Who Is Responsible Anyway?

May 072012
 

Have you ever been to a restaurant and had a great meal only to become sick a few hours later? Did you wonder if it was the food you had eaten? What if it was the flu and not the food at all? Would you return to the restaurant again? Would you wonder if it was really the food after all? Would you get queasy as you entered the restaurant?

I met a young mother of two, pregnant with her third this weekend that discussed her last birth with me. She is considering a different home birth midwife this time. I inquired as to why. Her husband really wants her to, feeling the midwife lives too far away. I asked for more details. Seems her second labor was so different in the lack of intensity from her first that she mistook active labor for really being early labor with her second. She had called the midwife, but had not even taken the time to time contractions yet- feeling it very early in the labor. But when intensity came over her, a call to the midwife was only 30 minutes prior to the birth. The midwife did not make it in time for the actual birth, but arrived a bit later. I did not ask if she was happy with her birth. But it seemed the father had not been happy about the unassisted birth. This time she wants a doula. I suppose she thinks a doula may know when to call the midwife sooner. She also said she would feel better about having the doula come sooner than she would have the midwife come. Although, I am unsure why. But as I pondered this more I thought, the midwife did nothing wrong. Yet the father assigns the negative memory of this birth to this midwife.

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Labor and Birth Jenga

Apr 202012
 

Labor and birth is a balancing act. Moms sit down with their doulas and share what their birth ideals are but often times what is shared is what she thinks her birth ideals are supposed to be. She may be thinking she wants one type of birth, but internally she is not sure she is committed to that ideal. There are a lot of factors that enter into their birth experience. What kind of birth does her partner want for her? What kind of birth does her family want for her?  She may be committed to her  birth ideals but as her labor and birth unfold parts of the jenga puzzle are pulled out and all of a sudden emotionally she is spent and she can not hold onto the ideals she thought she was committed to at first. Perhaps her water breaks and her labor does not begin on its own. The augmentation to her labor shakes her to her core and she no longer is able to see herself managing without pain medication. Perhaps she thought she would begin labor rested but instead it began after a long day of work and beginning labor fatigued is too much for her to be able to stay the course originally planned. Perhaps her water releases only to reveal thick meconium and the plan to labor in the tub are no longer an option. Maybe in her wildest dreams she labors for a full day but then when 24 hours of labor pass and she still has more to go, she can not move past it being longer than she had ever imagined. Maybe she thought she had her friends and family on board with the emotional support she felt she needed, only to have phone call or text messages asking why she has not already had that cesarean that seems to be inevitable anyway. There is a wall she can not climb over. Continue reading »

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Taking Credit

Apr 012012
 

March was a whirlwind month for me as a doula. And I had some pretty awesome experiences. Last night I was driving home from a long birth that ended up in the OR for a cesarean. I did what is my custom, I called my best friend who also is a doula and educator with my company. She usually talks me home when I am sleepy and also allows me to regroup or process a birth. And she reminded me that we can’t take credit or blame when a birth does not go as the mom wanted any more than we can take credit when it unfolds beautifully just as the mom has  dreamed. And of course it made me realize this needed blogging about!

Last week a women chose to not hire one of my newer, less experienced doulas since many of her births had ended in a cesarean. And I wrote the woman back an email letting her know of the other doulas who were available. She had originally specifically asked about this particular doula. This is what I wrote her:

I understand your concerns- I will say that this doula’s outcomes are more about where the moms have chosen to birth and chosen as their care providers more so than her lack of experience. But the more experienced the doula, the more experience she will have with water births and particular practices and hospitals. For instance 49% of my births are at the hospital you are choosing- 68% of my births are unmedicated and 28% are water births- but that says something about the moms as well as the doula… all of the women who come to me do not want to have an unmedicated birth and some do not choose water births… so keep that in mind when finding the right doula.

I often have moms ask my for my stats as if it is a grade of what kind of doula I am.And I do keep my stats to see trends and also outcomes overall. But my stats don’t prove what kind of doula I am.  I support moms. I offer suggestions and guidance. I do not make them do what I think they should do nor do I judge them when they make decisions different from the ones I would make. Where and how I would give birth is fundamentally not part of the equation for their births. If someone is looking for a birth that is quite different from the ones I have had or like the ones I mainly do, it does not mean I can’t support them.

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Tincture of Time

Mar 272012
 

What does tincture of time mean to you? This week has been a time of clarity of what that can really mean…

I have a mom who stopped back by for a second visit after having had her baby. She came to get some breastfeeding support and advice. Seems her pediatrician was not fully supportive of breastfeeding due to a slow weight gain by her son. He looked great, was wetting lots of diapers but seemed to have what her doctor felt were too irregular. She felt this mom may not have good nutrition to her breastmilk. This mom appeared quite healthy and has a great diet. The doctor suggested she only give formula for a few days and bring the baby back to be weighed. The mom knew this did not seem right but she followed the directions but still pacified the baby at the breast and pumped to keep her supply steady. The thought was if the baby did not gain well, it must be a metabolic issue or something wrong with the baby. But again, looking at the baby as Dr. Newman suggest is done rather than looking at the scale, the baby seemed quite healthy and happy. A few days later, the mom called me to tell me that the baby gained fine and she was resuming full breastfeeding again. The tincture of time was what was needed. Hopefully this pediatrician will become more supportive of this dyad in the future.

I have a mom who waiting patiently for her baby to be born. She went past her guess date and had tests done by the perinatologist that showed all was well with her daughter. She went into labor just before 42 weeks. Her daughter did not enjoy labor and showed us so profoundly just as the back up physician to the midwife entered the room. It was as if she was waiting for him to arrive to let her desire to be born by cesarean known quite loudly. The baby girl was born and needed to have a few days of transition in the NICU before returning to her mom and was home. The mom pumped her colostrum in the meantime. Today the mom called me with what she thought was an oversupply. I reminded her that the tincture of time was needed for her body to acclimate to how many babies she had had and begin to regulate her supply. Time is all that is needed. Continue reading »

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An Extension of Your Arms

Mar 172012
 

I have been a doula for a long time. I have owned the VHS tape the Rebozo Way by Guadalupe Trueba. I have used rebozos in labor for more than a decade. I teach the use of them in my childbirth class. I have attended a Spinning Babies training with Gail Tully and am certified as a Dancing for Birth instructor with Stephanie Larson  where they both teach the use in helping facilitate movement for babies in labor.

But not until I attended Gena Kirby’s Rebozo Workshop had I ever heard the analogy of using the rebozo like arm extensions in supporting a mom in pregnancy and labor. When she said that something clicked! Did I learn anything I had never been exposed to before in my previous training?- no. But was it delightful to be challenged to take that which I had been shown in the past to a new level and begin to really incorporate it into my labor support more fully- yep! And for that I can say thank you to Gena for inspiring me to take a rebozo use to a new level with my work as a doula and childbirth educator.

She told us about a company out of Vancouver that supported a village of women in Laos who made jias and supported their families in doing so. A jia is the asian version of a rebozo- the mexican shawl that midwives use in labor to help a woman be more comfortable and also for use in labor.  I contacted the company and put together an order for several of the birth professionals in the Atlanta area. but I also ordered some for inventory to sell to others.  These are very large rebozos- they average 8.8 feet long and are about 27 inches wide.

They can be used to carry infants and children as well as the “extensions of your arms” if you are a birth care provider.

If you want to purchase one, let me know.The pics are below. The cost is $50 and is a pick up price and I will have them in stock by late April. Here are some photos of a rebozo in use for inspiration!  And I hope Gena returns to Atlanta- I would happily host her again to be further inspired!

 

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What I Have Learned After 500 Births As A Doula

Dec 072011
 

This past month, I was able to be at my 500th birth as a doula. I have been attending births for 19 years!  I thought I would share some things I have learned in that time and in those experiences.

  • Birth is normal. And although the unexpected can happen, most births are normal. Enter into a birth expecting normal things to happen rather than awaiting the emergency.
  • Birth is unpredictable. I caught my 501st birth in the bath tub of her home- only 2 and a half hours after she left the hospital being only 3cm for the last two hours with no change- and it was her first baby! You have to trust birth so that when the unpredictable happens, you are able to move fluidly through it.
  • Fear is part of the process. But if you have not dealt with your fears before your labor begins, fear can be a harmful enemy in the midst of labor. Deal with it prior to your labor b beginning and it is amazing how your labor will unfold.
  • Women’s bodies are made to give birth. But we are instinctive birthers. If you move a mom- tell a mom how to birth- put her on her back- have her be in an environment that causes fear, you will destroy her ability to listen to her body and birth instinctively. Continue reading »
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