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Posts Tagged ‘pregnancy’

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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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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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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Hire a doula to avoid an induction!

There is an epidemic of inductions occuring in the United States and Canada right now. The Listening To Mothers II Survey found that, “More than four out of ten respondents (41%) indicated that their caregiver tried to induce their labor. When asked if the induction caused labor to begin, more than four out of five of those women (84%) indicated that it did, resulting in an overall provider induction rate of 34%.”

(You can read more about it at http://www.childbirthconnection.org/pdfs/LTMII_report.pdf)

At the end of pregnancy these days, there are a host of potential reasons your caregiver might suggest an induction. UNLESS YOU HAVE SOMEONE TO TALK TO about it, you are likely to go along with the suggestion. Think about it: at 38 weeks, most of us feel DONE with being pregnant. We’re ready to meet our babies! So when someone offers to make that happen, like, tomorrow, it’s hard to resist. Especially if they add a medical-sounding reason to the idea.

But the fact is that most women do not grow babies too large to birth and most women have plenty of amniotic fluid. But these reasons to induce are offered to many, many, many women nowadays. It’s just not possible that 41% of North American women have suddenly developed narrower pelves and have less amniotic fluid. We have more information (like estimates of amniotic fluid levels) because of more technology. But more information is not leading us to make better decisions. Instead, our caregivers feel compelled to give us the information and the “worst-case scenario” associated with that information. That worst-case scenario is likely to sway us toward induction.

But if we are able to wait a few hours, breathe, relax, think it all through, we can make the decision that is right for us. Of course, there are some situations that call for an induction. But there are many, many more that do not.

Here’s where your doula comes in. Your doula will not be able to give you medical advice and she will not be able to make the decision for you. But she can offer help in YOUR decision-making process. She can ask questions. She can point you to resources. She can connect you with other women who have faced similar dilemmas who might be willing to share their wisdom. She can tell you stories. She can suggest a long list of natural induction methods you might try before going the medical route. She can guide you to think through how you might feel if this induction turns into either an epidural or a cesarean.

In short, she can help you make your best decision. It might be that the best decision is to induce. It might not. However, talking your decision over with your doula — someone who knows your birth plan, your birth vision, your birth dreams — will help you have peace of mind.

I run mom-and-baby groups in my hometown. So many new mothers come to our group with great sadness and regret about how their labors went. They say, “If only I had known…” a lot. A doula is like insurance against regret. She helps you make your decision fully and consciously so that, no matter what happens later, you have confidence that you made the right decision to begin with.

[P.S. Why does avoiding an induction matter? Because when women are induced, a host of other interventions often follow (called “The Cascade). A common drug for induction, Pitocin, makes contractions feel more painful. FOr a woman planning a natural birth, this can really get in the way! But even for a woman planning an epidural, Pitocin contractions in early labor can be a problem. If you get an epidural before active labor really kicks in, your labor can be long and slow. But if you wait until active labor is really going, you will probably have to weather some significant, unplanned-for pain. In other words, no matter what kind of birth you are planning, Pitocin gets in your way. (If you want to read more about this, I refer you to either Henci Goer’s book “The Thinking Woman’s Guide to a Better Birth” or my book “Natural Hospital Birth.” Both of these books talk about Pitocin in detail.)

Another important reason to avoid induction is that the rise in induction rates corresponds with a rising rate of babies born prematurely. If our dates are off (which they often are!) we could be asking our babies to be born a few weeks too soon. Nature has a fabulous plan for your baby’s birthday. Let a doula help you avoid an unnecessary induction and discover your baby’s “real” birthday!]

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What do doulas need in their stockings or in their Hanukah packages? Hmmm, I thought I would dream about good gifts for doulas. I am VERY practical gift-giver. I like gifts to be useful and not anything that will add to clutter. I suppose some will think “thank you notes” could add to clutter, but I think they also add to a nicer world, so they remain on the list. Cheers!

1. A child-size rolling pin from Palumba (http://www.palumba.com/product/298/)

I always carry one in my doula bag in case a laboring mom wants back pressure during contractions. After about an hour, I can’t do hip squeezes anymore. My wrists give out. But I can run a rolling pin over a mom’s lower back for 20 hours. I know. I’ve done it! If I use the rolling pin during labor (probably about 1/4 of the time I do), I give it to the parents as a baby gift along with a cookie recipe at my first prenatal visit. It usually gets a smile.

2. Beautiful Thank you notes, maybe with her name embossed on them?

Always a good idea to have a package of thank you notes in your doula bag for nurses, doctors, midwives, lactation consultants. For anyone who is helpful in any way at the birth. Helps spread the love for doulas a little bit further.

3. Essential oils

I get my essential oils at a great local shop called Indigo Forest. Beth will ship to you and consult by phone about your essential oil needs. She convinced me this year to carry frankincense with me and I am glad she did. It’s such a useful essential oil! You can google its many uses (or call Beth and ask her. She’ll convince you, too!) Of course, the moms you attend may or may not be into essential oils, but even if the mom I am attending does not want to use them, I use them on myself! I always, always have lavender for calming myself down. It works in an instant. It’s like deep breath in a bottle. If the mom I am working with does not like scents or finds aromatherapy too “out there”, I am careful, of course. I just smell my bottle, I don’t put any on my skin. And if she is allergic, then, sadly, I don’t use them at all. (Indigo Forest is http://visitindigo.com and phone (734) 807-9909)

4. Honey Sticks

I get these at our local farmer’s market. If someone bought me a package for Christmas, I would be thrilled. I always have to make sure my kids (aged 10 and 7) haven’t gotten into my stash before I attend a birth. They are so great for an energy burst (for mom-to-be or me or, in one case, the tired doctor).

5. A donation to a birth-related cause on rockethub or another crowd-funding website

There are a FEW birth-related projects out there looking for funding. I happen to know the woman who is doing this project personally. She’s a young, inspirational college student trying to help teenage moms. She became a doula last year. Check out her project at rockethub and make a donation in the name of your favorite doula! http://www.rockethub.com/projects/4703-teen-pregnancy-help

6. An extra few hours of sleep

If anyone knows where I can find this this December, please let me know. We are fresh out of this hot commodity in Ann Arbor. I’m hoping a new shipment comes in soon!

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Hire a doula because, when all is said and done, she is the only one at your hospital birth (besides your family and friends) who answers to you as her final boss.

Your midwife, doctor, and nurse are probably wonderful and probably they want to help  you achieve the birth you want. But midwives, doctors, and nurses who work in hospitals have to answer to a lot more people than just you. They have to answer their colleagues. If they manage births in an unusual manner, and in today’s world, “unusual” may mean “more natural” just because of the statistical realities of interventions, their colleagues can exert subtle or not-so-subtle pressure to get back in line. And they have to answer hospital review boards and insurance companies. Insurance companies have a lot of impact on our medical institutions. Since obstetricians are the most-sued doctors in America, you can imagine that insurance companies care how they are practicing!

But doulas do not answer hospital review boards or insurance companies. They answer to mothers. Doulas are there for mothers. It is their entire job. One hundred percent. They do not have to spend time during your labor inputting lots of data into computers. They are focused on how you feel.

So it is definitely a good idea to make sure that your entire birth team is on board with your birth vision. It’s a great idea to make sure your care provider can handle whatever comes up (even if that means transferring your care. Transferring is still great care.). But it’s also helpful to hire someone who answers only to you. When you look in her eyes for reassurance in your decision-making process, you can be certain that she is reassuring YOU. She is helping you make the best decision for YOU.

Do you have any stories that exemplify this? I’d love to hear them!

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