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.
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.
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.
I got great news over the weekend, which gave me the idea for today's post. I then asked other doulas to share something they love -- it could be tangible or intangible. Something that makes us smile. Something that makes us cry. Something that keeps us connected to this work we do. I loved that the responses I got were all so different, yet they are pretty universal when it comes to doula work.
I received a simple text message on Saturday, and it made my day. "Hey, Stacie -- we will be needing you again!"
"I can never get over the shock and awe when parents see their baby for the very first time. So much emotion, so much love, so much birth ❤️." Ashley Rodside
"I love watching partners take over and lead the coaching they just saw from me a minute ago. Then, I can fall back into the ether while they labor without me."
-Sarah Branion of Wonderstruck Doula Service
"That moment of instantaneous relief and pure ecstasy as the new mom and dad meet their baby for the first time."
-Brittany Kurtzhals of Holding Space Birth
"I love it when I am working with a mom who has valid fears and she overcomes them. They are so happy that they did it!!"
-Erin Swart of Erin's Doula & Birth Services
"The look on mom's face when she sees her baby and realizes she did it!"
-Courtney Little of Little Miracles Birth Services
"When I watch a partner or dad tuned into the laboring person's needs, and I know that my job is simply to hold space for that magic to happen.
-Andrea Hewitt of East Nashville Doula
"I love watching new dyads getting the first feeding latch -- the look on the face that says 'Wow, I'm doing it!'"
-Vicki Bloom of Whole Self Doula
"The tangible relief and burden lifted I watch happen in families when they know they have someone (their doula) who's going to be like their guide through the process!"
-Camille Nyman of Abundant Birth Support
Marivette is one of the doulas I have the pleasure of knowing in real life. She is an amazing woman I admire, look up to, and learn from. I loved this piece she sent me -- and with permission from the others involved, this creates a picture of what support can look like from your fellow doulas.
After being a doula for 20 years, I got the calling to become a midwife. I didn’t accept the calling haphazardly. About a year passed by, lots of contemplation, discussion with my husband, and then the application process, before I became an enrolled student in a MEAC-approved school. Now I’m in my third year, and things are getting hectic.
I have a circle of doulas around me, though! And do you know what these doulas do best? They doula me through this midwifery journey. Some of the best times I have is when we get together for doula lunches, and we just hang out together around a good meal. It never fails that they ask me how school is going, and encourage me with their kind words. It’s like I have my own support team, and they are wiping the sweat off my forehead with a cool rag.
I sent several of them a message a few weeks back, including Stacie. Just knowing that I have these few doulas, surrounding me, giving me encouragement, and simply being there, is a huge boost to my morale. They are helping me get through this active stage of labor! I don’t even think they know that they are doing this for me. It’s such a part of the fabric of being a doula, that it comes naturally for them.
Hey you all! I am just so thankful to have you all as part of my business circle, but I also consider you all my friends. You all giving me your support through this challenging midwifery school journey means so much to me. I'm in tears as I think about how your words lift me up. When I feel down and heavy with all the school work, your words encourage me. You don't even know how much your words of kindness mean to me. I truly appreciate your friendships!!!
To all of you Doulas who are there beside me, rooting me on, THANK YOU for being my encouragement doulas. Thank you for being MY Doulas during my labor as a student-midwife. Don’t stop doing what you do. I really need you all!!
Do you know someone who is going through a difficult time? Or do you know someone who has chosen to move forward into the midwifery journey? What do you do to encourage those people? A simple, “You’ve got this,” goes a long way!
Marivette Torres is the founder/owner of Tender Doula Hands, a rebozo trained instructor and distributor. She is a CBI certified birth doula with 19 years experience serving the Bakersfield, California area. She has eight children ranging in ages from 26 to 8 years old. Her first child was born via surgery at a community hospital due to breech presentation. Her subsequent seven children were all VBAC births, two of which were born at a hospital birth center and five were born at home attended by a midwife.
She is currently halfway through her dream of pursuing a midwifery career. You may visit her website and Facebook page. She also has a page dedicated to specific rebozo class information.
When someone says, "At least I have a healthy baby," how do you interpret she feels about her experience? Birth is a transformative experience, and women can be transformed for the better, or for the worse. How can we, as doulas, help support someone who has had a traumatic experience? Abby gives excellent ideas which remain within our scopes and roles as doulas.
When you look at the probability of trauma in the course of a woman’s life, the statistics are high. One in three will experience sexual abuse in her lifetime, one in four will perceive her birth as traumatic. So, if you’re a childbirth or postpartum professional, you are regularly working with women who have experienced trauma. And keep in mind: a woman who has previous trauma or a history of abuse has a much higher chance of being triggered in birth and experiencing trauma again.
What is birth trauma? It’s all about perception. When a woman perceives her birth as traumatic, she has felt one or more of the following in an intense and damaging way:
Birth trauma will have immediate effects on a woman and change her experience of birth, postpartum and motherhood. As birth professionals, our goals are to prevent birth trauma by providing support, information and guidance for laboring Mamas. Some of the things you can do during your time together are build trust, tune in to Mom’s behaviors to establish safety in the labor room, and speak to her in a calm, affirming voice. But unfortunately, we can’t always prevent birth trauma.
Women who have experienced a traumatic birth can develop PTSD (posttraumatic stress disorder). It can be misdiagnosed as postpartum depression or anxiety but the symptoms are actually different. Some signs of PTSD in a new mother are:
There are some important things to keep in mind when dealing with a Mom who has birth trauma. Your support will be critical to establishing safety, support and eventually healing from this difficult time.
Here are some things you can do to support a Mom with trauma
The exciting and encouraging thing to hope for is what’s called post traumatic growth. With proper self-care, nutrition, sleep, and exercise she will begin to feel better. Suggest to her that some women find healing through yoga, body work, trauma therapy and groups. Post traumatic growth provides women the opportunity to heal from trauma and become stronger, wiser and more compassionate because of it. With adequate support, education and care, new Moms can fall in love with their babies and leave the shame and pain of trauma behind.
Abby Bordner’s background is in medical settings, community education and entrepreneurship. She currently has many online and in person projects for the non profit sector and her private business. She is a Cappa Doula Trainer, Labor Doula, and Lactation Educator. She is a certified ICEA Childbirth Educator, as well as an author and entrepenuer, creating such projects as Yoga Born, Birthing Tree Cooperative, Relationship Based Parenting, and Modern Motherhood. She travels around the US providing certification training for future Cappa doulas, and Yoga Born Childbirth Preparation classes – trainings for prenatal yoga instructors which integrate yoga and childbirth education.
If there is one thing I love, it is helping other doulas get started. There are so many aspects of doula work left to individual preference and style -- it can be beneficial to watch and learn from other doulas as you discover your own shape. The first time I was able to shadow a doula, it was accidental. I was hired by a family, along with a second doula, because both of us had prior scheduled events near the due date that we couldn't miss. The offer was then extended: If you are both available then you can both come and support our birth. As luck would have it, we were! Although I had plenty of doula experience at this point, it was my first time in a new hospital; the other doula was generous with her knowledge -- I couldn't help but grow in many ways thanks to her openness to share all kinds of things with me.
Have you ever shadowed an experienced doula or asked to be shadowed? Did the experience match your expectations?
I think one of the greatest challenges new doulas face once they’ve finished their initial training is learning how to put their knowledge of textbook labors into practice when so very many labors are not textbook. I remember walking out of my initial training excited, feeling ready to jump in as a knowledgeable support person, only to find myself at a 56-hour complicated and confusing labor both for me and the couple I was supporting. It wasn’t following any of the textbook rules. Neither did the next 2 births I attended, which were equally complicated and confusing for entirely different reasons.
Many certifying organizations offer only a short introduction to the labor process in person in which there isn’t much time to get over the natural and normal variations of labor. While there are many books, articles, and websites available for further study into the various reasons why a labor might look active when it’s not or why it might not progress in a linear fashion, it takes time for a new doula to start putting those puzzle pieces together. I had to learn as I went.
Often on the fly, little by little, we learn as we go. I sort of took those early difficult labors as a test of my will to be doula. Wouldn’t that be so much easier, wouldn’t it be so much faster though, if there was a mentor to help in those situations? This stress over feeling not well enough prepared is what leads many doulas to try find someone to shadow or another doula they can call while at a birth. But it’s not always so easy to find or implement. I often hear from doulas that they asked around but no one was willing, or that they found someone but then their client don’t want someone sitting in the corner watching, or that they were afraid to wake a mentor at 2 A.M. to ask questions about a situation unfolding. While many certifying organizations encourage finding a mentor, few formally arrange for it.
As someone who comes from a strong teaching and mentoring background, I really wanted to offer shadowing situations for new doulas. But I found that the shadow concept didn’t work well for me or for my clients for a lot of different reasons. It might be a new doula that I didn’t personally know very well, the connection with the client might be awkward, or often the case, the new doula might reach out once and then never follow up. The energy output for a mentor is high. When it’s not reciprocated, it can be frustrating and discouraging. I needed a different solution, which luckily presented itself as most great ideas do, like a light switch coming on.
I’m fortunate that I often get to work with licensed midwives, and an important part of becoming a licensed midwife is be an apprentice. An apprenticeship has all the things I was looking for: It addresses that most people learn best by watching and then doing; it’s a formal relationship with clear expectations; it’s long term so you get to know each other well; and, clients know we come as a package.
By this time, I was already working in a group practice. We had already worked through the logistics of our business model, things like work load distribution, call time management, money management, and most importantly communication requirements. It was relatively easy to slip an apprentice into the mix, what remained was deciding what was required of the apprentice and how to select one. This process has evolved and been refined over the years and includes the obvious things, such as attending prenatal sessions, active labor, and postpartum follow-up with the client, but also now has requirements about reading, advanced classes, and hands-on experience. When our group turns a doula out into the world, we want to be confident and we want that doula to feel confident that they have the skills and experience to handle any situation. The birthing people and families in our community deserve excellent doulas. We really enjoy being a part of helping to make that happen. It’s an honor and a privilege.
In case you’d like the do the same, here are a some tips to you started:
In working with an apprentice, I believe that it’s very important to know yourself before you can know what you need from an apprentice (it’s not all just you giving, it’s a reciprocal relationship). For example, what are your core values or what makes you tick? Your values help you to stay focused and keep on track, make appropriate decisions, connect with like-minded people, and be inspired.
Some questions to ask yourself (answer truthfully!):
Best of luck to you and your students! If you need a mentor, I’m here!
Teri Nava-Anderson, PhD, CD(DONA), ICCE has been assisting pregnant people and their families through their labors since 2008. She is the CEO and founder of the Harmony Doula Group and co-founder of the Modesto Doula Group, both private practices dedicated to community education, mentoring new doulas, and advancing “mother/baby-friendly” practices in local hospitals. She has been teaching advanced doula training classes since 2012. Teri is the Northern California Regional Representative for DONA International, and the Board President of Mt. Diablo Doula Community.
Evan was such a great "sport" with this feature. I loved the unique position of this excited dad -- he said it was even he who called the doula (which she later admitted to Evan and his wife, was unusual enough that, had she not remembered them from class, she might have thought this was a hoax doula call). Dads need doulas, too! And the "coaching" support they get can often be invaluable.
Week 4 of our childbirthing classes, our instructor said, "Next week, we will have a doula come talk to us about doula support. A doula is like a coach and you parents are a team. She coaches you through birth." I was curious! Well, as a junior high school teacher, I have coached a lot of different sports, from volleyball, to track and field, football, softball, and baseball. I am a sports-lover, so that term had me excited to learn more.
As promised, the next week me met Renate, the doula. Renate was a confident-looking woman, in her mid-forties. She knew about birth, that was clear. Renate shared about meeting with couples before birth to learn about them. She walked us through a typical doula/couple relationship from before the birth to after the birth. She told us about a few things she carries in her bag. When you add that all together, it looked like the perfect playbook to help a team win a game. I wanted in!
Convincing my wife, Shelly, that a doula would be good for us was a different story. Shelly was more inclined to let things happen on their own without a lot of preparation or planning. "I just want a healthy baby," is what she would say to me. Everyone wants a healthy baby. Everyone wants to finish the game. As a coach, I wanted more. I wanted to feel good about the effort we put in as a team in this birth "sport," and I wanted to feel like we won.
Where was the turning point in this? Our doctor. At one of our appointments, Shelly shared with our doctor that I was making a little book filled with information I would need to help her cope. In this "playbook" were things like, 4-1-1 (when to go to the hospital), labor stages and signs, the Take-Charge Routine, what happens in the hospital's mandated "Golden Hour." When our doctor heard this, she asked, "Oh, have you thought about hiring a doula?" I nodded my head yes. "What's the hold-up? Often it's the dad who doesn't want one." I pointed at Shelly. Maybe that wasn't the most mature thing to do.
"What do you think, Mom?" our doctor asked. Shelly replied: "I hear birth stories all the time. I have so many friends who had ideas about their births, and then their plans went out the window. I don't want to set myself up for some special experience, and then feel let down." Our doctor said there are no guarantees in birth, but that doulas can help couples feel better about their overall experience. She handed us a list of local doulas, starred a couple she thought we might get along with. Shelly still wasn't convinced, but she agreed to meet with a couple doulas and see what she thought.
We recognized one name on the list: Renate! We arranged a meet-up.
When it came down to it, Shelly and I liked Renate and we felt she could help us both achieve our birth goals. She was an amazing help. My father had an accident a few days before our baby was born, and he was in Intensive Care Unit of the same hospital where we were having our baby. He actually had a surgery planned for the day Shelly went into labor! Because of Renate, I could run between these two important people in my life to make sure they were all okay. I could know about where things were with Renate texting me, so I could be with my dad for a few minutes before his surgery. I was also able to stop by once he was out of recovery. The most exciting thing was, when I could come back to my dad and step-mom with a picture of our baby, Stuart Henry, to his grandfather, Henry Stuart.
With Renate by our side, I didn't need to clutch my playbook to my chest. I could relax and trust her coaching abilities. When I say coaching, I say she supported Shelly, and she helped me support Shelly. But she absolutely coached me! And that was just what I needed.
Evan is a middle school teacher from Des Moines, Iowa. He, Shelly, and their daughter can be found screaming their heads off at Iowa Wild Hockey games, or cruising around their neighborhood on their tandem bike (with a baby seat).
♥ four young boys and a boy dog (offspring)