Season 2 #2 Michelle Mayefske

My guest today is Michelle Mayefske, a birth and postpartum doula who works with families in the mid west of Ireland. She helps expecting parents navigate pregnancy and prepare for their best possible birth. Her passion is helping parents move from a place of fear to one of confidence.

This episode may not be of interest to everyone, but I was curious to speak to someone with so much experience of working with pregnant people. We speak about the range of fears people can have around pregnancy and birth, where these might come from and the options available if you do want to go on and be a parent. I definitely learned a lot from our conversation!

You can go to Michelle's website https://www.limerickdoulaservices.ie/ and Instagram https://www.instagram.com/limerickdoulaservices/ for lots of useful information and to find out more about her services.

Episode Transcript:

Margaret O Connor 0:09 Welcome to season two of the Are Kids For Me podcast. I will continue to speak to people in a range of different circumstances about their personal and professional experience of answering this question. Thank you so much for your positive feedback on season one. And I really hope you find these episodes useful. Today's guest is Michelle, a birth and postpartum doula supporting families in the Midwest of Ireland. She helps expecting parents navigate pregnancy and prepare for their best birth possible. Her passion is helping parents move from a place of fear and worry to one of confidence as they journey to meet their baby. We speak about the range of fears people can have around pregnancy and birth, where these might come from, and the options available if you want to work on them and go on to be a parent. This episode might not be for everyone but I was very curious to speak to somebody with so much experience of working with pregnant people to get their point of view and it was a really interesting conversation. So thanks, Michelle. I'm I'm really excited to talk to you and thanks for taking the time out of your busy schedule to chat to me this evening. Michelle Mayefske 1:17 Yeah, thanks for having me. Margaret O Connor 1:18 Perfect. So I suppose I was wondering, maybe we could start with just explaining if you if you can kind of what a doula is and what kind of things you do in that role? Michelle Mayefske 1:29 Sure. So there's a couple different types of doula. One is a birth doula, and the second would be a postpartum or postnatal doula. I am both. And really, I suppose for today's topic, I would be chatting more about the birth doula role. And I like to compare a birth doula to like a trail guide. So if you're going on a hiking trail, and maybe it's a trail you've never been on before, you don't know what to expect, maybe you've read a little bit and you've prepared...a doula is somebody who would be like a trail guide who can tell you, you know, where your hike might get a bit steep, or where it might get rocky and where you might want to take a break. And they're basically somebody that has like walked that path before. So they can tell you where there might be challenges, and where you might need some extra support, or when it might be time to turn around. So a doula really is somebody who has the knowledge and experience and is professionally trained to support people through pregnancy and birth. And they're really there to give you as much information as you want. And I would be a big advocate of making informed decisions. And I know, we'll probably chat a little bit more about why. But basically, they're there to support you throughout all of pregnancy, answer any of your questions, go over fears, concerns, and really get you feeling prepared and confident for birth. And then of course, they're there to support you during birth, whether that's at home, or hospital, and then they usually follow up with you afterward just to check in and see how you know, you're getting on, (laughter) you're getting on with life with a new baby, which is a very overwhelming exciting time all in one, with sleep deprivation and everything else that comes with having a newborn. So they're really one person, that continuity of care, and you get to build a relationship with them and get to know them and trust them. And sometimes, that's ultimately what people really want, is they want somebody that they know and trust, because many times when people are going to the hospital, they're seeing different midwives and different consultants every time and when they're in labour, they also don't know who will be there on the day. So a lot of times your doula is the person that you.. is maybe the only person in the room, you know, other than, you know, your partner, Mom, friend, whoever might be supporting you during labour. So I think it's a really, really amazing service. I had a doula myself. My first labour did not go how I had hoped, and I would have classed it as a negative experience. So the second time around, I told my husband you know, if I'm if I'm giving birth in a hospital again, then I really want to hire a doula and have that extra support, not just for me, but for both of us. And you know, that that second experience was so much more positive. And I had this strength that I you know, I was able to recognize this strength within myself that I didn't know even existed. And I think, you know, it was my doula that really helped me uncover this strength that I had all along. So, yeah, I went on and it was years later, you know, I thought about it and you know, kind of put that to the back of my mind. And I was doing something else professionally, so, and then I had a third baby. And then I said that's it like I have to (laughter). This is what I think I really want to do. So I trained and became a doula and I've been supporting families ever since. Margaret O Connor 5:20 Wow. Okay. Yeah, it sounds it sounds lovely. And yeah. And can I ask you, I suppose just what kind of training is, is involved in it? How'd you learn how to do all of that? Michelle Mayefske 5:32 Yeah, no problem. So there's, it's, it's not a regulated service within Ireland and many other countries as well. So I suppose taking a step back, obviously, with my accent, I'm not from Ireland, I'm from the United States (laughter). My first three children were born there. And I knew following my third birth that I did want, I did want to become a doula. But I didn't see the point in training over in the States when I knew I was going to be eventually moving back to Ireland and going to be supporting families here, because the maternity services are very, very different. So usually, what happens then there's different doula training agencies. I mean, there's dozens and dozens of them worldwide. And for me, it was a two day, two 10 hour days, and you learn all about the physiology of birth, you also learn all about hormones, and how to support birthing people, you learn, like comfort measures, you also learn this, how to respect people's decisions, because not everybody, you know, some people have there, it's kind of a spectrum, if you will, where some people are like, I want no interventions, I want something really calm and peaceful, maybe even a home birth, but if not, like I don't want you know, they'll go up to the hospital and say, I don't want anything. I don't want any pain relief. So you need to know how to support that family. And alternatively, you need to know how to support somebody who's like, I want to be drugged up to the eyeballs, I don't want to feel a thing (laughter). So you need to know, you need to know how to support both people in a way that is very unbiased, non judgmental. And really, a doula becomes an expert at basically getting to know people, getting to know people and what their preferences are. So like, every client of mine is different, every like every single, every single person is unique. And everybody's preferences for birth are different, too. And that, I suppose I was, I was to be quite honest, I was used to that. Because prior to becoming a doula, I worked at a rape crisis center. So and at a rape crisis center, you see all different types of individuals experiencing all different types of trauma. And some people want to report their assault, and some people don't. And you have to respect their decisions as well. So when I went to my doula training, I was like, I know all about supporting people in an unbiased way, because I had been doing it for years. So that, to be honest, that part for me was super easy, because I was like, I've, you know, I don't and I'd done the trauma, all the trauma informed training and all of that. But yeah, so I went up to Dublin, and I did my two day training, and then you have coursework, and you have to support a certain number of families, and then you have to report back. And one of those families has to be interviewed, so like, it is a process that can take more than a year all depending on, you know, how you take the exams, and you know, how quickly you're able to get.. for me, it was three families I had to support. So for me, it was it was within a year I had had done everything. But no, I and I enjoyed it. So it's something that I enjoy just learning about in general. And then yeah, I got stuck into it. And I've been now I've been supporting families for just over five years. Margaret O Connor 9:17 Oh wow okay..And can I ask is, because it feels like this is maybe a new word or a new role, but I also get the feeling that maybe the role has been around for a long time. Is it is it kind of both old and new? Or is it just our awareness of it now? Michelle Mayefske 9:34 I think it's both yeah, I think you're right. I mean, women have supporting have supported women through childbearing you know, since the beginning of time, but the word the actual word doula is a Greek word and it means to serve. So I women, you know, people whether whether you know, women or other practitioners have been supporting women forever. And that's midwife that includes midwives as well. It's only recently that we moved birth into the hospital setting. So birth always used to happen in communities and in homes. And it's only you know, it's it moved to hospitals, relatively recently, where it's like you just assumed everybody was giving birth in a hospital. And then the role of the doula and the midwife, you know, began to diminish. And now and now, I suppose there's a comeback of now we're, we're starting to recognize and acknowledge the value in having that relationship and that continuity of care and all of the benefits that come with it as well, because there's so many benefits that come along with having a doula or midwife. And to be honest, I wish more people, I wish more people understood, you know what those benefits are so like, for example, people who have a doula are less likely to have a cesarean, they're less likely to use pitocin, which speeds up labour, but also has, you know, risks associated with it. So any type of injury or intervention has risks. So your cesarean risk goes down, your pitocin risk goes down, the risk of having an instrumental delivery goes down, and you're more likely to have a positive experience. Like they, you know, they had people report back after and people who had a doula, you know, said like, yeah, it was, and it's not even that the birth went perfect. Like, I always say, there's no such thing as a perfect birth, it's just that people left that experience feeling respected and heard, informed and involved. And ultimately, that's what I see a lot of my work revolves around is just helping people advocate for themselves. So they do know how to ask questions and how to also push back if they feel like, you know, there's some sort of treatment or something that they want, and they're not getting, or, you know, maybe an intervention is being suggested, when it's not really medically necessary, that they can then ask those important questions of like, why are you suggesting this? And what are the alternatives? So it's really giving couples, or you know, whether it's couples, those who are single, you know, whoever it is that I'm supporting, basically, giving them the tools that like, that we just don't often think are necessary. Like you wouldn't, you wouldn't give somebody keys to a car and expect them to drive off knowing exactly what to do. Like you don't just conceive and know what, what to do from there (laughter). You know, there's so much more involved in the pregnancy and birth preparation than just getting pregnant. Margaret O Connor 12:56 (laughter) Yes..and I suppose you would generally meet people once they are pregnant, would you just clarify? Like, would people ever come to you for advice about maybe the process themselves? Or if they had any doubts about it? Michelle Mayefske 13:09 Sometimes they do. Yeah. So sometimes, like, especially now that social media, you know, is everywhere people stumble upon my Instagram or Facebook page somehow, or, you know, a friend comments, and it pops up for them. And they read a little bit more, and they'll message me, you know, saying we're going to start trying to conceive, but I have this fear, like, people will contact me before they, like some of these fears that people have, are so deeply rooted. Yeah, you know, that, that they're already afraid before they've conceived. And other times, I would say, I would say probably 90% of people are they've already conceived. And now, you know, they're starting to think about the birth. But what I found personally, and what I also found, what I've found with many, many people is, you know, they take a pregnancy test, and usually people are finding out, you know, 5/6/7 weeks, whatever the case may be. And it's not until they're in maybe their second trimester, where it's like, all of a sudden, it hits them, like I actually have to birth this this human being like, yes, it because you don't, a lot of times people don't quote unquote, feel pregnant. Like even if they have pregnancy symptoms, maybe they don't have a bump, they haven't felt any kicks. You know, none of.. they're not feeling any of those things quite yet. But then, you know, they wake up in the middle of the night one night, or they see something on television. And they're like, oh my gosh, I actually do have to give birth and now all these feelings that I didn't even realize were there are now bubbling up at the surface and many times people don't know what to do about it. Margaret O Connor 15:00 Okay, and I suppose that's really what I was curious to hear from your perspective, I suppose what are the things that the, I suppose people worry about or have anxiety about? And I suppose whether that's around, you know, the pregnancy, the birth or what comes afterwards. So, and I know it's so hard, but just, I suppose kind of patterns or themes that you notice. Michelle Mayefske 15:23 I would say most people, there's always people who are nervous about, especially if there's any kind of issues within their family about, you know, will I be able to conceive? Or what is that going to look like? So there's always kind of those fears. But once once people are pregnant, many people aren't too concerned about like the course of their pregnancy, there's, there's kind of an assumption like, and to be honest with you, it's 90% of people don't have any real complications. So 90% of pregnancies are what are called quote unquote, low risk pregnancy. So there's not any, you know, huge complications, or medical issues that would warrant them being classed as high risk. So many people are not concerned about the pregnancy, but they're more concerned about childbirth, and everybody's different, where I would be very surprised...very, very, I've never met anybody in my entire life, who had no fears of childbirth. Everybody is afraid of something. And, you know, if, if you think about your own childhood, and the different images and depictions that we've seen, of birth, like think of television, and, you know, anything you've read in a magazine, or books or you know, whatever the case may be, birth is always depicted as being this really horrible, excruciatingly painful, dramatic thing that, you know, sometimes spirals out of control. And I think it's no wonder there are so many people afraid of birth, if we see it as this crazy medical emergency. When that's not what birth is, birth is not some uncontrollable, I mean, it is unpredictable and there's not a lot, you know, when we talk about control, I can chat a little bit more about that. But it's so often depicted as this really dramatic thing. And it doesn't have to be, it really, really, really doesn't have to be, you know, birth can be really boring, birth can be a really boring event until the baby arrives (laughter). Like it doesn't have to be this really dramatic thing. So I think that's where a lot of people's fears come from, is that they've heard and seen these really horrible things their entire life. They've many people have never seen or heard somebody talk about birth as being positive. Yeah. And once people conceive, and they start telling people, it's like, all of a sudden, all these stories start to come in, like, oh, my gosh, as soon as you get to the hospital, make sure you get the epidural as soon as they offer it to you because if you don't, you'll be roaring to place down, or I was giving birth, and the woman in the room next to me, she was screaming so loud, I could hear you know, there's all these really horrible, negative stories. And as I say, if that's all you've heard, no wonder, no wonder we're so frightened of it. You know, I suppose...So I prepared a few statistics that I just wanted to shout out here, I suppose. So the first one is that 37% of people leave birth with a trauma, they would describe their birth as being traumatic. So that's more than one in three people. And 27% indicated that there was some form of informal coercion. So essentially, they felt like somebody else was making decisions for them or trying to, you know, giving biased information, and sometimes just downright, you know, being coercive and telling them what to do as if they didn't have a choice, and you know, of the 37% of people that leave, saying they've had a traumatizing experience, 5% of them are later diagnosed with PTSD. So I find those numbers shocking. And I don't think they're the result of anything being wrong with people or people's bodies or inability to inability to birth. If you talk to anybody who's kind of a birth advocate, advocate or activist and/or activists like I am, there's nothing wrong with people's bodies, I think there's something wrong with the way that we approach birth, and part of it is that we see it as this really medicalized process, and some of the most common fears... So 50% of people who come to me, usually are first time parents that have heard these really horrible stories, and they basically come to me saying, I don't want that to happen to me. The other 50% of people have are now on their second, third, fourth, you know, next pregnancy, and they've already had a negative experience. And they say, you know, I need this to go differently. I know, I can have a more positive experience. And I know I need support, I need support with that. So there's all kinds of fears, but what usually, people are trying to prevent, is feeling like a spectator, at their own birth, and, or feeling like things are spinning out of control, because that's so often what seems you know, what seems to happen when people have come to me, after having a negative experience, they'll say, like, you know, I felt like decisions were being made for me. And I felt like I couldn't speak up. And all of a sudden, you know, things started to snowball out of control. And I felt like there was nothing I could do in that situation. And I think that's so incredibly sad to hear that, you know, like, you should be at the center, if you are pregnant, and you are giving birth, you should be at the center of that experience. This is your birth, your baby, your body. Nobody else is in charge but you, you know, no matter, even if birth takes a path that you weren't intending, you are still able to control your response to that situation and ask the questions and decide what the next step is. You know, so that's really and there's there's all so that's, I suppose, would be that the biggest fear is, you know, we've heard these horrible stories, how do we know how do we prevent, how do we prevent things from spiraling out of control, but there's loads, there's loads of other fears as well. So some people are really afraid of having a cesarean, others are really afraid of tearing or needing an episiotomy. Or, you know, they've heard or you know, postpartum hemorrhage, there's all kinds of, you know, things that can happen during birth. And I completely understand those fears. And I've had, you know, people repeat the same fears. But my big goal when I work with people, is telling them like, because, again, people tell stories, and I will, will remind people of just, that is somebody else's experience, their experience doesn't have to be your experience, and there is so much that people can do that I don't, I don't know why we're not shouting it from the rooftops, like, there, there are things I go down a list with people like these are the top five things you can do to prevent tearing when you are in labour. So even if somebody does have a fear, as such, like, it's my role to support them with that and say, okay, if you're afraid of tearing as baby is, you know, emerging from the body, you know, one of the things you could be doing is being upright. You know, being upright during labor reduces your chances of tearing, what else can you do, avoid an epidural. That you know, that helps or pushing on your side or pushing off your back. Or, you know, there's, there's all these things that people can do, it's just this knowledge really, is not.. you have to go looking for it. Margaret O Connor 24:04 Hmm. I find it kind of conflicting in that, I suppose..you know motherhood and birth tend to be portrayed as such a natural things. And then but then there's like a block against actually learning about it. So like, you know, how are you supposed to know all that stuff if you haven't done it before? Or even if you have so it's like, there's this assumption that everybody knows, but then there's no actual education, or proper education maybe around it. It's, it's a strange situation... Michelle Mayefske 24:36 It is. It is. And you know, obviously, I did not go to secondary school in Ireland, but from the people I've spoken with (laughter) the people I've spoken with here and even in American culture, like you were told, don't have sex or you'll get pregnant, but then there's nothing about childbirth and there's nothing about like, what's normal, or how to like there's there's no education about how to advocate for yourself or why you would need to. Margaret O Connor 25:06 Yes, yeah. Michelle Mayefske 25:08 Like, you know, why would I, why would I need to go into birth knowing all this information? And why can't I just trust the people who are in the hospital? And a lot of times you can. But you know, there's there is, there is, I suppose the big the big thing is, is that birth has become super super medicalized. And there's more interventions now than ever before. And it's not because our bodies have changed, you know, have changed drastically, in the last 50 years, you know, there's, oh, there's been so much change within maternity culture. And I think, you know, there's so many people like the people that I connect with, most of them don't know anything about childbirth. And like, I didn't, I didn't when I was first pregnant, I didn't know anything. And thankfully, there are antenatal classes, you know, that people can take, there are antenatal classes, through hospitals. And you know, given given the time that we're in, right now, they're not in person, many of them are online. But you know, not all classes are created equal. So one person might go to one class, that that is very surface level, versus somebody else might go to another class, which dives a little bit deeper. So like, for example, I went to a Irish hospitals antenatal classes, and they were very surface level and like, okay, when you turn up at the hospital, and even the language that was used, is very interesting. So like, for example, you know, when you come to the hospital, we're going to do, we're going to do X, Y, and Z. And then these are, this is what gas and air is, this is what Pethidine is, this is what an epidural is, but there was no explanation of why, like, why are you doing X, Y, and Z as soon as I turn up at the hospital? Yes, these are my pain relief options. But why might I want to choose one or the other? Like what are the benefits, what are the risks? You know, there's there was nothing. So when I talk surface level, it is like very much like tip of the iceberg. And there's so much more, but as, as you say, there's not, there's not like this, across the board curriculum that everybody gets, or, you know, there's, you really have to search for this information. Margaret O Connor 27:55 Yeah..it almost sounds like it's setting you up to be quite passive, like, you come to the hospital, and you kind of hand over ..we do this and we make these decisions. You know, it's.. Michelle Mayefske 28:06 I would agree (laughter). I would agree that there is kind of assumed level of passivity for sure. Yeah. Margaret O Connor 28:15 Whereas obviously, you want people to be much more actively involved. Because you feel more in control if you're, if you're involved, you know, not you know, you are open, open to collaboration, but but you know, actively involved in what's going on in those decisions. So that would obviously be a better, better situation. Yeah. Michelle Mayefske 28:38 Yeah, I would say I would say for most people, it is.. now many..there are many people who come to me, or I even see online and they say, you know, I'm I'm just gonna turn up at the hospital. And I'm gonna go with the flow. And that's totally, if that's what somebody wants to do, that's 100% okay. However, I really encourage people to ask, well, whose flow are you going with exactly? If you're going with the flow, are you going with the flow of your body? Are you going with the flow of the midwife, of the consultant.. whose flow you know, like, who's flow are you going with exactly because the reality is, is you might hope your birth goes a certain way. But there might be a midwife or a consultant who is very used to doing things a different way that wouldn't you know, wouldn't be your preference. So I don't know how much you know about birth or how much your listeners you know, know know about birth but Ireland, developed, it was actually developed in Dublin, what is called this system, which is the active management of labour. And active management of labour, is basically putting all birthing people into the same box, no matter what your race, gender, medical history, cultural background. No matter what number baby you're having, and what active management of labour, it's exactly like what it sounds like, it is managing your labour. And in Ireland, what that looks like, if somebody would go to the hospital, you know, labour has started on its own, they go to the hospital, and your cervix will dilate to 10 centimeters before your baby is born. Here in Ireland, all hospitals are following an active management system. And once you reach two centimeters, your waters are then broken. So your amniotic sac that your baby is enclosed in and all the fluids, you know, like everybody goes, oh, my god, my water broke during, you know, birth on television or movies (laughter), that's what they're rupturing when you're two centimeters, and then you're essentially on a clock, where there is this expectation that your body, your cervix, will dilate one centimeter an hour until the birth of your baby. And this is assumed. So this is for everybody. And that's what active management is. And basically, you know, some women will come to me and say, you know, I felt like I was on a conveyor belt, like they just wanted to get me in, and get me out. That's, that's what can happen when there's active management, and it is, it's very much, you know, and let's say somebody's labour slows down. So you go in and your body isn't contracting a centimeter an hour, well, then they try to give you medication to speed things up. So, you know, when somebody says, I'm going to go with the flow. If that's If that's you, then what you have to know is that you're signing up for the flow of active management. And actually, what does that look like? You know, and what are the benefits of that? And what are the risks of that? Now, most people who come to me have already made up their mind, I've already kind of made up their mind of, they usually want a low intervention experience. And if you want something that's low intervention, then active management is not going to work in your favor here. So then we kind of talk about, you know, the alternatives and what your options are. And when I when I chat to people, these conversations are two or three hours long. So you know, people have way more options than than what they think. So we go over, we go over all the options and what the, you know, potential benefits are, what the potential risks are, and alternatives. And, you know, we can, there's so many avenues. You know, we talk about natural sort of labour, we talk about induction, we talk about, we talk about everything, you know, just so they feel, and then they also go into labour feeling prepared for anything like yes, I'm going to hope for the best and I'm going to plan, you know, everybody talks about birth preferences or birth plan. You can plan as much as you want for your ideal, but I really think you need to, you know, have your plan B, Plan C, and D, all these other things, because, you know, if, if somebody is afraid of something, many people.. I have found many people feel better when they're like, able to talk it out. Margaret O Connor 33:47 Yeah. Yeah. Michelle Mayefske 33:49 You know, so most people want to know more, there are there are some people who say like, I don't want to know anything, like, the more I know, the more fearful I might be. But I would say the vast majority are like, hit me with everything. Give me everything you got, so I am prepared no matter what the scenario might be (laughter). Margaret O Connor 34:11 I did want to ask you about that, because I suppose for people who maybe are unsure and you know, if people are listening to this, it's probably because they're they're undecided about whether they want to, you know, have any of that experience. But yeah, I suppose it's hard, and maybe it's hard to advise but, you know, do you think it's better to know, I suppose, you know, what can happen? What can go wrong, you know, the all sides of it, do you think, yeah.. Is there anything such a thing as too much information? Or is it better to know as much as you can? Michelle Mayefske 34:43 I think you're better I think you're better off to know at least, the basics and the basics... The basics, I would say are knowing the different stages of labor, like what is early labor, what is active labor, what is transition like those.. you go through three stages of labor before you actually are pushing out your baby. So knowing like, knowing what's normal. Like, knowing what's normal is like the baseline. Like, it is not normal to dilate a centimeter an hour. That's not that, like, that's what active management tries to do. But like, and that is a system that's used within Ireland, however, like the World Health Organization, you know, UNICEF, World Health Organization, have all said like, that's totally unrealistic(laughter). You know, so all these different organizations have come out and said, like, it's an outdated, it's an outdated way to try to manage quote, unquote, labour, yet, it's still being used. So once you know, what is normal, I think that can reduce so many fears for people, like, you know, you can, you're much less like, okay, so I'll take a step back... So many people who come to me when they've had their second, they're now pregnant the second or third time, what they, you know, they'll what we always start with was like, oh, so how was your first birth? You know, and they'll kind of tell me what happened. And I can see, like, as they're talking, I can already see the path that their birth was basically led down. And I can kind of predict the outcome. Because it's active management of labor, like I can, I can already see how they got on to the active management train. And there were all these things that happened that they weren't expecting. And many times what people report to me is, you know, this X, Y, and Z happened, and I had no idea that could be a side effect. I had no idea something like that could even happen. You know, we we agreed, we agreed to, for example, pitocin, or syntocinon, is a drug that is put in through an IV and it promotes contractions. So but what many, so a lot of times people will get this in the hospital, and they'll say, oh, we're just gonna give you a little something, to bring on the contractions for you. But what they aren't told is it can actually stimulate the uterus too much. And they aren't told that it can actually cause distress for their baby. So, you know, it's, you know, and these are all, it's not that these things are guarantees, but it is something that could happen. But oftentimes, these things are not explained.. we're going to give you a little bit of something to speed up labor... And you know, so I'll hear this story, you know, from somebody, and they'll say, you know, they never told and then, you know, my contractions were coming, you know, they were one after another, and I didn't have any breaks, and my body got really tired, and I wasn't able to push out my baby, because I had no energy. And then they'll step back and say, you know, but I was never told that, you know, my uterus could be hyperstimulated, I didn't even know that could happen. And that's why I think knowledge is power. Because you're much less likely to regret a decision, if you do go in knowing all the information. And what I mean, I think I have, there's this acronym that I love, it's called brain. And I think it can be used in all different ways. You know, preconception, if people decide to have children, like this can be used throughout your entire life. So I'll run through it quickly. So, brain basically encourages you to ask, so the B stands for benefits. Like if something is recommended, like what are the potential benefits to me? And my baby, for that matter? And then R is what are the potential risks? For me and my baby? A is what.. what are the alternatives? There are always alternatives. Like, what are the alternatives? And then I using your intuition, like what is your gut instinct telling you to do? So often we disregard our intuition when I think it's a really powerful thing. And then N is do I need to make a decision now? And in most cases, people have even if it's just a minute, a minute to five minutes, I mean, most most cases, there's very rarely a time in the maternity system, especially when like when you're giving birth, that something needs to happen right this second. So you usually have time to say can we think about this or can we chat about this and get back to you so that you you know, you can do that throughout pregnancy, like if if something is suggested throughout pregnancy, you can run through that. And that's a really great way to prepare yourself and whoever is supporting you. So I think more knowledge is power and you can get as like, you can get in as deep into this, (laughter) you can get as deep into the birth world is you want, like, I don't expect anybody to be like me, a birth geek and be reading up on the research or anything, you know, after their kids are in bed, they open up the laptop to the research, but like, you know, knowing that knowing the basics can really, really help people, you know, decide what to do. And I suppose as well, if people are thinking about, like, you know, do I want to have children? Do I not want to have children? This whole childbirth thing scares the hell out of me. What I would say to them, is, if, if you're holding back, because childbirth is something that absolutely frightens you, do know that there are so many support services available now, that did not exist before. Like, now we have the internet. Like my mom, my mom, you know, my mom's generation did not have the internet, she did just turn up at the hospital and hope for the best. Whereas now, you know, now people have far more options. So home birth is an option for people. There are no birth centres in Ireland, but if somebody is listening in the UK, or the United States, like a birth, you know, a birth center is an option for you, you can also have midwife led care within Ireland, which does not include a home birth. You know, and knowing the difference between public you know, being a public patient or being a private patient, and what that might do, you know, so there's, you can also, you know, take private antenatal education, you can work with a doula like me, so, like, I, I educate people as well. So I'm a doula, but like, there's people who don't hire me to be at their birth. I might help, they just want the, they just want the information, they want somebody who can say, here it is, and just offload it onto them. So you know, if somebody is thinking like I don't, and here's the other thing... And this is like, this is a complete reality and a possibility for people. So I've worked with people who are absolutely terrified of childbirth. The idea of something, you know, many people have a fear of the unknown, because we live in a time where we can control a lot. Now, there's a lot of things that we can control. And we have this kind of instant gratification culture, we're like, we want something we get it (laughter). And birth isn't, you know, birth isn't like that. And there are elements of unpredictability, there are loads that you can do. So there's loads that you can do to kind of stack the odds in your favor. But if.. I've worked with people who are very, very, very afraid of going into labour, whether that's, you know, naturally going into labour or induction, the reality is, is that a cesarean is always an option for you. So if some people are like, I don't ever want to push anything out of my vagina (laughter) there is.. you can go to your consultant, talk to them about your fears. Now, there are consultants who will still try to encourage you to have a spontaneous delivery, like there will be doctors who are encouraging of that. And there are you know, there are important reasons why. However, if you're someone who's like, I don't even I don't want to deal with the uncertainty. I don't want to you know, like, I get it, I completely understand where people are coming from, you can absolutely advocate for yourself and have a cesarean straight up. So it is an option for people. Margaret O Connor 44:18 Okay, okay. Yeah, because I suppose I would hear from people who, some people just maybe really dislike the thought of being pregnant on one hand, but then the childbirth obviously, some people would be like if the child just arrived, you know, that'd be that'd be different (laughter), if I didn't have to go through the whole process... But that's really useful to know that there are so many more options than people, than people might realize, and so maybe that might be helpful to people if there are specific kind of issues around that. Yeah, thanks. That's really good. Yeah. Michelle Mayefske 44:54 Yeah absolutely. There's loads of options now loads of options, loads of information. And, honestly, there's so many people that do want to help. Ireland has so many. .It has so many births and postpartum doulas, way more than I even realized when I trained. I trained and then there's this, there's this huge community of people who really do want to help, you know, taking that first step and reaching out to somebody. And like, even before, you know, if you're thinking about having kids, like you could even reach out to doula before and I know, they would, they would absolutely chat through some of this stuff with you. And, you know, it could it could be 15-30 minutes on the phone. And that's it, just to give you a little bit of information and support that way. Like, that's never a problem. Margaret O Connor 45:45 I think that's amazing. Because getting some objective information, as you said earlier, like not just hearing all the horror stories, or equally hearing people who just skip over kind of the reality, you know, I think people find it difficult to get proper, real, you know, objective, but still accurate information. So I suppose it sounds like you'd be able to provide that kind of with your span of experience, which would be really useful, I think, can really reassuring.. Michelle Mayefske 46:10 Yeah, I don't sugarcoat anything (laughter). Sometimes it's hard. Sometimes it's hard, you know, but I am, I'm very much very much a realist where I want I want to tell you how it really is. Okay. I'm gonna be honest, I'm gonna be honest. And the truth is, is that there is the maternity system within Ireland is not perfect. It's not perfect anywhere. Margaret O Connor 46:34 Yeah, yeah. Michelle Mayefske 46:35 You know it's not perfect anywhere, anywhere. But there are ways that if you choose to have children, that you can navigate that with more ease. And like that trail, that hiking trail guide, there's somebody who's been through it and seen it all, I can tell you, you might have difficulties here or here, but these are the things you know, there's another path that goes this way. So there's loads of things that you can do. Margaret O Connor 46:58 Yeah. And you know, I as I said, I was even just having a quick look through your, your Instagram, your blog, and you have loads of really useful information and kind of those questions that people might have, but might be afraid to ask. So it's definitely a good place to start. And I think maybe if you'd want to find out a little bit more and just just even just expand their thinking around it even you know, if we have been thinking in a particularly narrow way, just even you even just listening to you like straightaway, you're kind of thinking oh, okay, yeah, you know, there's there are other ways and it doesn't have to be maybe the way we've seen it, as you've said, on every every TV show, right. Yeah. Yeah, that's really, really interesting. Brilliant. What do you know, I think you've answered all of my questions (laughter) without me even having to ask which is fantastic! Michelle Mayefske 47:47 Yeah, great (laughter) Margaret O Connor 47:49 Yeah, I just say, oh, is there anything else you you'd add? Because I suppose I was going to ask you for advice to people, but you've covered that. And.. Michelle Mayefske 47:59 Yeah, I think the main thing I would say to people is, don't be afraid to ask questions. You know, whether it's because many people are man.., and I remember being a first time on myself, and like, not even it sounds bizarre. Like if you would go to your doctor for anything else, you feel like you can ask questions, but for some reason people enter the maternity system and just feel like they freeze and feel like they can't ask questions or, you know, why are you suggesting this? Or what could I do instead? And you've always have you know, you pregnancy does not erase your autonomy. Margaret O Connor 48:43 Okay, yeah. Michelle Mayefske 48:45 Full stop (laughter). You are always you are always deciding what feels best and what feels right for you. And if you can surround yourself with you know, supportive friends, family, midwife, doula, whatever, you know, care path you decide to go. Pregnancy and birth can be a really wonderful, positive, empowering, amazing thing. And, you know, sometimes things don't go as planned, but that doesn't mean it has like, birth does not have to be a train wreck. You know, there's there's many paths, but they don't have to be negative ones. Margaret O Connor 49:26 Look, that really, really is it is fantastic, I suppose..you know, I really just wanted to include this this aspect, as I said, for people who are undecided or if that you know, if the kind of pregnancy and birth aspects were particular issues for them. So I think that's really informative and really positive. Thank you so much for for sharing your experiences with us. And as I said, I'll put up links to your blog and your pages if anybody wants to find out more about. That's really, really, really interesting. Thank you so much. Michelle Mayefske 49:56 Yeah, you're welcome. Thanks for having me. Yeah. And just reach out. If any anybody has questions you can reach out to me anytime. Margaret O Connor 50:02 Brilliant. Thank you so much. Michelle Mayefske 50:04 Thanks. Margaret O Connor 50:12 Thanks very much to my guests for taking part and to you for listening. I would love to hear your feedback and any suggestions for other topics you would like to see covered in this series. I would also love to build a community of like minded people, so please follow the Are Kids For Me pages on Facebook and Instagram if you want to find out more on this topic. I look forward to hearing from you and watch out for the next episode soon. Transcribed by https://otter.ai