On Wednesday 13 November 2019, I attended the OMP Ambassador workshop in Sydney. In this workshop the instructor, Ginny Phang-Davey, discussed an upcoming mentorship exchange program in China. The first trip was happening in less than two weeks and the subsequent one in April 2020. I was sitting in the room thinking how amazing an opportunity it would be to be able to go along on this program. However I had clients due in both November and December that had not yet had their babies and it would be unreliable and unethical of me as a Doula to pick up and disappear. I pride myself on doing my best to be available for my clients when they need me.

And so the workshop continued and I had an amazing day and learned so many wonderful tools to help better support my clients in their journeys. That night I received a message that one of my clients was in labour... and over the next three days all of my November and December clients had their babies! On Saturday I was reflecting on the births I attended (how I had applied these new tools and techniques) and the OMP workshop and had a thought that maybe it was not too late for me to attend the mentorship exchange program in Gui Yang, China that started the following week!

So I called Ginny, and asked her if there was any chance that I may be able to attend. She said that there was one remaining spot in the program, and she would be thrilled to have me, however the trick would be arranging everything in time, including ensuring I’m on the same flights as two other participants flying from Sydney, and especially my visa for China. You see, to request the visa for China, and with no guarantees it will be accepted, you need to have purchased your airfares and your accommodation first. And so I took the plunge, purchasing the flights and accommodation. I spent the better part of Monday at the visa application center submitting my forms and passport. I then spent the next few days catching up on the itinerary and the pre-requisite information for the trip. On Thursday I successfully picked up my passport with visa, and on Saturday 23 November I was on a flight to China, leaving my family behind for 11 days.

Talk about a whirlwind decision to snap up a last minute opportunity!

Amanda the Sydney birth doula and for postpartum support attended an OMP Optimal Maternal Positioning workshop and mentorship exchange program in China to learn how to help support women to have the best and smoothest birth.

The participants and hospital staff from our OMP mentorship experience in China, using Optimal Maternal Positioning strategies to help mothers have better birth outcomes

I was one of 12 participants on this program. Six of us were from Australia, and the remainder from various parts of China including mainland China, Singapore, Hong Kong, Taiwan and Macau. All of us had completed an OMP workshop, and were working as OMP Ambassadors. All of us were Doulas or Midwives, or other birth related professionals. We were strategically divided into four groups of three, with each group containing a bilingual speaker to help with the language barrier at the hospital.

The first day was filled with team building activities, ice breakers and opportunities to get to know each other. We were taken on a tour of the hospital and introduced to the important members of staff. Each team was allocated a staff member. Thereafter, we were thrown into the hospital system supporting women as they arrived in labour. We had a special designated area where we could bring some of the women to practice the OMP techniques. And, this area was also used by us to rest during the day, or the night while we were on call for labouring women.

Sydney based birth and postpartum doula and her Team 4 at the Optimal Maternal Positioning mentorship exchange program in China in Gui Yang, with birth photographer Heather Clayton and doula Gaia from Taiwan

Over the next five days my team supported six births, as well as observing other teams, and had the opportunity to be mentored by Ginny each step of the way. If we were unsure of the best protocols or techniques to use we could check in and be guided in which skill set should be applied at that specific time or circumstance. We also had mini-workshops where Ginny reminded us of the purpose of some of the tools, and the questions to ask ourselves to work it out. There were opportunities to debrief and process the births and learn from the experience. Overall it was an amazing opportunity for live hands-on guidance to learn the best ways to help the baby navigate the cardinal movements through the pelvis by assisting the mother through a series of exercises, positions and techniques. We were truly able to see just how beneficial and how much of a difference OMP can make to a labouring woman. And of course, how much women valued having us there as Doulas too, where they would otherwise often have no support or be left to labour alone.

Sydney vbac mum and birth doula holding a baby in china at the OMP mentorship exchange program for OMP Ambassador growth

I was pleased that we were able to support a variety of births including first or second (and even a third) time mums. The lifting of the one child policy has made this easier for families to have more babies (Interesting fact: the population of China is currently more than 18% of all humans on Earth: that’s almost 1 in 5!). However... Birth in China is handled very differently to here in Australia. In Australia women generally have the opportunity for discussion or consultation, where in China, I felt that choice was often taken away - as though there was no place for consent or even bodily autonomy.

Keeping in mind the language barrier, here is my interpretation of some of the other main differences:

vaginal exams: women were often not asked first and frequently had someone insert their hand into their vagina without permission
sterilising the environment: we wore gloves, masks, scrubs and special shoes in delivery, and mothers were regularly wiped down with betadine
induction: this was handled over up to 4 days... sometimes a balloon catheter was used, but mostly it was a syntocin drip that would be turned off at night so a woman could sleep and recommence labouring the next day... however if after 4 days there was no established labour or good progress they were sent straight for a cesarean…
cesarean: no support people (be it the husband or us as registered doulas) were allowed into theatre... women were shaved from the ribs down to the thighs (including all pubic hair)... babies were taken away to the delivery rooms to be measured etc while Mum was in recovery (family was not able to be with the baby or mother yet)
labour and delivery: women laboured in rooms of 3 or more (3 was a VIP room and some rooms had up to 8 women!) and apart from a bed with linen, nothing else was provided (no food or toilet paper! or even bluey’s - the waterproof mats... all BYO - except there was a kitchenette families could use to cook meals at the hospital!!)... once women were ready to go through to delivery, their family/support was left in the labouring area waiting and there could be 2-3 women in delivery at once all in the same room!... they were encouraged to lie on their backs with legs in stirrups for birth too (we did our best to encourage other birthing positions)... and once their baby was born, they often returned to the same room they laboured in for their postnatal recovery... also in every delivery a mother was administered oxygen, IV fluids and syntocin
gender: almost all of the medical staff were female - Midwives and Obstetricians included... I saw three male staff members, one an OB, another a porter (for theatre beds/wheelchairs) and the other a cleaner
ruptured membranes: if a woman’s waters released or were broken, she had to stay on the bed as there was a big fear around cord prolapse… even in an induction, membranes were not broken until she went through to delivery (unless they released first on their own)
change: for change to be made to policy, it has to happen at a national level, rather than a decision to be made at an individual hospital level
delayed cord clamping: this is very much encouraged (yay!!) and at one birth a baby who needed resuscitation was left attached to the pulsing cord while they brought oxygen to the baby - I wish we had more of this in Australia so babies could receive maximum amounts of oxygenated cord blood
pain relief: there was no option for pain relief - women had to birth a baby on their own, or if they needed assistance they went for a cesarean (and then they could have an epidural)… infact, aside from syntocin, there were no other drugs used (including gas, morphine, cervadil etc…)

Photos of using OMP with labouring women…

Some of the babies our team helped welcome into this world…

Unbeknownst to me ahead of time, this trip became as much about professional as personal development. It was a cultural experience visiting a tier two city in China (i.e. not as developed as Beijing or Shanghai as most of the western world is familiar with). We had holes in the floor for squat toilets, and you had to BYO paper and hand sanitizer as they did not provide that or soap to wash hands (we each brought our own bumbags -aka fanny packs- so we were never caught out!). We brought latex gloves from home too for personal safety as this region has a prevalence of Hep B and HIV. It was suggested that we bring our own snacks, muesli bars and protein packs from home as the area is well known (famous even!) for its super spicy food and we may not be able to adjust to the significant dietary differences. Don’t worry - we definitely did not go hungry and I somehow gained three kilos over my week and a half in China! 🙈

There’s nothing like being far away from home, immersed in a different country and culture, to make one appreciate how good life can be and is. I feel so lucky to be Australian.. to grow up in abundance and privilege, never going without or struggling. Our medical system and first world conveniences are things I would often take for granted. It’s so wonderful to be able to pause and reflect on what our lives are actually like versus what they could of been had we been born in a different time or place.

I have deep gratitude to my amazing husband who supports and encourages me to take these opportunities in life, and manages everything at home without me (it’s not easy!).

To me, life is all about the experiences we get to have (like birthing a baby!), and this mentorship trip to China was an amazing one that I will forever be grateful to have had the opportunity to participate in.

If you’re interested in an OMP session with me, please read more about it here, or get in touch here.

Thanks, Amanda x