Posts Tagged ‘birth’

It’s World Doula Week!

Sunday, March 22nd, 2015

How are you celebrating?! Share your own video response in the comments on YouTube! Who are the doulas in your life?

Awe & Gratitude

Monday, February 9th, 2015

I have been putting together a scrapbook of pictures, cards, letters, and memorabilia from the doula clients who have so graciously shared such items with me. As the 8×8 book comes together, I find myself full of memories of each story. I have not forgotten a single birth. Not one. Each one is a treasure I carry with me wherever I go.

There is a weight to each memory. A weight characterized by humble, gritty, glorious women at their peak vulnerability and strength. Never is a woman so beautiful as when she is bringing new life into our small world. A brand new human being, who has never existed before, has been formed painstakingly, and brought with blood, sweat, and tears into the arms of his loving parents.

It is exquisite.

And I get to be a part of it.

My gratitude for this work will never wane. Sometimes, it is hard for me to believe that this is a path God has called me to so clearly. Unequivocally, with women is where I belong.

With women.

The root meaning of the word “midwife.”

Thank you for being part of my journey. Whether you are a client, a mentor, a colleague, or a member of my amazing family, I could not do this without you.

Grace & Peace,
Tiffany

A Little Birth Poetry.

Tuesday, January 20th, 2015

Birth is amazing.

I attended three in the space of about 40 hours this weekend. Two butter births on a Saturday morning. Both filled with intense power and work, capped by peace when they were all over. The other a triumphant victory, and a step toward healing of a past rough experience.

Women are incredible.

There was the most spectacular sunrise on the way to one of the births. I have never seen one that struck my heart so deeply. The very sky seemed on fire. Too bad I was driving, and couldn’t capture it to share with you. A fitting beginning for the act of creation that is birth.

Though the baby didn’t enter the world with the dawn, the dawn greeted him anyway.

I was struck, as I watched each mama work hard to bring her baby to her arms in her own way. Each one unique. No two women labor alike. And thousands do it together everyday. What a marvelous sisterhood we share!

I was reminded, yet again, why I do this work. Why I am a doula. Why I want to be “with woman” as a midwife. This work is sacred. Beautiful. Insanely difficult. But so very worth it.

I rarely write poetry, but I hope these verses hit home. Each one represents one of the mothers I served this weekend. They’re kind of silly. Just haikus, but I had fun writing them. Enjoy.

Labor at sunrise,
Intensifying slowly.
Care, quiet, tranquil.

A hint, it’s coming.
Giant, crashing, clamoring,
“I can’t, but I did!”

Freight train rolling fast,
Can’t quite keep up, but she does.
Dad meets tiny pirate.

How did you spend your weekend?

Grace & Peace,
Tiff

My Ideal Client.

Wednesday, October 22nd, 2014

Me holding the fruit of my sister's labor, Baby Ellie.

Me holding the fruit of my sister’s labor, Baby Ellie.

Recently at an interview, I was asked the following question:

“What is your ideal client, and why?”

I think that might be one of the most intelligent questions I have ever been asked. I knew the answer immediately, and had to keep it short.

As a doula, part of my training is to identify and evaluate my personal biases, and how they might affect the care I give. From the beginning of my career then, I have always had to think about these kinds of questions. I have had to evaluate whether or not I ought to set boundaries around which kinds of clients I will or will not take on. If I do set boundaries, what should they be, and why?

I started doula work because I wanted to be a midwife.

That has a great impact on the types of clients I prefer to serve. (And doulas – admit you have a preference – we all do. Anyone who says they don’t is selling something.) Of course, I have often served outside my comfort zone, and while I don’t regret it, I have often been burned. Not by the client, but by really rough rides. Birth work is hard.

In order to be a good doula, there is a certain amount of emotional investment I must make if I am to be effective at all. The line between professional and personal relationship gets a little bit blurred, and so I carry a bit of each birth with me, wherever I go. I can remember every birth I have ever been to, and how it made me feel as a woman, mother, wife, and human being.

So, yes. I have an ideal client, and I have discovered that it has very little to do with circumstances, and everything to do with the client herself.

My ideal client is one who educates herself, and who takes full responsibility for the choices she makes along the way during her birthing year.

She doesn’t take her care provider’s word for everything. She doesn’t take my word for everything, either, but makes her own decisions.

My ideal client educates herself by taking classes, or reading evidence-based books and online resources. She knows how to evaluate information, weighing it against her instincts and risk factors, confidently choosing what is right for her and her baby.

My ideal client understands informed consent and refusal. She understands her patient/client rights, and asks intelligent, informed questions to gain insight into what is best for her and her baby. She is willing to keep an open mind and explore the benefits, risks, and alternatives to each option available to her.

My ideal client understands that a birth plan is not a list of demands to be met, but a conversation to be had. She understands that her choice of provider and place of birth is important. If she cannot make her ideal choice (because that can’t always happen), she is able to communicate her needs effectively, and to make the best she can of a tough situation. She knows when to compromise, and when to stand her ground.

My ideal client is flexible. She understands the wisdom of learning non-medical pain management, because her birth may go too fast to get the epidural she planned for. She knows that her labor may go on longer than she thought, and she needs the nap an epidural can help her get.

My ideal client knows that there is no “one-size-fits-all” birth, and she is prepared to advocate for her needs, and the needs of her baby.

My ideal client almost doesn’t need a doula, but she will benefit greatly from hiring one.

Probably 99% of women who hire me fall into this ideal. Women are intelligent, thoughtful, flexible, and strong–and I am there for them when all they need is the reminder that these things are true of them.

In your line of work, who is your ideal client? Why or why not? As a mom who hired a doula, how does this post make you feel?

Grace & Peace,
Tiffany

A Weighty Responsibility

Monday, August 4th, 2014

Image credit: longdrivejourney.com


Finishing up a class is always bittersweet, triggering a time of self-evaluation, reflection, and a desire to do better next time.

Childbirth education is not a job where I can just show up, punch a card, and go home. It is filled with challenges as unique as each student who walks through the door. Each student requires some customization of the curriculum, and will invariably ask a question I don’t know the answer to. There will be rabbit trails every so often, and bringing class back on track in order to cover the essentials adequately is critical. It is also just as critical to know when it is time to abandon a few of my slides in order to acknowledge and travel down a rabbit trail with purpose.

It requires constant research, reading, and learning on my part. I cannot recycle the same information over and over, and expect to meet the needs of an ever-changing population. Every class series I teach, while built upon the same foundation, will be a little bit different.

As I work toward finishing my re-certification process as a CAPPA Certified Childbirth Educator, I am overwhelmed at the amount of new information permeating the atmosphere surrounding the perinatal year! I am required to choose and read ten complete studies relating to my field that were published in the last five years. I thought it would be a challenge to find new research. I was wrong. The information is out there. It is accessible, if you know where to look, and I am astonished and excited at how much I still have to learn!

I am so glad I chose to certify with an organization that has such rigorous standards for its members. If it weren’t for the constant challenge of re-certification, I think it would be too easy to fall into a rut and stay there, becoming more and more irrelevant in the community. More and more useless in effectively navigating the changing state of childbirth in this country.

When I am up front teaching, I am viewed as an expert, and even an authority on childbirth. Shame on me if I fail to strive to live up to such labels by maintaining a steadfast continuing education. While I know I can never impart everything I know to every student who walks into my classroom, it does not excuse a lack of evidence-based, current knowledge driving and directing my passion. All the passion in the world means nothing if it isn’t paired with a working knowledge of current evidence, applied realistically, and presented in a way that is easy for students to integrate into their own real-world experience.

A discerning childbirth educator changes with the times. Changes with each new group of students who choose their class. Incorporates new information into curriculum as quickly and accurately as possible, enabling students to apply the new knowledge to their own circumstances and worldviews. A wise childbirth educator strives to get a little better each day, understanding that people are making decisions based (at least in part) on what they have said in class.

It is a weighty responsibility.

And I love it.

How do you continue to learn, grown, and change in your own work? What drives you to keep reaching for the next step?

Grace & Peace,
Tiffany

Being A Doula

Friday, July 18th, 2014
Image credit: tumblr

Image credit: tumblr

Being a doula, for me, is not about changing hospital policy, or steering women away from “bad” providers. It is not about disseminating information to every client. It’s not about birth plans. It’s not about informed consent. It’s not about vaginal birth, home birth, or cesarean birth. It’s not about statistics. It’s not about rebozos, crock pots, or rice socks. It’s not even about making a difference or changing the world.

Being a doula is about laying aside my notion of what a particular birth ought to be, and instead surrendering to what it actually is. It is opening my eyes to the reality of each woman’s circumstances, and meeting her right where she happens to be.

It is seeing beyond myself, and stepping into someone else’s experience. It is opening my hands in service, in whatever way the mother sees fit. It is about humbling myself, and understanding that each birth can and will teach me something I did not know before.

It is about respecting the care provider(s) my client has chosen, simply because she has chosen them. It is about learning how to show respect and compassion to everyone in the room, even when I don’t feel like it, because it is the right thing to do. Many times, it’s about being an example.

It is about protecting space around a birthing woman and her partner, so all they see is each other. It’s about becoming invisible, so that the birthing woman can focus on what is most important.

It is about being with this woman, right here, in this moment in time. It is often about helping her surrender fully to this great work she is doing. It is looking her in the eye and lending her my strength when she runs out. It is opening a door when she hits her wall. It is about believing her when she expresses pain, and validating her struggle.

It is believing in her, even if no one else does.

It is about bringing a little bit of sunshine into this storm that feels so big, and reminding her that it will not last forever. Being a doula is a lot like trying to be a rainbow in someone’s cloud.

It is about love.

And I love being a doula.

Grace & Peace,
Tiffany

 

Childbirth Education Myths 1

Monday, January 27th, 2014

Over the next several weeks, Team Preparing for Birth will be debunking some common myths surrounding childbirth education classes. Check back every Monday to see the newest post.

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MYTH #1: “I’m having a homebirth, and my midwife will do all my education.”

Home birth families often see childbirth classes as an extra, rather than a valuable and necessary tool to help them have the birth they are hoping for. The most common objection they have is that they will be able to get all the education they need from their midwife. While midwives do educate their clients to some extent, this perception that they can (or should) cover everything is a myth, for several reasons.

1) Education is not a midwife’s job.

Just as obstetricians are not childbirth educators, neither are midwives. Just because midwives are more likely to do more education than an obstetrician, does not mean they give comprehensive education, and they should not be expected to. That is not their job.

Rather, a midwife’s primary job is to maintain the clinical safety and health of the mother-baby dyad. This will involve some education, yes, but only as a by-product of good midwifery care.

A good midwife will encourage her clients to be active participants in their care by reading, taking classes, and educating themselves proactively, instead of passively relying on the lack of intervention common to home birth. Midwives want clients who are thinking women, who take responsibility for their own care, and who can integrate what they learn in practical ways.

 

2) The reality of transport.

Another downside to relying solely on your midwife for childbirth education is the preparation for hospital transport. Realistically, around 10% of women and babies need something that cannot be offered at a homebirth, for whatever reason. It is not a midwife’s job to prepare you for the hospital.  Her job is to prepare you for birthing safely at home. Therefore, an expert on the hospital system is needed to prepare a birthing woman, in case of a transport. Most midwives spend very little time in the hospital, due to the low transport rate, so their expertise on local practices may be limited.

On the other hand, childbirth educators work very hard to stay up-to-date on all policy changes, protocols, and the general attitude of the staff in local hospitals. They often work (or have worked) as doulas, and have regular opportunities to interact with staff in the local hospitals that midwives simply don’t have. (This is not a criticism, merely a reality.)

While a midwife can go over what a typical transport looks like in her practice, a good childbirth education class will be able to prepare the client for what a hospital birth will look like. She can help the client to understand how to navigate the environment, and teach her how to communicate with the staff effectively.

 

3) The birth tool belt.

Midwives know that most women need a wide array of pain management techniques available to them, since an epidural is not an option at home. While a midwife will teach her clients the importance of stress management, emotional health, and relaxation, there is no substitute for a good independent childbirth course where you can actually practice tried and true techniques from all kinds of sources. This creates a solid foundation of knowledge, provides varying perspectives, and allows the birthing pair time and space to learn or review valuable tools for labor.

 

4) Prenatal appointments can only cover so much.

Even though midwifery appointments are much longer than typical obstetric appointments, it is still a very limited amount of time for a woman to learn all she needs to know about birth. Not to mention the birth partner, who may not be able to attend very many of the appointments. Childbirth education can fill in the gaps, empower a birthing pair, and provide opportunity to practice valid techniques in a real-world environment.

It is never wise to assume that your care provider will simply take care of everything, no matter who they are. Leaving the decision-making and responsibility solely in your midwife’s hands is not fair to her, to you, or to your baby. You owe it to yourself to take a proactive approach to childbirth education.

 

How To Find Moolah For a Doula.

Saturday, October 19th, 2013

Image credit: primecoordination.wordpress.com


So, you’ve read the literature, or seen the infographics on the measurable benefits to having continuous, trained labor support in the form of a doula. (You haven’t? Oh. Well, then. Click HERE to read the best, most recent evidence, then come back here and finish this post.)

Based on that measurable evidence, you’ve decided that you need a doula, but are wondering how on earth you can afford one. You’ve seen that doulas are worth every penny they charge, but it doesn’t matter if you don’t have the pennies, right? Right. I know that feeling! I think we all do, in this current economic climate.

As I mentioned in my last post, doulas in the Colorado Springs area charge anywhere from about $300 up to $650 at the moment. Of course, insurance doesn’t consistently cover us yet, though there are reports of some insurances doing just that after claims are submitted by clients. It’s slowly, but surely happening. Still, that upfront cost is still there.

To start, I would like to cover the basics of what you must have for a newborn. (Stick with me, I’m going somewhere with this.)

  • Boobs. With milk in them.
  • Something to cover & clean their behinds.
  • Maybe two weeks’ worth of clothes, depending on how often you do laundry, and how often your baby blurfs on you, or has poopsplosions.
  • Car seat. Must-have, if you ever need to go out and buy food or something.
  • Some sort of barrier between spit-up and your clothing.
  • Some sort of well-made babywearing device.
  • Small diaper bag.

Really, everything after that is gravy. Sure, there are a lot of very handy devices, contraptions, and doo-hickeys, but most of those are luxury items, that add up very quickly to hundreds of dollars or more. Of course, many of these items are covered by the ubiquitous Baby Shower. Everyone is eager to pick up your Target registry list and go crazy!

There are…

  • fancy nursery sets
  • cribs
  • high chairs
  • various swings
  • pack n’ plays
  • child-proofing devices
  • baby gates
  • teething rings
  • toys
  • floor mats
  • wall decals
  • strollers
  • blankets
  • socks
  • hats
  • specialized bath tubs
  • giant diaper bags
  • SO MANY THINGS!!!

Do you really need all of that? No. Most of those are created needs. They come in handy, certainly, but most aren’t needed in those newborn days before six to eight weeks postpartum. Oftentimes, it makes sense to put off getting most of these items until you know for sure it’s something you will use. Time will tell very quickly in that case.

So, instead of creating a registry for SO MANY THINGS! for your baby shower, might I suggest: Have a simple money tree, or card box set up, and ask people to contribute what they would have spent on stuff to your Doula Fund. Most people tend to be as generous as they can toward new mothers and babies, and will be happy to do just that.

In lieu of all the stuff, you will likely end up with plenty of money to pay the doula you would like to hire. You may even have some left over to pick up one or two items that you find you really would like to have. It’s a win-win!

Of course, that’s not the only way to go about it. I just think it’s often the easiest way. Still, there are other options.

Some other ideas to help you pay the doula you’ve chosen:

  • Bartering. Many doulas have need of the skills you or your partner possess. Offer a dollar-for-dollar trade, up to a certain amount, then pay cash for the balance.
  • Sell some stuff. Maybe you’ve already had a baby, and found you didn’t need that $400 jogging stroller, and barely used it. Perhaps your garage needs to be cleaned out. You may be able to scrape together enough to afford the doula you’d like to hire.
  • Make and sell some stuff. Do you sew at all? Crochet or knit? Make fabulous cakes? Jewelry? Do you paint? Photography? Put those skills to good use!

When all else fails, and you honestly can’t pull together the entire balance…

  • Hire a training, or newer doula, and work with her to pay her what you can afford.
  • Ask for a discount. Be specific. “I can’t afford x, but I can afford y. Can you do that?”
  • Ask for a payment plan. Again, be specific. “I can make payments of x amount, over 6 months.”

Most doulas are willing to work within certain parameters, as long as a client is upfront, honest, and is willing to put a financial agreement in writing. We hate to say no to someone in need, and most doulas will bend over backwards to help you make it work. We know that we have measurable benefits. We know that doulas are much more of a need than a luxury, especially in the current birth climate in this country. We want to help, but communication runs two ways.

You only have to ask.

It’s almost always feasible to afford a doula – you just have to get creative, be flexible, and find a doula that can work with you in your particular circumstances. Remember, you are trying to secure evidence-based, customized, continuity of care for yourself and your baby. It’s more than worth it. You will likely never regret spending money on a doula, because you are really investing in yourself and your care.

What ideas do you have for raising moolah for a doula? What have you done in the past — either as the doula or the client — to make it work?

Grace & Peace,
Tiffany

Dad Matters – A doula’s perspective

Sunday, September 29th, 2013

Many men in our culture are fairly apprehensive about birth. Most have never seen a real birth, or talked about it outside of sex ed. They are often nervous about birth itself, seeing their partner in pain, the what-ifs, and all that may come after. They doubt their ability to support their partner in her journey, and wonder if they’ll be strong enough.

In fact, they often doubt and fear and wonder just as much as their partners do, but are often not allowed to express it, because they’re not the ones giving birth, so they feel that they don’t really matter. They may feel like they don’t have much voice in the process, and are just expected to go along for the ride, smiling and nodding whenever the experts speak.

Yet, at the same time, they are expected to know everything about birth, protect their partner, communicate her wishes, and support her physically and emotionally without pausing for breath.

Many worry that they just can’t live up to all of that. It really is an awful lot to ask of one human being, after all. Especially since history shows us that there have always been many support people surrounding a mother during birth.

Still, many men don’t realize just how much they are capable of. They don’t realize that they matter, too, and that they can enter their partner’s birthing space with confidence, ability, and strength to meet the challenges of supporting a labor and birth.

 

So, how do we help fathers to step into the birthing space with confidence?

 

We free them to be who they are, that’s how. We let go of our expectations, and help them to form their own expectations and desires for supporting the birth of their child. We help them to see that they alone can define their role in the drama and sacredness of birth.

I would suggest two important things that may help a father gain confidence and acquire tools to help him fulfill the role he wants to play during birth: 1) Independent childbirth education classes, and 2) Hiring a doula.

The more a man knows, the less he will fear birth, and taking Childbirth Classes is one of the best ways to lower anyone’s fear level in anticipation of birth. Many men appreciate information given in practical, interactive ways, and independent childbirth classes are often right up his alley. He can join with like-minded dads, ask questions, and have his concerns addressed more readily.

Information is a great, big factor in helping couples manage their stresses and fears regarding birth—as much for the father as it is for the mother. As an educator, at the beginning of a series, I usually see high levels of apprehension, which quickly fade from week to week, to be replaced by realistic expectations and informed confidence in both parents.

This is just as powerful for the father as it is for the mother. When Dad has confidence in Mom’s ability, she believes in herself all the more, and Dad begins to see that he has power to influence her for the better! Dad is able to acclimate himself more readily to the realities of birth, and begins to realize that he is an important part of her support team. Perhaps the most important part.

He feels a little more ready to step into his support role, and probably has clarified what he wants that role to look like. He will feel more confident about what he can do, and more realistic about what he might not be able to do.

 

In which case, he may begin to consider…

 

Hiring a Doula to help him fill in the gap in the support team he might not be able to fill himself. If he participates in choosing and hiring a doula, he is much more likely to have his own expectations met, as well as those of his partner. When Mom and Dad are both fully supported, Dad is far freer to just be and do what his partner needs him to be and do.

While he will likely remember a lot of what he has read and learned about, that information may become secondary to him during the birth, and take a backseat to more immediate concerns in his mind.

He may become simply focused on loving this woman who is birthing his child. And why shouldn’t he? Why should he have to remember every counter pressure technique? Every massage technique, position change, or even the water jug and bendy straw? Why shouldn’t he be the face close to hers, his eyes beaming his love, concern for, and confidence in her?

A doula allows Dad to be front and center in the support role he always wanted to fill for Mom, in whatever way makes the most sense for their individual relationship in this particular moment. If he wants to be the Expert – he ought to be equipped to do that. If he doesn’t, then he needs the space and freedom for that, too. Or anything in between.

When he is free, all his anxieties and apprehensions tend to fall away, and he finds that birth is a challenging, beautiful, amazing space to be in with his partner. He finds that he is strong to meet the challenge, just like she is. Together, they grow in strength and confidence, becoming truly ready to meet this tiny new person they have made.

Doulas help open wide the door, making the birthing space more navigable, understandable, and pleasant for fathers. This, in turn, can only benefit the mother as she is able to rest in the support of her birth team. She no longer feels concern for her partner, because he shows no reason for her to be concerned. She is able to just birth.

Then, we can just step back and watch, as he exceeds all the expectations we have laid on him, and as he steps into Fatherhood in the way that makes the most sense to him and his new family.

Tiffany Miller, CLD, CCCE

Scavenger Hunt Contest

Monday, December 3rd, 2012

Preparing for Birth is having an online scavenger hunt to ring in December.

 

You could win this cute pocket diaper.

 

Here is the scavenger hunt:

Answer:

1)      How many births has Desirre Andrews attended?

2)      Name a doula that is working through Preparing For Birth?

3)      How many on average gel capped pills can be made from a placenta?

4)      What breast pump brand does Preparing for Birth have for sale?

 

Answer these and provide a link to the source:  

5)      What is the most common risk of induction?

6)      What is an evidence based reason for induction?

7)      What is the Bishop Score used for?

8)      What are Daniel Berwick’s three principals of patient centered care?

 

Find:

9)      A picture of a child nursing in a funny position.

10)   A picture of artwork that’s at least 100 years old depicting a woman in labor.

 

Bonus Questions:

1)      What is your favorite pregnancy or childbirth related blog?

2)      What is your favorite pregnancy or childbirth related book?

Send your entry to nichole@prepforbirth.com by 9pm Wednesday December 5th.

The winner will be announced Thursday, December 6, 2012, and must be able to pick up the prize in person. Everyone who enters will get a coupon for a free birth or postpartum plan session with one of the doulas from Preparing For Birth.