​One of the most crucial things we do as doulas is help parents make decisions. It's not as glamorous or often discussed as giving massages, squeezing aching hips, or whispering words of comfort and encouragement (not that any of those things are particularly glamorous). But it's one of the most important things we do.

Decision-making happens frequently during pregnancy. Choosing a care provider, a place to birth, which breast pump to buy through your insurance, what kind of birth preparation class to take, what sorts of things to register for, and so on...the decisions to be made sometimes feel endless.

But during labor, things are different. No longer is there a stretch of weeks or even months before baby is on the way - things are happening right now. Add to the urgency of time the fact that most laboring families are not necessarily calm, cool, and collected the way they might like to be when making decisions. Parents often don't even understand the implications of the options their care team is presenting.

That's where we come in.

In our prenatal visits and birth classes, we often use a tool well-known in the birth world. In fact, it's a tool now used by many who encourage healthcare literacy as a helpful way to approach decision-making with care providers. This tool comes in handy no matter where you're birthing, but we find it's often especially helpful for clients who are having their babies in a hospital setting.

The tool is an acronym: BRAIN. When a question comes up in labor, or a procedure or medication is suggested as the next step, our first suggestion is always to stop and take a breath. Sometimes these situations can be nerve-wracking in labor. So give yourself a moment rather than responding quickly and impulsively.

Once you've gotten a nice breath or two under your belt, take some time to go through the acronym letter by letter and ask some questions. 

B: Benefits The first question to ask is what the benefits of the suggested procedure, medication, or change to the situation would be. Remember to consider benefits both for you and for your baby. We've found that usually care providers answer this question even before you have to ask it, because their suggestion is made with the intention of giving you and/or your baby a certain benefit. But if you have any additional questions about the benefits, ask them!

R: Risks Next to ask is, what are the possible risks to you? To your baby? Usually in a medical setting the answer to this question reads more like the side effects listed on a drug label. While this is good information to know, there are other indirect considerations to think about which sometimes fall outside the realm of the care provider's role in that moment.

For example, sometimes our clients ask their nurse or anesthesiologist about the risks of an epidural. Usually we hear care providers mention things like the possibility of a drop in blood pressure, headaches, nausea, itching, etc. 

However, I've never heard a care provider mention the increased risk of a longer pushing phase, the increased use of medication to augment a labor slowed by epidural (pitocin), or the increased difficulty of breastfeeding after births involving an epidural (probably due to the IV fluids that accompany the administration of an epidural). These are things we discuss with our clients if they're considering an epidural, along with the benefits including "therapeutic rest" if labor has been long and hard. 

If you ask about the risks of your care provider's suggestion and receive information from the drug label, also ask if there are any other indirect risks they know of. (And check in with your doula too, to see if they have any other information that might help you as you make your decision.)

A: Alternatives Ask your care provider if there are any other alternatives that can be tried first before proceeding to the suggested procedure or medication. There may be something less invasive or more temporary that might help address the issue at hand. 

​Often care providers and medical staff are much more comfortable with medications and medical technology in birth than parents are - primarily because they're around those things all the time. They see highly medicalized care help families every day. But most expecting parents aren't in that boat. Our clients are often surprised that their care providers suggested something more invasive when there was a less invasive alternative. Understanding where your care provider is coming from can be really helpful in this case. And of course, if your care provider suggests an alternative or two, make sure to use your BRAIN when exploring those options as well.

I: Intuition What does your gut say about this? How are you feeling about the situation at hand and the proposed next steps? Studies have actually shown that the intuitive, ancient part of our brains (the part that gives us those gut feelings) often works faster than the more analytical part of our brains. Here is a fascinating article on the subject.

It's important not to discount the sensations in your body we refer to as a gut feeling because what it can mean is that some part of you already knows the answer. It may just take a while for the rest of your mind to catch up and figure out the "why." Pregnancy, birth, and parenting involve a LOT of intuition. Don't leave your intuition at the door when you enter the birth room.

N: Nothing Also known as, "What if we wait an hour?" This question can help you determine whether your care provider feels the situation is an emergency or not. If the answer to "Can we wait an hour?" is "Sure, I'll come check in later," you know you have time to think things over. But if the answer is, "Waiting isn't an option - we need to make a decision now," obviously that gives you a different picture.

​If the care provider's response to waiting an hour is positive, sometimes parents are surprised they were being asked to make a decision earlier than necessary. It's important to keep in mind that care providers are often on a schedule and juggling multiple patients at once. Sometimes the timing of things has more to do with their patient load than with your particular situation, which is another reason why it's important for parents to be asking these questions. This question is especially powerful for parents who want to minimize medications and medical technology in their births. 

You should be able to take your time in making your decision unless there is a medical emergency at hand.

After you've had a chance to ask your questions, request a few minutes alone without your care providers in the room to consider your options. (If you have a doula, it could be beneficial to have them in the room with you as you talk things over. But if for any reason you'd be more comfortable having the conversation alone, by all means let your doula know.)

Once you're ready, let your care providers know you've considered your options and made a decision. If you are choosing to accept your care provider's recom-mendation, often the conversation will be fairly straightforward. But if you're choosing instead to try an alternative or wait a while before trying anything else, sometimes care providers can feel that their expertise is being undermined or that someone is convincing you not to accept their recommendation. This is a very human reaction!

To help diffuse any tension if this happens, speak from your HEART when communicating your decision to your support team.

H: Hear "I hear what you're saying and I understand why you recommended this..."

E: Empathize "...and I know you want the best for me and my baby..."

A: Affirm/Assert "...but I intend to wait a while longer before considering x, y, or z." OR "...I would rather try this alternative instead."

R: Reassure "I will let you know if anything changes."

T: Thanks "Thank you so much for your time and for taking good care of us."

These kinds of conversations can be difficult, especially if any medical concerns are present. These tools will give you an anchoring point when making decisions in labor and beyond.

​Remember to use your BRAIN and HEART!

​Megan has been serving growing families since 2014. She is an Advanced Birthing From Within Mentor and doula based in Orange County, CA. She is passionate about providing holistic guidance for her clients, helping them cultivate resilience and openness on their journeys to parenthood. In addition to offering birth doula support, she also teaches birth and parenting preparation classes. Megan practices in partnership with her wife, Marlee, who is also a birth and postpartum doula, childbirth educator, and lactation counselor. Together they serve families of all shapes and sizes with respect and compassion. Find out more about her by visiting Hero Birth Services, or her Facebook page. 

I've been a doula for over 10 years. I've seen a lot of doulas come and go in this profession for many reasons, but the one reason for leaving doula work that always hits at my heart, is when other doulas say "There's too much competition". I wish to flip that perception.
 
​Take a step back, and think of where you heard the term doula. Was it from a friend? You're own birth? In the news? Chances are, it wasn't a common discussion, no matter where you heard it.

Statistically, in the US (because nothing is coming up for Canadian doula stats) only 6% of birthing families chose to have a doula. If we are talking about over saturation in the job market, that number would be a lot higher! It also goes on to mention that another 27% would have liked to hire a doula.
 ​
I like to look at that as a challenge. Obviously, we know that the word doula is still relatively unheard of in most mainstream circles. For as long as I've been a doula, I still run into people that say - I don't know what that is.
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How do we change this? How do we get the word doula to roll off the lips of every beautiful birthing person? This is the challenge; to make it part of everyday conversations.  The way for it to make it into more conversations, is if it becomes the norm, and a way to make it the norm, is if there are more doulas! Abundance.

I often share fellow local doulas info, blogs, etc on my business page. I have people ask me all the time why I do this. Why should I share and promote the "competition". To that I say, until every family on this vast planet knows what a doula is and does, I will keep sharing. I share because I'm not the right doula for everyone. I share because my doula sister has some great info, I share because even if I don't get the client, I know they are getting who they need and now one more family has doula support. One more family can now share the word doula with honour and love. Abundance.

I'd like to change the word competition (rivalry for supremacy) to abundance (overflowing fullness). If we believe that we do this work out of love, then we need abundance. The world we raise our children in, that we bring future parents into, needs more love. By believing in abundance of love and support we all win. 

When we flip the idea that other doulas are competition, we lose the fear, we start to see how strong we are. We start to see the tribe of support that stands around us, holding the space for big things to come. That there is strength in numbers, and with those numbers, we have the power to create a birth world revolution. ​

​Natasha is the mother to 4 spirited children who, along with their dogs, cats, and reptiles reside in Spruce Grove Aberta, Canada. 

Natasha has been a practicing doula for over 10 years, and has worked in all Edmonton area hospitals, along with the local Lucina Birth Center and home births. 

She takes her role as doula very seriously, and in doing so she is forever upgrading her skills.  Natasha has taken training through DONA, Stillbirthday University, and GK University. She is currently enrolled in The Cultured Doula Program, and has recently completed her Masters Rebozo with GKU. As a placenta specialist she trained with PBiU.

Natasha can be found at Supermomma Doula & Placenta Edmonton, and her Facebook page.

I sat next to one of my closest friends from college in the hospital room. Her husband and I were desperate to help. The nurse came in to the room: “you seem to be in pain, you should really get some pain medication,” she said for the fifth time with one glance at my friend. It was only a few more hours until my friend agreed and the nurse sent us out of the room while an epidural was administered. Her husband and I went to get some food from the cafeteria. He returned to the room with her mother for the birth of his firstborn. I spent the first few nights postpartum at my friend’s home doing all I knew to help her and her newborn. I was obsessed. In love. Infatuated. Though my friend would go on to be buried in postpartum depression, she saw my passion and suggested I become a doula.

I took as many classes as I could possibly find and attempted to create my own company. My first potential client was excited to hire me. I was petrified. How could they put me in charge of their birth? I had never attended a birth before. Was I crazy to want to be a doula? What if I just wanted to be a mom?

With that thought, my career as a doula ended. The answer was a resounding: yes. I did want to be a mom. With that I turned my back on the birth world and continued my pursuit for a career path, eventually getting two masters and starting my journey towards a PhD. In 2015, I had to drive two hours round-trip to get to work every day. My boyfriend had recently introduced me to podcasts and, in an attempt to find a new podcast to listen to, I decided to punch “birth” into the search bar. The Birth Hour, Birthful Podcast, Longest Shortest Time, and Mom and Dad are Fighting. (Today I have some new favorites: Fourth Trimester Podcast, Informed Pregnancy Podcast, Sprogcast, and All Things Breastfeeding Podcast.) I would come home from a full day spent collecting field notes only to spout birth facts -- until my boyfriend begged me to stop talking about birth.

A year and a half later, in November of 2016, my boyfriend found a job in California, we moved across country, and I decided to be a volunteer doula instead of immediately starting my own company. Volunteering as a doula is a unique opportunity. There are not many hospitals nation-wide that have volunteer programs. What I did not realize back in North Carolina in 2009 was that the University of North Carolina had its own volunteer doula program. Had I decided to volunteer the first time around my life would have taken a very different path.

San Francisco also has volunteer programs at San Francisco General Hospital (SFGH) and St Luke’s. SFGH’s volunteer doula program is well established. It took me five months to get into the program after applying and another month to get my badge so I could work there. 

SFGH is primarily shift-based doula work. We were required to do one twelve hour shift once a month at the hospital’s labor and delivery ward. I did not enjoy it. There were times when I would sit for hours in the staff break room with nothing to do, staring at a screen trying to decipher the abbreviations that at the time meant nothing. When I was asked by the nurses to help a patient out I would find myself in a situation like this: a woman had barely acknowledged her desire for the epidural that was administered. It was explained by several hospital staff how it worked. Once we were alone she turned to me, “what is this?” she asked, pointing to the epidural button.

If I had been there earlier, I could have helped her understand all of her options, cope with her pain, have the birth she wanted, or at least explained to her the confusing birth hospital system she had been thrown into: all things I was able to do while on call with families at St Luke’s. Instead, the women we serve in shift-based work at SFGH only get support from a doula midway through their births, and at that point I was little better than the drugs the hospital had set her up on: another unexpected, confusing intervention to a natural process that modern medicine has somehow turned into an esoteric exercise for medical technicians.
​ 
I no longer do shift-based volunteer work and no longer volunteer at St Luke’s. Instead I work at San Francisco General Hospital for their small on-call program where I help with high-risk births: substance abuse survivors, rape victims, women whose babies will need surgery immediately postpartum, etc. I also started Sweetbay Doula as a doula who works to nurture the relationship between birthing individual and their partner that I believe is so important. And I love my job.

​Since May 2017, Darby Morris has been serving private clients, and volunteers at both San Francisco General Hospital (SFGH) and St. Luke’s Hospital as a birth and postpartum doula.

Darby believes in providing doula experiences based upon continuing education and spreading that knowledge to families. Her business, Sweetbay Doula, is named after the Sweetbay Magnolia tree. Magnolias are known for their strength, flexibility and beauty.  They can be found in both warm and cold climates, and are either deciduous or evergreen, depending on the environment.  Their blooms are not affected by frost so they are able to bloom into late spring.

In short, Sweetbay Doula, like its namesake, is highly-resilient, flexible, and open-minded in all of the ways an expectant parent needs. 

​My name is Nicci and I am a Bereavement Doula from Pretoria (Gauteng Province, South Africa), dealing exclusively with miscarriage, stillbirth and infant loss. I have been a "death doula" since 2015 and I am currently one of the most experienced bereavement doulas in the country. 
 
Death humbles you. It leaves many wounded and scared (and scarred!) but also just as many people are awakened to the miracle and the fragility that is life. It opens your eyes to the absolute gift it is to breathe (and have those you love breathe) every single day.  I deal with indescribable pain and heartache. My job is not an easy one, in fact, it’s probably one of the most emotionally challenging professions out there. But it is made bearable by knowing that I could help a mommy or daddy carry the load, even if it’s only for a little while.  There is something unique about child loss. Because you don’t only lose a child you love, you lose the promise of that child’s life. You lose the "could have beens". You miss their first day of school. You miss their 16th and 21st and 30th birthdays. You miss out on every little thing that would have made that child "yours".
 
Like the character in the book The Shack, I carry The Great Sadness with me every single day of my life.  Sometimes The Great Sadness is quite satisfied to sit in the corner of a room or on the roof of my car and just leave me alone – sometimes even for a day or two. Other days, The Great Sadness would just not let go of me. It will cling to me whilst I brush my teeth, when I feed the dogs, when I pray, when I speak to a telesales agent and decline a cellphone contract for the umpteenth time. It will rear its sad head when I walk in a shopping centre and see something or someone that triggers a memory.  Sometimes when I walk passed a baby store The Great Sadness would hug me so tight that I struggle to breathe. But the Great Sadness and I have come to an agreement: Whenever I am with a client, it will not show up for a while. But sometimes The Great Sadness breaks its word and all that I can do is be sad with them.
 
The parents I assist and I usually have a lot of time talk and cry and yes, even laugh. Sometimes it’s much easier to talk about your pain to a stranger – somebody that you don’t feel guilty over because you are "burdening" them with your pain. Someone that won’t judge, just listen – who may shed a tear or two with you but who will not fall apart.
 
As a bereavement doula I am learning more and more about life, death, loss and everything in between every day. I have seen that parents feel guilty because they are experiencing deep grief over the death of their child. Statements made by well-meaning friends may cause them to question the validity of their deep feelings of sorrow – statements like the following: “Just be glad you didn’t get to know her. This way you won’t have to suffer the grief.” Or  “The woman down the street lost all her children in a fire, you are lucky compared to her.”

The fact is that grief cannot be compared – not even between parents. Grief will not lessen just because the grief of another person is perceived to be greater. Also, they may have given birth to another child. But this will be another child, not a substitute for the one who has died. I always say babies aren’t puppies who can fulfill a general need. And to be honest, not even a dog can be replaced, how on earth can people expect parents to "replace" their baby who has passed on with another!
 
Although primarily my focus, I don’t just assist with baby loss but also with other losses.  I have assisted a mother who gave birth via c-section to a healthy, beautiful little baby boy. The reason she needed me though, was because her husband was brutally shot and killed in front of her. This woman was shattered and tears jumped in my eyes when I looked into hers. It was almost unbearable to look at her. But she needed a calm, collected and professional person to assist her during the birth. In hindsight, I was none of the above. I may have appeared calm and collected, and yes, even professional to the untrained eye. But I was falling apart on the inside. The moment the doctor lifted that precious little boy from his mommy’s tummy I had such a huge lump in my throat I couldn’t breathe. The Great Sadness won that day…
 
Because there is such a huge need for bereavement birth workers in South Africa, I have written an Online Bereavement Training Program to enable as many people as possible in South Africa with a heart for bereavement to assist parents going through loss.  Students are equipped with the right information, tools and coping skills to guide families in South Africa going through the unimaginable. 
 
It is my dream that my profession will be formally recognized and acknowledged in South Africa and that bereavement doulas’ services will be covered by all medical aids.  The motto of the bereavement doulas trained by Nicci.doula Bereavement is “to serve with love in loss” – I hope to be able to do this for a very long time to come.

​Ever since the traumatic birth of her firstborn, the subsequent birth of his brothers, 6 infertility treatments, 3 miscarriages and 1 adoption, it has always been Nicci's dream to make a difference in the lives of bereaved parents. She is Birth and Perinatal Bereavement Doula, and a certified SBD Doula®. Passionate about ensuring families of all kinds have the unique support they need, she is the former director at Voice of the Unborn Baby, and Managing Director of Doulas of South Africa. Nicci is an avid writer and has written many short stories on her experiences as bereavement doula. Nicci also wrote a book about her infertility struggles. Besides being a doula, she is also a professional stillbirth photographer. Nicci believes in the power of encouragement, and in building confident and empowered doulas to make a difference in South Africa.  She also believes in dreaming big and working hard. She is passionate about people in general and more specifically about the doula profession.​ If you would like more information on the work Nicci does, please visit www.niccidoula.com or visit her Facebook page. For international bereavement training please visit www.stillbirthday.com.

Nicci lives in a leafy suburb at the foot of the Magalies mountains,  in the Pretoria area  of Gauteng Province, South Africa.

I love Sharon and her creativity, and what an idea machine she is! She is great to brainstorm with -- I lay out all my half-baked imaginings, and Sharon helps plug the holes into a complete activity, or she offers an additional use of something I came up with. When I asked her to share in this year's 31 Days, I had a vague idea I tried to (poorly) convey: "...something about motivating yourself to write when it's the last thing you want to do. How do you come up with creative content, over and over and over?" Well Sharon has figured it out. She took that seed of an idea and grew this amazing, inspiring post, sure to help any new or blocked-blogger out there. 

I have hosted a celebration of doulas on my blog. The original idea was something I thought of, literally, on April 31, 2014. I was struck with the idea of trying to feature 31 days of guest posts written for doulas, by doulas, or about doulas. International Doula Month is every May, so this didn't give me much time to act! I quickly contacted a doula friend who had recently shared a blog post about all the things she learns at births, and that was Day 1 of 31 Days of Doulas, 2014. As the days progressed, I sought out other pieces, either crafted for this project, or previously written, to feature on my blog. This was overwhelming to tackle, but so rewarding! So rewarding, in fact, that this project carried into 31 Days of Doulas 2015, and 31 Days of Doulas 2016.

Sometimes doulas or families approach me with a piece to share. Sometimes I know something of someone, and I ask if they would consider contributing an original essay or article to the project. I have also stumbled upon other blog posts related to doulas, and sought permission to repost them on my blog. My most favorite thing ever about acting as editor in this role is when I know there is a story in someone, and I can encourage them of its value and help bring the words to life, now having meaning for someone else -- people who never thought they could write, people who never thought anyone else would care to hear that story -- proud of what they created and pleased to see how that helps others.

Because I love to blog, I created a Facebook group Blogging About Birth. My intention is for this to be a place where birth workers can share ideas, new bloggers can be mentored and buoyed up, and experienced bloggers can be challenged and revived. I love seeing what members share and what projects they are up to. 

Each year I prepare a little earlier, because the 31 Days project is a hefty one! Generally I spend one hour a day editing, formatting, putting together the layout, creating or procuring graphics, linking, posting, and writing introductory/closing remarks for each post -- and that doesn't factor in the time connecting with the various authors. If I am lucky, I can stay one or two days ahead of schedule, and beg, borrow, or steal from friends and people I know if contributions are coming up short. 

I am always looking for posts that relate to doulas -- if you are interested, please, let me know! And now, I end stealing words I wrote to close out the first 31 Days of Doulas: "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 write."

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." 

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

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.

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.