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What’s Your Nervous Nelly?

After attending births for a while, some stories begin repeating themselves. Every caregiver’s eccentricities begin to become apparent. A doula begins to learn that one doctor seems to caution every mother about big babies. One midwife insists that every mother wears a belly band after 32 weeks to keep baby from flipping into breech position. One practitioner wants to know that everyone’s membranes have ruptured, whether naturally or artificially, by the time she’s six centimeters, while another is adamantly opposed to breaking anyone’s membranes at all. Another midwife gives each patient “the shoulder distocia talk.” One lactation consultant hates nipple shields, while another sends every client home with one. Why, when practice is supposed to be evidence-based, does this happen?

I explain it to my clients this way – Everybody has a Nervous Nelly. A Nervous Nelly is a set of circumstances that makes our red flags go up. It’s a moment that holds the potential to have our inner self sweating and wringing her hands with worry. As birthworkers, our experiences and our memories make up a huge part of who we are in our work. There’s more to birth work than “just the facts.” The wisdom that comes from our experiences plays a huge role in the decisions we make and the advice we give.

Anyone who works with birth for a significant amount of time has probably been part of a story that she doesn’t want to see repeated. So, she learns more about it, looks into the details of why it may have happened, and learns what may prevent it from happening again. This becomes the advice that is given to everyone. It becomes part of the client education that is given in the future.

It’s important to know your own Nervous Nelly, and talk about it with others. I have this conversation with every client, and I own openly and honestly that my personal Nervous Nelly is the mama who knows that her water broke, and isn’t willing to tell her practitioner about it. Why? Because once many years ago, after a beautiful and uncomplicated birth, I was pulled aside (into the newborn nursery, in front of tiny babies, no less) and screamed at (at top volume) by a doctor who was furious that this had happened – that I knew the mama’s water broke that morning, and she didn’t. Now, I didn’t know that the doctor hadn’t been told – I had asked my client, as I ask everyone, if she had called the practice to let the doctor know she was in labor, and was told “yes.” That doesn’t matter. The fact is, I knew relevant information that the doctor didn’t. Now, I’m much more clear in my guidelines – if it’s important enough to tell me, it’s important enough to tell your doctor or midwife. If the fear is that a practitioner won’t be supportive, it’s important to me now that a client learns this early on, so that she can choose a practice that she trusts enough to tell the truth. So, we talk a lot at first appointments about how to choose a practitioner that a client can trust. One rough experience, one time, with one doctor, changed the way I will deal with every client now and in the future.

Doctors and midwives are the same way. One powerful experience, one time, changes the way he or she thinks. This isn’t “bad” or “wrong”, it’s just part of what makes each of us unique. We’re all human. Our experiences become part of who we are. Sometimes statistics matter less than what we’ve seen with our own eyes. It doesn’t matter if the risk is one in a thousand – if you’ve seen the one, whatever that one may be, you likely don’t want to see it repeated, and are more inclined to actively prevent it from happening to someone else, ever again. The resulting advice may not always be factually accurate, but it almost always stems from compassion and caring.

Know and befriend your own Nervous Nelly. Let that inner wisdom guide you into becoming better at what you do. Know that everyone else has a Nervous Nelly, too, and allow the compassion that comes from this understanding to transform you into a being a better communicator with everyone on the birth team.

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A Day in the Life of a Doula

My alarm rings at 6:30, and my morning begins with coffee with my dear, counting our gratitudes and  mapping out the day.

By 6:45, two boys are on their way to high school, and depending on the day of the week,  up to four more members of the household are out the door by 7am, on their way to work or school.

I have fifteen minutes to check email and answer any texts that came during the night before waking the youngest, getting her ready for school and out the door while getting myself ready for the work day ahead.

Morning prenatal appointment at 9am, followed by an hour of phone time. I check in with mamas who had doctor appointments in the last couple of days, check in on the two mamas who had babies last week to see how they’re doing. In the afternoon, I have an hour for updating my records on the computer, getting insurance invoices together while I eat lunch, a phone consult with a doctor at 1, and a new client interview at 2.

3pm, I pick my daughter up from school, come home to say hi to the boys, oversee homework, and then get the grocery shopping done for the next few days.

Back home at 5, I start dinner for the family. We sit down together, our family of 8, as often as we can. Afterward, depending on the day of the week, I might have a client appointment, or a class to teach. There’s navigating the picking up and dropping off at various lessons. On other nights, there are choir concerts, school plays, PTA meetings.

Back home in the evening, there’s laundry to be done, household needs to be tended, and precious time to spend with my beloveds. In the spaces between, there are bills to pay, a dentist appointment, errands to run, a movie I want to see, friends invited over, family members to connect with, and so on.  At the end of the day, today’s undone “to-do’s” are added to the top of tomorrow’s list.

Lather, rinse, repeat.

Or, none of the above. Any day, any time, no matter what I may have planned, I could lift right out. When the “come now” call happens, at least once a week, my life screeches to a halt as I make a quick change, grab my birth bag, and get in the car. I might be out of bed in the middle of the night. I greet the sunrise through a hospital window,  bleary-eyed, having spent the last twelve hours with a laboring mama. My sitter gets a 6am wakeup call, asking her to step in where I cannot, to tend the morning in my absence. My clients get last minute calls to say that I won’t be seeing them today. My family might move through the day without me, while I miss the school play, the dinner guests, or the tucking in at night.

I’m often asked, “Isn’t that hard? How do you do it?”  In my view, I’m the lucky one – I’m getting to do as I love. My family’s needs for food, clothing, and shelter are met by my getting to live my passion. Sometimes, I might have a pang of, “Oh, I wish this was happening on a different day”, but when I’m present at a birth, most of the time I’m not thinking about  being anywhere else.

Committing to someone’s birth means giving them the privilege to take the reins over a day in this precious, beautiful life of mine. I get the blessing of being part of a miracle. It’s my family that pays the price. It’s the people I love who have learned that I may or may not be home when they get here. I may or may not be at the concert, the Halloween parade. The boys might have to make dinner. The laundry might wait yet another day. My kisses  and “Good night, I love you” might be by text. It’s my dear friends who accept that I may not make it to the birthday party. Inviting them over is always iffy. My mother’s phone call to ask how I’m doing might go unreturned for two days. That these who are so dear to me love me anyway is my greatest treasure.

Without their acceptance, flexibility, and support, I couldn’t do it at all. For the people who love me, I am truly grateful.

 

Beware the Hive Mind!

A stranger on the internet says: I chose a great birth center to have my baby in, but as of this morning they say that I’ve risked out. I don’t want to have my baby in the hospital. So, I’m reading a few things about unassisted homebirth, and I’m thinking that my husband and I can do this ourselves. We’re planning to call the paramedics when I’m delivering so that they can be there to help.

A hundred people in reply say:  Heck yeah! That’s a great idea! You can do it! Don’t let them bully you!

Another stranger on the internet says: My sister’s doctor says that she needs to be induced tomorrow. I’m trying to talk her out of it. How long should I tell her she can wait?

Another hundred people say: Tell her not to show up! Wait as long as she wants. I know someone who went three weeks after her due date, and she’s just fine!

And here on the other end of the screen, I sit on my hands.

I can’t believe that I even need to say that this is a bad idea on so many levels.

We have NO other information about these mamas. We don’t know why the practitioner that she knows and has chosen to trust with her medical care is advising her to make this decision. We don’t know what her birth center has said, or why the OB is concerned enough to think that the baby is suddenly safer on the outside. We know nothing of test results, or mama’s health, or signs that the baby may need help.

As a birth community, when we advise blindly to ignore medical recommendations, we are just as much in the wrong as the practitioners who apply all interventions to everyone regardless of need.

As doulas, childbirth educators, or even online birth junkies, it’s great to encourage and support. Mamas no doubt need the community around them who is willing to say “You are so strong! You can do this!”  Yes, we are in this together seeking to learn, and sometimes, we might know information that is relevant and useful.  However – these decisions should never be left to the opinion of strangers on the internet. When we cross the line into saying, “Don’t listen to anyone!”, we are taking the risk of jeopardizing the wellbeing of a mother and baby we don’t know. This is a serious breech of ethics.

We may be a lot of wise women, but we do not possess the collective wisdom to know what is best for a person that we have never met, that we cannot see, who has been advised by a practitioner that we don’t know, about medical facts that haven’t been shared.

My answer?

Mama needs to talk with her practitioner. Ask the benefits. Ask the risks. Ask the alternatives. Ask if doing nothing is an option. Then, make her own best choice. No hive mind needed.

 

The Birth of a Mother

 She is standing, swaying, breathing deeply when the surge from deep in her womb begins to build like a wave. As her belly tightens, her hands grip her beloved, her face tenses, and she begins to moan. Rolling her hips, eyes closed, groaning deeply with each breath, she works through the intensity as the wave begins to subside.

“That’s it, mama. Good. Just like that. That one is done. Let that one go. Rest in between”, I say softly.

She’s been laboring for hours. When her birthing time began this morning, she was antsy with excitement when she called to let me know. She’s been preparing for this day for months. She read all of the childbirth books, the baby care books, made lists of names and things to buy. She had taken weeks of classes, and for the last several days was well past the point of taking in even one more word. She had become a weeping ball of baby and impatience. Now the time had come, and “ready” didn’t even begin to cover how she felt.  She was chatty and bubbling as she talked through the contractions that she described as “really strong”. I thought to myself that if she was still able to talk, she had no idea yet what “really strong” would look like. That moment had yet to come, though it surely would.

The mood has shifted now. There’s no more chatter – only intervals of hard work and of rest. The daylight has passed, leaving the room dark and quiet. The intensity that she feels in her body is breathtaking, consuming all of the energy she has. I hear the subtle shift in her breath that signals that the next wave is beginning.  She’s hot and trembling, and nauseous and exhausted. This isn’t fun anymore.

“You can do this. You already are”, I whisper. “Your body knows how. Your baby knows how. All is well. Everything here is exactly right.”

The word “labor” means work. The work of labor is to open. It’s the opening of a mother’s body, her flesh and her bones, to make room for the baby to pass through. It’s the opening of her heart, to love this new human being deeply and unconditionally. It’s the opening of her relationship with her partner, to love one another in this new territory of parenthood. It’s the opening of her life. It’s the wide-open stretching of all that she is, to become born anew in the next step of her life journey.

As I hear her moaning grow deeper, I know before she does that the moment of meltdown is now drawing near. It always does – in hundreds of births before, I’ve seen that every birth has one. We are closing in on the time when she will reach the edge of her very being, and will need to call upon every resource that she has. It’s the moment of “I can’t do this anymore! That’s it, I quit! I’m done, no more!” Sometimes it’s loud and tear-filled, sometimes the words are spoken only in a whisper, and sometimes, it happens silently in her head. I don’t know what form it may take – I know only that it will happen. As part of her labor, it must.

This phase of the last few hours of pregnancy is a time of in-between. It is neither here nor there – on the verge of bringing forth life, a mother is at once her old self and her new self. One foot is in the only world she has ever known, and the other is in a new uncharted territory. Standing at the edge of a new life – it is a moment both welcome and terrifying.

The medical, clinical, scientific terms for this window of time are easy enough to learn – transition, contractions, oxytocin. Websites are full of advice that says, “The good news is that if you’ve made it this far (without medication), you can be coached through this stage with constant reminders that you’ve done a good job and your baby is coming soon.”  The messages are always that what is happening in this moment is temporary and insignificant, so don’t wimp out. Lighten up, honey, you’re just having a baby.

What’s missing from our language, our culture, and our scientific understanding is reverence.  To give birth, whether birth happens at home in a tub or in an operating room surrounded by beeping machinery and medical personnel, a woman must journey to this place between the worlds. This meltdown is the work of her soul as she approaches the place where the veil between-here-and-there has grown thin, to reach through and bring back with her the new soul that she has invited into her life.

When we allow the reality that the heart of this holy moment is spiritual as much as physiological, we create room for awe and wonder. Whether or not those who surround her recognize it, to be present with a woman in this time is to stand on sacred ground. This uncertain phase of in-between is a necessary event, essential to the rebirth of a woman as she becomes Mother. It is an ancient understanding that the midwives once knew, now forgotten and shrouded in the quantifiable measurements of thinning and dilation.

This is the transition of modern civilized woman into primal birth goddess.  Logic, ration, and reason melt away. The intellectual medical vocabulary of hormones and timing and measurement become useless and without meaning. There’s no thinking, no pretense – just the genuine, undiluted energy of a woman giving birth. It is raw and powerful. Though profoundly beautiful, it is intense and sometimes unlovely.

My hands press her hips, stroke her back, smooth her hair, as she chants “I can’t, I can’t”. She can do it, of course, just as her mother and sisters and a thousand grandmothers before her have done. This is the sacred struggle of every laboring woman, standing toe-to-toe with her own fears as she battles through her resistance. It is the time when every thought she carries that no longer serves her, every story she’s heard that has undermined her belief in herself, every fear she’s never voiced is released. They are shed through her tears, her sounds, her fluids, and her blood. She quivers and shakes with the energy and the effort of letting go; of sweet surrender to the life force larger than herself. This round, weeping woman is battling her own monsters as she undergoes the alchemy of complete transformation.

She has reached the magic threshold where she makes the inevitable choice, as women throughout time have done, to take just one more step into the mystery. She becomes all elements embodied; the pure channel for a new soul to emerge from the waters of her belly, through the ring of fire, arriving on Earth to take her first breath. She returns from the brink, victorious, with her wet, squalling newborn daughter naked on her skin, and her newly-born mother-self rising up as never before.

I watch her face, moments before twisted in pain, become alight with joy and ecstasy as she falls in love with her tiny baby girl. “You’re here, oh look, you’re here! You’re so beautiful! I love you!  We did it!” It hasn’t been easy, but it has been worth it. It always is. She knows, now, down to her bones,  in a way that can never be taken from her, the story of her own courage and strength.  She is not a “poor thing” – she is a mighty warrior.

I am grateful today for her safe passage as she joins the sisterhood of women who have traveled this rite into motherhood. I am grateful to be part of the sisterhood of women for whom holding space for this time of in-between is their life work, just as it was for my great-aunt midwife before me, and countless hundreds before her.  I am grateful, always, for the opportunity to offer love and affirmation in the face of such vulnerability, for the gift this birth has given me to witness a woman reaching the end of all that she thinks she knows, and to see her through to the other side. I return home knowing that I have, once again, been witness to a miracle.

 

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This is Not the Doula You’re Looking For

Have you ever heard a “bad doula” story? Chances are, if you’ve been in this field any time at all, you have at least once. She crossed a line, rubbed somebody the wrong way, didn’t do what was expected, things didn’t go as planned… In her own version of the story, the doula may have put her best foot forward. Sure, sometimes we all make mistakes. That’s part of learning and being human. It might also be true that, no matter what she did or didn’t do, this story was not going to have a good outcome in the end.  Not every doula is a good fit for every mama.

As we learn, grow, and hone our skills, a really important lesson comes in the form of knowing when to say, “I’m sorry, I’m not the right doula for your birth.” It’s not easy, especially in the beginning. A new doula is excited to have an opportunity to serve as many as she can. She’s eager to meet with new clients, and willing to stretch herself as much as possible to make her mamas happy. The thought of turning a client away is fear-provoking. She needs the experience, wants the income, and has in her heart a desire to be helpful.

Eventually, the lesson comes that we, as birth workers, are responsible only for our commitments. We are not responsible for our clients feelings, or the choices she makes, or her struggles. We are not responsible for whether her birth meets her own expectations. Nor are we responsible, though our egos love to think so, for her joy. We are accountable for our integrity – for doing as we say we will, when we said we would. Nothing more, nothing less.

A big part of showing up in integrity is knowing ahead of time what we can and cannot do. Saying, “That’s beyond my ability”, especially the first few times, is terrifying. The hamster wheels in our head get to spinning. We may think, “What if she doesn’t like me anymore?  What if she doesn’t hire me?  What if she tells her friends, and then I get a bad reputation? What if she doesn’t find someone who is right for her?” We worry about creating stories of abandonment, or hurting feelings. Doulas are, at the heart of the matter, compassionate people. But, if we truly long to help not just this mama, but the many who may come after her, knowing when to say “no” is truly an act of service within itself.

If we take on the responsibility for the journey of a woman’s pregnancy and outcome of her birth, we have robbed her of the opportunity to claim her own responsibility in creating her birth story. Denying a woman the power of using her own voice and strength is the greatest disservice we can do. The “bad doula” that you’ve heard about?  Chances are that she was speaking for the mama instead of encouraging the mama to speak for herself. It’s likely that she was holding herself accountable for this birth, instead of holding herself responsible for support. She showed up in combat gear to do a peacemaker’s job.

On my own doula path, I’ve come to recognize a few red flags that let me know clearly when I’m not the right doula.  Other doulas may have their own signals. A few I’ve come to recognize are:

If a mama is…

hoping that hiring a doula is all she needs to do to have an unmedicated birth

not interested in taking childbirth classes or reading books (at least one or the other)

learning all she needs to know from watching birth shows on TV

suffering from unresolved trauma, panic attacks, or debilitating anxiety for which she is not seeking other professional help

working with a doctor she hates and is unwilling to change practitioners

working with a practitioner who has made it clear that he or she doesn’t want to work with doulas

delivering in a facility that has strict policies against what she wants, and she’s unwilling to go somewhere else

planning to accidentally have her baby at home without qualified support

wanting to have uninterrupted hands-on doula support from the time her first mild or erratic contractions begin (even when it’s clear that birth may be days away)

truly terrified of giving birth at all, with or without medication

wanting to be told what to do, rather than given her options and asked for her decision

wanting to be protected from an abusive spouse or family member who will be present for her birth

… then I’m not the doula she’s looking for.

This doesn’t mean that I don’t care. Rather, it means that in knowing my own limits, I’m in a much better position to say “here’s someone else who might be able to really help you”. Maybe I send her toward a great therapist, or a support group, or even another doula who specializes in exactly what she’s looking for. Sometimes, saying “I’m sorry, but no” is the best support that I can offer. Is it easy?  Heck, no. My hands sweat and my knees shake, every time. But in the end, I know that in the temporary disappointment for us both, I’ve offered her far greater support than I ever would have if I’d have made a commitment I knew I couldn’t honor. I sleep with a clear conscience, she has the opportunity to get the support she really needs, and all will be well.

 

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Give Me an Epidural Right Now!

Almost every mama I talk to says that she wants to have an unmedicated birth, or at least wants to get as far as she can without medication. Most of the time, that’s exactly what happens. My epidural rate is less than ten percent. As part of the support team, I give my word that I’ll pull out every tool I can to help. The question I am always sure to ask, though, is: “How will you let me know if you’ve changed your mind?”

Sometimes, this will catch someone off guard. Why would I ask about her changing her mind if I believe in her and will support her through her birth? The answer is simple. I ask so that I can be fully supportive. I want her to have the power to make her own decisions with this birth. Deciding to use or not use medication is her decision, not mine. I want her to have the freedom to say whatever she wants to, and do whatever she decides is right. Do I think she can do it without an epidural? Absolutely, I do. If natural birth was impossible, the human race would have died out long before now. But, when all is said and done, I want her to know that she did it for herself, not because of anything I said or did.

Every mama who has ever had a baby has reached that moment when she says, “That’s it. I’m done.” It might happen out loud (very loudly), or it might be only a passing thought in her head, but it does happen. It’s a very charged moment – it’s usually when she’s in the most short and intense part of the labor process, often right before her body begins to push. Physically, this is when contractions are the strongest, longest, and closest together they will be. Getting through them one at a time requires a lot of focused effort. Neurologically, this is when rational thinking part of the brain has shut down, to allow the hormones of labor to do their work. Emotionally, it’s the moment when she has reached the threshold of the only life she has known, and is at the no-turning-back point, stepping into the foreign territory of life as this new person’s  mother. That’s a huge step, and it’s normal to have strong feelings of resistance, doubt, insecurity, and fear come up. I want a mama to have the safety and freedom to express her doubts and fears, to know that she is seen and heard, without holding back because she’s afraid that her desires for natural birth will no longer be supported. I want her to know that she can experience and release these feelings however she needs to, without anyone doubting her strength by offering drugs.  If that means that she becomes silent and centered within herself, that’s wonderful, and if she instead chants, “Give me drugs!” and “What was I thinking?” through every contraction, so be it. Coping comes in many different forms. She is free to do whatever works for her.

I want every mama to have the autonomy of knowing that a natural birth is something she chooses to do. Nobody is forcing this on her. Knowing that this is her choice allows her to believe in herself and experience her own strength. Yes, it’s hard. It hurts, and it’s work. She can do it – she already is. Nothing she can say will make me doubt her ability to get through this. For me or for anyone else to say, “You know, you can have an epidural if you want to” undermines her own power. I won’t do that.

I also want her to know that she has the right to change her mind, and that if she does, she will not be judged, shamed,  or abandoned. There are situations in which medications or anesthesia are exactly the right tool. That’s not all of the time, certainly, and probably not even most of the time, but there are circumstances when an epidural has made the difference between having a vaginal birth or having a cesarean.

Likewise, I will not stand in the place of telling someone that she cannot have anything she is asking for. I don’t control anyone else’s choices with her birth, ever. It would be nothing short of abusive to say, “No, you told me to tell you ‘no’ if you asked for medication. You said you didn’t really want it.” That would be my taking on a power that doesn’t belong to me in her birthing space.

So, we come up with a plan. I ask, “What do you want me to do if you say, ‘Give me drugs right this minute’? I already know that right now, that’s not the choice you prefer, and I will support you through every moment. I know you can do it. So, if you tell me that you’ve really changed your mind, what do you want me to do?” We talk over the possibilities.   I can go get the nurse.  I can offer to step out so she can talk it over with her partner. If she’s very close to giving birth, we might talk her through the necessary steps of making that decision, with the awareness that by the time all is said and done, her baby will likely be here.  (That might sound like “ok, first the nurse will need to hook up your IV, and that will take about 20 minutes to complete, then they’ll call anesthesia. It’s about another 20 minutes to get the epidural in place…”) Would she like for me to empathize that this is hard, and tell her that she’s doing it just right? Would she like me to suggest something else? (“Let’s get through this one first, and get you in a better position. Then we can talk through it if you still want to, you just let me know.”) We might decide in advance on a way that she will let me know – a code word, a phrase – that she has 100% changed her mind and there’s no conversation to be had. (If a mama tells me “I’m at red”, it means “we’re not even talking about it, call someone in here now.”)

The benefit of having this conversation in advance is that once we’ve come up with this plan, we hardly ever have to put it into action. There’s a clarity that comes with the knowing that this birth belongs to her, that she’s calling the shots with her own body, and that her desires will be taken seriously. Thinking through the possibilities and having a contingency plan in place allows her to have the peace of mind that comes with knowing that she can change her mind if she wants to, and that will be respected. Then she is fully able to release, surrender, trust in the process, trust in her body, and get through it in the way that feels exactly right to her. As her doula, that’s the best I could wish for her.

 

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I Support You

I am a doula. I have worked with over 400 families.

I have known  mamas who breastfed easily, who cherished their nursing relationship.

I have known  mamas who struggled with babies who wouldn’t latch or wouldn’t gain weight, and breasts that never produced milk.

I have known mamas who chose to formula feed out of medical need.

I have known mamas who chose to formula feed from the beginning.

I have never known a mama who didn’t care that her baby was fed.

I support you.

I have known mamas who have birthed peacefully with no medication or intervention.

I have known mamas who struggled with labor that didn’t go as planned or hoped for, changing their course of action in the moment.

I have known mamas who have had cesarean births out of emergency.

I have known mamas who have chosen cesarean birth.

I have never known a mama who didn’t care that her baby was healthy and safe.

I support you.

Breast or bottle, vaginal or cesarean, co-sleeping or crib, stay-at-home or work-outside-the-home… It’s time to end the Mommy Wars. You love your children. Your heart swells with joy when they smile, and breaks when they cry. You worry, I worry. You toss and turn when all is not well, just like me. You hope that you’re doing it right. So do I. You care deeply that he or she is healthy, strong, loved, compassionate, and a functional adult who is an asset to the world when all is said and done. You’re doing everything in your power to make it so. Me, too.

For this, I support you.

Join me in supporting the I Support You movement. Find out more from Mama By The Bay, here.

What Your Doula Wants You to Know

This Spring marks the 14th year that I have been serving families as a doula.  In attending many births and in networking with other doulas during these years, it seems there are a few things that every doula would like for her clients to know. So parents, if you are using a doula for your birth or are considering hiring a doula, here are some thoughts to keep in mind.

Keep me in the loop. You have hired me to attend your birth, and I’m really looking forward to that. It’s important that you know that a big part of the support that I am able to offer you begins long before labor does. Please don’t hesitate to reach out to me. I’m here to be your “walking birth wiki”. I’m way less scary than Dr. Google, and I love to talk about birthy stuff. Pick my brain. Ask me questions. I will offer you information, share my resources, give you encouragement, and lend an empathetic ear to your concerns.   I especially want to know if you go to the hospital for any reason, or have something happening that you are worried about. It’s good for me to know what’s on your mind as you prepare for your baby, because this might come into play with your birth experience. Keep me posted about what’s going on with your prenatal care. Even if it’s just a note that says “Hi, we’re all great!”, I want to hear from you. It’s never “bothering me” to call. No apologies or guilt necessary. I’m going to let you set the pace for our communication; call me once a day, or call me once in pregnancy – that’s up to you. Everybody’s needs are different. I’m going to trust that you know that I’m here, and that you are reaching out as much as you need to.

Understand my role. You are the boss of this birth, and you have hired me as your doula.  This means that I don’t get to tell you what to do. You tell me what’s right for you. As an experienced doula, I might have relationships with your doctor, midwife, nurses, or hospital. With any luck, they are good relationships, and our being on a birth team together is something that will enhance your experience.  Providing non-medical labor support is my role on the team. I will do all I can to help you give birth the way you want to, while respecting the medical professionals and the rules of the birthplace you have chosen.  I am not there as a bodyguard or a bouncer. I don’t arrive prepared for combat.  I cannot throw myself between a woman and the doctor who is about to break her water. If I tried that, they would throw me out and never let me or any other doula come back. I want to support your birth, and I also want to be able to show up for the next mama who plans to birth there. So, I won’t speak to your doctor on your behalf. I don’t get to tell them what you will do. You certainly may, though. What I will do is remind you of your goals. I encourage you to ask questions that help you gather information, so that you have clarity to make your own decisions. I stand behind you in exercising your right to use your own voice to speak up about what you will accept or refuse.

Set yourself up for success. If you really want to have a low-intervention unmedicated waterbirth that’s “as close to a homebirth as possible”, then the big teaching hospital with a 95% epidural rate and no tub is probably not the best place for you. Chances are pretty good that if you choose to give birth there, the birth you want isn’t going to happen. Make sure that your birthplace and your birth attendant are a good fit for what you have in mind. You, as the consumer, have a choice. Look into the facilities that are available to you. Ask what options they provide, and find out what they offer to support you in creating the kind of birth you want to have. The same is true for choosing your doctor or midwife. The practitioner who says, “Ugh, I don’t like doulas” isn’t very likely to be into the idea of other requests you make, either. Take personal responsibility for learning the rules of your attendant and your birthplace. Though I, as doula, may wish the highest and best for you, my being present will not protect you from factors that come with the territory of the location or practitioner you have chosen.

Prepare yourself for your birth.  It is up to you to take charge of readying yourself as fully as you can for birth in body, mind, and spirit. Participate in good classes, educate yourself about birth options and coping skills, and take excellent care of your body and your mental and emotional health. Seek out the support that you need to do this. Your power is already your own, whether you choose to claim it or not.  It  is not mine or anyone else’s to give to you or to take away from you. I do not empower your birth. I do not advocate for you.  I support you in learning to empower and advocate for yourself. Likewise, I know a lot about having a baby, but I am not having your baby. I can make suggestions for positioning or comfort measures, and help you remember all of the ways that you have learned to cope with the intensity of labor. I can encourage you to ask for what you want. I cannot guarantee you that your birth will be easy or uncomplicated. Labor is hard work, whether you have a doula or not.  Birth is unpredictable, even when you’re well-prepared. When all is said and done, you are the one responsible for your choices. You are the one who will go through this process to become your child’s mother. Prepare yourself to surrender and release, and let your mind, your heart, and your body be open.

You have my unconditional support. This is your birth, not mine. My priority is to see that you know what your options are, and that you are informed in making your own best choice. I want to understand your hopes, fears, and goals for this birth, so that you feel seen and heard. When I ask about these things, I want your deeply honest answer. Please don’t concern yourself about the “right” answer, or what you think I want to hear.  I will offer comfort in whatever way I can to help your experience happen in the way that you hope for. I will remind you of the wishes you have shared with me, and give you encouraging words and hands-on support if you want to have a drug-free birth. I believe in you, and I know you can do this. I will not leave you if you change your mind and decide that pain medication is the right option for you. I will not judge you for the choices that you make. This is your body, your baby, and your birth. I trust you to make the best decisions for yourself. If something happens differently than what you had hoped or planned for, please don’t apologize to me. You have my support when you are scared. You have my support when you think you can’t do it anymore. You have my support when you are crying. You have my support when you are angry, or irreverent, or unglued, or unlovely. You have my support in your joy.  This is your birth. I’m here for you.

Our relationship will change. I love being your doula. I love the whirlwind courtship of getting to know you well in a short time. I love hearing your stories about your life,  the births of your children before this one, the story of how you met your beloved, the story of your own birth as your mother told it to you. I ask intimate questions that perhaps you hadn’t even thought about before, about your hopes and fears, and how you cope with overwhelm, and what makes you feel safe. More than anything, I listen. Toward the end of your pregnancy, we may be talking once a week. In the last few days, we might be checking in every day.  I might not ever know the names of your siblings, or where you grew up, or any of the other things your friends would usually know, but by the time your baby is born, we have forged a bond that is close, and real, and beautiful. Then, after your baby is here and you are settled in as a new mother, I don’t see you much anymore, and we hardly ever talk.  Please don’t take it personally. Know that I still care very much, even if I probably won’t make it to your child’s birthday party. Our relationship as doula and mama happens for a finite period of time. I miss you. I still love you. I cherish the memory of the time I have shared with you, and now I’m offering that same support to my next mama. I’m just as busy with her as I was with you. This is what doulas do.

I will always be grateful. Thank you for allowing me to serve as your doula. I would say thank you every day, if I could. Thank you for inviting me into your life, your home, your birth space.  Thank you for trusting me to witness the birth of your child. Thank you for the honor and the privilege of caring for you through this part of your life. Every birth touches my heart. Every birth brings a lesson, and I am grateful for the learning that comes from your birth. I am grateful for this place where our paths crossed, and our life stories are woven together for this short while.  Thank you always, and blessings on the journey.

 

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Dads and Doulas

By now, it has become pretty well known that doula care provides plenty of benefits for mamas and babies. Women who birth with doulas on their team have lower c-section rates, use less pain medication, are less likely to need pitocin or intervention, and feel happier overall about their births.*  As well and good as that may be, it’s very normal for dads to wonder, “Ok, so what about me? I’ve read the stuff I’m supposed to, and went to the classes, and I think I’m going to do a pretty good job. What am I, a third wheel?”  Sometimes, dads are a little embarrassed to even ask this question – it seems that many think it at least a little bit, and yet they all wonder if they’re the first to have this thought. Really, it’s ok, I get it.

The thing is, in the last twenty years, dads have become more involved in birth than ever (as in, more than ever in the history of “ever”.)  This is a great thing – mamas need the comfort, companionship, and support of the partners who love them, especially in a time that’s as vulnerable as birth can be. Our current system is still figuring out what to do with this, and while the system has come a long way, the kinks aren’t quite all worked out yet.

There’s a pretty huge set of expectations for partners and husbands these days. You have nine months to learn to speak fluently the language of labor support – “surges”, “waves”, visualization,  counterpressure, what will help, what will hinder, what to do and when to do it. Meanwhile, you are also learning to speak fluently the language of “Hospital” – intermittent monitoring, hep lock, cord clamping, Erythromycin. You’re in a strange room, with unfamiliar equipment all around you, each piece of which beeps and dings at random intervals (Is that a “this machine is out of paper” ding, or an “emergency-come-here-now” ding?) Chances are, the birth of your own child is the first (or maybe second or third) birth you will have ever seen. There’s a lot that happens in normal birth that isn’t very normal in any other context – there’s some pretty primal moaning going on, and hot flashes, and cold sweats, swearing, and blood, and fluids, and throwing up.  The doctor or midwife and nurses will be there, but they’re usually only in the room for a few minutes at a time, with hours sometimes passing in between. You might be at the hospital for a very long time, and chances are that at some point you’re going to get tired or hungry.  Let’s just throw into the mix, while we’re at it, that while her instinctive  brain tells her body to go into groaning-baby-having mode, your instincts might be more inclined towards “Protector mode” (another human instinct, left over from the time when this meant standing outside the cave with a big stick, ready to keep away saber-toothed tigers).

So, putting this all together: On one of the most important days of your life, you are completely responsible for remembering everything you’ve learned, providing comfort and support to a woman in the intense throes of labor, communicating all of the important stuff your beloved wants you to remember, in a strange place, with unfamiliar faces, with a whole lot of potentially nerve-wracking stuff going on, ALL WHILE PREPARING EMOTIONALLY TO SEE YOUR CHILD’S FACE FOR THE VERY FIRST TIME. You’ve got one shot at this, and you’d better get it right. No pressure. Good luck.  Not a very good set-up, is it?

Now, consider what having a doula will do for you. She knows all the labor support tricks, and will suggest the ones that are likely to work. She’s talked with you and the mama about what’s important for both of you for this birth, and will help you remember who to tell and when to tell them. She’s  going to talk you through any of the parts that make you a little nervous. She knows the machines well enough to tell you which beeping thing is which. If she’s familiar with your hospital, she knows their rules, and she probably knows your nurse and your birth attendant. She knows where the vomit basins and the extra towels are. She knows when to say, “This is normal. You’re doing fine.” Your doula has no interest in being in the spotlight, or stealing your mojo. She’ll cover for you if you need to go eat, or make a phone call, or catch a power nap.

The love that you are able to provide for the birthing mama is immeasurable. The connection between the two of you is one of the most important things going on in the birth room. Your doula helps take the pressure off, so that you can show up and love your wife and your baby fully, in the way that only you know best. If the two of you need some alone time together, that’s fine. Your doula won’t mind. Likewise, she’ll probably also be pretty skilled at knowing when to gently step in for a little more support.

Dad, here’s the thing:  I think you’re going to be fine. I have no doubt that you’re going to do a great job. I’m not there to watch and tell you what you’re doing wrong – I’m there to see that you don’t feel lost in the shuffle. We’re in this together,  in a way that is going to benefit you, the mama, and your baby.  Think of your doula as part of your tribe, your walking Birth Wiki, and the best wing-chick you will ever have.

Go team!

 

*(DONA 2001)

More Like This, Please

Let’s play a little game together.  Right now, where ever you are, I want you to take a moment and look around the room you’re in, and find everything you can see that is the color green. No matter how big or small it is, look for and notice as many green things as you possibly can. I’ll wait.

Did you do it?

Good.

Were you surprised by how many green things  you hadn’t really seen before? Maybe little details started popping out at you, like a tiny leaf in a picture, or a pencil eraser, or a paperclip. Did you also notice how your mind started to draw your eye to things that were a shade of blue or grey or yellow, that were almost green?

Now, let me ask you, without taking a look around again:  While you were looking for all of the green things,  how many things did you see around you that are red? My guess is, not nearly as many as green things, right?

Now, take a look around for the red things. Oh, look!  They’re all over! And how about the oranges and pinks and purples that are almost red? There they are!

This works anywhere. It’s the same thing that happens when you begin to drive a new car, and it suddenly seems that there are so many more of that same car on the roads than there were before you drove one. Or, when you first learn that you’re having a baby, and suddenly pregnant bellies are everywhere. So, why does this happen?

It’s really all a matter of where we allow our attention to go. As human beings, our brain is capable of taking in far more information than we can consciously process all at once. So, we take more  notice of what we choose to pay attention to.

  Where we choose to focus our attention determines what we notice more of. It’s like listening to music while sitting at home – we notice the lyrics and the sound of the notes far more than we notice the sounds of the floorboards creaking, and the wind blowing outside, and the fish tank bubbling in the corner, and the dishwasher running in the next room. All of these things exist, and we can hear all of them at once, but where we’re consciously choosing to place our attention is on the music we’re enjoying.

Now here’s another one:  I invite you to remember a moment in the last six months when you felt truly content. It can be anything. It doesn’t have to be a major life event. It can be as small as getting a hug from a good friend, or taking the first bite of a truly enjoyable meal. Remember what it felt like to be in that moment. As you  focus on that memory, recalling exactly how right and good you felt, I invite you to notice the response to the recalling of  that moment that happens in your body.

  Maybe you noticed that the tension in your shoulders released a bit, or your breathing became a little softer and deeper, or your heart rate slowed down and you sighed. Even though this particular moment may have happened weeks ago,  you were probably able to feel a little more content, like you did then, just by thinking of it again.

Where we choose to place our attention determines what we see, or hear, or feel more of, right now. An interesting effect follows this – just like noticing the “almost greens” – where our attention goes, our intention follows.  This means that when we’re making the choice to look for more positive experiences, we begin to actually experience more positives, simply because we began to notice them. It’s almost as if a magic switch inside of us gets flipped, and suddenly more and more good begins to come our way!

The possibilities for more peace, less stress, more joy, and more well-being exist around us all the time. When we notice happiness, we begin to live in more happiness. When we notice  kindness, we experience more kindness. When we notice more peace, we invite more peace. We can choose this consciously, every day, at any time, by saying “in this moment, I choose now to feel more like I did when…”, and it works.  In time, this becomes habit, and can be life changing.

We can intentionally nurture this way of living by simply beginning to notice the moments in which we are already feeling joy, comfort, love, safety, awe, and wonder. Catch yourself in moments of feeling good, and simply state, “More like this, please!” Notice what this good feeling is like in your body – your soft shoulders, your relaxed jaw, the open feeling in your chest.

Choose to consciously anchor this feeling as a clear memory, so that you now have it in your memory banks to call upon. It doesn’t really matter whether the moment you are choosing to anchor is a big, “Oh, WOW!” or is simply that moment of calm pleasure when you walk outside and notice that the air is warmer than it was yesterday, and the breeze feels nice. “More like this, please”. It’s a way of directing of your attention, and a focusing of your intention, and expressing a willingness to experience even more that is just like that.

For a  positive and empowered birth (or parenting or relationship or business or life) experience,  begin noticing the positives that surround you now, and claim them for yourself. Notice the things that are already like exactly what you hope for.

Begin with “I am at peace”, and notice the moments of peace, even in the stressful day. Affirm to yourself, “I choose joy”, and notice the happiness. Focus on “I am loved and appreciated”, and count all the colors and forms that love takes in this day.  Declare “I am safe”, and notice the calm, and the trust that grows.  They are already there, already within and surrounding you, and always available.

Embrace the power of making a conscious choice, and watch it begin to happen. It is up to you to see them, just like all the shades of green.

More like this, please!