The.Smart.Doula, Leeds (2026)

05/06/2026

What do you think is driving the rise in emergency caesareans?

This article talks about a culture of fear and litigation, with most maternity claims relating to a caesarean being performed “too late”.

But when was the last time you heard of a claim for an unnecessary caesarean?

I do think fear of litigation plays a role.

But I also think we need to look at the bigger picture.

Despite studies that often conclude otherwise, induction rates have risen dramatically. In the real world, many women experience the induction cascade, where one intervention leads to another and ultimately increases the likelihood of a caesarean birth.

At the same time, we continue to rely heavily on continuous CTG monitoring. A technology that has repeatedly been shown not to improve overall outcomes for babies, while increasing caesarean and instrumental birth rates.

Add these together and it starts to look like the perfect storm.

More inductions.
More monitoring.
More intervention.
More fear.
More caesareans.

And all of this while stillbirth rates remain relatively unchanged, raising important questions about whether many of these interventions are actually delivering the benefits we expect them to.

What do you think is behind the rise in emergency caesareans?

👇 Let me know your thoughts.

05/06/2026

What do you think is driving the rise in emergency caesareans?

This article talks about a culture of fear and litigation, with most maternity claims relating to a caesarean being performed “too late”.

When was the last time you heard of a claim for an unnecessary caesarean?

I do think fear of litigation plays a role.

But I also think we need to look at the bigger picture.

Despite studies that often conclude otherwise, induction rates have risen dramatically. In the real world, many women experience the induction cascade, where one intervention leads to another and ultimately increases the likelihood of a caesarean birth.

At the same time, we continue to rely heavily on continuous CTG monitoring. A technology that has repeatedly been shown not to improve overall outcomes for babies, while increasing caesarean and instrumental birth rates.

Add these together and it starts to look like the perfect storm.

More inductions.
More monitoring.
More intervention.
More fear.
More caesareans.

And all of this while stillbirth rates remain relatively unchanged, raising important questions about whether many of these interventions are actually delivering the benefits we expect them to.

What do you think is behind the rise in emergency caesareans?

👇 Let me know your thoughts.

04/06/2026

So angry, how could not one of the ‘medical professionals’ question that decision.

The OB that ordered the drugs
The midwife that administered them

Induction should not be performed on a baby that may already be struggling.

This is basic logic.

We know artificial oxytocin causes stronger, more painful contractions, it’s a continuous dose rather than a self regulated peak and trough pattern that natural oxytocin has.

We know it increases the risk of fetal distress.

We know it can cause hyperstimulation and uterine rupture.

If there is any concern about your baby.

Are you bleeding?

Are their heart rate concerns?

Are their possible signs of fetal distress (meconium? Reduced movements?)

Are their concerns that placental blood flow is restricted? (Faltering growth? Doppler measurement? Concerns about IUGR?)

Ask your self, will a stronger labour with less time to recover inbetween contractions and an increased infection rate benefit me or my baby?

Watching the panorama investigation is haunting, this baby died, they said they didn’t know why.

She dies because they sped up her mother’s labour, caused a partial placental abruption to worsen by increasing contraction strength artificially - denying the maternal request for a caesarean.

It’s horrific, it’s not a one off.

Think for yourselves.

02/06/2026

🤔A new assisted birth device is being trialled in the UK and many are hoping it could reduce some of the trauma associated with forceps births.

And honestly? I hope so too.

But we also need to ask a bigger question…

Why has the UK remained so reliant on forceps when many other countries moved towards ventouse decades ago?

The Birth Trauma Inquiry highlighted that countries such as the Netherlands have almost eradicated forceps use in favour of vacuum extraction.

Sky news has recently released the data you see on screen

Why does that matter?

Because evidence consistently shows forceps are associated with:
• more severe perineal trauma
• more maternal pain
• higher rates of a**l sphincter injury

A Cochrane review comparing instruments for assisted vaginal birth found forceps were less likely to fail than ventouse, but caused more maternal trauma.

In simple language:
Forceps are more likely to “work” first time.
But they are also more likely to injure women.

The review found attempted forceps births had around a 42% lower chance of failed delivery compared with ventouse.

At the same time, ventouse has been associated with fewer severe tears and less need for pain relief afterwards.

The current data does NOT prove OdonAssist is better than ventouse.

Many unsuccessful OdonAssist births ended up needing forceps anyway and we already know multiple attempts with instruments increases trauma risk.

So yes, there is reason to feel hopeful.

But perhaps the bigger conversation is why UK maternity care still relies so heavily on forceps in the first place.

📚Sources:

Cochrane Review
O’Mahony F et al. Instruments for assisted vaginal birth. Cochrane Database Syst Rev. 2021.

The OdonAssist inflatable device for assisted vaginal birth
AJOG 2023

Birth Trauma Inquiry Report 2024

Simulation study comparing OdonAssist and V***a vacuum technique
IJGO 2026

02/06/2026

How did I do?

I don’t mean to poke fun or belittle the seriousness of this.

But those of us who work in this space can tell you exactly what these investigations and reports will contain without ever seeing them.

It’s why I focus on individual families whilst spending energy raging at the system only when I have energy to spare.

02/06/2026

The story of a second time mum who knew she needed to do things differently this time.

An out of guidance birth plan for a home birth.

A virtual and in-person doula.

She embarked on a journey filled with evidence based podcasts and blogs because for her knowledge was power.

A beautiful physiological homebirth story ❤️

01/06/2026

Over 50 five star reviews 🤍

And every single one feels bigger than a number.

Because behind every review is a family who felt:

✨ “confident and empowered”
✨ “in control”
✨ “supported”
✨ “reassured”
✨ “heard”
✨ “prepared”
✨ “positive about their birth”
✨ “able to advocate for themselves”

Women have told me I helped them navigate previous trauma, make informed decisions, challenge information that didn’t sit right, and find the confidence to trust themselves again.

Some have said I was the support they “so craved” in a previous pregnancy.

Some said hiring me was “the best decision” they made.

Some said they will be “forever grateful”.

Some said they finally have a birth story they can reflect on positively.

That is what matters to me.

Not perfect births.

Not ticking boxes.

Not proving a point.

But helping families walk away feeling informed, respected, supported and deeply connected to their own choices.

This work can be emotionally heavy.

It can be unpredictable.

It can be hard to convince people that support like this is worth investing in.

But then I read your words.

And I remember that the ripple effect of one family feeling empowered can last a lifetime.

So thank you to every family who trusted me with such a vulnerable chapter of their lives.

I carry your stories with me every day 🤍

01/06/2026

Imagine being in labour.

Scared.
In pain.
Unsure if what you are feeling is normal.

And the people you turn to for help are being told not to be too kind to you because you might come back.

“FOH” on a handover board.

“Don’t be too kind to them.”

Not about difficult patients.
Not about abusive behaviour.

About women in early labour.

This is what happens when a system becomes so overwhelmed that compassion starts to be viewed as a problem.

Because if a woman feels safe, listened to and supported, she may return when she needs help again.

Read that again.

Maternity care cannot be reduced to flow charts, targets and bed pressures.

Women are not inconveniences.
They are not burdens.
They are not problems to be managed away from the hospital door.

Early labour is often when women need reassurance the most.

A kind conversation will not create dependence.

But a dismissive one can create trauma.

The most disturbing part is not three letters on a whiteboard.

It is the culture those three letters reveal.

A culture where returning for support is seen as failure.
A culture where compassion is rationed.
A culture where women learn that asking for help makes them unwelcome.

Women deserve better than this.

And an alive mother and baby is not the only measure of good care. We should expect safety, dignity, respect and kindness too.

The bar cannot be on the floor.

01/06/2026

You said no to induction. Then someone offered you “just the balloon”.

Not because they were lying.

But because they only gave you part of the picture.

Many women planning a VBAC are told that a balloon catheter is the “safer” induction option because it does not use synthetic oxytocin. What often gets left out is that for a large proportion of women, the balloon alone does not start labour.

The next conversation is often about breaking waters.

Then oxytocin.

Then stronger contractions.

Then pain relief.

Then interventions that you had hoped to avoid.

And before long, you can find yourself wondering how you got here.

Technically, you can change your mind at any point.

Technically, you can stop.

Technically, you can ask for more time.

But after days of appointments, monitoring, waiting, procedures, pressure, and emotional investment, many women describe feeling “locked in” to the process. Not because they have lost their right to choose, but because it becomes psychologically much harder to step off the pathway once you are on it.

This is why informed decision making matters.

Not just hearing that a balloon has a lower rupture risk than oxytocin.

What is the actual risk in your situation?

What are the absolute numbers?

What are the risks of continuing the pregnancy?

What are the risks of induction?

How likely is the balloon to work on its own?

How likely is it that you will need your waters broken?

How likely is it that you will need oxytocin afterwards?

How likely is it that you will want or need additional pain relief?

This isn’t about telling women to accept or refuse induction.

It’s about making sure you understand the road you are being invited onto before you take the first step.

If you’re planning a VBAC and induction has been suggested, I highly recommend listening to Season 2 Episode 16 of The Birth Untethered podcast It breaks down the evidence, statistics and considerations around VBAC induction in far more detail and helps you ask better questions before making your decision.
untethered

31/05/2026

What is more dangerous?

A machine that doesn’t improve outcomes?

Or a machine that doesn’t improve outcomes and teaches us to distrust women when they tell us what is happening in their own bodies?

This story has stayed with me.

A woman with an unstable lie. A history of fast labour. A planned caesarean. She knew what contractions felt like for her. She knew things were changing. She knew time mattered.

Yet her words carried less weight than a monitor that kept losing contact.

The CTG couldn’t reliably show what was happening, but somehow it was still treated as the source of truth.

How have we reached a point where a woman saying “I am contracting” is not enough?

Technology has a place in maternity care. But when a machine becomes more trusted than the person experiencing the labour, we have a problem.

Because this is about more than one birth.

It is about a culture that increasingly values data over observation, protocols over critical thinking, and printouts over people.

Thankfully, she was persistent. She kept advocating for herself. She got the caesarean she wanted before events overtook the situation.

But not everyone has the confidence, knowledge, or energy to keep pressing the call bell.

And that is what worries me.

The best technology should support clinical judgement and a woman’s own awareness of her body.

It should never replace them.

Have you ever felt like what you were telling staff was ignored until a machine confirmed it? 👇🏻

The.Smart.Doula

05/06/2026

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31/05/2026

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