I once wrote how teaching about birth is like selling a house. I was happy to see Joyce's comparison here, and even happier how her points lined up with reality. We hear many analogies for the roles doulas hold. I think this one stacks up well -- what do you think?
Although doulas are increasingly popular additions to the birth team, not everyone is clear on what they do for a birthing family. There are several useful analogies out there, but the comparison of a doula to a real estate agent is less discussed. So here is my attempt, 10 ways a doula is like a real estate agent!
1. The doula's goal is the client's goal.
Just like your real estate agent is not searching for his/her perfect home, your doula is not pushing her perfect birth onto you. Your doula will get to know you before your birth as much as possible, so s/he knows what you want in your birth.
2. Your doula can help you navigate your options.
Your real estate agent knows her/his local real estate market, just as your doula knows his/her local birth market. Your doula can help you find the best birthplace to fit your desires, just as your real estate agent can help you identify your ideal neighborhood.
3. Your doula is up-to-date on the current market.
Your real estate agent will know how properties are selling currently. Your doula will be familiar with local maternity care.
4. Your doula knows what to look out for to help you have a positive birth experience.
Just as your real estate agent knows what items to ask for on your offer (the appliances!), and whether or not the cracks in the plaster walls are something to fret about, your doula will know what questions you need to ask in order to make informed decisions.
5. Your doula is trained and experienced in the field.
Even a brand new doula without children of his/her own has received extensive training in both normal childbirth and its variations and complications, and in caring for childbearing women. Just like a real estate agent has been trained in navigating the real estate market.
6. Your doula will support you if you change your mind about what you want.
Just as your real estate agent will continue to help you if you change your property search criteria, no matter your reasoning, your doula will support you if you change your mind about choosing that hospital, or planning an epidural, or having a waterbirth.
7. Your doula will offer his/her advice, but you are the decision-maker.
A real estate agent will offer her/his advice when pricing a property, or writing an offer, but you are still the one making the sale or the purchase. Your doula will remind you when you stray from your birth plan, but this is your birth, and your baby.
8. Your doula knows where to go for complementary pregnancy and birth services.
Your real estate agent knows the title companies in your area, the lenders, the exterminators, the inspectors, and has worked with them before. S/he can help you find a reputable professional in your property-selling/purchasing process. Your doula knows the chiropractors, the accupuncturists, the prenatal yoga instructors, the lactation consultants, the babywearing groups, the back-to-work support groups, in your area, and can help you find perinatal professionals in your area to help you.
9. Your doula will walk you through the entire birth process.
Just as a real estate agent will assist you through the entire purchase or sale, your doula will help you from the earliest inklings of Birth Day through the first couple of hours postpartum. Whether her support is over the phone, email, text, or in person, your doula is supporting you the entire time.
10. Your doula follows up with you after your birth and helps you adjust to your new family.
Your real estate agent will follow up with you after your sale or purchase to make sure everything continues to go well, and answer any last-minute questions. In the years after your property purchase, you can even contact your realtor for referrals on remodeling projects! Your doula is the same way. Just because your contract period has ended with your birth doula does not mean you cannot contact him/her again! For example, the definition of postpartum depression is any depressive symptoms in the year following the birth. Your doula wants you to be well, go ahead and reach out to her if you need anything.
Joyce Dykema, MSc, CD(DONA), HCHD, became a certified birth doula in May 2012. She is also a trained Hypnobabies® Hypno-Doula, volunteers as leadership for ICAN of Lincoln, and is an Evidence Based Birth Instructor. Joyce is a woman-focused doula. While passionate about natural birth and what research shows is the best for moms and for babies, the goal she strives for with every client is for women to have empowering and positive births, as the woman defines it. In addition to her doula credentials, she holds a BA in psychology and an MS in biological sciences. She breastfeeds, uses cloth diapers, uses baby sign language, babywears, and homeschools because these choices made sense for her family; she encourages others to explore and find what makes sense for their families. Joyce and her husband have three children, and live in the Lincoln, Nebraska area.
Amber is no stranger to the 31 Days of Doulas project. She wrote about the advantages of a doula who hasn't had children yet, how doulas help in all kinds of births, and her "labor" as she started nursing school. This year's addition gives us a peek inside Amber's life. Nursing school is not easy! And Amber's confidence was shaky -- until she realized the true value those doula skills held.
Doula training has a way of bringing out the best in people. Sure, before I was a doula, I was caring and compassionate, but I was also a wild 20-year-old who wasn’t always focused on others. When I completed doula training at 22 years old, my eyes were opened to the injustices that many women and families face as they meet their baby for the first time. I was made more aware of how much what we say matters, and how important it is to simply listen and respect people. During my training, I also learned physical skills to provide comfort. I didn’t know it at the time, but the knowledge I gained over my two-day doula training would stay with me, even when I wasn’t supporting women and families during the childbearing year. Most notably, my doula skills have all proved extremely useful as I’ve journeyed (yes, sometimes trudged) through my last 2.5 years as a student nurse.
Prior to starting nursing school, I absolutely loved being a doula. Being present for one of the most intimate moments in a family’s life was an immense privilege. The qualities that I already had were allowed to shine when I was a doula for a family. Once I started nursing school, I was immensely saddened that the magical relationships that I built with my doula clients would be a thing of the past. It was time to become a nurse, and my touchy-feely relationships would only be distant fond memories.
At the end of my first semester in nursing school, I was talking to one of my professors about how much harder nursing school was turning out to be, in relation to my expectation of what it would be like. Her response was one I vividly remember. She told me that you can be a nurse forever, and learn all these fancy technical skills, but that it is extremely hard to learn how to be truly empathetic, be good at listening, and have emotional intelligence towards your patient. She told me that it seemed I already had these skills. It wasn’t until she pointed this out to me that I had really stopped and realized just how much I had translated my doula training into my practice as a student nurse.
I hadn’t realized it, but I had been all of my patients’ doulas. The older folks who had dementia who just needed someone to talk to, the veteran who was depressed, the widow who was confused and scared because she didn’t know where she was -- these were now my doula ‘clients’. Except, they were my patients.
There was something that I brought to my practice that was slightly different than some of my classmates. Now, the other students in my cohort are amazing. We are all very different, and have very different skills. Some of them are fearless, they always jump at the opportunity to insert an IV or catheter. I, on the other hand, was sometimes almost petrified with anxiety just thinking about doing something I didn’t feel confident in. Some of my other classmates were really book-smart, they had memorized complex physiological processes and medications. I sometimes compared myself to these other students, and felt inadequate, that I would never be as good as them. But, once I realized that emotional support was my strong suit, I stopped beating myself up.
When it came to talking to patients who were depressed, needed someone to talk to, had just received bad news, had dementia and missed their loved ones, or were in pain, I felt very comfortable. It seemed that knowing appropriate yet comforting things to say came easily for me, and I didn’t shy away from using physical touch on my patients. With this knowledge in hand, the rest of nursing school has been different for me. Yes, I’ve had some tough days (and nights!) but I know that every single one of my patients felt emotionally supported, respected, and truly cared for. I know that if I were in the hospital, this is how I would want my nurse to be, too.
Now that I’m at the end of my nursing school journey, I feel confident that I’ve left a trail of cared-for patients in my wake. The unique set of skills that I will always carry with me as a doula can be translated into any area of life, and I am so happy that I don’t ever have to stop being a doula. I am especially grateful that I also had the opportunity to share some of my doula-ness with my classmates. I think some of the knowledge about providing comfort will stay with my classmates. Some of the doula wisdom I’ve shared with my class, which can be translated to almost any patient are:
I’m planning to start working as a labor and delivery nurse this summer, so I will truly get to put my doula skills to use on my patients. But, I also know that wherever nursing may take me, no matter a patient's sex, age, or whatever brought them into contact with our medical system, I will always be their doula.
Amber is a special soul to me. Years ago when I was bringing the first of many DONA-birth doula trainings that my former trainer, Connie Sultana, would offer in Chico, CA, I got a phone call. It was Amber's mom. She asked me questions about doulas, the training, what it would mean for someone like her daughter who had a fascination with helping people and a passion for birth. She passed along that information to Amber, and the rest is history! Amber and I became fast friends although we weren't exactly peers -- me with three kids, and she, college-aged and free! But we had a connection, and we built on that. Slowly we started finding more doulas, bringing Connie back for more trainings, serving families, and creating plans for better ways to serve families. Eventually we helped form Chico Doula Circle. All this time, Amber was set on getting into a nursing program. I moved away, and she got into a program -- and here she is, at the end of that schooling-journey, ready to jump into the world as a nurse! Amber will be an amazing nurse, in any field, although her heart is set on birth. I am so excited for what her future holds!
I'm sure we have all heard different myths about doulas -- whether it's thinking doulas catch babies like midwives, or they come together to dance beneath the full moon -- there are a lot of misconceptions out there. Becky amazes me -- not only is she a comic genius when it comes to doula humor, her graphic art choice is the perfect medium to convey her message. She addresses common myths about doulas, and leaves us full of happy feelings for the work we do.
There is often confusion over what a doula is. Many times I have talked with couples nervous about a doula possibly taking over their birth. They are afraid that a doula may guilt them into a certain type of birthing. To add a little silliness I have illustrated examples below with my subpar Window’s Paint skills. These show the differences between someone that will fight against your birth, a duel-a you could call her, and a doula, or birth support for your choices.
This may be new to you, but doulas are not just for natural birth. They are for anyone wanting more support for their birth. Doulas are helpful in cesarean births, medicated births, natural births, hospital births, home births, single parent moms, and so much more. Whether you have a plan or not, we are here for you, no light sabers involved. Note: In the odd case that you want light sabers at your birth, we can help you with that. We do not discriminate against nerds; we just won’t use them to stop your choices.
The next concern often had regarding doulas: "But I want my husband involved. I want him to intuitively know what I need.” If he helped start this baby business, then it totally makes sense to want him right there involved in the birth.
Can I tell you my secret? We LOVE it when dads are hands-on and involved. It is our biggest goal to facilitate the best connection between you and your partner. We know that dad helps get the oxytocin and birthing hormones going. Some men need a little direction along the way. They are new to this. Our job isn’t to replace dad, it’s to help him help you best. If dad isn’t there this works the same for grandmas and friends. We will not erupt in flames if someone else gives you counter-pressure.
I met with a doctor today. He was a little on-guard, and he felt the need to explain how he goes out of the way to help his patients. Sadly, too many providers have met some kind of duel-a, or have heard stories of them. All he knew was that I was a doula and he assumed that I had a negative view of him as a doctor. In reality, I have yet to meet a provider that did not want the best for mom and baby. Sometimes they have differing opinions on care, and different points of view, but they all care. Doulas are not out to defy anything medically related. We need the medical team so that we can focus on emotional support and comfort for mom and the family.
Doulas work with mom’s birth team to help her best reach her desires. Doulas will encourage you to choose a provider that you feel you can trust that you can work with together. They encourage mom to ask questions, find evidence-based information, think over benefits and risks, and if needed, help mom stand up for herself. Our job is not to have a show down with the medical staff. Our job is not to speak for you. Our job is to help you get the information you need to make choices, and to support you as you speak for yourself.
I am not a duel-a. I am not out to fight or prove anything. I am a doula -- a supporter of women, babies and families.
Becky Hartman serves as a birth, postpartum, and bereavement doula, birth and pregnancy photographer, Benkung belly binder, and energy worker. She has been shaped by her own births, and the realization that education factors into creating an empowering experience. Becky strongly believes women can follow their hearts and they will know the decisions that are right for their situations. She encourages families to learn, explore, develop ideas, and then go with the flow of their birth experience. Becky lives with her family in Clearfield, Utah.
What a pleasure to feature Yiska's piece on self-care! The longer I stay working as a doula, the more I realize the value in taking care of me -- and it seems to get harder each passing year. As a new doula, I bounced back from births more quickly, feeling like Super Girl. Now I drag myself around for a couple days as I try to fit back into the pace of my (still-running-around-me) life. Yiska has a gentle heart that is bursting with ideas and eagerness to help not only birthing families, but also those who support those birthing families.
The topic of self-care is an essential one for any care-giver. As doulas in particular, we’re always telling our clients to make self-care a priority, but do we listen to our own advice? There are some obvious and some less obvious ways doulas can take good care of ourselves. The following are the top 4 areas, in my book, for doula self-care…nourishment, body posture, recovery practices, and emotional self-care.
Packing healthy nourishing foods for births and staying hydrated is priority number one. Some great portable meal and snack ideas include protein bars, hard boiled eggs, yogurt, a thermos of bone broth or other soups, homemade nutrient dense smoothies, fresh fruits, trail mix, coconut butter packets, almond butter and jelly sandwiches, etc. A helpful tip here is to avoid peanut butter because it’s such a common allergen and keep stinky foods tucked away.
Emergen-C packets are a great way to keep your immune system boosted and I started mixing mine with CALM magnesium packets as well. Some use magnesium to help them sleep but the reason it works for that is because it calms the nervous system. I found myself feeling way less strung out and more grounded as a result of adding this to the mix. Both powders dissolve in water and you can nurse the drink anytime throughout the birth.
Bottom line is, staying hydrated is key to sustaining our well-being. Whether you’re a coconut water lover or into the vitamin c and magnesium mixture, keeping your own water bottle nearby will help ensure you don’t end up dehydrated, just like your clients. Hospitals are notoriously dry too!
2. Body Posture
When I first started doula-ing, I would get myself into all sorts of contorted positions trying to support my clients. Part of the reason I teach comforting touch for birth the way I do is based on what I’ve learned over the years around taking care of my own body even while I serve my clients.
Now, if I get twisted up trying to support a client, after the next contraction, I make sure we all adjust our positioning so I can face their back or hips head on, without compromising my own well-being. There’s always a way to find a win-win, but we need to be willing to include ourselves and our needs as well. It doesn’t have to be us or them.
One of my biggest tips in this vein is to use your body weight when offering comforting touch. Rather than muscling your way through a counter pressure or massage technique, lean your body into and onto your client, taking advantage of gravity. This approach tends to feel more enveloping, intimate, safe, warming and less effortful, all adding to the comfort value.
Watch this video from my Comforting Touch for Birth guidebook as an example of how to adapt your double hip squeeze so you’re straining your muscles less and leaning in more. Both you and your clients will appreciate the difference.
3. Recovery Practices
Taking time for recovery after a long birth, double-header or simply being up all night is crucial to keeping up with this work and life in general. Some approaches are as simple as a healthy meal, a bath or shower and a long, uninterrupted sleep. If you’re still on call, look into ways to program your phone to ring only for your “favorites”, and put those clients on that list. I also turn my text tones off and let my on-call clients know they must actually call me if they need me. This way I’m not woken up by unnecessary text message notifications.
The biggest thing here is to be kind with yourself and allow yourself the time it takes to recovery your energy and catch up. Some births will be more taxing than others. Many doulas feel the time they need to recover increases over time, so adjusting to what we need as we need it often takes self-compassion as we adapt our expectations. Just as you’d advise a client to be gentle with themselves postpartum and relax expectations, we could use the same advice in the days following a birth.
Additional practices I’ve found helpful in the days following a birth including getting a massage or acupuncture, taking a yoga class, a trip to the local Korean spa, and a magnesium float. Just like it helps to calm the nervous system when you drink it, flotation or sensory deprivation tanks can be found in most major cities. The intense concentration of magnesium salts makes you float while you rest for an hour in a dark, sound proof room, as if in the womb. I can’t think of a better way to recover from a birth than going back to the womb!
If any of these fee-based recovery practices appeal to you, the key is to budget for them just as you budget for childcare or travel expenses and include the cost in your doula fee. Self-care is including ourselves in the equation of care financially too.
Finally, for a great restorative exercise, visit my blog post on constructive rest here.
Emotional self-care is just what it sounds like. As we mentioned above, being kind with ourselves both after as well as during births is one way to care for ourselves. Doulas are drawn to this work for many reasons, but at the crux of it all, we care. We care about women and we care about birth. Sometimes, when there’s only so much we can do, it can be hard to accept the things that lie outside the realm of our care, responsibility, experience-level, or control. Births can stir up a lot.
Making time to talk about our experiences with friends or colleagues is often helpful. Whether we’re feeling uncertain about something we did or traumatized by something that happened, expressing it will always lighten the load. Journaling is another great way to process the emotional content of births. However we do it, giving ourselves space and time and permission to feel our feelings is hands-down one of the greatest acts of self-care there is.
I hope these suggestions help you add a few new things to your self-care tool-box or simply serve as a reminder, so you can continue to do your work feeling healthy and strong. You deserve it!
Yiska Obadia-Gedal is a proud, been-at-this-for-more-than-half-her-life massagapuncturist, oxytocin-fiending, Comforting-Touch obsessing, doula, wife, friend, writer, teacher, rockin’ Moroccan, dance-loving, wannabe-mama and one of the world’s best huggers (or so she's been told)! She has trained in Israel, China, Maryland, and New York, but calls NYC home.
Yiska is the creator behind Comforting Touch for Birth Workshops and the subsequent guidebook -- a comprehensive curriculum for doulas and expectant parents. These resources are designed as tools to give partners and doulas confidence, skills, and ease in offering hands-on labor support, regardless of experience level.
"Birth is one of those rare life experiences where power and vulnerability live side by side. That is all! To touch that. To touch others who touch that, is my great pleasure and honor."
Being the mother of four boys who love comic heroes and villains, I am constantly hearing characters' origin stories -- how they became who they are. I have pulled this over to the doula world, the idea of the origin story, and it is something I love to hear: how a doula made her way into the world of serving families during birth. Emily learned about doulas but had none locally to connect with. Here she shares how she has made her way in the doula world. Enjoy her origin story!
I grew up in a town of 10,000 people. We had 3 stoplights, five 7-11s, and both hospitals 20 minutes away. When I learned I was pregnant I began to research everything. What foods should I avoid? How active should I be? What type of birth would I have? Through my research, one term stood out to me. This word was “doula.”
It sounded like an interesting word so I dug a little deeper. The definition I found was “a woman experienced in childbirth who provides advice, information, emotional support, and physical comfort to a mother before, during, and just after childbirth” (Merriam-Webster). This sounded like the type of person I wanted to know! I began to find out anything I could about this seemingly magical profession. There could really be a person who is there solely to help me remain as comfortable and calm as possible during labor?
I discovered that finding a doula wasn’t always easy. In my town, delivering in a hospital meant travelling at least an hour away. Homebirth was an option but not possible in our circumstances. On top of that, who would drive all the way here? So I came up with the next best solution. I decided to become a doula!
I poured my all into discovering the different pathways to becoming a doula. I looked at different certifying organizations and what they each had to offer. After discovering all the amazing possibilities, I decided I would become a DONA International Certified Birth Doula. Now came the fun part: immersing myself in all things birth!
I’ve since moved to Richmond, VA. The birth community is large, and steadily growing. I’ve learned that doulas in my area work together like a large, close-knit family. Though I haven’t attended any births to date, I feel comfortable knowing that there are so many people I can rely on to help give my future clients the best service I possibly can. Pursuing this path has been one of the best choices I’ve made and I’m so excited to be a part of something that can positively change the lives of so many families.
Emily Mozingo is the owner of Little Love Birth Services, LLC in Richmond, Virginia. She is a Certificated Lactation Educator Counselor and is certifying through DONA as a birth doula. When she is not with clients she is spending time with her husband and their daughter. They spend time exploring the city and at home with their many pets. Currently, Emily is also working on childbirth education certification as well as continuing education to become an International Board Certified Lactation Consultant. She hopes to one day become a Certified Professional Midwife.
As promised, here is part 2 of Joyce's explanations in helping us understand primary research better! Did you print out the study shared and mark it all up? Let's see how well you did! (In case you hit this page first, you may wish to view Part 1 first.)
My journey to becoming a doula makes plenty of sense in retrospect, but it is a winding journey. I entered college as a pre-veterinary science major, ultimately switched to a Psychology major, hated counseling but fell in love with animal behavior research, and graduated with a BA in Psychology, Biology minor, and Biology Honors. I then entered a PhD program at the University of Nebraska-Lincoln in the Biological Sciences with the intention of becoming a research professor. I actually completed my coursework for a PhD, but cut my research short to graduate with a Masters when I decided a career in academia was no longer what I wanted. After graduation, I became a homemaker and mom when our son was born 5 months later. When he was 10 months old I completed my doula training with DONA International, and attended my first doula birth one month later. Now my husband and I have three children, I am a certified birth doula with DONA International, a Hypnobabies Childbirth Hypno-Doula, co-leader of ICAN of Lincoln (International Cesarean Awareness Network), and have attended more than 55 births. I have a passion for teaching others, empowering women and families to love one another better, birth, birds, and chocolate.
I wanted to write a guide to other doulas and to parents-to-be on how to find, read, understand, and use primary research literature. When you have found, read, and understood the research, using the information will be a highly individual decision that only the patient themselves is able to make, based on their intuition, desires, trusted counsel, and circumstances. Yesterday, I discussed how to find and read research papers in Part 1. Here in Part 2, I walk you through a short research article and talk about how to understand the paper, and how to use that information.
Here is a short example of how I read a research paper. This article is a short write-up of a conference poster session. This is preliminary research, it is probably not peer-reviewed (critiqued by other scientists in the field to make sure it is done well), and though we can still gain valuable information from it, keep in mind our knowledge can change drastically with more studies, more research, and better analysis. Go read it. Really. It's quick, you'll be back in no time! Here is the paper (if you want to and have the means, print it out and grab a pen!):
Afshar, Y; Wang, E; Mei, J; Pisarska, M; and Gregory, K. 279: Higher odds of vaginal deliveries in women who have attended childbirth education class or have a birth plan. American Journal of Obstetrics & Gynecology, 2016;214(1):S162.
Since this is such a small write-up, there is no introduction or background section, simply a research objective. Do Child Birth Education classes (CBE) and/or birth plans impact the delivery mode of those women?
Let's look at the study design. The authors looked in the past (retrospective) at a group of women all from the same period of time with similar demographic characteristics (cohort study), and give the dates and type of birthing facility. Because birth modes can differ so much between singles and multiples, the authors only looked at singleton births. They also divided the groups into all moms, and just moms having their first birth (nulliparous). Then they divided each group into moms who attended CBE, those who had a birth plan, and those who did both.
Understanding statistical analysis is a whole other ball of wax, and there is no way I can explain everything here. What you need to know is when p-values are reported (p=0.01, p>0.1, p<0.0001, etc), the smaller the p-value, the greater the effect of the variable being tested. The p-value is basically the probability that any difference between the groups is due to chance, so if the p-value is small, the difference between the groups is probably due to the different variables. There is a lot more to statistics than just understanding p-values, but there's your crash course in statistics for today.
In this study, there were over 14,000 births that were included in the analysis (met inclusion criteria). There were differences between groups of women who did and did not attend CBE and/or have a birth plan. After adjusting for these population differences, the authors found that women who had attended CBE, had a birth plan, or both, had higher odds of a vaginal delivery compared to the group who did none of those, but there was no stronger effect of doing both. This effect was true of first-time moms as well, so the impact of CBE and/or birth plans is the same no matter which birth this is for a woman. In their original poster session, the authors likely included more figures, including their logistic regression analyses, which would help us understand the relationship between the variables and their effects, but it's a simple study and we can understand the basics with the information given here.
The authors conclude that attending CBE and/or having a birth plan increase the odds of a vaginal delivery, and they state that further research is needed to understand how this works. In my opinion, given my cursory understanding of this study, I think this conclusion is sound.
The questions I have after reading this are:
Finally, the authors found a statistically significant difference in delivery mode based on CBE and/or birth plan, and with a relatively small group of women! In human research, 14,000 people is really not much. That's approximately the population of downtown St. Louis, MO. To find a statistically significant effect in a small sample size suggests that either it is due to random chance, or this is a very strong effect. I am excited to see what further research shows in this area!
In lengthier research articles, there would be a list of references. For more information on the topic and related topics, this list is where you want to start. In lengthier research articles, there would be a list of references. For more information on this and related topics, including additional studies, this list is where you want to look.
Now, how do you use this information, either for your doula or CBE clients, or for yourself? First, you must understand that research does not, and can not predict your outcome. Research is not a crystal ball, it cannot predict with certainty, in real life, who will and will not experience which outcome. In addition, the facts, found in the scientific literature, are an important piece of any decision-making process. But your intuition, your desires, the availability of options, the counsel of trusted medical caregivers, and many more variables will come together to determine the best decision for you in your circumstances. Science tries to isolate variables, to pinpoint and quantify the exact effect of one thing, which is vital for understanding how one thing affects another. But we do not live in a laboratory. Applying those results to real-life, complicated, individual healthcare decisions is something that only the patient themselves can do.
I hope that now you are better equipped to find, read, understand, and use primary research articles. Happy reading!
Joyce Dykema, MSc, CD(DONA), HCHD, became a certified birth doula in May 2012. She is also a trained Hypnobabies® Hypno-Doula, and volunteers as leadership for ICAN of Lincoln, her local chapter of the International Cesarean Awareness Network. Joyce is a woman-focused doula. While passionate about natural birth and what research shows is the best for moms and for babies, the goal she strives for with every client is for women to have empowering and positive births, as the woman defines it. In addition to her doula credentials, she holds a BA in psychology and an MS in biological sciences. She breastfeeds, uses cloth diapers, uses baby sign language, babywears, and homeschools because these choices made sense for her family; she encourages others to explore and find what makes sense for their families. Joyce and her husband have three children, and live in the Lincoln, Nebraska area.
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 heard a doctor say once, when presenting a pivotal intervention to the family I was working with, "If you were my wife, this is what I would do." It truly does offer the feeling: "He really cares about me." This is actually a fallacy -- faulty emotional appeal. It isn't based on science, or evidence, or the unique needs of mother and baby. It is simply an opinion said with feeling, and it can be swaying. Maddie McMahon hits the nail on the head here, and she offers sage wisdom to those of us who work with families -- families who may be vulnerable to the words we say and feel with emotion, that may not exactly be the truth.
These are the kinds of things I hear parents saying quite a bit, and they always remind me that being kind is just not enough. Meaning well is just not enough. Smiling and speaking gently is just. not. enough.
There is a lot of talk in health care about compassion. And so there should be. It should pretty much be a core quality of anyone working in a caring role. Compassion means having a deep understanding and sympathy for another’s suffering. It also means wanting to do something to fix that suffering and take it away.
The problem is, compassion on its own can be a problem. If we believe we can make this all better, if we believe we know better, if we can’t bear to see present or potential future suffering, if even the idea of risk is frightening, then compassion can be dangerous.
Compassion needs to be tempered and balanced with empathy. The ability to enter into another person’s feelings, to see the world through someone else’s eyes. It is this ability that allows us not to get caught up in our own emotions and not get swayed by our own assumptions as to what might be right of wrong for this person. It is empathy which allows us to step outside of ourselves, just a little, and make space to really listen – and more than listen, understand WHY someone might feel the way they do.
So my plea to you wonderful, compassionate practitioners out there, whether you are doctors or midwives or nurses or lay supporters like doulas: Please try not to coerce with your kindness. Is this mother doing as she’s told because you’re so kind and she doesn’t want to upset you, or is she making a fully informed decision? Are you laying YOUR stuff on her or are you truly holding the space while she looks at the benefits and risks of all her options then follows her heart? True kindness and care means trusting that those we care for can make safe, appropriate decisions for themselves, even if we disagree with them.
My New Year resolution this year is to pour a cup of Alongsideyou Tea and strive to listen harder and longer and deeper, whenever I can to everyone I meet and give my empathy muscles a workout.
Maddie has been a doula since 2003. She is a Doula UK Mentor and runs Developing Doulas, a Doula UK approved doula preparation course. She is a founder-trustee of Cambridge Breastfeeding Alliance and also a Breastfeeding Counsellor with the ABM. She recently achieved her childhood dream of being a published author with the publication of Why Doulas Matter in 2015.
She enjoys blogging on her site for parents and birthworkers The Birth Hub.
Mum to boy and girl teens and stepmum to one all-grow-up boy, she lives and works in Cambridge.
I love this post. It reminds me of Jennifer Kara's post last year, "There Will be a Time After This." I am amazed by these doulas and the work that comes with being on the receiving end of help and service. Health is something taken for granted, and when our state changes suddenly, adjustments become necessary, and often the biggest one is within our brains. What also happens, though, is a change in the heart. I love that Sejal shares her change of heart here.
Today as I sit and write this, I am reminded of how lucky I am to be sitting in this cozy bed with all my gadgets and chargers next to me, and my constant companion for now (my pain, that is), motivating me to write. On the morning of March 28th, 2016, as I am going down the stairs outside my clients’ home from an overnight shift, I slipped on a thin layer of ice. I heard a snap and I saw my left ankle being twisted while I tried to hold on to the side rail to avoid the fall. I screamed loudly due to the excruciating pain, and I thought I must have woken up the whole neighborhood. I started to see stars and began crying like a baby getting his vaccinations, surprised by the needle. I felt sad for myself, and then I tried to remember my client’s address because I am in no position to get up on my feet.
I called my client instead, since I am sure she knows her own address. She comes and calls 911 for me. I am so grateful she was there and that she picked up my phone call. The firefighters come first, and they ask me if I am hurt anywhere else. I am so happy to see them since I am thinking they are paramedics! Pain messes with your brain. They put a temporary splint on me while I tried not to scream.
The paramedics and firefighters tried to carry me down the rest of the flight of stairs, since I am in no position to walk. At this point I am blabbering stuff at them about how sorry I was that I had to call them, and blah-blah-blah. I get nasal Fentanyl since my veins are fried, from panicking probably. I think I am in a good place as they take me to the ER. The x-ray tech comes and wheels me out to the x-ray room, and I hear myself begging, “No! No! No! Please don’t!” as she is trying to position my leg the best she can without causing me pain. The x-ray results confirm there is a fracture of the distal tibia and I am going for surgery the next morning. Loads of morphine helped me come to my senses, and I start thinking, “Oh my, I have to work tonight and tomorrow night for the same client!” I texted my client and asked her if she wanted someone else to come for the following two nights. She says she will be okay.
I talk to my husband about how I am feeling. He says that he understands, but that is why we call incidents like these accidents. I think in my mind, he does not understand me at all, and I quietly lay in bed. He has been working from home for the past year developing his own business, and many times it has been difficult on our family to adjust to that financially and emotionally. I am worried about our income, and I know he is too. We had to cut down on our kids' extracurricular activities and extra spending to meet our budget. I thought I was helping ease the financial burden by doing my doula work, and that income is gone as well. I am not good for anything. I am not a good wife, mother, or postpartum doula.
I am really grateful that he is at home and ready to help me anytime -- if I need to go to the bathroom, or if the pillows under my leg need to be adjusted, or if I need to hold his hand while my pain meds kick in. Besides doing all that, he also takes care of the kids and all the household chores while still trying to build his business. I am just overcome with guilt and fear. That does not help me or anyone else, but that is the reality.
I am very fortunate to have a circle of friends, family, and clients who have brought me food, flowers, chocolates, and given me their time to just sit and hangout with me. I am still recovering from the injury, and my splint has come off and sutures taken out. The hard part now is the physical therapy and rehab. The hardest thing for me to learn from this accident is accepting help from everyone and not feeling guilty about it. I had to practice what I preach, and it is not as easy as I used to think it was, even to this day. I thought that I was being a hypocrite to feel that way, and then to expect mothers to follow my advice. I decided to learn to accept help, even though it is still one small step at a time.
I had to acknowledge the fact that I did help people when I could, and it would not be so bad if some of them chose to help me and family. I started calling people to see if they were available to visit me, and as daunting as that question was for me to ask, I was surprised how many actually said yes. I am a social person, and I felt the best way for me to heal is to socialize. I didn't think people would have the time to hangout with me, but even if it is half an hour, it is worth my sanity. I kept talking to friends via Facebook, text, and phone. Some even stopped by to view an online conference with me, or to bring me lunch or dessert.
I called my brother up on my worst day of pain and told him to drive from Washington state to come hangout with me, and he did that more than a few times. I asked my sister to stop by to see me on days that she may have been doing something else, and I felt guilty about it, but seeing her and my nieces made that guilt go away very quickly. I learned that no matter how busy I thought she was, she was happy to come see me. I am learning not to feel guilty for laughing with people when they visit me while my husband is cleaning the kitchen or doing laundry. There are good days and bad ones, but most of them are good and I learn a new thing everyday about having patience and bowing down to my circumstances instead of fighting them.
Some very important life lessons that I have learned from my injury and the process of recovering from it:
Hitting the pause button has taught me how to be the gracious receiver of help that is offered. It is not easy, but it is helping me become a better and more understanding caregiver for all my future postpartum families.
May is International Doula Month. And here we are again! The third year of celebrating 31 days of stories for, by, or about doulas! For day one, we feature my dear friend and fellow Bakersfield doula, Emily Willett. I will admit, a year ago a nurse mistook me for my client's mom! I wanted to say to her, "I am only 9 years older than she is!" I simply said, embarrassed, "I'm just her doula." I really appreciate Emily's response, and I fully plan to steal it in the event this happens again!
When I began my work as a doula, I envisioned myself as a laboring Mom’s professional peer. When I would attend a birth in the hospital, the OB would generally ask the laboring Mom, “Is this your sister?” And, I didn’t mind at all. Because it was quite obvious that we were close enough to the same age.
Fast-forward 5 years…I’m sitting in a client’s home and we’re talking about standard childbirth topics. She looks at me and says, “I’m not sure about in your generation, but in my generation...” And inside a little part of me is totally caught off guard. I think to myself, I’m not that much older than her. Remember, we could be sisters, right?
And then about a week later…I’m with a client in the hospital. She just had a beautiful birth, and the OB turns to me and says, “You must be one happy Grandma!” Grandma? I’m supposed to pass as her sister!
And then I remember…6 years ago I was sitting in the home office of my midwife. I was recounting to her how my husband and I were so surprised when we met her that she didn’t have gray hair, or knit, and that she was young. And she said, with a gentle smile: “But someday I will have gray hair, and I will be old. And I will still be a midwife."
Today…I don’t have gray hair, YET, but I am beginning to feel the change of no longer being seen as a birthing mama’s peer -- maybe being seen more as an experienced woman or mother and doula instead. And as much as I enjoyed the sisterhood of age, I think I am learning to appreciate and cherish the role as an older doula.
There are moments when a woman presses in, burying her face in my chest and gathers her strength to pass through her next contraction, and I have words for her. Words that have brought many mamas through intense moments in their journeys. And I am thankful for the years of experience I have had leading up to that moment.
There are moments when a daddy looks at me, referencing my face, to see if what is happening is “ok.” And, when he sees my soft lines and smile wrinkles, he finds comfort in that visual embrace. For that, I am thankful.
There are moments when a nursing mama calls me in tears, wondering what is happening in her body, and I can share the stories of all the women who have come before her, feeling the same feelings, wondering the same things, and ensure her that she too will find her way. And, for that, I am humbled, and blessed, and thankful.
Yes, being young and new can be thrilling, and exciting, and somewhat ego-stroking. But if there is anything that I am learning as the years add up, it’s that there’s nothing like settling into something you love, and being allowed to pour out all that has been given to you. And, age is just a marker of all the time I have been given to learn to love, and cherish, and pass along to this world the beauty of women and babies and birth.
So, to the gray hair, I say, “Bring it on!”
To the Mama who sees that there is a generational difference between us, I say, “Let me share with you some stories.”
And, to the OB who asks if I am this child’s grandma, I say, “If I were only so lucky!”
Emily is an "Al Dente Mom"TM, navigating the space between ultra-crunchy and mainstream mothering. As a birth doula, childbirth educator, and breastfeeding peer counselor, she founded Mommy Matters in 2011, with the hopes of educating and supporting mothers in her community. Emily is passionate about helping mothers find their voice, and confidence, while following their unique parenting path.
♥ four young boys and a boy dog (offspring)