Dear Family and friends,
A letter to families of women and people expecting twins or multiples.
Perhaps you were looking for a doula for someone you love and care about, or you were told by someone in your family or someone you love, about me. Either way I want to tell you a little about myself and put your mind at ease if you are feeling anxious about me and my role in all this lovely, but sometimes anxiety-inducing, birth business.
Let me start by saying, I want to reassure you that I completely appreciate how important your loved one is, and your want for the very best pregnancy and birth for your beloved, and the precious lives they are carrying. I too want the very same. You are not wrong for questioning who I am, and what I am all about, as I would do the same.
My name is Sarah and I am a mum of 4 including twin girls. I support all pregnancies but specialise in twin and multiple pregnancy and birth. My twins shared a placenta which is one of the highest risk pregnancies you can have. My twins developed a condition called TAPS. That is one of the few, but very serious complications, that only pertain to multiple pregnancy and almost exclusively if they share a placenta. They are 7 now and fit and healthy. Because of this experience it is my life's work to raise awareness and support families expecting twins and multiples.
With that said, I know how important good monitoring is in multiple pregnancy, especially where twins or more share one placenta and I understand why. I work with professionals including an NHS obstetrician, an ex independent midwife and someone who works closely with one of the leading research teams in the world who research conditions that can affect twins that share a placenta. We speak almost daily and our WhatsApp chat is called "twin geeks", and sometimes, with permission I might discuss cases and people I am supporting with them, being careful to protect anonymity if need be. I do this in order to support my client best. We also run a course for other birth-workers and midwives to learn more about twin pregnancy and birth through my Doula Doula Academy.
This is not to say I don't have believe in holistic and non-allopathic support. I believe in balance and the current NHS model of care is flawed. However what I do or do not believe in is not important. I believe that the person I am supporting will make the right decisions for them and they know best what they need.
I am not clinical and will never pretend to be, nor do I want to be seen as a replacement for clinical advice. I will however do everything I can to advocate for the best clinical care for your loved one, and when information is given, I can try and explain why it is advised in easy to digest terms. I like many of the people you are talking to speak twinglish. Twinglish is a very unique language full of many variations of chorions, amnions, anastomoses, big vessels, small vessels, umbilical insertion points and then there are all the acronyms. Many many acronyms TAPS, TTTS, SFGR, MCDA, MCMA, DCDA, MCA and so on. When in the birth space I will help my clients feel heard and supported. I cannot carry out clinical checks or monitor labour the way a midwife does.
As a doula my role is very well defined in that I must always support my client first, and then the family and loved ones. As such I will always support my clients decision even if it doesn’t meet with what you might have them do. I will direct them towards evidence based information and research, and I will encourage them to find their own. I will also explain why sometimes research simply doesn’t exist yet in the case of multiple pregnancy and birth. They then, hopefully following discussions with you, their families and loved ones, make up their own minds. I will and must support them, even if they go against medical advice, as I have done so before. I will support them even if they choose to go against their own wants for their pregnancy and birth in favor of doing what you, or someone else would have them. I do this, not because I am ambivalent or don’t care about consequences real or imagined, but because I care very deeply that they do what feels right for them, and that I remain someone they can turn to who doesn’t come with a set of expectations, that only someone in a deep and loving relationship with them could or would have.
I can’t promise you that everything will be okay, I can tell you that the majority of the time it will be. I can’t tell you it will always be easy, I can tell you that with good monitoring there are better outcomes in twin and multiple pregnancy. I can reassure you I would never discourage your loved one from seeking medical advice or not following medical advice, but I will hear them and what they want and I will support them 100%. I do this because my job is being the one constant in their lives throughout their pregnancy and birth that is unwavering. I provide the continuity of care that is currently lacking in NHS midwifery, which is the continued support of someone that is with women which is where the word midwife comes from. I extend this to being with person or with family.
You will not see many pictures of me holding babies because I wouldn’t ask my clients if I could use pictures of their babies or their birth pictures for my social media, or to promote my business, after all how could they say no when for the most part they think we as birth workers have done so much to help them when really, they did it all themselves.
I believe and have seen that all twin and multiple birth can be beautiful with the right support and with the mother or birthing person central and heard. Environment is key in birth, and when supporting anyone who may require a hospital birth I do everything I can to create a homely environment with everything that they need to make them feel comfortable. I can take pictures on your phone or my phone or even bring my photography equipment. Importantly, those pictures are yours and yours alone, leave the USB card with you. This we can discuss.
I have worked with a variety or families from various backgrounds and discretion and client confidentiality is integral to how I work. I believe in pregnancy and birth being a sacred precious experience, this is another reason why I don't share or post about my clients births and unless offered a testimonial I don't ask for one. In short will certainly never place your loved one or your family in a position to feel you owe me anything least not your private intimate moments.
My job is also advocacy, and as such I understand NHS legislation and NICE guidelines, so that I can do everything in my power to prevent the risk of coercion, or the type of physical and emotional harm that can lead to birth trauma; the biggest cause of postnatal depression and/or PTSD. I can be as assertive or as passive as my client would like in regard to interacting with health care professionals. I offer emotional, practical and moral support which then allows you, or their chosen birth partner to be completely present with them.
Safeguarding is a word that conjures up fear in people because safeguarding procedures can lead to situations where the family isn't safe. Safeguarding in my profession is very different. In advocacy situations I safeguard the short term and long term consequences for your family. I don't believe in using an individual to right all that I perceive to be wrong in the world. I will always be honest with you if I have any concerns but importantly when working with other professionals, unless given expressed permission I share no information about my client or their birth. I work with my clients in a fully holistic way to help them feel supported and held. This is all crucial to creating a trusting relationship.
There is no limit to when I am available to your loved one by message, email or even for a call because I know that pregnancy alone is a time fraught with anxiety, without it being a twin or multiple pregnancy. It is better that I take time to process with your loved one rather than them sitting with anxiety. If I am not asleep I will reply as soon as I can. During the on-call period I am free 24 hours a day 7 days a week and my phone volume is set to as loud as possible, I also provide an emergency contact number. I promise that I will be there for the birth as soon as I can, unless to do so would put them or the unborn/soon to be born babies at risk; Such as serious illness such as covid, sickness bugs and flu.
I do hope this has put your mind at ease somewhat. If your loved one wishes I can meet you with them and introduce myself either via video chat or in person and you can ask me as many questions as you like.
If doula support isn't something your loved one thinks they would benefit from, or my supporting your partner is not something they chose then I wish you all the very best. I will always be here if I am needed to help in whatever way I can, even if just a friendly voice on the end of the phone. I really do always have time for twin families as it is a truly blessed yet tumultuous road at times.
I will end with my favorite Gabor Maté quote "Safety is not the absence of threat, it is the presence of connection"
Warmest Regards
Sarah
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