When living in Chico, California, and starting as a doula, I did not enter this work with a professionally-created business plan clutched in-hand – I walked in with my heart open and extended, ready to help families. The focus on business in the doula world has been huge in the last few years, and I absolutely see the value in that. When I started as a doula, there simply were not resources past the doula trainings we took. I did as many others did – made things up as I went along. With freedom and (eventually) experience, I made changes as needed to better fit how I wanted to do business. I have known all along that I do things differently than many other doulas, and I am perfectly content in that. In order for me to stay sane, happy, and sustainable as a doula, my business beliefs and practices have to match me. Take, for example, payment.
It is the norm for doulas to be paid-in-full before a baby is born – often by 36 weeks. The agreement generally is, if you have not paid your doula before your birth, she does not consider herself on call for you. I deviated from this years ago after seeing an uncomfortable situation with a doula friend and her client.
Anne was called to labor with a client at home. The client had not yet paid the second half of Anne’s fee, but Anne made the choice to attend her client. After a night spent working through contractions, labor stopped. Anne left to wait for her client to share when labor began again. But Anne’s client never called, and soon Anne learned the baby had been born. Expecting to be paid, Anne contacted her client to make arrangements. The client, though, expected that since she didn’t have direct doula support for the birth, nothing was owed. For weeks and months I saw this play out, and I felt bad for Anne. The amount of time and energy she put into trying to collect payment was painful to watch. I understood Anne’s side of things, and yet I could imagine a situation where her client felt good about birthing without a doula.
Anne never was paid.
I have since moved from Chico to serve the areas of Visalia and Bakersfield, yet my belief hasn’t changed: my true heart of this birth business lies in wanting families to have what is right for them – even if that means they change their minds about me. I cannot stress this enough! Thoughts come to me: what if a family finds that fee-remainder would be more important to them than doula support? What if I miss a birth? What if they are laboring confidently and a doula’s presence doesn’t fit the flow of their birth? What if a planned cesarean birth is needed and they feel well-enough supported? I wanted my clients to have an “out,” to be free not to call me, without worry of penalty.
My contract expectations are as follows:
There it is – all in place should a family find it useful.
This structure is worrisome to many doulas I have shared it with. What about being on-call and then suddenly having your time wasted by not attending the birth? Unless I block my calendar out for specific dates (and as my husband is a teacher, I block out some time in the summer), I am on-call a lot. When weighing this as an option for families (against my inconvenience), I want families to win.
Ultimately this has been more of a non-issue: I am getting close to 200 births as a solo doula, and I changed my contract to reflect this option around birth 30; in all of that time, I have never had a family NOT call me, and I have never had a family NOT pay me. So why keep it in my contract at all, if it isn’t going to be used? Because I believe birth is a time when your choices shape your outcome – and who is on your birth team should always be one of your choices.
I recently had an inquiry into my doula services. Knowing there was a slight chance I might be out of town for a couple days around this couple’s EDD, I offered a partnering situation, where a second doula and I share all the pre-birth responsibilities, and then whoever is most available attends the birth and the follow-up visit (for more information about ways to work with other doulas, contact me). In a case like this, we split the deposit, both attend all prenatals, and then have a way of determining who will most likely arrive at the birth (sometimes this is as simple as who is more rested in the case of another recent doula birth, sometimes we wait and see who the family contacts first, and sometimes it is just a pre-arranged agreement between doulas). The family agreed with this type of arrangement, so I contacted a doula friend, asked if she were game, and all of us met for an interview.
The partner I selected for this birth is much my junior in the birth world. We had recently partnered for a birth where I was asked to help a young mother-to-be in foster care – there were no funds for doula support, yet this situation was too important to let that stop me. Knowing I had a pretty busy birth schedule, I asked this doula if she would partner with me for this volunteer birth, and she heartily agreed. I loved her style, her knowledge, her heart. She has a real passion for serving, and I can’t wait to work with her more.
Our interview went well. The family originally found me through my website. They were impressed that I kept an active blog, and they appreciated my experience, certifications, and the seriousness with which I take this work. The expectant father is someone who deals a lot with numbers – he is a numbers guy. He did seem concerned that I might be out of town during their due-week. I also live about 40 minutes away from the hospital where the couple would be birthing, and my partner lived about 10 – this was another number for the expectant dad to absorb and think about. The expectant mother, because it was her second baby and she had a fast-paced job where she gets little rest and is always on her feet, had practically been assured by her doctor her baby would be early. With the dual coverage provided, and knowing babies don’t generally come lightning-fast, she seemed very comfortable with how the situation would work out.
Upon ending the interview, the expectant mother basically said, “Thanks for taking the time to meet with us. I will call you tomorrow to let you know how we want to proceed. But I am feeling pretty good about all of this.”
My partner and I walked away feeling really positive about the meeting, and we said our good-byes.
The next day came and went, and I didn’t receive a call. Because this family was due within a month or so, this day passing without hearing from them was a tiny, pink flag to me. The following day, I did get a call from the expectant mother. I could tell by her tone she was having a hard time putting her words together. That’s when I knew for certain: they were not choosing me. Okay, that sounds weird, as we were already aligned to work as partners. But I could sense they wanted to alter the design, and being as mine was the only contact information they had, that meant they had to, essentially, go through me to get to my partner.
Talk about awkward! I held the reins here. The expectant mother explained, it really came down to me possibly being gone, and that 40 minutes of driving for me to reach the hospital – her partner was not comfortable with these numbers (maybe they felt a better connection to the other doula? And if so, they did not mention this, but she is amazing, so of course it could add to their reasons, but they did not say that to me). I stopped the woman, as she was uncomfortably offering a finder’s fee, and apologizing all over the place – I knew she felt bad and this was hard for her to do. I told her one of my core values as a doula is that families find the doula who is right for them, and that won’t always be me. I hold true to that, and I really believe I get the clients I am meant to get.
I assuaged this mother’s guilt as best as I could. I told her not to worry about it one more minute. I gave her the other doula’s information, then asked if I could talk to my partner doula first? She agreed. I wished her well, again told her I was happy they found a match that felt comforting, and said good-bye.
Then I dialed my partner doula.
She was in disbelief, knowing I had more experience, and that the family found her through me. She was also extremely apologetic and humble. I assured her this family was firm in their decision, and I told her she should take the time to feel good! She was chosen! Relish in that and feel proud! I said I appreciated her being gentle with me, sounding and feeling disappointed and surprised, questioning their choice, and I wanted her to let it go to her head a bit – celebrate! I knew she would be a great doula for them, and I could honestly say I was happy with how things turned out.
I do, absolutely, feel everyone deserves a doula, and that doula won’t always be me. Families come in all shapes, sizes, and situations, and they have ever-branching needs. I feel confident in the work I do and the care I have to offer. And I know so many other incredible doulas I can say the same about. It is more important to me that we support families than I be the one supporting all the families. Because of this, I can still be happy and gracious when the right one is not me.
I have a son who was born with an aortic stenosis. This means his aortic valve is narrower than it should be. He just turned 14 and up until his cardiology appointment last month, there has never been an issue.
Before we found ourselves back in the office, we had been rescheduled twice, so I was already feeling on-edge. Walking into the waiting room, there was not one place to sit. This added to my feelings of annoyance. When we finally met with the doctor, I was relieved, until after placing the transducer on my son’s chest his first question was, “Have you had a growth spurt recently?” Not what you want to hear when your child has a heart defect.
The most recent reason we had been rescheduled was our doctor had a spider bite on his leg that needed treatment. I rolled my eyes when the receptionist shared this with us (good thing it was over the phone). I thought it sounded like an interesting excuse – who has to go to the hospital for a spider bite? But another part of me wondered: Why is she telling me this? Is that my business?
At this bad-news-appointment, we were told medication would be needed to lower my son’s blood pressure – not because it was high, but because the rate of flow through the narrowing could cause damage to the area where the blood comes through, like spraying a pressure washer constantly at one spot on your house. We were also asked if we had other children, and if they had ever been assessed by a cardiologist? We have 4 sons total, and no one has ever told us this before – that was jarring. The doctor was adamant my husband and I be checked, as well. Our heart-son’s health is monitored fiercely because there is a known issue – but if this were genetic, any of us could have an issue and not know. That was frightening.
We were the last appointment of the day and the office was shutting down. As the doctor was performing the echocardiogram, he kept sharing details of his spider bite, occasionally shaking his leg or letting out a sigh or “ouch” here and there – it was obvious he was not feeling well. He also said he couldn’t wait to get out of there that day and change the dressing.
So here’s us: bombarded with overwhelming information.
And here’s our doctor: trying to help us while being distracted with his own issue.
I left that day feeling sad, scared, and unsure about all his recommendations. Knowing we didn’t have his full attention added to my stress and confusion. I questioned our relationship with this professional, and again to my mind came: Why is his issue my business?
So how does this relate to doula work? Let me share another story.
A number of years back I had a couple I loved, and I think they loved me. We were so excited to work together. A week before they were due, my grandma passed away and the funeral was in another state. Of course I was going to attend – in the grand scheme of things, my grandma’s funeral is going to be more important to my health and memories than the birth of a client’s baby. So I let my client know my plans.
It was an emotional phone call, because she was one of the first people I told. I did cry when I let her know I was going out of town, and of course I would provide a back-up for her. I felt good about everything. I was gone for 5 days, and just as we hit the California state line again, I knew I would be home by nightfall and things would return to normal! I could still be there for her birth.
I was unprepared for the phone call I got within an hour of that feeling. It was my client. She said she didn’t want there to be any bad feelings at the birth, and they had decided to proceed without a doula. I felt confused because I knew I didn’t have any bad feelings – had I been clueless to their feelings?
The next day we talked it out more. I felt I had made it back and things would proceed as planned. But what I didn’t realize was, my business had become her emotional baggage, as she worried about my loss and whether I would be back in time for her birth.
At the time I remember thinking, “No one cares about me.” Meaning, clients don’t offer the same emotional support and empathy that doulas do. Our lives don’t get the same priority as the pregnant families we serve. It was an acutely painful realization made worse by the loss of my grandmother and exhausted nature of the trip.
Of course, I was wrong. That’s how it should be when I am being contracted to provide a service. And once I was mature enough to realize it, I decided I wanted my clients to feel like I don’t have a life. Never again would I burden a client with my personal business. I want them to realize, when it comes to their expectations of me, there is nothing more important (even at the most inconvenient times), than their call of: “we need you.”
I have heard from many women over the years, words and situations that haunt them, where a professional’s business was made the mom’s business (which is really bad for business).
-A mom was waiting for her midwife to come for a postpartum home visit. The midwife told the mom she couldn’t find childcare for her little boy, so she would need to reschedule. The mom experienced a pretty traumatic birth, and she was eager for this visit and the need for someone to look over her baby again. She was so worried she took her baby to the ER just to have someone tell her the baby was safe and healthy (which she was).
-A mom who wanted a TOLAC (trial of labor after cesarean) ended up with a repeat cesarean birth. It was very emotional, everything leading up to this and ultimately, having an unexpected surgical birth with an unexpected provider. Toward the end of the birth, the doctor said, “Can someone take over for me? I have to get to my granddaughter’s piano recital.”
-A mom who experienced terrible postpartum anxiety and depression who was desperate for support. She sought out a therapist recommended to her by a friend. Once there, sharing her story in an uneasy fashion, with tears, and memories, and guilt, the therapist let this be an opening to share her own struggles with depression after her brother’s suicide. Suddenly "a little postpartum depression" felt minimal compared to this professional’s loss.
We pay professionals for a service. They should be taking care of us. When the tables turn and we are suddenly made aware of their personal lives, it can stir up feelings of empathy and sympathy. It can make us feel like we should be the caretakers now – we need to look out for this person and not bother them with our trivial matters. “I don’t want to load too much on her, because she has struggles of her own.”
But then, what are you paying that person for again?
Professionals need to leave their personal business out of their professional lives.
That’s not to say clients are rude or uncaring – they aren’t. And the focus still needs to be on them. What can we do when something comes up?
As a doula serving Bakersfield and Visalia, California, I strive to build families up and let them know I will be there for them, come hell or high water. I also contract personally with a back-up doula who attends prenatals with us, thus laying a foundation of support in the small chance I am unable to attend a birth (it rarely, rarely happens, and the cost of paying for a back-up’s time is absolutely worth my peace of mind). It shows a family: I am committed to you, and sometimes things come up; if that happens, here is my trusted back-up so you won’t be alone in this journey.
Ultimately, I believe me making my business your business is bad, overall, for business!
You may not even know it, but you and your baby have been working hard, preparing for the next step in your relationship after pregnancy and birth -- breastfeeding. Just as you provided everything your baby needed to grow on the inside, you are sequenced to continue this job once baby is on the outside. Currently I am working toward increasing my formal lactation knowledge to better serve the Bakersfield and Visalia areas. To add to my current 6500 direct breastfeeding counseling hours, I am completing 90 hours of specific lactation education (required to become eligible to sit for the exam to become an IBCLC). I came across these quotes while studying, and I was struck by the timing of these events!
While we are designed to nurse our babies, that doesn't mean it will happen easily. If you are experiencing breastfeeding issues, reach out for some help! There are many places to look, starting with the hospital where your baby may have been born, WIC offices, local public health options, private practice IBCLCs, and group support gatherings, such as La Leche League and Breastfeeding USA. Often you can call any of these resources for some phone help or questions answered. If you need more support, hopefully the person on the other end of the phone can further direct you to the best resources for your situation.
Just because we are mammals and breastfeeding seems like it should be "natural," that doesn't mean we won't need some good information and ideas from others who are in positions to help. Don't be afraid to get some guidance -- you are your baby are in this together!
For more resources, view this past post.
Before working as a doula in Bakersfield, Visalia, Hanford, and the lower Central Valley, I was in Chico, CA -- up north. This mother was a client of mine, and here she is shown having her second baby at home, after a very medicalized first birth due to her baby's health issues. This time around she labored all night, with erratic but strong contractions. When she finally realized they needed the midwife, it was just in the nick of time! The joy and ecstasy she experienced by this fast, healing birth shows in her body language, and of course her face! For this woman, being left undisturbed to labor was a huge part in the emotions and feelings that helped her have an ecstatic experience. It is a day she will always remember and have pride in -- and no matter how a woman's birth experience goes, with support from her team and knowledge of her choices, she can also be left with these good feelings.
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.
I recently had a family reach out to me looking for a doula in the Bakersfield area. I knew I was not available for when they were due, so I offered the names of three other doulas, with reasoning as to why I thought they would be good matches. I also shared the resources area of my website, where I try to keep a running list of doulas in the greater Bakersfield and Visalia areas. I kept in contact with this family for a while, to ensure they had their doula needs met.
A couple weeks ago, after coming away from a prenatal with a current client, I noticed I had a Facebook message, and a text message. I thought, wow, someone has been looking for me! I opened them both to see it was one of these three local doulas, thanking me for the referral, as this family hired her. I was tickled with surprise and appreciation for this small act! We are all busy, and I am sure we often think, that was nice of her, I should let her know; the reality is, we don't always follow-through. I know I will remember this doula faster the next time I have a referral, and I also know I will rush to thank the next person who offers me a similar favor.
When working towards my certifying births for DONA in Chico, CA, there was one experience where the doctor left before I could ask for an evaluation. Hoping for the best, I wrote her a note and included an evaluation form and a SASE. Honestly, this doctor wasn't my favorite...but she didn't have to be my favorite to provide good care to my client. I thought of authentic statements I could share to show I valued her place in this birth.
"Dear Dr. Doe,
I had the privilege of helping Jane and John Person during the birth of their baby, Baby. Jane said nothing but good things about you during our prenatal contact -- it is clear to me she felt you two truly connected. I appreciated the way you cared for Jane throughout the pregnancy and birth, helping her feel confident about the experience...."
The next paragraph explained the certifying process, a bit about DONA, and that an evaluation from her would be helpful. I closed with: "Thank you for taking the time to do this for me."
Guess what? She sent it back, and I was able to use it for my certification.
Once at my pediatrician's office, I was telling my friend (nurse manager of the clinic), how much I appreciated the woman who worked at the registration counter. Every time we came in, she knew our names. She always asked how we were doing. She even remembered things we had talked about before. She felt like a friend, and I noticed this was not just how she treated us -- this was how she treated everyone in this clinic, which had a high rate of patient appointments where many families had Medicaid. She never seemed annoyed, she never acted like people were an inconvenience. As I was sharing this with my friend, she handed me a paper and pencil and asked me to write a note to the hospital which oversaw this clinic, sharing my feelings with them. I thought nothing of it -- it took less than 5 minutes of my day, and then honestly, I forgot about it.
The next time we visited the clinic, this woman came rushing toward me, arms open wide, and she thanked me heartily for what I shared. She said it meant so much to her, to be acknowledged and praised for the work she does daily.
Expectant families often ask if they can do anything for their nurses, not only to show appreciation for the long, hard hours nurses work, but also gain a happy member of their birth team. I was impressed when a client showed me the basket of goodies that would accompany her and her husband to the hospital. Knowing nurses often get gifts of yummy (but not always healthy) food, she wanted to be different. Her basket was thoughtfully packed full of hand lotions and sanitizer, Propel packets, pocket-size tissue packs, gum, Chapstick, Jolly Ranchers, and tiny chocolates. This woman had a fast labor, and she didn't go through as many nurses as she expected, but every nurse that walked in -- even her doctor and I -- were encouraged to pull things from the basket we wanted. "Now I don't want to take any of that home! I brought it all for you!" she told everyone, happily. The nurses were tickled at this sweet gesture. Her doctor, at first reluctant, did finally concede, "I do always need Chapstick."
Some might say this is unnecessary, that nurses are being paid at their jobs, so why are "gifts" necessary? One L&D nurse I know shared, "I love the thank you cards. I am shy about gifts and food. It's very nice though, but not necessary." A second one told me: "I absolutely love when patients bring in something special for the unit. We are there for joyous occasions and heartbreaking occasions. When patients acknowledge our work it makes us all feel good about the job we are doing. It lets us know that we made a difference during a very important time in their lives."
Isn't that what a true thank you is about? Acknowledging someone's good work? Isn't that something we all want? To know someone noticed, someone cared, it mattered to someone what we did? It's not a hard thing to do, and it can mean so much. I dare you to care enough to say "Thank You." Two little words.
My older sister likes to remind me that once upon a time, while pregnant with my first, I responded to her question of, "Are you going to breastfeed?" with an unsure, "...if I can." To this day I still deny it. I honestly have no recollection whatsoever of that conversation -- I know she wouldn't make it up, though.
Over 16 years later, life has put me in a different place. I have successfully breastfeed my four children. Soon after my second baby's birth I went on to become a breastfeeding counselor, leading meetings for local mothers and mothers online, taking phone calls from frantic mothers all hours of the day and night, making home visits and hospital visits, and participating on our county's local breastfeeding coalition. I have written articles for journals, magazines, and blogs, spoken at breastfeeding conferences, and I am currently working toward becoming eligible to sit the exam to be an IBCLC. I cannot imagine who that person was who meekly replied, "...if I can," all those years ago.
Yet with all the future-breastfeeding moms out there, this is a common feeling. I think it stems from allowing a bit of room for failure -- not setting the bar too high in case of disappointment. Simply put, lowering expectations.
You only have to go as far as your nearest mother to find why this answer has held its place as, I would guess, the number one response: We love to share our horror stories. Any pregnant woman can attest to this when it comes to birth stories -- suddenly women are crawling out of the wood-work to tell you their impossible experiences -- the pain, the suffering, the horridness of it all, oh, and good luck! This carries over to breastfeeding experiences as well.
One day in the grocery store, a young clerk asked, while checking my items, if this was to be my first baby? I was prepared for her to launch into her personal drama, so with my fists clenched, and most likely talking through gritted teeth, I replied, "Yes." She looked at me so sweetly and honestly. "You are going to do just fine." I was stunned! She must have sensed this -- she went on to say, "Having my son was the best experience of my life. I wouldn't trade his birth for anything." I left for my car feeling like she had just revealed a secret to me -- I felt this young lady, about my age, had seen something in me I did not know I possessed. I felt powerful.
Birth and breastfeeding are related in the way we think about them both: We hope for the best, but in the end, we do not have ultimate control over how things will turn out. This tends to be more true for birth than for breastfeeding. Some of the most committed breastfeeding mothers I have met have been mothers who had to have cesarean births after planning completely natural births. I think many of them found exerting energy into the breastfeeding relationship healed the loss the cesarean birth left with them.
As women, we need to focus on sharing our positive feelings about birth and breastfeeding. We need to assure other mothers although there can be problems and set-backs, there is always a way to accommodate, adjust or overcome with the right network of support.
Let me share the biggest secret to a successful breastfeeding relationship: Know where to get help. You can always call me with your breastfeeding concerns. My doula role ends after your baby's birth, but my role as your breastfeeding counselor continues until you no longer need me.
I help breastfeeding moms with lactation support in the Bakersfield, Visalia, Tulare, and Hanford areas of California's Central Valley. So often when I answer the phone to a mom looking for breastfeeding support, somewhere in there I hear the voice-cracking and the tell-tale pauses that show she is working hard just to reach out and share her story. We are often not prepared for how hard breastfeeding can be, and the toll it can take on our hearts. We hear of the joy babies bring, the bonding, their smell, their sweetness -- maybe someone out there mentioned being really tired or not showering easily in the first weeks. We are culturally conditioned to worry more about birth than breastfeeding.
When a mom is struggling, what can we do to lift her up? What words and actions can scaffold her, infuse her with strength? I asked women to think back to what was encouraging and motivating, that anyone (not just a breastfeeding helper) could do, to make the journey a little easier. Here is what was shared:
1. "Keep the focus on me." Many of us have had issues with breastfeeding, and often the inclination is to quickly get to our own story and how we survived. "I cracked and bled for two weeks. I didn't have enough milk so my friends gave me donor milk. I locked myself in a room and said, 'we will figure this out,' and I never gave him a drop of formula, even though my doctor suggested I was starving him -- I just powered through." This is not helpful. It isn't that on a normal day Mom can't appreciate your experience, it's just that right now, it takes away from her very-current state of being vulnerable and needing support. If you can relate, say something simple that doesn't turn the whole subject back to you, like, "I remember that." It's okay to reaffirm you have felt something similar; it's not okay to shift the focus so now you can talk about yourself. In this moment, it needs to be all about Mom and Baby. It takes acute awareness to stay in the present with her, and this truly is your gift to give.
What is not helpful: Launching into your own tale of triumph, terror, or failure, especially with the intent of showing Mom you had it worse; the same holds true if you feel compelled to share your grief, your anger, or what you would do. Apply Susan Silk's "Ring Theory," which I have adapted. The idea is, the person facing the crisis (Mom) has the center spot. She is allowed to say whatever she wants or needs to, to anyone else. As the rings extend, others are assigned positions according to how close they are to the center. So Mom's partner is next. Again, he or she is allowed to vent in an outward fashion. Family and friends will have their own feelings, and it is appropriate to dump those outward as well. Advising, sharing your worries or coping methods, explaining your exasperation with the situation, etc., is never done inwardly, because this adds to the load of those dealing most directly with the crisis.
2. "Use those active listening skills we hear about." Rephrase what she says: "It sounds like you are scared that breastfeeding is not going to work." By restating what you heard, you aren't going to tell her something she doesn't already know, and it lets her know you heard her. If it isn't what she's feeling, she can clarify by offering more information: "No, I feel like it is working, I just think maybe it will never end up being a smooth, easy process, like I imagined." It's okay if you don't get it right -- she will understand you are trying to listen to her feelings. Acknowledge her struggle -- you can never go wrong by saying something like, "I see how hard you are working." Don't ever under-estimate the therapeutic power of being a good listener.
What is not helpful: "Maybe it's not meant to be." "Haven't you tried hard enough?" "Formula/ bottles are here for a reason." "Your cousin Jill wasn't able to breastfeed, and everything turned out fine for her."
3. "Don't be afraid to touch me." When the dam holding back the tears and feelings breaks, she can feel cracked open and raw, and having an audience can make those feelings even worse. You can touch her shoulder, take her hand, or offer the comfort of a hug. Sometimes touch can give more solid support than any words can. When a baby cries, he is letting us know he needs something, and that gives us the opportunity to respond and help him feel better. When adults cry, there is the same opportunity to help someone feel better while also creating a bond of love or friendship. You may not know what to say when you see her like that, but you can't go wrong by showing her physically that you care.
What is not helpful: Staring at her, pretending she's not showing emotion, visibly looking uncomfortable, or telling her not to cry.
4. "Share in the loss I am experiencing." Whether breastfeeding will ever work for Mom and Baby, in the middle of the crisis, it is a loss -- a loss of hopes, a loss of dreams, a loss of what she thought would be an "easy and natural" way to feed her baby. It is okay to treat this as any loss a friend might face. This isn't the same as having two choices for dinner -- chicken and rice or beef and potatoes -- and then having the choice made for you. Breastfeeding comes with many overwhelming emotions. When she feels like she can't feed her baby, in that moment there is nothing that can feel worse, and it feels like loss. We can accept and value that, even if we can't understand it.
What is not helpful: "It could be worse." "At least you have a healthy baby." "I don't understand why this is affecting you so much, it's not like someone died."
5. "Let me decide when I am done." Well-meaning friends and relatives who are concerned about Mom's physical and emotional well-being may try to convince her that she's worked hard enough. Mom is the only one who can judge that -- she knows her options. Wait for her to tell you where she is in this journey. One woman, a neurologist, shared: "If you say you are suicidal, people don't say, 'yeah...you should probably just go ahead...' They figure out how to help you, they talk you off the ledge." It obviously isn't the same thing, but in the storm of hormones, emotions, life changes, and struggles, the very-real feelings of hopelessness and loss of control can be strong and similar. Keep encouraging her. This is her marathon to run -- she decides the pace, the route, when to take a break, or even when to stop -- you cheer her on from the side no matter where she is in that loop, no matter how you are feeling about her situation. As another woman put it: "It's cruel to try to take someone's hope away."
What is not helpful: "It's unlikely by this age your baby is going to figure out how to breastfeed." "Just try X, Y, or Z -- it fixed our issues." "Not everyone can breastfeed." " I just can't bear seeing you so upset."
6. "Do something for me that will save me from having to do it myself." Rabbi Harold Kushner is the author of, "When Bad Things Happen to Good People." When asked to share what he's learned in his years supporting people in the midst of suffering, he said it could all be summed up in this statement: "Show up and shut up." Anything you can do for Mom that gives her more time to be with her baby and concentrate on self-help and healing, is priceless -- and ANYONE can help. "My husband has always been supportive. He always left it up to me to decide what I wanted to do. And when I decided I wanted to continue to try, he helped me pack up the baby and drove me to LC's and LLL several times a week. He washes bottles and pump parts, he's a pro at freezing, thawing, making bottles, hooking up my pump. His labor of love is so important at continuing exclusive pumping, because I alone have logged about 3,000 hours of work towards pumping and pumping-related activities for the first year of my baby's life." Further out of the ring, family and friends can take care of pets or outside responsibilities, bring meals or snacks, run errands, make phone calls, drive Mom and Baby to appointments, and always, always there is housework and laundry.
Ronald A. Rasband shared: "If you come upon a person who is drowning, would you ask if they need help -- or would it be better to just jump in and save them from the deepening waters? The offer, while well-meaning and often given, 'Let me know if I can help,' is really no help at all." It can take energy, effort, and humility for a person to list what she could use help with. In the movie "Robots," one of the characters, Bigweld, had this motto: "See a need, fill a need." Jump in and do what you can -- when there seems to be nothing else, there is always service.
What is not helpful: Service with conditions; making the job seem too complicated to take on, or making it too complicated for Mom to delegate; rushing in to offer babycare when Mom and Baby could be bonding; expecting a thank you card.
Society says feeling bad when breastfeeding is hard is not appropriate or okay. We don't want to make anyone feel bad if they can't breastfeed, so when a woman struggles to continue, her hard work is not always encouraged or even noticed. To really help, though, we need to suspend this judgement and be willing to accept her feelings and her reality. Becky Bailey writes: " Acceptance means recognizing that people, situations, and events are what they are. Each moment simply is as it is. Acceptance doesn't mean that we approve of the moment, only that we recognize that what is happening at a certain moment is, in fact, happening."
Two women in particular said they couldn't remember anything helpful or hopeful that was said to them. This lack of acceptance is apparent when they shared what they wished they had been told:
"This is the hardest thing you will ever do, but you will get through it. You are getting through it. One day at a time. You are amazing and strong and this will be worth it. It does matter."
"I support you and will be here to help you if you decide to keep trying or you want to stop. I value you and think highly of you as a mother and person, no matter your decision."
Accept her struggle. Accept her feelings. Open yourself to her reality and you increase her willingness to accept your help. When she comes out the other side (whatever that other side looks like), it can be with positive memories of the support and care that was shown to her and her baby.
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Titles and terms can be confusing when it comes to assessing a doula's experience, training, and certification. Did you know:
I am the first to admit, you don't need experience, training, or certification to be an incredible doula and make a difference -- we all start from a desire to serve. I value the doulas in my community and I honor the differences in our personalities and styles, interests and specialties. This is a work of the heart, and by following our instincts to care for a mother and family during birth, we offer unique support that helps build them up for the start of their parenting journey.
Why certify? Read what doulas and moms have to say about it.
♥ four young boys and a boy dog (offspring)