My birth photographer is there and Charlene has also arrived, and worked her magic in the room, transforming it into a much friendlier place.

The surges quickly become more intense and very soon they are 2 minutes apart. Charlene and my husband take turns massaging my lower back through the surges, which is where I am feeling the most pressure. 

I need to be hooked up to the CTG a lot and for this I have to lie down on the bed, which is much more uncomfortable that sitting on the birth ball or standing and swaying my hips through a surge.

At some stage I have to go to the toilet, which is outside of the labour room. It takes a lot of courage to venture out of the room and when I finally do, I take Charlene with me. I simply cannot bear to face a surge without someone by my side. (Which not-so-clever person designed these labour rooms and didn’t include a toilet..?!)

There is quite a bit of blood and we think it is a good show.  As labour progresses, I can however feel that there is fluid leaking out at the end of every surge, and I assume that this is amniotic fluid.

At 17h00 my gynae comes to check up on me again, and notices that I am haemorrhaging. “Why is there so much blood?” I hear him asking the midwife. So that is the fluid that I feel at the end of every surge! He also checks the foetal monitor printout, and then comes to tell me that I am 7 cm dilated at this stage, but I am also bleeding, the foetal heart rate is declining, and he is not happy about either of this. Those are the 2 things that we agreed would mean a change in our birth plan.

A decision is made quickly and calmly that we will proceed with an emergency c-section. Both baby and I are fine at this stage and there is no panic. I keep breathing through my surges, still lying on the bed and connected to the CTG, while Charlene and my husband keep massaging my back.

At 17h40 my gynae comes back to take me into theatre and I am pleased to discover that the assisting doctor also assisted with my previous c-section, and the anaesthetist is the one we requested for our booking the following day – this helps to put me at ease even more.

Charlene once again works her magic and soon there is beautiful music playing in the theatre, which helps to create a light and calm atmosphere.

15 minutes later we’re ready to start the c-section and at 18h00 our baby is born! Because we didn’t want to find out the gender during the pregnancy, the gynae lifts the baby up for a gender reveal: it’s a girl!! My husband has tears in his eyes when he turns to me and says, “we have another girl!”.

I really try to be more present to all that is happening than I was with my previous c-section. The gynae tells me that my scar is fine and wasn’t the cause of the bleeding, and that he cannot see where the blood was coming from. We assume that it could have been from the placenta starting to detach and this confirms that a c-section was the right decision. The baby was also facing forward and that was causing my back labour.

Once the paed finishes his check-up, she is placed on my chest skin to skin and we get to cuddle a bit while we wait for the surgery to end. There is a happy atmosphere in the theatre with lots of smiles, we have a healthy baby girl and all is well!

Charlene accompanies us to our room and helps to get us all settled in before leaving hubby and me to bond with our little girl, who is breastfeeding like a pro and soon falls asleep right there on my chest.

The next day starts off well, I am up and able to take a shower. I feel fantastic, with hardly any pain at all thanks to the pain meds, and I am looking forward to our “big sister meets little sister” visit that afternoon.

It is truly one of the best moments of my life, watching my older daughter meet her younger sister, and our lovely birth photographer captures some amazing pictures for us. I love every moment of it, and in the excitement of it all, I get up far too often and move around far too much… by the time my husband leaves with our daughter, I am in a lot of pain and can hardly stand up straight. I am now very annoyed with myself, as this is not my first c-section and I should really know better than behaving like I have just done! I also need to empty my bladder but try as I may, I can’t go. It is just too painful!

The pain gets worse and eventually I am in complete agony with what feels like one large abdominal spasm, almost like a labour surge that peaks and never ends! A nurse comes to measure my blood pressure and temperature, telling me that both are raised – I get annoyed with her, because it doesn’t take a genius to figure out that all this pain is causing the raised measurements. At this stage the spasm pulls up on the right-hand side from my abdomen into my shoulder and I am desperately trying to find a comfortable position to lie in. I’m clinging on to the bed rail and moaning through the pain! Finally, after what seems like an eternity, my gynae comes to check on me. I am in tears and tell him that I think I might have torn something with all my movement earlier. I feel completely responsible and am so disappointed with myself, and I am in so much pain. He gives me a voltaren injection, the nurse reinserts a catheter and eventually the pain fades. I am able to have a fairly restful night.

The next morning my gynae pops in on his rounds and tells me, that he thinks my bladder might be punctured, and that I will need to go for a scan. Baby stays with the nurses while I head off to the radiologist. Not much later we have confirmation: my bladder is leaking and will need to be fixed.

At lunch time my gynae returns with the urologist, and together they assure me that this is not my fault and that nothing I did could have caused the bladder puncture. It must have happened during the c-section and gone unnoticed. Surgery is scheduled for 19h00 that evening. Until then I am not allowed to eat or drink anything… not great, as I trying to establish breastfeeding.

Later that afternoon I have another abdominal spasm with pain as bad as the day before, and this leaves me exhausted and more than willing to go back into theatre just 49hrs after having a c-section.  My baby does an hour long feed and then falls asleep just before her daddy arrives to look after her, while I go in for surgery.

The urologist checks on me outside theatre, and once again assures me that it was not my fault and that he will fix my bladder for me shortly. I am tearful and sore, feeling very sorry for myself and heartbroken for being away from my 2 day old baby. A theatre nurse walks past and sees me lying there looking miserable. She stops to come and console me, stroking my hair and telling me not to worry, that all will be fine. Sometimes angels don’t have wings and wear scrubs instead.

Surgery takes an hour and much to my relief I really do wake up without any pain. After recovery I return to my room to find hubby sitting peacefully in the easy chair with a sleeping baby girl skin to skin on his chest. She slept through the entire thing! 

I spend 6 days in hospital with 2 catheters and went home with the suprapubic catheter strapped to my leg with a “pee-pee bag” as my daughter called it. Not the most comfortable thing to have but at least I was mostly pain free. Charlene also came to visit me at home for a doula check and a long heavenly foot massage, where we talked and talked, and I had an opportunity to debrief.
The suprapubic catheter was removed after 11 days and I was mighty glad to be rid of it.

So in the end my deeply desired vbac turned into another emergency c-section. Not what I had hoped for but this whole birth experience taught me one thing: “Surrender, it is what it is.”

 I kept on repeating that phrase to myself, and I also kept looking for the blessing in each situation:

I look at the photos of our daughter’s birth, I see myself during those few hours of labour, actively participating in the birthing process, and in the end, we had a calm and joy-filled c-section birth with lots of smiling faces.
I would never want to go through the pain of the abdominal spasms again, but I treasure the fact that my husband got to spend those hours bonding with his little girl, while I had to have another surgery. Precious time that he would probably not have had otherwise.

Hospitals are by no means a restful place, but I had 6 days alone with my baby, before we went home to a very excited 4-year-old sister. 

I am at peace with the turn my birth took and Charlene sums this up beautifully in one of her poems:

Even when things go in the opposite way of what was intended. 
It’s that most sacred of moments.
When she locks eyes with her babe for the first time…
Skin to skin now on her chest she lies. 
“You must be mother. You are, this place – is my home.” 
She holds her closer and adjusts her position to bring her closer to her breast. 
The noise and voices and bustle of the hospital dim all around her… 
Yet, she suckles… and the circle is complete.

Aimee’s Birth Story

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It was my honour to walk beside Aimee and Ryan for the birth of their baby girl Kenzy. Here is their story…

When I think back on my “Birth Day” it was nowhere near what I expected, despite all my reading and “scenario-planning.” And to be honest, I wasn’t convinced I needed a doula in the beginning. I went to the Relax into Birth workshop which was incredible and empowering. Then I listened to the tracks every single day, and after a month I’d realized something. Not only did I now want a doula, but I only wanted Charlene. I couldn’t actually imagine giving birth without her there. I didn’t know my water had broken on Saturday. It just felt like I’d wet my pants. On Monday a confirmation call for Tuesday’s gynae appointment became the green light to come into hospital *with my bags*… There was some urgency as it had been almost 40 hours since the water breaking and I hadn’t experienced any contractions. But the phone call was pleasant and relaxed; and when I hung up I had a little joyful cry and some reflective me-time while I waited for Ryan to come home.At the hospital, a litmus test for amniotic fluid was positive and the gynae started a Propess induction immediately. (According to my Birth Plan, I hadn’t wanted to be induced, but by then it had been 45 hours since my waters had broken, and I was completely at peace with it). I was told it would take a while, and we could just relax! Great! The baby would be coming that night or in the early hours of the morning (it was only 2pm at that point). We were excited, joyful, “floating”! So we started sending some messages to the family and we told Charlene that she could come in after the traffic died down. 

Half an hour later, I was in agony and I couldn’t bear to lie down on my back. The baby’s heart rate was high. She was in distress – fetal tachycardia. The Propess was removed and I needed to have an emergency caesarean. My gynae was so kind, gentle and professional. She knew I had wanted to have a vaginal delivery, but we talked through the situation and I felt like we were always on the same page. Physically, it was agony, but emotionally I felt cared for and respected. I even felt quite content about going in for the surgery, knowing that my baby needed it. (We learned later, during the surgery, that it was all because her umbilical cord was wrapped around her neck twice. I am so glad I trusted my doctor.)

Then it was a whirlwind to get prepped for surgery. Even though our time schedule had changed drastically, I was mostly just feeling excited to meet my baby. Charlene arrived just in time! I was relieved to hear her voice: the same calming voice I’d been listening to every day.  She put on some beautiful music and came to massage my shoulders, which was just what I needed then because I started to really feel a lot of pain. It felt like I was being bullied internally, my organs being pushed and pulled. Tears were rolling down my face and I could hear myself groaning with every surgical touch. The pain was too much and I agreed to a general anesthetic. I know I was hyperventilating, but I felt Charlene’s firm grip around my shoulders and chest guiding me to breathe slowly while the gas was administered. Despite the intensity of it all, I felt safe. I closed my eyes and woke up to see my beautiful healthy baby 45 minutes later.


Five months later I filled in that missing 45 minutes. Charlene had captured the whole birth on video on my husband’s phone! It was such a gift.

Ryan and I hadn’t spoken through the “sedated-scenario” and by that stage he was quite traumatised by my pain. He was so worried about me that he didn’t even watch the birth; he just held my hand and kept watch over me. When Kenzy was born, he didn’t know what to do or expect.  (And that was exactly why I had wanted a doula: Someone to be a guide for us both, to be on our “new parents” team, our coach.) Ryan was particularly grateful to Charlene for talking him through those first moments of our daughter’s life. A funny moment comes up in the video where we hear Charlene saying “take off your shirt” and Ryan looks so surpised! He thinks she’s joking. But because he listens, the nurse brings Kenzy to put on Dad’s chest right away for skin-to-skin. I bet she didn’t expect to get a mouth full of hair while looking for her first drink! He really cherishes that time he got to share with his daughter.

Ryan bonding with his baby girl for the first time

It was an unexpected arrival in most ways, but I am so grateful I was prepared for every surprise step. I praise the Lord for modern medicine and how swiftly and professionally the whole team worked!