PictureBrian Patrick
I am currently 37 weeks, 6 days pregnant.  This means, like Arnie Grape says, "I could go at any time."  In the past have I ever gone this early?  No.  But two nights this last week I started having irregular contractions in the evening -- more than those warm-up Braxton Hicks, but less than what I deem to be "true" labor.  And it has given me a little bit of anxiety as to the realization that yes, someday soon, this baby will have to come out.

I have taught families about birth for years!  I have touted the benefits of minimal-intervention during birth as long as mom and baby are okay.  I have been excited for birth, pledged my allegience to birth, shared my mammalian theories about birth, and basically been on fire for the wonders birth can bring -- simply from a new, sweet baby, all the way to that complicated glimpse into what we are capable of as women.  Birth has been my world -- it has been something I believe in, something I put my faith in, and something I have experienced as an incredible part of being a woman.

Yet here I sit, getting heart flutters and panic, as I experience a contraction that feels a little stronger than normal.  When I get those nagging self-doubts or scary flashes of fear, I push them right out of my mind -- I can't even entertain them. If I had business with them, if there were something fruitful to come from their company, then there would be a purpose in having them hang around. But I know this much about myself:  Negative thoughts are part and parcel to my brain and its chemistry, and they mostly have no function to fulfill.

To counter my own inclination of dwelling on the negative, I have found some solace:  When I think about the women I have supported during their own experiences of birth, I find my confidence in birth being rebuilt. 

There was Karen, who birthed her second son at home in a horse-trough-looking tub, all 12 pounds, 2 ounces of him, like nobody's business.  

Amanda, who exercised her right to attempt a vaginal birth after cesarean (VBAC) in a local hospital; she walked into the hospital (no wheel chair for her!) at 7 centimeters open and soon after birthed her baby in a squat, close to the floor (I don't know if she even sat in the bed at all before the baby was born!). 

Kim, who had her baby in the car on the way to the hospital with just the support of her husband.  

Tara, who labored at home with a walk to Jamba Juice while she and her husband shared the story of how they met years before, as co-workers, at that same Jamba Juice (he snuck a kiss in the walk-in fridge!).  Their baby was born a few hours later, peacefully and in the water.  

Another Tara, who labored hard for almost two days to bring Brian Patrick into the world, on St. Patrick's day, no doubt, after being thisclose to having a cesarean birth. 

Leah, who didn't let her fears get in the way of the hard work that birth is. 

Kim, who was on bed-rest -- she ate breakfast, had a conference call for work, realized her water broke, went to the hospital and had a baby within an hour, had a follow-up call from someone at work regarding the conference call, and then had Thai food for lunch! 

Laura, who experienced the worst kind of tragedy during pregnancy which she used for strength to have a home-water-VBAC -- I will never forget the words she kept chanting during transition, "The only way out is through.  The only way out is through."

There are so many more.  I remember them all.  One thing I will say about birth -- no matter how you have a baby, no matter where you are or what your personal experience will be made up of, birth is a day of hard work.  Regardless of whether a woman has a spontaneous, normal birth, an epidural, a cesarean birth (or whatever combination), it is generally not a day at the spa.  But one thing I have always said, it is mostly a mind-game:  You can psyche yourself up or you can psyche yourself out.  I, for one, am working on the former, and I am so grateful for all those families who have allowed me to witness their power and strength, because right now, that's exactly what I need.      
   

 
 

  Q.  Why would we want a doula?  Wouldn't that be like having a stranger at our birth?

A.  Unless you know your doula before pregnancy, she does start out as a stranger.  During the course of your meetings, though, you get to know each other.  She gets a good feel for your needs and desires for birth, and you experience the way she cares for and nurtures new families.

What expectant families don't often realize is, the day your baby is born, your doula might be the only person in the room (aside from family and friends) who ISN'T a stranger!  The option of choosing your medical birth team is not always available.  In offices with many practitioners, you may meet with all who may potentially catch your baby, but rotation schedule is most likely the factor in deciding who will be there on your baby's birthday; likewise, a practitioner in a solo practice -- if unavailable -- has a back-up whom you may not have even met before.  In these situations, a doula can help remind you of your birth intentions, and she can support you and your partner no matter who is on your birth team that particular day.

Q.  My partner is planning to be my support-person -- what good would a doula be then?  Wouldn't she make my partner feel displaced?

A.  Most partners plan to be the main support person during birth -- and a doula doesn't interrupt this plan.  A partner's support is different than anyone else's on the birth team:  The partner is the only one at a mother's side because he or she LOVES the mother, cares about the mother, and has a great interest in the outcome and future for mother and baby.

Every partner is ready to participate in the birth process at varying levels.  Some are very comfortable with the scenes, sounds, and smells surrounding birth; others need a little more space to process the events going on.  Regardless of level, a doula supports mother and partner where they are at, and helps bring them where they wish to be.  Doulas allow birth partners to participate at the level THEY are comfortable with.

Q.  How else can a doula help besides actual birth support?

A.  All doulas offer prenatal support before birth.  This is a time to learn about birth options, birth planning, and expectations for becoming parents. In addition to this, many doulas also offer breastfeeding support, infant/mother massage, postpartum doula services, information about local resources, and a continued listening ear about the transition to parenthood.

Attention:  I personally authored these FAQs.  Please do not copy them without permission.

 
 

I am often approached by women who feel a pull towards this work.  A common comment in situations like these is:  "But you know so much!  I don't know nearly enough -- how could I do what you do?"

There is a secret.  I learned this though years of personal observation and experience.  I would love to share it with you if you have come here in the hopes of figuring this out for yourself.  Are you ready for it?  Now, pay attention, because if you understand and embrace what I am about to tell you, you may gain a boost of confidence that can buoy you up in times of self-doubt and personal conflict.

Imagine this:  You are shopping in your favorite grocery store.  You notice the refried beans are no longer in their spot on the shelf.  You ask a passing employee for help.  She confirms visually they are missing and says, "Oh.  I don't see them.  I don't know what?  Sorry."  Then she leaves.  How are you feeling?  Frustrated, mad, let-down, unimportant?

Imagine now the same situation.  You see garbanzo, kidney, white, black -- but no refried beans.  Again an employee walks by and you ask about the beans.  She looks, sees their place on the shelf has been taken over by other beans, and turns to you to say, "I don't know, but let me find out for you."  Now how are you feeling?  Cared-for, worth it, appreciated?  That employee took more time to help you, admitted she didn't have the immediate information you needed, and in the end, she helped you solve your problem (the beans had been moved by the tortillas, salsa, and canned peppers!).

Women are coming to us for information, yes, and often they are needing comfort, reassurance, affirmation, compassion, an ear to hear and sometimes a shoulder to cry on.  It is so much more important that we encircle that woman in our attention and our care versus offering her the precise answers to her questions and then sending her on her way.  The surface problem she presents may be just the tip of the iceberg, and without skills like active listening, seeking clarification, reacting with appropriate body language, we can miss what's under the water.

When does a woman feel cared-for?  When she knows you are focusing on her and that you care about her.  The way to show this is by being present with her.  It is okay (and appreciated!) to tell her you aren't familiar with the issue, and you will aid her in finding helpful resources.

So the answer to the question, "Am I smart enough?" is this:


"Stuff" can be pulled out of books -- facts, statistics, information; this comes from without and slowly takes root within.  It can be sterile, static, and cold.

"Stuffing" is what you have to offer,  what makes a teddy bear comforting; this comes from within and (often, not slowly!) makes its way without.  It can be calming, assuring, and warm. 

One makes you a smart doula; the other makes you a great doula.

 
 

Q.  What is your feeling about taking clients that have the same due date?

A.  I would actually prefer to have two clients with the same due date, as opposed to having clients with a two-week space between due dates.  It is speculated that only 5-10% of babies are born on their actual due dates -- that is maybe one out of ten women, so the chances of two women, with the same due date, having their babies at the same time is even less than that.  On a personal note, I have only ever had back-to-back/same-day births with clients where I thought there was a safe distance between due dates, but babies come when babies come -- they don't often get the memo about due dates.

Once a client of mine had a cesarean two weeks early for a medical issue (about
2 pm), and another client had her baby the same day (her due date), 6 minutes before midnight.

Second time I had a client go two days early; my back-up doula had a client go 18 days overdue (my back-up had to leave on day 16).  My back-up's client (whom I was now the doula for) was in the hospital working on day 2 of an induction.  My client went into spontaneous labor, and actually had her baby at about
midnight.  Before I left, I went to pop into the other family's room, but their nurse assured me they were sleeping.  I geo home (35 minutes away) and barely fell asleep, when the phone rang.  I ran back to the hospital, very sleepy!  Baby was born about 12 hours later around 3 pm.

Third time I had a client go 16 days past her due date, and another client went a couple of days early.  Over-due mama delivered at about 
10 pm; early mama called me at 1 in the morning stating her water broke.  Back to the old grindstone!

A few things you should know about due dates:

-What Goes in a Due Date?
-When is that Baby Due?
-ACOG Guidelines for Induction