Archive for the ‘pregnant’ Category

A Guide to Finding Your Doula

Tuesday, August 2nd, 2011

Building a labor support team is part of conscious preparation during pregnancy for your labor,  birth and life with the very newborn. Hiring a labor doula continues to gain in popularity for the expecting family. Your doula comes alongside you in pregnancy through labor and delivery with some additional early postpartum follow-up.  For additional after birth support, a postpartum doula is a great addition.

Step 1: Finding a Doula

  • Inquire with friends, family, local support/informational groups (for example – ICAN, LLLI, Birth Network, Birth Circle, Cloth Diaper store), childbirth educators, care providers, prenatal massage therapists, prenatal exercise instructors, lactation experts and chiropractors for referrals.
  • Use your favorite search engine and type in your city or area name with the keyword doula
  • Search training and certifying organizations such as CAPPA, DONA, ICEA ToLabor , Birth Works and Birth Arts International
  • Search general doula sites such as All Doulas, Doulas.com, About.com, Doula Match or Doula.com

Step 2: First Contact

Once you have located local area doulas, the next step is  to make contact. You will likely find that most doulas are women though occasionally you will find a male doula in your area.  After visiting any websites; phone or email only the doulas that most interest you and fit your particular needs.  Generally there is not much need to contact more than three perspective doulas.

During your initial phone conversation or in your email be sure to include:

  • Full name
  • Contact information
  • Estimated Due Date
  • General location where you live
  • Care Provider
  • Birth Location
  • Top needs and desires for birth
  • If referred, by whom
  • Any financial considerations

Step 3:  Setting up the Interview

I encourage after the phone or email contact and response, set-up in-person interviews with the doulas you found most compatible with you.

  • Unless the doula you are meeting has her own office, interviews are usually held in a public place such as a coffee house, restaurant, library, park, or shopping center. If you meet at a place where beverages or food will be ordered you can offer to pick up the tab for everyone if you desire, but it is never expected.
  • Your partner, husband or other support who will be attending the birth needs to be at in-person interview if at all possible.
  • Expect the interview to be approximately an hour and to be free of charge.

Step 4: The Interview

The interview is to gain more detailed information from the doula, as well as, share more  about yourself and what you want.  It is customary for the doula to either email ahead of time her client packet or bring it with her to the interview. It may include her professional profile, client agreement, services, and support details, as well as, additional offerings.

Suggested Interview Questions:

  • Why are you a doula?
  • What is your philosophy of childbirth?
  • Where did you get your training?
  • Are you certified? Why or why not?
  • How long have you been a doula?
  • What is your scope of practice?
  • What types of births have you participated in?
  • What types of birth locations have you been to?
  • How many births per month on average do you attend?
  • How many clients would max you out in a month?
  • Have you ever missed a birth? Please explain why.
  • Do you specialize in working with a specific type of clientele or birth plan?
  • What has been the most challenging birth you have attended? Why?
  • How do you work with my husband/partner/other support?
  • Have you worked with my provider before? If yes, please describe the experience.
  • How many prenatal visits would there be?
  • In general, what is covered in the prenatal visits?
  • Will you help me make a birth plan?
  • Please explain how your fee is structured.
  • Do you accept barter?
  • Do you have a back-up and do I meet her ahead of time?
  • When do you go on-call?
  • Do you labor at home with me?
  • What do you do if I am induced or need to schedule a cesarean?
  • When will you see me postpartum and what does it include?
  • What are your expectations of me as a client?
  • How long do I have to decide before you would contract with someone else around my EDD?

Of course that is a fairly long list of overview questions. Brainstorm some of your own. The interview is not meant to be a free prenatal visit, it is simply to find out if you and the doula are a fit personality wise and in how she practices.  Most doulas do not expect to be hired on the spot. You  need time to think and process after each interview. If a doula is pressuring you to hire on the spot because she fills so quickly, that could be a red flag and cause for you to take a pause.

Step 5: Hiring the Doula

Within 1-2 weeks,  contact the doula you would like to hire and proceed and those you did not choose to let them know you have hired someone else so they will not be holding your EDD space open any longer.

Details to be clear about when initially hiring your doula:

  • Sign and return the agreement/contract she gave you at the interview (if applicable).
  • Return any intake paperwork by mail or email.
  • Payment  – First portion of fee is usually paid upon hiring a doula.
  • Ask her usual business hours and contact preference for non-emergencies or labor related needs.
  • Let her know your contact preferences and all phone numbers to reach you and your spouse/partner or other support.
  • Set the date and time for the first prenatal appointment. Give her directions if your home is not easy to find.
  • Get clarity on what routine contact she would like from you (updates after care provider appointments, etc.)

Happy doula-ing!

Wish List In 2011

Sunday, January 2nd, 2011

A clean slate. A fresh start. Hope and dreams reactivated. Passions toward change are stirred. All of this by the calendar rolling over from one year to the next. It is not just  anew year though, it is a new DECADE to set precedent in. To make a mark. Oh the possibilities and opportunities that are ours to reach for and accomplish.

In the spirit of all of this, I decided to make an #in2011 wish list on New Year’s Eve 2010 and with some help from a few friends here is what flowed out.

#in2011 breasts will be viewed as nurturing, comforting, and beautiful.

#in2011 the majority of women will be served under the midwife model of care for the majority are low-risk and will remain so.

#in2011 Childbearing women will be greeted with open arms by providers with their questions, needs and knowledge.

#in2011 pioneering social media women will gain even more ground in their work liberating childbearing women.

#in2011 delayed cord clamping and physiologic third stage will become the norm.

#in2011 doulas will be respected as educated, knowledgeable birth professionals by staff and care providers.

#in2011 childbearing women will be given opportunity not limited

#in2011 Those striving to improve the maternity system at the ground floor as educators will be mutually respectful and supportive.

#in2011 Doulas from all backgrounds and organizational affiliation will be open to one another, supportive, sharing.

#in2011 a woman with needs and opinions with not be marked for a cesarean because of it.

#in2011 Homebirth transports will be treated with dignity and respect.

#in2011 Stigma of mental illness and motherhood will be adsressed by every childbirth care provider. RT @WalkerKarra

#in2011 Childbearing women will not have to live in fear of their providers.

#in2011 We CAN change the world together for childbearing women. Put your words intro action.

#in2011 More birthing women will have low-intervention births that lead to healthier outcomes.

#in2011 Childbearing women will be seen, heard, respected and offered a variety of care options.

#in2011 there will be less imbalance of power between maternity patient and provider.

#in2011 childbearing women will rightfully claim their health records as their own -RT @midwifeamy

#in2011 we will wake up to and address the shameful disparities in access to and outcomes of maternity care RT @midwifeamy

#in2011 Less pointing fingers among insurance companies, providers & orgs that continues to feed this ever medicalized maternity system.

#in2011 I would like to see an equal playing field with accessibility to all to maternity research, guidelines, statistics…

#in2011 I would like see accountability for providers and institutions in their maternity care practices.

#in2011 I would like to see hospitals treat only the patients they serve the very best – high-risk or in-need mothers and babies.

#in2011 I would hope more women stop blindly trusting and do their own research for pregnancy, birth and postpartum.

#in2011 I would like to see arrogance leave the treatment room. It is not a personal affront for a patient to have an opinion and needs.

#in2011 I hope women are treated as holistic beings especially in pregnancy.

#in2011 I hope for care providers to be transformed into partners with their patients instead of authorities.

#in2011, I want to see care providers and family members taking postpartum mood disorders seriously. RT@smola04

#in2011 I hope women stop being treated with hostility and looked down upon for wanting something more in pregnancy, birth and postpartum.

#in2011 I would like to see more women receiving comprehensive postpartum care from their OBs and hospital based midwives.

#in2011 I hope that women will openly mentor those coming up after them to better understanding and expectations in birth.

#in2011 I hope social media efforts have even more impact on unveiling the hidden and progressing healthy birth practices.

#in2011 I hope less mamas are unnecessarily cut open in pursuit of delivering a baby.

#in2011 I hope to see midwives working together no matter the track they came up on. Being respectful and open.

#in2011 I hope to see women who have experienced amazing births be loud and proud sharing the good news without fear.

#in2011 I hope that midwives of all types will be fearless in their pursuit of their model of care for women.

#in2011I hope that hospitals and providers realize they need to offer individualized care to women and babies for the health of it.

#in2011 I would like to see women openly breastfeeding their children without shame or discrimination.

#in2011 A drop in the cesarean rate would be progress toward healthier practices.

#in2011 I want to see women in droves having their eyes opened and being fierce about the care they receive. About their maternity options.

#in2011 I would like to see less care providers offering up defensive and fear based medicine to their maternity patients.

#in2011 I hope for more accessibility to home and birth center births for women and babies.

#in2011 I would like care providers to view women as a sum of all parts, not a uterus growing a baby more valuable than she is.

#in2011 I would like to see more women taking charge of their care, taking personal responsibility and being powerful pregnant women.

#in2011 I desire more respect and autonomy for maternity patients.

#in2011 For women who want a VBAC to easily find an accommodating provider.

Is all this attainable in one year? Perhaps not, but pushing toward the positive and never taking the eye of the reason for all of this, the childbearing women and families, I do believe we can change the world and make the maternity care system as a whole a safer, healthier  and more respectful place.

What is on your 2011 wish list? If you would like to have it added here, leave a comment.

Reader Additions:

Kay Miller:

I hope that we (doulas/educators) can stop alienating the providers, instead partnering with them to provide the best care possible for the mamas and babies that we work with.
I hope that doulas/educators and providers can have mutual respect for one another, and realize the value of the care and support that each provides.
I hope that while we work to change the negatives of health care for pregnancy, birth, and postpartum, that we can remember to openly recognize and affirm the positives.
I hope that families will make decisions based on education and research, not on fear.
I hope that both “sides” stop using fear tactics to persuade families to make certain choices. A decision to home birth due to fear of hospital birth is still a decision based on fear.

The Best isn’t Better. Usual is where It is at.

Thursday, September 16th, 2010

There has been much ado surrounding the language of breastfeeding being normal and usual versus the best for baby and mother in great thanks to Diane Weissinger. It is so valuable to recognize that while we all desire to be the best, we often hit the normal everyday averages in life. We are comfortable reaching a goal that seems more attainable. Best or better can feel so far out of reach where average and usual seem quite in reach most of the time. None of us generally want to be below the average or usual. Thus the language of the risks of NOT breastfeeding is so vital.

I would like to see the same type of language revolving around pregnancy and birth as well.

In the overall picture here is the usual occurrence: Ovulation leads to heightened sexual desire, which leads to sexual activity, which leads to pregnancy, which leads to labor, which leads to birth, which leads to breastfeeding…..

So how do we look at language as an important part of our social fabric and belief systems surrounding this process?

Let us look at contrasting statements of what is often heard and how a positive point of view can be adapted.

Pregnancy is: a burden, an illness, an affliction, a mistake, something to be tolerated……

Pregnancy is: a gift, wonderful, amazing, part of the design, someone to grow…..

Labor is: scary, worth fearing, the unknown, unpredictable, painful, to be avoided, to be numbed from, to be medicated, to be induced, out of control, unfeminine…..

Labor is: what happens at the end of pregnancy, hard work but worth it, manageable by our own endorphins and oxytocin, an adventure, not bigger than the woman creating it, to be worked with, worth be present for, is what baby expects……..

Pushing and Birth are: terrifying, physically too difficult, only works for women who are not too small, short, skinny, big, fat, young or old, responsible for pelvic floor problems, out of control, horrible……..

Pushing and Birth are: what happens after dilation completes, to help baby prepare for breathing, bonding and feeding, sometimes pleasurable, sometimes fast, sometimes slow, able to occur in water, standing, laying down, squatting, on hands and knees, often most effective when a woman is given the opportunity to spontaneously work with her baby and body, not always responsible for pelvic floor issues, amazing, hard work, worthwhile, sets the finals hormonal shifts in motion for mother and baby……

Is it really BETTER? I say no. It is usual and normal.

  • Spontaneous labor is not better – it is the expected usual occurrence at the end of pregnancy.
  • Unmedicated labor and birth is not better – it is what the body mechanisms and baby expect to perform at normal levels.
  • Unrestricted access to movement, support and safety in response to labor progression is not better – it is the usual expectation to facilitate a normal process.
  • Spontaneous physiologic pushing is not better – it is what a woman will just do, in her way.
  • Spontaneous birth is not better – it is what a mother and baby do.
  • Keeping mother and baby together without separation is not better – it is what both the mother and baby are expecting to facilitate bonding, breastfeeding, and normal newborn health.

Denying the norms and adding in unnecessary interventions, medications and separation is creating a risky environment for mothers and babies. Thus increasing fear, worry,and even a desire to be fixed at all costs.

Perhaps even worse, an atmosphere has been created where the abnormal has become the expected norm and the normal has become the problem to be eradicated.

Bottom line, our language matters and will help shape for the positive or negative the future of birth.

Do It Your Way – Birth That Is

Friday, September 10th, 2010

In the past months I have become very aware of the deep notion in our birth culture, and yes even in the natural birth circles, that there are so many do it this way and don’t do it this way put upon women or she is wrong or not quite right.

The truth is, women do a variety of things in labor and birth. They do not all need the same education, need the same type of support, need to birth in the same type of location, or look the same during the process.

Women sometimes prefer:

  • Touch and movement
  • Solitude
  • Sound
  • Quiet
  • Bright light
  • Dim light or darkness
  • Smells
  • Lack of smell
  • To eat
  • To drink orally
  • Deep connection with those around her
  • To have direction and encouragement
  • To do it her own way with no outside input
  • To vocalize
  • To be inward
  • To have clinical assessment
  • To have no clinical input
  • To have a care provider
  • To be her own care provider
  • To catch her own baby
  • To have another person catch her baby
  • To be coached through labor and pushing
  • To physiologically push and deliver her baby
  • To have a doula present
  • To be totally alone
  • To have a crowd around her
  • To have it be very intimate
  • Birthing at home
  • Birthing at a birth center
  • Birthing at the hospital
  • and many, many things

It breaks my heart to see women beating up other women under the guise of being helpful.  Women are not plug in play in need of a prescription to make her do labor and birth right. We need to trust that women will do what is most beneficial in labor and birth when the space and opportunity is given to do so.

Bottom line: We need to stop making women feel badly for just doing what they want to do. We need to encourage women to trust their instincts. We need to continue to give women information on healthy birth. We need to not make it about US and let go of other women’s choices.

Technology and the Prenatal “Diet”

Wednesday, February 17th, 2010

In westernized countries, television and the internet have almost completely replaced the generational teaching and learning found in the “circles” of the past. Women would gather over sewing, quilting, canning, and life events including pregnancy and childbirth. They offered support, told their stories, spoke of family life, shared their everyday knowledge, wisdom and expertise while the children played at their feet.

At first glance it seems that through these technologies women are able to gain vast amounts of incredible knowledge regarding childbirth.  There are very popular websites, message boards and forums to meet and greet other women who are expecting the very same month.  Any topic is available to explore. Excellent places for a sense of community and belonging. The information is so prevalent that some women even eschew childbirth classes because they feel well enough prepared from all the exposure. Fantastic to be sure, at first glance.

Upon a deeper look  with a critical eye at the most popular shows and on-line communities, it becomes pretty obvious that overwhelmingly the messages and scenes actually have little to do with real encouragement and instilling confidence in a woman’s design and inherent ability to birth.

Let’s start with the satellite/cable television shows on the learning and health channels. Stop for a moment and think of what occurred during the last episode you viewed.  Did you see a spontaneous labor from entry to hospital to birth without augmentation, epidural, or any other intervention except for intermittent monitoring and perhaps a saline lock (IV port) placed? Was it an induction with an epidural? Was it a cesarean or a vaginal delivery? Did she have adequate support? Was her background given in any detail? Who made the decisions? What about informed consent? Was the laboring woman paid attention too or were the machines heeded more? What sort of comfort measures did she employ? Was she ever out of bed? Who delivered the baby?  What response to her baby did the mother have? Who saw her baby first? With that clear memory in mind, how did you feel after viewing it? What thoughts came to your mind? Now consider that essentially all of the births shown take place in a hospital. In fact any birth that does not, is often touted as extreme or some other like descriptive.

Let’s move on for a moment.

Now let’s take a look at the most popular pregnancy websites, message boards and forums where women connect with one another.  The “conversations” and threads are filled with all things related to the impending birth. Chatter about baby showers, maternity leave, body changes, vaccinations, previous experiences, breastfeeding, nursery preparations and so much more. Really anything under the prenatal sun. Inspecting further though, there seems to be an inordinate amount of discussion regarding the need for scheduled inductions and cesareans and very little conversation or even support for natural or spontaneous labor and birth.

With intervention appearing to be the ruling majority within the technological communities and filling the television, how is a pregnant woman feeding her eyes, heart, and mind on this type of diet supposed to feel confident, uplifted and excited about her upcoming birth? I am uncertain that she can with the seeds of inadequacy, fear, brokenness, helplessness, and lack of options being sewn into her being at such an alarming ratio.  Sometimes yes interventions are needed, however, in practice it isn’t a need for many women and babies.

These shows and internet locales are like junk food. Like all junk food they are not to be an integral part of a healthy prenatal “diet” that will be encouraging, expand useful knowledge, grow confidence, spark self-advocacy, promote self-awareness, ignite excitement, and offer joy to the expecting mother.

How can an expecting mother improve her “diet” regardless of the type of birth she is planning? What are the better places to “shop”?

  • Turning off the TV
  • Check out and attend local groups and support meetings. Educational sessions and workshops are often free of charge. For example: Doula Groups, ICAN, Midwifery Groups, Birth Network, Birth Circles, and similar.
  • Try some different message boards, forums and sites. See Blog Roll and Resources listed on this site.
  • Seek out positive free videos to watch on You Tube.  http://prepforbirth.com/2009/07/30/birth-videos/
  • Talk to women who have birthed in the hospital, birth center and at home. Get a variety of positive stories.
  • Try some different reading on for size. http://prepforbirth.com/books-videos-and-more/
  • Rent or borrow movies from Netflix, a doula or childbirth educator, such as, Business of Being Born, Pregnant in America, or Orgasmic Birth to name a few.
  • Take the challenge to learn about and be open to the variety of birthing techniques, locations, options and provider types that women are utilizing.

Bottom line, the most prevalent “food group” in a diet is going to positively or negatively affect the parts and the whole of the journey to having a babe in arms.  No matter what the mother and baby live with the outcomes from the birth. Enriching the prenatal “diet” is not a guarantee of outcome or path to the birth. It does however give much more possibility and opportunity for both mother and baby to have a better birth and start together.

Preparing For Birth – Affirmations

Friday, October 9th, 2009

Guarding what you put into your eyes, ears, and mind is such an important part of pregnancy and birth.  As women we learn socially, from one another.  When we allow the pervasive negativity (TV, horror stories, fearful education, good patient education, unsupportive comments, etc.) to take root we lose so much inborn knowledge and wisdom of all the women who came before.  I encourage you to read the below affirmations, use them, tweak them, and then write your very own. Place affirmations everywhere that you are. Encourage others around you to also speak them to you. whenever you think of labor and birth, recite your affirmations.  Build in the positive at any opportunity. If someone gets a negative experience out to you, stop and ask what she would have or could have done differently if she was able.

  • I will take labor one contraction at a time. I can do ANYTHING for a minute or two.
  • I am able to make the best possible choices for a healthy, joyful birth.
  • I TRUST my body to labor smoothly and efficiently.
  • My design is PERFECT to birth my baby.
  • I trust my baby and body to choose when labor will begin.
  • I will receive the start of labor and I will labor well.
  • I accept the unknown of labor and birth.
  • My baby already knows how to labor and come into my arms.
  • I am well equipped to mother my baby.
  • I can make choices and decisions based out of love/evidence not fear.
  • I embrace the concept of healthy pain.
  • I am welcoming my contractions.
  • I have enough love to go around.
  • There is always enough love for me.
  • I am strong, confident, assured, and assertive and still feminine.
  • I am helping my baby feel safe so that she can be born.
  • I am a strong and capable woman.
  • I am creating a totally positive and new birth experience.
  • My pelvis is releasing and opening (as have those of countless women before me).
  • I am accepting my labor and believe that it is the right labor for me, and for my baby.
  • I now feel the love that others have for me during the birth.
  • I will treat my mate lovingly during the birth.
  • I will have exactly who I need supporting me for my birth.
  • I am birthing where I will be the safest, most peaceful, and most encouraged.
  • I have a beautiful body. My body is my friend.

If you would like to add to my list, please email me at desirre@prepforbirth.com.

Morning Sickness and Nausea Tips

Friday, August 14th, 2009

Nausea is such a common complaint among pregnant women.  Usually the extreme nausea passes by the time a woman enters the second to mid-second trimester, however, some women experience it throughout pregnancy.

Though no solution is full proof, there are some things that can be done to aide in a calmer digestive system.  Remember that food aversions or smell aversions are normal.

  • Eat regularly and frequently though smaller meals
  • Use peppermint in the form of tea, essential oil, or candy such as Altoids
  • Use ginger in the form of ale, tea, raw pieces, candy, or essential oil
  • Have a honey stick or other quick sugar (a few jelly beans) prior to getting out of bed in the morning to abate low blood sugar from not eating for many hours
  • Stay hydrated with non-caffeinated beverages
  • Take prenatal vitamins with food or in the evening. Another options is to switch to a liquid or whole food vitamin which absorbs more readily and less likely to be irritating.
  • Limit coffee intake
  • Drink herbal tea (read labels some are not encouraged during pregnancy
  • Eat yogurt and take probiotics to ensure a healthy digestive system
  • Take digestive enzymes
  • Wear a sea sickness acupressure band
  • Seek out an acupuncturist for treatment
  • Seek out an herbalist or naturopath for treatment
  • If nausea or vomiting is severe or extreme, consult with your care provider as you may have a more serious form of morning sickness (hyperemesis gravidium) which requires a special course of treatment.

Here is to gestating in peace and digestive harmony.

What is a labor doula? What does she (or he) do?

Sunday, August 9th, 2009

Women have supported women throughout the ages.  In our very busy and ever transient culture, the woman to woman education and support of yesteryear is sorely lacking.  It is very common for an expecting woman not have family nearby or to have support women who know the ways of natural, normal pregnancy, labor, delivery and immediate postpartum. The labor doula was born out of this need.  Essentially this is a woman of knowledge and skill in pregnancy, birth, and immediate postpartum (yes there are a few men in who are labor doulas as well) who comes alongside a pregnant woman (family) offering education, physical support and emotional support to both the mother and partner/husband/other support.

Below is a detailed description of what a doula is and does according to CAPPA a wonderful organization that trains a variety of doulas and other birth professionals.

What is a Labor Doula?

A doula is a person who attends the birthing family before, during, and just after the birth of the baby. The certified doula is trained to deliver emotional support from home to hospital, ease the transition into the hospital environment, and be there through changing hospital shifts and alternating provider schedules. The doula serves as an advocate, labor coach, and information source to give the mother and her partner the added comfort of additional support throughout the entire labor. There are a variety of titles used by women offering these kinds of services such as “birth assistant,” “labor support specialist” and “doula”.

What Does a Doula Do?

The following is a general description of what you might expect from a CAPPA certified labor doula. Typically, doulas meet with the parents in the second or third trimester of the pregnancy to get acquainted and to learn about prior birth experiences and the history of this pregnancy. She may help you develop a birth plan, teach relaxation, visualization, and breathing skills useful for labor. Most importantly, the doula will provide comfort, support, and information about birth options.

A doula can help the woman to determine prelabor from true labor and early labor from active labor. At a point determined by the woman in labor, the doula will come to her and assist her by:

  • Helping her to rest and relax
  • Providing support for the woman’s partner
  • Encouraging nutrition and fluids in early labor
  • Assisting her in using a variety of helpful positions and comfort measures
  • Constantly focus on the comfort of both the woman and her partner
  • Helping the environment to be one in which the woman feels secure and confident
  • Providing her with information on birth options

A doula works cooperatively with the health care team. In the event of a complication, a doula can be a great help in understanding what is happening and what options the family may have. The doula may also help with the initial breastfeeding and in preserving the privacy of the new family during the first hour after birth.

What does a doula cost? This can be a huge spectrum and is defined by where you live.  A labor doula may volunteer, work for barter, or basics like gas reimbursement, childcare coverage, snacks, etc.  I have heard of fees from $100 to $1800 (mind you this is in NYC).  On average I would say a labor doula costs $250-$600 in many areas.   Call around or visit websites in your area to get a firm idea.

What about insurance? Private doulas usually do not bill insurance though many will give a super bill to be submitted for reimbursement by insurance.  many insurance companies after some effort will pay a portion of the fee as an out of network provider.

Will a doula provide my complete childbirth education? Sometimes.  Often not.  Some doulas are educators. I provide classes separately from doula services. The labor doula will often fill in the blanks and personalize the education the client already has.  Many doulas have lending libraries or recommended reading and watching lists.

If I am going to a birth center or having a homebirth will a doula still benefit me? Yes in both cases.  When going to a birth center a doula would labor at home then arrive at the birth center at the same time as the laboring mother just as with a hospital birth.  In a homebirth scenario the doula who is not a midwife and does no medical tasks is often a welcome extra set of hands and does the same emotional and physical support as she would do in any other location.

Does evidence support that having a doula in attendance has benefits? YES. Here are some of the benefits. Lowered epidural, narcotic, induction, cesarean, and instrumental delivery rates. Increased satisfaction, breastfeeding, and bonding.  Also shorter labors!

For more information, email me at desirre@prepforbirth.com.

What might a cesarean get you? Often more than is bargained for.

Tuesday, July 28th, 2009

This is a  slight re-do from a popular blog post from early 2008. The information is vital and pertinent to the near 1.5 million women (based on previous CDC data) who will have a cesarean surgery this year.

Having a cesarean section will almost always  get you a baby.  Generally there is much more to it and anyone could bargain for or anticipate even in the best of recoveries.

Let me count the ways in no particular order:

  • A scar that in no way makes a bikini look better. Sometimes described as a shelf or a pouch.
  • The feeling of failure, guilt or less than deserving of motherhood.
  • The struggle of living with the huge dichotomy of loving your baby and perhaps hating the birth.
  • Higher probability of losing your ability to have more children either through physiologic secondary infertility, pregnancy complications, self-induced secondary infertility, hysterectomy or lack of sexual intimacy in relationship.
  • Higher probability of difficulty in breastfeeding.
  • Postpartum depression or PTSD, especially in an unwanted cesarean.
  • The feeling of failure as a wife or partner.
  • Having others discount your feelings and needs. After all you “just” had a baby. Really you just had MAJOR surgery, perhaps by coercion, a true medical indication, or completely from interventions and medications.
  • Living with the idea that you failed to pass induction, you failed to push out your baby, you failed because _________ (fill in the blank).
  • Obtaining your records to find what you were told and what was written are different. Could your trusted care provider have lied and cheated you?
  • Simply finding out that no one told you and you didn’t think it would happen to you. That being induced, getting the epidural, allowing AROM, not getting out of bed, etc. is why you had the cesarean. Is maternal ignorance and fear enough to quell what you feel and make it okay?
  • How can you trust yourself as a mother when you ignored your maternal intuition and kept saying yes, because the nurse, midwife or doctor told you to?
  • The way your marriage or partnership takes a turn toward hell or in the least a divided place.
  • Living with dread when a hungry hand sweeps over your scar. Being sexual can be extremely difficult physically and emotionally.
  • Having great fear of becoming pregnant again.
  • Having great fear of going for a VBAC and ending up in the OR at the end.
  • Not being understood and having others say to your face how lucky you are that you got to take the easy way out.
  • Pain.
  • Difficulty moving, walking, getting up, rolling over, coughing, laughing, tending to personal cleaning…. You get the idea. It is surgery.

Though not every woman will experience what is on the list, many do.  For all of these – there a stories layered and interwoven for too many women.

Every thirty seconds a woman is surgically having her baby delivered. Light her a candle. Offer her a meal. Let her speak. Listen to her intently. Don’t judge her. Send her to ICAN. http://www.ican-online.org/.

The Doula Seed

Sunday, July 26th, 2009

Whenever I am asked why I am a doula, I need to stop and think for a moment.  My response every time is that as a doula I am filling the gap (along with others)  that is missing in today’s transient and autonomous society. When I respond, I am thinking of the days when girls and young women learned the ways of pregnancy to all things postpartum at the feet of their grandmothers, aunts, sisters, cousins, and other women in their community.  What a beautiful and age old scene that is.

Then that scene brings me to my own journey in becoming a doula.  Here is my “why” story.

Living without my own mother since I was 10 years old, I yearned for the mentoring and teaching that I am called to act upon in my life’s work.   Even without my mother, I was blessed to grow up around some other women who modeled breastfeeding, cloth diapering, and natural birth for me.

I also think of the journey that brought me to being a doula for real.

I had an epiphany one day almost 25 years ago when a close friend and I were waiting for the bus to get home from work.  She described her birth – left by her partner during pregnancy, her mother refused to come since she was unwed, and she was at an overtaxed county hospital where the staff was barely in the room to support her.  She was utterly alone and scared.  My heart broke for her and her daughter. No woman should ever be alone to fend for herself under those circumstances.  EVER.  In looking back, I can say at that moment my doula heart seed was planted though it would be years before the seed came to full bloom.

Fast forward a couple of years and I had a knack for mamas and babies.  I could help a baby latch and mom grow confidence in breastfeeding.  I knew how to calm a mama when she was tired and at her wit’s end. I understood the pregnant mama and could easily encourage.  I was invited to attend a birth of a family member I was very close to.  She delivered in a freestanding birth center.  It was an amazing natural birth with very little requirement of her except to labor and birth.  An atmosphere of encouragement, freedom, and calm. I will say it was one of the most comfortable places I have ever been in my skin supporting her.  I didn’t understand the job I had done with her, but it was good.  I think I was on a birth high for weeks.  The doula seed was beginning to ferment.

I attended birth along the way for friends and other family, assisted in breastfeeding and talking through general pregnancy issues. Mind you I hadn’t had my own children, was educated and worked in fields that had nothing to do with birth.  I loved the mamas and families that I knew.  When I started having my own family, it seems the mojo went into high gear.  I was asked questions all the time about many things pregnancy, birth and breastfeeding related, no matter where the place or situation.  Even my husband began fielding calls when I wasn’t home from friends who needed baby help.  The doula seed was slowly sprouting.

When my dear youngest boy weaned himself, I began wondering OKAY now what am I going to do while maintaining being a SAHM? My sister-friend “J” found the CAPPA website and told me I needed to take the trainings and then I could really support the families in my community as an extension of what I was already doing.  Get the education she said.  I went to the site, spoke to my husband at length and took the leap.   Three trainings in 5 months.  Then I began to to seek out clients, put together curriculum, and found a local doula group to join.  The doula seed exploded into a blossom of great fragrance about me.

I ill not say the work is easy. Anything worth any value is not.  From the prenatal meeting, to the birth while looking into a mother’s eyes encouraging her down the path so many have walked before, to the early postpartum time in assisting with breastfeeding, attachment and family health, I am honored and blessed doubly.  Participating in the most intimate time possible, witnessing the transformation that so often occurs in a woman (and her huband/partner/family), and hearing that first sound of life when her baby “speaks” is beyond description.  A miracle takes place each and every time.

The doula blossom has deep roots now.  On occasion it needs some pruning, soil treatment, and large doses of sunshine as all beautiful plants need to maintain health and well-being.  Still it is very good.