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Posts Tagged ‘midwifery’

Not everyone who is having their first baby had a wedding first. If you did, though, you have a natural window through which to peek at your relatives’ likely behavior — and your likely feelings about their behavior — at the birth of your baby. If you did not have a wedding, you may be able to think of another emotionally-heightened event at which family play a big role that will act as this window.

Mothers, mother-in-laws, sisters, and close friends are all likely to want to play a role at the time you give birth. I will focus mostly on mothers here, although for any mom-to-be it may be a sister or friend who lives nearby who is the focus of your attention. The question that pregnant women often ask their doulas is, “Should I invite her to the birth?”

If the woman had a wedding, this is where I usually start my questioning. Because it’s not about whether the relationship itself is good or bad. If you are considering inviting this person to your birth, I will assume the relationship is at least pretty positive. It’s about how the woman feels when she is doing something meaningful, stressful, and full of rapid decision-making in the presence of this other person.

Did you feel like your mother (sister/aunt/friend) understood exactly what you needed in the moment and was acting like an extension of yourself at all the wedding events? Or did you feel like she kept bringing you problems and issues to solve? Did she love your ideas and offer to help out anywhere? Or did she disapprove of your decisions (subtly or not so subtly)? Did she try to talk you out of ideas that meant a lot to you? Did you feel like her feelings enhanced and deepened the meaningfulness of your wedding for you? Or did her feelings about your wedding interfere with your own enjoyment?

 

Mothers can be just like us or very different from us and still be capable of offering genuine support. But not all mothers can offer genuine support. Their own needs get in the way of that.

Take a good look at how you felt about your mother (sister/aunt/friend)’s role at your wedding. If you have any lingering feelings of resentment or disappointment, I would strongly urge you to find a way to keep your laboring space free of their presence. Give her an important job to do away from your birthing space (making a birthday cake for the baby is a great job, for example). You do not get a re-do on your birth experience, so, like a wedding, it’s important to plan carefully. Don’t discount this treasure trove of information about how people are likely to act. Together with your gut instinct, this information about the past can usually tell you what you need to know about, “Should I invite her to the birth?”

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Hello pregnant women!

Fewer of us than ever before are signing up for traditional childbirth education classes. You know, those old-fashioned classes that meet in person. With a teacher. And maybe a textbook. Perhaps “class” reminds you of high school. Or college. And you do not want to be in SCHOOL any longer.

Besides, everything you need to know about birth is on youtube. Right? OK, well, then. Maybe it’s on Parenting.com? Or Childbirth.org? Or the American Pregnancy Association? Or WhatToExpect.com? 

Oh, dear. There’s a lot of websites that offer “childbirth information.” And the information they offer conflicts. A lot. More importantly, the information is not well-tailored to your unique situation.

No, problem, says the modern mama-to-be. I know how to get information tailored for me! I will jump into some chat rooms or join a website and ask my specific, individualized questions. Then the magic of the Internet will quickly provide me with the answers I need.

This is, indeed, how the majority of American women are preparing for childbirth. But childbirth is a very different process than researching what car to buy or whether or not to cut bangs this week (Michelle says, “Yes!”). Preparing for childbirth on-line is sort of like preparing for a triathalon on-line. There are good tips out there, but we all know that the REAL preparation is occuring off-line in what I would call “real life.”

Childbirth is a unique life event and probably nothing you have ever done in your life (except give birth previously!) can serve as a good model for how to prepare. I don’t know of any other event that requires the combination of social (how to interact with hospital staff and birthing professionals well), emotional, relational (negotiating the needs/wants of partners and parents and siblings), intellectual, and physical that birth requires. Many people compare birth to endurance sports events like marathons, but the fact is that few marathoners have to negotiate important medical decisions with doctors while they are running.

So, what you get in childbirth education classes that you CANNOT get on-line is the opportunity to practice in the presence of an experienced guide. When you READ information, it does not stick with you nearly the way it does when you have practiced what that information tells you to do. As Yogi Berra said, “In theory there is no difference between theory and practice. In practice there is.

You learn SO much by getting to ask a question and having a personal INTERACTION about your question. You get to practice — try out — different ideas in this safe place that is not yet your labor or your baby’s birth. In this place, you get to practice thinking and feeling and relating different ways. You have a teacher, who has probably been at a number of births and seen some of those ways play out in real life, who can guide you in your thinking and feeling and relating.

Childbirth education classes are not really about information. The “facts” are readily available on-line. It is the practice of trying this idea and then this one or, hey, maybe this one that makes this information useful for you. When you are in labor you do not need theoretical knowledge. You need very, very practical knowledge.

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Reposting my all-time favorite post. Because I love my job! Every so often I get a bug to become a better-paid birth professional. Doulas are just not the top earners in the birth field, sad to say.

And part of me is a real midwifery geek. I know I would love learning to become an obstetrician or a midwife or a labor and delivery nurse. I love learning about blood vessels leading to the placenta, about how to guide a breech baby out, about how to diagnose an ectopic pregnancy. Really. GEEK is the only word for the thrill I get from reading about such topics.

But when I am at a birth (as I was a few days ago) I have this fabulous role. This birth brought it home. Everyone else in the room at this hospital VBAC birth was focused on getting a recalcitrant baby out of a woman’s body as fast as possible: cutting her vagina open, attaching vacuum suction cups to the baby’s head, and adjusting various accoutrements to keep track of the baby’s heart rate (which was low and not coming up in between contractions… thus the drama and concern).

In contrast to the midwife, the L&D nurse, the obstetrician, the resident, and the neonatal team, my job was to remain full of trust in birth. My job was to help the mother stay connected to her calmest, most trusting place inside herself. I was allowed to smile and tell the mother that we could all see dark, curly hair as her baby’s head crowned. Everyone else was 100% focused on getting this baby’s head OUT. Fast. The mother and I were able to concentrate on this baby’s individuality. (Her previous babies had blonde hair.)

When the baby was born, the neonatal team whisked him away because of the heavy meconium. (Yet he was FINE immediately. At one minute he had an Apgar of 8. So much for all the panic!) No one but me noticed that the mother was panicked without being able to see or or hear or touch her baby.Of course, after all that drama when she didn’t hear a cry right away, she was afraid her baby was not OK. I was able to stand in the middle of the room and relay news about how her baby was waving his arms and legs and his skin was a beautiful, healthy pink color. All the birth professionals were busy, with important jobs for which they went to school for many years and for which they get paid fair salaries.

But would I rather learn how to measure a cervix or help a mother find her inner power? I am so, so glad that there are birth professionals out there who answer, “I want to measure the cervix.” Without these professionals, birth would not be as safe as it is today. Yet I am happy when I remember that my greatest joy is not measuring blood pressure or fetal heart tones, it is in aiding a woman have the experience that makes her feel like she is a powerful, amazing mother who can do anything. This is a feeling she gets to keep for the rest of her life.

Helping women smile when they remember giving birth. That is a doula’s job.

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I just read a blog by a woman who was trying to decide whether to hire a doula in her second pregnancy. She eloquently captures that inner dialogue that I bet a lot of women have about this question: Is a doula a luxury or a necessity? In her blog post, she talks about her unease with consumerism. Do we need to buy things to be happy? Do we need to spend money to regain our confidence in our own birthing bodies? You can check out her blog here: http://mothershavefeelingstoo.wordpress.com/2012/08/29/doulas-necessities-or-luxuries/

In this post, I want to offer one idea in response to the Mastercard-buy-more-to-be-happy-consumerist problem we all live with in the First World. One of the problems with consumerist culture is that we mistakenly believe that the THINGS we buy are what gives us pleasure. In fact, the things we buy are things that real humans made, transported, sold. It is their WORK that gives us pleasure. When we buy services (massage, health care appointments, a haircut, or doula services) this is more evident than when we buy objects.

When we remember that it is human’s work that we are paying for, not just “things,” we can make wholly different choices about spending money. We can spend money and stop being a “consumer” if that makes sense. We can USE money to connect with other humans. So often we do the opposite. We use the fact that we are paying someone money for something like a haircut or cleaning our house or taking care of our children as an excuse to treat them differently than we would a friend or relative. We all do it. (Be warned: Sometimes when I try to treat someone I am paying for a service more humanely than they expect, they act as if I am crazy.)

As a doula and as a woman, I value so-called women’s work — no matter who does it, men or women. Long ago as a teenager learning about women’s work in history I vowed that I would pay childcare workers fairly even if they themselves did not charge a fair amount (which is true in our area. Our babysitter charges an absurdly low hourly rate and doesn’t charge for sick days: hers or ours!). A more accurate term I learned in graduate school is “reproductive work” — which is all the work that is (usually) unpaid if it happens within a family. It is the work that is necessary to reproduce ourselves everyday (taking a shower, mending clothes, cooking, doing dishes, gardening, etc.) and to reproduce another generation (childcare, etc.)

Because of larger cultural and global forces outside of any one person’s control, we are not able to do all the reproductive work inside families anymore. In my case, a big factor is that my parents, my husband’s parents, and all our siblings (eight in all) live far, far away from us. The closest is a ten-hour drive; many of them live across the globe. Many of my friends rely on their extended family for SOOO much help. My best friend here sends her two kids to her in-laws overnight every Saturday. [An aside: I can’t imagine having a night off of children to spend with my husband free of charge every week. When we do hire a babysitter, we have to go out of the house. I would love to stay at home and sleep at home with my husband with no kids in the house!] Just because I would prefer to have much of this reproductive work done inside my family networks doesn’t mean that is the best way to do it in 2012.

In general, I try hard to be thoughtful about using money and when I pay for reproductive tasks I find I am even more thoughtful than when I am buying plain-old commodities like new running shoes. I want to be thoughtful when I am buying running shoes, too, but I find it is easier to be thoughtful when I actually meet and interact with the human who is doing the work. Because when I pay for reproductive work (cooking, cleaning, childcare, doula work) I am asking someone to step into the shoes of my relatives. I am asking someone to care for me/my loved ones. Money is just the vehicle that allows someone else to have the time to do this work that I do wish my sister, my mother, my grandmother could do for me. But they can’t. So I am using money as a tool — not a substitute — for connecting to real humans.

It’s not a perfect solution to our consumerist culture. But being clear that money is really a metaphor for human time and that what we buy is human work — not “things” — makes me more thoughtful about my choices. And the surprising conclusion I come to when I think this way is that I want to spend MORE of my money on things like doula services and home-cooked meals and less of my money on things like technological gadgets.

What about you?

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Every so often I stumble across or someone forwards me a review of the book that is out there in cyber-land that I’ve never seen. It’s such a strange feeling, still, to know that real people read the book, have opinions about it, but I never get to meet them. It feels like this large family of like-minded birth geeks out there. Wish we could all be in one room together, but I guess there are way too many of us for that! Here’s the link: http://library-mama.dreamwidth.org/135374.html

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Dear Doulas,

My sister recently attended her first two births as a professional doula! (See her at https://www.facebook.com/DueLove?sk=wall) I am happy to say she was also MY doula when she was fifteen years old and I was giving birth the first time. AND she attended our niece’s birth when she was only twelve, I think.

It made me remember those wonderful days of beginning down the doula’s path. I was full of passion and fire. I was really jazzed about women’s power. I couldn’t wait to attend LOTS of births. I was ready to be awake all night. I was so ready, in fact, that when my second birth was imminent, I couldn’t sleep for days BEFORE the baby arrived. And that labor turned out to be two days long. Rookie mistake. 🙂

I wanted to write to my sister, and all the other beginning doulas out there, to share something I’ve learned over the years to avoid burnout but keep up my passion. I heard it first from my doula instructor Ann Fuller, but it didn’t sink in. Then I heard it from a midwifery teacher, Elizabeth Davis, but it didn’t sink in. Then I learned it from a wise doctor in Russia and she said it just differently enough that it finally sank in.

Ann Fuller said: “When you attend a birth, remember you are not the one giving birth.”

Elizabeth Davis said: “When you attend a birth, remember you are not the one giving birth.”

Still, somehow I managed to feel disappointed, as if I had failed in some way, if my clients did not have what I considered “perfect births.”

Finally, about a year into being a doula, while I was working in a Russian birth hospital, I was lucky enough to hear a Russian doctor say, “It helps me if I assume that the Universe gives every woman and every baby exactly the birth they need to learn the lessons they need to learn in this lifetime.” Wow. That shifted my thinking. She later told a group of Americans who were complaining about the Cesarean rate in the United States (in 2000 it was at 25% and we were complaining. Now it’s at 33%) that she believed that, while the rate was high and we should all do what we can do to lower the rate, she preferred to think of it a different way. She said, “What if most of the souls who need the lessons of a cesarean birth are choosing to be born in America?”

I do not use this rather “spiritual” thinking to justify unnecessary interventions in birth. I use a different part of my brain, a very rational part of my brain, when I am analyzing cultural patterns and medical statistics. When I write and talk about larger cultural patterns, I think it is appropriate and useful to access anger and outrage.

But when we are talking about an individual’s experience, I find that accessing this spiritual, zen-like, accepting mode of thinking helps me. I can focus on learning lessons from the experience, rather than kicking myself for failure. Believing that a woman’s labor went just the right way for her and her baby helps me bring a softness, an acceptance, a respect for what she actually, really experienced. I can honor what really happened instead of focusing on what “should have” happened.

And, best of all, I can work as a doula without carrying the weight of the world on my shoulders. I can help women and families. I can rejoice when births go “perfectly,” but I can also rejoice when they go less than “perfectly.” I am better able to focus on the power, strength, and effort of women (and their families) and I am less likely to focus on the negative.

Please do not misunderstand me. I believe that COLLECTIVELY we must focus on improving birth in America. But not at the expense of burning out doulas, midwives, nurses, or doctors. And definitely not at the expense of blaming individual women. If women do not get the birth they truly desire, I automatically blame what surrounds them: a culture that says pain is bad in all forms except perhaps sports, a culture that turns to pharmaceutical solutions far too often (not just in labor), a culture that makes birth sound terrifying and awful, a culture that does not honor the work of women generally (or the family work of men, for that matter).

But accepting each individual birth as perfect just as it is, that is good for my soul.

Thank you for doing the work you do, doulas!

Yours, Big Sister Doula

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This is a quickie post to let you know I will be speaking at the DONA International Conference in Cancun, Mexico as a keynote speaker in July 2012. Come to Mexico with us! I’m so excited!!!! Here’s the link to the conference site: http://www.dona.org/Conference2012.php

I’m planning a session on “Secrets to Support a Natural Hospital Birth” and “Regifting the Gift of Birth By Developing Empathy for Hospital Staff.”

Who’s coming???

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