Meet Molly Grenham - doula, lactation consultant, entrepreneur and passionate advocate for women's birthing and post-partum choices. She is the main practitioner at Mother Nurture Hong Kong which offers doula services, breastfeeding support, childbirth education and placenta encapsulation. Molly lives in Hong Kong with her husband and two sons, ages 6 and 2.      
You transitioned from a 13-year corporate career to helping women have better birth and post-partum experiences. What was your aha moment?
When I finished my last project, I knew I didn’t want to go straight back into corporate change management. After several directionless weeks, a girlfriend who knew of my passion for natural health and the birth process, suggested I become a doula. Immediately, I felt “Yes, that’s exactly what I want to do!” The training course was challenging and interesting. The confirmation that this was the right move came while attending my first birth. It was long, emotional, inspiring and exhilarating.
How did you start changing your career? What steps did you take?

The first step, was to give myself permission to do something new when the opportunity presented itself. Without knowing exactly what I wanted to do next, I needed time to explore options. I am incredibly fortunate to have support from my husband, which allowed me the luxury of time to test out ideas. I then spoke to all of my friends to identify my strengths. I thought a lot about how I wanted my life to look and tossed around a number of ideas. The last step, which I still do over and over, was to try something new and assess it afterwards. In my case, guiding couples toward and through birth has been incredibly gratifying and rewarding. I learn constantly, build lovely relationships and get to celebrate new beginnings.

Molly with her son 

Any advice for women who are contemplating a major career shift? 

Ideally, start working toward your new career while you are still employed, to allow time to build experience, tweak your approach, and build a social media presence.  This also means that you will have fewer financial pressures as you build momentum, and can confirm that this is the right move for you.  If instead you have a clean break, the advantage is that you are able to immerse yourself in the next career and upskill faster.  It is key to focus on which of your previous experiences and skills are valuable going forward.

So, what is a doula? and how does she differ from a mid-wife? 

A doula is a person who supports a woman through labor and birth. The difference between a doula and midwife is that a midwife is medically trained, generally employed by the hospital, and primarily focused on the mechanics of birth. A doula attends to the laboring woman’s (and the father-to- be’s) physical, emotional and psychological needs. Another distinction is that a doula provides continuous, independent, and judgement-free support. In practice, this means that a doula provides evidence-based information about the process, helps couples design a birth plan, stays with the couple through active labor (and birth in private hospitals), accepts and supports all decisions, and follows up after birth to make sure that the new family is adjusting well.

With a client after a successful birth 

Should all women should consider having a doula? should women having planned c sections also consider doulas?

Absolutely, almost all couples benefit from having a neutral, knowledgeable, and experienced support person to guide them through the birth journey. A doula is a competent and comforting pair of hands to help everyone manage their particular ups and downs. While doulas are critical when another birth partners are not available, randomized studies have shown that doulas benefit births in a number of ways. The most noted benefits refer to vaginal births, such as, shorter labor, and lower rates of Caesarian section, induction, epidural use, and instrumental delivery. However, there are also benefits for all births, including Caesarian sections, such as, the decreased risk of the baby needing to go to the special care unit, and decreased risk of the mother feeling dissatisfied with the birth experience.

What does it feel like to attend the birth of a client?

Exhilarating and an honor.

With the family

You had two very different births yourself - tell us about them.

I’ve been exceptionally lucky with my births – both were amazing and empowering. What I liked about the first (planned homebirth in England) was being tucked into my own bed with my son a mere two hours after his birth. With my second (public hospital birth in Hong Kong), I liked the competent, efficient, affordable care. If I could have changed the second, I would have liked to have given birth at home again, but Hong Kong’s infrastructure does not support this approach. Yes, I had a doula with my first birth. She attended me all through the night. She was quietly comforting, and she protected me from outside distraction and my internal emotional turbulence. Most importantly, her presence allowed my husband to play a central role without feeling responsible for doing it “right”. With the second birth, I had an independent midwife who also fulfilled the role of a doula. She focused on me completely, supported me emotionally and physically, and encouraged my self-confidence and strength. Their unspoken message to me was, “I know how you are feeling, but you can do this, you’ve got it.” Both of these incredible women inspire my work every day.

What has been the best moment so far for you in your career as a doula?

Oh, it’s so hard to choose, as there are many delicious moments! I get such satisfaction witnessing and encouraging people as they grasp their role as parent with each turn. My most powerful moment, so far, was physically supporting a mother as she birthed her daughter. I held her leg and leaned toward her so she could push against me. I was able to look into her eyes, see the start of the contraction, and encourage her strength again. Between each contraction, I helped her relax as fully as possible and wiped her brow with a cold cloth. It was amazing to see the joy and relief on their faces as the baby was born. Everyone was tired from the physical and emotional tension, so it’s wonderful to experience the shift as they all settle in and get to know each other quietly afterwards.

Downtime

You also play a central role in La Leche League in Hong Kong. We have seen breastfeeding rates around the world are lower then doctors recommend. Why do you think that is?

Our society expects everyone to be fast, predictable, controllable, and autonomous. Normal birth and breastfeeding do not fit this model. Babies require a slower pace, they don’t often adhere to schedules without fallout, and they require a team of support. In essence, our fast-paced society doesn’t value the time required to breastfeed. Maternity leave is short in Hong Kong and most other places, and flexible working is not embraced by many industries. This does not allow mothers much time to establish a breastfeeding relationship and fully recover from birth. While many hospitals advertise that they are breastfeeding friendly, they don’t always understand what is required to get breastfeeding off to the right start, and may give conflicting or incorrect information to new mothers. Some of their normal practices even make nursing more difficult during the crucial first weeks. At La Leche League, we hear from a lot of new mothers who feel confused or overwhelmed. We seek to prepare parents-to- be for the early hours and days of breastfeeding, provide practical information, and emotional support for mothers to help them to continue nursing for as long as the family likes.

Any advice for nursing mothers?

Learn as much as you can before the baby arrives – ideally attend a class on breastfeeding with your partner. Nursing little and often helps to establish your supply. Delay using pumps, pacifiers and bottles for the first six weeks. Patience, persistence and extra support are required. Seek out support from people who are currently breastfeeding or have been successful in the past.

Helping a labouring client

Are there any unique challenges to giving birth in Hong Kong?

The main challenges for giving birth in Hong Kong stem from a belief that birth is always a dangerous medical crisis. From an expectant mother’s point of view, this fear creates anxiety and physical tension. These reactions lead to an increased experience of pain and a decreased ability to think logically or make decisions. When then faced with health care providers who also believe that birth is dangerous, the laboring mother will often accept a high degree of intervention without question. If, instead, an expectant woman believes that birth is a normal, biological process that can usually be managed peacefully, then Hong Kong’s approach may be too intrusive to allow her to have a spontaneous, natural birth. In order to stack the odds in her favor, she must learn to break the Fear – Tension – Pain cycle, actively protect her environment, and take responsibility for her experience.