This post was born from a Facebook comment Sejal made about not understanding why professionals are hesitant to share their knowledge. I asked her if she could think about it and share something for the 31 Days project. Sure enough -- she gives her back story, and then shares how fortunate she has been to be mentored by amazing, open IBCLCs.
A few days back while I was in the hospital visiting a friend of mine after their surgery, I saw a family with a brand new baby heading home from the hospital. As I walk past them, I see a lady walking next to them, pushing a hospital cart filled with a few balloons and flowers resting on top of a couple of Trader Joe’s reusable bags and a duffel bag.
This brought back so many memories of my own discharge from the hospital I gave birth at and how it was a cold December morning that we walked to the parking garage with our newborn daughter dressed in a red fleece dress and buckled up in her car seat. I don’t think we realized how cold it was for her tiny little feet to be outside in the breeze.
My baby girl was upset with the draft of the cold breeze and I was so upset with her crying as we tried to get her into the car. Fumbling through the seat belt and a bunch of other stuff to keep her warm, we managed to at least get out of the parking garage. I sat down in the front passenger seat (mind you this was the one time I hated sitting down because of the perineal pain). If I had known what I know about mother infant separation and how I could have been closer to her and kept her less stressed and more warm by being in the seat next to my daughter I would have been able to keep her calm. But what did we know as new parents, apparently nothing, but as they say ignorance is bliss and bliss we did feel when we had her in our arms after a long traumatic birth.
Here we were leaving the hospital, embarking on this journey as three of us instead of two of us, completely oblivious to what was ahead of us. The drive home was not too pleasant and every bump in the road was causing me pain. It felt like I was hanging on to the handle on the inside of car so I did not have to put any pressure on my perineum. At home my kind and loving parents were waiting for us to get home with our little nugget. I just wanted to lay down but the pain was too much and by the time I reached home, my feet had gotten half a size bigger. I still had no idea what was going on. I could not walk properly or sit properly and then the idea of breastfeeding my baby without any help from the nurses seemed daunting. My mom was really willing to help and she did try but somehow my daughter could not latch without a nipple shield. Also no one at the hospital had shown me how to breastfeed my daughter lying down and that was a completely foreign concept to me. Every time that my little girl needed to breastfeed I would sit upright in my bed, get my Boppy pillow ready, cover it with a receiving blanket to protect the pillowcase (mind you I was a clean freak back then) and have my mom bring my baby to me to feed, and every time she tried to latch, either the nipple shield would fall off or she would accidentally whack it out of place and then the whole saga of a screaming baby and flailing hands and crying mama would begin.
By Day 3, my breasts were getting engorged and my feet were super swollen. I could not walk to the bathroom, which was only 10 steps away from my bed. I called my OB's office and they said I needed to come in as soon as possible because they were not sure what was going on with my swollen feet. When my OB came in and saw my face, my feet, and my hands, she smiled and said, “You look like the Michelin Man”. I was unfamiliar with who the Michelin Man was but figured it was a character out of some movie. She gave me a script for diuretics and sent me home. She did not even tell me that the number of times I would need to get up to pee would be exhausting in and of itself. I came home and breastfeeding was still difficult for me and my baby. I kept using the nipple shield and having the struggles. I went to develop mastitis and had a really high fever which put me into a delirium. I kept telling my mom, that she should take care of my baby in case something terrible were to happen to me. The pain with breastfeeding was excruciating and I was feeling like I was going to die.
The doctor’s office called in a prescription for antibiotics and I started them immediately. They told me to use the manual pump that I had to relieve any engorgement. I ended up using the nipple shield for 3 months before I went in for a lactation visit at our local hospital where I met a lactation consultant who helped me breastfeed my baby for the first time without a nipple shield. I had never pictured myself not using the nipple shield.
Fast forward my life 10 years and now I was a veteran mom who has helped her friends through their postpartum journey, and my kids were growing up and I was doing the best I could to fit this mold of a supermom, partly created by the expectations of the society, the family and myself. Due to a life event, I had to make the choice of going back to school to get a vocational certificate that could get me a job and somehow I chose to go to nursing school. I became a CNA and then started taking my prerequisites to apply for nursing school. I was also working as a CNA at a private nursing home. I worked 4 half days and learnt so many things on the job as well. During my year as a CNA, my younger sister who was pregnant at the time sustained a fall and broke her leg. She could not move and had to have surgery. She had to stay in bed until her baby arrived and I left my job to care for her. She had her baby and I was there to help her during her postpartum recovery and so were my parents. She was having breastfeeding troubles, her baby was not gaining weight very well and had jaundice. The hospital lactation consultants came and helped as much as they could and then we went home.
The breastfeeding continued to be a struggle and she had to start supplementing with formula. We tried to look for someone who could come to her home for a lactation consult and finally found a lady who did. The lactation consultant started her visit and I was a mute spectator in the room, and all I could think was, who is this person who is so knowledgeable about breastfeeding and was able explain everything to us so clearly? Her name was Meg Stalnaker. Why did I not meet her when I had my first baby ? I absorbed and listened to everything she did and said, as did my sister and brother-in-law. I just had a lightbulb moment. I wanted to do what she does. That was it. I did not want to be a nurse. I wanted to be a lactation consultant. I talked to my sister and she told me that I should ask for the contact information for this angel who helped her. I don’t know why, but I did.
I kept doing my own research about what classes I needed to take and signed up for them at the local community college. I kept in touch with the Meg via email. After I finished my community college classes, I contacted her again and asked her if she could be my mentor. She said yes, but there was a caveat. I needed to wait until she finished mentoring two other students she had at the time.
I was really sad that there was not enough guidance on how to find mentors for the pathway I had chosen to become an International Board Certified Lactation Consultant. It also felt like there were a lot of negativity in regards to choosing to become an IBCLC as a career. I kept looking to see if someone would be interested in being my mentor and taking me on as a student.
During one of my lactation classes at the community college, we had a guest speaker by the name of Peggy Andrews, who was giving a lecture on the topic of jaundice and breastfeeding. I saw a tall woman with golden and white hair walk into our classroom with a smile. She had the brightest smile I had seen on someone’s face. She started the lecture and I was just mesmerized by her way of teaching and felt like I was back in India in my middle school, listening to my favorite biology teacher. At the end of her lecture she shared her email address with our class and something in my head said, “Sejal, you need to email Peggy and ask her if she could be your mentor.” I mean that was a spur of the moment thought and I acted on it by sending her an email asking if that was possible.
The next moment I thought, oh boy, have I made a big mistake by asking this guest speaker to be my mentor. I was hoping that I would get an email saying how inappropriate that question was. To my surprise, I hear back from Peggy saying she loves to mentor students. I was cooking and jumped up and down in my kitchen saying, YESSSSSS!! Wait that is not it, I actually got a call that evening from Peggy asking me if I wanted to go on a lactation visit in Washougal the next morning. I said, I most certainly would, but then I thought, where in the world is Washougal? Well it is in our neighboring state of Washington.
The next morning I meet Peggy at a designated location and she said to me that she will be driving me to the appointment since it is so far. I was so excited and off I went on my first official visit. I started learning about how to talk to a new mother, ask specific questions and give her plenty of time to tell her story. We were there for an hour and a half and I felt like I still made the right choice by asking Peggy to be my mentor. I have learnt so much about being a good listener from Peggy.
I never for one moment thought that Peggy was keeping any information from me when it came to lactation. I had asked a few other local lactation consultants and they said that they don’t mentor students and I was quite discouraged. I am sure other students like me were discouraged as well. Meg, also let me go on a few lactation visits with her and I kept learning from both Peggy and Meg.
One day I saw a class on hand expression at a local boutique taught by another lactation consultant named Bryna Sampey. I immediately signed up for it, and when I went to the class I was secretly happy that I was one of the two people in class, although I also felt sad that people did not sign up for this informative class. I felt like I had learnt so much about manual expression of breastmilk in this class and that little voice in my head said, “Sejal, ask Bryna if she would mentor you.”
After the class, Bryna asked if I wanted to have a bite to eat at the place next door. I jumped at the opportunity to hang out a few more minutes with this brilliant brain. I was practically salivating. We talked about what I did as a postpartum doula and how I was studying to be an IBCLC and she mentioned to me that she also mentored students. I almost wanted to give her a hug and say, where were you a year ago and why did I not meet you earlier. I did not want to be a total psycho so I did not hug her, but told her that I would love to be her mentee. She said that she would let me know as soon as a spot opened up.
What I learned from Bryna and her brilliance made me think critically about breastfeeding and the challenges that come with it and how she made breastfeeding a breeze with all the techniques and tricks that she shared with her clients. As I followed these three amazing women, as my mentors, each one of them taught me how to help with breastfeeding challenges in their own special ways. I feel blessed to have learnt from them and will be eternally grateful for them sharing their wisdom, knowledge and time with me.
I was talking to other lactation students like me one day, who were in the same boat as I was and one of them told me that when they asked a local IBCLC to mentor them, the local IBCLC said to them, and I quote, “Why would I let you shadow me ? You will take my knowledge and compete with me once you get certified.” I was so shocked to hear this. I have no idea who the IBCLC is and don’t even want to know, but it made me realize how fortunate I was to have mentors like Peggy, Meg and Bryna.
With the struggles I had in finding mentors, I had decided in my mind that if I ever become an experienced lactation consultant, I will mentor students. I am an IBCLC now, and I am a brand new IBCLC, but I hope to someday mentor students. I think it is our responsibility as professionals to mentor the future IBCLCs. My dad used to say, knowledge only increases by sharing. He is a brilliant surgeon and he has helped many other doctors become surgeons and I am certain he never thought this way.
So, why do some people have a hard time sharing their knowledge with others who are seeking mentorship in the field of lactation consulting ?
Maybe the experienced professional does not have the time or the resources to mentor someone. Maybe the experienced professional thinks that, sharing their knowledge with newbies will reduce their chance of personal success.
Maybe the experienced professional does not trust this newbie. Trust building does take time.
Maybe the experienced professional in the specific field is a knowledge hoarder.
Maybe the experienced professional wants to have monopoly in their field.
Maybe the experienced professional feels more powerful if they don’t share their knowledge.
Being a mentor and taking on mentees is also a huge responsibility and one that is not easy. I understand that it may be difficult to take on students, but in the field of lactation consulting, I wish we had more mentors. I wish students had access to mentors without having to wait for a long time. I wish experienced IBCLCs would be willing to share their knowledge and expertise with them.
Mentors are an inspiration. Mentors can connect you with opportunities. Mentors know ways to make you succeed professionally. Mentors keep you motivated. Mentors invest their time and energy in you to help you grow. Mentors teach you about finding a good opportunity. Mentors have been where you are and can empathize with your struggles and help you find your way through the obstacles and hurdles. I am so thankfull to have found such mentors who continue to be there for me and do not feel threatened by my success.
Sejal Fichadia, owner of Kindred Mother Care, is the first 31 Days participant to be featured four years in a row. In 2014 she wrote "Our Culture's Needs for Postpartum Doulas," in 2015 she added "Growing Happy, Healthy Moms." Last year she added "Hitting the Pause Button." She has a love for babies and mothers, and feels it is important to help families learn skills to help them on their parenthood journeys. Sejal works hard at expanding her education and working to improve her knowledge base so she can provide families with up-to-date, evidence-based information, which in turn gives them the tools to parent with confidence. This year she passed the exam to add IBCLC to her credentials. She has a caring heart, and as soon as she can, she will be mentoring others wishing to get to IBCLC.
If there is one thing I love, it is helping other doulas get started. There are so many aspects of doula work left to individual preference and style -- it can be beneficial to watch and learn from other doulas as you discover your own shape. The first time I was able to shadow a doula, it was accidental. I was hired by a family, along with a second doula, because both of us had prior scheduled events near the due date that we couldn't miss. The offer was then extended: If you are both available then you can both come and support our birth. As luck would have it, we were! Although I had plenty of doula experience at this point, it was my first time in a new hospital; the other doula was generous with her knowledge -- I couldn't help but grow in many ways thanks to her openness to share all kinds of things with me.
Have you ever shadowed an experienced doula or asked to be shadowed? Did the experience match your expectations?
I think one of the greatest challenges new doulas face once they’ve finished their initial training is learning how to put their knowledge of textbook labors into practice when so very many labors are not textbook. I remember walking out of my initial training excited, feeling ready to jump in as a knowledgeable support person, only to find myself at a 56-hour complicated and confusing labor both for me and the couple I was supporting. It wasn’t following any of the textbook rules. Neither did the next 2 births I attended, which were equally complicated and confusing for entirely different reasons.
Many certifying organizations offer only a short introduction to the labor process in person in which there isn’t much time to get over the natural and normal variations of labor. While there are many books, articles, and websites available for further study into the various reasons why a labor might look active when it’s not or why it might not progress in a linear fashion, it takes time for a new doula to start putting those puzzle pieces together. I had to learn as I went.
Often on the fly, little by little, we learn as we go. I sort of took those early difficult labors as a test of my will to be doula. Wouldn’t that be so much easier, wouldn’t it be so much faster though, if there was a mentor to help in those situations? This stress over feeling not well enough prepared is what leads many doulas to try find someone to shadow or another doula they can call while at a birth. But it’s not always so easy to find or implement. I often hear from doulas that they asked around but no one was willing, or that they found someone but then their client don’t want someone sitting in the corner watching, or that they were afraid to wake a mentor at 2 A.M. to ask questions about a situation unfolding. While many certifying organizations encourage finding a mentor, few formally arrange for it.
As someone who comes from a strong teaching and mentoring background, I really wanted to offer shadowing situations for new doulas. But I found that the shadow concept didn’t work well for me or for my clients for a lot of different reasons. It might be a new doula that I didn’t personally know very well, the connection with the client might be awkward, or often the case, the new doula might reach out once and then never follow up. The energy output for a mentor is high. When it’s not reciprocated, it can be frustrating and discouraging. I needed a different solution, which luckily presented itself as most great ideas do, like a light switch coming on.
I’m fortunate that I often get to work with licensed midwives, and an important part of becoming a licensed midwife is be an apprentice. An apprenticeship has all the things I was looking for: It addresses that most people learn best by watching and then doing; it’s a formal relationship with clear expectations; it’s long term so you get to know each other well; and, clients know we come as a package.
By this time, I was already working in a group practice. We had already worked through the logistics of our business model, things like work load distribution, call time management, money management, and most importantly communication requirements. It was relatively easy to slip an apprentice into the mix, what remained was deciding what was required of the apprentice and how to select one. This process has evolved and been refined over the years and includes the obvious things, such as attending prenatal sessions, active labor, and postpartum follow-up with the client, but also now has requirements about reading, advanced classes, and hands-on experience. When our group turns a doula out into the world, we want to be confident and we want that doula to feel confident that they have the skills and experience to handle any situation. The birthing people and families in our community deserve excellent doulas. We really enjoy being a part of helping to make that happen. It’s an honor and a privilege.
In case you’d like the do the same, here are a some tips to you started:
In working with an apprentice, I believe that it’s very important to know yourself before you can know what you need from an apprentice (it’s not all just you giving, it’s a reciprocal relationship). For example, what are your core values or what makes you tick? Your values help you to stay focused and keep on track, make appropriate decisions, connect with like-minded people, and be inspired.
Some questions to ask yourself (answer truthfully!):
Best of luck to you and your students! If you need a mentor, I’m here!
Teri Nava-Anderson, PhD, CD(DONA), ICCE has been assisting pregnant people and their families through their labors since 2008. She is the CEO and founder of the Harmony Doula Group and co-founder of the Modesto Doula Group, both private practices dedicated to community education, mentoring new doulas, and advancing “mother/baby-friendly” practices in local hospitals. She has been teaching advanced doula training classes since 2012. Teri is the Northern California Regional Representative for DONA International, and the Board President of Mt. Diablo Doula Community.
♥ four young boys and a boy dog (offspring)