 It is hard to admit, staying home with a baby can be a lonely time. It is ironic that, on one hand, you have a baby that needs you all.the.time, and yet we can still feel alone. Sarah shares some great ideas in this feature. As doulas, we can work to create space for new moms to make friendships, and we can offer support for their changing emotional needs. As moms and women, we can look for opportunities to build and nurture friendships. And it's all good for growing families. So you find yourself sitting at home, looking at your new baby who has finally settled into a sleep after feeding for what might seem like the last six hours continually. Your home might be a little untidier than usual, the washing is piling up, you have given up on the idea of bothering to iron anything (flat clothes are slightly over-rated anyway!) and you can’t remember the last time you got to have twenty minutes of “down time”. Your partner is spending long hours at work (still trying to catch up on the backlog from his paternity leave) and the influx of visitors that wanted to greet the baby have slowed to zero as everyone else returns to their day to day lives. And here you are… coming to terms with your new “normal”. During Birthability coffee mornings we always try and have a “topic” of conversation which people can dip in and out of as they wish. We have always been so humbled that our mums don’t “play pretend” with each other. They don’t sit there and dress up their weeks to show off how brilliant parenting is. Instead they are brutally honest and share their experiences openly, offering a realistic perspective that sometimes it is hard to cope, and gain solace that they aren’t the only ones feeling that way. One week I asked the mums to share how they felt emotionally. Of course a few people said they loved being with their baby. A couple of mums felt that they would take time to adjust to their new roles, and were wondering if they could ever accept that this was “the future” for them. But worryingly, the most common feedback was that our mums felt “lonely”. Lonely despite always being in contact with another human (albeit a baby!) Lonely despite seeing their partners every day and often seeing pre-baby friends on a weekly basis. Lonely despite being part of a new network of hundreds of other mums that have recently gone through their experiences . And Lonely despite visiting coffee mornings each week. Since we set up our weekly Bumps and Newborn support sessions, we have had many mums telling us that we provided the most important service that they accessed. Mums feel that we provide an “anchor point” in the week – and if they can just make it through to that day then they can come along, chat through any issues, sit down and be waited on with a cup of tea and a biscuit, and feel like an individual again, rather than just “babies mum”. Don’t get me wrong – our small team loves to coo over their babies as they come in – but actually we are really more interested in offering the mums a listening ear and hearing about their week. Our group has organically grown into a peer support session, where new mums are always identified, welcomed and introduced to another set of mums with the same age baby. We often choose a “buddy” mum that we know is comfortable chatting with new mums and able to help them feel part of the group quickly. In truth we don’t know how we achieve a “non cliquey” group – but somehow we do!! So, we could pat ourselves on the back for running a great session – But what happens at the end of a coffee morning? Well, the mums pack their stuff up – put their babies back in their car seats – and drive back home where some of them will feel lonely again until next week. So as I stand watching my mums sitting around the room and freely chatting, I have to wonder why it is that women are often unable to continue those friendships with strangers outside the room, and it strikes me that we are pretty useless at being forward! How easy would it be to say to another woman that you have met at a coffee morning “Hey, you know its been great to chat with you, it feels like someone else really understands my perspective – would you like to meet up during the week for a coffee?” Scouting has a wonderful motto – “A stranger is just a friend you haven’t met before” So, if you are feeling lonely, afraid, overwhelmed or just a little bit bored by the monotony of parenting, why not look into your local groups? When you go in just ask to speak to the leader and explain that you don’t know anyone and would really appreciate it if they could introduce you to a couple of mums. I can tell you that a number of our mums joined us like that – and have gone on to form lasting firm friendships. Some of our more experienced mums invite new people to join them after in the pub for a quick lunch – and a couple of them have even grabbed unsuspecting mums walking past the venue with a new baby in a pram and said “Hey, why don’t you come in and join us for coffee? It’s a great group and they would love to meet you!”. Women need to start loving each other. We all have lonely days. Be brave and reach out to “strangers” around you – it could be the beginning of a lifelong friendship.  Sarah is a co-owner of Birthability. She has been teaching antenatal courses in Warwickshire, England for over 7 years, and has taught over 3,000 couples across the region. She trained as an NCT birth companion in 2010 and received certified accreditation from the University of Worcester. She loves to meet couples in early pregnancy, watch their journey through labour and birth and offer support at coffee mornings until mum is feeling confident enough to move on. Sarah has 4 children, and in her spare time is often running around to Hockey matches with her boys, and walking their dog “Luna”. You can find Birthability on Facebook as well.
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 I often say a doula is like your walking/talking/breathing childbirth education class -- a live, recalling commodity that can guide you through the things you learned in your classes. I love Veronica's insights here -- yes this concept of a doula works, and it works optimally when the family has taken good classes beforehand from an experienced childbirth educator. Excellent points are made about why one (a doula) is not equal to the other (a childbirth educator), and vice versa. When I decided to make the switch from the investment field to my current career, I ended up looking into becoming a childbirth educator and a doula at the same time; as it turned out, I started teaching less than 6 months after attending my first birth as a doula, so my professional identity had almost always included both roles. There is some doula/childbirth educator crossover, but not as much as you’d think. One reason? It’s far easier to get trained and certified as a birth doula than to be trained and certified as a Lamaze Certified Childbirth Educator, mostly because there are simply more doula trainings. One thing, though, that I feel very strongly about is making sure people realize that hiring a doula is not an acceptable substitute for childbirth education, and a childbirth educator isn’t a substitute for a doula. Both are necessary, and they have very, very different roles. A childbirth educator, and thus, a childbirth class, is important to help you understand the birth process, various interventions, and help you set realistic expectations for the first few weeks after your baby is born. You need to know these things before you go into labor– once you’re in the midst of birth and postpartum, you just won’t have enough bandwidth to absorb any of that information. And as I wrote previously about the relevancy of childbirth education in 2014, the conversations that we can have in class can not be replicated through any other means. As a childbirth educator, my certifying organization works very hard to make sure we are staying up to date on evidence-based care. In fact, I’d argue that since we aren’t contractually required to follow a set curriculum that is rarely updated, Lamaze Certified Childbirth Educators are the most likely to have the most up to date policies and guidelines included in the class content. The policies and standards of care are ever-evolving; usually with the goal of improving outcomes for moms and babies. As a doula, I prefer if the parents I work with have developed their birth preferences separate of my input. That way when the doctor or midwife asks them about their preferences, I know that the family has fully thought through what they want and don’t want. Education allows them to sort through all of their options, and doula support seeks to help them achieve those goals. And really, to think that 2 or 3 prenatal visits can cover as much as is covered in a birth prep class is an insult to those of us who are childbirth educators. BUT…as a doula, I offer in-person support at the time of birth. That’s obviously not something I do for the families who take classes at BabyLove (unless they contract with me and my doula partner for doula services). As a doula, my role is to stay there, in the moment, to offer physical and emotional support to the birthing mother and her partner. The act of being a doula is fluid, sometimes intangible, and it’s hard to articulate exactly what I do. So much of what I do comes from instinct, from my experience with other births, and largely just following mom’s lead. As doulas have become more mainstream, the role of childbirth education has diminished. And I am frustrated that the same women who are fighting so hard to promote paid doula care are also trying to say that what they do is a replacement for childbirth education. If they want respect, they should be respectful. We would all do a lot better if we could acknowledge that it takes interdisciplinary cooperation to best care for and support new families.  Veronica Jacobsen, BA, CD(DONA), CLC, CPST, LCCE, FACCE, is the owner of BabyLove in Eagan, MN. BabyLove is an independent childbirth education center where classes, support groups, doula meetings, and a whole host of birth/baby/breastfeeding-related happenings occur. Veronica brings a unique skill-set to her work, as she formerly worked in the investment field -- she offers business consulting as well. Veronica is a prolific blogger with her topics ranging from traditional ones you would expect related to birth, to insightful business tips, to her all-too-relatable Real Mom Confessions. As an educator, Veronica provides mothers and dads/partners with the understanding and trust they need to navigate through the wonderful transition into parenthood. As a doula, her goal is to provide care that informs and empowers women from all walks of life. She believes birth should be viewed as a normal, natural process, and not as a medical emergency.
 Just good, old-fashioned, doula praise! Sometimes it doesn't get better than that! The doulas shared here are Coleen Salazar and Avira Wenn. In the beginning of my pregnancy, I didn't even know what a doula was. I honestly met a doula while serving on a jury. While on a break in Visalia, CA, Coleen approached me. I was reading Ina May’s Guide to Childbirth, and it peaked her interest about me. We began to talk about birth, my pregnancy, and the struggles I was having with trying to get my OB on board with the natural birth I wanted. We talked at great length, and I loved everything about her so much that I kept in contact with her. In addition to being a doula, Coleen was also a lactation consultant at a hospital in Tulare, so she invited me to a free class she was teaching on breastfeeding. I went to the class and found out the it was part of a local birth network. From that day on, I became very involved in the birth network. I began to educate myself on natural birth, breastfeeding, and various other birth related topics. In my third trimester, I also left my OB and switched to a midwife who was totally on board with the way I wanted to birth. Although I had learned a great deal about birth, and switched to a midwife, I still wasn't sure I really needed a doula. However, I really wanted Coleen at my birth because she was the first person, throughout my entire pregnancy, that made me feel completely confident in my decision surrounding my plan for a natural birth. When I asked her about being my doula, she told me about her friend, Avira, who was finalizing her doula certification. She needed to attend births in order to fulfill her requirements. Coleen encouraged me to be open to the idea of having two doulas. After meeting Avira, I couldn’t say no! She had such a calming presence that proved to be amazingly beneficial during my birth. I feel very fortunate to have had two doulas by my side. Although I hired them late in my pregnancy, they still came to my house to discuss their role in my birth, nutrition, my birth plan, and further educate me on birth options I didn’t even know existed (delayed cord clamping, passing on standard but unnecessary needle pokes, etc.). I was on a tight budget, but they were committed to helping me have the birth I wanted and worked with me on payments. Both Avira and Coleen were by my side through my entire labor. Avira literally supported me through some of my contractions and massaged my back during the most intense parts of my back labor. She knew just what to say and how to touch me. Coleen knew just how to motivate me when my contractions were tough. She encouraged me, kept me hydrated, helped me with positioning during contractions, and helped me know when I should transfer to the hospital.  Their job as doulas was to be completely in tune to my needs, and they were. I consider my doula experience completely invaluable! I really don't know what I would have done without either of them by my side. My daughter had better care due to my doulas, I had the birth I envisioned for myself, and I was able to successfully breastfeed my daughter due to Coleen’s breastfeeding expertise (still going at nearly two)!
I had amazing postpartum care as well. When I needed anything, or had questions, they were there for me. They both came to my house and stayed with me while having some issues with my daughter nursing. They helped me through some of the toughest times I’ve had. The only other person as fully devoted to me throughout my entire experience was my husband. I'm so glad I made the choice to have a doula, and I don't plan on birthing anymore babies without one. I will be forever grateful to both of them for supporting me through such an amazing time in my life.  Being on-call as a doula can be hugely stressful. I appreciate hearing how other doulas manage their lives and calendar -- there is always something to be learned from the experiences of others. Thanks to Staci Plonsky for this helpful guest post sharing the ways she keeps it all together when she could be pulled up away from daily life at any moment to support a woman in labor. I get asked a lot, “How does your family manage when you’re on call?” Here are a few things we do to make life manageable for the on call times. (Typically, I’m “officially” on call 5 out of every 6 weeks. “Officially” means I have 1 or more clients at 37 weeks pregnant or greater.) 1) Flexible husband. My husband has some flexibility in work and can take off enough time to pick up the kids from school and man the fort until school the next morning. He puts in extra hours when I'm on call to prepare. This picture shows my husband treating our youngest to lunch in their favorite restaurant.  2) Backup babysitter. My mother has finally retired! That means she’s my new backup babysitter. The kids love it when Nana comes over to take care of them. She's much nicer than I am, they claim. 3) Frozen meals. I try to keep some frozen dinners on hand. I make a double batch of pancakes, meatloaf, chicken noodle soup, etc. when I make dinner and then freeze one for times when I’m not home. The funny thing is, my kids usually talk their Dad or Nana into McDonald’s. Then I use the freezer meals when I’m home recovering from an overnighter. Here’s a great meatloaf recipe, by the way. 4) Google calendar. I religiously record all events and upcoming activities and kids’ school project deadlines. There shouldn’t be any surprises, as long as the calendar is checked. 5) Schedule caveats. “As long as I’m not at a birth” is added to any invitations I accept when I’m officially on call. And I try to purchase (and gift wrap) birthday gifts, teacher appreciation gifts, and other items before the day of the event to save my husband trying to figure out what to buy. 6) Reasonable expectations. I don’t expect the home to be spotless (although my husband usually cleans better than I do.) And the family knows when I am on call. There are no surprises if I can’t make it to a function, although I do try to give the kids a heads up so they’re not missing me. 7) Excellent backup support. I know that if my children have a medical emergency, I can trust one of the Brevard Doulas to provide excellent doula services to my client. (I’ve never needed to use my backups so far, but I love that they are just as committed as I am.) 8) Professional approach. This is my profession. I realize it’s unpredictable in timing, but I am as committed to my work as the 9-5ers are to theirs. My family understands that I get paid to support clients and that income enriches our lives. Those are just a few ways we prepare for a spontaneous work week!  Serving families on the Space Coast and Brevard County area since 2010, Staci Plonsky CD(DONA) is a certified doula, committed to providing exceptional support to families through their pregnancy, birth and postpartum experience. Passionate about keeping her skills sharp and her knowledge current, Staci is also a certified childbirth educator through Florida Outreach Childbirth Education Program and pre-certified as a Labor and Postpartum doula with ProDoula. Along with these certifications, she stays current with Spinning Babies, VBAC Facts, La Leche League, midwifery assistant training and pre-nursing college classes. She achieved a Bachelor of Arts degree from Florida Southern College in 2001. Staci serves as the leader for the local Brevard chapter of the International Cesarean Awareness Network (inspired by her own Cesarean and subsequent vaginal birth after Cesarean "VBAC".) She has presented on the benefits of doula support, Cesarean prevention and natural comfort techniques in labor. A native Floridian and 14 year resident of Brevard County, Staci lives with her husband, 3 children, and Basset Hound. She enjoys riding her Irish Draft Cross Horse and gathering eggs from her resident hens.
 I was talking with some fellow doulas about ways we mark births, or record them, for our own purposes. I shared that I often will journal a birth in 300 words -- not only is it an exercise in brevity, it helps me really focus on the what I want to remember. There was a lot going on this day, and with a back-up midwife very ill, the on-call midwife needed a little more of herself to spread around -- which is why I was invited to this birth, never having met the parents before. It was a beautifully simple birth. The phone rings at 6:30 – I am still asleep. A midwife-friend asks if I can come help a couple birth their baby. I shower, grab my bag, kiss my baby and husband goodbye, and head to the hospital.
I see him first. “Alan?” I introduce myself as he applies counterpressure to the heap of a person lying in front of him. She is the beautiful Audra. Her face glistens with sweat, sticky long strands of hair cling to her cheeks. In the throes of this labor, she looks Snow White-ish and other-worldly. This work is intense. Her voice cries out. Her own mother brings comfort -- soft hands and sweet words; mother did this for her daughter, and now daughter does this for a son. Head-to-head, their noses reflect their sameness. One face is molded with effort, while the other is shaped by concern. In the mother, we first learn love. Alan has her now, cradled in his arms as she rocks toward him. I press, press, press on that bulging place on her back that signals a baby's passing – that upside-down triangle which starts where flesh dips and thins at the top of her warm buttocks. I smell her – the smell of life – spicey, earthy, and hot, and tinny. Alan's fingers graze mine and for a blink we connect with this woman's power. It won't be long. Her baby emerges in a bag of egg-drop soup, wearing his cord as a scarf. The midwife gently unwinds his traveling clothes and hands him to his mother. He squints his eyes and searches, following his hands like a blood-hound on the trail. The power that expelled him caused her breasts to force out shiny beads of honey. As he suckles, mother and baby are brought back to their circle of one.  Joyce learned about doulas during her first pregnancy, and like so many, she went on to train and work as a doula herself. I am a fan of birth stories, of course, and what struck me about this one is how we are not only seeing Joyce's journey unfold, but also we are learning about physical and emotional changes that occur along the way. This is a great example of what loving support can do for a woman experiencing a difficult labor.  First off, my goal, as long as the baby and I were both doing well, was for a nonmedicated childbirth. To help towards that goal, we hired a labor/birth doula, Marsha, as labor support for me and Justin. A doula's presence speeds up labor, reduces mothers' requests for pain medications, increases babies' Apgar scores, decreases postpartum depression, decreases cesarean birth rates, increases mothers' satisfaction with the birth partner/husbands, support, improves the birth partner/husbands' satisfaction with the birth, and more. They're awesome. Marsha brought along Becky, a doula-in-training, as well. Carol, my midwife, told me to call her when contractions lasted at least a minute long and were 3 to 5 minutes apart. I woke up at 3:30 am on Friday, Nov 7th, and couldn't fall back asleep. I finally realized I was having contractions at 4:15, so I got up and tried to distract myself by putting together a lamp for our living room. However, I was still having them at 5:30, and they seemed to be pretty regular, so I woke up Justin and we started timing contractions. At this point they were about a minute long and 3 to 4 minutes apart, but I was able to talk through them, so I took a shower and we timed again at 6:30. They were still a minute long, but now closer to 2 minutes apart, but I was still able to talk through the contractions, so we didn't know what to do. You're not supposed to be able to talk through active labor contractions. I called Marsha, who was also unsure, but told me to call Carol. Carol instructed us to go to the hospital, so we started packing the car and left for the hospital just before 8 am. Justin sweetly made me a PB&J sandwich, which I promptly threw up about 10 blocks from the house, right on "A" Street during morning traffic. Poor commuters. This was actually a good sign that this was it. We got to the hospital and checked in, and Jill, the student midwife who's training with Carol, came in and examined me. I was 5 cm dilated and having regular, long, strong contractions that were now difficult to talk through. Marsha arrived soon, then Carol and Becky. Marsha started helping me relax during contractions and keeping my mind clear between them. One of the things doulas do to speed labor is encourage the laboring woman to change positions frequently, every 20 minutes. First, she had me walk through the halls. That made me puke again, which is a pretty good indicator that labor was progressing quickly! My active labor was from about 8 am until 1:30 when I started pushing, just 5.5 hours, which is pretty fast for a first-time mom!  Doulas also help mom move in ways that encourage the baby to position itself correctly for delivery. Baby K started out facing my left hip, and should have been facing my back, so we tried all sorts of different positions to get him to turn. Unfortunately, my son inherited my stubbornness and independence, and turned to face my front instead. This position leads to "back labor," or excruciating back pain during contractions that typically doesn't abate between them. It's just lovely... Luckily, being able to move around helped with the back pain. I didn't want to change positions, but getting into the new one always felt better. I also used the big Jacuzzi tub in the delivery room for pain relief - once you're about 7cm dilated, immersion in a big bath of hot water has been shown to be as effective for pain relief as an epidural and it can speed up labor because it helps mom relax. I still had terrible pain in my sacrum (very low back) during contractions, but I actually felt pretty good between them. Counterpressure on my back helped a ton, but poor Justin's back started hurting from hunching over me. Luckily, he had lots of people to jump in when his back got really tired. He also was able to eat lunch while I was in the tub - the doulas and midwives took good care of him. After an hour and a half or so in the tub, I was 9cm and completely effaced. I got out and during the next contraction my water broke. This is when I really entered transition, the shortest but most intense phase of labor, right before you start pushing. For most of my labor, I was pretty quiet, but during transition, moaning seemed to be the thing to do. Apparently something like 90% of no-med women scream during their labor - I guess I'm 1 in 10! For me, transition really felt like (sorry!) I needed to have a bm, but didn't have anything in my colon. Like that nauseated feeling several minutes before you throw up. You want to puke, but you just can't yet. I wanted to push, but I couldn't.   Pushing was the most difficult part for me because of the way Baby K was positioned. When baby is facing mom's front, the angle of their head and neck means that the part of their head that has to fit through the pelvis is larger than if they were facing mom's back. I pushed for 2 hours. He actually crowned after about an hour or so, but we just weren't getting anywhere after that. Jill decided to do a small episiotomy to try to speed up delivery, since his heart rate had started dropping during contractions now, and that did the trick. I watched my son being born in the mirror, Justin got to announce to the room that we had a baby boy, and he cut the cord.  Jill and Carol are positive that if I hadn't had Marsha and Becky encouraging me to change positions and move around, or if I had been unwilling or unable to do so, I would have needed a cesarean because of Baby K's position. He just wouldn't have descended at all. I also think that my pelvis was able to shift and move to get him out partly because I was seeing a chiropractor throughout my pregnancy and my joints were nice and loose. I'm also lucky that I had a midwife who let me push for so long. I'm really lucky that Baby K and I both physically handled labor well and I was able to have a med-free birth like I hoped for. I also couldn't have done it without Justin. He was with me through every single contraction, and he helped me focus my energy while pushing. I am a lucky, lucky, lucky woman.  Joyce Dykema, CD(DONA), HCHD, became a certified birth doula in May 2012. She is also a trained Hypnobabies® Hypno-Doula. 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.
 The first time as a doula I witnessed the consequences of sexual abuse on a woman's birth experience, two things struck me: 1-I was amazed at what we can carry around every day, having pretty good control over, stuffing down and away, that can come bubbling up during something as intense and consuming as labor. And 2- Who did this to her? I felt helpless in the moment, and I just prayed to help and not hurt her; I promised myself I would learn more. I am so grateful to Julia for sharing this with us. And please, add your ideas and resources if you are aware of any not listed here. I am a survivor myself, living through an extremely violent rape that happened by knife point. I subsequently became pregnant and had the awful choice of deciding what to do, and living through an abortion procedure alone. I continue to work extremely hard to continue to process new memories that have surfaced, and live with PTSD. After my assault, my rapist moved out of state, and re-offended, his next victim being a 12 year old girl. He was prosecuted, and he served 7 years. He currently lives less than ten miles from me, and those I love, and I've seen him four times around town. Since I didn't prosecute, I can't get a restraining order, and the statute of limitations has long since run out for me. Since the rape, I've been a strong supporter of organizations whose main goals are to support survivors of sexual assault, and serving survivors as a doula... as childbirth brings up a lot of triggers for women. Several friends have asked "how can we help" in the light of the recent sexual abuse scandals (most notably by the eldest Duggar son against his sisters, which then went unprosecuted, and of which he never received any punishment, nor rehab for.) So. Here's what you can do as an ally. (Note: In this post, I refer to survivors as female. I do this only because I identify as female, and am speaking from my personal perspective. I only use the female pronoun for ease in this context. Male survivors especially have many more hurdles than female survivors and have a very hard time reporting abuse. Furthermore, I refer in this story to rape as the general term for the crime committed. Again, as that is my own story and for ease of not listing every possible sexual abuse category. All violations are egregious and deserve attention in the media and by law enforcement.) Support local/national politicians looking to make a change. One such person is Wendy Davis. She has been a passionate advocate for eliminating the statute of limitations on sex crimes. Support her. Comment on her FB wall, write a letter, tweet support, sign ANY petitions on this topic that she brings to the masses. Learn about some of the injustices out there facing rape survivors. Mariska Hargitay is a part of an organization called Joyful Heart Foundation. One grave injustice are to the survivors who subject themselves willingly to a rape kit, and their kits NEVER GET PROCESSED. From first-hand experience, a rape kit is an extremely violating experience, especially after living through a violent sexual assault. It involved pictures, statements, they take your clothes and do intense exams. Women who go through this should never have to wait for their kit to get off the shelf. It says "there is money to fund other crimes (most notably not sex crimes) but you aren't important enough to follow up on." I have NO idea whether my kit got processed (I didn't prosecute, nor do they have my name, so there is no way to follow up on this) but I imagine it is still sitting there. In my hometown of Portland ALONE, there are nearly 2,000 unprocessed kits. You can donate to End the Backlog. Only 39% of kits are ever submitted for crime lab processing. THIRTY NINE PERCENT. This is outrageous and unacceptable. Find organizations that support survivors and support them. RAINN (Rape, Abuse & Incest National Network) is an amazing organization who deserves every dollar they are given. Looking to give local? Find a local organization and give of your time or money. Know a survivor? Ask them "Would you like me to ask about your experience?" I can't tell you how healing it has been to have people ask me questions, bear witness to my story, and not look at me with a huge pity face while doing so. Just today I was able to share with a friend about some of the details, who has taken on a very challenging role to assist me in healing and honestly, just being asked is so affirming. My (their) story matters. Sharing and being acknowledged that I went through this is healing. Don't know what to say? "I'm sorry that happened to you." Or, "That sounds like that was a really hard thing to live through." Or, "I believe you." ALWAYS appropriate. (Not appropriate: anything that starts with "at least" or "what were you wearing?" or "Why were you in that part of the building?" I mention this from direct quotes.) Remember, I (we) can always say "I don't really want to talk about it," but know, nobody EVER asks. Imagine having a transformative event in your life that nobody ever wants to talk about. Know what's worse than talking about my rape? Not talking about it. Understand #rapeculture. Society blames women for rape. What were you wearing, why were you at a party, why walk down an alley, why were you drunk? This stuff is real. We need to take society from a "No means No" to a "Yes means yes" POV. Educate your children about sex. About CONSENT. Yes, teach your girls how to keep themselves safe, but teach your BOYS to respect boundaries and talk openly about consent, and situations where lines are blurred. Seek out resources for yourself! Need more ideas on how to support a loved one? Check this site out! Band Back Together.
Seek out trainings or resources that help you better work with survivors. A good resource book is When Survivors Give Birth by Penny Simkin. This book is a hard read as a survivor, and also focuses strongly on childhood abuse, not teen/adult assault. There is a lot of triggering material, as you’d imagine, in this book. A training that I love is A Safe Passage. They help teach birth workers, and give them tools to allow for the feeling of safety for survivors during pregnancy/birth.  Julia Schetky, SBD, CD(DONA), has been a practicing Birth Doula since 2013, and a Bereavement Doula since April 2014. Her passion is supporting families prenatally. Her main goal is to make sure that each birthing mother feels she is well prepared for birth. Julia helps families know what to expect, and how to adapt to any new directions a birth may take them. Prenatally, Julia helps clients to discover what their ideal birth would look like, and also to explore a Plan B & Plan C. This way, families feel prepared, no matter how the birth unfolds. Julia specializes in high-risk births and families expecting twins or triplets. She is confident and knowledgeable when it comes to navigating the medical system and helping families feel informed and empowered to participate and lead their own birth story. In addition to her extensive multiples experiences, Julia has a heart for serving mothers who have dealt with infertility and loss. Her Stillbirthday Bereavement training has given her additional tools to assist families dealing with pregnancy after loss, or through a difficult diagnosis. Julia is the owner of Northwest Birth Services, and a Full Spectrum Doula at Do It All Doulas, and serves the Portland area and beyond.
 As doulas, we learn much about birth -- and what do we learn about life? Jessica Goggin tackles this question today. Her post resonates with me in many ways. I imagine our lists would be as varied as our experiences. Jessica shares what has impacted her on her journey thus far. I have learned so much from my time as a doula: how to conduct effective prenatal and postpartum visits, what to wear to a birth (and not to wear), what supplies I need and don’t need. I’ve found more effective ways to squeeze hips, encourage women on the brink of giving up, engage others, and hold space. I’ve also learned a lot about being “good enough.” In the last few months, I attended a string of births which caused me to sometimes question my value as a doula. I spent a lot of time talking it over with my husband and fellow doulas. Here are three lessons I walked away with when it comes to navigating the complex emotional landscape that come with doula work. We Can Be Our Own Worst Critics It’s easy to see every little misstep or flaw and beat ourselves up for not being perfect -- or to look around and believe that everyone else is better or more qualified. The list is endless. Just as we help our clients see their own strength and value, we must remember to see our own, even in uncomfortable or unexpected situations. For example, one client in particular had hoped and planned for a low intervention, unmedicated birth. She chose to deviate from her plan and in the end described her birth by saying: “that was terrible. I am never doing that again.” She had negative feelings about her birth immediately after, but was glad to have my support. I walked away from that client relationship feeling like I hadn’t served her well and somehow I should have done something differently for her. Months later, she reached out to me to say that she refers any and all pregnant women to me and said how wonderful it was to have me and she couldn’t have done it without me (she totally could have, but I’ll take the compliment). I didn’t expect that at all. When I’ve done my best, I know I’ve done great work. Each woman and family I serve can teach me something new. I’ve learned that from my perspective, I am more able to see flaws and missteps in my work and I tend to be highly critical of myself. I now make those observations and see them as opportunities to grow and become a better doula. How a Situation Looks or Feels Later is Different than How It Looks or Feels Now Before I began doula work I was doing endurance training and events like half marathons and triathlons. In the moment, during a practice or a race, it’s pretty awful, honestly. I remember swimming in some pretty icky waterways, pedaling some pretty hard hill climbs or running over rough terrain and thinking “WHY am I doing this again? I hate open water swimming/biking (period!)/trail running!” And then came the body aches and soreness from pushing my body to its limit (hmm, I’m seeing some parallels with birth). During my workout or race, I was working hard and the payoff seemed an eternity away and quite possibly not worth the effort. I saw this parallel when working for another client, who had her baby attended by a pair of midwives, one being her own mother. Additionally, her husband and three of her sisters walked with her on her journey. Her labor suite was filled with kindness and care. She was treated with much tenderness and reverence, surrounded by the people who knew her best and loved her most. More than once I was moved to tears by the outpouring of love I saw. In the moment, this made me feel superfluous and unnecessary, and I thought she and the rest of her team felt the same way. I left feeling like a fake. But in the end, my client reached out to me and praised my work during her birth. But after a short while, with some time and perspective, the narrative changed. Allowing for that processing time and some space to be able to step back and see the whole picture lets us see the reality of the situation. Looking back, I believe I was an important part of her birth team (and so does she). I learned to give myself some time to process and take a step back from a birth that doesn’t “feel” amazing to me right away because it will change for me with time and distance. We Must Write Our Own Story It is so important that women write their own birth story and our telling can be less relevant for them. Sometimes, after particularly traumatic events, we can help shape that story for her and help her to discover a more positive aspect and find her own way to peace and healing. Generally though, women need space to discover, craft and retell their own birth stories. Our narrative has no place in her story. At one of my first few births, I perceived it as pretty terrible. I’m embarrassed to say it, but it’s the truth. Obviously the births I attend as a doula are not mine, yet I as a new doula, had my own (misguided) ideas about what made a good birth. However, this client’s unfolded almost exactly how she had imagined it. Before I left her hospital room, she thanked me for being with her and described her birth as “awesome.” I realized that in many cases, this is the first time this woman will experience birth. She defines her own best birth and has her own expectations on how it will unfold. Listening to her story as she tells it is a truer account of the reality of her story. I encourage my clients to write their own stories. I may help fill in some details or put the timeline in order if they ask, but often, I listen to their re-tellings with an open mind and without judgement. Finally, I’ve learned that it’s important to remain confident and self-assured, yet humble in the birth space. My clients look to me to find calmness and reassurance. If my own courage waivers, how can I help my client find her own inner strength and determination? We have to trust in our skills and experience. I don’t know everything about birth, not by a long shot, but I know I’m a good doula. And that’s something I try to remember when the going gets tough.  Jessica Goggin is a doula in San Antonio, Bexar County and surrounding areas, providing quality support to expectant and new mothers. She offers emotional, physical and informational support during pregnancy, childbirth and the postpartum period. She is passionate about helping new moms plan, prepare for and achieve one of life’s most challenging, yet rewarding experiences: childbirth! Jessica believes that during the period when a woman is pregnant, she is at her strongest, bravest and most intuitive, and that mothers on the verge of delivery achieve their best results when surrounded and supported by those with knowledge, wisdom and compassion. Learn more about Jessica by visiting her website and Facebook page.
 This week I received notification that I, once again, passed the Lamaze International certifying exam (making me the only listed LCCE in Bakersfield, one of two in Visalia). In light of that, I was curious to know why as doulas and educators, we choose to extend the extra effort and resources to gain and keep these initials after our names? Sharon Muza offers her thoughts to this topic. Additional quotes follow from not only doulas, but also mothers. And my answer? Grievance policy, as strange as that sounds -- I appreciate DONA offering this, as it protects my clients, and it protects me. I am both a certified doula with DONA International, CD(DONA), and a certified childbirth educator with Lamaze International, LCCE. I am very proud of the fact that I hold and maintain these certifications. I worked hard for them and it means a lot for me to have these credentials. Here are my top six reasons for certifying AND maintaining certification with well-known, long-standing, internationally recognized organizations: 1. Demonstrates my serious commitment to being recognized as a professional doula and childbirth educator. 2. Assures my clients, students, my colleagues and the health care providers that I work with that I have successfully completed the requirements for certifications as set forth by my certifying organizations. 3. My clients, students, my colleagues and HCPs are assured that I abide by and practice according to the standards of practice and code of ethics that have been established by well-known and well-respected certifying organizations. 4. It allows me to support the organizations that I believe in, with my membership and certification dollars, allowing them to work toward improving maternal infant health outcomes as a serious player on the national and international level with my support. 5. Maintaining recertification shows my commitment to receiving continuing education that is current and applicable, and demonstrates my desire to remain up to date with best practices. 6. Provides a grievance process for clients, students, colleagues and HCPs who might have concerns about my practice standards, actions or ethical behavior. I am very proud that I am a certified birth doula with DONA International and a Lamaze Certified Childbirth Educator. I look forward to continuing to maintain these certification in the years to come. I encourage you to seek out reputable and well-respected organizations to align yourself with and pursue certification in a professional manner.
 Sharon Muza, BS, CD(DONA) BDT(DONA), LCCE, FACCE has been an active childbirth professional since 2004, teaching Lamaze classes and providing doula services to hundreds of couples through her private practice in Seattle, Washington. She is an instructor at the Simkin Center, Bastyr University where she is a birth doula trainer. Sharon is also a trainer with Passion for Birth, a Lamaze-Accredited Childbirth Educator Program. Sharon is a former co-leader of the International Cesarean Awareness Network’s (ICAN) Seattle Chapter, and a former board member of PALS Doulas and Past President of REACHE. In September 2011, Sharon was admitted as a Fellow to the Academy of Certified Childbirth Educators. Sharon Muza has been the community manager, writer and editor for Science & Sensibility, Lamaze International’s blog for birth professionals, since 2012. Sharon enjoys active online engagement and facilitating discussion around best practice, current research and its practical application to community standards and actions by health care providers, and how that affects families in the childbearing year. Sharon has been a dynamic speaker at international conferences on topics of interest to birth professionals and enjoys collaborating with others to share ideas and information that benefit birth professionals and families. To learn more about Sharon, you are invited to visit her website, SharonMuza.com.
 In commemoration of the 34th anniversary of the WHO Code, today's guest post is about donor human milk. Marivette is a local-to-me (Bakersfield) doula with a passion for educating the public about informal milk sharing. In fact, this last summer, she presented information regarding Human Milk 4 Human Babies at The San Diego County Breastfeeding Coalition during a mini seminar for physicians and other health care providers. One of the jobs of a doula is to provide resources to pregnant women and their families. We may provide a list on a piece of paper, or provide verbal information regarding different resources in the community. It could be anything from where to find a childbirth educator, a lactation consultant, an IBCLC, or even where to locate other new moms. Often an area that is forgotten or which is not known is information regarding milk sharing. What is milk sharing and how can doulas offer this as a resource to new mothers? On page 10, paragraph 18, in the “Global Strategy for Infant and Young Child Feeding” by The World Health Organization (WHO) and Unicef (2003), it states the hierarchy for infant feeding. If a child cannot be fed directly from the mother’s breast, first the child should be fed the mother’s expressed milk, secondly the child can be fed donor milk through a wet nurse or milk bank, and then finally a breast milk substitute can be fed (WHO & UNICEF, 2003). There is caution to be taken when feeding a breast milk substitute, though. WHO and UNICEF (2003) state, “Infants who are not breastfed, for whatever reason, should receive special attention from the health and social welfare system since they constitute a risk group.” In this hierarchy of infant feeding options, donor milk is often neglected, but should be considered before a breast milk substitute is given. Milk sharing is a centuries old tradition. Centuries past there was a process called wet nursing which utilized the services of a mother, with or without her baby, to feed another woman’s baby (Thorley, 2008). Sometimes this was done forcibly by slave owners, and other times there was compensation given to the lower class women who provided this service to those in the upper class (Thorley, 2008). In modern times, wet nursing is sometimes confused with cross-nursing which is the feeding of another woman’s baby out of a sincere desire to help without compensation. With time, these traditions began to fade away, and soon it was close to non-existent (Thorley, 2008). Oh, that’s not to say it wasn’t happening! It just wasn’t widely practiced anymore, because it was much harder to find someone who could cross nurse a baby. However, in the last four and half years, there has been an increased awareness of the benefits of peer-to-peer milk sharing also known as: informal milk sharing.  Currently, informal milk sharing is the process of donating excess, expressed breast milk to another baby in need of breastmilk without going through a milk bank. A mom who is producing enough milk for her baby, may choose to pump additional milk over and above what her baby needs in order to donate this excess milk to another baby. Many woman have chosen to save their milk to donate it to a baby whose mother is not able to produce enough for their own baby. A breastfeeding mom will generously donate her milk in an altruistic fashion. There is no monetary compensation during this milk DONATION. The compensation is knowing that her milk is feeding another baby in need. There are many reasons why a baby would need donor milk. The baby’s mother may have health issues like cancer, insufficient glandular tissue, may be on medication that is not compatible with breastfeeding, or a host of other health issues too long to name, here. The baby may have been adopted, and the new parents want to provide their baby with the biological normal sustenance, breast milk. The mother’s milk may have taken a dip, and she is no longer producing enough to fulfill the baby’s nutritional needs. The mother may be returning to work or school, and does not have enough of a supply stored away. The baby’s mother may have passed away, and the family seeks out donor milk to continue feeding the baby breast milk. This blog post could be pages long with the myriad of reasons why families seek out donor milk. The simple and hard fact is that there are babies who need donor milk to meet their dietary needs in a manner that is consistent and compositionally the same as their own mother’s milk. The growth and accessibility of social media has facilitated the exponential increase in the availability of donor milk. In Oct. 2010, in a grassroots efforts which opened up the doors to thousands of babies in need donor milk, Facebook was utilized as a platform to create Human Milk 4 Human Babies (HM4HB). This was the beginning of reaching scores of moms who had an excess amount of breast milk. Donor families used HM4HB to find recipient families who had a need of donor milk and vice versa. Years ago, it would have been difficult, if not impossible, to find someone locally who was breastfeeding and could provide a baby with donor milk. However, using social media, there is now a much faster method of reaching out to people in the community when there is a need. Informal milk sharing, although it had been happening on a much smaller scale, exploded. Volunteers generously committed hours to the creation of HM4HB public Facebook pages. These pages were set up all over the world to facilitate a place where families could search for other families willing to donate their breast milk.  The process of informal milk sharing is completely dictated and handled by the families who are donating or receiving breast milk. While there are risks involved both in breast milk substitutes and informal milk sharing (Gribble & Hausman, 2012), families must weigh these risks, ask any questions, including health questions or concerns, and make an informed choice. Informal milk sharing on HM4HB is the sole responsibility of each of the individual families. Administrators of the pages do not get involved in any manner other than to post requests/offers, or delete off topic information. Because of this, HM4HB does not have statistics showing how many people on their sites are sharing their milk and receiving donor milk. HM4HB operates much like a bulletin board. People post offers/needs, admins keep the place tidy. What about milk banks, you might ask? A non-profit milk bank, like the Human Milk Banking Association of North America (HMBANA) receives donor milk from families who have excess breast milk. This milk is reserved for the most vulnerable from our communities, preemies and ill babies. So, a healthy six-month old whose mother has had a decrease in milk production, would not be eligible for milk from a milk bank. While we NEED milk banks to provide milk to an extremely needy population, they cannot provide milk to all the babies. Additionally, there are restrictions for who can donate breastmilk. For example, a mother on herbal remedies would not be eligible to donate. Milk bank donor milk is being served to extremely delicate babies who have fragile immune systems and their donor milk must meet the strictest of standards. Hence, informal milk sharing is a valuable resource for families who don’t meet milk bank requirements for donor or recipient. As doulas, we can offer much in the way of support to families. An additional way to offer that support is to provide information to clients regarding informal milk sharing. We can share HM4HB with families. We can let them know that informal milk sharing is an option available to them. Now, with this blog post, you will be able to direct them, here, so your clients can read for themselves what informal milk sharing entails. Or you can send them directly to HM4HB. Had you heard of informal milk sharing before this reading this post? Have you been a donor or recipient? What are your experiences? Will you share this information with your clients?  Marivette Torres is the founder and owner of Tender Doula Hands, and is a rebozo instructor, childbirth educator, breastfeeding advisor, and an administrator of HM4HB California. She was part of the grassroots efforts in organizing HM4HB from the ground up. She has eight children ranging in age from 25 to 7 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, and five which were born at home. She breastfed all her children with her last child self-weaning at six years old. As a CBI certified, professional birth doula with 17 years’ experience, she provides birth doula services in the Bakersfield, California area. You may visit her website and Facebook page. References:Gribble, K. D., & Hausman, B. L. (2012). Milk sharing and formula feeding: Infant feeding risks in comparative persective. The Australasian Medical Journal, 5(5), 275-283. doi:10.4066/AMJ.2012.1222
Thorley, V. (2008). Sharing breastmilk: Wet nursing, cross-feeding and milk donations. Breastfeeding Review: Journal of the Australian Breastfeeding Association, 16(1), 25-29. WHO & UNICEF. (2003). Global Strategy for Infant and Young Child Feeding. |
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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
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