On Friday we stopped breastfeeding.
31 months and 1 day.
2 years and 7 months and 1 day.
One of the longest, most rewarding, and most fulfilling jobs I have ever had. Yes : I said “jobs” – because whilst it was wonderful and tender and wrought with hormones and body doubt and body gratitude and self doubt and self care and self neglect and ideological ambition and realistic set backs and unwaivering perseverance and effortless ease and sublime miraculous grace : it was work. Holy work. I do see it as me having chosen to take on a job to nourish you, my child. A job commissioned by nature to fulfill as long as we both enjoyed the process and relationship of nourishing and nurturing / drinking and receiving. It was nourishment and nurturing of a complex and multifaceted nature. A journey and a relationship shrouded in blissful connection and sometimes underpinned by deep struggle. A journey that has naturally ended at the perfect moment; for both of us.
I still can’t quite believe that it is over; and to be honest it isn’t quite “over” as we are still talking about it between us: still touching Ninnie and feeling together how Ninnie is changing, laughing together at the incredulity of there being no more milk drinking. Ninnie is your name for my milky breasts – you know the word “breasts” but refer to my breasts (still now a few days later) as Ninnie.
If anyone would have told me when I was a few weeks pregnant that I would breastfeed you for this long I would have laughed in their face(!!!) I thought I would breastfeed for 9-12 months until you transitioned into food, and didn’t need the calories anymore….but then there you were, and my natural instincts blossomed and my rational mind was convinced after doing the research….and there you were: relishing the milk. Loving your safe haven from the exciting world, your body growing and flourishing so powerfully, your immunity and your health so strong – your desire to continue so palpable as each and every time you arrived at the breast your body relaxed and your nervous system reset.
We breastfed through a lot. We breastfed through our mutual recovery from a Caesarean birth after a long labour; for a few days we supplemented here and there as my milk supply came through – and despite the gruelling pumping schedule we breastfed through it. We breastfed through your Upper Lip Tie and for 9 weeks we breastfed with a nipple shield. We breastfed through the protracted death of my granny; your great grandmother. We breastfed through your first teeth, and your first mild fever. We breastfed through the arrival of each and every tooth that arrived – and at 12 months you had 14 teeth…each one bringing fresh chafing for my resilient nipples. we breastfed through the second level three day doula training I attended when you were 12 weeks old – your loving aunty bringing you at breaks and lunchtime. We breastfed through the flashbacks I started to have as part of the PTSD that was triggered in those first few months post partum; we breastfed through the ensuing migraines. We breastfed through a move to the UK for a few months; through the emotional rollercoasted that turned out to be. We breastfed through our happy return to Amsterdam. We breastfed through the first student births I attended, we breastfed through the “interuption to service” that the births and the hospital internships brought. You even had the privilege of breastfeeding from a friend whilst I was at the first full overnight birth. We breastfed through your first virus and your salmonella. We breastfed through your learning to walk and your increased sleep talking – thankfully no sleepwalking yet. We breastfed through the uncertain months of the beginning of self employment; me often reassured that whilst I wasn’t able to afford to put organic food and line caught salmon on our table as I had wanted – at least I could still offer you the breast -and that was as close to organic as it gets right?! We breastfed through your start at nursery, we breastfed through your decision to use the potty and the toilet. We breastfed though 2 years and 7 months of single parenting; and whilst a lot of parents in partnerships may not understand that there is a difference…that is no mean feat!
So how did it all come to an end?
On Friday night as we went about settling down for sleep after stories and tooth brushing; you said “Big Ninnie first” and out of nowhere I heard myself say “It is almost time to stop breastfeeding Jasper. You are a really big boy now, you can do so much for yourself, and Ninnie’s job is done – you don’t need to drink Ninnie anymore.” Your concern was initially mainly if you could drink from Ninnie tonight – naturally – your primary concern at 2y 7m is the present and immediate moment and the moment playing out in such a way that pleases you!!!
I cherished you as much as you would let me whilst you drank. I stroked your toddler head, your long blonde hair – totally different from the dark dark brown head of hair you were born with. I felt the size of your head; the solidity of it. I reminisced back to the first days of our journey when despite weighing 4.448kg at birth; you felt so tiny and fragile in my arms next to my blossoming bouncing balloon like breasts. I felt the full length of your little but solid toddler body next to mine and realised happily that you too will probably remember our breastfeeding journey in the longer term. This makes me so happy.
I have whispered into your ears at various points in the days since with tears in my eyes and my throat choked; “Ninnie will always love you – even though there is no more milk for you to drink; you can still put your head on the soft roundness and remember all the lovely milk you have enjoyed.”
The next night as we turned out the light after stories I invited you into my arm for a cuddle and you said; “Can I have Ninnie?” I smile in the half light (expecting the worst) and say “Oh no – we have stopped drinking Ninnie remember?” Tired after a lovely long day you say; “Oh yeah!” and lie back in your sheepskin.
Falling asleep the next afternoon; you are fidgetty and can’t get comfortable. You lie vertically on my body, your head over my heart, your arm outstretched over “Big Ninnie” (my right one) and fall asleep like that. I cherish the closeness; my heart hurting for you a little. Is it my projection or is this you searching for reassurance?
Last night you tried again – with a knowing and cheeky grin as you ask; “Can I have a little drink?” I laugh and say “Noooooo – the milk is gone now….”
“A tiny drink? A really really short drink?” you venture.
I reply with a clear voice defying my mental uncertainty; “Oh that would be so nice wouldn’t it; but Ninnie doesn’t have milk anymore – feel how wobbly they are now! They are very different now….” I’m half wondering if I should actually offer you some but the dread of the feeling of the dwindling milk being drawn up through the already very different feeling ducts persuades me not to(!)
I am so PROUD of you that you seem able to navigate this change with such confidence. Seeking out affirmations of our love and attachment, yes, but in what seems to be a secure manner. Our relationship is changing again – again! Oh how the wonderous journey of parenthood embodies the only certainhood we have in life: that nothing is certain – that nothing lasts forever.
In these last days of our breastfeeding journey (is it appropriate to say “The Wrap Up”?!?! Too soon maybe?!?!) I have laughed, I have cried, I have massaged and soothed my breasts in deep loving gratitude, I have reflected a lot on what the breastfeeding journey has meant for me, what I hope it has meant for you, and what it has meant for us as a mother and son. There are so many memories – some fleeting and funny, some raw and intense, some euphoric, some I have shared with others, some that will simply remain between you and I; and some that I hold close in my own heart just for me. It is also incredibly beautiful; that on the day that our journey stopped – the breastfeeding journey of a dear dear friend and her absolutely scrumptious newborn daughter began. The cycle continues!
I want to end with gratitude. Gratitude for you and your unwaivering determination from just minutes old, gratitude for your grunting and sucking and stroking and patting and burping and slurping, gratitude for my breasts and my body, gratitude for the healing nature of our “successful” breastfeeding journey after a birth journey that wasn’t what I had hoped for us, and last but not least – deep gratitude for all the people around us. The women, the dearest friends and family, the birthworkers and teachers, and the supporters who made our journey possible with their glasses of water, the delicious nibbles and snacks, the warming tea, the hand on the shoulder, the gentle reminders about techniques in those early days. Gratitude for their understanding when everything stopped so that I could sit down and nourish you; the knowing loving glances in cafes; the spoken words of tenderness, encouragement and support on the days when I was hollow eyed and “over it”; and everybody and every act of support in little and big ways since: THANK YOU.
I’m guessing you are here because your birth story included a Csection. Perhaps it was planned, perhaps not. Either way you are now healing from major surgery. OK, I know that technically speaking a Csection is not “major surgery” because the uterus – the giver and nurturer of human life – is not considered to be a “major” organ?!?! I am a woman, a mother, a feminist, and a doula in Amsterdam; and because I am writing this post we will define a Csection as major surgery here.
So you are healing from major surgery whilst also facing those intense cocooned days of living with your newborn baby, waiting for milk to come in, comforting and feeding your newborn baby, trying to remember to eat and drink enough yourself, not to mention your whole body and system recovering from 8/9/10 months of pregnancy…..
all. at. the. same. time.
Now, as many clients and friends will testify, I am a great believer and fan of the body’s ability to heal itself miraculously – but given that there is so much going on for you after having had a baby, a major surgery and a major rite of passage – a little helping hand to support it in it’s recovery and reacclimatisation can go a long way to a happy healthy postpartum period.
Here beneath you will find a comprehensive list of holistic healing tips to help your body, mind and soul heal and thrive following a Caesarean birth.
# Bed and bedroom # Rework it for practicality’s sake. Leaving the remarkable ease of a hospital bed with hoists and levers and buttons to raise you up and down to your heart’s content can be a big shock to the system. When you arrive home head straight to your bedroom with someone on hand to do the heavy lifting (in NL we are so lucky to have Kraamzorg for this support) and make the necessary adjustments.
- Make sure baby is close; to you and/or your partner. Consider safe co-sleeping to make sure they are really close. Having baby as close as possible will limit the moments where your heart might break a little bit as you are struggling to get up and reach baby.
- Get something to step up onto your bed if it’s high, something strong and sturdy to hold on to as you lower yourself if it is low.
- Set up an adequately sized bedside table (this may mean drafting in a larger or wider temporary table) which is big enough to house a big bottle of water, a tea pot full of tea (see below), a breast pump or a baby bottle, your mobile phone and it’s charger (maybe you will need an extension lead), a lamp suitable for use in the night, a muslin cloth, pain meds, and if there is any room left – a little bowl of healthy nibbles to be topped up by your loved ones every 12 hours – think fresh fruit, nuts, crackers, dried fruits, dark chocolate (it helps the oxytocin keep on flowing and boosts serotonin don’t you know?!)
# AIR to the wound as much as possible # Lie down whilst baby sleeps or is carried by your partner and just let clean dry air reach the wound – in the very immediate days that might mean that you need to hold the belly up off the wound as your body begins to reacclimatise to not having a full pregnant belly anymore.
# Nothing more than water! # In the first couple of weeks water is all that is needed to wash the wound; and the most important thing: dry it scrupulously (moist patches of skin can be breeding ground for fungal infection; see aromatherapy hacks for antifungal oils) – see the old cotton sheet tip hereunder – these strips can make soft, clean and reusable drying cloths too.
# Pain medication # Keep on top of the dose for the first few days. Double check with your healthcare providers if the pain relief you are prescribed is compatible with breastfeeding. Many medications work by building up a certain level in the blood; so when you take a dose set an alarm or get someone to remind you when you are due to take the next dose in order that your dose remains on an even keel and so that you don’t get caught unawares by intense pain.
# Big ‘Bridget Jones’ knickers # When lying naked in bed skin to skin with baby isn’t possible for whatever reason – big Bridget Jones knickers to the rescue. At least 5cm above your belly button (if you can find them!!!), 100% cotton, at least two sizes larger than you would normally wear (they will help keep the sanitary towels in place too!) and if you can bear it; have someone take a photo of you doing your most seductive hip shaking in these pants – so you never forget the comfort of these hip huggers!
# Rip it up # Additionally, tear up or cut up an old cotton sheet – get it washed in a hot hot wash (60 degrees plus) and tear it into strips about 15cm x 25cm in size, to fold or roll up and to tuck between your wound and the aforementioned Bridget Jones knickers.
# One step at a time # Keep moving. Slowly but surely, a little bit more each day. Keeping moving helps our whole body to heal, regulate and keep functioning optimally through good circulation and good flow of the lymph and other fluids. Keeping mobile can also help to prevent a build up of trapped gases. You don’t need to head out of the door if you don’t feel ready, but stroll around the house, if you have a garden have a wander in the garden. Don’t carry or lift anything heavier than baby though remember, and do what you need to do to help your body feel safe and supported; even if that means physically holding your abdomen with your hands as you walk for a few days.
# Sleep When Baby Sleeps # The original and best restorative modus operandi for our bodies. Potentially easier said than done with a newborn baby; so I mean it when I say “Sleep when baby sleeps!” The washing, the cleaning, the ironing, the phonecalls, the social media updates can all wait: sleep is where the healing is at!
# “It takes a village” # Every family needs extra help after the birth of a newborn, but following a Caesarean birth, with rest being as fundamental to physical healing as it is; organising a meal train, or someone to come and entertain siblings or the dog, someone to put a load of washing on and peg yesterday’s load out on the line (you get the idea) can really make a difference to your peace of mind and the logistics of those early weeks. I can’t speak for elsewhere but I know that here in Amsterdam and elsewhere within The Netherlands, we have some incredible mother-led communities and organisations being initiated by volunteers that are easily accessible for all. You can find the Postnatal Support Network of Amsterdam here, and I have no doubt that you will find someone in your area that can point you in the right direction for help and support. If not: reach out to friends. You can set up a WhatsAp or Facebook group for those friends in your circle who can offer some support and get used to asking for what you need during the coming few days, weeks and months.
Food & Drink
# Water Water Water # Aim to drink at least 2 litres of pure water a day (on top of teas and broths). This is essential for rehydrating after surgery and a hospital stay which can be notoriously drying for the body. It also helps prevent infection, flush out inflammation and traces of analgesia and antibiotics, help keep the bowel and urinary tract moving and flushing, along with providing enough hydration as your body begins to produce breastmilk too!
# Wholesome Good Food # This is important however you give birth, but especially after a Caesarean. A varied, well balanced diet rich in protein, good fats, minerals, vitamins and fibre will help your body attribute the necessary nutrients to all the different bodily functions happening at once (as mentioned above). Foods which help to fight inflammation are also helpful for your body right now.
Spicy / Herbal Hacks
Get the kettle on! Tea time!
Nettle tea, dandelion tea, fennel tea and breastfeeding teas such as the Weleda tea will all help to promote breastfeeding but also assist your body in flushing out all the excess fluids your body produced during pregnancy, aswell as help your body cleanse out all the pain medication, anaesthetics, antibiotics and IV fluids that you may have received during the Caesarean and immediately afterwards.
Warming spices: ginger, cardamon, cinnamon, turmeric – hello Chai latte! In Traditional Chinese Medicine giving birth to a baby represents a serious interuption to the flow and force of one’s qi or “chi” as we commonly say in the West. It is therefore considered essential to post partum healing to replace the lost heat after any birth, but giving birth via major surgery is considered an even greater deficit in chi.
Also worth noting: turmeric is not only a warming spice but one of nature’s greatest anti inflammatory substances (over the counter anti-inflammatories include Advil/Nurofen/Naproxen), and is a galactagogue (a substance which encourages the production of breast milk) so turmeric can truly have a multitude of highly beneficial side effects. See this link for a wonderful recipe for a rich nourishing turmeric “golden milk” at no. 7 & a simple but tasty turmeric tea at no. 1 It is worthwhile noting that Turmeric is best absorbed by the body when paired with black pepper; again more info via the link above.
Raspberry Leaf Tea – whilst after any other type of birth I would encourage the use of Raspberry Leaf Tea, following a Cesarean I would encourage caution. Longer term certainly helpful as it is such a wonderful uterine tonic at any stage of a woman’s life, however for the first six weeks following the operation I would personally be limiting this tea to once every few days.
Peppermint Tea or Peppermint Oil – whilst normally both peppermint tea and oil would be wonderfully helpful after surgery on or around the abdomen for gas or trapped wind, following a C-section during the period of time where you are likely to be trying to initiate breastfeeding – peppermint oil is understood to interrupt milk supply and production. See instead the aromatherapy section further down the thread.
Find the position that works the best for you and your baby. Maybe it is sat upright holding baby in the “rugby ball” position. Perhaps you can lie on your side with baby adjacent to you (this might not be possible immediately after a Cesarean). If you are sitting cross legged it can be really wonderful to put a cushion or pillow underneath each of your knees as it takes the strain off your abdomen. If the breastfeeding pillow which you bought with every good intention in the world isnt working for you – don’t hesitate to try without!
Please head over here to KellyMom.com (a great source of breastfeeding information and support) for their take on setting yourself up for successful breastfeeding after a Caesarean birth.
Milk Production/Pumping – I just want to be upfront and honest that milk production can take a little longer following a Caesarean (and analgesia); and so pumping might well be suggested to “improve” or hasten milk flow. Please don’t despair, this does not mean that “you can’t breastfeed after a Caesarean”. In those early days it can feel like you’re climbing a mountain on your hands and knees, but keep in mind that in fact it is the first 8 weeks post partum which determines your milk production and flow, and each day you are probably noting that you feel a little bit better, a little bit stronger: have faith – this too shall pass! All that said, given that it can be more difficult to initiate breastfeeding after a C-Section, if you have any pain or doubts about baby’s latch or your breasts, then make sure to consult a well recommended Lactation Consultant or Peer to Peer Breastfeeding Counselor to iron out any issues before they take route. Lastly; due to the IV fluid that you receive when you undergo a Cesarean birth combined with the fact that baby doesn’t withstand the compression of a vaginal birth; babies born via Csection can have a slightly higher birth weight than their vaginally born counterparts. This can in turn mean a slightly elevated weight loss in the early days…remember to bring this into any conversation about baby’s weight loss (even if it’s just a personal reminder to reassure yourself) and perhaps consider waiting one more day before intervening with supplementation.
Probiotics – after having been exposed from the inside out to bacteria which are so different from our own microbiome in an operating theatre, and then receiving a big dose of antibiotics; taking probiotics in the form of supplements, or drinking yoghurt or water kefir, or eating fermented foods like Sauerkraut can really help mothers and their babies readjust their microbiome from the inside out. Studies are showing us that our guts are fundamental to good health, and unfortunately also show that having a Csection can have a detrimental effect on our babies’ gut health. I say “can have” because I believe that we can redress this difference. The probiotics have a great impact on breastmilk milk quality but also on our internal healing as they can help to reduce gas, constipation and bloating which are common post surgery side effects. Of course if you choose to feed formula then supplementing your baby with a dose of probiotics for babies is a healthy supplementation. I personally have had positive experiences using Bio-Kult and ABC Dophilus probiotic powder for babies from Solgar.
“Skin to Skin” – this is so helpful for promoting bonding, breastfeeding hormones, improving the microbiome of the infant and mother, regulating temperature of mother and baby, and don’t get me started on the yummy squishy smell of the newborn. (Be still my ovaries!) Make sure your room temperature is warm enough, and snuggle up together in bed – include your partner too!
When using essential oils on the skin they should always be diluted in a carrier oil. Good carrier oils include coconut oil, sweet almond oil and grapeseed oil; all of which are readily available – some even in super markets.
Immediate post partum the ways that aromatherapy can work are not related to the wound but more to the healing going on in the abdomen, specifically helping to eliminate trapped gases or constipation with gentle light touch massage around the upper abdomen.
Fennel, cardamon, ginger; all helpful should there be any trapped gas, or constipation. If you’re feeling a little warm or your temperature is up then fennel with it’s slightly cooling properties would be a wiser choice. The other blessing here is that all three of these herbs and spices are traditionally used as galactogogues – substances that promote and enhance milk production.
Please note it is wise to use only one drop of whichever one essential oil you choose to use on your body, as new mothers and their babies remain very sensitive to smells of all kinds (it is nature’s way of protecting the newborn). Dilute even one drop with a small teaspoon of carrier oil.
Rose, lavender, and chamomile to relax and restore. Bergamot and/or neroli to lift the spirits during the day. These essential oils could be used on a warm or cool compress on your face or your neck, or could be diffused gently in the room. Again; less is more.
Following the first 6 weeks of healing the wound should be healing nicely – or certainly appear to be doing so from the outside. From the six week point in the healing process, gentle massage and wound care on the skin can be supportive in successful longer term healing. Once again; go gently with the dosage – start with just one drop of whichever oil you choose in a teaspoon of carrier oil. Also, go gently with your touch and pressure – be mindful of how your wound is feeling. Start out for the first couple of months with light touch massage once or twice a week gently increasing if it feels comfortable; and then 3-4 months post partum introduce massage with an electric toothbrush or a vibrator (yes a vibrator!) if it feels comfortable for you. The gentle pulsation of the toothbrush or vibrator is thought to discourage adhesions from forming amongst tissue and organs.
Frankincense – a healing essential oil with antiseptic, antibacterial and anti fungal properties, it is also a cicatrisant (which means it promotes effective healing and regeneration of the skin/wounds/scars). It is also an effective digestive oil; when used externally through massage it can help to relieve trapped gas.
Lavender – wonderfully calming (but not necessarily the best essential oil to promote sleep as it actually improves mental function), antibacterial, antiviral and proven to be an effective essential oil for pain relief. It has also been understood to speed up the healing process of wounds, cuts, burns, and sunburns because it improves the formation of scar tissue.
Chamomile – antidepressant, antispasmodic, sedative, anti-inflammatory, and cicatrisant (see above), wonderful for promoting skin healing and regeneration too; calming properties for even the most sensitive skin.
Carrot Seed Oil – antiseptic, antiviral & disinfectant, carminative (removes stubborn trapped gases), It stimulates both circulation and metabolic function; which in turn can promote good healing. Carrot Seed essential oil stimulates the growth of new cells and tissues. It also tones the skin and prevents it from hanging loose or showing signs of aging. It has a soothing earthy aroma and is known to promote relief from stress and anxiety, which having a refreshing effect on the emotions.
One last word of caution; even after the 6 weeks…go gently; especially if you are breastfeeding. One or two drops in a heaped teaspoon of carrier oil is more than enough. The body is so sensitive for the first 4 months after giving birth; and whilst essential oils are natural, they are powerful and can impact on the function of the uterus and the production and regulation of hormones amongst other things, so over use can result in heightened sensitivity.
I carry the Helios Homeopathic Childbirth Kit in my doula bag – always! I know many other doulas do, and I find it to be very helpful during all stages of labour, birth and post partum parenting. It has five powerful remedies in an adequately potent dose to assist inside out healing following a Cesarean Section too.
Arnica: a common addition to many first aid kits, Arnica is useful for all new injuries, and can help reduce soreness, bruising, tissue damage, and bleeding related to surgical procedures. Very helpful for alleviating bruising, swelling, and soreness during recovery from most surgeries.
Bellis perennis: commonly referred to as Bellis Per. Useful when bruising and trauma occur to soft tissue, and/or to deep internal tissues after surgery involving the abdomen, breasts, or trunk-especially if a feeling of stiffness or coldness has developed in the area.
Calendula: to help complete the healing of deep wounds (a Csection incision means cutting through seven membranes) along with preventing inflammation, suppuration and infection at the site of the wound. Calendula also helps prevent keloid formation of the scar.
Staphysagria: useful when pain persists at the site of a surgical incision, or after procedures that involve the stretching of a sphincter muscle. It is also indicated after surgeries involving reproductive organs (prostate surgery, hysterectomy, C-section, episiotomy) or the abdomen, stomach, and rectum (including hemorrhoids). Staphysagria may also help after operations on traumatic injuries.
Hypericum: particularly useful for injuries, wounds and surgeries involving nerve rich areas of the body.
I took the remedies above for three weeks on rotation. The Helios Childbirth Kits include the remedies at a very potent dose (200c), so for clients I recommend two weeks at the strongest dose as included in the kit, then acquiring the same remedies at a lower potency (30c) for another week or two. For more specific advise on any other symptoms you are experiencing I recommend finding a qualified homeopathic practictioner in your area.
Rescue Remedy: another favourite from my doula bag! This is very helpful for the emotional side of the healing and coming to terms with the experience, along with those moments of potential overwhelm which come with just having had a baby, and are exacerbated by the intense aches and pains that come with Cesarean recovery. A few drops under the tongue when you feel like you need it; as an added bonus it is very “cleansing” for the body too.
Psychological & Emotional Healing
Acceptance and Integration – these are simple, commonly used words which psychologically are the foundations of a healthy processing of any difficult experience in life, including difficult or traumatic birth experiences. First of all, tell your story as often as you feel comfortable sharing it. Seek out your partner, your friends and family, your healthcare providers, a therapist, your doula (or post partum doula), the neighbour, the dog(!)…anyone who can listen to you unconditionally and non-judgementally, and simply allow you to speak things out and recall things one by one to make sense of how it all unfolded. This is a very important step for your brain in processing the experience; this is one of the primary ways in which it organises difficult or traumatic events.
Journaling – could you find the time to write down a few words each day about your feelings about the Caesarean, your recollections, what you’re grateful for from the experience, how you feel you are healing each day, what disappointments and concerns have come up for you that day? It doesn’t need to be worthy of Anne Frank; it might just be a list of words, it may be a collection of pictures or diagrams, you could use video or voicenotes. Again, journaling in this way can be incredibly helpful in assisting the brain to process the experience and not file it away as a trauma. The three feelings you should pay keen attention to and treat with extra special care are guilt, shame and fear; if these feeling persist then consider getting a referral to a therapist.
Support Groups – there is a lot of support, empathy and healing to be found in the experience of sharing birth stories with others who have gone through a similar kind of birth experience (particularly if that experience was far away from the experience that you were hoping for). It is important to find a group which is facilitated by someone who you feel safe with, and who can hold space for all members of the group, and who can be relied upon to maintain healthy, non judgemental, mature and open communication in the sessions. I know many birth workers (myself included – click here to join the Cesarean Support Network NL); midwives and doulas, along with coaches and therapists who host group meetings in person; there are also organisations such as the International Cesarean Awareness Network (ICAN) that have local chapters just about everywhere in the world. Facebook and other online forums also have a variety of virtual support groups which can be sources of tremendous value; especially when they are international and there are people online around the clock.
VBAC/ Vaginal Birth After Cesarean – one of the most difficult things I have read about women who give birth by Caesarean Section is that they are significantly less likely to choose to have more children because for many the experience of having the surgery, and recovering from surgery is too much to imagine going through a second time. I do maintain that some of that is because there is so little follow up care from health care providers, and somehow such a stigma attached to Cesarean birth that there are few resources out there on successful short, medium and long term strategies for healing successfully from a C-Section. Please keep in mind that the outdated adage “Once a Caesarean, always a Caesarean” is NOT TRUE. Many women go on to experience vaginal birth following a C-Section; so please don’t let your experience of having had a Csection put you off planning a VBAC. Most doulas have experience supporting VBAC; and as I do run a VBAC Support Group in Amsterdam, I hope to write a comprehensive VBAC post in the not so distant future *watch this space*.
Longer Term Healing Hacks (6 weeks +)
Keep working on Acceptance and Integration – this journey can make leaps and bounds and take long rests over many months and years.
Body work – consider seeing a chiropractor, an accupuncturist, an osteopath, a cranio sacral therapist, a somatic coach, a Mizan therapist, an energetic healer, or an Arvigo practitioner. Whilst the mind commands a lot of our attention, our bodies can often go ignored, and our bodies store a lot which actually we often need to release. Seeing any one of the therapists mentioned above (and there are many other types of physical therapy that can help – you need to work out what is good for you) could have a very supportive role in healing the body from the experience of surgical birth.
Massage or cupping – one of the potential complications with longer term healing following a Csection is adhesive scarring (internally). By massaging the area directly around the scar (as mentioned above with an electric toothbrush*** or vibrator), the adhesions are understood to be less likely to form. Gentle cupping (non therapeutic grade) around the scar after a few months can also discourage adhesions (extensive scar tissue) from forming. It can also be very beneficial for gently removing any inflammation and/or stagnation in the area of the scar; improving sexual response, improving the functioning of the uterus, and bringing blood flow, lymph flow and warmth back into the region. A great practitioner for this is Mirjam Heemskerk of Gentle Beginnings here in Amsterdam; she specialises in holistic recovery in the post partum period. You can visit her and her wonderful work over here.
(I have successfully used my Philips Sonicare toothbrush for both excellent teeth cleaning and Caesarean scar healing! *** Not the brush end; the body of the toothbrush!)
What can you add??? What worked for you???
Leave your comments with your own tried and tested healing hacks, or your experiences with the suggestions above – would love to know if this helped you in anyway.
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I have been pretty busy these last few weeks fighting and getting over some seasonal bacteria(!), coaching my coaching clients through their year reviews and assisting them in planning ahead for 2017, getting my own business goals and business tools in place for 2017, and meeting with new and current clients. Two points came up in all four new client meetings that I thought would be great to share here in a blog post and offer clarification on…
- “I didn’t think a doula would support (xyz) type of birth”
- “I have the impression that a lot of doulas have some kind of agenda”
These concerns always worry me a little – because I wonder how many women shrug off the idea of having a doula because they just don’t think their birthing preferences are in keeping with the type of birth a doula will support?
In my opinion (obviously as a professional doula in Amsterdam; I’m a little biased here!) even one woman disregarding the possibility of doula support because of that uncertainty is a crying shame!
Let’s get clear on each point by turning the statements into questions:
- What type of birth is a doula best for?
- What kind of birth agenda does a doula have?
Q1 – What type of birth is a doula best for?
Answer: Every type of birth!
Whatever type of birth you want – a doula is a good choice for extra support. More often than not; your midwife or gynaecologist will not be able to stay by your side the whole time. A doula can be with you (& your partner), or just outside your door (should you wish to be alone) from the point you need her until a couple of hours after the birth of your baby. A doula can be by your side in the theatre as you have a planned Csection, she can hold your hand over the pool side as you have your baby in the birthing pool at the Geboortecentrum (birthing centre), she can support you and your partner through an induction at the hospital, she can kneel down and hold your left hand as your partner holds your right hand and look up at you in your eye to reassure you as the anaesthetist administers your epidural, or she can be sat behind you on the baarkruk (birthing stool) as your husband catches your baby in your bedroom. A great doula has experience in all types of birth!
Q2 – What kind of birth agenda does a doula have?
Answer: A doula has an agenda to support you and your partner in navigating your pregnancy, birth and post partum period (particularly the first 6 weeks) in the way that you want to be supported by her.
She has no agenda of her own other than how best to support you in preparing for, in having and in recovering from the birth that you want; supporting your birth (& parenting) agenda. Of course a doula can offer helpful pointers about research, direct you to support groups or webinars or articles that may be of interest to you, hold your hand as you say yes or no to any change of plan in any birth setting, and most importantly: do all of the above and be with you in an unconditional, reassuring and non judgemental way.
Let me emphasise this in bold typeface and by colouring it purple: her agenda is supporting your agenda.
All this said; there are doulas who do express preferences for a certain approach to birthing or to parenting, and usually they will be upfront about what type of birthing or parenting that is. If you feel that doesn’t match your chosen direction then rest assured there are many other doulas out there to choose from; doulas are not necessarily one size fits all.
To be clear about my approach as a doula from our very first phone call or meeting:
I will listen to you.
I will ask you questions, I will offer sign posts to helpful information about studies, alternative and possibilities; I will encourage and empower you to make informed choices.
I will be there at your side to support you – whatever your choices – and I hope you will never feel judged by me.
I will offer unconditional support around you and your birthing space, wherever that space may be.
I will support you in the way that you decide you need me to support you, and it may be that the mode of support you need changes along the journey – I can handle unexpected change and I will remain by your side unconditionally.
This is your journey. It is an honour that you ask me to be a part of it.
There are so many lists out there for guidance on packing your bag for taking to the birth centre or hospital. Often the hospital or birth centre will issue a list of their recommended bag contents and so what I include in the list here is the “other” stuff; that as a doula in Amsterdam I see is often overlooked – or when providing birth support I see really makes a difference.
- Your own pillow – when you are in labour you are open to your environment in an unparalleled way (we are mammals after all). The familiarity of touch and smell of your pillow in the hospital or birth centre setting can work wonders to relax your nervous system and bring comfort in a way that a plastic coated sterilised pillow just can’t compete with.
- Rescue Remedy – use it as you make the journey from home to the birth centre or hospital, as contractions become more intense, as you perhaps encounter the thoughts of “I can’t do this anymore” whilst you traverse through transition…this is on repeat order from my suppliers for my own doula bag!
- Aromatherapy oils – the top five for me are Lavender (relaxing, wonderful to ease muscle tension, antibacterial, lovely used in massage), Clary Sage (for relaxing into the other wordly state that labour hopefully brings, to intensify contractions), Frankincense (calming emotions, promoting physical relaxation, centering and can assist later in post partum skin healing – diluted in an appropriate carrier oil), Peppermint (or nausea, to cool off, to cut through fatigue, massaged into the back when experiencing back labour it can encourage baby to adopt a more optimal position) and Eucalyptus (for bringing clarity during transition and ready for following the urge to push, if the air is stuffy, or to cool off).
- Forget the diffuser!!! a spray bottle with some lavender and/or clary sage or frankincense essential oil suspended in water ready to shake and spray. Otherwise hospitals and birth centres usually have a surplus of flannels and washcloths that work very well as compresses – warm or cool.
- Coconut water and/or Miso soup – both jam packed full of electrolytes; which your body needs a constant replensihment of during labour and post partum in the hours after birth. It is physically strenous work and the more you can feed your body what it needs the more effectively it can do it’s job and recover afterwards. The combined heat of Miso soup is very healing post partum too – or if labour slows and things need “heating up” again.
- A straw or two – just makes drinking at unusual angles a lot easier! Drink, drink, drink – and urinate, urinate, urinate!
- Facial spritz – because sometimes a compress just doesnt’t cut it and you deserve to be spritzed as you work so hard should you so desire
- Favourite luxurious shower products – for afterwards – it can go one of two ways that first shower. Either you rush through it because you can’t bear to be away from your precious little bundle, or you luxuriate in feeling your body as you cleanse away the sweat, the milk, and the stickiness of the last who knows how many hours. Again – familiar comforting smells really help to promote feelings of safety, comfort and wellness.
- Loose comfortable clothing – body shapes change at different rhythyms after birth, and our bodies often feel tender – so loose fitting layers to layer up or down depending on your body temperature are best.
- A big soft shawl or scarf – the familiarity and comfort of the smell, the flexible practicality of having something to wrap around your shoulder during the first feed or two. If it is long and strong enough – you can also use it as a rebozo during labour.
- A loose comfortable outfit to travel home in – sounds obvious but you’d be amazed how often this is overlooked; the clothes you arrived can’t be guaranteed to be so appealing to travel home in.
- *** Don’t forget: TWO EXTRA COPIES OF YOUR BIRTH PLAN. Yes – your midwife and or your care providers will of course already have them “on file” but care providers are busy – very very busy often and so if the care provider on shift for whatever reason haven’t had a chance to read your birth plan already – then a printed copy that you can hand them will save them and you a lot of time and energy finding and or explaining.
For your birth partner
- Camera, battery pack or charger, memory card – so much to capture (unless you have a birth photographer of course!) and you don’t want the battery or memory to cut out just before a crucial moment.
- Rescue Remedy – whilst it goes without saying that the labouring mother experiences a lot during labour; so does the birth partner. Whether it is the first or fifth time around; it can get a little emotionally overwhelming at any given moment.
- Swim trunks / change of clothing – if labouring in water or water birth is on the cards as a possibility then it is great if Dad or birth partner is equipped and ready to support in any setting.
- Nibbles and plenty of liquid – when birth partners are fully supporting the labouring mother; it is hard work for them too. As far as the hospital or birth centre goes, they try as much as possible to support the birthing team too, but their priority is always the labouring mothers – and often birth partners don’t feel like they can “trouble” the care providers for what they need. Plan for them to be optimally hydrated and energised, to ensure you are taken the best possible care of. Whilst it can be that a sweet sugary snack seems appealing; the best bet for sustainable energy is something packed with protein and or slow releasing carbohydrates. Think apples with a handful of nuts or a hunk of cheese, or miso soup with tofu, or a super food brownie packed with seeds and nuts with a few dates on the side.
- A pillow/cushion/meditation cushion – birth is a very grounding process, and so often a labouring mother following her instincts will not choose to be laying on her bed in a hospital bed but to be swaying on the birthing ball, or on all fours on the floor. Birth centres and hospitals generally have a few extra seats for birthing partners, but if you want your partner to stay close and be comfortable then think about an extra pillow or solid cushion for them to sit on/be supported by.
- A doula – Well obviously; Doulas are for Dads too
Again, refer to the more standard lists of what to pack in your hospital bags for all the details, but for our quirky list one thing to consider and two reminders.
- Cord ties – for years the thing used to clamp a baby’s umbilical cord has been a plastic clamp. More and more people are considering the experience of the baby and that has seen rise to the more frequest use of cord ties, as it is considered the most gentle option for baby (ie. less uncomfortable than a plastic clamp resting inside the nappy). You can make cord ties yourself, it may be that your doula would happily make cord ties for you (I do – as seen in the picture), or you can buy them from Etsy or specialist handmade businesses.
- Birth Planning for post natal preferences – Include in your birth plan/ birth preference document a very clear section on your decisions regarding the post partum care and choices for your baby, including things like the use of cord ties (as above) or your choices about whether or not you will breastfeed, or give Vitamin K etc.
- Baby car seat – When you give birth in The Netherlands you are required to transport the baby home in a suitable baby car seat – best to pack this close to your hospital bag…if you are planning a quick exit from hospital especially, then noone will need to return home to collect the car seat.
Please check out the fabulous Mama Natural and her quirky recommendations for what to pack into your labour bag:
If you love the beautiful Cath Kidston bag as much as I do – click here to treat yourself!
You’ve all read the headlines, the sensationalist introduction to link to new studies on the latest medical research, the byline underneath the headline:
“Moms beware! C-section may harm your baby’s ‘concentration’ “
“Mother’s agony as anaesthetic wore off during C-section”
“Are women losing ability to give birth naturally? They’re relying too much on C-sections and drugs, says expert”
“The mothers made to feel guilty about their C-sections by OTHER MOTHERS”
“A study revealing the prolongation of labour, thanks to epidurals, has been useful in identifying the iatrogenesis – doctor induced harm – at the root of the cesarean problem”
“BIRTH IS THE KEY in breastfeeding: a natural birth unlocks breastfeeding potential and so much more”
“Induced labor may double the odds of C-section”
“Cesarean birth without labor associated with breastfeeding problems say two new studies”
“C-section babies more likely to become overweight”
Then we have the commonly rolled out “statistics” on how having a doula attend your birth means a “40% decrease in the risk of having a cesarean” or how “One-to-one midwifery care reduces C-sections and improves health care”, and the ever so helpful article entitled: “How to reduce your risk of having a Cesarean”, followed by a provocative article asking “Once a Csection, always a Csection???”….I saw that one and thought of the brave, courageous ladies who come to share their hopes and fears in the VBAC Support Group and thought “oh dear – how would you be feeling about your planned VBAC after reading that tagline?”
There I was, scrolling away on my Facebook page the other day – and the newest well intended article about how Csection babies seem to have a higher chance of having Autism, ADHD, obesity related illness, a bad temper*, longer eyelashes*, multiple nipples*, a recurrent ingrowing toenail* and a tendency to smile later* than babies born via the vaginal canal popped up in my news feed. Following my own positive experience of a C-section and subsequently well documented break up with the Natural Birth Movement these articles do intrigue me and I almost always click in to read them, review the science, consider the message and absorb what I can to support my son’s health. I read the article and noticed my mood had worsened. So I observed the feelings, felt them. Fear, worry, dismay, guilt….and then the thought struck me:
“Are these articles doing more harm than good – are we perpetuating fear of Cesarean birth and contributing to birth trauma by doing so ???”
First of all it is important to say: I don’t know the answer. I don’t believe that there is a binary answer to the question. I’m questioning whether or not I should even pose the question publically or just ponder this further alone?! As a disclaimer I will also point out that I have no science to back up this question or subsequent questions.
The criteria for experiencing birth trauma are well clarified by the Birth Trauma Association with a very clear list of potential contributary topics which contribute to birth trauma.
- High levels of medical intervention
- Traumatic or emergency deliveries, e.g. emergency caesarean section
These are two very clear very distinct definitions from a list of sixteen identified contributary factors. How do these events lead to trauma in some mothers but not others? They are not unusual birth outcomes. Is it the physical trauma of the body within these birth circumstances leading to a psychological trauma, or these birth circumstances having been feared/dreaded/denied as a possibility by the mother/never considered as an option meaning that when these circumstances unfold in this manner; the subsequent experience is therefore psychologically traumatic? It’s a bit of a chicken vs egg anomaly. How could we ever really study the impact of having read articles denouncing the perils of Csections on any women, let alone a wide ranging statistically meaningful group of women? Perhaps the only thing we can really do is to be conscious of the question as we encounter another article with a shocking headline?
When it comes to the notion of birth trauma and headlines like these contributing to birth trauma; the more comprehensive question would be
“By repeatedly using sensationalist and confrontational headlines when we publish these studies and their findings regarding birth by Cesarean are we:
a) setting women up with irrational fear of a procedure that sometimes becomes inevitable in an emergency?
b) paving the way for great disappointment in not “achieving” the optimal spontaneous vaginal birth?
c) laying the foundations for trauma by inherently invalidating and dismissing many women’s experience of birth by cesarean as suboptimal? ”
I certainly don’t believe that if we are perpetuating the fear of Cesarean birth in this way that we are doing so consciously – although unfortunately I have seen well meaning birth workers commenting on how “graphically violent” an image of a baby being born by Csection was (which seems a little counter productive to the notion of unconditional birth support).
I read the research, studies and their findings keenly (despite the way the headlines are worded) as a birth professional too; as I stand for informed choice. Informed choice in childbirth should be fundamental, always – whether the choice comes in an emergency situation, a semi emergency situation or even as a choice earlier in pregnancy. I can see and have seen that risks, benefits and options are not always explored fully with expectant or labouring families by medical professionals; and so I can see that by using sensationalist headlines information comes to parents through other channels which otherwise they may not encounter. New research which is consistently being conducted means that sometimes people who made a certain set of choices a few years ago, may well discover something that would affect their decision were they given the opportunity to make the same choice again now; sometimes those people are deeply effected by these articles too. I hope their concerns can be somewhat allayed by reminding them that we do our best with the knowledge that we have at the time.
Above and beyond being crucial in women having all the information they need to make informed choices for their families, the publication and sharing of the research is important and meaningful in the evolution of how we collectively approach birth as mothers, fathers, birth workers, health care providers and policy makers; how medicine and medical protocol advances; and how we can best support our babies’ health post partum, throughout childhood and onwards into adulthood; catering to the specific needs which are unquestionably sometimes a little different to babies who are born via the vaginal canal. This is wonderful as we are actually able to develop practices like seeding the microbiome of the mother’s vaginal canal into the newborn baby’s body post Csection, in order to best replicate some of the benefits of vaginal birth. For more information on this practice head over here. It means that the procedure of the C-section itself can be adapted to offer the mother and baby some of the psychological and physical benefits of spontaneous vaginal birth by performing “Natural C-sections” or at the very least “Gentle C-sections”. For a personal account of a Natural C-sectionby a mother who took part in a study currently being conducted by UCLH in the UK please head over here.
It does seems clear to me though, that some of the aforementioned headlines could be perceived to be perpetuating fear of Csections; intentionally or not.
The question does then broach the bigger picture of the presentation of birth within mainstream media, and the notion of birth as a feminist issue (although birth as a feminist issue deserves it’s own book – let alone a blog post!). I was reminded of the visual presentation of health crisis in the media recently when my beloved grandfather had a heart attack and said a number of times to the emergency healthcare providers; “I can’t believe I’ve had a heart attack – I wasn’t rolling around on the floor groaning in agony with a puce face at any point”. Women’s impressions of birth from mainstream media are often equally misguided, and can range anywhere from “I gave birth on the toilet – I didn’t even know I was pregnant” to “my waters broke as I left the expensive department store, I gave birth in the taxi on the way to the hospital into the taxi drivers hands” to “I fainted in the street and was rushed into hospital via blue light straight into theatre to be put under general anaesthetic and my baby was delivered by emergency C-section”. Certainly any of these situations are possible: but all fairly unlikely. The reality is that there are many opportunities for you as parents to ask questions, discuss your desires for your birth plan, discuss and negotiate the “What Ifs?” or grey areas of birth preferences, and to sometimes even say “I hear that the protocol states we ought to do something to further the progression of my labour right now; but I do not want to and am not ready to agree to any intervention”. Indeed when looking at the reality of pregnancy and planning birth preferences; there is usually very little ‘high drama’ to attract big audiences or a large readership(!)
What can we do with this question? I’m not even sure: doula it? Hold space around it? Consider that client we know who is currently going through the fog of PND or PTSD after having experienced a birth outcome she wasnt anticipating? Consider the heightened intuition of the client who is 39 weeks pregnant and who we know who is digging deep for faith in her body as she prepares to VBAC after having stalled last time she laboured at 3cm? Consider holding space for those clients and others like them before we repost the article unthinkingly and unquestioningly?
It feels important to me to ask the question of myself and the communication I contribute to the discussion around birth; specifically via Caesarean birth.
And so in the name of desensationalising Caesarean birth, in the name of anecdotal evidence to allay your fears about the shocking headlines telling you the dangers and suboptimal outcomes of Caesarean birth: let me finish by telling you the last chapter of a beautiful birth story of a mummy and baby boy I know very well (ahem ahem blush blush) who ended up meeting eachother in the bright, blue, loving and gentle theatre of the OLVG through a stargate wound as opposed to having met in their living room after the full journey through the vaginal canal.
It wasn’t what they had planned.
It was exactly what the mother had feared the most.
But it was beautiful, truly beautiful.
It was deeply healing.
It was what she needed, despite having had a doula, an independent midwife and a best friend as birth attendants to try to avoid it.
It was a whole host of things underpinned by a whole host of emotions; but it was their unique, wonderful birth story.
She experienced that heart burstingly ecstatic moment right there in the theatre.
The magical miracle of birth, albeit a different kind of magic to the magic she’d been hoping for but magical all the same.
Breast feeding worked out.
The wound healed perfectly and quickly with no infection or complications.
And to date there are no health issues to report in her son, partly because she reads all the articles she can on the health impact of Caesarean birth, and makes the choices that feel right for her and her family in order to best mitigate any “potential long term health impact”.
Words can’t always express the emotion of birth; but I believe these photos capture some of them – a big big thanks to Claudia Van Dijk (midwife from vive: vroedvrouwen in verbinding who took them.
*Please note* no studies currently prove any link between babies who are born via csection to having a higher chance of having: a bad temper, longer eyelashes, multiple nipples, a recurrent ingrowing toenail, or a tendency to smile later (you’ll be glad to read).
I wish I’d been more prepared…
I wish I had read more about what to expect…
I wish I’d known that I could say no…
I wish I had known that I could question their decisions…
I wish I’d made a birth plan…
I wish I’d asked them to follow the birth plan…
I wish I had known I didn’t have to lie on the bed…
I wish I’d learnt how to breathe…
I wish I had waited before agreeing to induction…
I wish I’d known about the other choices…
I wish I had known I didn’t have to have constant monitoring…
I wish I’d been more assertive…
I wish I had been given a clearer picture of the consequences…
I wish I had really understood what a doula does…
I wish I’d had a doula!
I hear so many different mothers and fathers saying these things or variation on these themes.
Even long before I became a coach and doula, people have told me their stories and secrets. I often joke that I have a sign on my forehead that says “Tell me the things you would normally never tell a stranger”. I love hearing these details, despite them often being difficult or painful to hear. I believe passionately in people telling their stories, owning their stories, giving their stories space and time to heal, to evolve and to transform. Ultimately it is these eclectic stories I’ve heard that led me to become a coach.
It is a strange thing now as a doula though (perhaps it’s also that I’m a mother) that I catch myself so often wishing that I could have met them sooner, told them about the myriad of wonderful birth workers in Amsterdam that they could choose from – that their regrets over how their birth unfolded or how their trauma occured could somehow have been less painful, less rueful. It’s a nonsensical line of thinking though of course – because these experiences of birth; be they ecstatic, traumatic, blissful or agonising – have the power to reshape our lives and experiences and propel us into a new direction or simply propel us forward to begin to question the paradigms we had previously accepted without a second thought. And that is beautiful.
I’ve been privileged to have supported many second time mothers and fathers, and after having experienced a very different type of birth the second time round they say things laughing like “I wish every family could have a doula” or “I wish we had had a doula the first time” or “I wish every family could have the chance to prepare like we did this time around”
I previously wrote an article on “what a doula does” which goes into a little more comparative detail about what a doula can support you with compared to other people in the birth team, but I didn’t speak of how doulas can offer so many different support options and how affordable a doula can be.
Obviously I can’t speak for all other birth workers but I can speak for what I am able to offer aside from my doula support packages as stated here:
- Birth Planning Session: 2 hours discussing birth, labour, post partum and induction/interventions in detail. I leave you with a few birth planning templates and review the document with you a week or two later over the phone/email. €175 per couple.
- Best Birth Support Companion Ever: 2.5 hours teaching your birth partner “how to doula you” €175 per couple.
- Birth Story/ Birth Trauma Healing: 2 hours speaking, counselling and coaching through your previous birth experience and ending with body or energy work to finish the session. €150
And two last points:
- It is never too late to hire a doula! Don’t be the one that says “I wish I’d gone for it and hired a doula”! I offer a last minute package (if I have availability) which is priced at €695 for one two hour prenatal appointment, being on call for you 24/7 from the moment of hiring, and one post natal appointment. I am even open to you keeping my phone number in your phone and if you end up in hospital thinking “right about now I would appreciate having someone here to support us” then try me – whatever the hour!
- To put the cost of full doula support into context, the Principal Doula Package will cost you less than €20 per week of pregnancy…doesnt it seem much more affordable when put like that?! Please see the testimonials page for more insight into how others have valued my services.
And the very last point(!) – my teachers Jennifer, Jacky and Joyce at JJ Doula Training have details of many student doulas who have completed the education with them but who are looking for experience – and a student doula support will cost between €200 – €350 in Amsterdam (level and experience dependent) for two or three prenatal appointments, birth support and post natal support. I’m happy to facilitate contact or you can reach out to them directly.