There is such emphasis on what to bring to the hospital -- you can find a hundred lists on Pinterest and other places. While we try to anticipate what a laboring person will need, inevitably, something may be forgotten. Here's a handy list of things you may already have access to simply because you are in the hospital.
Every doula learns her own tricks according to the laboring person's needs, the hospital's set up, and the nurses' suggestions. It's always a good idea to ask before you go searching in drawers and cupboards. But I have found, if you have a need or an idea, the staff is supportive of out-of-the-box ways to comfort someone in labor. What has worked for you?
I was at a birth as a doula in Bakersfield, CA recently where the couple's nurse was wearing a mask. I didn't think anything of it. Soon I realized the parents were worried, because you know, people in masks cannot be trusted (reference, anyone?).
Many hospitals require their employees to get yearly flu shots. Even as a childbirth educator and health worker formerly employed by a hospital-based midwifery clinic in Chico, CA I was meant to get the vaccine -- it was all ready for me in our on-site medical refrigerator. But like many, I chose to decline it.
What does it mean if you decline the flu shot? The Center for Disease Control has this to say about health workers and vaccinations:
"CDC conducts science-based investigations, research, and public health surveillance both nationally and internationally. CDC adopts recommendations that are made by the Advisory Committee for Immunization Practices. These recommendations may be considered by state and other Federal agencies when making or enforcing laws. CDC also has infection control recommendations for health care settings. However, CDC does not issue any requirements or mandates for state agencies, health systems, or health care workers regarding infection control practices, including influenza vaccination or the use of masks. However, some employers require certain immunizations. Hospitals, for example, may require some staff to get the flu vaccine or hepatitis B vaccine or take other precautions such as the use of masks."
(This link also had some very non-helpful links for further information.)
Enter the mask!
When I noticed my clients were looking at their nurse's mask with trepidation, I explained many hospitals require employees who decline the flu vaccination to wear a mask during flu season. The mother looked relieved as she shared, "I just thought she was sick and still working." That's a pretty scary thought when you are about to have a baby!
I then engaged the nurse in our conversation, so she could confirm or clarify what I had said to these parents. She let us know she had a bad reaction to the flu shot once, and ever since, she declines it and opts to wear the mask instead.
I have a good friend, Jessica, who works in a hospital and also chooses, every year, to wear the mask. As a mother who has a vaccine-injured family member, her reason is different: "I always tell people that I feel safer with a mask on my face than a shot in my arm. I feel better protected. The flu is not the only nasty thing that goes around this time of year, and when the CDC only promises 18-30% effectiveness for this year's flu shot, I'm 100% protected with a mask on my face."
The next time you see someone in the health field sporting a mask, don't worry -- they likely aren't sick! They may have just decided the flu vaccination is not a health risk they are willing to take, and this is their way of still serving you safely.
(I know Jessica would appreciate if I linked to the website for Vaxxed: From Cover-up to Catastrophe. Her mask stickers actually mention the movie, but the text wasn't coming out clearly in the picture, so I changed the words to better fit this post.)
Amy is a fellow doula and friend from my Chico days. When I learned about the plight of refugee families, I, like many others, watched and read until my heart hurt and my head couldn't handle the helplessness I felt. Carry the Future came from mother Cristal Logothetis' idea to provide donated baby carriers to fleeing families. Genius! If I had to grab my family and leave my home, on foot, amidst thousands of people doing the same, carrying and keeping my baby safe would be my highest priority. A baby carrier would serve the crucial roles of keeping my hands free and keeping my baby near. I can't go to Greece myself, I can't be there. I am grateful for people like Amy, who can help make a difference in such a simple way, for this very complicated problem.
When did you train as a doula? Six years ago I became a doula. I have always been fascinated with birth. I witnessed my first baby born at age 12. For years, my work centered around supporting women becoming mothers, and also their new babies. Becoming a doula seemed a likely next step.
Did your own experiences of birth and being a mother factor into wanting to be a doula? Yes, I had amazing "birth plans," and used midwives, and my mother and sister -- I relied so much on their support. When everything about my plans went out the window with my first birth, I understood the power of that extra support person to speak to me, to help me navigate my options.
What is it you like about doula work? Witnessing the birth of the mother...her power. With each birth, I am always humbled to my core to be there as a supporter, to have been asked to help in this intimate, sacred space. The first gaze of mother to child is the most precious of moments for me.
How did you hear about Carry the Future? Carry the Future came to me through a text from an amazing mentor, Debbie Pierce. She casually asked if I thought helping fit refugee mothers with baby carriers was a possibility for me. When I answered that it sounded like a life goal, I quickly was put in touch with a group of mothers in a non-stop Facebook chat that was inspired by a woman's Indiegogo campaign to collect carriers. Two months later, I was traveling to Greece with nine strangers, who have changed my life.
We hear about human tragedy a lot, and wish we could help -- what motivated you to actually take the steps to travel to Greece? My children are a little older now, but I also have been practicing saying "Yes" more, and almost without too much thought, I committed, and it felt like something bloomed in my heart...it was right, and I have never been the same since.
How did you feel when you finally saw for yourself the situations these families faced? The refugee families were MY family! I was these mothers. I felt the fierce protection they had for their precious children. I saw the men holding their families tight, offering support to their wives, and often being the person to carry the babies on their chests. I was so taken by the grace of the families as they arrived, coming through the shock and unspeakable loss many (most) had endured. I was able to see how they could teach us, in solidarity, how connected we all are -- how the same we all are.
How safe is it for volunteers like you? I have never felt in danger on my trips. I have been to Athens two times, and Lesvos once. We would arrive sometimes at 4 am and stay until past midnight. There are eyes on everyone, caring for and keeping everyone safe. The situation has become slightly more volatile with the terrible EU deal with Turkey and the boarders closing. There is desperation, but I am returning June 3 to do the work, sit with these mothers, share and hold space like some do for each other. [A true doula's heart~SB]
Can you describe a typical day? As a group, we created jobs for ourselves, like a mama bear to make sure everyone was eating and crying and laughing enough, ferry trackers to watch the ships come in on a boat, watch apps on the phones, and photographers and journal writers to record this work. We would be up most days around 4 am, shovel a protein bar or an apple in, and taxi to the ports. The ferries carry 1000-2500 refugees at a time, and some days, we received 6 boats. These are the large boats bringing all the people from the islands after they made it from being smuggled overnight from Turkey. We would maybe take a nap at the cafe or back at our apartment if there was time between arriving boats, or travel to the short term camps to distribute aid and carriers, or even just sweep the floors. We spend time in the warehouses collecting specific needs for the camps we are going to that day, and organizing if there is a ferry strike. Many late nights, we would gather to decompress, cry it out, and share a plate of pita or Greek salads. The next day would often start 5 hours later. I have never been so glad to be so tired. It was like having a newborn child, you just "do it" and love hard.
I have always been impressed by your mother's kind and gentle, generous nature. How has she shaped your desire to help others? My mother's kindness and amazing compassion has absolutely created the desire in me to help others. I saw her always welcoming a new neighbor with dinner, or helping to feed or clean for a new mother. I have always believed we are all neighbors and connected, because of my mother's nature. She inspires me every day to be more giving and gentle, even with myself.
How many times have you been to Greece now? Are you planning to go back? What is required in planning a trip? I leave June 3rd for my 4th trip (I did a back-to-back trip in February from Lesvos, and then met and led a team in Athens six days later -- my first trip was in November last year). Buying a ticket is the first step. Everything for my personal needs has to fit in a carry-on. Each team member meets up at a distribution center (we now have three across the country) and picks up about 400 pounds of carriers to travel with. What is needed? A valid passport (not expiring within 30 days), an "anything-could-happen" team player attitude, and a desire to show love are all the requirements you need. Most of our trips are planned the same way until a situation changes, then we must be fluid and rearrange locations and accommodations -- the love and dedication stay the same.
This next trip will be more solo, and I will be working in the camps and directly with a female-friendly space for breastfeeding support, re-establishing lactation, and a place for mothers to bond with each other as they will likely be in camps in Greece for what may be a long time. I will continue to do this work, and I will return until I am no longer needed -- in Solidarity.
Sometimes I feel like we don't hear enough about the benefits of being active and laboring/birthing in upright positions. Babies have to navigate the pelvis in a series of necessary movements. When Mom is sitting in bed, a baby must do this all on his own; if she is moving around -- sqautting, walking, climbing stairs, rocking on a birth ball, changing her positions from being active, to resting, her baby has more help to get into optimal positions. This is a true partnership between Mom and Baby -- she helps her baby in the race to meet the outside world. And as Bernie points out, this makes things better for birth.
You have just grown a tiny person,
You are Wonder Woman,
Stand up and be proud!
OK, so you may or may not feel like adopting the Wonder Woman stance for your entire labour and birth, but here are 7 great benefits to being upright during labour:
1. Do You Know the 3 Cs? Feeling Calm, Confident and in Control!
2. Shorter labours!
3. Less chance of Distress to your Baby!
4. More Comfortable Labour!
5. More Room for Baby!
6. Decrease Chance of Assisted Delivery by 23%!
7. Decrease Chance of Episiotomy by 21%!
Whole, Healthy and Intact - Avoiding Perineal Trauma, by Tracy Donegan
What is the Evidence for Pushing Positions?
2012 Cochrane review, Gupta et al., de Jonge and Lagro-Jansenn 2004; Green and Baston 2003; Green et al. 1990. Lawrence et al 2013
Bernie Burke is a GentleBirth Instructor and DONA trained Birth Doula, with a background in Holisitic therapies. Bernie found GentleBirth during her second pregnancy and fell in love with the program, it transformed how she felt about birth. She is passionate about all things birth and she has seen first-hand the positive change in her clients and their partners while using the program.
Bernie believes that when women and their partners feel empowered to make decisions about their birth, no matter what path it takes, they step into parenthood feeling confident and secure. Bernie is looking forward to assisting families as a Doula in 2016.
Supreme love and thanks to my friend Christine for allowing me to share her amazing pictures. She deserves to be a meme <3. Stacie
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.
Every birth is its own adventure -- but this one really had my heart racing! From giving birth in a foreign country, to asking strangers for a ride to the hospital -- even the humorous spirit the dad brings to the whole thing -- this birth adventure is inspiring and fun to read. Thanks to Amanda and Charlotte for sharing this with us.
Sariah knocked on my door at 12:10 am and said “It’s baby time!!” Her face was so hyped up. I was immediately thankful that I was feeling better. “Ok,” I said, “I’ll be right up.”
I went into the bathroom and got my ziplock bag of a mini-version of my doula kit. I had good feelings all along that it was going to be a fast birth so I didn’t feel like I had to bring very much. I went upstairs to their apartment. Charlotte greeted me with a big grin. She said “I’m having lots of contractions and I can’t talk through them.” We were all excited.
She phoned the doctor, as she was standing on the second step. She began having a contraction so she handed the phone to me. I heard a beep and I wasn’t sure if it was an answering machine so I just started talking.
“Hi, this is Amanda, Charlotte's doula. Charlotte is in labour and we are going to head to the hospital.” Then I heard a very groggy voice say “Ok, Charlotte…. right…. ok how long until you are at the hospital?”
“45 minutes,” I said.
“Ok, I’ll meet you there.”
We phoned Oscar, our taxi driver who was going to be on call for her birth. Charlotte had a few more contractions and then Oscar knocked on the door. Eric grabbed the bags and we were headed upstairs.
As we were gathering our stuff, Cora woke up. She hadn’t woken up in the night for over a year, Eric told me later. She woke up, sat up in bed and said “Baby sister is moving.” Charlotte went over to her and said “Yes, baby sister is coming.” Cora said, “Um, yes. I’d like some milk.” Sariah and Charlotte laughed. “Yes, Cora. You can have some milk.”
We went upstairs and got in the cab. Charlotte was on her hands and knees in the back seat of this huge van that Oscar brought. We all got in and Oscar tried his first attempt at the very steep driveway. The tires squealed in protest. He reversed and tried again.
Oscar’s friend who was with him hopped out. Then Eric got out too and they were trying to figure out how to get the van out of the steep driveway. Charlotte was getting anxious as she didn’t want the van to roll back and squish Eric. She was yelling at him a bit from inside the van. Then they reversed and tried going up the other side of the driveway. (The driveway was a circle.) No luck on the other side either and then Charlotte said, “Oh, my water just broke!”
I yelled at Eric that Charlotte’s water broke. It was clear the van was not getting out and the bumping and jostling was really hard on Charlotte as she barely had any time between contractions.
Finally she turned and yelled at Eric out the window, “We need to get out of here!” He said “Ok babes, I got this! I will get us out of here!”
By this time the taxi drivers were talking to this other woman at the top of the driveway. Eric walked up to her and asked “Can we get a ride to Puerto Vallarta please! My wife is in labour and her water just broke.”
The lady said “Of course. Jump in!”
The lady, who introduced herself as Georgina, and her English husband Danny owned the smallest car in existence. And in the backseat was a carseat. Georgina wedged herself into the carseat. Charlotte was in the front seat on hands and knees. I was in the middle, leaning forward, rubbing Charlotte’s shoulders and whispering encouragement into her ear. Eric was beside me in the backseat.
Danny was an excellent driver. Between he and Georgina, they knew every bump and pothole along the way. He was careful and he was very fast. Charlotte worked on keeping her moaning low pitched to allow her cervix to Open Open Open. I would count on her ear when the contractions came, to give her something to focus on. We would come up to a red light and Georgina would look and say “Ok, Danny. Just skip in. We have to keep moving!”
Outside of Bucerius, there was a police car going the same direction as us, we pulled up beside it and Georgina, sitting in the child’s car seat, yelled out the window to them, asking for a police escort.
They pulled ahead of us, lights and sirens going, and we went very very fast behind the cruiser. He pulled off as we got to Nuevo Vallarta, and waved us onward. Charlotte was doing so well through all this stress. The contractions were strong and very frequent. She concentrated on her noises and said “Open open open.” Her ability to remain as calm as she did through all this uncertainty and near-disaster impressed me to no end.
The epidural was in place and Dra Laura said “I have to move the baby’s head just slightly. I am going to stick my hand up and when I tell you to, I want you to push just a little and I can tip the baby’s head.”
Dra Laura did just that and Charlotte looked at me with wide eyes and said “I can feel the baby coming down the birth canal.”
They decided it was time to move Charlotte to the delivery room. They told Eric and I to go put our stuff in her postpartum room and then come down and get in our scrubs. He and I got into the elevator with all our stuff and were just told a room number. The doors shut as we saw Charlotte wheeled down the hall and Eric looks at me and says “And this is when we steal your baby!” And I laughed. But we both felt a bit uneasy.
We dumped the bags and headed back down. The hospital was entirely empty so we weren’t sure where to go. We saw someone and asked. They gave us scrubs and we were changing and trying to figure out a one-size-fits-a-mammoth scrubs. Eric’s head bandana looked like a nun’s hat until he tied it. Then he tilted it to the side, real gangsta’ style.
We got in the delivery room, as Charlotte’s baby was starting to crown. She said “The baby will be here any minute!”
Within 10 minutes, the baby’s head was clearly going to come out. In between contractions, Eric started telling me a pirate joke, which I honestly can’t remember a word of. Then suddenly, out came the baby! They cut Lyra’s umbilical cord and lay her on Charlotte’s belly. Charlotte cried and said “Hello, welcome baby!” Eric too was making joyful exclamations of being a dad again.
They took Lyra to the warmer, and checked her out. The pediatrician suctioned out her nose and she put her hands up to fight him. She was immediately alert and looking around. Charlotte quickly delivered the placenta so that no one but the doctor even noticed.
The staff put Lyra in an incubator and took her to the nursery with Eric following closely behind. He was clear and confident in his role of dad. I mean, he’s done this all before!
Charlotte and I stayed in a corner of a hall for more than an hour while we waited for the effects of the epidural to wear off a little. Then after a few times asking the nurse, they moved her upstairs to her room. Soon they gave her baby Lyra and Lyra latched on immediately.
Mom and baby safe and happy. After such an adventurous and fast labour, they were home from hospital that very afternoon.
It was such a privilege to be a part of a whirlwind Mexican birth experience. Charlotte, I am extremely proud of you at what you accomplished. Eric, you were a fantastic and assertive father in exactly the role you needed to play. You together make a great team and I am nothing but grateful to be included in such a momentous day.
Amanda Seguin CD(DONA) LCCE, gave birth to her baby December 2010. She had doula support and loved what that brought to the birth. This experience led Amanda to pursue becoming a doula herself in 2011 -- Amanda has completely enjoyed the journey, also becoming a certified childbirth educator. Every birth is unique, and Amanda learns something every time. She has a special passion for helping families who face parenting a baby with compromised health, as she has navigated this potentially confusing and unfamiliar medical world when her daughter was born with a congenital heart defect, requiring multiple surgeries. Amanda lives on the West Coast of Canada, and serves families in the Victoria/Sidney/Gulf Islands area. To learn more about her, visit her website.
Melissa is another fabulous doula in the Modesto Doula Group. She brings up some great points about doula work, including potential awkwardness when the mom you are supporting is older than you are, and the many reasons why doulas burn out.
I am currently 24. I started "Doula-ing" when I was 21, right after the birth of my first child. I had always been fascinated with the biological mysteries that surrounded birth. It was always my most anticipated subject in science. I was a birth junky from the start and I didn’t even know it. I first started out like most young doulas, volunteering free services just for a chance at some experience. I attended the birth of a friend; other than that though, business was fairly dry for me in the beginning. It was slightly discouraging as I was so eager, but at the same time I had a 6 week premature infant to care for so I wasn't exactly striving to be extremely busy with births.
I got the opportunity about 6 months after my first DONA training and birth to come and sit in the Bradley class I had taken while pregnant, by my old teacher. It was potential for a birth and I felt fairly confident. I was hired by two couples in the class, both women about 6-7 years older than myself. I felt the twinge of hesitation from the both of them when I told them my age. I wasn't surprised. Standing at 5'2 and only about 114 lbs soaking wet, I looked more like 16. The teacher assured them of my skill set, and I was officially on call.
When I was called into the first birth I was slightly nervous, not knowing if I was going to have to work harder to gain trust from someone older than me. I was taught to "Mother the Mother." How do you "mother" someone older than you without sounding slightly patronizing? All in all it worked out fantastically and we found our footing together. When I really think back through the births I have been hired for, I have noticed that almost all the women I have served were older by quite a few years, and it makes me wonder if the younger doula's out there question age gap between themselves and their clients.
I did a very informal, and simple, one-question survey (thank you, Facebook): "How old were you when you started Doula-ing"? Out of 100 answers that I got, I averaged it out to the age of 27. The number seemed fairly accurate to me since by this age most people have had a childbirth experience (whether personal or a family member) that has led them to the path of birth work. But when I started to dig deeper, I started realizing how high the burnout rate of birth support professionals really is.
Most women who train to be a doula only average 2 years in the field. The worst part about this is that I am not the least bit surprised. The idea of birth work is largely romanticized in my opinion. It's easy to think of being with birthing families and babies during one of the most important and transformative times of their lives, and look right over the not-so-nice things, like the long hours -- and I'm not talking 2-hours overtime type hours. I'm talking about the births that last 22-57 hours from start to finish.
The exhaustion after long births is felt on a cellular level. Emotionally you are too tired to care about anything but the next step you are taking, and physically, well let's just put it this way, along with your arms being sore from the double hip squeeze that you did for 17 hours, and your legs being sore from standing and supporting another human for that long, even your teeth and your hair hurt. But it's even more than that, it's the expectations of an ideal birth that fall just a bit short for whatever reason. It's the looks from resentful hospital staff. It's watching a family's entire world fall apart in front of them. This is what I think causes a large number of doula burn-out -- we are not prepared to handle the true exhaustion of body and spirit. I don't want to take away that magic of birth work, because I wouldn't trade this job for anything, but it's anything but easy. And when you start out in this field without anyone to help guide you, it can be impossible to continue going without feeling disheartened along the way.
I have been extremely fortunate -- I was taken in by a fantastically wonderful circle of experienced doulas and together we created a (totally kick-ass) Doula Group. Being the youngest in the group, it’s a bit different for me sometimes, in the sense that my birth approach is different. I learned after those first initial births that instead of "Mothering the Mother" I "Sister the Mother." I try hard to get on a sister/friend level -- someone that is along for the ride with them no matter how many bumps there are in the road. More peer, less authority. I have been told on more than one occasion that I am an assuring presence in birth because, "seeing someone so young and knowing that you have done and accomplished what I am trying to accomplish is comforting." I have gotten out of the nervous mindset of working with a clientele that is older than I, because it doesn't help anything.I go in confident in not only myself, but also the laboring mama and the process of birth, and this is what helps.
I have come to realize that there are definitely some up-sides to being on the young end of the doula age-spectrum, at least for me. Before getting pregnant with baby number two, I was actively training for my black belt in Kung Fu. To say that I have the physical stamina for this job is an understatement! Not only that, but I love the physical demand of birth work. If I don't feel sore after a birth I wonder if I didn't do enough.
Another thing that was brought to my attention by my favorite midwife in conversation about this particular topic of age was: "The earlier you start, the more years of service we can get out of you, and the longer period of time you can commit to the long-term vision of radically changing our maternity care system. There is no end to the benefit of young women going to births. Of course all women at whatever age they start get my vote and I'm excited about it, but I look at young women like, great! So we can get close to 50 years out of you!" And its true! The younger doulas start, the more of a difference they can make. The more experience they can gain. The more knowledge they can spread.
The fact is that no matter what your age, if you are a dedicated doula, you will find a way to practice that works for you and your mamas. You're always the right age to help provide evidence-based care and support.
Melissa is Birth Doula certified through Still Birth Day. She is one of the doulas in the Modesto Doula Group. She is an experienced Bradley Childbirth practitioner and assistant instructor. Melissa has a background in Child Development, Education and Psychology, and an interest in special-needs and high-needs children. Melissa brings to her clients her personal experience and expertise with premature labor and birth, the challenges of parenting in the NICU, and breastfeeding a premature baby. She has excellent skills in communication and listening, massage, visualization and meditation practices to help during pregnancy, birth, and the postpartum period.
When I initially read this story, I was struck by the challenges Katrina faced while pregnant -- a reminder that there are many health issues that can make pregnancy more difficult than normal, whatever normal means! I also loved how her doula set things up for Katrina to not only ease Katrina's adjustment to the hospital, but to also ease her mind. Katrina makes unique, comfortable gowns for moms to labor and birth in -- so when you are done reading her story, go check out her website!
I think it is important to tell you the story of how baby Graeme (pronounced grey – UHM) came Earthside because the more we hear about birth the less we fear birth and that is a catalyst for the continuing change towards mother centered birth. This is his birth story.
My mother had lived with us for several months before Graeme made his entrance. This was because I have Rheumatoid Autoimmune Arthritis or as it is now called Rheumatoid Autoimmune Disease (it does NOT have me. :)) and it was actively flaring during pregnancy. I was unable to keep up with the demands of a household and our high-spirited toddler. This made for a unique environment with both good and bad points. By the end I believe we had become weary of the dynamic so you could feel the sizzle of anticipation in the air both from waiting for the baby, waiting for my disease levels to subside, and waiting for the end of our situation. I was told during pregnancy that having another child would be a very bad idea because of the many mounting health problems so having mourned that and come to terms with that I was very very ready to be done. When you come to terms with something, accept it, and move on and you have to wait several months for the moving on to come to an end it gets tedious. You are just waiting and pulling forward one day at a time to see a goal. It’s like closing the chapter to a book but you are watching the two covers come together in slow motion and it catches your breath. Ready to be done.
I had followed the pattern like my daughter’s labor I had labored off and on for 2 weeks. Real bouts of labor followed by several days of nothing. I thought this was Braxton Hicks, but my doctor once again told me otherwise. Graeme was born on a Monday morning. The Thursday before I had my last prenatal appointment and my doctor who has practiced over 30 years said “You are a 7 and you are 78% effaced. See you at the birth center this weekend or Monday.” Having seen it all he is never wrong. He told me with my daughter “see you in the next day or two” and she was born the next day. Yes he sent me home. He is one of the few doctors out there who trust the natural birth process completely. Trusts a mother’s body to do what it is intended to do. He only intervenes when it is absolutely necessary. I am fortunate to have had him as my doctor for the births of my children.
On February 10th, 2014 at 3:35 am I went to the bathroom. I felt a ton of pressure and was unable to go to the bathroom. This felt different to me. I had felt pressure sitting down for weeks but it became clear to me that this was different. I literally could not contract the muscles to go to the bathroom. This was a lot of pushing down. It didn’t feel like contractions to me but I felt “opening” and so I continued to sit as the half squat was helping that action . I was 39 weeks 4 days pregnant so I wasn’t sure if this was “it” or not. Then I began to feel the pressure come and go. This hadn’t happened this intense before. I started timing these “pressure “waves”. Before I could even get the timing app started I felt my body lurch forward. Labor is like that. You feel yourself being pulled and pushed down from inside. It is a powerful, earthy, painful and at once strange feeling. I texted my husband and said “Hey I’m stuck on the toilet in labor. Finding pants now.” He said “Ok. Waking Nana. FYI Blowing snow”. It was blowing snow across the highway and there was an advisory to avoid travel if possible. I feel very fortunate that we had my Mom living with us and we could just go, no having to wait or anything. We would ordinarily stay home until later stages of labor but my contractions STARTED at 3 minutes apart and we didn’t want to end up on the evening news as that couple who gave birth on the side of the road in blowing snow. (Congrats to those who do. You have bigger balls than I do.)
3:40 am Got in the car. Contractions 2 1/2 minutes apart. Cascading one on top of each other. Couldn’t breathe. I texted our doula/longtime friend that I was “going to the hospital now” and off we went.
White knuckle driving in the dark on an icy highway with no lines, high wind, and snow.
Growl at husband “No” when he attempts to put music on. Growl at him “No” when he attempts to turn it off. Poor fella couldn’t win. Yell at him “IF YOU COULD ATTEMPT TO NOT HIT POTHOLES THAT WOULD BE GREAT! THANKS!!!” with my eyes shut breathing through the wham wham wham of hard fast labor. Didn’t realize that we were two blocks from the hospital when he hit the pothole and this car trip was almost over. Laboring in the car sucks butt. I don’t recommend it at all.
4:10 am. Arrive at hospital. Nurse Stacey comes out. She is pretty great, she recognized me because she had talked to my doula. Nothing like being recognized to bring the walls down. My amazing doula had pre-arranged many of the nurses and people who were a part of our team. One was a homebirth midwife in another state, my post birth nurse who cared for us was a doula for many years and was wonderful. RN Stacey has many children herself. I had a 180 degree experience from last time. I am a sexual assault survivor so this was all pre-arranged to preserve my mental health and command the respect my body needed to do what it needed to do without the anxiety. This time no one asks me to do intake paperwork. My contractions are still 2 1/2 minutes apart. I am trying to keep cool through the pain. Fast labor is no picnic. It is like taking the entirety of regular long labor and smashing it into a few hours. Intense, overwhelming, terrifying and at times makes you doubt yourself and your ability to do it.
We get into the room and I had to sit on the bed because we needed to get antibiotics in. I don’t want to but I have to. I tested positive for Group B Strep during pregnancy and despite measures to get rid of it at home we didn’t succeed.
They get a line in and get antibiotics going. They try to get a heart beat on baby. This time manually. I am not strapped to the machine thank goodness.
Doula Lindsay arrives around 4:30am
They want me to stand to get a heartbeat on the baby. Husband steps out to get water. My doctor has arrived and he is sitting with his feet up on the front desk chatting up the nurses. Typical for him. He’s a character.
I HATED standing. I had to rest my head on my doula’s chest to get through it. I kept moaning/half-crying “Get me in the water. I want the water now.” “I can’t do this without the water.” Water reduces pain levels greatly and it is SO MUCH EASIER to labor in water. 110% easier. A nurse is running the water while we try to get a heartbeat. In fast labors sometimes the baby gets squeezed so much, so hard that the heartbeat isn’t consistent at all. Fast labors are hard on mom and hard on babies; they aren’t completely “normal”.
About 5 am Graeme finally cooperates and I can get in the water. Thank the Lord! At this point I was in so much pain that I didn’t even realize my husband still wasn’t there. I was so hyperfocused breathing through the pain. Contractions are on top of each other. I can hardly breathe. My doula says “breathe.” I breathe in.
As I sit in the hot water I lean back. Worst idea ever. I almost throw up it hurts so bad. I lean forward into almost a squat. Doula pours hot water on my stomach. It doesn’t help much. These contractions are so much more painful than with my daughter. My husband comes back. I cry “I can’t do this. I need pain medication” My doula says “you are doing this. You can do this.” I didn’t know that I was so close to having the baby. This was transition. I wish someone had told me, in retrospect, because I know the stages of labor. I thought this level of pain was going to go on for hours and I started crying. I started to not know what to do with my limbs. Almost flailing from the level of pain.
“I need to stand. I can’t sit here any more. I have to stand.”
6:15 am I stand and get out of the tub supported by my husband and my doula.
Yanno how they say when your water breaks it is never like it is in the movies? This was like the movies. WHOOSH it splashes everywhere. The bathroom floor is coated in amnion. Sorry about the shoes guys! (Never wear shoes to a birth if you can help it. Feet are washable.)
As soon as I stood up I started to push. When natural labor is unencumbered and progresses on its own a beautiful thing happens. The body pushes on its own. No orders. No instruction to push. I have to stop every foot on my way to the bed to push. I half-squatted every time and groaned that gutteral, earthy groan, down into the floor using my husband and doula for support.
I reach the bed. I feel I need to sit up with my breasts right against my knees. I begin to push and the team gets ready. No one counts this time. I push as the contractions tell me to. Which is a wonderful thing.
My son was a big boy so the nurses and our doula keep saying “pull those legs wider” I do. I hear my hip pop slightly out of socket and feel the pain of that. But I know this is the end of it so I keep going. I push that pain to the back of my mind and focus on the goal.
Something crucial happens. My doula tells me to “relax”. When a person tenses while pushing she tears. If she relaxes then the baby does their work and they don’t tear. That tissue is supposed to stretch and it will if you relax it. This was the ticket for me. Every time she said “relax”, I did. I am ever grateful for that. My son slowly corkscrews out. On his way out, I didn’t know it, but he split a vein with his shoulder. There was a lot of blood. And my doctor, being the calm man he is, says “Don’t look down” even though there was a lot of blood. My husband retained composure holding my hand even though he said it was a lot of blood and freaked him out a bit. He said nothing. That is an amazing gift he gave me so I wouldn’t panic.
6:37am Graeme is born. He cries and they place him skin to skin on my chest. He latches like a champ. I cry tears of joy at the instant ability of my eager baby to nurse. We had a long trial with my daughter and his gulping noises fill my heart to brim. I rotate my hip back into place after my doctor stitches my vein and minor tears. We wait for the cord to stop pulsing before cutting. I deliver the placenta which turns out to be huge and my doctor says “I’m sorry” as it comes out because it is folded over on itself. It’s like birthing another baby. Kudos to you twin moms out there, you rock. The placenta weighed in at just over 6 lbs. This is not uncommon for moms with active autoimmune disease during pregnancy. The placenta had to work extra hard to keep my baby boy safe. I am grateful for this organ and what it did for my son.
He is here. He made it. Hello baby boy.
Katrina Tholen is the mom of two, and owner and designer of Luna Labor gowns. Luna Labor started on June 3rd, 2011 as an idea. Katrina had made her own labor gown based on a basic scrubs pattern. She really enjoyed having the bright colors of her personal labor gown and the fact it was washed in her own home with her own detergent. The next day when Katrina's doula visited she said “those gowns are great, I bet you could sell those” and that was it! Katrina's gowns fit better than hospital gowns and have all the capabilities for laboring and breastfeeding. Her doula for Graeme's birth was Lindsay Bench of Welcome Baby Doula Care.
One thing about being a doula is, you learn quickly what positions a mom likes; and you learn just as quickly, what positions are hard for you to maintain. When performing the hip squeeze with your own hands, you exert pressure in an awkward manner (envision your hands on either side of a woman's hips, fingers reaching toward each other over her back, and you pressing inward, with your elbows poking out). But women respond to this over and over and over! By pressing the top of the hips, the base of the pelvis can actually be helped to open wider, and this feels good to the woman, especially if she is experiencing back labor. With my own birth a year ago, my doula was charged with "The hips! The hips! The hips!" as a contraction would build. These tips Marivette shares will definitely save a support person's strength, as well as help the mother with restorative and relaxing ways to cope with labor. Thank you, Marivette!
I first became aware of the rebozo eight years ago when I visited a border town near Weslaco, Texas, called Progresso, Mexico. The women and young girls were carrying babies and toddlers on their backs with a fabric. After showing an interest in that cloth, my mom, who had taken me to visit Mexico, took me to a small store to purchase one. My first ever rebozo was a beautifully woven white rebozo.
Fast forward six years, when I see an advertisement for a rebozo class for doulas and midwives. After reading the information on what the workshop offered, I signed up. That day, was the first day that fell I love with the rebozo for the use in pregnancy, labor, and birth. The Rebozo is a shawl or scarf which is long enough to wrap around a woman's body and has been used for centuries to help women find comfort and support during the birthing process. There are several other uses for the rebozo such a baby wearing, using as a shawl on a cool day or evening, or using it as an accessory to an outfit. These are only a few of its uses; there are many other methods to use the rebozo. In this blog post, you will read about its use in pregnancy, labor, and birth. A rebozo comes in different lengths. For the purposes of pregnancy, labor, and birth, the ideal length is 9 ft long X 2-3 inches wide. The shortest it should be for optimal labor support is 6 ft.. Rebozos come in a variety of textures and colors. My favorite rebozos are the handmade ones from Laos because they are thin, long, and have some beautiful hues.
As a doula, one of my goals is to integrate the partner with the laboring woman. The majority of my clients are husband and wife relationships. The husbands desire to have a very active role in supporting their wife's labor. Where as before, all I had to offer were the use of the hands as a tool, I can now offer the use of the rebozo. Most men like tools. Having a tangible item to use in labor, can help him feel connected to his wife. I have found that the rebozo is a great tool to facilitate the bond between partner and mother. The rebozo can be used to engage the partner in the birth process and is an extension of the labor partner's arms.
There roughly more than 30 different ways that a rebozo can be used for pregnancy, labor, and birth. You will be introduced to five in this post. If you would like to discover other uses for the rebozo, taking a rebozo class or workshop for either pregnant families or professionals would be extremely beneficial. You will gain knowledge and hands on experience in the use of this traditional shawl.
A rule of thumb when using the rebozo, and any other comfort method, is to always ask the laboring woman if she is comfortable with what is being done. If she likes the way it feels, the partner should continue with the comfort measure. IF at anytime the woman feels discomfort the partner should stop what he/she is doing. The partner can readjust the rebozo or discontinue its use altogether. Always measure continuing the use of any comfort method based on how it feels to the laboring woman. Since doulas do not diagnose nor treat their birth clients, the rebozo is meant only for comfort, support, and extension of the arms. The rebozo should never be used as a treatment.
The following are five ways to use the rebozo to give comfort while performing the hip squeeze. The hip squeeze is one of the most desired labor comforts. The partner uses his or her hands to squeeze the hips together to alleviate some of the pelvic pressure from contractions. Hip squeezing can last up to a minute or more during a contraction. Although the partner would never voice this in labor, it can be a tiring job for him or her. If her main support is her husband and he has any wrist injury, he would be unable to perform the hip squeeze with his hands alone. The rebozo can take the place of the hands, thus allowing for longer and stronger hip squeeze support.
3. Hands and knees
The hands and knees position is great especially if the laboring woman is having back labor. This position relieves some of the pressure from her back. If she isn't having back labor, it could still help take some of the baby's weight off her back. Help mom get on hands and knees. Wrap the center of the rebozo around the woman's hips paying attention to that it is not on her abdomen. For the hip squeeze, we want the rebozo around her hips. The partner holds the open part close to the woman's buttocks, and tightens the hips. A knot can then be made in the rebozo to assist with the squeezing of the hips. Once the knot is in place, the partner can use one free hand to put pressure on the sacrum. Continue as long as mom desires.
5. Leaning over the bed
This position can be done similar to the above mentioned hands and knees. If she is in a hospital, the bed can be raised to a more comfortable level for the woman's height. She can then lean on the bed and hug a pillow or two for comfort and to support her upper torso. The center of the rebozo is wrapped around the woman's hips making sure not to wrap on the belly while she is leaning on the bed. The partner holds the opened side of the rebozo (fringed side) and tightens the rebozo around her hips. Make a knot at the end close to her buttocks as tight as she likes. The partner will have a free hand to add some pressure on the sacrum.
The use of the rebozo can free a partner's hand to give him or her the ability to use an additional comfort measure such as massage and a gentle anchoring hand on the shoulder. It can assist in longer durations of comfort measures to the laboring woman because the partner is not too tired from using his or her hands. This is beneficial to the laboring woman because she will feel fully supported by her labor team. In all, the rebozo is an amazing tool which can enhance the labor and birth experience.
Marivette Torres is the founder/owner of Tender Doula Hands, a rebozo trained instructor and distributor. She is a CBI certified birth doula with 16 years experience serving the Bakersfield, California area. She has eight children ranging in ages from 24 to 6 years old. Her first child was born via surgery at a community hospital due to breech presentation. Her subsequent seven children were all VBAC births, two of which were born at a hospital birth center and five were born at home attended by a lay (unlicensed) midwife. She breastfed all her children with her last child self-weaned at six years old this January. In her birth doula practice, she utilizes some of her own personal experiences and many years of labor support experience with well over 175 clients. She is currently teaching rebozo classes to pregnant women and their partners and to birth professionals which includes midwives, doulas, nurses, doctors, and anyone involved in the birth community. You may visit her website and Facebook page. She also has a page dedicated to specific rebozo class information.
Did you know? For two years in a row, I have celebrated International Doula Month (May) by featuring guest posts by and about doulas? This is Day 28 from 2014, and it is constantly being re-pinned on Pinterest. I am always looking for stories to feature, and 2017 will be the 4th year of this tradition! So if you are a doula, or had an experience with a doula, contact me to reserve your guest spot! You can write something just for this occasion, or share something you have previously written.
Tesa is a doula who, after my recent move, gave me my first insight into the local birth climate. She has such a passion for helping moms and babies through pregnancy, birth, and breastfeeding, working with families to ensure they have positive, safe experiences. A mother herself, with a 10 year career in the Air Force, she has an impressive story of how she even ended up in the birth world. She is currently overseas getting practical training to become a midwife; I appreciate that she took the time out of her educational pursuits to share this with us.
I discovered soon after training as a Doula that I wanted to pursue Midwifery. I was told by many my Doula experiences would translate into my midwifery training and the experiences of supporting Mothers in the hospital would be immeasurable. I focused intensely on how to interpret a woman’s body language during labor. I knew from experience that most women did not communicate their emotions or physical discomforts throughout labor. I knew that I needed to get good at feeling what she needed. I did not realize the extent of this intuition that I developed until my experience while interning for my midwifery clinical requirements.
Our family decided that I would take an opportunity to travel abroad to volunteer at a birth home in the Philippines for my clinical experience. I was a bit nervous about the language barrier, even though I was assured that most of the mothers spoke English to a point which we could communicate. I planned to learn basic phrases before I set out. Of course life was busy, and a lot of other preparations became a higher priority. So I landed in the Philippines without even knowing how to say hello. I know, bad planning on my part. Luckily I was met at the airport by an American and was never in a sticky situation where I needed to speak Tagalog (the language spoken by Filipinos). From the airport I was taken to the birth home where I met the other American Interns and the Filipino Midwives. Again no need for language skills there either.
The next morning I was integrated into the prenatal check up routine, and that’s when it all came and smacked me in the face. I quickly realized I needed to learn how to communicate with these women if I was going to assist in their care. So where am I going with this? Well after a few weeks I was ready to start attending births as student under supervision, and again I was nervous about communicating with the mother. How would I know what she was feeling? Up to this point my training had focused on the physiological changes to observe that would help me assess the stages of labor, the health of the mother, and fetal well-being. My first birth was a bit of a blur, but the second birth I settled into a very familiar role as this Mother immediately connected with me.
Reflecting I can recall the moment when I understood not a single word she said to me but I could feel everything she needed from me. My Doula heart took over the emotional and physical care of this mother as she labored hard and just needed to feel safe in her moment of vulnerability. I did not need to speak in her language to support her. I was able to express that I was there for her by not leaving her presence. With sincerity in my touch I think she was able to feel safer and more relaxed. I helped her with breathing patterns and movement, only through demonstrating it myself first. These unspoken instructions quickly helped her gain control of her labor and gave her confidence in her ability. Holding her hand through contractions, reassured her I was not leaving. Simple nods from me seemed to confirm to her that everything was normal. No words were required between us; it was a dance of sharing a common goal to bring her baby into the world safely and peacefully.
It’s now been almost 3 months since I have been here in the Philippines and I have since learned many useful Tagalog words to aide me in communicating with woman in the prenatal as well as labor and birth. Like sakit and pwerta, go look them up. Now more than ever I realize the value of my Doula experience, and how it will always be a part of me as a Midwife. The ability to communicate without words extends across many roles in life. I’m very grateful for my experience here and the woman that have allowed me to stand, rock, moan, and cry with them as they birthed their babies. They have given me more than I have given them, and I will hold it close as I move forward to serve many more.
Tesa Kurin is the mother of 6 wonderful children, each different in their own way. She believes that every pregnancy is different and every Woman’s needs are different. Tesa also believes you have the right to choose your birth path. Whether you choose to give birth in a hospital or home, she will provide you with the support and information you need. Find her through her website.
♥ four young boys and a boy dog (offspring)