Sometimes a cesarean is necessary and a family knows this before labor begins. This gives them a chance to prepare in ways they may not have thought of during a regular labor-turned-cesarean birth.  ​

​“Why are you still working?! Your due date is next week, what if your water breaks while you’re at work?”

“Oh that’s not going to happen to me, they do that in movies for dramatic effect. In real life, the water breaking in a gush only happens to about 8% of women, that won’t happen to me, I will be fine”

This was a conversation between myself and my good friend Jammie one week before my October 13th due date with my first child. I had an easy pregnancy, no morning sickness or vomiting, and I had not taken a single day of work off the entire nine months. I manage an office, it’s not physical work and since I had felt fine, I felt no reason to stop working even with my due date right around the corner. I wanted to maximize my time off after the baby arrived. Little did I know, I was about to be one of those 8%...

On the morning of October 14th, one day overdue, I awoke to my dog barking. She doesn’t usually bark at night unless she needs to be let out to answer the call of nature. I groaned internally. “Ugh, it’s 2:30 a.m., I don’t want to get up and let her out,” I complained internally. Then I thought, well I probably have to pee anyway, it’s only been an hour since last time I peed and everyone knows how often pregnant ladies need to pee. I heaved my big, pregnant belly up and began walking to the bathroom. "Oh, I guess I really had to go," I thought, as I felt fluid trickle. By the time I got to the bathroom, there was a gush and a lot of fluid. Apparently my water had broken, signaling that the arrival of my baby was imminent. I called to my husband and told him to get up and let the dogs out while I cleaned up.

The first call I made was to our doula. I had made the decision to hire a doula fairly early in my pregnancy, and she came highly recommended from a mother of 6 that I have known my whole life. I hired a doula because I was afraid of having a hospital birth, I was afraid of being forced into taking unnecessary medical interventions during labor, and afraid of being bowled over by a medical team that had never met me, knew nothing about me or my baby, and didn’t know what I wanted from my birthing experience. I envisioned an intervention-free birth, preferably at home, with a midwife. My husband, rightly concerned with my health and that of our unborn baby, objected to my home birth plan and preferred a hospital setting. The compromise came in the form of our doula, who I wanted to help me through an intervention-free hospital birth.

“My water just broke, should I go to the hospital?”

“How do you feel? Have your contractions started yet?”

“I feel fine, I am not in pain and having no contractions yet.”

“It’s up to you whether or not you’re ready to go to the hospital. However, it can take some time for the contractions to catch up once the water breaks. Since your water is broken, if you do go to the hospital, it's likely they won’t allow you to leave once you’re there.”

“Ok, well I don’t want to go too early, I think I will wait a while and go later. I should not go to work though, right?”

“NO!!! Do not go to work, and keep me updated.”

After getting off of the phone, I called my mother and told her the news. I told her I wasn’t going to the hospital yet and I didn’t expect the baby to arrive for several hours, probably not until late evening. I expected a long labor, everything I had heard and read said that most first time mommies have a long labor so I was prepared for a marathon. With this in mind, I decided to go to work. This decision was made because I knew I couldn’t get someone to cover me, I work at 4:30 am, and I just planned to go briefly to give a quick morning meeting and inform my staff that I would be out until the end of my maternity leave. My husband got dressed and drove me to work, and I was there for half an hour before we left and drove through McDonald’s for breakfast to be fueled up for all the work ahead of me!

At home around 6:30 am we both laid down, I wanted us both to try to get some rest for the long day ahead. I was having minor contractions at this point, 15-30 seconds long and 5 or so minutes apart. At about 9 am I sent my husband to drop our dogs off at a friend’s house. My contractions had increased in frequency and length but I was still not ready to go to the hospital. I was texting our doula and asked how long I could safely wait to go to the hospital? She said it was up to me how long I felt safe staying home, and she advised me to contact my doctor for an appointment to check my progress. If I had progressed enough, I could go directly to the hospital, but if I wanted to go back home, I could do that too. That sounded ideal to me, my doctor’s office was located in the parking lot of the hospital I would deliver at.

This is why I wanted a doula and why I decided to go with our doula specifically; she listened to me, asked me how I felt, and asked what decision I thought was best for me. Essentially, she helped me to decide for myself instead of just telling me what to do or what she thought was best. From our prenatal courses, she knew my concerns about having a hospital birth and advised me with that in mind. Our doula knew that I was concerned about going to the hospital too early in labor, and that I was concerned about having my movement in labor restricted by monitors and hospital rules.

The most important thing that I learned from our doula was that I had choices for this process. I could be in charge. There were productive ways to communicate with hospital staff to facilitate the birth that I wanted, and decisions that I could make to affect my birth, like the decision to stay home and labor for a while instead of going straight to the hospital when my water broke. I didn’t have to be merely a participant in my labor, I had choices and a voice. In our prenatal courses, we had talked extensively about my birth plan, making 2 or 3 drafts before we were satisfied with it. I also made a gift basket for the nurses and doctors in the hospital, to thank them for their hard work, and partly to schmooze just a little bit! The birth plan would help to communicate what I wanted in the heat of labor, and the gift basket would help them to remember me in a positive light.

​I called my doctor’s office. When I told them my water was broken, they told me to go straight to the hospital. I explained that I wasn’t ready yet and that I wanted my doctor to check me first. Fortunately my doctor was working and agreed to see me at 11:15 am. I took a shower, which was the best shower I have ever taken in my life, so relaxing! And my husband and I departed for the doctor. We pulled into the parking lot shortly after 11 am and I knew in my heart that we weren’t going home. My pain level had increased significantly since 9 am, but I was still unsure whether or not to go straight to the hospital. In my mind, I was clinging to the 4-1-1 rule (contractions every 4 minutes, 1 minute in length, happening for at least 1 hour) and I wasn’t there yet! My contractions were only about 30-45 seconds long, and I didn’t think they were long enough for me to go to the hospital.

Once in the doctor’s office, I had trouble disrobing from the waist down and getting up onto the exam table. When my doctor arrived and checked me, we were both surprised to find that I had already dilated to 5! It was time! I was going to the hospital! I was put in a wheelchair to go across the parking lot. I texted our doula: “I am at 0 station and 5 centimeters dilated, I need you here ASAP!” “I’ll be there as soon as I can!” My husband accompanied me to the room and I sent him back out to the car for the hospital bag. The desk nurse gave me a hospital gown and asked for a urine sample. I got into the gown but the urine sample wasn’t going to happen. I was in too much pain, and I curled up on the hospital bed in the fetal position instead.

When my husband got back from the car, I was crying. “I need an epidural, I can’t do this, I’m going to die!” Cue the theatrics! He went for help. The nurse checked me and immediately ordered a birth kit; baby was coming faster than any of us anticipated. I asked for an epidural. My husband asked if I was sure, and in that moment, I certainly was! The nurses told me it would be at least an hour before I could get one; in retrospect I am sure they knew there simply wasn’t going to be time. The baby was going to be there before the anesthesiologist anyway! Our doula arrived around noon I believe, and everything became a blur. I was very lucky that my doctor was on duty and was there for the birth. Between her, our doula, my husband, and the nurses, everything seemed to happen at lightning pace. Almost immediately, they had me pushing, I had plenty of help and support. My dear husband, who had pledged to stay by my head during labor to avoid the potentially traumatizing show, found himself holding one of my legs up while I pushed, after a nurse said “here, help her." Before I knew it, baby was crowning. My doctor asked if I wanted to touch the head? “No! What are you talking about?! We are wasting time, let’s get her out of there!”

At 1:13 pm, Tegan Janine arrived. 7 pounds, 3 ounces and 18.5 inches of pure, healthy perfection. I remember seeing her for the first time, her arms outstretched. As they laid her on my chest, I was overwhelmed with emotion and disbelief. She had arrived so quickly, I was caught off guard and burst into tears, “I’m just so happy." Delivering the placenta was slightly problematic, it didn’t want to dislodge itself. The doctor massaged away at my abdomen for 20-30 minutes, and I cursed loudly…but it was eventually delivered. I was given a shot of Pitocin in my thigh because I was bleeding a little more than they would have liked, but otherwise everything was fine.
​ 
All of the preparation and planning were worth it. The decision to hire a doula and educate myself on my choices and decisions was crucial. I am extremely fortunate that I had an easy pregnancy and a fast labor, many mothers aren’t as lucky as I was. I recognize that genetics and pure good luck played a huge part in me having a positive labor experience. I hope that by sharing a positive story of birth, other mothers can feel more confident. There are so many terrifying stories of labors gone wrong, I feel that women need to hear that labor can be a positive experience.

​When living in Chico, California, and starting as a doula, I did not enter this work with a professionally-created business plan clutched in-hand – I walked in with my heart open and extended, ready to help families. The focus on business in the doula world has been huge in the last few years, and I absolutely see the value in that. When I started as a doula, there simply were not resources past the doula trainings we took. I did as many others did – made things up as I went along. With freedom and (eventually) experience, I made changes as needed to better fit how I wanted to do business. I have known all along that I do things differently than many other doulas, and I am perfectly content in that. In order for me to stay sane, happy, and sustainable as a doula, my business beliefs and practices have to match me. Take, for example, payment.
 
It is the norm for doulas to be paid-in-full before a baby is born – often by 36 weeks. The agreement generally is, if you have not paid your doula before your birth, she does not consider herself on call for you. I deviated from this years ago after seeing an uncomfortable situation with a doula friend and her client.
 
Anne was called to labor with a client at home. The client had not yet paid the second half of Anne’s fee, but Anne made the choice to attend her client. After a night spent working through contractions, labor stopped. Anne left to wait for her client to share when labor began again. But Anne’s client never called, and soon Anne learned the baby had been born. Expecting to be paid, Anne contacted her client to make arrangements. The client, though, expected that since she didn’t have direct doula support for the birth, nothing was owed. For weeks and months I saw this play out, and I felt bad for Anne. The amount of time and energy she put into trying to collect payment was painful to watch. I understood Anne’s side of things, and yet I could imagine a situation where her client felt good about birthing without a doula.

Anne never was paid.
 
I have since moved from Chico to serve the areas of Visalia and Bakersfield, yet my belief hasn’t changed: my true heart of this birth business lies in wanting families to have what is right for them – even if that means they change their minds about me. I cannot stress this enough! Thoughts come to me: what if a family finds that fee-remainder would be more important to them than doula support? What if I miss a birth? What if they are laboring confidently and a doula’s presence doesn’t fit the flow of their birth? What if a planned cesarean birth is needed and they feel well-enough supported? I wanted my clients to have an “out,” to be free not to call me, without worry of penalty.
 
My contract expectations are as follows:

• non-refundable deposit due at contract-signing (half of total fee)
• remainder due at postpartum visit (other half of total fee; yes, due after the birth)
• if I am not at the birth (they fail to call me, precipitous labor, illness, etc.), no additional money is due, we are square with the deposit to cover our prenatal time together
• if after a missed birth they wish me to come to the hospital (precipitous situation), the fee remainder goes down by 1/2; again, due at our postpartum visit

 
There it is – all in place should a family find it useful.
 
This structure is worrisome to many doulas I have shared it with. What about being on-call and then suddenly having your time wasted by not attending the birth? Unless I block my calendar out for specific dates (and as my husband is a teacher, I block out some time in the summer), I am on-call a lot. When weighing this as an option for families (against my inconvenience), I want families to win.

Ultimately this has been more of a non-issue: I am getting close to 200 births as a solo doula, and I changed my contract to reflect this option around birth 30; in all of that time, I have never had a family NOT call me, and I have never had a family NOT pay me. So why keep it in my contract at all, if it isn’t going to be used? Because I believe birth is a time when your choices shape your outcome – and who is on your birth team should always be one of your choices. 

I recently had an inquiry into my doula services. Knowing there was a slight chance I might be out of town for a couple days around this couple’s EDD, I offered a partnering situation, where a second doula and I share all the pre-birth responsibilities, and then whoever is most available attends the birth and the follow-up visit (for more information about ways to work with other doulas, contact me). In a case like this, we split the deposit, both attend all prenatals, and then have a way of determining who will most likely arrive at the birth (sometimes this is as simple as who is more rested in the case of another recent doula birth, sometimes we wait and see who the family contacts first, and sometimes it is just a pre-arranged agreement between doulas).  The family agreed with this type of arrangement, so I contacted a doula friend, asked if she were game, and all of us met for an interview.
 
The partner I selected for this birth is much my junior in the birth world. We had recently partnered for a birth where I was asked to help a young mother-to-be in foster care – there were no funds for doula support, yet this situation was too important to let that stop me. Knowing I had a pretty busy birth schedule, I asked this doula if she would partner with me for this volunteer birth, and she heartily agreed. I loved her style, her knowledge, her heart. She has a real passion for serving, and I can’t wait to work with her more.
 
Our interview went well. The family originally found me through my website. They were impressed that I kept an active blog, and they appreciated my experience, certifications, and the seriousness with which I take this work. The expectant father is someone who deals a lot with numbers – he is a numbers guy. He did seem concerned that I might be out of town during their due-week. I also live about 40 minutes away from the hospital where the couple would be birthing, and my partner lived about 10 – this was another number for the expectant dad to absorb and think about. The expectant mother, because it was her second baby and she had a fast-paced job where she gets little rest and is always on her feet, had practically been assured by her doctor her baby would be early.  With the dual coverage provided, and knowing babies don’t generally come lightning-fast, she seemed very comfortable with how the situation would work out.
 
Upon ending the interview, the expectant mother basically said, “Thanks for taking the time to meet with us. I will call you tomorrow to let you know how we want to proceed. But I am feeling pretty good about all of this.”
 
My partner and I walked away feeling really positive about the meeting, and we said our good-byes.
 
The next day came and went, and I didn’t receive a call. Because this family was due within a month or so, this day passing without hearing from them was a tiny, pink flag to me. The following day, I did get a call from the expectant mother. I could tell by her tone she was having a hard time putting her words together. That’s when I knew for certain: they were not choosing me. Okay, that sounds weird, as we were already aligned to work as partners. But I could sense they wanted to alter the design, and being as mine was the only contact information they had, that meant they had to, essentially, go through me to get to my partner.

Talk about awkward! I held the reins here. The expectant mother explained, it really came down to me possibly being gone, and that 40 minutes of driving for me to reach the hospital – her partner was not comfortable with these numbers (maybe they felt a better connection to the other doula? And if so, they did not mention this, but she is amazing, so of course it could add to their reasons, but they did not say that to me). I stopped the woman, as she was uncomfortably offering a finder’s fee, and apologizing all over the place – I knew she felt bad and this was hard for her to do. I told her one of my core values as a doula is that families find the doula who is right for them, and that won’t always be me. I hold true to that, and I really believe I get the clients I am meant to get.
 
I assuaged this mother’s guilt as best as I could. I told her not to worry about it one more minute. I gave her the other doula’s information, then asked if I could talk to my partner doula first? She agreed. I wished her well, again told her I was happy they found a match that felt comforting, and said good-bye.
 
Then I dialed my partner doula.
 
She was in disbelief, knowing I had more experience, and that the family found her through me. She was also extremely apologetic and humble. I assured her this family was firm in their decision, and I told her she should take the time to feel good! She was chosen! Relish in that and feel proud! I said I appreciated her being gentle with me, sounding and feeling disappointed and surprised, questioning their choice, and I wanted her to let it go to her head a bit – celebrate! I knew she would be a great doula for them, and I could honestly say I was happy with how things turned out.
 
I do, absolutely, feel everyone deserves a doula, and that doula won’t always be me. Families come in all shapes, sizes, and situations, and they have ever-branching needs. I feel confident in the work I do and the care I have to offer. And I know so many other incredible doulas I can say the same about. It is more important to me that we support families than I be the one supporting all the families. Because of this, I can still be happy and gracious when the right one is not me. ​

Recently for the Bakersfield BirthNetwork, I was presenting on comfort measures for birth. Expectant families, as well as doulas, come to these gatherings, and I love being able to offer information that is not only helpful to parents, but also information other professionals can take to their clients! As a Lamaze-certified Childbirth Educator, I am always putting together ideas in an unusual way to help make learning about birth fun!

The inspiration for this started when I had a few ideas I wanted to squish together into an activity:
1. Update the stages of labor to reflect an additional pre-labor phase at the onset of the first stage
2. Scaffold the stages/phases of labor by choosing and practicing supports meant to intertwine with the key emotional and physical events occurring
3. Provide a handout which not only helps visualize the opening of first stage, but also serves as a cheat sheet to labor happenings, timing, and ways to cope

What I came up with, I call the "Spinning Circles of Womb." Just kidding, I don't. But I think it works, and it's pretty simple, and that's all that counts -- no frilly title needed. Basically, here are the supplies: 

• items/ideas that comfort
• items that encourage art
• non-negotiable for this activity are 4 circles measuring 3cm, 6cm, 8cm, and 10cm, tacked together with a metal fastener 

I can't remember a time when I sat participants at a table, but for this activity we did, indeed, sit at a table. Surrounded by Mr. Sketch Markers, paper circles, and stickers, I began to share the stages of labor by tacking three sheets of (laminated) paper onto the wall. There is relief when an expectant parent realizes there are only three stages of labor (I did have a dad once who suggested there were 14, but that was his lucky number, and I asked him to take a guess!).

Three. That's not hard to remember, right?

​Then I tack up two more papers, which you can see below, right. I share how some genius decided to break the first stage of labor up into phases, which is another word for, let's just insert more stages into this stage and call it good. 

On the front of the circles we write things like average length of that phase, approximate cervical dilation achieved, contraction action, and more (note: I don't show all of that in the picture). The pinnacle of this is affixing the face sticker to the appropriate phase​, as a handy visual reminder of what a laboring person might be feeling in that moment. 

While we are moving through the phases with markers and stickers, we are also brainstorming what comfort measures might be beneficial at what time, and those are added to the back of that circle. We practice these comfort measures as we go. If we expect people to feel comfortable with different physical ways to counter the strong sensations of labor, we can't expect them to get there from a picture alone! Would you step into a ballroom, ready to dance in front of judges, simply from pictures you saw in a book? We need to actually show families what these positions and movements look like, how they feel, and when they help -- or they are of no help at all.

​At the close of this activity, families walk away with their concentric circles of information, a piece of pool noodle, and an information sheet which shows about 20 different physical positions of a laboring person and partner working together.

Not a bad way to merge my three goals! A handy takeaway that can be utilized easily during birth.

I have been a doula for 18 years. I began after the birth of my third child who was born at home with a direct-entry midwife. My midwife asked me if I would help her at births, and that launched me into being a home birth doula for seven years. She eventually moved away, and at that time, it was too far for me to travel to be a doula for her clients. I decided to start attending births at hospitals, and I have been an in-hospital doula for 11 years now.

When I was a doula at home births, I never saw myself in the position of midwife. I think at that time in my life, I wasn’t ready for that kind of responsibility. My children were all very young, and I wasn’t yet done having children. I was a lot younger, and I felt I wasn’t quite qualified and didn’t have enough experience to be in that role. So, I’d occasionally tell the midwife with whom I worked, that I didn’t want to be a midwife. I also thought that midwifery was not for me. After all, I had been pregnant while a senior in high school, barely graduated (attended a California’s continuation program to finish high school) and I had five children by the time I was 29 years old. By the time I was 38, I had eight children. Life was busy enough with homeschooling, church, helping my husband with his business, and being a doula. I couldn’t possibly add anything else to my over-flowing plate.

Well…that all changed in 2014. I noticed a trend in homebirths not only in the nation, but in my own community. I noticed no midwifery care was being provided to Spanish speaking women in my community. While English speaking women at least had the option of receiving midwifery care from a midwife who spoke their language if they so desired, Spanish speaking women in my county do not even have that option. “Someone should do something about this!” I thought. I still didn’t think that person would or could be me.
I became friends with a doula in a nearby city. She also has a large family, AND she was studying to be a midwife. I was excited for her! A doula-turned-midwife was a great journey. As the months and years of our friendship developed and grew, she eventually finished midwifery college, passed the NARM exam, and became a licensed midwife. During this time, I began being moved to pursue midwifery. I think it was always in me to become a midwife, but I just couldn’t imagine how I would pursue a midwifery degree. Watching my friend inspired me, so I began asking her questions about midwifery school.

My friend patiently answered all my questions, provided me with links, and fully encouraged me to go this route. I talked to my husband, I prayed about it, and I -- finally -- knew this was the next step for my life.
After looking at different schools, I chose Midwives College of Utah (MCU). MCU offers continuing education classes and these classes are a non-committal fashion to figure out if a distance education platform works for a person. After one semester of continuing ed classes, and getting a feel for how MCU operates, I knew, for sure, this was the school for me. I began the process of enrolling, and I was accepted into the Associates of Science in Midwifery at Midwives College of Utah in August, 2015. It will take me three years to complete the academic portion of the associate’s degree, and possibly another year to complete the clinical portion, totaling four years before taking the NARM exam.

Changing careers at the age of 45 has been an exciting and stressful adventure. My whole life, and how I operate, changed drastically. I went from having plenty of time to do all the things household, to doing school work 6-8 hours per day, including the weekends. I had to adjust my way of thinking, accept that going to school is the same as having a full-time job. When deciding to take vacations or weekend trips, or even day trips, I look at my calendar. I may have to do extra school work to make up for days I won’t be able to get any work done. I may have to take some school work with me, and get some studying done while on vacation. I have had to adjust everything around my education, and it has been difficult to make that transition.

Everything, right now in my life, is all planned around my schooling. In case any of you might by thinking, “Well there are summer breaks.” No, actually, there aren’t any summer breaks. MCU operates on a trimester schedule. That means, school runs all year long. We have four – fifteen week semesters: fall trimester, winter trimester, spring trimester, and summer trimester. Between semesters, we get a two-week break. That’s it, folks! So, no summer breaks! Now, if I plan it just right, I can finish up about 3 weeks early, and have about a 5-week break, but that means doubling up on assignments to get done early. It’s doable, but not an easy task!

​Currently, I am in the assist phase and working with a preceptor (a licensed midwife who has been approved by MCU to be my supervising midwife). Being in an apprenticeship is such a blessing, but such a huge change for me! I have been accustomed to being in the doula role (education, information, and labor support – which means, never any medical advice is given and no medical procedures are ever done!). Being in the midwife apprentice position is completely different. I get to check blood pressure, pulse, and feel the abdomen for the baby’s position (Leopold’s maneuvers). These are things which are out of the scope of practice for doulas, but within the scope of practice for midwife’s apprentice while under the supervision of a licensed midwife. It’s amazing and exhilarating to be in this new role!

Another big change, for me, is that I now call meetings with my preceptor’s clients “prenatal” appointments. As a doula, I never felt comfortable calling meetings with clients a “prenatal,” because that, to me, is a term used to describe an obstetricians or midwife’s appointment to receive prenatal care. But, now, I am in the midwife’s apprentice role, and can call these "prenatal" meetings.

Going from doula to midwife is completely polar opposite. Doulas provide one to three meetings before birth, provide education, information, and emotional support, provide labor support, some breastfeeding support, and one visit after the baby is born. Doula support is invaluable! Doulas do not, however, provide any medical services, whatsoever.

Midwives provide one prenatal visit once per month from 4 weeks – 28 weeks of pregnancy, one prenatal visit every 2 weeks from 28 weeks – 36 weeks of pregnancy, and one prenatal visit from 36 weeks – 40 weeks and beyond if needed. That’s a total of approximately 15 prenatal visits. These visits include blood pressure, pulse, weight, and fundal measurements. They include lots of information on pregnancy health, nutrition, exercise, and things to expect. They make sure mom and baby are well, and that there are no medical issues. If there are issues, they refer them to an OB. Each prenatal visit typically lasts an hour, sometimes more…Postpartum, they provide approximately 3-4 visits…

​So, for me, going from the doula role, to the midwife assistant role, has been a huge transition. Being part of the care a woman is receiving during her entire pregnancy is a completely different role from the doula role. I am in transition. As we know, transition is a hard place to be -- and I am eager to make the changes to get to my dream of becoming a midwife. ​

I had been looking forward to Sunday afternoon all week. A local midwife (and friend!) was throwing an open-house party to reveal her new office and birth suite. There was to be a petting zoo, bounce house, food, families, and fun. I couldn't wait, and I excitedly brought my mom and Ezra along for the ride. 

LaMonica Bryant, LM, CPM, has been a midwife since 1999. She offers homebirth services to families in Kern, Tulare, and Kings Counties. LaMonica is based outside of Bakersfield, and after moving to a farm with more room, it was time to create a dedicated office space. It was also decided to include a birth suite, for situations when families may want the option of out-of-hospital birth closer to town than they may be. 

I arrived to the party, eager to check out the new space and visit with LaMonica. I saw many friends, including my own midwife, Linda Cowley, who had helped me birth Ezra. Tables were set up and food was near, so I sat and visited for a bit, always keeping an eye out for LaMonica as I wanted to tour the new space with her. After about a half hour, another friend came to our table and whispered something about there being a baby born that morning. 

Let me back up: LaMonica was pregnant, due around Valentine's Day. Her party's date was supposed to have been far enough ahead of her baby's date to not get the two mixed up. But as we all know, sometimes baby's have other plans!

The night before the party, around 11 pm, LaMonica's water broke! Labor ensued, and at 6:17 am, on the day of the planned party, Jasper was born! A short while later LaMonica's husband asked what they were going to do about the party? LaMonica said, the food was bought, the bounce house was on its way, so the show must go on! A bit bewildered, I would imagine, her husband agreed -- as long as she promised to stay in the house, in bed, with her baby.

Thanks to fellow doula, Melissa Hettick, for sharing pictures of the office/suite.

The most important thing that I learned from Stacie was that I had choices for this process. I could be in charge. There were productive ways to communicate with hospital staff to facilitate the birth that I wanted, and decisions that I could make to affect my birth, like the decision to stay home and labor for a while instead of going straight to the hospital when my water broke. I didn’t have to be merely a participant in my labor, I had choices and a voice. In our prenatal courses, we had talked extensively about my birth plan, making 2 or 3 drafts before we were satisfied with it. I also made a gift basket for the nurses and doctors in the hospital, to thank them for their hard work, and partly to schmooze just a little bit! The birth plan would help to communicate what I wanted in the heat of labor, and the gift basket would help them to remember me in a positive light.

​I called my doctor’s office. When I told them my water was broken, they told me to go straight to the hospital. I explained that I wasn’t ready yet and that I wanted my doctor to check me first. Fortunately my doctor was working and agreed to see me at 11:15 am. I took a shower, which was the best shower I have ever taken in my life, so relaxing! And my husband and I departed for the doctor. We pulled into the parking lot shortly after 11 am and I knew in my heart that we weren’t going home. My pain level had increased significantly since 9 am, but I was still unsure whether or not to go straight to the hospital. In my mind, I was clinging to the 4-1-1 rule (contractions every 4 minutes, 1 minute in length, happening for at least 1 hour) and I wasn’t’ there yet! My contractions were only about 30-45 seconds long, and I didn’t think they were long enough for me to go to the hospital.

Once in the doctor’s office, I had trouble disrobing from the waist down and getting up onto the exam table. When my doctor arrived and checked me, we were both surprised to find that I had already dilated to 5! It was time! I was going to the hospital! I was put in a wheelchair to go across the parking lot. I texted Stacie: “I am at 0 station and 5 centimeters dilated, I need you here ASAP!” “I’ll be there as soon as I can!” My husband accompanied me to the room and I sent him back out to the car for the hospital bag. The desk nurse gave me a hospital gown and asked for a urine sample. I got into the gown but the urine sample wasn’t going to happen. I was in too much pain, and I curled up on the hospital bed in the fetal position instead.

When my husband got back from the car, I was crying. “I need an epidural, I can’t do this, I’m going to die!” Cue the theatrics! He went for help. The nurse checked me and immediately ordered a birth kit; baby was coming faster than any of us anticipated. I asked for an epidural. My husband asked if I was sure, and in that moment, I certainly was! The nurses told me it would be at least an hour before I could get one; in retrospect I am sure they knew there simply wasn’t going to be time. The baby was going to be there before the anesthesiologist anyway! Stacie arrived around noon I believe, and everything became a blur. I was very lucky that my doctor was on duty and was there for the birth. Between her, Stacie, my husband, and the nurses, everything seemed to happen at lightning pace. Almost immediately, they had me pushing, I had plenty of help and support. My dear husband, who had pledged to stay by my head during labor to avoid the potentially traumatizing show, found himself holding one of my legs up while I pushed, after a nurse said “here, help her." Before I knew it, baby was crowning. Doctor Blair asked if I wanted to touch the head? “No! What are you talking about?! We are wasting time, let’s get her out of there!”

One thing I will always remember about this birth: It was an intense and fast birth in Bakersfield, CA, and soon the room was filled with voices offering suggestions and helps to work Tegan out. While I listened to the voices of incredibly caring and wise nurses, and my client's amazing (I cannot say that enough!), AMAZING doctor, I heard them calling my client by her given name, and not her preferred name. It struck me in that moment, what an advantage I had as her doula, with the benefit of many hours of time together before birth! I was able to get to know this family, understand their desires and needs, and offer them the education and tools they would use to shape their birth experience. I knew them, and to me, that really means something.

I have a son who was born with an aortic stenosis. This means his aortic valve is narrower than it should be. He just turned 14 and up until his cardiology appointment last month, there has never been an issue.
 
Before we found ourselves back in the office, we had been rescheduled twice, so I was already feeling on-edge. Walking into the waiting room, there was not one place to sit. This added to my feelings of annoyance. When we finally met with the doctor, I was relieved, until after placing the transducer on my son’s chest his first question was, “Have you had a growth spurt recently?” Not what you want to hear when your child has a heart defect.
 
The most recent reason we had been rescheduled was our doctor had a spider bite on his leg that needed treatment. I rolled my eyes when the receptionist shared this with us (good thing it was over the phone). I thought it sounded like an interesting excuse – who has to go to the hospital for a spider bite? But another part of me wondered: Why is she telling me this? Is that my business?
 
At this bad-news-appointment, we were told medication would be needed to lower my son’s blood pressure – not because it was high, but because the rate of flow through the narrowing could cause damage to the area where the blood comes through, like spraying a pressure washer constantly at one spot on your house. We were also asked if we had other children, and if they had ever been assessed by a cardiologist? We have 4 sons total, and no one has ever told us this before – that was jarring. The doctor was adamant my husband and I be checked, as well. Our heart-son’s health is monitored fiercely because there is a known issue – but if this were genetic, any of us could have an issue and not know. That was frightening.
 
We were the last appointment of the day and the office was shutting down. As the doctor was performing the echocardiogram, he kept sharing details of his spider bite, occasionally shaking his leg or letting out a sigh or “ouch” here and there – it was obvious he was not feeling well. He also said he couldn’t wait to get out of there that day and change the dressing.
 
So here’s us: bombarded with overwhelming information.
 
And here’s our doctor: trying to help us while being distracted with his own issue.
 
I left that day feeling sad, scared, and unsure about all his recommendations. Knowing we didn’t have his full attention added to my stress and confusion. I questioned our relationship with this professional, and again to my mind came: Why is his issue my business?
 
So how does this relate to doula work? Let me share another story. 

​A number of years back I had a couple I loved, and I think they loved me. We were so excited to work together. A week before they were due, my grandma passed away and the funeral was in another state. Of course I was going to attend – in the grand scheme of things, my grandma’s funeral is going to be more important to my health and memories than the birth of a client’s baby. So I let my client know my plans.
 
It was an emotional phone call, because she was one of the first people I told. I did cry when I let her know I was going out of town, and of course I would provide a back-up for her. I felt good about everything. I was gone for 5 days, and just as we hit the California state line again, I knew I would be home by nightfall and things would return to normal! I could still be there for her birth.
 
I was unprepared for the phone call I got within an hour of that feeling. It was my client. She said she didn’t want there to be any bad feelings at the birth, and they had decided to proceed without a doula. I felt confused because I knew I didn’t have any bad feelings – had I been clueless to their feelings?
 
The next day we talked it out more. I felt I had made it back and things would proceed as planned. But what I didn’t realize was, my business had become her emotional baggage, as she worried about my loss and whether I would be back in time for her birth.
 
At the time I remember thinking, “No one cares about me.” Meaning, clients don’t offer the same emotional support and empathy that doulas do. Our lives don’t get the same priority as the pregnant families we serve. It was an acutely painful realization made worse by the loss of my grandmother and exhausted nature of the trip. 
 
Of course, I was wrong. That’s how it should be when I am being contracted to provide a service. And once I was mature enough to realize it, I decided I wanted my clients to feel like I don’t have a life. Never again would I burden a client with my personal business. I want them to realize, when it comes to their expectations of me, there is nothing more important (even at the most inconvenient times), than their call of: “we need you.”

I have heard from many women over the years, words and situations that haunt them, where a professional’s business was made the mom’s business (which is really bad for business).
 
-A mom was waiting for her midwife to come for a postpartum home visit. The midwife told the mom she couldn’t find childcare for her little boy, so she would need to reschedule. The mom experienced a pretty traumatic birth, and she was eager for this visit and the need for someone to look over her baby again. She was so worried she took her baby to the ER just to have someone tell her the baby was safe and healthy (which she was).
 
-A mom who wanted a TOLAC (trial of labor after cesarean) ended up with a repeat cesarean birth. It was very emotional, everything leading up to this and ultimately, having an unexpected surgical birth with an unexpected provider. Toward the end of the birth, the doctor said, “Can someone take over for me? I have to get to my granddaughter’s piano recital.”
 
-A mom who experienced terrible postpartum anxiety and depression who was desperate for support. She sought out a therapist recommended to her by a friend. Once there, sharing her story in an uneasy fashion, with tears, and memories, and guilt, the therapist let this be an opening to share her own struggles with depression after her brother’s suicide. Suddenly "a little postpartum depression" felt minimal compared to this professional’s loss.
 
We pay professionals for a service. They should be taking care of us. When the tables turn and we are suddenly made aware of their personal lives, it can stir up feelings of empathy and sympathy. It can make us feel like we should be the caretakers now – we need to look out for this person and not bother them with our trivial matters. “I don’t want to load too much on her, because she has struggles of her own.”

But then, what are you paying that person for again?

Professionals need to leave their personal business out of their professional lives.
 
That’s not to say clients are rude or uncaring – they aren’t. And the focus still needs to be on them. What can we do when something comes up?

As a doula serving Bakersfield and Visalia, California, I strive to build families up and let them know I will be there for them, come hell or high water. I also contract personally with a back-up doula who attends prenatals with us, thus laying a foundation of support in the small chance I am unable to attend a birth (it rarely, rarely happens, and the cost of paying for a back-up’s time is absolutely worth my peace of mind). It shows a family: I am committed to you, and sometimes things come up; if that happens, here is my trusted back-up so you won’t be alone in this journey.
 
Ultimately, I believe me making my business your business is bad, overall, for business! ​