There was a woman who named herself after the mountains where she had communed with other women and wrote poetry. In the end she went berserk with agitation, climbed out of her hospital bed in an attempt to lie on the earth again. We covered her in blankets as her community of friends took turns sitting vigil. Her strong body and spirit would not give in to disease without a great fight. Back in bed, she lasted for weeks like that, feeding off the fuel she had accumulated over a lifetime until one day, the flame burned all the way to the core and released her free at last.

​There was a woman quiet and withdrawn, who only nodded yes or no. Yet when a dear one entered and approached, she open her arms to bring them in close. Her adult children had lost a father just two years before and her illness had mostly been a secret, a failed attempt at protecting her loved ones from pain. All we can do is be there to support and minimize suffering. The existential journey is their own. At a time when one can no longer deny death, loved ones gather with tears and smiles for all the healing that can finally begin. In the end, friends and family gathered in the chapel to acknowledge and honor her life. Then came a parade of flowers our way, grandiose bouquets perking up the solarium.  

A volunteer angel drops in every now and again, effortlessly singing A cappella, opening the portal within the spirits of the dying, attempting to free them of blocked emotional meridians and move them forward on their individual path, on the labyrinth of existence.  

​An emaciated woman already a skeleton slowly turned to look at me and offer a weak smile, appearing to wonder about my treatment or judgement of a lifelong multi-drug abuser lying on her death bed before she was even old. She is estranged from all family. I offer reassurance that she will be cared for with kindness and respect. She replied "thank you". I suggest that she has experienced a lot of trauma in her life. She replied "scary". Perhaps at birth, or in the mother's womb, she was already addicted. Maybe now, in a time as vulnerable as birth, she can finally just receive love and care without having to do anything to earn it. She seeks to have her pain and anxiety resolved, just like any other human being. And in a couple days, after a week hiatus in the desert, I will return to this work, wondering if she survives still. As a death doula, I will either care for her with kindness and compassion, or if she is gone, I will care for the others who come next to this house.

When I was in college, I worked at a gift and candy shop. It was an easy gig, I got to eat all the homemade chocolates I wanted, and I worked mostly unsupervised and alone. I remember distinctly, an interaction with a customer where I just wasn’t feeling it. I decided I didn’t have any energy to add anything extra to my exchange with her. She brought me her merchandise and attempted to make conversation, and I sat with a sour look on my face, going through the motions of ringing her up. (This is all horrifyingly embarrassing to me now, by the way, but as a teen, I didn’t give it a second thought.) Suddenly the woman said, “It seems like you aren’t in a good mood today.” She said it kindly, without expectation, and it hit me: She noticed I wasn’t being nice!
 
Wherever doulas gather, there is a question often asked: “Can I thank a nurse?” Not meaning, can I say thank you when she brings us a chair or a drink, but, when I notice a nurse going above and beyond for my client, can I send her a thank you note later? Is this appropriate?
 
I have heard doulas answer, absolutely not! She is just doing her job. If she hadn’t been your client’s nurse, she would have been someone else’s. She did it yesterday, she did it today, and she’ll do it tomorrow. She is being paid to work as a nurse. She is just doing her job.

As a doula and a childbirth educator, I take clients in the Bakersfield, Visalia, Hanford, and Tulare areas of Central California. I recently attended a birth where I witnessed a nurse just doing her job. It wasn’t that the nursing care she gave was poor – it was just her flat affect showed she simply had nothing else to give. Just like the teenaged-Stacie in the opening story, this nurse was going through the motions with no smiles, no casual conversation, no empathy for the pain my client was dealing with. She was on autopilot, she could have been a robot, and we all noticed it seemed like she was in a bad mood. In that moment, it felt like she hated her job and resented the fact that someone dare be having a baby on her shift in L&D.
 
As people, don’t we like to hear when someone notices and appreciates the job we are doing? I know I do! Why not, then, send a note to a nurse you felt went above and beyond versus just doing her job? In fact, send it to her boss, and her boss’s boss! Send that praise onward and upward! Let the world know you appreciated this nurse’s attitudes and efforts, her care and concern.
 
Fortunately, I can say this is a rarity. Most of the nurses I encounter are helpful and kind to the families they serve. We all have bad days, and I bet that lady I served so long ago doesn’t even remember me and my attitude way back when. But the day your baby is born – every person who walks in or out of that room can become a permanent fixture in the recollection of that memory. I still have deep, personal feelings for the nurses who cared for me through all my births, and how grateful I am that they are filled with positivity!  ​

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And then I remember…6 years ago I was sitting in the home office of my midwife. I was recounting to her how my husband and I were so surprised when we met her that she didn’t have gray hair, or knit, and that she was young. And she said, with a gentle smile: “But someday I will have gray hair, and I will be old. And I will still be a midwife."

Today…I don’t have gray hair, YET, but I am beginning to feel the change of no longer being seen as a birthing mama’s peer -- maybe being seen more as an experienced woman or mother and doula instead. And as much as I enjoyed the sisterhood of age, I think I am learning to appreciate and cherish the role as an older doula.

There are moments when a woman presses in, burying her face in my chest and gathers her strength to pass through her next contraction, and I have words for her. Words that have brought many mamas through intense moments in their journeys.  And I am thankful for the years of experience I have had leading up to that moment.

There are moments when a daddy looks at me, referencing my face, to see if what is happening is “ok.” And, when he sees my soft lines and smile wrinkles, he finds comfort in that visual embrace. For that, I am thankful.

There are moments when a nursing mama calls me in tears, wondering what is happening in her body, and I can share the stories of all the women who have come before her, feeling the same feelings, wondering the same things, and ensure her that she too will find her way. And, for that, I am humbled, and blessed, and thankful.

Yes, being young and new can be thrilling, and exciting, and somewhat ego-stroking. But if there is anything that I am learning as the years add up, it’s that there’s nothing like settling into something you love, and being allowed to pour out all that has been given to you. And, age is just a marker of all the time I have been given to learn to love, and cherish, and pass along to this world the beauty of women and babies and birth.

So, to the gray hair, I say, “Bring it on!”

To the Mama who sees that there is a generational difference between us, I say, “Let me share with you some stories.”

​And, to the OB who asks if I am this child’s grandma, I say, “If I were only so lucky!”

Expectant families often ask if they can do anything for their nurses, not only to show appreciation for the long, hard hours nurses work, but also gain a happy member of their birth team. I was impressed when a client showed me the basket of goodies that would accompany her and her husband to the hospital. Knowing nurses often get gifts of yummy (but not always healthy) food, she wanted to be different. Her basket was thoughtfully packed full of hand lotions and sanitizer, Propel packets, pocket-size tissue packs, gum, Chapstick, Jolly Ranchers, and tiny chocolates. This woman had a fast labor, and she didn't go through as many nurses as she expected, but every nurse that walked in -- even her doctor and I -- were encouraged to pull things from the basket we wanted. "Now I don't want to take any of that home! I brought it all for you!" she told everyone, happily. The nurses were tickled at this sweet gesture. Her doctor, at first reluctant, did finally concede, "I do always need Chapstick."

Some might say this is unnecessary, that nurses are being paid at their jobs, so why are "gifts" necessary? One L&D nurse I know shared, "I love the thank you cards. I am shy about gifts and food. It's very nice though, but not necessary." A second one told me: "I absolutely love when patients bring in something special for the unit. We are there for joyous occasions and heartbreaking occasions. When patients acknowledge our work it makes us all feel good about the job we are doing. It lets us know that we made a difference during a very important time in their lives."

Isn't that what a true thank you is about? Acknowledging someone's good work? Isn't that something we all want? To know someone noticed, someone cared, it mattered to someone what we did? It's not a hard thing to do, and it can mean so much. I dare you to care enough to say "Thank You." Two little words.

My husband was the one who came up with the idea for The 52 Weeks of Motherhood Project. We were watching the snow on a cold, cold Cleveland day in December and talking about stereotypes of pregnancy, birth and parenthood that we see everyday. I wanted a platform for real people to share their stories. And my genius partner came up with this idea. I would collect stories from people who have lived experiences of pregnancy, birth, and the postpartum period and I would feature the stories weekly, corresponding to each week of the year. We are now in our second trimester, entering week 18.

The goal of The 52 Weeks of Motherhood Project is to show the reality of the first 52 weeks of motherhood—from conception through the 4th trimester—from the points of view of people who have actually gone through the experience, instead of the idealized or scary images fed to us daily. So far there have been stories of surprise pregnancies, women who feel utterly awesome and others who feel the worst they've ever felt, reactions to the news of twins and a rainbow baby, and a family dog who knew Mom was pregnant before anyone else. I've loved seeing how different people’s experiences are, but how there are still some threads of similarity that weave throughout the stories. All the stories express at least a twinge of both hope and fear, and lots of expectations. There’s also the eternal negotiation of internal and external pulls and pushes. Being focused on and centered in your body, sensing the internal changes that are so subtle but so profound, while simultaneously working and playing and interacting with the “outside” world... has there ever been a pregnant person who hasn't experienced this?

My brother and his wife were expecting their second daughter any day and I desperately wanted to be there for her arrival.  Now, it should be known that we are a family of “moderate hippies." Grow-ing up in the Pacific Northwest, you are subject to crunchy granola-ism by proxy.  Like it or not, you will be more “green” than people from, say, Detroit, just by default. So I was confused, but not surprised when my sister-in-law announced that she would be using a doula for her second child’s delivery.  “A what?” I asked…”a doula.” was the reply. “What is that?  Is that like a midwife?”  “No, it’s like a birthing coach or a mother’s helper.” “Huh.”  I was picturing a stern matronly woman that smelled of patchouli and wore Birkenstocks.  Someone that espoused the virtues of going drug-free while standing on your head and breathing like an Iditarod racer through contractions…no thank you.  With three children to my credit, I have always been happily pro-drug, pro-hospital, pro-doctor.

Despite the fact that I have given birth more than once, I still became quite excitable as we timed the contractions.  My sister-in-law braved the pains from the comfort of her upstairs bedroom as we waited for her doula to arrive at the house.  I was timing them at three minutes apart and was wondering why we weren’t just meeting this delivery person at the hospital.  I harbored secret fears that my niece would be accidentally born at home and I don’t know if I could’ve kept from passing out if she had tried that business…

It was also interesting to watch her “work the crowd."  You could tell she had assessed the situation (slightly hysterical grandmother, worried sister-in-law, sick husband – did I mention at that very moment, my brother, the father-to-be, had been struck by a gastrointestinal bug?) Ashley diffused all that was ramping up.  Focusing on mom, but speaking to all present, she assured everyone that the baby would not be there in the next hour and that we would calmly work our way to the hospital.  I’m certain that my sigh of relief was audible when she made it clear that this baby would not be born in the upstairs bedroom of their family home.  

I stopped perspiring when it became more-and-more clear that this gal knew what she was talking about.  So far the baby had not fallen out en route, despite my misgivings about contractions that were three minutes apart and our not being hauled by screaming ambulance to the emergency department. Remain calm faithful reader.

Our doula (yes, at this point she has become “our doula”) was as steadfast in her calm and patient demeanor as I was borderline hysterical. I watched this magical gift of a woman do her thing. Yes, at the risk of sounding like a crazy, hippie-dippy, magical loving, fruit loop of a nut job, I will put it out there. I will say it: This magical gift of a woman, this doula, was wonderful.

In what was, for me, the comfort zone of beeping machines, copious hand sanitizer and droves of personnel equipped with advanced degrees and special badges, I watched the most basic of all things natural unfold: A woman, comforted, coached and calmed a laboring mother while the laboring mother brought her baby into the world.  It was a revelation for this mother, how a delivery could go so smoothly…

Because we are led to believe that laboring women need monitoring, constant checking, IV’s, medications, interventions and whole carts of instruments to bring a human being into the world.  When maybe the most effective, and dare I say, most important vehicle to assist in delivery is a calm companion -- someone who knows, with unshakable conviction that women were designed to have babies.  That birth is not an instantaneous process.  A person comfortable with the fact that labor and delivery take as long as they take, a person adept at soothing a laboring mother through the pain and anxiety of childbirth.

Having seen it for myself, watching a team work with a laboring mother in that hospital room, it dawned on me what a genius arrangement this was.  Dad was watching the progress, eagerly engaged, free to ask questions and procure ice chips while mom was fully tended by a constant, unwavering support person.

During my own delivery, six years ago, the assigned labor nurse whom I had grown to love, had her shift end smack dab in the middle of my laboring!  And she left!  She went home because her work day was done.  The second shift came on as I was transitioning into hard labor and I hated that second delivery nurse.  She was loud and obnoxious, interjecting her belligerent opinions with every breath.  And I was too wrapped up in birthing a baby to tell her where I really wished she’d go.  What a different experience that could’ve been.  If I’d had a doula, as a personal support person at my side, “Nurse Ratchet”, as she’s become infamously known in my birthing story, could have gone away.  Or at least shut up.  But I had not known there was this option.  I only knew what the hospital staff told me…

And let me tell you another story where a doula could have quite possibly changed the course of history.  A couple of years back, I was invited to photograph at a delivery.  Not a National Geographic-type assignment, but a tasteful, photo-journalistic capture of the first moments of life. Mother laboring, father cord cutting, baby weighing in, all of those moments.  At three centimeters, this laboring mom was beside herself with pain and she became petrified at the prospect of having to birth a baby.  She screamed frantically until an anesthesiologist came in and gave her an epidural. She was dilated to four centimeters.  As her contractions continued, the epidural was not enough and she became terrified. Her mother could not talk her down, the daddy had to leave the room – everyone was asked to leave the room.  The epidural was turned up and medication was administered intravenously.  The shrieking subsided as we all waited in the hall.  She was dilated to seven centimeters.  Her labor progressed.  Before she was ready, she was at ten centimeters and there was no more medication to be given.  This birthing woman screamed and cried and swore and shrieked and there was nothing more to be done (pharmaceutically) as she endured that transition into second stage.  

The doctor arrived amidst chaos and hysteria while a crowd stood, wide-eyed, in the hallway. Suddenly and abruptly, all of the ruckus stopped.  Dead silence.  Minutes later, a nurse emerged with a silent, swaddled infant.  I will never know what actually happened in that delivery room in the wee, wee hours of the morning, but I do know there was no audible first squeal from that baby, there was no “war cry” as that laboring mom delivered her infant with her own body.  I can speculate that when her practitioner walked in, he evaluated the hysterical situation and whacked that mom up with something akin to the old twilight sedation that women in the 1950’s delivered with, and he pulled that baby out before things got any crazier.  That is what I honestly believe happened, but I will never really know for sure. What if she had a doula?

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

My wide (oops! wife!) is the one suggesting doula in our house. I am the one who scoffs at this idea. Women and men have been having babies forever and I am obviously capable to be there to support her (like all the dads before me right?). When we have disagreements we have a system where we each right down 5 reasons for our point of view and we share these with each other. . . sometimes it ends up fixing our issue and sometimes it ends up a way for me to sleep on the couch. We tried it. I had some good ones.

1. Money factor when we would have lots of bills and expenses 
2. Stranger at the most (almost most) intimate time of our life
3. Doctor P. said he wouldn't recommend it
4. Hurt our moms' feelings since they both want to come and we told them no
5. I really think I will feel bad if you have someone else taking care of you. I am sure I don't need a doula to help me take care of you.

Well my wife decided to hit each of my points with her own points (she even used a red pen and underlined things twice. Did I mention she is a teacher?): 
1. Money factor when we would have lots of bills and expenses 
YOU AREN'T HAVING THE BABY. SO WE CUT BACK ON EATING OUT.

2. Stranger at the most (almost most) intimate time of our life
WE WILL MET HER AND HIRE HER, WE GET TO CHOOSE HER. YOU AREN'T HAVING THE BABY.

3. Doctor P. said he wouldn't recommend it
DR P. ALSO SAID HE DID HIS OWN VASECTOMY. HE IS NOT HAVING THE BABY EITHER.

4. Hurt our moms' feelings since they both want to come and we told them no
REMEMBER HOW MY MOM ACTED AT OUR WEDDING? AND HOW YOUR MOM ACTED AT YOUR NEPHEW'S CHRISTENING? WE DON'T WANT THAT CRAZY IN OUR HOSPITAL ROOM. AND THEY AREN'T HAVING THE BABY EITHER.

5. I really think I will feel bad if you have someone else taking care of you. I am sure I don't need a doula to help me take care of you.
I AM SCARED TO HAVE A BABY. I HAVE NEVER DONE THIS BEFORE. I WANT A DOULA. I AGREE YOU DON'T NEED A DOULA. YOU ARE NOT HAVING THE BABY. 

So in the interest of sleeping in my bed I agreed to meet some doulas. And guess what? I was right that I didn't need a doula. But my wife did. And I admit she knew what she as doing.