Developing Your Inner Doula

This is a copy of my notes (polished up a bit and put into sentence form) from the doula conference this weekend.

I was VERY nervous, but received overwhelmingly positive from feedback from most of the people who were there, as well as encouragement from the PR Director of DONA (who was in attendance) to submit this article for publication in DONA's industry publication, International Doula. This in itself is quite flattering, as I have had the cover story in this magazine before, and I would nearly burst with pride to have it again.

So please post your comments or questions, and I will consider them all in the writing of my final draft of this article, before I submit it for publication to DONA. Thank you, and happy reading!

And to those of you whom I met at the conference-- it was lovely to meet you all, and I wish you nothing but the best in your pursuit of being the best doula you can be!

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To develop your inner doula is to become a gatherer.

Picture a squirrel, constantly seeking out small nuggets of nourishment, and savoring each little bit, treating it as if it were gold. This is how we nourish our minds, and our creative skills for our clients. Their nourishment is food, and ours is information. We should constantly be seeking new perspectives, and new information. It may not be useful in this moment, but tuck it away, and when you need it, it will be JUST THE THING, and nothing else will do.

Developed doulas teach classes.

To teach, even if once a year, you put yourself in a position to gather unique information. You can learn a lot from others. Perspectives and vulnerabilities you can’t see from any other vantage are visible in the nuanced interpersonal connections between teacher and the nervous expectant parent. Pay attention to how different people make you feel, and ask why they make you feel this way. This is a great way to test yourself for your own preconceived ideas about people and birth. Ask yourself if you feel effective in reaching your ‘problem students’, and what you could have done differently for them. The answer will change you.

What you can learn about yourself by teaching is invaluable. Seeing yourself through the eyes of the expectant family can help you fine tune the image you want to portray, and your communication skills. So, Tell the world who you are, and what you believe in, and you’d be surprised who is listening.

I think it’s important to note-- Teaching is not just for our cleints, we can teach one another as well, in meetings large or small. Topic oriented meetings are best, I have found, as doulas LOVE to talk birth! And if we don’t have an agenda, we will generally fill the allotted time and barely finish up the introductions! So make sure you have a goal or topic in each setting, and reach for it.

Developed Doulas attend/volunteer for Non Profit Organizations dedicated to new moms

To help a mother with BF issues, you need to know what the most common issues are in the first weeks and months of life. La Leche League is the best place to go to hear about these issues, and the multitude of women with variations on each issue and how to handle it. This group is an amazing resource for finding ‘alternate ways’ to look at common problems, as well as other methods of coping. The main points of the more common breastfeeding obstacles can be read in a book, but the tips, pointers, and life skills are passed from mother to mother, and if you go to the meetings, they will pass on to you, as well.

In one meeting your inner doula may learn enough to help a woman continue to breastfeed up to or beyond her original goal, and we all know this makes all the difference in the lives of that mother and baby. These same rules apply to meetings for ICAN, and other groups related to birth and parenting. They all have a unique point of view or group of mothers in need that YOU could learn something from.

In order to grow, we need to learn, and meetings like this will stretch our brains beyond our own experience and allow us to be a better doula to women with the specific issues these groups cater to.

Developed Doulas contribute to their community. And not just with money.

Do a BOLD Red Tent Event, startup a Trust Birth Initiative, sign up as a guest speaker at ICAN, LLL, or at different types of birth classes. As doulas, with each act of giving, we get so much in return. So let us give, for the betterment of others, for the betterment of ourselves, and the betterment of our doula community.

You don’t need money to invite women into your home to learn and talk about birth. There is more to giving than dollars—we can give our sense, too!

But please donate something, as it develops our roots in the community as doulas, our connection to the people we serve, and an awareness of doulas in the cultural consciousness. Donate your time so that women know how to find a doula on the day they decide they need one.

Developed Doulas are aware of the mainstream and cultural forces in their field

We should spend two hours each week reading industry materials. And no, I don’t mean blogs. Blogs are a FABULOUS WAY to keep your head and your name involved in the goings on of your field, but reading a blog on someone else’s opinion is reading an editorial. Newspapers differentiate between news, which is fact based, and editorials, which are opinion based—and you should, too.

While these outlets may serve to reinforce your opinion, or get you motivated, it is not to be confused with following the research or literature of the industry we work in.

Developed Doulas check their sources and ask hard questions. Developed Doulas don’t accept anything as fact because of who posted it on Facebook.

Check your sources, and make sure they are reputable, consistent, and fact based. Emotion-laden media serves a lot of purposes for doulas, but please don’t confuse it with fact seeking. Developed Doulas know their stuff. J

Developed Doulas do not indulge the negative media surrounding birth on television.

This is not the good for our professional self-esteem, and in most cases just gets us riled up and frustrated. So turn them all off (unless you know an amazing midwife or doula on a particular episode, and then you SHOULD watch—because those are the shows that we hope will change the rest of them).

Instead, we can read a book, or watch a reputable DVD to expand our knowledge base, so our personal wisdom grows. And with wisdom, comes confidence, grace, and a greater ability to conduct yourself in a relatable manner to your audience, no matter who your audience might be.

Developed Doulas make friends with people whose professions compliment theirs

Visit the offices of professionals who serve the same clients you do. Get to know them, how they work, and their side of the birth story—as we don’t all see it from the same point of view.

Get to know a massage therapist, a physical therapist, an acupuncturist, a lactation consultant, a postpartum therapist, a chiropractor, a midwife, a nurse, an Obstetrician *gasp*, a medical biller, etc. This will create a great referral base, and make you more knowledgeable about birth and pregnancy as a whole.

Developed doulas know their fellow doulas.

Make an effort to meet all of them, and not just the ones nearby. Know the other options, and opinions that help to shape birth in your area.

Developed doulas have backups, and lots of them.

Create a backup program with doulas from the four corners of your ‘workzone’. Meet with them quarterly. Develop a backup fee structure, as well as a ‘finders fee’ for referrals so no one loses when we’re not a good fit with someone.

Developed Doulas ‘Mother each Other’

Share birth stories, and the emotionally difficult parts of working birth for you, and for your family. Share where you felt inadequate, and where you felt strong. Share your general impression of yourself, and who you hope to become. We need to share these things with our backups, to create an intimacy, and a loving trust.

Offer them the opportunity to do the same, and tuck away the seedlings you see in them and hope to see more of in you. This builds us up from the inside out. When we allow ourselves to be mothered, we become more comfortable mothering others. We need to receive nurturing in order to do it well.

We love our clients with the same hearts we love our families, our fellow doulas, and ourselves with. So spread the love, and share your journey.

Developed doulas refer to others.

When a client isn’t right for us, or we can’t take their EDD, the responsible thing to do is to refer the mother on, so she doesn’t have to go back to square one. We need to lovingly, and gently hand that mother to the waiting arms of other trusted doulas we know. Who better to help them than the women we know best?

Those local doulas whom we’ve sought out relationships with, and whom we trust and understand deeply are waiting with open arms to help the people you can’t. Now we have already acted as doula to that woman and her family by mothering her, and sharing the love with the doula we referred her to.

And her new doula, has a mother who is pre-loved, and comfortably nestled within a community of confident, caring women, and already knows she is home. This mother has already benefitted from the gifts a doula has to offer before she even chooses one—and THAT is good for business, it may not hit our pocket books just now, but it will catch up in time.

Social Media can be amazing. Developed Doulas use it.

There are legions of people out there with interests like yours, who are passionate about your passions. Social media is a tool you can use to keep motivated and forward thinking. There are also people who need to hear what you have to say. Some of them don’t have access to a doula, or are unsure that you even exist.

So get on Facebook, get on twitter, speak your mind, spread your words, and get people interested. It will keep you interested as well, and that will make you better at what you do. So after you read this, friend me!

Developed doulas Blog about their experiences.

It is important to maintain client privacy, but you can still blog about your thoughts, and issues you perceive to be important.

We should share tiny things we learn over time that can improve someone’s postpartum or prenatal period. These are the small nuggets that the other doulas will seek out, and hold onto as treasure until the moment that your experience can improve the life of one of their clients.

Sharing your tricks makes us all better, and community success means individual success, as well. Blogging will make you create the time you need to really think about your true feelings on each aspect of birth. This will also clarify your thoughts and make the information you share with clients more concise, and thoughtful.

This is how we learn, how we assimilate new info, and how we share what we’ve learned with others. This is how we create a community of women, all coming together to feed their inner doulas. This is also how to create a better world for women to grow up in, and mothers to birth in.

And in this way, developing our inner doulas will make the world a better place.

And you just thought we made the world better by creating fabulous birth experiences for as many women as we can reach! But we’re so much more! Especially when we grow as a team.

Let’s develop ourselves into a mighty presence of confident women who are in the business of sharing our wisdom to change the experience and culture of birth for this and all future generations.

Lets support change by supporting one another, and spend our time being purposeful and dedicated so we can change the world!

I am a developed doula—and everyone reading this and seeking more information is, too!

Give yourself a hand for pioneering a field that is so unique and so needed, and let’s work together to create a powerful movement, and an enormous lobby. Let’s change the world one birth at a time, and by leaps and giant feminine steps!

Let us leave in imprint on the birth community in the shape of our high-heeled shoes (or our birth crocs). Please join me in the reshaping of birth in America. I look forward to sharing my journey with so many amazing, and powerful women. Thank you.

A few compliments worth mentioning....

This is an excerpt from a blog from a student and doula client of mine, I thought it was worth sharing.

Yesterday put us at Week 35. The biggest thing on my mind right now is making it full term . . . to Week 37. I think once I hit that milestone I'll be able to take a deep breath. Or at least when baby drops! Whichever comes first - lol!

Tonight we have childbirth class. I cannot tell you what a positive experience that has been! Most of you who know me very well know that I need all the details and facts up front before taking on anything big. (I'd say giving birth is pretty big, wouldn't you?) I need to dig my nails into tons of information, ask hundreds of questions, and make informed decisions. T is much the same. These past 8 weeks of class (and 4 more to go!) have opened my eyes to so much that I never even conceived of. Everything from the effects of good nutrition to the business of birth in the US to exercises that help baby get into position to dealing with emotional/relationship issues prior to birth. Babywearing. Breastfeeding. The effects of drugs. Midwife vs. OB. C-Sections. How they administer an epidural. How to deliver a baby in the car. Tearing vs. Episiotomy. Even orgasmic birth! (which we're all pretty sure isn't in the cards for us, but if it is - hoo haa!).

I've met the most wonderful woman (our instructor and doula) - Colleen - who has been not just a wealth of information, but a strong emotional support for us (well, mostly me when I go batty over something). She introduced us to a great provider and I will never look back on deciding to leave our previous OB and go with a midwife. There is so much to be said for women helping women during pregnancy and birth - for women empowering other women. And Dad too! While we ladies may first take notice of a guy's hair, eyes, body - I can honestly say that I've never loved my husband more than when we are talking about how we want to birth this baby. How WE want to bring this child into the world. He has never shied away from or turned his head in disgust of any topic, video, or photo he's seen. He's all hands on and I am so blessed to have him coach me on the big day. I'm going to miss these nights going to class together. It might not sounds like a date, but I'd consider it one. (ok, feel free to gag if you want to :)

We've also met some great couples in class - all of us first-time parents navigating the waters together. We've spent countless e-mails discussing pediatricians, cloth vs. disposable diapers, vaccines, class, and most recently - the fact that we're all due within a few weeks of each other and they've also now switched to the same midwifery we're using. Ha! Wouldn't it be something to all be labor at the same time!

The best part about that last line is that two of them delivered 14 hours apart at the same hospital and the same group!

Birth Porn-- the power of birth videos and dads

I show a lot of videos. The kind that people are afraid to see. The kind that people assume I will show, and are anxious about before they go to a birth class. The kind that make expectant fathers drag their heels in the sand and beg to stay home to watch the game instead. Full frontal birth porn. That’s right, I said it. Birth porn. It’s graphic, it’s messy, it’s in your face, and I play it on a large screen.

A few of the dads in my last series came in with some squeamish reservations, putting on a brave face but doubting their ability to view and support the act of birth without some sort of visceral or fear-based reaction. I had a lot of questions on the first day about the emotional repercussions that couples experience in their postpartum sex lives as a result of the dad’s ‘trauma’ by seeing the birth, and also a lot of questions about what exactly they would have to see, and if it was possible for them to see little, less, or none of it at all. I heard about fear of blood, and being afraid to watch their partners be in so much pain and not being able to do anything about it—the old adage that partners of laboring mothers are ‘helpless’. These are not uncommon questions, and I get them all in some form with every group. In time, I make sure they all learn how very powerful their influence is on the day of the birth, and how powerful his perspective, and attitude, and words will be for her—even if they’re said from a few feet away. And then with each group I say the same thing—this class is a safe place for you to view and familiarize yourself with the images of birth. It is your responsibility to challenge, recognize, and respect your limits when your child is born, but you won’t know what those limits are until you challenge them. If you find that you will be unable to view the birth, it is your responsibility to communicate this to your partner and birth team, and then hire a doula, or find someone who can do so in your place, because a laboring woman will need you nearby, even if you are supporting her from a seat in the corner.

I start slow, showing things on the more modest end of the spectrum, and work my way up to a few more ‘extreme’ births. Starting slow is no consolation to many dads, as they have never seen a birth in their life, and it seems so PRIVATE and INVASIVE and INTIMATE and PAINFUL to watch. To say they are uncomfortable when viewing these films is quite an understatement. From the point of view of a beginner, what many of us see as beautiful and natural, appears dangerous, messy, fear-inspiring, and foreign. I think it triggers in them, too, a fear of what their responsibility will be to their partner, as they undergo this foreign and painful looking process.

So, we start slow, but I don’t pull any punches. This is desensitization. I will explain exactly what they are going to see, what they need to watch for, and what I want them to learn from watching each film. My goal here is for them to see so much birth that it starts to look familiar, and no longer sounds the alarm in the part of your brain that detects danger. This same part of your brain produces anxiety as a fight or flight response to perceived ‘danger’. By watching these videos week after week, I take away the threat that theses birth images pose from the men in my classes. It’s a slow a subtle process, but it works. Even if they make faces, or turn away, they slowly acclimate to the images before them, so that when their partner is laboring, he has nothing left but the knowledge of what to do to comfort and support her, and his own emotions of anticipation, excitement, empathy, and perhaps a little sleepiness.

I perform my weekly ‘exposure therapy’, where we see bodies and births and babies galore. Eventually their responses grow less physical, and I see fewer and fewer grimaces, even as I start to show videos that are VERY graphic, and more intense than anything they are likely to see at their own birth—like the unassisted home birth of twins, where the second one is a footling breach. They may not enjoy the videos, but they don’t bother them much anymore. And since I have 12 weeks to do this, it’s quite effective, and in the end, they almost all thank me for showing the videos I did, realizing that this allowed them to attend their birth without fear—something birth classes often only focus on for the mother.

My last series just ended, and they’ve almost all given birth now, and I was present at their births—and they were AMAZING. Each dad knew just what to do when his wife needed it, and none showed even the slightest aversion to the ‘wetter’ parts of the process, or the birth itself. One dad watched as his baby became visible in his wife’s vagina, and looked up at me with amazement, and excitement—and none of the aversion or fear he thought he would have on that first day we met. And he ALMOST, ALMOST reached down to bring his baby up to his wife as it was born. At the last moment he chose to hold his wife’s hand, a decision that I fully support. But I am convinced that with the next baby, that daddy is going to deliver! He didn’t wait for his baby to be cleaned up, but reached out immediately, loving all the wetness with his whole heart and body, with no interference from that pesky fight or flight response center.

I was SO. PROUD.

The BAD Labor and Delivery Nurse, and what to do about it...

Today Facebook is abuzz with the blog post by a personal friend and soon to be student of mine. She was privvy to a VERY inappropriate conversation on Facebook that was also very public between an OBGYN and a nurse working in the same facility. To protect her privacy, I will simply post the text of her post here:

So-called compassion for c-sections from L&D doctors and nurses?

On Facebook, I have one particular friend from grade school who happens to be an OBGYN. Last night, she posts this status update (name removed for obvious reasons):

OBGYN - Waiting on a delivery.... Baby please come soon. I'm getting tired. 10 hours ago via Facebook for iPhone ·
To which her friend, a labor and delivery nurse responds:
NURSE - Ahh just cut her. Fuk it!
10 hours ago

I was infuriated to say the least and sickened to my stomach. I honestly felt like I was going to throw up. I couldn't sit there and let it go:

ME - wow NURSE - that's about the most insensitive thing i've ever heard in my life.
9 hours ago ·
ME - and this is coming from someone who had a doctor cut her baby out of her, never followed up on her care, didn't know her baby was transfered to another hospital in critical condition, left her with a festering infection for two months and could care less that i was stuck to a wound vac for another month after that. so yeah, just "cut her" sounds like really great advice.

8 hours ago · If you think any of that was enough to make you toss your cookies, these are the responses I woke up to this morning:

OBGYN - NURSE is an amazing labor and delivery nurse..., who knows me well and knows that I don't do inappropriate sections. I'm sure she was joking.
8 hours ago

NURSE - Relax MOTHER all that wasn't necessary. I am sorry u had such a bad experience for such a joyful moment. And thank you OBGYN I truely love my job and I know how to relax and joke! Hope the delivery went a bit quicker and MOTHER I hope you found a new doc....try dr ####!!
5 hours ago

ME - Out of curiosity - I wonder what the mother of that delivery would have to say to you if she saw what you wrote...what do you think her reaction would be?
about an hour ago ·

NURSE - im sure she would have a laugh with me instead of being so uptight like certain people on facebook. The problem with patients is they try to control their own deliveres so much for example "birth plans" that they set themselves up for failure. Than they dont actually look into their doctors history they just randomly pick an OB and thats how things go so terribly wrong. Patients need to have a true advocate if they feel they cant do it for themselves. So its always nice to not treat ur nurse like shit and she can be your advocate.
40 minutes ago

I'm still debating what route to take next. With the skyrocketing Cesarean rate in this country, and people finally looking at those numbers - calling it unacceptable - I'm still shocked that two "professionals" would retort in such an ignorant manner. I am 100 percent open for suggestions on this one.

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To begin, this may have been a VERY callous and in poor taste joke between two overworked birth workers. The hospital environment is a hard working and exhaustive one, and I don't think anyone would believe that having a family and being up all night delivering babies is easy. I would like to state for the record, that I do not indulge in 'doctor bashing', or 'nurse bashing', and that I do try very hard in all of my classes and exploits to show consumers what birth looks like from the other side. Each side/perspective of birth has it's own share of pressures, inequalities, and points to consider. I always seek to understand the differences facing each side of a birthing issue, and try to bridge that gap. I spend a lot of time in my classes explaining how birth works for the hospital worker, as well as the added pressures faced by OB professionals and Midwives that people may not be aware of. This awareness creates understanding and sensitivity, and can make all the difference in the feeling and function of the 'team' at a birth.

So all of that out of the way, what this nurse said online is heinous. It's irresponsible, it's insensitive, it's rude, and worst of all, it's ignorant. It's ignorant of what kind of ramifications a surgical birth can have on a mother and family. It's ludicrous that a birth nurse could be so naive to these things, especially with all the news in the last month about cesarean. First, there was the NIH VBAC conference, which called into scrutiny womens' lack of access to VBAC births, and noted that repeat and initial cesarean rates were too high. And just this week the CDC released the 2007 statistics on the American cesarean rate, and it's at an all-time, all-world high. I won't be surprised if this bumps us from 28th in world rankings for maternal and fetal outcomes to dead last, so it's not an insignificant piece of news. A piece of news you would expect a birth worker like her to have heard about.

Clearly, there is a problem in our country, that this nurse doesn't see to understand, but more than that, she seems to be unaware of the massive efforts to change the problem, and even the current events on the subject. Add to this, that she seems UNCARING about the problems our country face, which can only be addressed one birth at a time. This is regrettable, to say the least.

It is repugnant that someone would be so unthinking to post an exchange like this in a public place, and with the attention this is getting, I sincerely hope her administrators are made aware of it and some sensitivity training and cesarean prevention education is put in place for not just her, but her entire workplace, as attitudes like this tend to fester in overworked and overstressed work environments.

Another point I'd like to make is her commentary on consumerism in birth and birth plans. We've all heard the rumors that nurses 'don't like them'. I have my students write their 'birth preference lists' very carefully, taking care to say things like, 'I trust your judgment, and these are my wishes in the event of an uncomplicated labor/delivery'. This nurse's experience is right in saying that women need to choose their providers more carefully if they want certain things to happen or not happen at their birth. Our biggest assurance for the birth of our choice is the questions we ask and the provider we choose.

However, many people stick with their teenage ob/gyn and don't look into their options, or choices. Women DO need to get educated and make better choices. This is our responsibility for our own health and our own experience. And again, this is something I cover extensively in my classes. HOWEVER.... this nurse seems t o go astray of reality when she starts assuming that women write birth plans as a mechanism to control their births because they do not have a supportive provider. This is where her personal prejudice takes over, and this is unfair to all the women under her care who do their homework.

To make the assumption that anyone with a birth plan is a 'control freak' a 'difficult patient', or 'bound for a cesarean' is a personal prejudice that does exist that I'm not sure what to do about. This nurse talks about parents needing an advocate in the birth process, and I agree. They need a DOULA, someone whose role is nearly the definition of what she is describing. But when this nurse suggests that a woman's advocate should be her nurse, I must say that I thoroughly disagree, and I do so with the utmost respect to nurses.

I have worked with some WONDERFUL women , and not every nurse is guilty of these kind of personal prejudices-- in fact, I think and I hope that most aren't. To rely only on the advocacy of your nurse, who will be working with several other patients and doctors, and whom you will meet only after labor has begun, and whom you know nothing about is not a good idea. A doula, on the other hand, will meet with you and offer support and education from early in pregnancy, and offer a continuity of care and personal attention throughout your labor that a hospital nurse cannot. You can get to know your doula and choose someone who 'click' well with your personality-- but the nurse you get is luck of the draw, so personal prejudices and opinions about birth won't be discovered until labor is in full swing, which is not the time to realize you're lacking support from the only source you planned on.

I also want to address the idea that is expressed by this nurse that women need a 'buffer' between themselves and their care provider. The sentiment here is that it's 'us vs them', which I could not disagree with more sharply. I emphasize choice and consumerism to my clients and students, and together we construct a personalized birth team based upon their wishes, goals, and specific medical concerns. The idea of advocacy in birth is wonderful, as labor does put a woman in a vulnerable place. For the laboring woman and her partner to feel 'safe', having the continuous presence of a doula who acts as an emotional support, an educational resource, and another pair of hands is only natural. But some women don't feel threatened when they are vulnerable, and some partners are well equipped to care for their laboring mothers. Educated consumers will have a provider who is aware of their wishes, and on bo ard with their goals. They will have assembled a birth team that is supportive and loving and of the same mindset, and they won't need to be protected from the 'snipping scizzors' that this nurse perceives to be always at the ready. It's also important to note that the most supportive nurse in the world cannot sway the decision of the medical care provider, or 'protect' the laboring family from intervention if its the opinion of the caregiver that it is needed.

I love nurses, and I really don't want this to be a tirade on nurses, even this particular nurse, who is largely guilty of misinformation and insensitivity. I teach my students and clients to befriend their nurses, and write down their names so they can ask for them with the next birth. I do believe that being nice to your nurse WILL give a better birth, and in many ways, the nurses are the gatekeepers and keyholders to smoother and kinder birthing experiences. But I think it's a real shame that there are nurses out there like this one, whose view point is so skewed that even on her best day, the care she provides will have an undertone of intolerance and impatience for 'that certain type' of patient who writes up a birth plan, even in the most respectful of ways.

I try to foster good relationships with the nurse s I work with so that we will remember one another and have a bond to build from with each birth we work together. We are both birth workers, there for mess and glory of birth. We are both away from out families for nights at a time, and we are both there to support a woman through a challenge that will stretch and shape her into a new kind of woman-- a mother. We should be working together. We are not so different, and this is why I am so upset by what I have read from this nurse's point o f view.

This whole issue is not new, but rather a barometer for an existing problem. This is not a setback, but an opportunity to raise awareness, push for education, and to think about our own prejudices about the birth workers we stand next to when we work. I would like to see some media coverage on this, as well as something done at the administrative level of hospitals to curb this kind of finger pointing an d negativity.

Let us seize this opportunity to ask for change. Let us use this moment to become better, ourselves. Let us turn a very ugly exchange int o a better experience for women to come. Please pass this on, and please consider your own personal prejudice and how it may be devaluing the experiences of the laboring women you serve.

Emergency Childbirth, Gregory White

YAY! One of my FAVORITE books that I think every couple should read is now available in PDF. This is huge because it's out of print, and hard to find.

It's short and sweet, and HERE it is, in all it's glory!

And while we're on this note, here are some guidelines from the Department of Defense should you ever find yourself having a baby in an unplanned fashion without the help of a medical provider.

Emergency Childbirth: A Reference Guide for Students Medical Self-Help Training U.S. Department of Defense
EMERGENCY CHILDBIRTH

What To Do

1. Let nature be your best helper. Childbirth is a very natural act.
2. At first signs of labor assign the best qualified person to remain with mother.
3. Be calm; reassure mother.
4. Place mother and attendant in the most protected place in the shelter.
5. Keep children and others away.
6. Have hands as clean as possible.
7. Keep hands away from birth canal.
8. See that baby breathes well.
9. Place baby face down across mother's abdomen.
10. Keep baby warm.
11. Wrap afterbirth with baby.
12. Keep baby with mother constantly.
13. Make mother as comfortable as possible.
14. Identify baby.

What Not To Do

1. DO NOT hurry.
2. DO NOT pull on baby, let baby be born naturally.
3. DO NOT pull on cord, let the placenta (afterbirth) come naturally.
4. DO NOT cut and tie the cord until baby _AND_ afterbirth have been delivered.
5. DO NOT give medication.
DO NOT HURRY--LET NATURE TAKE HER COURSE.

2009 Holiday Letter

Hello and Happy Holidays from your favorite teacher and doula! I just wanted to send out a note to commemorate the goings on of the last year, and to thank you for letting me take part, however small, in your journey into parenthood. This is a career path I chose because of the good it does for people, and I hope you all know how much it means that you put your trust (and many times your bodies) into my hands. Thank you for letting me part of such a pivotal experience in your life. I hope my influence improved your experiences.

This year has been an exciting one. In January, I was DONA certified, and later in the year I was officially La Leche League, and Bradley certified as well. In September, I held The BOLD Red Tent Event, which helped many women open up to conversations about birth in our culture and in their own lives, and how to make positive changes for future generations. It was a great day. In October, I began hosting the Frankfort La Leche League meetings (much thanks to the Belly Factory for providing the location), and I have a small but steady group of moms who continue to come and learn about nursing and parenting. In 2009 I had 3 newspaper articles written about me, and an article I wrote published in the ‘International Doula’ journal for doulas across the globe. I have attended (though the year may still have a surprise for me) 19 births, and taught 11 couples.

This year has seen many ups and downs, as new businesses often do, but all in all, things are better than I would have hoped. I have worked very hard, and have a website up, as well as a blog; I have an active facebook page that I use to disseminate information, as well as a twitter account. If you are feeling generous, and would like to tell the world about my services, I would be happy to post your testimony up on my website, or you could also post it on a referral site for consumers, like doulamatch.net. That would mean so much to me, and it would help me to touch more lives in the ways I have touched yours. My mission remains for pregnant couples to know the benefits of doulas, and that every woman who wants one should have one-- I would appreciate any help toward that mission you could provide. This includes telling your friends about me!

2010 holds the promise of birth classes to be taught in the offices of two different midwife groups, one hospital birth and one home, as well as at a retail location in Orland Park. I will still be teaching Baby Boot Camp and Breastfeeding for Dummies, as well. I am looking into a partnership with some of the area doulas so we can be more secure in our backup plans for our clients, and in the distant future, I hope to have a few doulas under my employ, and manage a firm of my own—that, however, won’t be for another year or two! All in all, this sounds like a busy year ahead, and I am already booked with births through March

Much love and many blessings to all in the year to come, and I hope you’re all in good health! Please email me pictures of my babies! And I may be hosting a ‘reunion’ soon, so watch your emails for details!

May Happiness Abound in 2010!

Patience, patience, patients...

I was at a birth that was over 30 hours this week, and WHEW it was hard work for all of us-- obviously less for me than the laboring mother, but you get the idea. I just wanted to say KUDOS to those women who carefully choose their providers, and THANK YOU to those providers with enough confidence in 'normal' birth to not mess with things.

This was for my 'anonymous' mom who switched to my FAVE midwives at 35 weeks. What a brave, but sensationally brilliant move. I know a lot is said about how offices are supportive (or unsupportive) of VBAC moms, but I want to point out that AVOIDING cesarean should be applauded, as well. And this was certainly done.

They exhibited NOTHING but patience, despite the midwife being well into her third trimester herself, and despite an all hands on deck showing by the staff in the office, I really really fell strongly that she got the BEST care possible, and a beautiful vaginal birth.

I learned from one of these midwives that last week they let a different mother push for 6 hours. SIX HOURS-- she obviously had an epidural, but the point here is that most people would have cited 'failure to progress' or CPD and sent her to the OR after 2 or 3 hours. But baby looked fine, and this office let her go for 6. God bless Midwives. I know where I am having my next baby!

What we're thankful for.

Today I am thankful for my family. My wonderful, patient, kind husband, and our beautiful, spirited little boy. I am thankful for Tom's support, his selflessness, his work ethic, his intelligence, and his sense of humor, and I am thankful for Finn's tenacity, persistence, creativity, and endless joy. I am thankful for our health, for having a warm home to live in, and plenty of food and fresh water to eat and drink. I am thankful for indoor plumbing.

I am thankful for my mother, for giving me life, trying to teach me things I didn't want to hear about, and for her good health. I am thankful I had a father to raise me and love me, even though I don't have him any longer. I am thankful for my Gram, who had strong hands, great cookies, and silly names for all her furniture, even though she has left us as well.

I am thankful for my sister, for being my best friend, beautiful, strong, and compassionate. I am thankful she has found the man to spend the rest of her life with, and I am also thankful for him. I am thankful for my brother, who is disciplined, and selfless. I am thankful for his happiness and good health.

I am thankful for my inlaws, for loving me from the moment they 'got me', and for their support. I am thankful for Grandma and Poppa and how much Finn adores them and his cousin Soupie. I am thankful for my cousins, aunts, uncles, and other family members as well, even though I don't see them all nearly enough, and sometimes we don't get along.

I am thankful that I still have two healthy dogs, and that we have the technology to keep Murrey alive with minimal effort.

I am thankful for those that have reached out to us, and who help us. You know who you are, and you have changed our lives. Thank you for such amazing opportunities.

I am thankful for my friends. They support us, they love us despite our flaws, they listen to our bad jokes, and cry with us when we need consoling. I am thankful for the deepness and the strength of the bonds we have, and with so many. I am thankful for each person in my life, their health, and their good fortune. I am thankful that all of our victories are shared.

I am thankful we live in a country where speech and thought and free, and I am thankful to those in our government and military who work to keep it that way. I am thankful for fireman and local law enforcement, and all their work to keep everyone safe. I don't always agree with many of the decisions my government makes, but I am thankful to live here, and to know that I have an opportunity for my voice to be heard. I am thankful that change is possible, and I am thankful for democracy. I am thankful for Barack Obama, and the change he inspires.

I am thankful that we live in a country that is not war torn, or so corrupt that people are sick or starving, and I am hopeful that the future will show us a healthcare reform to change the lives of those in our country who do suffer. I would like all our citizens to have the access to care that my diabetic dog has.

I am thankful for medicine, and medical technology, and for all the lives it improves and saves. I am thankful for healthy babies, innocent smiles, and big, round, pregnant bellies. I am thankful to have an awesome job that allows me to touch people in very big, significant ways. I am thankful to those who have supported my studies and work to get me here. I am thankful for the opportunity to get here, and the people who let me scrub their toilets to pay my way.

I am thankful that our country tolerates all religions, and the lackthereof, and that our lawmakers will support our right to diversity, since many of us have questions, and few of us have answers. I am thankful that people in my country are learning to tolerate homosexuality and same sex adoption, and I hope there is more to be thankful for in the near future.

I am thankful for our oceans, and the vast beautiful wildlife on this planet. I am thankful for those working to research, conserve, and defend our natural resources and wildlife habitats.

I am thankful people are going green.

I am thankful for so much more.... and hope for more to be thankful for next year.

Ducks in a Row (the Aflac kind)

I just got my ducks in a row to be able to bill insurance! Most carriers won't have caught up to the new code yet, and I don't know how many of them will recognize it, or pay for it. But I can give you the code and you can call and check on it with your carrier.

Then, after the birth, I could provide you with an invoice and you can fill out a claim for and submit it to see if you're reimbursed-- isn't that DANDY???

The only thing really holding us back is that doulas are not state licensed, so we won't be recognized as a legitimate 'provider of service' so I don't think I can 'get on' anyone's plan just yet. Hopefully in the future this will change, but for now, I'm happy to offer my clients some form of reimbursement, however small!

Good luck and I hope you're covered!

The Doula's Ripple Effect

Recently, I blogged about the importance of finding the right provider, and how that's not always easy. This is made more difficult if your needs change, or if you overlook a small detail in your discussions, only to learn late in your third tri that your one missed point is a deal breaker with a doctor or CNM you thought you loved. This is very stressful position to be in, when moms are often 'nesting' and needing to know they are in good hands, and all is ready.

I recently helped a client in this particular situation get a new office whom she and DH are VERY happy with, and now things are smooth as silk again. There was a one question deal-breaker, that was somehow overlooked, and when it came to light, we were 33 weeks or so, and not happy. I am pleased, though, that she stood her ground, and found someone who could offer her more, because I know it will make her birth day much better. Well, this mom emailed me again this week to let me know that her late term switch inspired her friend to do the same.

This friend of hers walked into her OBs office with a 'birth plan' or something like it, and the doctor refused to even look at it. He then went ON about how OFFENDED (yes, actually offended) he was that she would bring something like this in to him. He has been delivering babies for (blah blah blah), and what does she know about it as a first time mom? How DARE she question 'his majesty'. Thankfully, this woman had a very level head, and said, 'thanks but no thanks', and walked.

She is now on the search for her new obstetrical mr. or mrs. right, and has told my client that her last minute search's success gave her the strength to stand up for what she believed in and get more for herself.

Now it upsets me to the Nth degree that there are ACTUALLY medical professionals out there who behave this way. God Complex, much? Since when is informed consent a frivolity, and since when does a woman not have a right to ask questions and make requests about what's done to her body when she's in labor?? Those outdated people who see birth as 'frought with danger... but we have the technology to save you from these perils', and who see it as a 'medical procedure' and not a life-changing, spiritual, beautiful right of passage, well, they make me ill. But all we can do is say NO, and go to someone who will respect us.

We need to be educated consumers, and to vote with our dollar.... and it is my hope that more and more women will do this, after hearing stories like my clients', and being encouraged by their doulas and other support professionals, that these outdated control freaks will soon step aside-- forced into early retirement due to public pressure for an open-minded, respectful physician.

I take this as a good sign-- that someone I don't even know is going to get the birth she wants because of encouragement I gave to someone else. So while this is a job that comes with many frustrations, it's important to take moments like this revel in the ripple effects your empowerment has on the community you live in. Personally, I couldn't be happier with my small role in the outcomes for these two women. And it has me pumped up to keep going, and to change the world a bit more each time!

Go Doula!!! Go Women!!! Go Birth!!!


RAH! RAH! RAH!
I hope the sidelines are always this powerful!