Recently I was watching The Labyrinth, that incredible movie of my early teenhood. I watched that VHS tape so much it started to warp. I know just about every line, I sing every song, and I am ALWAYS ready for it to have a different ending, even though I know that never really happens.
I was struck by the opening credits -- when the words "It's only forever," play. This one day, when we birth our babies, stays with us forever. Shouldn't we do all we can to improve our experiences so the memories bring us happiness instead of disappointment? Enter, the Labyrinth...
The basic premise: Sarah is an imaginative girl who loves to dress up and pretend play. She has to baby-sit her half-brother, Toby, and she dreams her story to be that of having a wicked stepmother and she being forced to work and have no life. Her brother begins to cry from his crib. She accidentally sends Toby off to the Goblin King, Jareth. She then has to rescue him, through the maze of a huge labyrinth, or he will be lost to her forever. Ultimately she has a few choices -- live in her pretend world forever and forget about Toby, become Jareth's queen and live happily ever after with him, or fight to get Toby back -- and of course, that's what she does.
But did I mention who Jareth is?
Um, yeah -- that's why I was always Team Jareth...but I digress.
1. This is a piece of cake!
Often labor starts out so small, we work up confidence and think, like Sarah after making a good choice, "this is a piece of cake!" That's right before she falls into a hole with nothing to stop her except a bunch of "helping hands."
While early labor is often something we can handle on our own -- occupying our minds, resting, bouncing on a ball, relaxing in a tub or shower -- as things progress, our bodies will demand more from us. Instead of worrying that this is a predictor of how hard labor may be (at some point in the future -- I call this 'catastrophysing,' and in real life, I am pretty good at it), we need to enlist support from those around us. This is where partners, doulas, midwives, mothers, nurses -- whoever is there to fill that role, come in.
Labor WILL get more intense -- that's the nature of the process. With support, we can be lifted up by those caring people on our birth team, those helping hands.
2. There can be a lot of waiting!
There is an average amount of time women will labor. For first time pregnant people that is 12ish-24ish hours. Be mindful of that when you start telling people you are in labor, people forget birth is a marathon, not a sprint. It may only be an hour of time that has passed and well-meaning friends and family can start to ask if your baby has been born yet!
Some families consider sitting with this information for a while until there is something more exciting to report. Often the invitation (or expectation) that people will wait happily in the lobby can be a lot of pressure to the laboring person! I have been at more than one birth when a guest pops into the laboring person's room, unannounced, and either there was nothing going on, or the person had to be shooed out quickly because it was pushing time or naked time or toilet time -- this doesn't have to happen to you! You can decide where your loved ones will bide their time, and it doesn't have to be at the hospital.
3. It may help to lose your head
Whether it comes as a loss of control, or a needed suspension of reality, staying in our left brain where logic and reason try to make sense of things isn't always productive in labor.
As labor progresses, we need to move to our right brain and listen to what our bodies are saying. Linear flow of time, labor math, and trying to make predictions according to what we know and what has happened all need to go by the wayside. Our team should help protect this state of mind by moving with us, going at our pace, finding another place for their fears besides our ears, and knowing how to help if we are truly lost -- like getting into take-charge mode. Labor is challenging, and we are working hard enough to keep our own heads straight -- partners and others can respect this and flex to it as long as we are feeling safe and moving forward.
4. Ultimately, birth isn't fair
We learn. We read. We immerse ourselves in information and do our best to plan for our births. But in the end, there are so many things that aren't in our control. Does this mean we shouldn't even try?
What can we really plan about birth? We'd like to think we can plan a lot -- hospital, support team, safety. But we've all seen videos of women birthing unexpectedly in their cars (as a doula I had that happen once). So what's a pregnant person to do? I'll tell you: take a comprehensive childbirth class where you'll learn your options in a nonbiased way. Understand the labor process, how to cope, and what to expect. Build your dream birth on a foundation of sound evidence-based information -- this will ensure if your Plan A becomes a Plan B, you will know exactly what your new set of choices are -- because you ALWAYS have choices. Birth, like life, may not be fair, but you can adjust the scale in your favor with knowledge and options.
5. "You have no power over me."
I recently had a conversation with a pregnant woman who shared: "I know no one can make me do anything I don't want to do. I can always say no or ask for other options. That's my right."
Not sure what your rights are? According to the American College of Obstetricians and Gynecologists (ACOG), pregnant people:
This is what ACOG is laying down that many physicians aren't picking up: no one can guarantee the outcome for you and your baby -- and because of that, the choices we make during pregnancy and birth are ultimately our own. This doesn't mean you have to be contrary out of the gate, this simply means when you have researched, thought over, pondered, prayed about a decision which may differ from that of your medical provider, no one holds more power than you.
Anne is one of my most favorite doulas in the world. I wish we still lived close to each other so we could work together. She has a different way of looking at things, which makes them more memorable and easy to understand. I thought this post was a great one to end on -- it shows how we can let go of the discomfort that might normally accompany us when it comes to being around and touching others -- as doulas, this is what we do. Enjoy, as Anne shares how she bursts her bubble.
I worked with somebody once that had a definite “bubble” of personal space. It was kinda fun to subtly test the limits of those boundaries. I finally determined, through months of occasional observation and experimentation, that the space was 3 feet. Step, even 1-inch, into that invisible 3-foot force-field, and my subject would move away to reestablish the 3-foot bubble.
I, too, have a bubble. When it comes to supporting a woman in childbirth, I temporarily deflate my bubble to support my client AND the rest of her support team. Conversely, I understand that my client may also have that bubble. So, how does that work in such a short amount of time and in such an intimate setting?
In a combination of ways. Conversation, empathy, care-taking, simply being, and sometimes, sleep deprivation.
Conversation and sleep deprivation Labor room conversations, at least the ones influenced by my quirky personality, can be hilarious. The people in that labor space learn things that –- well, let’s just say that things that happen in the labor space, stay in the labor space. Humans are social. Somebody has a story about skunks, everybody else has to share their story about skunks or some other wildlife interaction, which leads to some other topic like nudist colonies and the technicalities of furniture cleanliness in regard to naked rears. Sleep deprivation just makes it all that much more entertaining. People start shlurring theyr wors an mis..misum.... an people don hwere tings wite.
Empathy I have huge amounts of empathy. The people that have chosen, or have been chosen, to be in the labor space care about the mama in labor. We all want to make the experience easier in whatever way we can. We cheer her on, we give her water, we massage tense muscles, and tell her how beautiful she is. We acknowledge her perception of her experience and help her to see the big picture. We all get giddy when her efforts culminate in 10 glorious centimeters of openness. Pushing is the best. Everybody breathlessly tells her that is the way, just like that, good job…and we grunt and we hold our breath and we push too!
Care-taking The bubble slowly deflates with a soothing of a brow. Light massage. As labor intensifies, the bubble deflates completely. It becomes all hands on deck. Time for position change; one person holds IV lines, another person holds the blankets for privacy screen, another person changes the chux pad, another person physically helps mama roll, the person holding the IV line passes a pillow to the person helping mama roll, the person holding the privacy blanket then wipes mama’s brow with a cool washcloth, and the nurse readjusts the baby monitor-ducking under the person giving the mama a sip of water. All bubbles deflated, we are all up in one another’s business!
Simply being Probably the most important. The care team for my client become protective. We hold the space, her privacy, her concentration, her focus, her rhythm, her ritual, HER ever-evolving strategy for bringing forth her infant into this world. In the early stages of labor, a knock on the door is a welcome distraction. In the final stages, a knock on the door is met with looks of annoyance and protective aggression.
Birth is a short, intense, intimate journey. Some are “mush longer den udders.” Sleep deprivation joke, get it?!? Guffaw, snort! Emotional support begins long before labor begins. Physical intrusion into the bubble is typically a gradual process, becoming more involved as the intensity of labor calls for more support and the temporary removal of the bubble. Informational support never ends. Doulas aren’t medical experts, but we are quite familiar with the key terms to know in the chapter of life called the Journey to Parenthood.
Anne is the youngest of 6 children, which is probably why she gets along well with people. She also grew up on a dairy, which is probably why she gets along with animals. She has two daughters, and is a volunteer 4-H Community Leader. She was one of the original creators of the Chico Doula Circle, volunteered for a hospital-based doula program, and offers gratis support to expectant teen moms. Anne is currently waiting with bated breath to see if she passed the Lamaze Exam to be a Certified Lamaze Childbirth Educator. Find her at Happy Pushing or on Facebook.
Debbie called me at 8:30 am to let me know contractions had started. I joined her and her best friend Lisa at the hospital – Debbie was 2-3 centimeters. Debbie and I worked through the contractions. She would really have to focus. Lisa and I would stand on either side of the bed rubbing Debbie’s arms and shoulders, smoothing her hair, and giving her space to focus. Lisa was not quite respectful of Debbie’s need to focus and go within herself to endure, and Lisa would ask Debbie questions about unimportant things while Debbie was trying to concentrate. I kept redirecting Lisa respectfully, reminding her that Debbie needed space to focus, and could we wait until the contraction is over to get an answer? A vaginal exam at 1:15 revealed Debbie to be 100% effaced, 4-5 centimeters dilated. Debbie had AROM followed by her epidural at 2:00. The contractions spaced out to 8-10 minutes, and Debbie’s blood pressure dropped dangerously low. Debbie’s nurse, Mary, stayed with us in the room for almost 2 hours charting and watching Debbie and her monitors. Debbie’s blood pressure did eventually increase. At 4:30 pm Debbie was checked and found to be complete. She started pushing at 6:00, and baby was born via Mighty Vac at 6:52.
Debbie is a single mother and she felt a doula would help her feel supported and informed. My primary goal for Debbie’s birth was to make her feel special, strong, and empowered. I knew Debbie wanted an epidural. Debbie had a severe knee injury which happened about the time she became pregnant. That, coupled with being very overweight, greatly reduced her options for movement. I helped a lot before Debbie got the epidural with coping techniques such as counting backwards through contractions, and massaging her hands, which grew tired from gripping her bed rails. Debbie’s situation reminded me of something Penny Simkin wrote of a client who left an abusive relationship: I think Debbie did not need to feel any pain on this birth day.
Debbie reacted well to her labor! She really had to focus from about 11:45 until 2 pm. She seemed to leave for a minute and find someplace in her mind where she could cope, and once the contraction was letting up, she would slowly open her eyes and release her grip on the bedrails. When I would say, “Debbie, that was great. You have found a place and you are really doing a wonderful job focusing and relaxing,” Lisa would discredit what I was saying by replying with, “Yeah, Debbie’s thinking ‘Whatever,’” or “Debbie’s thinking, ‘Shut-up already.’” I don’t think Debbie was thinking any of those things. It really felt like I was being undermined. When I would ask Debbie the, “What was going through your mind…” question she would usually reply “I just wanted to get through it.” She never had a panicked or scared reaction. Debbie reacted very sweetly to her new baby.
I learned some good people-coping skills. Lisa is a tough kind of gal. When Debbie’s blood pressure fell, and then her legs went numb, Lisa was upset and wondered why they didn’t stop the epidural? Lisa ’s personal experiences led her to believe the numbing aspect of an epidural was abnormal (“That did not happen with my epidurals”). I tried to explain how epidurals worked, but she got very defensive. I finally said I did not know, and she should ask the doctor about it (he was also Lisa ’s doctor). I learned sometimes it is better to “not know.” I learned sometimes I need to stand away and be useless, like while the baby was being delivered and I was not by Debbie (Lisa was to her left, doc at the end, nurse at her right). After Leah's birth, I was able to help more practically. Lisa had left, and Debbie was alone. I stayed longer helping with breastfeeding and ensuring Debbie got a nice meal as well. Debbie’s father arrived about an hour later, and I was able to help him hold his granddaughter for the first time -- he swayed and shooshed her right to calmness. I learned even though a person only thanks you for bringing them dinner, that can mean a whole lot more.
When someone says, "At least I have a healthy baby," how do you interpret she feels about her experience? Birth is a transformative experience, and women can be transformed for the better, or for the worse. How can we, as doulas, help support someone who has had a traumatic experience? Abby gives excellent ideas which remain within our scopes and roles as doulas.
When you look at the probability of trauma in the course of a woman’s life, the statistics are high. One in three will experience sexual abuse in her lifetime, one in four will perceive her birth as traumatic. So, if you’re a childbirth or postpartum professional, you are regularly working with women who have experienced trauma. And keep in mind: a woman who has previous trauma or a history of abuse has a much higher chance of being triggered in birth and experiencing trauma again.
What is birth trauma? It’s all about perception. When a woman perceives her birth as traumatic, she has felt one or more of the following in an intense and damaging way:
Birth trauma will have immediate effects on a woman and change her experience of birth, postpartum and motherhood. As birth professionals, our goals are to prevent birth trauma by providing support, information and guidance for laboring Mamas. Some of the things you can do during your time together are build trust, tune in to Mom’s behaviors to establish safety in the labor room, and speak to her in a calm, affirming voice. But unfortunately, we can’t always prevent birth trauma.
Women who have experienced a traumatic birth can develop PTSD (posttraumatic stress disorder). It can be misdiagnosed as postpartum depression or anxiety but the symptoms are actually different. Some signs of PTSD in a new mother are:
There are some important things to keep in mind when dealing with a Mom who has birth trauma. Your support will be critical to establishing safety, support and eventually healing from this difficult time.
Here are some things you can do to support a Mom with trauma
The exciting and encouraging thing to hope for is what’s called post traumatic growth. With proper self-care, nutrition, sleep, and exercise she will begin to feel better. Suggest to her that some women find healing through yoga, body work, trauma therapy and groups. Post traumatic growth provides women the opportunity to heal from trauma and become stronger, wiser and more compassionate because of it. With adequate support, education and care, new Moms can fall in love with their babies and leave the shame and pain of trauma behind.
Abby Bordner’s background is in medical settings, community education and entrepreneurship. She currently has many online and in person projects for the non profit sector and her private business. She is a Cappa Doula Trainer, Labor Doula, and Lactation Educator. She is a certified ICEA Childbirth Educator, as well as an author and entrepenuer, creating such projects as Yoga Born, Birthing Tree Cooperative, Relationship Based Parenting, and Modern Motherhood. She travels around the US providing certification training for future Cappa doulas, and Yoga Born Childbirth Preparation classes – trainings for prenatal yoga instructors which integrate yoga and childbirth education.
Note: There is often the need for back-up posts for 31 Days of Doulas -- if you would like to share something you have written, contact me and we can see where you might fit.
I loved Jessica's piece immediately. Not all doula days are this packed with life, but it absolutely does happen! Many doulas are cautious about taking multiple clients with close due dates -- I know for me, the only times I have had two births in one day is when I had clients who were due weeks or even a month apart -- then inevitably one client goes early and one client goes late. That's the doula life -- unpredictability at its finest! With confidence, reliable back-up, and maybe a coffee or a sweet treat, we manage to balance the best we can.
4 am One of my clients texts that she’s been having contractions on and off for a couple of hours that keep waking her up. I ask a few questions to get more details. I try to go back to sleep.
5:00 Different client texts that she’s been having regular contractions since about 1. They’re about 10 minutes apart. We converse for a few minutes.
5:10 Toddler wakes up for her morning nurse.
5:25 I slide out from under my baby and head downstairs to check my doula bag. All I really take with me are personal care items like toothbrush and toothpaste in case of a long birth, and snacks. I top off my snacks and mill around a bit. I start texting my back-ups because obviously I can’t be two places at once. I freak out a little when I don’t hear back right away.
6:30 My daughter B wakes up and asks right away if I have a birth. She’s so astute. I text my fellow Essentials tutor and our Classical Conversations director and let them know I might need a sub for my class.
6:40 Water broke for second client! She reports contractions are little closer. I stay in regular contact with my client and her husband as I get ready and get the children ready. I tell my husband all of the things that need to happen. It seems this client’s moving pretty quickly, so I decide to head to the hospital while my clients wait for Grandma to come to their house to take care of their toddler. I hear back from my back-ups and breathe big sighs of relief. I give necessary info so I don’t have to think about my other client still having irregular birth waves during another client’s birth. I try to get the kids organized to help my husband as much as possible; they do amazingly helping each other.
7:50 I text my clients to see how they’re doing as I’m pulling into the parking garage. They are on their way.
8:05 In triage–the nurse is all business, bustles in and tells client to pee in cup and change into a gown. My client is working incredibly hard. It always amazes me how strong and beautiful women are when they feel loved and supported through their labors. Her husband was feeling a little frantic, but he is taking good care of her. She is handling her labor waves wonderfully, even as they come every few minutes. She climbs up onto the narrow bed and promptly assumes the elbows and knees position. I suspect she is ready to just get this baby out, so I ask if she wants to skip the monitoring and just get checked to see if she could get back in her room. She thinks that sounds like a solid plan and affirms with a terse “YEAH!” It’s hard for women in labor to respond to people’s questions, and it’s best to just ask questions or make statements they can answer with a nod or shake of the head. The midwife asks if she can flip over to have her cervix checked. My client does not think that sounds like a good idea. The apprentice midwife is awesome and says she would do her best to check her in this “non-traditional” position! Many care providers make the laboring mother roll over on their backs for a cervical check. Apprentice midwife concludes client is at a 7 or 8 (10 being complete and ready to push the baby out), and we could immediately move down the hall to a room.
8:20 Officially admitted. Once we get settled in the room, I start the tub in case she has time to get in the soothing warmth of the water. They still have to monitor baby for a while according to hospital regulations. I’m stroking her hair and head, saying soothing, encouraging things while her husband rubs her back. Dad suddenly realizes his car is still down in the circle drive in the front of the hospital, and thinks he should move it. I say, “No, no, stay here! I’ll run down and park it for you.” I figure the distance would be about the same so I decide to run around the hospital instead of having to walk through it, and I am literally sprinting once I get outside the building. It feels amazing to run, even though I never do it anymore and am quickly out of breath. I find them a primo spot right next to the hospital door in the parking garage, grab their bags from the trunk and hightail down the hall, back to the elevators.
8:35 Baby born. As I enter the Labor and Delivery Unit, the nurse grouches, “You missed it.” My first thought is “Oh man! Bummer!” and my second thought is “Better me than him!” But all I say is, “I never thought I’d miss a birth because I was moving their car!” I have missed it by mere seconds thanks to my sprinting, as they haven’t cut the cord or hatted the baby yet. Mama is looking more gorgeous than ever now that baby is here, and Daddy is all choked up and beaming. I love these moments! I immediately pluck up my camera and snap some photos. I’m strictly an amateur photographer, but I know my families appreciate some memories captured from those first precious moments. I hang around for a couple of hours after the birth to answer questions, give leg massages, run errands such as getting heated blankets or coffee, talk things over, help with baby’s first breastfeeding if necessary, take photos of when babe gets weighed and measured, and just be there, holding space for them, as they need.
11:00 I take my leave and head for our Classical Conversations Community, where my four older kids already are. I’d been in a bit of a time warp and can’t believe it is still morning! It is a grey, wet day which usually makes me sluggish and morose, but not today! I swing by Panera to treat myself to a scone, a breakfast sandwich and coffee. Depending on the time of day, I almost always get myself a store bought coffee after a birth. I feel like I deserve it and, just on Birth Days, I want to act like a grown-up who has a job and money, instead of a stay at home mom, who scrimps on the coffee creamer. It’s always surreal for me to go back into the regular world after just witnessing the miracle of a new life, and seeing the overwhelming love between new parents and from them to their new family member. It’s almost weird to see people just working on their laptops, just drinking their lattes, doing regular people things. I want to yell at them, “Don’t you know what I just got to do?! Don’t you know where I just WAS?! Don’t you know what just happened? A BABY WAS BORN! A new person was given LIFE today! A mama found out how strong and powerful and wonderful she is!! Don’t you KNOW?!” But I hardly ever do that. I arrive at Classical Conversations in time to see the kids do their review. I have some really amazing conversations, and a friend prays for me and some relationship struggles I’ve been having. I immediately feel the pain and heartsick hurt dissipate. It is really incredible.
12:00 pm We all eat lunch together, which is always loud and overwhelming, but I get to talk to my friends and be with my Mama Tribe.
1-3 In the afternoons, I teach an English class. We do math review in addition to English grammar and writing. My phone goes off right at the end of class. Perfect. My text tone for my doula clients is the Justin Bieber chorus “baby, baby, baby ohhh” which gets my attention, no matter the time of day, and always makes me smile. I have been in contact with my other client all day and she is contracting more regularly now, and they are feeling more intense. We decide I would take my kids home, spend some time with my wee ones, and then I would head in to her house after an hour or so. I snuggle and nurse Finnella and read a few books to Elivette. I chat with the older kids and try to squeeze in their daily quota of hugs.
4:45 I arrive at client number two’s house. We spend time chatting while she is laboring. Her husband gets their other kids ready to go and I keep her company and help as she seems to need through the labor waves. She is handling them wonderfully.
7:10 When we get to the hospital, I am completely shocked to hear her tell the nurse they were a 10+ on the pain scale because she was so completely calm and relaxed on the outside. She really wants me to keep talking during her waves, which is surprisingly awkward for me. I’m used to most women not wanting chit-chat during the contractions. Everyone is upbeat and lively for quite a while. She watches some funny YouTube videos (Zach King, if you’re wondering), and we laugh and banter. As things heat up, we discover scalp rubs really help her relax during her birth waves. We do some relaxation exercises and she says she is feeling really calm and peaceful during this part of her labor.
7:44 We are in her room. She has some delicious essential oils in her diffuser going and I am thankful because this room really smells like nursing home.
8:47 It is time to push, and she starts out on her back. After pushing there awhile I suggest a squatting position. She tries that for a while and feels it isn’t effective. She wants to be on her back. I learn that as long as the mother chooses the position, it’s a great position to be in.
9:39 Her baby comes out face down, and completely rotates to face up. This is really unusual! Baby’s shoulders get stuck, which can be dangerous because the baby can’t get oxygen while the head is out and the chest is still in the birth canal. Extracting them is a little more complicated than usual because of baby’s face up position, but the midwife acts quickly and stays calm. Her expertise and instant action save the day.
9:41 Baby born! Baby is able to be placed immediately on mom before they take her over to the warmer and check her oxygen levels. She is fine and almost right away is brought back to mom. It was scary there for long minute though! I am so happy they were able to put baby on mom right after birth.
I’ve been at a homebirth when baby wasn’t breathing right away and mom was holding baby and talking to her and rubbing her while the midwife gave oxygen and did the necessary things. I’ve also been at a hospital birth where baby was taken away immediately to give oxygen and do the necessary things. The mom had no idea what was happening, the doctor wasn’t giving any kind of updates, and it was terrifying. I wish they could always do the former as much as possible. I stayed for a few hours after the birth, taking more photos, talking and helping any way I could. This mom was still nursing her toddler and didn’t really need any assistance nursing.
Two baby girls, born almost exactly 13 hours apart. They were both third children, and one weighed over three pounds more than the other. Both mamas handled their labors gorgeously, and completely differently. Two different hospitals, two different midwives, interestingly, both with a midwifery student.
I got home around midnight and promptly went to sleep.
Jessica Holst is a farmer's wife, the mother six rambunctious blessings, and the owner of Farm Fresh Birth in Iowa. They live in a temperamental 160+ year old farm house that has had Holsts living in it since 1889. She home educate her little ones, tutors an English class in her homeschool community, and writes for the Quad City Mom's Blog.
Jessica has experienced a Cesarean birth, a hospital VBAC with epidural, an unplanned unassisted homebirth, and three midwife attended homebirths -- including a water birth. Jessica's varied birth experiences ignited a fire within her to pursue birth work, as she knows how life changing the power of birth is. She knows how crucial being appropriately and continuously supported during birth is. As a doula and a Birth Boot Camp childbirth educator, she offers support to Quad City women.
The excitement that surrounds an expectant mother starts building as soon as the good news is shared. As her burgeoning belly grows, so does the attention from others. Baby’s arrival brings relatives, friends, and neighbors…at first. But as the much-awaited birth comes and goes, so do the people. Often this can leave a new mother feeling isolated, tired, and depressed.
In some cultures, the new mother is relieved of her daily duties and attended to for up to 40 days postpartum. Special restorative foods are brought to the mother, she is taken care of by members of her family, and her sole responsibility is to bond with her new baby. In our culture, 40 days after birth typically sees the end of a mother’s maternity leave!
You can help meet a new mother’s needs simply by using your heart and your hands, and sometimes your ears. Never expect to just plop in and be entertained – always ask what you can do to help. Often mothers have reservations about letting you pitch in with cleaning or laundry. If this is the case, place a simple list numbered 1, 2, 3 on the refrigerator. Ask her to write down three things she would feel comfortable accepting help with. The next time you visit, glance at the list and get going! If she insists life is great, do something unexpected for her. Bring her a pot of homemade soup and some warm bread. Drop off a new pair of pajamas for her, or the baby, or both! Demonstrate your active listening skills by using attending body language and summarizing her shared feelings; suspend your judgment and offer suggestions only if she asks for your opinion.
I have the fortunate opportunity to nurture and support women of the Bakersfield and Visalia areas during their experiences of pregnancy and birth. I have noticed the mother who functions well, feels good, and exudes confidence early in the postpartum period is the mother who continues to be blessed with help and visits from her extended supporters. Babies bring joy, but they bring demands as well. By meeting the needs of the new mother in your life, whether she is a friend, a neighbor, or your own daughter, you are enabling her to better care for and meet the needs of her own baby.
Three things that can help after the baby comes:
Did you know, those fabulous statistics we read about regarding "continuous one-to-one emotional support provided by...a doula," don't diminish if the person in labor also happens to be a doula? That's right! Even doulas hire other doulas, because we know EVERYONE deserves a doula -- even a doula. Are you tired of the word doula yet? Because it happens to be World Doula Week, and I am pretty positive the "d" word will be prolifically used herein -- fair warning! Now, settle back and read why doulas choose to have that unique support and help only doulas bring to birth.
Other reasons are longer, and they still make a lot of sense:
"Preparing for my fifth baby I considered a doula. However, my husband has been such a great support and I found myself using all the common reasons not to have a doula. I worried it may interfere with the dynamic between me and my awesome, supportive husband. I worried about expense. I also have precipitous labors and didn't know if I'd be able to make it to the hospital, much less if my doula would make it. I spent much of my pregnancy helping my own doula clients plan their births. Yet I struggled to focus on my own. Finally I realized that I needed some help to focus and plan on my birth. Talking with my doula was invaluable. She helped calm my fears and work through trauma from a previous birth. I still didn't know if she would be able to make it in time but having her help me prepare and knowing she would be there to help me process afterwards was a big comfort. I also knew that I could use all the hands I could get for counter pressure. When my birth came, it was longer than expected. It was wonderful to have someone that knew what I meant when I asked for different counter pressures or rebozo techniques. She read my mind so I didn't have to verbalize each step. I was able to hold onto my husband while she gave counter pressure -- to hug him while still having the comfort measures. In transition I was grateful for multiple hands providing relief. I have birthed four times without a doula. I have supported countless families as a doula myself. However, having a doula for my fifth baby, I will never personally go back to not having one again. There is always a use for one. You never know what may happen or how useful a doula may be."
-Becky Hartman is a doula, photographer, and energy worker in Davis County, Utah. She just birthed her 5th baby this past week, so this is all fresh in her mind! To learn more, visit her website and go "like" her Facebook page.
Sometimes the decision seems made for you:
"I didn't actively choose to have a doula for my births -- it just happened that the universe provided them. They were just the right amount of hands-off until absolutely necessary, and then hands-off again -- which is exactly how I work. I felt so relieved I could let myself fall into the network provided for me by my community. I'm eternally grateful to these women who gifted me their work, both emotional and physical! My midwives through the years have been amazing support, as well. There's nothing I would change about my births, thanks to their skilled care."
Bryna Sampey is the creator behind the Portland-based Doula My Soul. Always about community, she and the others at Doula My Soul offer birth and postpartum doula support, breastfeeding help, classes, and more.
Seeing mom working so hard to bring their baby out? Making noises that seem more appropriate coming from a howling monkey instead of a human? Watching things that maybe one has only seen on Discovery Health Channel through half-closed eyes? The blood, sweat, and tears of it all? Does that answer your question?
Birth is an amazingly transformative event in the life of the family. As a doula and an educator, of course I relish in the whole thing and view baby's emergence as a spiritual experience unlike any other. I am comfortable with the noises of labor and the sound of hard work -- the music which accompanies this great act. Not everyone is, though, and not everyone feels sure about the birth process and the safety of their partner, the laboring person.
My husband and I have been married 21 years. On our 11th wedding anniversary we found ourselves seated across the table from each other at a Chinese food restaurant. At this point we had three of our four boys, the youngest just a year old. I decided to start the conversation.
"I want us to think about our time together, and take inventory of our relationship, our family, and our lives." My husband suddenly looked like a he walked into a pop quiz. He didn't look eager to answer my probing questions. I was joking, but this did lead to one question that had been on my mind lately: "Well, answer this for me -- did you enjoy being at our babies' births, or would you have rather waited outside until it was over?" Being a birth-lover, I knew what answer I wanted to hear -- did I have it within me to hear the other answer, too?
"Honestly, I would have liked to come in when it was all over." I did kind of know this, I don't know why I was expecting to hear that other answer. I love my husband, and to his credit, he never left me needing or wanting more during labor; coupled with my doula's support, he was my main pillar of strength. I know he appreciated my doula's way of caring for me, of anticipating my next whim, of comforting not only me, but also him.
The realization set in that labor and birth is not everyone's cup of tea.
I have seen partners, unsure in the beginning, actually put a glove on and check Mom's cervix (with the help of a wonderfully encouraging midwife). I have seen a dad be the first to touch his baby's little head as it peaked ever-so-slightly out. I have even seen a baby tumble out into a dad's strong hands. But a partner does not have to do any of that to be involved and to show his or her love for the laboring person. Hands are important, but the location of hands is not. Hands on hair, hands on forehead, hands on back -- hands on hands -- can be accomplished by a birth partner at any comfort level. Touch is the goal -- touch and loving words.
In my husband's case, he held my hands during the most intense parts of labor, and he encouraged me with his voice; sterile gloves were not needed for either.
For almost two months, I have been faithfully blogging once a week. I had the opportunity to leave my doula world here in Bakersfield and visit Scottsdale with my kids -- so I took it! I had this experience, which I knew fit right in to what parents face as they create their personal plans for birth.
A family member works at WestWorld of Scottsdale. This is a huge venue where they host horse shows, rodeos, expos, and auctions. We had been invited to the Barrett Jackson Auto Auction -- we watch this on TV every year. With four boys from 3-17, this show did not disappoint!
Our family member showed us the following video, in anticipation of our experience -- she was giddy with excitement as the boys watched with dropped jaws:
After we viewed it a few times, I had some questions for my family member.
"Did you guys know they were going to do that?"
"Did they ask your permission?"
"If they had asked your permission, would you have allowed it?"
Even though she and her whole office couldn't stop watching this video, the answers to all three questions were, "No."
No, they had no idea this was being planned.
No, permission wasn't asked.
No, it would not have been allowed.
There are some scary scenes in this, right? The car drifts past people, past doors, around Mr. Jackson's Bugatti! Things are loud, dangerous-looking, out of the norm for the venue. But the driver has the experience of drifting, and he knows his car. He has learned how the car works, how best to throw a drift, what his car can and can't do. It is obvious he has had a lot of time behind the wheel.
This fits into how we can craft our birth plans.
I recently sat with a couple as they worked to put their birth preferences together. The example they were using was mighty -- like four-pages mighty! Four-pages mighty suggests you list every little thing you might even think of doing or accessing or trying. I suggest a less-is-more approach. Include 6ish of the most important choices you want. Now all the others fall under the umbrella of, we will try them if the time arises and the situation fits, generally without getting specific prior approval, but utilizing something until someone says why we can't. Do you see the parallel now?
So you want to use a peanut ball? Bring it out when it's time -- but you don't need to take up space on your birth plan stating, "Mother will use the peanut ball we brought to optimize baby's position if Mother becomes tired or needs to stay in bed."
Do you get sick or grouchy or faint when you don't eat frequently enough? Instead of writing, "Mother has snacks available and will eat as she feels necessary in order to maintain energy for labor and birth," just pack your food and snack as you need to.
If your goal is to be active in labor, you need not put, "We wish to labor out of the bed, so we will be walking, using the shower, sitting on the ball we brought, and rocking in a chair to achieve this." You can simply show the bed isn't where you want to stay, and get up and get moving.
Ideally, talking to your doctor ahead of time to discover what specific choices your situation warrants provides leverage. What if your doctor says no to everything you want to try? Then look for evidence. For example, in November 2015 the American Society of Anesthesiologists stated, based on evidence, that "Most healthy women could benefit from a light meal in labor." If your provider isn't keen on that, ask about this ASA recommendation -- why does it not apply to you? You can do this for many of your choices -- find the evidence and ask why you don't fit the recommendation. What is often termed as "hospital policy" can be broken down into "provider preference"; ensure you are getting accurate information.
Learn your choices. Understand how your body and your baby work together towards birth. Decide how you want to shape your experience by the options you face. And go for it. If you aren't "allowed" to do something, assess the risks and the reasons, and move forward. Try something else. Keep asking questions. Stay busy and active. This is your machine and you know it best.
Remember that saying: "It's easier to ask for forgiveness than to ask for permission"?
It absolutely applies here.
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:
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.
♥ four young boys and a boy dog (offspring)