Stacie Bingham: Birth Support in Kern, Tulare & Kings Counties
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Day 31: We've Reached the End!

5/30/2014

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Looking back over all these guest posts for May, I am in awe of the collective wisdom, courage, and ingenuity shared either by doulas, or about doulas. I remember once having a conversation with my oldest son. He was very young, and he and a neighbor boy got into a little spat. Frustrated, my boy called this other little guy "dumb."  We had a conversation about this. "Everyone knows different things. Some people are good at math. Some people are good at riding bikes. Some people are good at making friends. Some people are good at cooking. Everyone has something they know or can do that makes them smart, the key is figuring that out. So you see, no one is dumb." 
PictureSamantha, from day 14!
I have a belief that everyone has something incredible to share that the rest of us can learn from. Even when we think there is nothing interesting about us -- no talents to display, no skills to speak of, no formal education, nothing that makes us special -- there is always something. It has been such a privilege to solicit some of these stories from specific people -- knowing a bit about them. I was able to suggest topics I knew writers had experience with. I was convinced the stories were there, and by asking or suggesting, these moms and doulas (and one dad!) came up with beautiful true tales of healing, of love, of overcoming obstacles and families coming together -- doulas supporting, and doulas being supported. I truly did little more than ask.

A few of these posts were already written before I came along begging, but the majority of them were created just to be shared here, and I hope those doulas and moms continue to write, because you have words and experiences of value and interest! Occasionally I had to fill in the gaps, and this was also fun, pushing myself to create content! The Birth Footprint essay had been sitting in my drafts file for months, maybe even a year, and I had been stuck with it, so the pressure to fill a spot on the calendar got that finished. I know some doulas still intend to share their stories, and as they come to me, I am happy to add them as guest posts here and there.  

At this point, I feel I am out of words! I can only say amazing so many times to describe this project. I am grateful for all I learned. I am grateful for the help you gave when you participated. I appreciate the time it takes to dig deep, sort, and get it all out on the computer screen. Thank you. I have learned so, so much from all of you. 

All you Doulas out there, keep loving and serving families and being shaped by your experiences. And when you get a few minutes, don't forget to

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Day 30: What I Learned About Birth from My Mom

5/30/2014

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I remember, growing up, hearing my mom's stories of birth. I knew I was a breech baby born vaginally, as was my next sibling after me. My mother had 5 children, and what really stuck with me was, "You can deal with anything for one minute," in regards to contractions. Amy's mother had a very different first experience with a truly life-threatening condition. I love that Amy's mother was not only able to instill aspects of normal birth in her daughter, but that as a woman who had cesarean births, she felt healing as she witnessed the birth of her grandchildren. 
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Every April is Cesarean Awareness Month.   Cesareans of course are sometimes necessary and in some instances can be a lifesaving procedure for the mother, baby or both.  In my work as a doula I have attended a number or Cesarean births and one of my favorite clients to work with are moms who are planning a VBAC (Vaginal Birth After Cesarean) birth.

A lot of people assume that because I am a doula that I am anti-intervention and therefore anti-cesarean.  Believe it or not I am personally very thankful for Cesarean’s because my mother and I would not be here today without them.  I was born by an emergency, lifesaving Cesarean.

While my mother was pregnant with me she experienced a complication called placenta previa.  Placenta Previa happens when the placenta is low in the uterus and either partially or completely covers the cervix.  In her situation it completely covered the cervix.  This complication is a true medical indication for a Cesarean birth.  It’s dangerous for the mother to even go into labor.

My mother was told she wouldn’t go into labor but would start bleeding first and to come immediately into the hospital when that happened.  She had been hospitalized earlier in the pregnancy for bleeding.  On June 3rd (due date was July 14th ) she started experiencing contractions, as a first time mom who was told she wouldn’t go into labor she didn’t realize what was happening.

She was staying with my grandma while my dad was at work and in the afternoon my grandma noticed her stopping to breathe through contractions and took her straight to the hospital.  Upon arrival she was checked and was fully dilated.  Things really got busy at that point as the doctor came in to do an emergency cesarean on her.  The doctor yelled at her for eating lunch while in labor because they needed to put her to sleep.  The nurse insisted that I had no heartbeat as my mom was being wheeled into surgery.  She was put to sleep right after the nurse said “I don’t know where that doctor thinks he’s hearing a heartbeat at.  This baby is already gone.”

Needless to say we both made it though.  I was a preemie but did great.  I didn’t even need oxygen.  My mom still talks about what a frightening experience my birth was.  She woke up assuming that she had lost her baby.  She had a really rough recovery after and woke up many times asking what happened to me and being reminded that I was ok.

Now for what I learned from my mom about birth.  My mom was never afraid to talk to us about her birth experiences.  I’m thankful for that.  Even with the dramatic way I entered this world I was not fearful of giving birth when my time to birth came because of her.  She talked to us about her disappointment in never getting to birth her babies.

She went on to have two more children both scheduled cesareans.  With my brother the youngest she was thankful for being able to have a spinal and be awake to hear his first cries.  She searched for a provider to have a VBAC with my brother but due to the fact that she had a classical uterine incision they felt it was too risky for her to attempt.

She always talked to us about what birth was supposed to be like.  Empowering, amazing and beautiful.

She was present for 4 out of her 5 grandchildren’s births.  She says it was healing for her to experience those births.  With the births of my children she was so supportive and helpful I can’t imagine not having had her there.

My dream is that my daughter and someday maybe my granddaughter’s won’t fear birth and that they will embrace it as a life affirming, empowering event that my mother taught us it could be.
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I gave birth to my daughter Maura in late 2005, an experience that led me to become a doula. When my son Ryan was born in April 2008, the process did not work out as well as I had planned, but this only served to reinforce my desire to help as many women have the birth they've always wanted.

My goal is for women to feel empowered by their birth experience. Women need to believe in their bodies and the natural process of childbirth, and nothing makes me happier than to be a part of their blessed arrival. In addition to my work as a doula, I am a Hypnobabies instructor, and a local ICAN chapter leader. Visit my website or Facebook page to learn more.

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Day 29: Graeme's Birth

5/29/2014

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When I initially read this story, I was struck by the challenges Katrina faced while pregnant -- a reminder that there are many health issues that can make pregnancy more difficult than normal, whatever normal means! I also loved how her doula set things up for Katrina to not only ease Katrina's adjustment to the hospital, but to also ease her mind. Katrina makes unique, comfortable gowns for moms to labor and birth in -- so when you are done reading her story, go check out her website!
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I think it is important to tell you the story of how baby Graeme (pronounced grey – UHM) came Earthside because the more we hear about birth the less we fear birth and that is a catalyst for the continuing change towards mother centered birth.  This is his birth story.

My mother had lived with us for several months before Graeme made his entrance. This was because I have Rheumatoid Autoimmune Arthritis or as it is now called Rheumatoid Autoimmune Disease (it does NOT have me. :)) and it was actively flaring during pregnancy. I was unable to keep up with the demands of a household and our high-spirited toddler. This made for a unique environment with both good and bad points. By the end I believe we had become weary of the dynamic so you could feel the sizzle of anticipation in the air both from waiting for the baby, waiting for my disease levels to subside, and waiting for the end of our situation. I was told during pregnancy that having another child would be a very bad idea because of the many mounting health problems so having mourned that and come to terms with that I was very very ready to be done. When you come to terms with something, accept it, and move on and you have to wait several months for the moving on to come to an end it gets tedious. You are just waiting and pulling forward one day at a time to see a goal. It’s like closing the chapter to a book but you are watching the two covers come together in slow motion and it catches your breath. Ready to be done. 

I had followed the pattern like my daughter’s labor I had labored off and on for 2 weeks. Real bouts of labor followed by several days of nothing. I thought this was Braxton Hicks, but my doctor once again told me otherwise. Graeme was born on a Monday morning. The Thursday before I had my last prenatal appointment and my doctor who has practiced over 30 years said “You are a 7 and you are 78% effaced. See you at the birth center this weekend or Monday.” Having seen it all he is never wrong. He told me with my daughter “see you in the next day or two” and she was born the next day. Yes he sent me home. He is one of the few doctors out there who trust the natural birth process completely. Trusts a mother’s body to do what it is intended to do. He only intervenes when it is absolutely necessary. I am fortunate to have had him as my doctor for the births of my children. 

On February 10th, 2014 at 3:35 am I went to the bathroom. I felt a ton of pressure and was unable to go to the bathroom. This felt different to me. I had felt pressure sitting down for weeks but it became clear to me that this was different. I literally could not contract the muscles to go to the bathroom. This was a lot of pushing down. It didn’t feel like contractions to me but I felt “opening” and so I continued to sit as the half squat was helping that action . I was 39 weeks 4 days pregnant so I wasn’t sure if this was “it” or not. Then I began to feel the pressure come and go. This hadn’t happened this intense before. I started timing these “pressure “waves”. Before I could even get the timing app started I felt my body lurch forward. Labor is like that. You feel yourself being pulled and pushed down from inside. It is a powerful, earthy, painful and at once strange feeling. I texted my husband and said “Hey I’m stuck on the toilet in labor. Finding pants now.” He said “Ok. Waking Nana. FYI Blowing snow”.  It was blowing snow across the highway and there was an advisory to avoid travel if possible. I feel very fortunate that we had my Mom living with us and we could just go, no having to wait or anything. We would ordinarily stay home until later stages of labor but my contractions STARTED at 3 minutes apart and we didn’t want to end up on the evening news as that couple who gave birth on the side of the road in blowing snow. (Congrats to those who do. You have bigger balls than I do.)

3:40 am Got in the car. Contractions 2 1/2 minutes apart. Cascading one on top of each other. Couldn’t breathe. I texted our doula/longtime friend that I was “going to the hospital now” and off we went. 

White knuckle driving in the dark on an icy highway with no lines, high wind, and snow. 

Growl at husband “No” when he attempts to put music on. Growl at him “No” when he attempts to turn it off. Poor fella couldn’t win. Yell at him “IF YOU COULD ATTEMPT TO NOT HIT POTHOLES THAT WOULD BE GREAT! THANKS!!!” with my eyes shut breathing through the wham wham wham of hard fast labor. Didn’t realize that we were two blocks from the hospital when he hit the pothole and this car trip was almost over. Laboring in the car sucks butt. I don’t recommend it at all. 

4:10 am. Arrive at hospital.  Nurse Stacey comes out. She is pretty great, she recognized me because she had talked to my doula. Nothing like being recognized to bring the walls down. My amazing doula had pre-arranged many of the nurses and people who were a part of our team. One was a homebirth midwife in another state, my post birth nurse who cared for us was a doula for many years and was wonderful.  RN Stacey has many children herself. I had a 180 degree experience from last time. I am a sexual assault survivor so this was all pre-arranged to preserve my mental health and command the respect my body needed to do what it needed to do without the anxiety. This time no one asks me to do intake paperwork. My contractions are still 2 1/2 minutes apart. I am trying to keep cool through the pain. Fast labor is no picnic. It is like taking the entirety of regular long labor and smashing it into a few hours. Intense, overwhelming, terrifying and at times makes you doubt yourself and your ability to do it. 

We get into the room and I had to sit on the bed because we needed to get antibiotics in. I don’t want to but I have to. I tested positive for Group B Strep during pregnancy and despite measures to get rid of it at home we didn’t succeed. 

They get a line in and get antibiotics going. They try to get a heart beat on baby. This time manually. I am not strapped to the machine thank goodness. 

Doula Lindsay arrives around 4:30am

They want me to stand to get a heartbeat on the baby. Husband steps out to get water. My doctor has arrived and he is sitting with his feet up on the front desk chatting up the nurses. Typical for him. He’s a character. 

I HATED standing. I had to rest my head on my doula’s chest to get through it. I kept moaning/half-crying “Get me in the water. I want the water now.” “I can’t do this without the water.” Water reduces pain levels greatly and it is SO MUCH EASIER to labor in water. 110% easier. A nurse is running the water while we try to get a heartbeat. In fast labors sometimes the baby gets squeezed so much, so hard that the heartbeat isn’t consistent at all. Fast labors are hard on mom and hard on babies; they aren’t completely “normal”. 

About 5 am Graeme finally cooperates and I can get in the water. Thank the Lord! At this point I was in so much pain that I didn’t even realize my husband still wasn’t there. I was so hyperfocused breathing through the pain. Contractions are on top of each other. I can hardly breathe. My doula says “breathe.” I breathe in. 

As I sit in the hot water I lean back. Worst idea ever. I almost throw up it hurts so bad. I lean forward into almost a squat. Doula pours hot water on my stomach. It doesn’t help much. These contractions are so much more painful than with my daughter. My husband comes back. I cry “I can’t do this. I need pain medication” My doula says “you are doing this. You can do this.” I didn’t know that I was so close to having the baby. This was transition. I wish someone had told me, in retrospect, because I know the stages of labor. I thought this level of pain was going to go on for hours and I started crying. I started to not know what to do with my limbs. Almost flailing from the level of pain. 

“I need to stand. I can’t sit here any more. I have to stand.” 

6:15 am I stand and get out of the tub supported by my husband and my doula.

Yanno how they say when your water breaks it is never like it is in the movies? This was like the movies. WHOOSH it splashes everywhere. The bathroom floor is coated in amnion. Sorry about the shoes guys! (Never wear shoes to a birth if you can help it. Feet are washable.) 

As soon as I stood up I started to push. When natural labor is unencumbered and progresses on its own a beautiful thing happens. The body pushes on its own. No orders. No instruction to push. I have to stop every foot on my way to the bed to push. I half-squatted every time and groaned that gutteral, earthy groan, down into the floor using my husband and doula for support. 

I reach the bed. I feel I need to sit up with my breasts right against my knees. I begin to push and the team gets ready. No one counts this time. I push as the contractions tell me to. Which is a wonderful thing.

My son was a big boy so the nurses and our doula keep saying “pull those legs wider” I do. I hear my hip pop slightly out of socket and feel the pain of that. But I know this is the end of it so I keep going. I push that pain to the back of my mind and focus on the goal. 
Something crucial happens. My doula tells me to “relax”. When a person tenses while pushing she tears. If she relaxes then the baby does their work and they don’t tear. That tissue is supposed to stretch and it will if you relax it. This was the ticket for me. Every time she said “relax”, I did. I am ever grateful for that. My son slowly corkscrews out. On his way out, I didn’t know it, but he split a vein with his shoulder. There was a lot of blood. And my doctor, being the calm man he is, says “Don’t look down” even though there was a lot of blood. My husband retained composure holding my hand even though he said it was a lot of blood and freaked him out a bit. He said nothing. That is an amazing gift he gave me so I wouldn’t panic.

6:37am Graeme is born. He cries and they place him skin to skin on my chest. He latches like a champ. I cry tears of joy at the instant ability of my eager baby to nurse. We had a long trial with my daughter and his gulping noises fill  my heart to brim.  I rotate my hip back into place after my doctor stitches my vein and minor tears. We wait for the cord to stop pulsing before cutting. I deliver the placenta which turns out to be huge and my doctor says “I’m sorry” as it comes out because it is folded over on itself. It’s like birthing another baby. Kudos to you twin moms out there, you rock. The placenta weighed in at just over 6 lbs. This is not uncommon for moms with active autoimmune disease during pregnancy. The placenta had to work extra hard to keep my baby boy safe. I am grateful for this organ and what it did for my son. 

 He is here. He made it. Hello baby boy. 


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Katrina Tholen is the mom of two, and owner and designer of Luna Labor gowns. Luna Labor started on June 3rd, 2011 as an idea. Katrina had made her own labor gown based on a basic scrubs pattern. She really enjoyed having the bright colors of her personal labor gown and the fact it was washed in her own home with her own detergent. The next day when Katrina's doula visited she said “those gowns are great, I bet you could sell those” and that was it! Katrina's gowns fit better than hospital gowns and have all the capabilities for laboring and breastfeeding. Her doula for Graeme's birth was Lindsay Bench of Welcome Baby Doula Care. 

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Day 28: Using the Rebozo in Labor

5/28/2014

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One thing about being a doula is, you learn quickly what positions a mom likes; and you learn just as quickly, what positions are hard for you to maintain. When performing the hip squeeze with your own hands, you exert pressure in an awkward manner (envision your hands on either side of a woman's hips, fingers reaching toward each other over her back, and you pressing inward, with your elbows poking out). But women respond to this over and over and over! By pressing the top of the hips, the base of the pelvis can actually be helped to open wider, and this feels good to the woman, especially if she is experiencing back labor. With my own birth a year ago, my doula was charged with "The hips! The hips! The hips!" as a contraction would build. These tips Marivette shares will definitely save a support person's strength, as well as help the mother with restorative and relaxing ways to cope with labor. Thank you, Marivette!
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I first became aware of the rebozo eight years ago when I visited a border town near Weslaco, Texas, called Progresso, Mexico. The women and young girls were carrying babies and toddlers on their backs with a fabric. After showing an interest in that cloth, my mom, who had taken me to visit Mexico, took me to a small store to purchase one. My first ever rebozo was a beautifully woven white rebozo. 

Fast forward six years, when I see an advertisement for a rebozo class for doulas and midwives. After reading the information on what the workshop offered, I signed up. That day, was the first day that fell I love with the rebozo for the use in pregnancy, labor, and birth. The Rebozo is a shawl or scarf which is long enough to wrap around a woman's body and has been used for centuries to help women find comfort and support during the birthing process. There are several other uses for the rebozo such a baby wearing, using as a shawl on a cool day or evening, or using it as an accessory to an outfit. These are only a few of its uses; there are many other methods to use the rebozo.  In this blog post, you will read about its use in pregnancy, labor, and birth. A rebozo comes in different lengths. For the purposes of pregnancy, labor, and birth, the ideal length is 9 ft long X 2-3 inches wide. The shortest it should be for optimal labor support is 6 ft.. Rebozos come in a variety of textures and colors. My favorite rebozos are the handmade ones from Laos because they are thin, long, and have some beautiful hues. 

As a doula, one of my goals is to integrate the partner with the laboring woman. The majority of my clients are husband and wife relationships. The husbands desire to have a very active role in supporting their wife's labor. Where as before, all I had to offer were the use of the hands as a tool, I can now offer the use of the rebozo. Most men like tools. Having a tangible item to use in labor, can help him feel connected to his wife. I have found that the rebozo is a great tool to facilitate the bond between partner and mother. The rebozo can be used to engage the partner in the birth process and is an extension of the labor partner's arms.

There roughly more than 30 different ways that a rebozo can be used for pregnancy, labor, and birth. You will be introduced to five in this post. If you would like to discover other uses for the rebozo, taking a rebozo class or workshop for either pregnant families or professionals would be extremely beneficial. You will gain knowledge and hands on experience in the use of this traditional shawl.

A rule of thumb when using the rebozo, and any other comfort method, is to always ask the laboring woman if she is comfortable with what is being done. If she likes the way it feels, the partner should continue with the comfort measure. IF at anytime the woman feels discomfort the partner should stop what he/she is doing. The partner can readjust the rebozo or discontinue its use altogether. Always measure continuing the use of any comfort method based on how it feels to the laboring woman. Since doulas do not diagnose nor treat their birth clients, the rebozo is meant only for comfort, support, and extension of the arms. The rebozo should never be used as a treatment. 

The following are five ways to use the rebozo to give comfort while performing the hip squeeze. The hip squeeze is one of the most desired labor comforts. The partner uses his or her hands to squeeze the hips together to alleviate some of the pelvic pressure from contractions. Hip squeezing can last up to a minute or more during a contraction. Although the partner would never voice this in labor, it can be a tiring job for him or her. If her main support is her husband and he has any wrist injury, he would be unable to perform the hip squeeze with his hands alone. The rebozo can take the place of the hands, thus allowing for longer and stronger hip squeeze support.
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1. Standing hip squeeze
The rebozo is wrapped around the woman's hips, then tied as tight as is comfortable for the woman at the front, back, or side in a knot. Only continue if the woman likes the way it feels.
2. Birth ball 
The birth ball can be a great tool to assist in opening the pelvic inlet. The laboring woman can still have the hip squeeze done while on the ball. Have the mother stand in front of the ball. Wrap the rebozo around her hips and lower back. Support the mother as she sits on the ball. The rebozo can be crossed around the front of the mom and squeezed as tight or as loose as if comfortable for the mom.
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3. Hands and knees 
The hands and knees position is great especially if the laboring woman is having back labor. This position relieves some of the pressure from her back. If she isn't having back labor, it could still help take some of the baby's weight off her back. Help mom get on hands and knees. Wrap the center of the rebozo around the woman's hips paying attention to that it is not on her abdomen. For the hip squeeze, we want the rebozo around her hips. The partner holds the open part close to the woman's buttocks, and tightens the hips. A knot can then be made in the rebozo to assist with the squeezing of the hips. Once the knot is in place, the partner can use one free hand to put pressure on the sacrum. Continue as long as mom desires. 

4. Double partner hip squeeze
This comfort measure can be used by two people, ie a hired birth doula, or second labor support person like a sister, mother, or friend. With the mom standing, wrap the rebozo around the woman's hips. The two partners stand beside the woman, and hold the end of the rebozo as it cris-crosses in front of her. The patterns then pull on the rebozo as tight as is comfortable for the woman.
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5. Leaning over the bed
This position can be done similar to the above mentioned hands and knees. If she is in a hospital, the bed can be raised  to a more comfortable level for the woman's height. She can then lean on the bed and hug a pillow or two for comfort and to support her upper torso. The center of the rebozo is wrapped around the woman's hips making sure not to wrap on the belly while she is leaning on the bed. The partner holds the opened side of  the rebozo (fringed side) and tightens the rebozo around her hips. Make a knot at the end close to her buttocks as tight as she likes. The partner will have a free hand to add some pressure on the sacrum.

The use of the rebozo can free a partner's hand to give him or her the ability to use an additional comfort measure such as massage and a gentle anchoring hand on the shoulder. It can assist in longer durations of comfort measures to the laboring woman because the partner is not too tired from using his or her hands. This is beneficial to the laboring woman because she will feel fully supported by her labor team. In all, the rebozo is an amazing tool which can enhance the labor and birth experience. 


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Marivette Torres is the founder/owner of Tender Doula Hands, a rebozo trained instructor and distributor. She is a CBI certified birth doula with 16 years experience serving the Bakersfield, California area. She has eight children ranging in ages from 24 to 6 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 lay (unlicensed) midwife. She breastfed all her children with her last child self-weaned at six years old this January. In her birth doula practice, she utilizes some of her own personal experiences and many years of labor support experience with well over 175 clients. She is currently teaching rebozo classes to pregnant women and their partners and to birth professionals which includes midwives, doulas, nurses, doctors, and anyone involved in the birth community. You may visit her website and Facebook page. She also has a page dedicated to specific rebozo class information.


Did you know? For two years in a row, I have celebrated International Doula Month (May) by featuring guest posts by and about doulas? This is Day 28 from 2014, and it is constantly being re-pinned on Pinterest. I am always looking for stories to feature, and 2017 will be the 4th year of this tradition!  So if you are a doula, or had an experience with a doula, contact me to reserve your guest spot! You can write something just for this occasion, or share something you have previously written.
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Day 27: Getting Reimbursed for My Doula!

5/26/2014

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Reimbursement for doula through health insurance is something we hear about every once in a while. I thought this was a great example of, you never know until you try! It seems to be the consensus that most companies will automatically decline the first request...but don't stop there! Sarah shows that her last-ditch effort actually proved fruitful!
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I was about 32 weeks pregnant with Hope when I thought about hiring a doula. Knowing friends who had used them, I thought it might be something I would benefit from, especially because I wanted to have a med-free birth. I emailed Charlie Rae Young, a doula that Jenny had used during her pregnancy with Noah. We met a few times before my due date and she was always available via phone or text if I had any questions. When I called my insurance company to inquire about coverage, their answer was short and to the point - "Sorry, but your insurance doesn't cover doulas. Even though I was going to pay $800 out of pocket, it was an experience I definitely didn't want to pass up. (for anyone wondering, that money covered two pre-natal home visits, the entire birth, a post partum home visit, lactation support and constant availability via text/email/phone).

I briefly wrote about how amazing it was to have a Charlie present at the birth of Hope. If anyone is on the fence or questioning having a doula for their birth experience, I say do it! You can never have too much support while you're in labor.

In January, I decided to write a letter to my insurance company, requesting reimbursement for my doula, or "labor support services." Even though I had been turned down over the phone, Charlie said it wouldn't hurt to send a letter. I mean, really, the worst they could say was no - and I'd already heard that.

Below is the letter I sent (certain areas blocked out for privacy):

(Name/Address/Phone)
DOB: x/xx/xx
(Insurance ID & Account Number)
Date of Delivery: November 15, 2012

January 8, 2013

With the labor support of Charlie Rae Young, DOULA, CLC, SM, I was able to forgo medical pain management and avoid other interventions that are costly to (Insurance Carrier), including a cesarean birth, during my recent vaginal birth at Florida Hospital.

The following were charged to Cigna during the birth of my first daughter on 11/15/10:

Vacuum Extract/Forceps: $197.00
Vacuum Mityvac: $126.83
Hi Risk Care per hour: $552.00 (8 hours)
Urinary Cath Ins-Foley: $202.00 (2)
OB Epidural Service: $506.00
Urinary Cath Ins-ST CA: $101.00
Daily Bed Service: $1508.00 (quicker recovery, so stayed one less night this time)

This is a savings total to (Insurance Company) of at least $3192.83, plus the cost of pain medication, as I used much less during the recovery period this time around. The cost of my labor support was $800.00, in which I am requesting reimbursement.

Please feel free to call with any questions.

Sincerely,
Sarah


I mailed it off, crossed my fingers, and waited to hear back. Four weeks later, I opened up my mailbox to see this:
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I went screaming into the house, I was so excited. Progress! And my total out of pocket expenses? $230. Not bad. 

Feel free to use the above letter to start drafting a letter to YOUR insurance company. If more companies were willing to cover labor support, I'd like to think we'd be on our way to less inductions, c-sections and an all around happier birthing experience for all women. Good luck!

(*Update - I also included an itemized invoice from Charlie along with my letter - something most doulas should provide.)


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Sarah is a full-time graphic designer in Orlando, Florida. She is a mom to two daughters, Emmalyn and Hope - and has a baby boy due in July. When she is not having babies and working her day job, she can be found photographing newborns, births and families and selling headbands in her Etsy shop. You can follow her blog as well. This was originally shared on her blog.



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Day 26: Our Operation Special Delivery Baby

5/26/2014

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In honor of our men and women who have served in our military, today's post shares the story of one family's birth experience when Dad couldn't make it home from his Air Force assignment. Using technology, Dad was able to participate via Skype, and he still had his leave 2 weeks later so this new family did have time together before Dad had to return to service. 
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When Lloyd got his orders and was leaving for the middle east, I was newly, newly pregnant. We knew this might happen. We made the decision to start a family anyway. This was Lloyd's second tour to the middle east. He had good expectations of what to expect, and so did I. 

I have been used to being home while he is away. We were engaged shortly before his basic training. As I said, he had been gone before. We had good ways of communicating. We would email and we tried to Skype once a week if not more than that. A friend on base suggested a doula. She said there was something military moms found helpful called Operation Special Delivery where trained women would help military families, especially if the father was away. I got a list of doulas from the Beale Pediatric Clinic and started calling around. I found my doula and she was about an hour from base, but it seemed like it would work. After all, my husband was due to have some R&R around my due date, and the plan was he would come home then. My doctor was open to inducing us so Lloyd could be there at the birthing.

My doula and I would meet so she could give me childbirth classes and help me with things I wanted to know. Once we even Skyped with Lloyd so it was almost like a a regular visit with mom and dad and doula, lol. I was feeling ready. I had things mostly ready at home. I was excited to have my baby and have Lloyd home!

Lloyd was schedule to come near my due date on June 17th. I woke up the morning of June 4th thinking I had wet the bed. I realized my water had broken. It was about 4:30 am and I wasn't sure what to do! This was not supposed to be! I got calm and quickly called my doula. She said sit tight, call your doctor, and I'm on my way. I did all that, and then I waited.

We got to the hospital at about 8:00. I wasn't really feeling contractions yet but my doctor wanted me to come in. I got an IV and they started a little bit of pitocin. I had trying to get in touch with Lloyd. I was sending him emails and I just hoped maybe he would check before he went to bed. With luck he did. He was able to Skype in and I had my laptop. We had set up the computer in the room so Lloyd could see me and I could see him.

Lloyd was about 11 hours ahead of us and he had a full day already. He was excited though. It took about 8 hours before I was feeling ready to have our baby. I was excited. But suddenly I was feeling something else. I was afraid and nervous. The doctor said I was ready to push, go ahead! But I felt frozen. I really felt I needed Lloyd right there with me. I felt like I was going to panic and I started to cry. My doula hugged me. She asked if I could have a few minutes alone to talk to Lloyd on the computer. It was a funny thing for her to do, but my doctor understood. My doula was going to leave the room, but I asked her to stay at the door while I talked to Lloyd. He just told me we were so close now! He said he was sorry it happened this way but he would be with us soon. He told me he loved me and was so proud of me. After I had a little crying spree, and my doula came back to hold my hand, the nurses and doctors returned. Lloyd was on my little table on the computer screen. My doula was next to me. I started to push.

We moved the table a bit so Lloyd could see our baby be born. My doula ended up behind me on the bed, supporting me as I sat up to push. Our baby came fast once I went through my emotional sadness and fear. We named her Evelyn and she weighed 7 pounds even. It was incredible, and even though my husband wasn't there physically, our doula helped us figure out how to manage things to still have great birth memories and experience. I am so grateful to Operation Special Delivery and to our doula and what they do for military families.  

Lloyd, Marin, Evelyn and (new baby!) Jake currently reside in Idaho. Lloyd and Marin had a doula for their second baby, and Lloyd was there for the whole thing. Marin plans to train as a doula to help others in the future. 
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Day 25: A Day of Rest

5/25/2014

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I had good intentions today, but with church, and then a terrible headache,  I knew I needed to wait until I was feeling 100% or I would not be doing the guest-poster justice. So for now, enjoy a day of rest. See you tomorrow!

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Day 24: Mini-Men Postpartum Doulas

5/24/2014

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The picture above shows my nephew holding Ezra, the first day of his life. Isaac is playing lullabies on the lap harp in the background. With Ezra's birth, I have had many helpers around, and the benefits from that are huge! Some days when I was feeling isolated, home alone, exhausted -- I knew I just had to wait for my boys to get off the bus and I could have a break. They aren't formally trained as postpartum doulas, but they have the brotherly skills to alleviate some of my stress, and who wouldn't appreciate that!?
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Evan and Ezra, Ezra's first night on earth.
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Jacob and Ezra after church.
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Isaac and Ezra.
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Jacob doesn't LOVE wearing Ezra in the Ergo because he was asked one if Ezra was his baby, lol. But Ezra loves it!
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These guys are buds!
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Sometimes you just need a chest to sleep on!
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My postpartum dog-la!
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Day 23: What to Do While You Wait for Clients...

5/23/2014

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I have known Avira for almost a year now. I remember being struck by her professionalism, and entirely impressed by what she had built up, all while waiting and feeling frustrated at the lack of doula clients coming her way. She didn't sit around waiting for business, she went out and created awareness about doulas, and community for birth workers! I was amazed at what her passion and efforts had "birthed." Hopefully this is encouraging to anyone still feeling stuck in that waiting period between wanting to work as a doula, and actually working as a doula!
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I had felt a tug since my own births, the first being over 12 years ago, that I wanted to be involved in other women’s births. But raising two little ones, dealing with special needs, and deciding to homeschool my children for a time, meant there was little time to give to this dream.

A new season in my life opened a way to my doula training at the end of 2011. It was intoxicating and surreal to be fully immersed in my favorite subject for a full weekend!

Afterwards I was left with the job to complete my certification steps and to blaze forward in this work, on my own accord, which seemed daunting, if not impossible. I was in an area that seemed to have NO birth community or even an awareness of what doula care is. There did seem to be a thriving little birth community about an hour away, but that didn’t seem very practical as a source to plug into, as our local moms would not be reaching that far either.

After a few months it occurred to me that I needed to start to round up some doulas to create a support circle. There were at least the ones I did the training with, and I had caught wind of a second nearby training that had taken place shortly after mine, so there MUST be enough of us to start a group! I sent out an email to everyone’s name I could gather, and the email got forwarded and forwarded, and soon we had rounded up a group of about 7 of us who were interested in meeting. We met at a local coffee shop and chatted up a storm. One of these amazing ladies, Coleen Salazar, was an experienced doula and IBCLC who had moved to our small area from San Diego several years ago, and was such a valuable resource for us! She welcomed us into her home for monthly meetings! From there we started our little Valley Doula Group, which ranged from 3-8 doulas a meeting. We would advance our education by digging into subjects and even have an occasional guest come and share with us. More than anything our purpose was to share and support each other on our various paths of birth work. This group was so inspirational and so needed for me. I would leave every night with my cup overflowing, by having others to share in my passion with me.

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As months went by, as much as I tried to promote myself as a doula in the community, no births would come. I felt so frustrated. How am I going to be a doula if no one will choose me to be theirs! Even offers of minimal fees and sliding scale didn’t seem to work. Then it occurred to me… people are not going to hire a doula if they don’t know what one is! 

Sadly, we live in an area where a very small percent of the population seemed to care about their childbirth experiences, very few even attend the low-cost or free childbirth education offered by the local hospitals. I knew that it had to start with education! 

Where I had formerly lived, in San Luis Obispo, CA, there was a “Birth & Baby Network."  I had browsed through one of their resource guides while sitting in the waiting room for an appointment with the CNM group who was providing my care. It was by browsing through that pamphlet, back in 2001, when I learned of the term doula, and became area of all my local pregnancy, birth, and parenting-related resources.

The idea hit me like a lightning bolt! We need a local birth network!! Ideas are funny how they hit you and they stick, and fester and grow. Well that’s precisely what happened. Soon I had the name chosen, the website purchased, began building it (thanks to my IT savvy husband!) and the beginnings of a birth network started to take structure. Now I just needed a team! 

Surprisingly only one of the doulas from our doula group was as inspired as me: Denise Stricklind, a local doula, placenta encapsulation specialist, and birth photographer. Denise recognized the need in our area and was fully on board with my mission! Together we plugged away, like a full time job, how to establish a local birth network as a resource for support and education in our community. 

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Visalia Birth Network was founded in the late summer/early fall of 2012. Now, a year and half later, we have grown to 21 members, all various local professionals who support the Mother Friendly Childbirth Initiative, which is the cornerstone of the Coalition to Improve Maternity Services and birth networks across the globe. The 10 steps in this Initiative propose a wellness model of maternity care that improves birth outcomes and substantially reduces costs. Every member must endorse this document upon joining. 

VBN offers free monthly educational meetings for our community. We have had topics like: 10 Ways to Avoid a Primary Cesarean Birth, Cloth Diapering and Baby-wearing, the Midwifery Model of Care, Perinatal Mood Disorders, VBAC: Can it be Done, Breastfeeding Q & A, and so much more. We also make a monthly appearance at our local farmers market to help integrate, and we also host some amazing events throughout the year such as the BOLD Red Tent (our 1st one coming this Saturday!), the Big Latch On, and the Rally to Improve Birth. We are a local collective of moms and professionals who care about birth experiences and who strive to make grassroots change in our community (you can follow us on Facebook if you’d like to keep up with our activities!).

I love the way VBN seems to be impacting our community. We are starting to have loyal moms, who come out each month, not only for the information but for the support circle that VBN provides. It’s a group where moms are met with nurturing, supportive, and a “come as you are” attitude. I believe moms are grateful for our presence. 

And the other good news is that I’m starting to get busier with doula work! Our education appears to be working too! Moms are learning the benefits of doula care and the undeniable help that doulas offer at every birth. My hope is that this birth community we’ve created continues to grow and take hold in our area for years to come, and that our area moms and families continue to benefit from the access and support of caring perinatal professionals.

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Avira has an expansive list of accomplishments! I just want to share what I know about her. She is eager to learn and eager to help. She has passion and talent. Avira's ability to rearrange her goals in order to maintain her love for doula work is the sign of her endurance and her creative thinking -- both excellent qualities on someone who supports families through the birth process! It has been a joy to work with her, and I have appreciation for what she offers to area moms, babies, and birth workers! Find her through her website, her Facebook page, VBN's Facebook page, and if you are an area doula, check out the Valley Doula Group. 

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Day 22: Healing Hurts through Rebirthing

5/22/2014

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I am incredibly excited to share today's post. When Keegan mentioned this to me, I was amazed -- that she had helped a mother through birth trauma by something as simple and genuine as a ceremonious bath intrigued me. Reading her story left me awestruck. If you feel you have a client who may benefit from a rebirthing, I would encourage you get in touch with someone who has experience in this area -- Keegan would have great information for you, I am sure! 
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As a postpartum doula and birth educator one of the areas I see a gap in our maternal care system is postpartum follow up, particularly when it comes to birth trauma. Most expectant mothers imagine what it will be like the day their new baby arrives. Others are afraid of what will happen on their birthing day, and try to put it out of their minds. Some women have a plan of how they would like their birth to go and some even put the words down on paper to give to their care provider. 

When a birthing day does not happen the way a mother envisions, it can result in shattered expectations and the loss of dreams. Any situation that a person is put into where they are forced to make a decision under duress (or without their consent) can result in guilt and second guessing.  Many of these mothers have difficulty forming the essential bond that new mothers have with their baby in the first days of life. Some develop perinatal mood disorders. They are not typically seen by their care provider until their six week follow-up, and even then new mothers struggling to manage birth trauma are often missed, and continue to fight their feelings alone. This is my story of a time I was able to help one of these mothers dealing with birth trauma by facilitating a rebirthing.

I received a call from a new mother, who was still in the hospital after she experienced a traumatic emergency caesarean section. She described to me that throughout her pregnancy, she envisioned seeing her son enter the world in a gentle way, surrounded by love and met with joyful anticipation. Unfortunately the birth had not happened according to her plan and after many long hours of labor, her doctor decided that it was time for her to meet her baby and sent her for a caesarian. I knew she needed to see her birth in a new way, and to have a second chance to have the birth that she wanted.  Physically, her recovery was difficult, and she and her son had difficulty establishing breastfeeding. He had been separated from her for over an hour after the birth, and was having trouble staying latched on and was often fussy at the breast. Mama was feeling hurt and powerless and she told me about the loss she had endured. They were all home from the hospital on the fourth day after her son was born, and I met with her soon after they arrived at their house.

I had heard about the idea of a rebirth, and I suggested that it may be a way for her to begin her healing. I had her prepare a letter written to her baby, telling him the story of the birth she had imagined for him. She spent some time talking through this with her husband, and when they were finished I ran a warm bath for them, lit some candles, and dimmed the lights. She and her baby got in to the bath skin to skin and I read her letter. Her eyes gently closed as she held her baby close and I saw them both relax almost as if they were melting into each other. She helped her baby to her breast, and he was able to latch on. He seemed like he was almost asleep, maybe he was just finally relaxed enough to nurse. They stayed in the bath for some time, and I encouraged her husband to stay and sit with them. 

I waited in another room, and when they all came out to join me, something had shifted. There was a stillness and peace that was tangible and I could feel their deep love resonating though their home. I stayed with them long enough to see baby latch on again. I saw her eyes fill with tears of relief, smiling as she looked at her husband beside her. This was the new start that they needed. 

Everyone who was there that day experienced their own rebirth, and I am forever grateful that I was able to be a part of such a special day for this new family. Every mother with birth trauma deserves a chance to find healing and peace, and I am humbled to have a role in that journey.

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Keegan Barkley is the founder of New Journey Postpartum, LLC, serving the Indianapolis area. She is a DONA trained postpartum doula, a HypnoBirthing Instructor, a Sacred Pregnancy mini workshop and Birth Journey instructor, and she is trained in Rebozo techniques for birthing. She also offers babywearing and cloth diaper consultations, basic breastfeeding support, and birth trauma and pregnancy loss support. She has worked in mental health and substance abuse counseling for seven years. If you are interested in learning more about rebirthing or any of the services she has to offer, please visit her website or her Facebook page.

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Stacie Bingham, LCCE, CD(DONA), CBS(LER)

Calm, comfortable Lamaze education & experienced support for pregnancy, birth, & breastfeeding serving Bakersfield, Delano, Hanford, Porterville, Tehachapi, Tulare, Visalia + the World

​661.446.4532 stacie.bing@gmail.com
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Photos used under Creative Commons from Renaud Camus, jmayer1129, jmayer1129, Rob Briscoe, jmayer1129, jmayer1129, jmayer1129, operation_janet, CJS*64 "Man with a camera", symphony of love, Aravindan Ganesan
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