I have always loved music. I love when families incorporate music into their birth experiences. In fact, the other day I was at a postpartum visit where Mom and Grandma were asking all sorts of important questions about life with baby, and Dad interjected, seriously: "I have a question..." Long pause. "Should I be playing her country music around the clock now?" I laughed, and answered back with a question of my own, "Do you listen to country music? I wish I would have known that before I agreed to be your doula." They do listen to county music, and their baby's birth happened over the weekend of Stagecoach Festival, an important event in their lives as music lovers. As a Music Therapist and Birth Doula, Kate offers compelling reasons and creative ways to bring music to birth -- I know I can't wait to learn more.
Music is an accessible, adaptable, and valuable tool for comfort during birth because music is a whole-brain- whole body experience. A holistic resource like music can reach the many needs of a family in labor: physical, neurological, spiritual, emotional, social -- even environmental by shaping the birthing space. There are so many reasons music for birth is just.so.awesome! And the music we choose for birth can be really impactful and powerful. As leaders in health care, music therapists have demonstrated how accessible and enriching music can be for improving quality of life, rehabilitation and healing. As a doula and music therapist, I’m entrusted to bring the music to the birth environment and I use it as therapy -- a prompt for change, discovery and self-expression. To be clear, music therapy for birth comes in many forms. I use my voice, my body, and at times various instruments through live musical interactions whenever appropriate. Yet, most often during the labor and delivery stage, music enters the space as pre-recorded playlists. Music is more portable and higher quality than ever before. So every time my phone beeps or buzzes in the middle of the night, I make sure my speaker is charged, my client’s custom birth playlists are downloaded, and that I am ready to help deliver one of my favorite birth bag resources: the music.
So for the birth workers and parents out there who are considering using music as birth support, I’ll share my top three reasons why the music you choose in childbirth matters.
1. Music can support comfort and relaxation during birth to reduce pain perception, optimize hormone release and steady breathing. I was privileged to attend a birth where the mother, so calm and so peaceful, took deep, slow, controlled breaths and did not need to push her baby into this world. Instead, the power of her breathing and the rhythm of her pulsing contractions, very simply, very gently, guided her baby out. Her vocal and guttural instincts were validated through the singer and supported by her beautiful lyrical mantra. The rhythm of the music helped the mother’s body entrain and progress, to open and release her baby gently into this world. Music has been shown to support, entrain and influence many dimensions of childbirth. So if there is music out there that will support this, do you think there is music out there that might work against the birth process, making birth more painful, longer and unsteady? Most likely there is, but this will be different for every person. This is why it’s important that doulas and birthing families recognize how every song you plan to use makes the birthing team feel, move, breathe and think -- tall order and a big responsibly. It is important to know favorites and to know what music typically is not preferred. It’s also important to know the difference between just streaming any “birth” playlist, and using carefully chosen songs to purposefully impact birth.
2. Music supports ANY type of birth. Regardless of what type or style is preferred, music can be incorporated into any birth plan and pairs nicely will ALL childbirth techniques. I collaborate with couples to create the most customized and comfortable playlists for birth no matter what type of birth they have planned. Many of my tips for using music work no matter how families plan to birth; active breathing, passive hypnosis, partner supported, even planned surgical deliveries. Everyone’s birth rhythm is different. This is why the music should reflect the goals for birth and the stage of birth. Feel like movement will make a difference? You’ll need a steady rhythm or a beat. Need to sleep? Try a single instrument or vocal tone to help lull the brain to deep relaxation. Epic contractions? Why not try that romantic soundtrack for support of vocal moaning? As a music therapist, I provide guidance in making the best song choices from preferred and familiar music to shape birth playlists to suit birth plans and personalities while maximizing the therapeutic potential of the music to support birth at home, in hospitals or during cesarean sections. In fact, music in the operating room and a doula by your side can make cesarean births calmer, more memorable and family centered.
3. Music will create unforgettable bonds with baby before and at the time of birth. As a whole brain stimulus, music is a window into great realms of creativity, self-awareness and healing. I’ve witnessed families experience the importance of prenatal sound together in music, making art, moving through the stages of grief and life and love; all initiated by a song. At the moment of birth the music can become part of the baby’s and parents' permanent memory landscape, a neurological imprint if you will. A carefully chosen playlist of songs can help families revisit the memories at any time, rejoicing in the happiness or healing from difficulties that were faced in labor. Along with supporting the biological imperative of bonding after birth, music can also etch the vibrations of your family birth song in your minds and on your heart, forever. Parents are always reporting back to Creative Childbirth Concepts® that they continue to use their custom playlists as they transition into the reality of raising a baby. Together they continue to explore and use their favorite music as a resource for parenting. Parents report music was an integral part to their therapeutic prenatal preparation. Their music playlists were magical in how they connected them as a team, shaped their environment and created lifelong memories as a soundtrack to their birth. The music helped heal their past birth experiences. The music helped them anticipate their fears and anxiety and work through them by supporting imagery and reflection. The music was “theirs” and the music was therapeutic. It CHANGED their births. This is why I believe the music we choose for childbirth matters.
I believe in the power of music at the moment of birth. I believe in the power of music for supporting the prenatal experience. I believe in the power of music bonding, to process fears, to address anxieties. And I believe in you: I trust that those of you who use music, make music, and incorporate music into birth already are capable of making awesome choices and using intuition when working in the moment. I trust that those of you who are invested in learning more will seek knowledge and integrate it into the best music choices possible. But I also believe it’s important for you to know that there is a growing number of perinatal music therapists out there who are here to guide you whenever advice is needed. We really do want to help make birth better through music. Connect with me and I’ll share my favorite birthing music with you!
It’s your birth. Be Creative.™
Kate Taylor, MA, MTBC is a birth doula, board certified music therapist and owner of Creative Childbirth Concepts® in Chicago IL. Kate provides perinatal music therapy services and assists families through labor and delivery as a birth doula. Kate provides creative supervision for music therapists and mentors birth professionals around the globe. She is passionate about educating others about music for childbirth and helps empower families through music, movement and other creative arts during infertility, pregnancy, birth, even during new parenting adventures. Visit www.birthmusic.net for more information or connect on facebook with: Creative Childbirth Concepts® Music Therapy & Doula Services. In depth YouTube interviews, blog radio interviews, and audio podcasts of Kate are also available for you to learn more about her music therapy assisted childbirth practices, doula work and personal journey as a birth worker.
I was so touched when my October client wanted to share her birth story -- it was amazing to be a part of. I cannot explain how it feels that families trust me enough to accept my support as they become parents. I wrote this about Tegan's birth:
"I always wanted to say something beautiful when my babies were born, something memorable and emotional. I am not sure I ever did, lol. I think I usually said, 'I am glad that's over,' giant sigh.
Yesterday's mom was swept up -- no drugs, fast birth -- and as her baby was lying on her chest, Mama burst into tears and cried, 'I'm just so happy!!!'
You never forget these moments <3."
“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 am, 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 my doula, Stacie. I had made the decision to hire Stacie fairly early in my pregnancy, 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 Stacie, who I wanted to help me through an intervention-free hospital birth.
“Stacie, 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 Stacie and asked how long I could safely wait to go to the hospital? Stacie 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 Stacie; 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. Stacie 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 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!”
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.
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!
In my classes, I have an activity I am pretty sure I learned in my Passion For Birth training where parents are encouraged to draw their ideas for birth. Taking left-brain concepts (hospital stays and medical procedures) and using right-brain-directed activities (drawing and coloring) blends our thinking and enables us to synthesize ideas, versus analyze them. What's the difference? When you analyze something, you have a singular focus on it and it alone.
Imagine being worried about having an unneeded, unwanted, unwarned-about episiotomy. Analyzing this can lead to worrying it might happen to you, without much recourse or thought into the bigger picture of how to prepare to avoid it. Synthesizing takes many pieces of information and plugs them into a bigger picture. In the case of episiotomy, you can learn when they are medically necessary, ways to prevent them during labor (for example, avoiding getting over-hydrated) and second stage (avoiding purple pushing and being more upright), your doctor's opinion and habits, and your birth location's statistics.
Here are pictures from students in my Chico, CA classes (I currently offer Lamaze childbirth classes in Bakersfield, Visalia, Hanford, Tulare, and many places in between and beyond).
I like the labor length and time-line for being home and being at the hospital.
A collaboration by Mom and Dad. I loved what I called The Parthenon -- it actually did represent support! What a great way to draw such an intangible idea!
Very neat and organized! All we need are some boxes next to each item and this would be a great packing list!
Another picture a mom and dad drew together. See the stairs? They are scaling the wall. The rainbow on the right Dad said, "represents God's love and presence." So many great symbols!
"Ninja Birth." A dad-to-be drew this. He and his partner were on the same page of wanting a normal birth free of unneeded interventions. She was gentle and calm in her desires -- he pictured worst-case scenario, including ninjas and Chinese stars.
So of course, sometimes these pictures get silly. But when you remember the role of the partner is one of protector, it makes sense. As a group we process and interpret the images, and families share why they chose what they did and what it means to them. These pictures serve as a jumping-off point so parents can not only discuss what's important to them, but also how to achieve these goals.
And I promise, this last picture? This family had a lovely hospital waterbirth with a midwife -- and no ninjas were needed.
Just good, old-fashioned, doula praise! Sometimes it doesn't get better than that! The doulas shared here are Coleen Salazar and Avira Wenn.
In the beginning of my pregnancy, I didn't even know what a doula was. I honestly met a doula while serving on a jury. While on a break in Visalia, CA, Coleen approached me. I was reading Ina May’s Guide to Childbirth, and it peaked her interest about me. We began to talk about birth, my pregnancy, and the struggles I was having with trying to get my OB on board with the natural birth I wanted. We talked at great length, and I loved everything about her so much that I kept in contact with her.
In addition to being a doula, Coleen was also a lactation consultant at a hospital in Tulare, so she invited me to a free class she was teaching on breastfeeding. I went to the class and found out the it was part of a local birth network. From that day on, I became very involved in the birth network. I began to educate myself on natural birth, breastfeeding, and various other birth related topics. In my third trimester, I also left my OB and switched to a midwife who was totally on board with the way I wanted to birth.
Although I had learned a great deal about birth, and switched to a midwife, I still wasn't sure I really needed a doula. However, I really wanted Coleen at my birth because she was the first person, throughout my entire pregnancy, that made me feel completely confident in my decision surrounding my plan for a natural birth. When I asked her about being my doula, she told me about her friend, Avira, who was finalizing her doula certification. She needed to attend births in order to fulfill her requirements. Coleen encouraged me to be open to the idea of having two doulas.
After meeting Avira, I couldn’t say no! She had such a calming presence that proved to be amazingly beneficial during my birth. I feel very fortunate to have had two doulas by my side. Although I hired them late in my pregnancy, they still came to my house to discuss their role in my birth, nutrition, my birth plan, and further educate me on birth options I didn’t even know existed (delayed cord clamping, passing on standard but unnecessary needle pokes, etc.). I was on a tight budget, but they were committed to helping me have the birth I wanted and worked with me on payments.
Both Avira and Coleen were by my side through my entire labor. Avira literally supported me through some of my contractions and massaged my back during the most intense parts of my back labor. She knew just what to say and how to touch me. Coleen knew just how to motivate me when my contractions were tough. She encouraged me, kept me hydrated, helped me with positioning during contractions, and helped me know when I should transfer to the hospital.
Their job as doulas was to be completely in tune to my needs, and they were. I consider my doula experience completely invaluable! I really don't know what I would have done without either of them by my side. My daughter had better care due to my doulas, I had the birth I envisioned for myself, and I was able to successfully breastfeed my daughter due to Coleen’s breastfeeding expertise (still going at nearly two)!
I had amazing postpartum care as well. When I needed anything, or had questions, they were there for me. They both came to my house and stayed with me while having some issues with my daughter nursing. They helped me through some of the toughest times I’ve had. The only other person as fully devoted to me throughout my entire experience was my husband. I'm so glad I made the choice to have a doula, and I don't plan on birthing anymore babies without one. I will be forever grateful to both of them for supporting me through such an amazing time in my life.
Karen is a doula I am lucky enough to have in my own backyard of Bakersfield, CA! I am always impressed by her thoughtful and wise words. I knew she had acted as her daughter's doula, and I asked her to share that experience -- this mixture of doula and mother offers more leeway than we may have in a normal doula situation. And it sounds like this was just what Jessica needed.
It’s Sunday afternoon and I am just enjoying a lazy day, knowing that any day it will change very quickly with a phone call. My daughter is 39 weeks pregnant with her first baby. After many years of wanting a baby more than anything, she is finally going to be a mother at the age of 38! She had really wanted a home birth (all those stories of me birthing her at home had really soaked into her psyche), but she finally came to terms that, due to her financial situation, she would be birthing in a hospital. She did a lot of research, spoke to some midwives, and had found an OB who would support her dream of having an intervention-free, natural birth. The phone rang and I could immediately hear a bit of concern in her voice. “Mom, how do I know if my water broke?” She had stood up and felt warm fluid trickling down her leg. After our conversation she was convinced it was not urine, but the leaking seemed to have stopped. I suspected that she may have had a small leak of fluid from the space between the amnion and chorion. She was not experiencing any further leaking or contractions so she decided to just ignore the occurrence. I, on the other hand, saw this as a sign that things may be happening and asked her if it was OK for me to go ahead and make the 2 hour drive to her home on Monday to accompany her to her doctor’s appointment on Tuesday. She was very pleased at the idea and told me to just pack to stay until after little Reyelle came earthside.
I arrived at her house and got settled in (as much as you can settle in when you are sleeping on the sofa!). On Monday we just hung around the house and tried to organize all the cute baby stuff. Well, maybe we played with all those cute little cloth diapers a bit too much! But it was a fun day just talking and dreaming about her future. It was a very special time of mother/daughter bonding. Tuesday came around and it was time for her appointment. She decided to tell the doctor about her “leaking” on Sunday. Needless to say he was not happy that she had not called him when this happened. And, yes, even her absolutely fabulous, natural-friendly doctor, pulled the “dead baby” card (which, of course, left her in tears). He did check for the presence of amniotic fluid in the vaginal canal and did an ultrasound to check fluids and did finally say that all was fine. He did not see any signs that it was amniotic fluid (although I still suspected it may have been a small leak).
On Wednesday she and I decided to do some shopping. She was 39 weeks 5 days at this point. She had a few last minute items she needed to purchase and/or exchange and I knew that walking would do nothing but positive things for her. At 5:15 PM we were at home and relaxing after our long day of shopping. Jessica went into the restroom and suddenly hollered out “MOM! Oh my goodness, my water just broke for sure!” I went into the bathroom and found her standing next to the toilet, straddling a large and growing puddle of clear fluid on the floor. I grabbed a feminine pad and a towel and got her into the living room. I had a pack of PH test strips ready for just such an occurrence (yes, I know it is “out of scope” for a doula, but this was my daughter and I thought I could take some liberties!) and went back into the bathroom to clean up and test the fluid. It was clearly 7.5 to 8.0 on the ph scale so I knew that it was definitely her amniotic fluid this time. I reminded her that her doctor had told her to call him or go into the hospital if her water broke. He had also told her that, absent a rupture, he was fine with her laboring at home as long as she wanted, even waiting till she felt the urge to push to make the 5 minute drive the hospital. She decided that since she was not contracting at all, she was just not comfortable with moving to the hospital at this point. My advice to her was that, if SHE did not want to go in yet, then the best thing she could do was for her and her husband to try to get some rest until things picked up. She decided that that was what she wanted to do and got her hypnobirthing audio going on her phone and went to bed to rest. She said that around 6:00 PM she began to experience very mild contractions but she could completely relax and even sleep through them. I periodically went in to check on her but she seemed to be resting quite comfortable and did not want to disturb her peaceful state.
A little after 9:00 PM she called me into her room and told me that she felt it was time to go to the hospital. She had decided that she did not want the drama of waiting too long before arriving at the hospital and would rather go now and get settled before things really picked up. She got dressed and just kind of casually got her stuff ready and packed in the car. At times I was unaware that she was even having contractions, although she did sometimes have to stop walking and talking to focus on her script and relaxation. Parking and getting into the hospital proved to be an adventure. We had to enter through the ER and check in with a security guard. He offered to get her a wheel chair but she declined. I am sure he must have been wishing she would have taken him up on his offer when twice, on the way to L&D, she had to get down on all fours on the floor of the corridor during a contraction!
We arrived in L&D at 10:00 PM and were admitted to triage. Of course she got the scolding again from them about the fact that she had been leaking fluid for almost 5 hours now and was just now arriving to the hospital. They examined her and found her to be dilated to 6 cm. But now, my baby who had been handling her contractions so incredibly well, was forced to lie on the gurney in triage, on her back while they hooked her up to the monitors. She now was having a hard time coping with her contractions.
The orders from her OB were for her to have intermittent monitoring (15 minutes out of each hour), a hep lock instead of IV, minimal cervical exams, no offers of analgesia, for her to be allowed mobility to labor in any position she desired when she was not on the monitor and, lastly, for her to allowed to push and deliver in whatever position she found the most comfortable and effective (unless, of course, there was an emergency situation that negated it). The nurse in triage was an absolute angel. Even though she had to make Jessica uncomfortable with the contractions during the exam and monitoring, she spoke nothing but positivity to her about her ability to birth her baby naturally if that is what she wanted. However, the nurse actually assigned to her once she was moved to a labor room was a different story (I will refer to her as “Nurse Sour Puss”!). We had to keep reminding her of the orders. The lovely nurse from triage even came in and backed us up! They were having a difficult time keeping the monitor on the baby and kept insisting that Jessica stay in positions that were very uncomfortable for her. She managed to do as they asked and, finally, at 11:00 PM, they were able to get the monitors off.
After that, I immediately suggested Jessica get into the shower. You could tell that Nurse Sour Puss was not happy with her patient being out of bed with ruptured membranes, but I just reminded her of the doctor’s orders, and Jessica told her that she was doing it anyway. Jessica spent the next 45 minutes in the shower and was doing very well. You could tell when she was having a contraction, but she coped quite well with them. At various times she would have me running the stream of water over her belly and at other times she wanted it on her lower back. She was making very little noise, just a low moan during the contractions. I noticed a couple of times that Nurse Sour Puss would be standing at the bathroom door just observing. I got the impression that this was the first time she had had a mother use the shower as a pain management tool and actually found it fascinating (hopefully she learned something!).
At 11:45 PM she insisted that Jessica get back into the bed for more monitoring. Again, my daughter (who had been managing her contractions quite well) started struggling with control. About 11:55 she was kind of thrashing in the bed and I thought that perhaps she was wanting to try another position. I asked her, “Honey, what are you trying to do? Do you want me to help you into another position?” She kind of whimpered and said, “I don’t know what I want! I am just trying to get away from it!” I leaned down and whispered to her that it certainly sounded like transition and that those feelings were just proof that she was making good progress and would be holding little Reyelle soon! The nurse kind of looked at me as if to say “How can you possibly know that without a cervical exam?!” She did not believe that this first time mom, who had just been 6 cm less than 2 hours ago, could be close to the pushing phase.
With the very next contraction Jessica began making some grunting sounds at the peak of the contraction. I asked her “Are you pushing?” She said that she wasn’t sure. But with the very next contraction (it was now midnight) she looked at me and said “Oh yeah, I need to push!” The nurse, still being the naysayer, told her to not push, wait for a few contractions to pass, and IF she still felt like she wanted to push then she would check her for dilation. Around 12:15 AM she did a cervical exam (only her 2nd exam since arriving at the hospital at 10:00 PM) and seemed quite surprised to announce that Jessica was complete and could push. Jessica was just experimenting with a couple of positions in the bed for pushing . At 12:30 the nurse just abruptly said, “Ummm, I will be gone a few minutes, stop pushing till I get back!” and abruptly left the room. Jessica was really struggling with the whole “don’t push” thing, so I gently reminded her that this was her baby, her body, her delivery and for her to do what she felt comfortable with. When, after several contractions, the nurse had not returned, I pushed the call button and asked when her nurse would be returning. The charge nurse came in and told us that Nurse Sour Puss had gone to lunch and that she would be helping us. While I was appalled that the first nurse decided to take off for lunch without so much as informing us what she was doing, it actually turned into quite a blessing that the charge nurse took over. This woman was convinced that Jessica (who had been struggling with moving the baby down at all) could and would push this baby out. She made some suggestions on positions/techniques and finally Jessica appeared to be making progress.
I remember pushing for almost 2 hours with my own first baby, and, as a doula, had seen many mothers push for long periods so I was not really surprised when things did not progress quickly. The new nurse was very encouraging though. She cheered for the tiniest bit of progress! What none of us realized was that the slow progress was due to an asynclitic baby! Mommy ended up pushing for over 3.5 hours. During that time there were numerous times when they had trouble keeping the baby on the monitor. While this nurse was obviously concerned with monitoring the fetal heart tones, she also was equally concerned with keeping mommy as comfortable as possible. Several times Jessica would say something like, “I don’t think I can push her out!” but the nurse was always encouraging to her. This phase was where I was so happy to have my doula training and experience to rely on. It was really hard to see my daughter trying so strenuously to bring her baby down and getting so discouraged!
Finally, after over 3 hours the baby was crowning. Because of the long pushing phase and the difficulty in keeping the fetal heart tones monitored, they called in the pediatric team in case there was a problem with the baby. The room was full of various personnel who were all in their little corners, chatting casually with one another, and just waiting for the baby to arrive so they could do their job. In the midst of this the doctor arrived and observed the atmosphere (discussions were going on about what they had for dinner, where they went that past weekend…). He announced to the crowd “I want the lights dimmed and everyone to be quiet and respectful! This mom wants a natural, peaceful delivery of her daughter and we are going to give her what she wants!” You could have heard a pin drop in the room! The lights were dimmed, the doctor asked for some warm oil and he started massaging the perineum. With the very next push Jessica made tremendous progress and within 3 pushes the baby’s head was out. It was at that point, upon seeing her lopsided cone head, that it became clear that her asynclitic presentation was probably the cause of her slow descent. With the next contraction the doctor instructed mom to reach down and grab her baby. Jessica was literally shaking with exhaustion and said “I can’t, I am afraid I will drop her!” The doctor assured her that he would NOT let that happen and to just grab her baby.
There could never be enough words to express the swelling in my heart when I watched my exhausted daughter reach down and pull her daughter out of her body and up to her chest! I had a new level of respect for my daughter! The pediatric team was quickly dispatched out of the room as it was immediately obvious that the baby was doing great. All she needed was a little skin to skin time with mom. Thankfully, this was at a hospital that has already obtained the “Baby Friendly” certification so they were not trying to hasten the separation of mommy and baby.
At this point I was able to kind of take a back seat and just observe the new mommy and daddy reveling in their new roles. Baby stayed on mommy’s chest while the doctor waited patiently for the cord to stop pulsing. It was quite something to observe. This long awaited baby was here and being loved on by her new parents. I could not help but think back to the births of my own children 40, 38 and 33 years ago. So much has changed since then, but so much is still the same. My daughter had managed to achieve a hospital birth that was very close to the home birth that I had experienced at her own birth 38 years prior. In my job as a doula, I know that the birth of the baby usually signals the beginning of the end of my relationship with this new family. This was so different. I knew that this was just the beginning of a lifetime of love that I would be able to shower on this baby and her parents!
PS: Some of you may question the fact that I do not mention dad much during the labor and delivery. Let me assure you that dad was very much there and involved in the process. This family has a unique circumstance where daddy has some severe disabilities in his legs due to burns he suffered many years ago. He is very limited on the amount of standing he is able to do. So, while dad was there and contributed very much to the emotional support of his wife, I was the one who provided most of the physical support to my daughter during her labor and the birth of her baby.
Karen is a mother, grandmother, and doula. She had a home birth in 1975 with a chiropractor attending. Karen is a Christian who doesn't think God made any mistakes with the way He designed women's bodies. Ever the caretaker, she has an adult, adopted developmentally-disabled brother who she helps care for. Karen loves to sew and cook, but she hates to clean up after both! Reyelle is her 5th grandchild. Find her on Facebook to learn more about her doula services.
I have doula clients right now I LOVE. This is the first official birth I have taken since Ezra was born and we moved away from Chico. They are an awesome couple, and I can't wait for their birth! At our first meeting, the mom shared her birthplan with me. While she knew the importance of advocating and working to make decision that would shape her experience, she wasn't sure how to best format her birthplan. To get the ball rolling, she formatted her plan after a template a relative used.
While I love birthplans as it gets mom and partner talking and on the same page, there are lots of things I don't like about them -- the biggest one being, when they are offered up like a terrorist's list of demands to hospital staff (I am sure I have Teri Shilling or Connie Sultana to attribute that to). Looking for a more engaging, palatable way to offer one's wishes for birth is something I whole-heartedly agree with. Along those lines, I came with a few examples of birthplans for this couple to contemplate.
I have to admit, I found this picture-birthplan in a doula group online, and I am still working on citing that doula to give her credit -- once I have it, I will post it here. My client borrowed this template to use for her birthplan, and she shared it with me last night. See, I am there, as is our back-up doula, who has also been invited to the birth...we both have bags, although my back-up's bag is lost in her mane of gorgeous hair!
Now, which birthplan is more appealing to you? Which one says, "I am a Type-A personality, trying to control every aspect of birth?" Which one says, "I am fun and flexible!" Which one invites help and support? Which one might contribute to defensive or negative feelings?
Most of us know we can't control everything about birth -- and we do know our choices shape our memories -- even when things don't go exactly as we imagined. When crafting your plans for birth, get creative, be different, and don't be afraid to show your personality!
♥ four young boys and a boy dog (offspring)