 In 2014 I shared an opening activity, What's in Your Head? I use this as a way to help families share their concerns and fears about pregnancy, birth, babies, feeding babies, and becoming parents. It helps folks see they aren't alone in the things that might be keeping them awake at night.  Looking for variation, I recreated this idea with Legos -- little plastic building toys we have amassed numerous buckets of over the years. All of these were pulled from our private collection, although the compromise with my kids was to put them in tiny zippy bags so things wouldn't get lost. The first time I did this activity, I passed the Lego head around and had each person pull out a zippy bag and share what they thought the toys might represent. In my next series, I decided to include a card with a general worry that related to the item in the zippy bag. I had participants look at the item first and see if it reminded them of any concerns they had, and if they were stumped, they could read the card. Then we go around the group and share our items and what they might represent.
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 Recently for the Bakersfield BirthNetwork, I was presenting on comfort measures for birth. Expectant families, as well as doulas, come to these gatherings, and I love being able to offer information that is not only helpful to parents, but also information other professionals can take to their clients! As a Lamaze-certified Childbirth Educator, I am always putting together ideas in an unusual way to help make learning about birth fun! The inspiration for this started when I had a few ideas I wanted to squish together into an activity: 1. Update the stages of labor to reflect an additional pre-labor phase at the onset of the first stage 2. Scaffold the stages/phases of labor by choosing and practicing supports meant to intertwine with the key emotional and physical events occurring 3. Provide a handout which not only helps visualize the opening of first stage, but also serves as a cheat sheet to labor happenings, timing, and ways to cope What I came up with, I call the "Spinning Circles of Womb." Just kidding, I don't. But I think it works, and it's pretty simple, and that's all that counts -- no frilly title needed. Basically, here are the supplies:
 I can't remember a time when I sat participants at a table, but for this activity we did, indeed, sit at a table. Surrounded by Mr. Sketch Markers, paper circles, and stickers, I began to share the stages of labor by tacking three sheets of (laminated) paper onto the wall. There is relief when an expectant parent realizes there are only three stages of labor (I did have a dad once who suggested there were 14, but that was his lucky number, and I asked him to take a guess!). Three. That's not hard to remember, right? Then I tack up two more papers, which you can see below, right. I share how some genius decided to break the first stage of labor up into phases, which is another word for, let's just insert more stages into this stage and call it good.  On the front of the circles we write things like average length of that phase, approximate cervical dilation achieved, contraction action, and more (note: I don't show all of that in the picture). The pinnacle of this is affixing the face sticker to the appropriate phase, as a handy visual reminder of what a laboring person might be feeling in that moment. While we are moving through the phases with markers and stickers, we are also brainstorming what comfort measures might be beneficial at what time, and those are added to the back of that circle. We practice these comfort measures as we go. If we expect people to feel comfortable with different physical ways to counter the strong sensations of labor, we can't expect them to get there from a picture alone! Would you step into a ballroom, ready to dance in front of judges, simply from pictures you saw in a book? We need to actually show families what these positions and movements look like, how they feel, and when they help -- or they are of no help at all.
 I use marker to write on laminated sheets as needed; I also include a wheel of what helps in labor. At the close of this activity, families walk away with their concentric circles of information, a piece of pool noodle, and an information sheet which shows about 20 different physical positions of a laboring person and partner working together.
Not a bad way to merge my three goals! A handy takeaway that can be utilized easily during birth.  I'm a doula. I love what I do, and I am really good at it. It is always an honor to help a family through birth by offering physical, informational, and emotional support unique to their situation. And I also recognize, as a certified Lamaze educator teaching families in the Bakersfield and Visalia areas, there are many reasons why a family might choose NOT to employ the services of a doula. These reasons might range from cost, to comfort, to hospital rules. In this situation, I want pregnant people to know how to shape their partner or other birth supporters into a doula. What are the advantages of a doula? How is she different than a partner, BFF, mom, etc.? She has no agenda or investment in this birth experience except to help a laboring person feel supported and know their options. What are the advantages of the partner, BFF, mom, etc.? You know this person better than anyone in the room. You know the likes and dislikes, the history and beliefs of this person, and you will be around after the baby is born. I often open this topic by asking each person to tell me something he or she knows about the person they have come with. I like this activity because it shows there will be professionals surrounding this birthing family, and while the professionals will know all the medical "stuff," the partners will know the pregnant person better than anyone in the hospital. Labor support is not rocket science. When you know what a pregnant person likes and dislikes, when you know what care this person would appreciate when sick or stressed, when you know what relaxes and what tenses -- this puts you in a prime position as a supporter, and suddenly you have something just as important as the professionals around you. By sharing things they know about each other ("She loves rocky road ice cream," "He hates his head touched") they see already they are armed and ready to doula their loved one.  I make goodie bags for all the families. They are filled with objects that symbolize a trait, activity, or way to support someone in labor.
When you love doulas, believe in their benefits, and are a professional doula yourself, it can be hard for class participants to feel you are unbiased on the subject (even if you are a professional childbirth educator, as well). I feel by offering an activity like this, you can show there are many different ways to create a birth support team -- and with anticipatory expectations of what a laboring person's needs are -- that doesn't have to include a doula.
 In my classes, I have an activity I am pretty sure I learned in my Passion For Birth training where parents are encouraged to draw their ideas for birth. Taking left-brain concepts (hospital stays and medical procedures) and using right-brain-directed activities (drawing and coloring) blends our thinking and enables us to synthesize ideas, versus analyze them. What's the difference? When you analyze something, you have a singular focus on it and it alone. Imagine being worried about having an unneeded, unwanted, unwarned-about episiotomy. Analyzing this can lead to worrying it might happen to you, without much recourse or thought into the bigger picture of how to prepare to avoid it. Synthesizing takes many pieces of information and plugs them into a bigger picture. In the case of episiotomy, you can learn when they are medically necessary, ways to prevent them during labor (for example, avoiding getting over-hydrated) and second stage (avoiding purple pushing and being more upright), your doctor's opinion and habits, and your birth location's statistics. Here are pictures from students in my Chico, CA classes (I currently offer Lamaze childbirth classes in Bakersfield, Visalia, Hanford, Tulare, and many places in between and beyond).  I like the labor length and time-line for being home and being at the hospital.  A collaboration by Mom and Dad. I loved what I called The Parthenon -- it actually did represent support! What a great way to draw such an intangible idea!  Very neat and organized! All we need are some boxes next to each item and this would be a great packing list!  Another picture a mom and dad drew together. See the stairs? They are scaling the wall. The rainbow on the right Dad said, "represents God's love and presence." So many great symbols!  "Ninja Birth." A dad-to-be drew this. He and his partner were on the same page of wanting a normal birth free of unneeded interventions. She was gentle and calm in her desires -- he pictured worst-case scenario, including ninjas and Chinese stars. So of course, sometimes these pictures get silly. But when you remember the role of the partner is one of protector, it makes sense. As a group we process and interpret the images, and families share why they chose what they did and what it means to them. These pictures serve as a jumping-off point so parents can not only discuss what's important to them, but also how to achieve these goals. And I promise, this last picture? This family had a lovely hospital waterbirth with a midwife -- and no ninjas were needed.   This week I received notification that I, once again, passed the Lamaze International certifying exam (making me the only listed LCCE in Bakersfield, one of two in Visalia). In light of that, I was curious to know why as doulas and educators, we choose to extend the extra effort and resources to gain and keep these initials after our names? Sharon Muza offers her thoughts to this topic. Additional quotes follow from not only doulas, but also mothers. And my answer? Grievance policy, as strange as that sounds -- I appreciate DONA offering this, as it protects my clients, and it protects me. I am both a certified doula with DONA International, CD(DONA), and a certified childbirth educator with Lamaze International, LCCE. I am very proud of the fact that I hold and maintain these certifications. I worked hard for them and it means a lot for me to have these credentials. Here are my top six reasons for certifying AND maintaining certification with well-known, long-standing, internationally recognized organizations: 1. Demonstrates my serious commitment to being recognized as a professional doula and childbirth educator. 2. Assures my clients, students, my colleagues and the health care providers that I work with that I have successfully completed the requirements for certifications as set forth by my certifying organizations. 3. My clients, students, my colleagues and HCPs are assured that I abide by and practice according to the standards of practice and code of ethics that have been established by well-known and well-respected certifying organizations. 4. It allows me to support the organizations that I believe in, with my membership and certification dollars, allowing them to work toward improving maternal infant health outcomes as a serious player on the national and international level with my support. 5. Maintaining recertification shows my commitment to receiving continuing education that is current and applicable, and demonstrates my desire to remain up to date with best practices. 6. Provides a grievance process for clients, students, colleagues and HCPs who might have concerns about my practice standards, actions or ethical behavior. I am very proud that I am a certified birth doula with DONA International and a Lamaze Certified Childbirth Educator. I look forward to continuing to maintain these certification in the years to come. I encourage you to seek out reputable and well-respected organizations to align yourself with and pursue certification in a professional manner.
 Sharon Muza, BS, CD(DONA) BDT(DONA), LCCE, FACCE has been an active childbirth professional since 2004, teaching Lamaze classes and providing doula services to hundreds of couples through her private practice in Seattle, Washington. She is an instructor at the Simkin Center, Bastyr University where she is a birth doula trainer. Sharon is also a trainer with Passion for Birth, a Lamaze-Accredited Childbirth Educator Program. Sharon is a former co-leader of the International Cesarean Awareness Network’s (ICAN) Seattle Chapter, and a former board member of PALS Doulas and Past President of REACHE. In September 2011, Sharon was admitted as a Fellow to the Academy of Certified Childbirth Educators. Sharon Muza has been the community manager, writer and editor for Science & Sensibility, Lamaze International’s blog for birth professionals, since 2012. Sharon enjoys active online engagement and facilitating discussion around best practice, current research and its practical application to community standards and actions by health care providers, and how that affects families in the childbearing year. Sharon has been a dynamic speaker at international conferences on topics of interest to birth professionals and enjoys collaborating with others to share ideas and information that benefit birth professionals and families. To learn more about Sharon, you are invited to visit her website, SharonMuza.com.
 I am incredibly thrilled to share today’s post. Samantha Morgan is the youngest trained doula I have ever known. She has faced adversity and prejudices, but that hasn’t stopped her from working toward her goals. At 14, I was thinking of boys and music – I certainly didn’t care much about birth and moms’ experiences! It has been inspiring to see Samantha’s passion, and her desire to help families.  I thought both of my doula trainings were amazing (birth & postpartum). I loved my trainers and they were able to bring fun into their trainings and put it on a level where everyone understood. I've been a vet tech for the last two years and I love getting to spend time with clients and I always love helping when an animal comes in with difficulties in labor. When a friend of mine told me about doulas, I couldn't believe there was actually such a thing, I was so excited. I have always loved kids and babies, and I love going above and beyond to help people. Thankfully DONA International doesn't have age restrictions, so I was able to take my trainings at 14, making me the youngest trained doula yet. I was able to graduate high school earlier this year and I'm now eligible to apply for certification having attended 6 births. At 15 (right before my birthday), I took a Lamaze workshop in Houston with The Family Way -- I am the youngest to take it and I plan on certifying in October once I take the exam. Being young and not having children myself is actually one of my biggest problems (that I don't consider my problem!). Last year I joined in affiliation with another doula business, and after about 3 months, the head doula called me in and said “the other doulas in the group don't feel comfortable having you as back-up since you don't know what women go through having not experienced it yourself. They are also worried, since it seems like you just jumped into the doula carreer, you are not likely to stay in it.” So I was “let go.” I started talking with another doula who was young and childless herself. Together we found, looking down on doulas who have not gone through birth can be a very big problem in the doula community. This led to me create a Facebook group strictly for those doulas 25 and under who don’t have children. I have never been turned down to be someone's doula. My clients always comment on loving my beliefs and personality. The local Midwife loves me, as I her, and she loves the fact that when I go to a birth, hospital or home, I'm dedicated to stay with my client no matter what. I have pulled all-nighter all the way to 3 nights with no sleep. Why? Because it's not my birth, I have plenty of time to sleep later. I was given great advice by one of my trainers to not freely give out my age. Of course if I'm asked I do tell, but you don't see it on my web page or in write-ups. My main client base comes from literally all directions. I normally find myself traveling for births. I travel up to 2 hours away. I suppose most of my clients are ones who already know how they are wanting to labor or deliver. I make sure my clients have an opportunity to tell, express, and fight for what they are wanting -- whether that be natural, medicated, or even upside down, I support my clients 110%. My clients choose me because of my heart, not because of my life experience. I love working with clients to find an affordable price, to find what they need, what I can do, even the smallest things, to be able to help them. I'm always there for my clients, and I don't need to ever step away to make a phone call to check on kids, a babysitter or husband. I'm devoted and educated. I know the most recent research and facts that have been proven so that the client can make informed decisions immediately. I love my job, my clients and everything in between. I don't worry about what client I will have next; my personal motto is that God will bring me what I need. He has never failed me. Often clients come from people I meet -- car sales man, bosses of expecting employees and such. For example, I needed a car and the salesman’s wife was expecting. He asked what I did, and I get the opportunity to share my passion. Guess what? He wants a doula for his wife. What an amazing divine appointment! I never let the strikes against me bring me down or discourage me; God will bring me exactly what I need and not a second too soon.  I am a DONA trained Birth and Postpartum Doula. I attended my Birth workshop in March 2013 along with a Childbirth Education Class and a Lactation Class (all DONA Approved). In April 2013 I attended my Postpartum Workshop. I'm currently working on my DONA certification. In April 2014, I attended a Lamaze Childbirth Educator Workshop and I'm looking forward to becoming certified in the late fall.
I believe every woman is empowered to give birth her way, naturally and confidently. My mission is to provide doula care and supply expecting parents with the information and education they need for pregnancy, labor, childbirth and the postpartum period. I want to give parents the loving support and encouragement they need during this special time. For more information, visit my website, my Facbook page, or find me on Twitter.   There are so many videos out there for the childbirth and breastfeeding world, and many come with hefty price tags -- it's hard to know what would fit your classes or clientele. Needing to make a concise list of my material anyway, I am taking the opportunity to also share what I have, how (if) I use it, and where it can be obtained.
One video I use at the beginning of every childbirth series is Lamaze's "Everyday Miracles." It is about 8 minutes long and for me, it sets the tone for my Lamaze-created curriculum, to let parents know what to expect and to introduce them to Lamaze as a philosophy (healthy birth practices) versus the older method (breathing). It follows three ethnically diverse couples through their labors and births with lovely, uplifting words detailing emotionally what the couples are experiencing. My only gripe is, they do not place the babies skin-to-skin with the mamas, but that is more about the time than the idea -- skin-to-skin and kangaroo care were just starting to get attention. Although this isn't a brand new video (2002), it is still relevant and the families shown look relatable. Two women have their babies in upright positions in bed, while a third births on a birthing stool. It is available to watch on Lamaze's website, and it is available for purchase for the very amazing price of about $13 through InJoy.  Teri at Passion for Birth held a contest a few weeks back asking the question, "Why I Became a Childbirth Educator." Guess what? I was one of the winners! As a winner, you get to select one of three prizes, Teri's Idea Box or Staying Energized, which are full of fabulous ideas for creative teaching, or her Trust Birth Poster (which I chose, as I already bought the other two when I first began teaching!).  Last Monday I accompanied a friend and former two-time doula client to an appointment with an OB/GYN. She had her babies with CNMs, but at 2.5 months postpartum, she was still experiencing bleeding, and everyone has decided it is time to figure out why. The first thought was retained placenta; luckily she has had no sufferings with her milk supply -- she is even nursing her infant and her toddler, and there is plenty of milk for all. But that the bleeding has not stopped is disconcerting for her and her practitioners.
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Stacie Bingham, LCCE, CD(DONA), CBS(LER)Calm, comfortable Lamaze education & experienced support for pregnancy, birth, & breastfeeding serving Bakersfield, Delano, Hanford, Porterville, Tehachapi, Tulare, Visalia + the World
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