This woman had it all covered! Not only did she bring her own lighting to the hospital, she had a diffuser, and her own Tupperware rolling pin, the one you an put cold or hot water in! She was, in just about all ways, prepared. And she did it in a way that made sense to her.
Pink was the theme! She beautified my suggested birth plan template and framed it -- setting it on the counter in her room. Every nurse that came in stopped, ooohed and awwwwed over it, and took the proffered chocolate treats sitting next to the frame.
Knowing her husband might need important information to be easily accessed, she put a list of must-dos on the back of the front door, so nothing would be overlooked or forgotten before leaving the house. She also had a small photo album full of ways to support her, phone numbers, and small self-care steps he could take for himself.
A packing list was created so all items this woman wanted would be included. Then it was broken down even more to specific location, so others would be able to find what she was needing or wanting without digging into the wrong place.
Another photo album was filled with calming images the woman could look at during labor.
Does this seem like a lot of work? Or does it sound like your style? You don't have to be this thorough! The key is to make your plans in a way that speaks to your own sense of organization. In labor, we can utilize comfort measures that we are familiar with and turn to during times of stress or discomfort -- we don't have to learn a lot of new-fangled coping measures that might feel unnatural or hard to remember. It works the same way when getting ready for labor and birth -- rely on an organizational strategy that feels good and works for you!
Anne is one of my most favorite doulas in the world. I wish we still lived close to each other so we could work together. She has a different way of looking at things, which makes them more memorable and easy to understand. I thought this post was a great one to end on -- it shows how we can let go of the discomfort that might normally accompany us when it comes to being around and touching others -- as doulas, this is what we do. Enjoy, as Anne shares how she bursts her bubble.
I worked with somebody once that had a definite “bubble” of personal space. It was kinda fun to subtly test the limits of those boundaries. I finally determined, through months of occasional observation and experimentation, that the space was 3 feet. Step, even 1-inch, into that invisible 3-foot force-field, and my subject would move away to reestablish the 3-foot bubble.
I, too, have a bubble. When it comes to supporting a woman in childbirth, I temporarily deflate my bubble to support my client AND the rest of her support team. Conversely, I understand that my client may also have that bubble. So, how does that work in such a short amount of time and in such an intimate setting?
In a combination of ways. Conversation, empathy, care-taking, simply being, and sometimes, sleep deprivation.
Conversation and sleep deprivation Labor room conversations, at least the ones influenced by my quirky personality, can be hilarious. The people in that labor space learn things that –- well, let’s just say that things that happen in the labor space, stay in the labor space. Humans are social. Somebody has a story about skunks, everybody else has to share their story about skunks or some other wildlife interaction, which leads to some other topic like nudist colonies and the technicalities of furniture cleanliness in regard to naked rears. Sleep deprivation just makes it all that much more entertaining. People start shlurring theyr wors an mis..misum.... an people don hwere tings wite.
Empathy I have huge amounts of empathy. The people that have chosen, or have been chosen, to be in the labor space care about the mama in labor. We all want to make the experience easier in whatever way we can. We cheer her on, we give her water, we massage tense muscles, and tell her how beautiful she is. We acknowledge her perception of her experience and help her to see the big picture. We all get giddy when her efforts culminate in 10 glorious centimeters of openness. Pushing is the best. Everybody breathlessly tells her that is the way, just like that, good job…and we grunt and we hold our breath and we push too!
Care-taking The bubble slowly deflates with a soothing of a brow. Light massage. As labor intensifies, the bubble deflates completely. It becomes all hands on deck. Time for position change; one person holds IV lines, another person holds the blankets for privacy screen, another person changes the chux pad, another person physically helps mama roll, the person holding the IV line passes a pillow to the person helping mama roll, the person holding the privacy blanket then wipes mama’s brow with a cool washcloth, and the nurse readjusts the baby monitor-ducking under the person giving the mama a sip of water. All bubbles deflated, we are all up in one another’s business!
Simply being Probably the most important. The care team for my client become protective. We hold the space, her privacy, her concentration, her focus, her rhythm, her ritual, HER ever-evolving strategy for bringing forth her infant into this world. In the early stages of labor, a knock on the door is a welcome distraction. In the final stages, a knock on the door is met with looks of annoyance and protective aggression.
Birth is a short, intense, intimate journey. Some are “mush longer den udders.” Sleep deprivation joke, get it?!? Guffaw, snort! Emotional support begins long before labor begins. Physical intrusion into the bubble is typically a gradual process, becoming more involved as the intensity of labor calls for more support and the temporary removal of the bubble. Informational support never ends. Doulas aren’t medical experts, but we are quite familiar with the key terms to know in the chapter of life called the Journey to Parenthood.
Anne is the youngest of 6 children, which is probably why she gets along well with people. She also grew up on a dairy, which is probably why she gets along with animals. She has two daughters, and is a volunteer 4-H Community Leader. She was one of the original creators of the Chico Doula Circle, volunteered for a hospital-based doula program, and offers gratis support to expectant teen moms. Anne is currently waiting with bated breath to see if she passed the Lamaze Exam to be a Certified Lamaze Childbirth Educator. Find her at Happy Pushing or on Facebook.
This post was born from a Facebook comment Sejal made about not understanding why professionals are hesitant to share their knowledge. I asked her if she could think about it and share something for the 31 Days project. Sure enough -- she gives her back story, and then shares how fortunate she has been to be mentored by amazing, open IBCLCs.
A few days back while I was in the hospital visiting a friend of mine after their surgery, I saw a family with a brand new baby heading home from the hospital. As I walk past them, I see a lady walking next to them, pushing a hospital cart filled with a few balloons and flowers resting on top of a couple of Trader Joe’s reusable bags and a duffel bag.
This brought back so many memories of my own discharge from the hospital I gave birth at and how it was a cold December morning that we walked to the parking garage with our newborn daughter dressed in a red fleece dress and buckled up in her car seat. I don’t think we realized how cold it was for her tiny little feet to be outside in the breeze.
My baby girl was upset with the draft of the cold breeze and I was so upset with her crying as we tried to get her into the car. Fumbling through the seat belt and a bunch of other stuff to keep her warm, we managed to at least get out of the parking garage. I sat down in the front passenger seat (mind you this was the one time I hated sitting down because of the perineal pain). If I had known what I know about mother infant separation and how I could have been closer to her and kept her less stressed and more warm by being in the seat next to my daughter I would have been able to keep her calm. But what did we know as new parents, apparently nothing, but as they say ignorance is bliss and bliss we did feel when we had her in our arms after a long traumatic birth.
Here we were leaving the hospital, embarking on this journey as three of us instead of two of us, completely oblivious to what was ahead of us. The drive home was not too pleasant and every bump in the road was causing me pain. It felt like I was hanging on to the handle on the inside of car so I did not have to put any pressure on my perineum. At home my kind and loving parents were waiting for us to get home with our little nugget. I just wanted to lay down but the pain was too much and by the time I reached home, my feet had gotten half a size bigger. I still had no idea what was going on. I could not walk properly or sit properly and then the idea of breastfeeding my baby without any help from the nurses seemed daunting. My mom was really willing to help and she did try but somehow my daughter could not latch without a nipple shield. Also no one at the hospital had shown me how to breastfeed my daughter lying down and that was a completely foreign concept to me. Every time that my little girl needed to breastfeed I would sit upright in my bed, get my Boppy pillow ready, cover it with a receiving blanket to protect the pillowcase (mind you I was a clean freak back then) and have my mom bring my baby to me to feed, and every time she tried to latch, either the nipple shield would fall off or she would accidentally whack it out of place and then the whole saga of a screaming baby and flailing hands and crying mama would begin.
By Day 3, my breasts were getting engorged and my feet were super swollen. I could not walk to the bathroom, which was only 10 steps away from my bed. I called my OB's office and they said I needed to come in as soon as possible because they were not sure what was going on with my swollen feet. When my OB came in and saw my face, my feet, and my hands, she smiled and said, “You look like the Michelin Man”. I was unfamiliar with who the Michelin Man was but figured it was a character out of some movie. She gave me a script for diuretics and sent me home. She did not even tell me that the number of times I would need to get up to pee would be exhausting in and of itself. I came home and breastfeeding was still difficult for me and my baby. I kept using the nipple shield and having the struggles. I went to develop mastitis and had a really high fever which put me into a delirium. I kept telling my mom, that she should take care of my baby in case something terrible were to happen to me. The pain with breastfeeding was excruciating and I was feeling like I was going to die.
The doctor’s office called in a prescription for antibiotics and I started them immediately. They told me to use the manual pump that I had to relieve any engorgement. I ended up using the nipple shield for 3 months before I went in for a lactation visit at our local hospital where I met a lactation consultant who helped me breastfeed my baby for the first time without a nipple shield. I had never pictured myself not using the nipple shield.
Fast forward my life 10 years and now I was a veteran mom who has helped her friends through their postpartum journey, and my kids were growing up and I was doing the best I could to fit this mold of a supermom, partly created by the expectations of the society, the family and myself. Due to a life event, I had to make the choice of going back to school to get a vocational certificate that could get me a job and somehow I chose to go to nursing school. I became a CNA and then started taking my prerequisites to apply for nursing school. I was also working as a CNA at a private nursing home. I worked 4 half days and learnt so many things on the job as well. During my year as a CNA, my younger sister who was pregnant at the time sustained a fall and broke her leg. She could not move and had to have surgery. She had to stay in bed until her baby arrived and I left my job to care for her. She had her baby and I was there to help her during her postpartum recovery and so were my parents. She was having breastfeeding troubles, her baby was not gaining weight very well and had jaundice. The hospital lactation consultants came and helped as much as they could and then we went home.
The breastfeeding continued to be a struggle and she had to start supplementing with formula. We tried to look for someone who could come to her home for a lactation consult and finally found a lady who did. The lactation consultant started her visit and I was a mute spectator in the room, and all I could think was, who is this person who is so knowledgeable about breastfeeding and was able explain everything to us so clearly? Her name was Meg Stalnaker. Why did I not meet her when I had my first baby ? I absorbed and listened to everything she did and said, as did my sister and brother-in-law. I just had a lightbulb moment. I wanted to do what she does. That was it. I did not want to be a nurse. I wanted to be a lactation consultant. I talked to my sister and she told me that I should ask for the contact information for this angel who helped her. I don’t know why, but I did.
I kept doing my own research about what classes I needed to take and signed up for them at the local community college. I kept in touch with the Meg via email. After I finished my community college classes, I contacted her again and asked her if she could be my mentor. She said yes, but there was a caveat. I needed to wait until she finished mentoring two other students she had at the time.
I was really sad that there was not enough guidance on how to find mentors for the pathway I had chosen to become an International Board Certified Lactation Consultant. It also felt like there were a lot of negativity in regards to choosing to become an IBCLC as a career. I kept looking to see if someone would be interested in being my mentor and taking me on as a student.
During one of my lactation classes at the community college, we had a guest speaker by the name of Peggy Andrews, who was giving a lecture on the topic of jaundice and breastfeeding. I saw a tall woman with golden and white hair walk into our classroom with a smile. She had the brightest smile I had seen on someone’s face. She started the lecture and I was just mesmerized by her way of teaching and felt like I was back in India in my middle school, listening to my favorite biology teacher. At the end of her lecture she shared her email address with our class and something in my head said, “Sejal, you need to email Peggy and ask her if she could be your mentor.” I mean that was a spur of the moment thought and I acted on it by sending her an email asking if that was possible.
The next moment I thought, oh boy, have I made a big mistake by asking this guest speaker to be my mentor. I was hoping that I would get an email saying how inappropriate that question was. To my surprise, I hear back from Peggy saying she loves to mentor students. I was cooking and jumped up and down in my kitchen saying, YESSSSSS!! Wait that is not it, I actually got a call that evening from Peggy asking me if I wanted to go on a lactation visit in Washougal the next morning. I said, I most certainly would, but then I thought, where in the world is Washougal? Well it is in our neighboring state of Washington.
The next morning I meet Peggy at a designated location and she said to me that she will be driving me to the appointment since it is so far. I was so excited and off I went on my first official visit. I started learning about how to talk to a new mother, ask specific questions and give her plenty of time to tell her story. We were there for an hour and a half and I felt like I still made the right choice by asking Peggy to be my mentor. I have learnt so much about being a good listener from Peggy.
I never for one moment thought that Peggy was keeping any information from me when it came to lactation. I had asked a few other local lactation consultants and they said that they don’t mentor students and I was quite discouraged. I am sure other students like me were discouraged as well. Meg, also let me go on a few lactation visits with her and I kept learning from both Peggy and Meg.
One day I saw a class on hand expression at a local boutique taught by another lactation consultant named Bryna Sampey. I immediately signed up for it, and when I went to the class I was secretly happy that I was one of the two people in class, although I also felt sad that people did not sign up for this informative class. I felt like I had learnt so much about manual expression of breastmilk in this class and that little voice in my head said, “Sejal, ask Bryna if she would mentor you.”
After the class, Bryna asked if I wanted to have a bite to eat at the place next door. I jumped at the opportunity to hang out a few more minutes with this brilliant brain. I was practically salivating. We talked about what I did as a postpartum doula and how I was studying to be an IBCLC and she mentioned to me that she also mentored students. I almost wanted to give her a hug and say, where were you a year ago and why did I not meet you earlier. I did not want to be a total psycho so I did not hug her, but told her that I would love to be her mentee. She said that she would let me know as soon as a spot opened up.
What I learned from Bryna and her brilliance made me think critically about breastfeeding and the challenges that come with it and how she made breastfeeding a breeze with all the techniques and tricks that she shared with her clients. As I followed these three amazing women, as my mentors, each one of them taught me how to help with breastfeeding challenges in their own special ways. I feel blessed to have learnt from them and will be eternally grateful for them sharing their wisdom, knowledge and time with me.
I was talking to other lactation students like me one day, who were in the same boat as I was and one of them told me that when they asked a local IBCLC to mentor them, the local IBCLC said to them, and I quote, “Why would I let you shadow me ? You will take my knowledge and compete with me once you get certified.” I was so shocked to hear this. I have no idea who the IBCLC is and don’t even want to know, but it made me realize how fortunate I was to have mentors like Peggy, Meg and Bryna.
With the struggles I had in finding mentors, I had decided in my mind that if I ever become an experienced lactation consultant, I will mentor students. I am an IBCLC now, and I am a brand new IBCLC, but I hope to someday mentor students. I think it is our responsibility as professionals to mentor the future IBCLCs. My dad used to say, knowledge only increases by sharing. He is a brilliant surgeon and he has helped many other doctors become surgeons and I am certain he never thought this way.
So, why do some people have a hard time sharing their knowledge with others who are seeking mentorship in the field of lactation consulting ?
Maybe the experienced professional does not have the time or the resources to mentor someone. Maybe the experienced professional thinks that, sharing their knowledge with newbies will reduce their chance of personal success.
Maybe the experienced professional does not trust this newbie. Trust building does take time.
Maybe the experienced professional in the specific field is a knowledge hoarder.
Maybe the experienced professional wants to have monopoly in their field.
Maybe the experienced professional feels more powerful if they don’t share their knowledge.
Being a mentor and taking on mentees is also a huge responsibility and one that is not easy. I understand that it may be difficult to take on students, but in the field of lactation consulting, I wish we had more mentors. I wish students had access to mentors without having to wait for a long time. I wish experienced IBCLCs would be willing to share their knowledge and expertise with them.
Mentors are an inspiration. Mentors can connect you with opportunities. Mentors know ways to make you succeed professionally. Mentors keep you motivated. Mentors invest their time and energy in you to help you grow. Mentors teach you about finding a good opportunity. Mentors have been where you are and can empathize with your struggles and help you find your way through the obstacles and hurdles. I am so thankfull to have found such mentors who continue to be there for me and do not feel threatened by my success.
Sejal Fichadia, owner of Kindred Mother Care, is the first 31 Days participant to be featured four years in a row. In 2014 she wrote "Our Culture's Needs for Postpartum Doulas," in 2015 she added "Growing Happy, Healthy Moms." Last year she added "Hitting the Pause Button." She has a love for babies and mothers, and feels it is important to help families learn skills to help them on their parenthood journeys. Sejal works hard at expanding her education and working to improve her knowledge base so she can provide families with up-to-date, evidence-based information, which in turn gives them the tools to parent with confidence. This year she passed the exam to add IBCLC to her credentials. She has a caring heart, and as soon as she can, she will be mentoring others wishing to get to IBCLC.
As a new doula it can be hard to know what books and blogs can be helpful. Today's post gives a list that is sure to get any new doula rolling in resources!
Every few months, I make a new friend or get reacquainted with someone and I see that twinkle in their eyes when I tell them that I'm a doula. And I know that before long, I'm going to get an email asking me for suggestions of books and blogs they can read to carry on their excitement about maaaybe becoming a doula. I wish I could go out for coffee with everyone who emails me with their maybe-doula excitement, but since I can't, here are my best recommendations to get you thinking about childbirth in America, doula support, and living the life of a doula.
There are so many resources out there, this is really just the very beginning! There are resources for supporting breastfeeding, books for all kinds of birthing methods, and MANY collections of birth stories. And I haven't even touched on the vast area of birth trauma, including resources specific to homebirth cesarean, vaginal birth after cesarean (or VBAC), and supporting survivors of previous trauma and abuse. I'm considering writing a follow-up post on resources for practicing doulas, so let me know if you would like to see this on the blog.
Books, Books, Books
Pushed: The Painful Truth About Childbirth and Modern Maternity Care, by Jennifer Block
This is the book to read to get grounded in the information about today's maternity care climate. You might be pumped about doulas because it sounds so lovely to massage a laboring woman's back while she labors in a birthing tub (guilty of that one, myself!). But you need to understand the institutions and practices that affect most birthing families in America to really offer comprehensive support during childbirth.
Birth Ambassadors: Doulas and the Re-Emergence of Woman-Supported Birth in America, by Christine Morton and Elayne Clift
This is actually a book ABOUT doulas and the doula profession! I firmly believe that all doulas should read this book. I found myself doing fist pumps, exclaiming aloud on the subway, and highlighting like mad while reading this book. It's an excellent look at the actually quite varied and disparate world of people practicing as doulas. I wish this book had been around when I started out!
The Birth Partner: A Complete Guide to Childbirth for Dads, Doulas, and All Other Labor Companions, by Penny Simkin
The author is one of the mothers of the modern idea of doulas. This book is very rooted in Penny's particular way of providing labor support and style of coping skills, which isn't right for everyone; but it provides solid information to help you and your clients prepare for and cope during labor. I took this with me to my first 10 or so births because it's a resource with so much depth, yet it's easy to use as a reference.
Spiritual Midwifery or Ina May's Guide to Childbirth, by Ina May Gaskin
Ina May's books are pretty foundational for birth workers! For some people, the ideas and language in the book are going to seem really out there. I consider myself pretty comfortable with the woo, but I remember being a little overwhelmed at times when I first read Spiritual Midwifery. Still, the birth stories are fantasticand many people find them incredibly empowering. Plus the statistics for birth outcomes at the Farm are outstanding.
Natural Hospital Birth: The Best of Both Worlds, by Cynthia Gabriel
This is the rare birth book actually written by a doula! She has attended a LOT of births, and she is also a medical anthropology researcher. The book is written for parents preparing to have a low-intervention birth in the hospital setting, and is a rich resource for helping clients to prepare! I learned a lot from reading this book, and recommend it now to every client planning for a low-intervention birth in the hospital setting.
Optimal Care in Childbirth: The Case for a Physiologic Approach, by Henci Goer and Amy Romano
Ok, I haven't actually read this book which takes a look at routine maternity care practices and what the evidence says about them. However, this is the newest book written by Henci Goer examining the research behind routine maternity care practices (previously she published Obstetric Myths vs. Research Realities and The Thinking Woman's Guide to a Better Birth). This one is based in far more current research. I own and love the other two, but if I was starting out now I would go for this one.
The Radical Doula Guide, by Miriam Zoila Perez
MZP is a reproductive justice activist and writer who has been part of the doula movement for quite a while now. The Radical Doula Guide is a self-published zine/primer on all kinds of political issues relevant to birthing people that many large, mainstream doula training and birth organizations tend to ignore. There's also information for doulas who may or may not see themselves widely represented in their local doula community - such as women of color, men, and queer/trans folks.
Blogs by Doulas
Miriam Zoila Perez's blog. Mostly contains profiles of self-identified radical doulas from all over, plus links to some of MZP's writings about reproductive justice elsewhere.
Doulaing the Doula
Amy Gilliland, PhD, is a DONA doula trainer and researcher. She has been at work for several months on a series of posts laying out the argument for national doula certification. She also writes a lot about the professional and personal developmental stages of doula practice. Intelligent, thoughtful insight into the working lives of professional doulas from someone who has been in the field for decades and is still practicing.
Other Birth Blogs
Evidence Based Birth
I can not sing the praises of this blog often or highly enough! Understanding your options in light of evidence-based birth practices (plus personalized, unconditional support) are at the heart of doula care. This blog has helped out doulas, maternity care providers, and consumers alike by taking the sort of research that is usually hidden behind a pay wall and making it accessible and understandable to a lay audience. Rebecca Dekker's thorough-yet-digestible reviews on the sorts of topics that are increasingly important to many birthing families today are invaluable for helping your clients weigh their options, determine their preferences, and communicate effectively with their maternity care provider to achieve their desired outcomes.
Primarily a mother-to-mother or consumer-focused organization, Improving Birth also focuses on the importance of evidence-based care practices in maternity care. They also advocate for consumer rights and awareness around maternity care practices, and local communities can organize Improving Birth Rallies around the country in conjunction with Labor Day. A great organization to pay attention to if activism and advocacy are important parts of your interest in doula work.
Science & Sensibility
The blog of the Lamaze Childbirth Educators organization, Science & Sensibility is another great resource for understanding current research and writings about maternity care practices. Henci Goer and Amy Romano both write for this excellent blog. It sometimes also contains useful business information for doulas and childbirth educators.
After several years as a practicing doula, I invested in the 100% Doula Business Foundation Training course this past year. No one thing has ever been such a big help to improving my doula business! My only complaint about this course is that I didn't have it when I was starting out as a doula. I so believe in this training that I would encourage any doula starting out in solo practice to jump on this when it is open. The course opens every February and September. Check it out!
Finally, doulas are HUGE on social media, so searching for the hashtags #doula, #doulas, #doulalove, or other things like that on your favorite social media site will turn up tons of fun Doula and midwife accounts. I like @carriagehousebirth, @ancientsong and @homesweethomebirth on Instagram. On Facebook, I love reading Peggy Vincent's birth stories from her days as a homebirth and hospital midwife in Berkeley.
Emily Landry is an experienced toLabor-certified Birth Doula, a Certified Lactation Counselor (CLC), a Licensed Massage Therapist, and a Lamaze Certified Childbirth Educator serving families in the Tulsa, OK area. When she's not attending births or teaching childbirth classes, you might find her working to improve the local community, coloring in quirky coloring books, playing games with friends, reading the newest book about birth, or running around town with her wife Emily (yep, they have the same first name!) They love visiting local restaurants, stores and coffee shops, and seem to run into previous clients every time they pop into Target or Sprouts. In 2015, Emily was interviewed by the Dearest Doula podcast about her life as a birthworker.
Your heart pounds, your mouth dries, your ears begin ringing, and your face suddenly feels so hot! You just got a call that a potential client wants to meet for an interview. This often leads to a mad-scrambling of resources, or the paralyzing shock of sudden responsibility.
No need to fear! First off, keep in mind these people have contacted you because they are aware of the services you provide, and they are wondering how you as a doula can help them as expectant parents.
Place: Where to meet? There are many different ideas about this. Many doulas feel there is nothing better than to meet in the expectant parents' space -- their home. The advantage here is, you are able to show them you can fit into their home and life. Pregnant women are traipsing to a lot of different places -- the doctor's office, the ultrasound office, the hospital to pre-register, their childbirth classes. Nothing is really accomodating, so to be able to visit a mom in her home can help with the whole why-one-might-want-a-doula-in-the-first-place: Having an advocate to help with physical, informational, and emotional support who is more just a random stranger on shift.
Sometimes a doula might feel meeting in one's home, without any prior meeting or credible information about a potential client can be a safety issue. For some doulas, if they personally know someone who personally knows the potential client, they are comfortable meeting at their home. If it is an absolute stranger, you can try to supersleuth on Facebook to see if the profile is real, see if there are pictures of the pregnant person, see if you have any friends in common. Going with your gut can be helpful here -- we encourage women to use their intuition to aid in their process of birth, we need to remember that and apply it to ourselves, as well.
There is another school of thought that says, this is an initial meeting where no commitment has been agreed upon yet, so the doula and the expectant family should try to meet in a public location about as in-the-middle as can be, which can be helpful if a doula lives a distance from the potential clients. This saves her gas money and travel time. Often if a doula is hired, she makes the full trip to the clients' home for her prenatal meetings.
A good alternative to meeting in a private home is a comfortable, public location. Places like Starbuck's, Barnes and Noble, local tea or coffee shops work. Other places people meet are parks (good if the weather is nice or the interviewee has other children), restaurants, medical office waiting rooms (this helps streamline a woman's appointments), her work place at lunch, WIC Office, baby store, or an apartment's recreation center.
It would be naive not to take some cautionary measures for your safety when going to an interview.
-Leave a note detailing where you are going, who you are meeting with, and how long you will be gone. Information that should be included: The names of the folks you are meeting, the address of the location, the email address or access to any online exchanges you have had with the person.
-Bring your cell phone with you, especially if you are meeting at a private home.
-If you feel something's fishy about the situation, choose a public place, and perhaps have someone come with you, incognito at another table, or as a doula-in-training learning the ropes -- saftey in numbers. I know this sounds odd, and if you really felt strange about something why go at all? There are times, however, where you aren't sure about the situation. If you have a "I'm not sure," kind of situation at or after an interview, or from initial phone or email contact, proceeding with a back-up plan is just an added measure of protection in an uncertain situation.
The point of all of this is not to strike fear into your heart, the point is to remember to listen to your gut and be mindful of your safety as you proceed down this road.
What do you remember of yor births? Are there thing you would change? Things you are surprised you did that didn't follow what you learned about or expected? In this feature, a doula shares her birth story with additional hints and advice as seen through her professional lens -- what a great idea!
On my first born's 6th birthday, an idea popped into my head to share the story, but this version will be injected with Doula Tips and new discoveries I’ve made since being a natural health educator.
When you get to know me, you know that I’m a big planner. Fortunately, we got pregnant the first month of “trying”. I took the pregnancy test in the morning, saw the + sign and danced with delight. I brought the test into our room to share the news with my husband. We instantly prayed together to thank God that pregnancy happened easily, and asked Him for health and well-being. I didn’t experience morning sickness. There were a handful of times I needed to vomit in the morning, but as soon as it came up I was ready to rock ‘n roll. I figured out that I was taking my prenatal vitamin on an empty stomach, first thing in the morning. DOULA TIP: purchase a natural prenatal vitamin.
One issue I experienced was the increase in headaches around the beginning of the 2nd trimester. My midwife advised I needed to drink more water. I remember one day driving home from work, and I had to pull over and vomit in a plastic bag because my headache was throbbing. Ouch + ick. The headaches didn’t last long. DOULA TIP: essential oils can address head tension. I wish I knew about them when I was pregnant the first time.
I have fond memories of prenatal yoga. It was so fun being surrounded by other mommas and baby bumps. Another great experience was our antenatal childbirth education class provided by BirthCare. It’s a 6-week class and they structure it so you have a coffee group once all the babies are born. We met weekly for about a year (when we all went back to work). To this day, these mommas are some of my favourite people in the world and I miss them dearly. DOULA TIP: create your supportive group of peers while pregnant.
Her due date was Friday … but she arrived three days early on Tuesday.
I woke up before midnight to use the restroom and when I wiped there was a “bloody show”. Exciting! There were mild tightenings, so I went to the living room to watch the wall clock. Sure enough, those tightenings were coming and going every 10 minutes. I remember our midwife telling me to sleep at night and not wake my husband (if at all possible). DOULA TIP: let your partner sleep and you really need to sleep too!
Back to bed I went to try to sleep, but let’s be honest, this is an exciting moment. I laid in bed, took a nap, then eventually woke Brad around 3am. In his delirium, he started to pack and wanted to throw things into the car. I laughed at him and just told him to calm down because it would be a while before going to the birth center. Brad started to time the contractions. We got ourselves organized, packed the last minute items, made some toast and a smoothie, and walked around the house. At 7am, we called the midwife to tell her what was happening. She encouraged us to keep moving at home and call when the contractions got closer together. I got into the shower, washed my hair, shaved my legs. I had rented a TENS machine, so we tried that around 9am. This was not comfortable for me, so we ditched that. Bummer that we wasted over $100 to rent it. DOULA TIP: ask your maternity provider about TENS because this can be an effective pain management tool for you.
We put on a Grey’s Anatomy as a distraction… do you remember the theme song? When you play the DVD, that song just keeps rolling over and over again until you press “play” so that was on in the background as the contractions started to get more intense and closer together. My husband was amazing. We found a groove of him massaging my lower back during the contractions.
After talking on the phone again with our midwife, she agreed it was a good time to head to BirthCare. We arrived around 11:30am and she said I would probably have to leave because I was smiling upon arrival. When she did the vaginal exam, I was 6cm dilated. She filled up the birthing pool (huge, Jacuzzi style tubs in the birthing room). I noticed that she dropped a couple drops of something in the pool. Later on, I found out it was clary sage. She is amazing. I didn’t know of essential oils back then, but I was so glad she used it in the pool. We got settled into the room and kept moving/ massaging/ going in and out of the pool. My midwife provided a carrier oil (probably sweet almond oil) for my husband to use on my back. DOULA TIP: I always have fractionated coconut oil in my doula bag when I attend births. A carrier oil helps hands to glide smoothly on momma’s back, even in water.
Both of our girls were born at BirthCare, Auckland – a primary birthing center across the park from Auckland City Hospital. No doctors, no epidurals… just large birthing rooms with pools and midwives and oxygen/ gas if needed. My main motivation for birthing here was that if you birth here (instead of the hospital), you get to stay in a PRIVATE postpartum room for three nights. Everyone else has to share a room with another momma + baby, or pay a ton of money for a private room. Looking back, the other part I love about BirthCare is that there wasn’t anybody else coming and going (no nurses, no lab techs). It was just Brad and Christine as my birthing team. It’s like a home birth, just in a comfortable space with more tools (and the freedom to leak blood and fluids and water from the pool/ shower all over the place). DOULA NOTE: find a birth space your are comfortable with
At some stage, my water broke (but I didn’t feel a pop or gush). My midwife noticed leaking and some meconium coming down my legs. Darn. She did a great job of protecting me from this information. She mentioned it, but did NOT say it was an “issue”. She let me keep labouring comfortably. My husband kept massaging my lower back. He only missed two contractions during the whole labor experience. What a champion. His hands must have been so tired. My midwife was on the phone with the Charge Midwife up at Auckland City Hospital. She was checking in with her decision making to keep me at BirthCare as she monitored the meconium situation. There was potential that I might need to transfer up to the hospital since meconium can be dangerous for baby. Did you know that I didn’t need to be on the fetal monitor until towards the end of my time in the birthing room? We used a doppler to check baby girl’s heart rate while I was moving in the pool and around the room. Due to the meconium, I was hooked up to the electric monitors to make sure Madam Blueberry was safe. DOULA TIP: you can request intermittent, portably fetal monitoring if birthing in a hospital.
I started to feel the urge to push! A couple of deep growly grunts were let out because I could feel my body taking over. I wasn’t fully dilated yet. So my midwife gave me some oxygen to breathe deep and regain control. The entire birthing experience was very calm, quiet. At this stage, I was up on the bed being monitored. I was checked again and given the go ahead to push. Another midwife came into the room to assistant mine. They had my legs up and coached me to “bear down” to push. My midwife wanted to get baby girl out as fast as possible because of the meconium. I was still oblivious to this being an issue. I took deep breath and pushed so hard that I burst a blood vessel in my right eye. Yikes! DOULA TIP: I now suggest that mommas “breathe” the baby out and spontaneously push instead of “bear down” coaching that most nurses and care providers use. But every situation varies.
Because I was so internally focused, I wasn’t honing in to my midwife's voice. With the last push, baby girl’s head came out at the beginning and I didn’t hear my midwife telling me to stop pushing… so out came the rest of her body all in one fast swoop. Whoops. That’s how you get tearing. DOULA TIP: listen to your lead maternity carer’s voice right at this moment. They are there to protect your perineum.
Baby girl was instantly placed on my chest for skin-to-skin time. She was born at 4:50pm, about 16 hours after seeing the bloody show. Talk about love at first sight. Whew. I didn’t know I could love a creature so much. It’s like loving a pet only times a billion. Baby girl was breathing fine -– she did have some meconium on her, so they wiped that off. My husband cut her cord, then my midwife waited for the placenta (we took it home and planted it below a lemon tree) and started my stitches. We started breastfeeding right away. I was able to take a shower in the birthing room before waddling over to my private postpartum room. Stitches on your bottom are sore. DOULA TIP: I recommend a blend of helichrysum and frankincense essential oils to help with perineum healing.
I felt so loved and safe and cozy in our room after that epic experience. BirthCare is like a hotel with midwives. The food is delicious and plentiful, the midwives help you establish breastfeeding, and there are educational video streams on the TV in your room. It makes me so upset that mommas of O’ahu don’t have access to the same maternity care experience covered by insurance. You can hire a home birth midwife and pay out of pocket for a similar set up. I count myself monumentally blessed to have been living in that part of New Zealand with my incredible midwife and our amazing natural birth experience at BirthCare. After three nights there, we headed home with our treasure. My midwife visited us at home for the next 6 weeks to check on my stitches, help with breastfeeding, and track Madam Blueberry’s growth. We did well. My husband had two weeks off work, then Mom and Dad came from Hawai’i for two weeks. We cherish this birth story and are so grateful to our midwife and all the midwives at BirthCare. DOULA TIP: postpartum blues are normal and the American maternity system is NOT mom-centered. Ask for help. A postpartum doula can provide references to services and can support you with newborn care, routines, sleep solutions, etc.
Jenna Clarke is a doula in O'ahu, Hawaii. She is the owner of Malama Momma, where she shares "Mālama" is Hawaiian, and it means, "to care for, to protect." Jenna provides labor and postpartum doula services, as well as lactation support and education. She is the happy mother of two little girls, born in New Zealand. Jenna and her husband are passionate about natural health, the importance of reducing toxic load, the science and pathology behind illness, and how to treat illness with plant-based therapies, whole food, exercise, and reducing toxic exposure.
Debbie called me at 8:30 am to let me know contractions had started. I joined her and her best friend Lisa at the hospital – Debbie was 2-3 centimeters. Debbie and I worked through the contractions. She would really have to focus. Lisa and I would stand on either side of the bed rubbing Debbie’s arms and shoulders, smoothing her hair, and giving her space to focus. Lisa was not quite respectful of Debbie’s need to focus and go within herself to endure, and Lisa would ask Debbie questions about unimportant things while Debbie was trying to concentrate. I kept redirecting Lisa respectfully, reminding her that Debbie needed space to focus, and could we wait until the contraction is over to get an answer? A vaginal exam at 1:15 revealed Debbie to be 100% effaced, 4-5 centimeters dilated. Debbie had AROM followed by her epidural at 2:00. The contractions spaced out to 8-10 minutes, and Debbie’s blood pressure dropped dangerously low. Debbie’s nurse, Mary, stayed with us in the room for almost 2 hours charting and watching Debbie and her monitors. Debbie’s blood pressure did eventually increase. At 4:30 pm Debbie was checked and found to be complete. She started pushing at 6:00, and baby was born via Mighty Vac at 6:52.
Debbie is a single mother and she felt a doula would help her feel supported and informed. My primary goal for Debbie’s birth was to make her feel special, strong, and empowered. I knew Debbie wanted an epidural. Debbie had a severe knee injury which happened about the time she became pregnant. That, coupled with being very overweight, greatly reduced her options for movement. I helped a lot before Debbie got the epidural with coping techniques such as counting backwards through contractions, and massaging her hands, which grew tired from gripping her bed rails. Debbie’s situation reminded me of something Penny Simkin wrote of a client who left an abusive relationship: I think Debbie did not need to feel any pain on this birth day.
Debbie reacted well to her labor! She really had to focus from about 11:45 until 2 pm. She seemed to leave for a minute and find someplace in her mind where she could cope, and once the contraction was letting up, she would slowly open her eyes and release her grip on the bedrails. When I would say, “Debbie, that was great. You have found a place and you are really doing a wonderful job focusing and relaxing,” Lisa would discredit what I was saying by replying with, “Yeah, Debbie’s thinking ‘Whatever,’” or “Debbie’s thinking, ‘Shut-up already.’” I don’t think Debbie was thinking any of those things. It really felt like I was being undermined. When I would ask Debbie the, “What was going through your mind…” question she would usually reply “I just wanted to get through it.” She never had a panicked or scared reaction. Debbie reacted very sweetly to her new baby.
I learned some good people-coping skills. Lisa is a tough kind of gal. When Debbie’s blood pressure fell, and then her legs went numb, Lisa was upset and wondered why they didn’t stop the epidural? Lisa ’s personal experiences led her to believe the numbing aspect of an epidural was abnormal (“That did not happen with my epidurals”). I tried to explain how epidurals worked, but she got very defensive. I finally said I did not know, and she should ask the doctor about it (he was also Lisa ’s doctor). I learned sometimes it is better to “not know.” I learned sometimes I need to stand away and be useless, like while the baby was being delivered and I was not by Debbie (Lisa was to her left, doc at the end, nurse at her right). After Leah's birth, I was able to help more practically. Lisa had left, and Debbie was alone. I stayed longer helping with breastfeeding and ensuring Debbie got a nice meal as well. Debbie’s father arrived about an hour later, and I was able to help him hold his granddaughter for the first time -- he swayed and shooshed her right to calmness. I learned even though a person only thanks you for bringing them dinner, that can mean a whole lot more.
I once wrote how teaching about birth is like selling a house. I was happy to see Joyce's comparison here, and even happier how her points lined up with reality. We hear many analogies for the roles doulas hold. I think this one stacks up well -- what do you think?
Although doulas are increasingly popular additions to the birth team, not everyone is clear on what they do for a birthing family. There are several useful analogies out there, but the comparison of a doula to a real estate agent is less discussed. So here is my attempt, 10 ways a doula is like a real estate agent!
1. The doula's goal is the client's goal.
Just like your real estate agent is not searching for his/her perfect home, your doula is not pushing her perfect birth onto you. Your doula will get to know you before your birth as much as possible, so s/he knows what you want in your birth.
2. Your doula can help you navigate your options.
Your real estate agent knows her/his local real estate market, just as your doula knows his/her local birth market. Your doula can help you find the best birthplace to fit your desires, just as your real estate agent can help you identify your ideal neighborhood.
3. Your doula is up-to-date on the current market.
Your real estate agent will know how properties are selling currently. Your doula will be familiar with local maternity care.
4. Your doula knows what to look out for to help you have a positive birth experience.
Just as your real estate agent knows what items to ask for on your offer (the appliances!), and whether or not the cracks in the plaster walls are something to fret about, your doula will know what questions you need to ask in order to make informed decisions.
5. Your doula is trained and experienced in the field.
Even a brand new doula without children of his/her own has received extensive training in both normal childbirth and its variations and complications, and in caring for childbearing women. Just like a real estate agent has been trained in navigating the real estate market.
6. Your doula will support you if you change your mind about what you want.
Just as your real estate agent will continue to help you if you change your property search criteria, no matter your reasoning, your doula will support you if you change your mind about choosing that hospital, or planning an epidural, or having a waterbirth.
7. Your doula will offer his/her advice, but you are the decision-maker.
A real estate agent will offer her/his advice when pricing a property, or writing an offer, but you are still the one making the sale or the purchase. Your doula will remind you when you stray from your birth plan, but this is your birth, and your baby.
8. Your doula knows where to go for complementary pregnancy and birth services.
Your real estate agent knows the title companies in your area, the lenders, the exterminators, the inspectors, and has worked with them before. S/he can help you find a reputable professional in your property-selling/purchasing process. Your doula knows the chiropractors, the accupuncturists, the prenatal yoga instructors, the lactation consultants, the babywearing groups, the back-to-work support groups, in your area, and can help you find perinatal professionals in your area to help you.
9. Your doula will walk you through the entire birth process.
Just as a real estate agent will assist you through the entire purchase or sale, your doula will help you from the earliest inklings of Birth Day through the first couple of hours postpartum. Whether her support is over the phone, email, text, or in person, your doula is supporting you the entire time.
10. Your doula follows up with you after your birth and helps you adjust to your new family.
Your real estate agent will follow up with you after your sale or purchase to make sure everything continues to go well, and answer any last-minute questions. In the years after your property purchase, you can even contact your realtor for referrals on remodeling projects! Your doula is the same way. Just because your contract period has ended with your birth doula does not mean you cannot contact him/her again! For example, the definition of postpartum depression is any depressive symptoms in the year following the birth. Your doula wants you to be well, go ahead and reach out to her if you need anything.
Joyce Dykema, MSc, CD(DONA), HCHD, became a certified birth doula in May 2012. She is also a trained Hypnobabies® Hypno-Doula, volunteers as leadership for ICAN of Lincoln, and is an Evidence Based Birth Instructor. Joyce is a woman-focused doula. While passionate about natural birth and what research shows is the best for moms and for babies, the goal she strives for with every client is for women to have empowering and positive births, as the woman defines it. In addition to her doula credentials, she holds a BA in psychology and an MS in biological sciences. She breastfeeds, uses cloth diapers, uses baby sign language, babywears, and homeschools because these choices made sense for her family; she encourages others to explore and find what makes sense for their families. Joyce and her husband have three children, and live in the Lincoln, Nebraska area.
Poetry ties in with birth work. So often, when moved (or tired), phrases that describe what I am seeing or experiencing come to mind. The way the words arrange themselves isn't linear, like normal, but often spiraling, like birth. Sometimes I write them down, and sometimes they float in, and then out, of my mind. I love that Bryna took the time, while exhausted, I am sure, to take note of the words that came to her this night.
Driving home from a birth or a late-night home visit, it’s quiet.
The car, my mind, the road– the same sort of weighty hush surrounds me that accompanies a snowfall at midnight.
The cobweb-cones of streetlights in the fog reach out for my car as I pass the dark trees on either side, making my way to my bed. The road shines in my headlights and gets dark. A bit beyond that, it’s lit a little by the moon and an orange brush of the lights ahead.
It’s this time when I think the veil is lifted just a bit. I’m jangled and frayed, having ridden the adrenaline and oxytocin and catecholamine waves with the family I’ve just come from serving.
I’m tired, and I’m quiet, so I’m listening. Connected.
In my exhaustion and exhilaration, it sometimes feels like something is standing just behind my left shoulder, just at the edge of my perception. I can all but hear the ebb and flow of life like waves crashing on a beach miles away.
Right now, someone is being born.
Right now someone is dying.
Birth, death, over and over and over again.
It’s endless- but these moments are so singular and defined. Everyday miracles, I guess, but those words fall so short.
It feels a little bit like sacrilege-- tapping into the pulse of the world.
When I get home, I pull off my shoes and grubby birth clothes, leave everything in a pile on the bathroom floor and slide into bed like nothing happened at all.
It’s just another night of work.
Bryna has 4 kiddos, a seafaring husband, and a sweet pup named Amelia Earhart. She loves to climb rocks, play in the surf, and camp in Big Sur.
She has been working with families since 2006, and became an IBCLC in 2010. She owns Doula My Soul, llc -- a private practice in the Portland, Oregon metro area. She works as a doula specializing in high-risk and surgical birth, a lactation consultant offering home, office, and online consults, and teaches classes through both Doula My Soul and OHSU Center for Women's Health.
Bryna has mentored many students through their IBCLC hours, and loves to share the joy of helping families meet their individual definitions of success!
Communication skills are of the greatest importance to me, as a doula, educator, parent, and person. I fell in love with this piece because it offers easy-to-follow ideas. There really is no place in life where we don't need to use communication skills -- so refining them will help us not only as doulas, but also as members of families, communities, and the world.
As doulas our profession is one that is infused with passion. We are passionate about the families that we serve and the beliefs that we hold, but unfortunately a doula’s passion does not always translate into professional communication. There seems to be a never ending obstacle course for doulas in their struggle to conduct themselves in such a manner that honors the profession that they have chosen. Unprofessional conduct from doulas spans from scope of practice violations to lack of respect towards fellow doulas and other providers such as nurses, midwives, and obstetricians. How many times have you read a doula’s post criticizing a nurse or provider’s actions at a birth she recently attended? Have you met a doula who is quick to speak negatively about another doula behind her back or criticize a doula for doing things differently? Doulas then wonder, “Why isn’t the nurse more accepting of me?” or “Why doesn’t that doula refer clients to me?”
Unprofessional conduct is not only an obstacle to a doula’s personal practice, but it breaks down the level of professionalism within the doula community as a whole. Professional conduct is actually an easy skill to master. At the heart of professionalism lies communication. With the advent of electronic communication, personal communication skills have seen a significant breakdown. If you don’t use it, apparently you lose it. Luckily, by adhering to the following communication 101 principles a doula can maintain a level of professionalism at all times.
1. Think before you speak/act/email. Remember the old adage to count to 10 before speaking? Turns out that this isn’t just a line your parents made up but is a timeless truth. Taking a moment before responding, whether in person or by electronic communication, can easily avoid a knee-jerk response that can cause irreparable harm. When it comes to electronic communication, think about whether you would actually say what you are typing if the person was sitting in front of you.
2. Speak with integrity. Choose your words carefully! Avoid words that intentionally inflame or create gossip. Ask yourself, “Is this how I would like to be spoken of/about?” Keep private subjects private, and avoid flaming or gossiping about other professionals in public forums.
3. Keep your promises. If you say you can back someone up, help with an event, etc., then do it. If you aren’t sure, don’t commit. Be clear when you communicate expectations around working with other professionals so that miscommunication doesn’t cause you to go back on your word. Don’t leave other professionals or clients in the lurch.
4. Don’t Assume. I am sure you know the expression about assuming! If you are ever unsure, clarify with the person directly, and by directly I mean in person as long as it is conceivably possible. While electronic communication can be an effective tool for a quick message, tone and body language are totally lost and these are integral to meaningful conversations. To not take the time to sit down and talk in person might send a negative message about your level of professionalism and respect for clients or colleagues, no matter what profession you are in.
5. Treat others the way you would like them to treat you. Is the provider at your client’s birth less than pleasant? Is a particular doula not giving you a warm fuzzy? You have no idea what that person has gone through that particular day. Maybe that person is struggling. Perhaps their loved one is critically ill. Perhaps they have been up for 24 hours working non-stop. Rather than taking it personally and speaking ill of that person behind their back, try extending that individual some grace and empathy. Ask yourself, “How would I like to be treated?”
By following these communication 101 skills, you can not only improve your own personal practice, but you can also help to further the level of doula professionalism as a whole. Be an advocate for all doulas by starting with your own professional conduct!
Heather Scott is a childbirth educator and a doula through the Childbirth and Postpartum Professional Association. In more recent years Heather has expanded her practice through earning her Bachelor’s in nursing from Regis University and is a registered nurse in the birth center setting where she has worked since 2008. Heather graduated in 2016 from the Frontier Nursing University MSN program and is a Certified Nurse Midwife. Heather and her family live in the foothills southwest of Denver. When not attending a birth or teaching a childbirth class Heather can be found spending as much quality time as possible with her husband, four children and usually a furry friend or two in the background! It is with great enthusiasm that Heather seeks to provide families with quality support through Cocoon Birth whose mission is to nurture, empower and honor your family.
♥ four young boys and a boy dog (offspring)