I have been a doula for 18 years. I began after the birth of my third child who was born at home with a direct-entry midwife. My midwife asked me if I would help her at births, and that launched me into being a home birth doula for seven years. She eventually moved away, and at that time, it was too far for me to travel to be a doula for her clients. I decided to start attending births at hospitals, and I have been an in-hospital doula for 11 years now.

When I was a doula at home births, I never saw myself in the position of midwife. I think at that time in my life, I wasn’t ready for that kind of responsibility. My children were all very young, and I wasn’t yet done having children. I was a lot younger, and I felt I wasn’t quite qualified and didn’t have enough experience to be in that role. So, I’d occasionally tell the midwife with whom I worked, that I didn’t want to be a midwife. I also thought that midwifery was not for me. After all, I had been pregnant while a senior in high school, barely graduated (attended a California’s continuation program to finish high school) and I had five children by the time I was 29 years old. By the time I was 38, I had eight children. Life was busy enough with homeschooling, church, helping my husband with his business, and being a doula. I couldn’t possibly add anything else to my over-flowing plate.

Well…that all changed in 2014. I noticed a trend in homebirths not only in the nation, but in my own community. I noticed no midwifery care was being provided to Spanish speaking women in my community. While English speaking women at least had the option of receiving midwifery care from a midwife who spoke their language if they so desired, Spanish speaking women in my county do not even have that option. “Someone should do something about this!” I thought. I still didn’t think that person would or could be me.
I became friends with a doula in a nearby city. She also has a large family, AND she was studying to be a midwife. I was excited for her! A doula-turned-midwife was a great journey. As the months and years of our friendship developed and grew, she eventually finished midwifery college, passed the NARM exam, and became a licensed midwife. During this time, I began being moved to pursue midwifery. I think it was always in me to become a midwife, but I just couldn’t imagine how I would pursue a midwifery degree. Watching my friend inspired me, so I began asking her questions about midwifery school.

My friend patiently answered all my questions, provided me with links, and fully encouraged me to go this route. I talked to my husband, I prayed about it, and I -- finally -- knew this was the next step for my life.
After looking at different schools, I chose Midwives College of Utah (MCU). MCU offers continuing education classes and these classes are a non-committal fashion to figure out if a distance education platform works for a person. After one semester of continuing ed classes, and getting a feel for how MCU operates, I knew, for sure, this was the school for me. I began the process of enrolling, and I was accepted into the Associates of Science in Midwifery at Midwives College of Utah in August, 2015. It will take me three years to complete the academic portion of the associate’s degree, and possibly another year to complete the clinical portion, totaling four years before taking the NARM exam.

Changing careers at the age of 45 has been an exciting and stressful adventure. My whole life, and how I operate, changed drastically. I went from having plenty of time to do all the things household, to doing school work 6-8 hours per day, including the weekends. I had to adjust my way of thinking, accept that going to school is the same as having a full-time job. When deciding to take vacations or weekend trips, or even day trips, I look at my calendar. I may have to do extra school work to make up for days I won’t be able to get any work done. I may have to take some school work with me, and get some studying done while on vacation. I have had to adjust everything around my education, and it has been difficult to make that transition.

Everything, right now in my life, is all planned around my schooling. In case any of you might by thinking, “Well there are summer breaks.” No, actually, there aren’t any summer breaks. MCU operates on a trimester schedule. That means, school runs all year long. We have four – fifteen week semesters: fall trimester, winter trimester, spring trimester, and summer trimester. Between semesters, we get a two-week break. That’s it, folks! So, no summer breaks! Now, if I plan it just right, I can finish up about 3 weeks early, and have about a 5-week break, but that means doubling up on assignments to get done early. It’s doable, but not an easy task!

​Currently, I am in the assist phase and working with a preceptor (a licensed midwife who has been approved by MCU to be my supervising midwife). Being in an apprenticeship is such a blessing, but such a huge change for me! I have been accustomed to being in the doula role (education, information, and labor support – which means, never any medical advice is given and no medical procedures are ever done!). Being in the midwife apprentice position is completely different. I get to check blood pressure, pulse, and feel the abdomen for the baby’s position (Leopold’s maneuvers). These are things which are out of the scope of practice for doulas, but within the scope of practice for midwife’s apprentice while under the supervision of a licensed midwife. It’s amazing and exhilarating to be in this new role!

Another big change, for me, is that I now call meetings with my preceptor’s clients “prenatal” appointments. As a doula, I never felt comfortable calling meetings with clients a “prenatal,” because that, to me, is a term used to describe an obstetricians or midwife’s appointment to receive prenatal care. But, now, I am in the midwife’s apprentice role, and can call these "prenatal" meetings.

Going from doula to midwife is completely polar opposite. Doulas provide one to three meetings before birth, provide education, information, and emotional support, provide labor support, some breastfeeding support, and one visit after the baby is born. Doula support is invaluable! Doulas do not, however, provide any medical services, whatsoever.

Midwives provide one prenatal visit once per month from 4 weeks – 28 weeks of pregnancy, one prenatal visit every 2 weeks from 28 weeks – 36 weeks of pregnancy, and one prenatal visit from 36 weeks – 40 weeks and beyond if needed. That’s a total of approximately 15 prenatal visits. These visits include blood pressure, pulse, weight, and fundal measurements. They include lots of information on pregnancy health, nutrition, exercise, and things to expect. They make sure mom and baby are well, and that there are no medical issues. If there are issues, they refer them to an OB. Each prenatal visit typically lasts an hour, sometimes more…Postpartum, they provide approximately 3-4 visits…

​So, for me, going from the doula role, to the midwife assistant role, has been a huge transition. Being part of the care a woman is receiving during her entire pregnancy is a completely different role from the doula role. I am in transition. As we know, transition is a hard place to be -- and I am eager to make the changes to get to my dream of becoming a midwife. ​

I had been looking forward to Sunday afternoon all week. A local midwife (and friend!) was throwing an open-house party to reveal her new office and birth suite. There was to be a petting zoo, bounce house, food, families, and fun. I couldn't wait, and I excitedly brought my mom and Ezra along for the ride. 

LaMonica Bryant, LM, CPM, has been a midwife since 1999. She offers homebirth services to families in Kern, Tulare, and Kings Counties. LaMonica is based outside of Bakersfield, and after moving to a farm with more room, it was time to create a dedicated office space. It was also decided to include a birth suite, for situations when families may want the option of out-of-hospital birth closer to town than they may be. 

I arrived to the party, eager to check out the new space and visit with LaMonica. I saw many friends, including my own midwife, Linda Cowley, who had helped me birth Ezra. Tables were set up and food was near, so I sat and visited for a bit, always keeping an eye out for LaMonica as I wanted to tour the new space with her. After about a half hour, another friend came to our table and whispered something about there being a baby born that morning. 

Let me back up: LaMonica was pregnant, due around Valentine's Day. Her party's date was supposed to have been far enough ahead of her baby's date to not get the two mixed up. But as we all know, sometimes baby's have other plans!

The night before the party, around 11 pm, LaMonica's water broke! Labor ensued, and at 6:17 am, on the day of the planned party, Jasper was born! A short while later LaMonica's husband asked what they were going to do about the party? LaMonica said, the food was bought, the bounce house was on its way, so the show must go on! A bit bewildered, I would imagine, her husband agreed -- as long as she promised to stay in the house, in bed, with her baby.

Thanks to fellow doula, Melissa Hettick, for sharing pictures of the office/suite.

I think it is important to tell you the story of how baby Graeme (pronounced grey – UHM) came Earthside because the more we hear about birth the less we fear birth and that is a catalyst for the continuing change towards mother centered birth.  This is his birth story.

My mother had lived with us for several months before Graeme made his entrance. This was because I have Rheumatoid Autoimmune Arthritis or as it is now called Rheumatoid Autoimmune Disease (it does NOT have me. :)) and it was actively flaring during pregnancy. I was unable to keep up with the demands of a household and our high-spirited toddler. This made for a unique environment with both good and bad points. By the end I believe we had become weary of the dynamic so you could feel the sizzle of anticipation in the air both from waiting for the baby, waiting for my disease levels to subside, and waiting for the end of our situation. I was told during pregnancy that having another child would be a very bad idea because of the many mounting health problems so having mourned that and come to terms with that I was very very ready to be done. When you come to terms with something, accept it, and move on and you have to wait several months for the moving on to come to an end it gets tedious. You are just waiting and pulling forward one day at a time to see a goal. It’s like closing the chapter to a book but you are watching the two covers come together in slow motion and it catches your breath. Ready to be done. 

I had followed the pattern like my daughter’s labor I had labored off and on for 2 weeks. Real bouts of labor followed by several days of nothing. I thought this was Braxton Hicks, but my doctor once again told me otherwise. Graeme was born on a Monday morning. The Thursday before I had my last prenatal appointment and my doctor who has practiced over 30 years said “You are a 7 and you are 78% effaced. See you at the birth center this weekend or Monday.” Having seen it all he is never wrong. He told me with my daughter “see you in the next day or two” and she was born the next day. Yes he sent me home. He is one of the few doctors out there who trust the natural birth process completely. Trusts a mother’s body to do what it is intended to do. He only intervenes when it is absolutely necessary. I am fortunate to have had him as my doctor for the births of my children. 

On February 10th, 2014 at 3:35 am I went to the bathroom. I felt a ton of pressure and was unable to go to the bathroom. This felt different to me. I had felt pressure sitting down for weeks but it became clear to me that this was different. I literally could not contract the muscles to go to the bathroom. This was a lot of pushing down. It didn’t feel like contractions to me but I felt “opening” and so I continued to sit as the half squat was helping that action . I was 39 weeks 4 days pregnant so I wasn’t sure if this was “it” or not. Then I began to feel the pressure come and go. This hadn’t happened this intense before. I started timing these “pressure “waves”. Before I could even get the timing app started I felt my body lurch forward. Labor is like that. You feel yourself being pulled and pushed down from inside. It is a powerful, earthy, painful and at once strange feeling. I texted my husband and said “Hey I’m stuck on the toilet in labor. Finding pants now.” He said “Ok. Waking Nana. FYI Blowing snow”.  It was blowing snow across the highway and there was an advisory to avoid travel if possible. I feel very fortunate that we had my Mom living with us and we could just go, no having to wait or anything. We would ordinarily stay home until later stages of labor but my contractions STARTED at 3 minutes apart and we didn’t want to end up on the evening news as that couple who gave birth on the side of the road in blowing snow. (Congrats to those who do. You have bigger balls than I do.)

3:40 am Got in the car. Contractions 2 1/2 minutes apart. Cascading one on top of each other. Couldn’t breathe. I texted our doula/longtime friend that I was “going to the hospital now” and off we went. 

White knuckle driving in the dark on an icy highway with no lines, high wind, and snow. 

Growl at husband “No” when he attempts to put music on. Growl at him “No” when he attempts to turn it off. Poor fella couldn’t win. Yell at him “IF YOU COULD ATTEMPT TO NOT HIT POTHOLES THAT WOULD BE GREAT! THANKS!!!” with my eyes shut breathing through the wham wham wham of hard fast labor. Didn’t realize that we were two blocks from the hospital when he hit the pothole and this car trip was almost over. Laboring in the car sucks butt. I don’t recommend it at all. 

4:10 am. Arrive at hospital.  Nurse Stacey comes out. She is pretty great, she recognized me because she had talked to my doula. Nothing like being recognized to bring the walls down. My amazing doula had pre-arranged many of the nurses and people who were a part of our team. One was a homebirth midwife in another state, my post birth nurse who cared for us was a doula for many years and was wonderful.  RN Stacey has many children herself. I had a 180 degree experience from last time. I am a sexual assault survivor so this was all pre-arranged to preserve my mental health and command the respect my body needed to do what it needed to do without the anxiety. This time no one asks me to do intake paperwork. My contractions are still 2 1/2 minutes apart. I am trying to keep cool through the pain. Fast labor is no picnic. It is like taking the entirety of regular long labor and smashing it into a few hours. Intense, overwhelming, terrifying and at times makes you doubt yourself and your ability to do it. 

We get into the room and I had to sit on the bed because we needed to get antibiotics in. I don’t want to but I have to. I tested positive for Group B Strep during pregnancy and despite measures to get rid of it at home we didn’t succeed. 

They get a line in and get antibiotics going. They try to get a heart beat on baby. This time manually. I am not strapped to the machine thank goodness. 

Doula Lindsay arrives around 4:30am

They want me to stand to get a heartbeat on the baby. Husband steps out to get water. My doctor has arrived and he is sitting with his feet up on the front desk chatting up the nurses. Typical for him. He’s a character. 

I HATED standing. I had to rest my head on my doula’s chest to get through it. I kept moaning/half-crying “Get me in the water. I want the water now.” “I can’t do this without the water.” Water reduces pain levels greatly and it is SO MUCH EASIER to labor in water. 110% easier. A nurse is running the water while we try to get a heartbeat. In fast labors sometimes the baby gets squeezed so much, so hard that the heartbeat isn’t consistent at all. Fast labors are hard on mom and hard on babies; they aren’t completely “normal”. 

About 5 am Graeme finally cooperates and I can get in the water. Thank the Lord! At this point I was in so much pain that I didn’t even realize my husband still wasn’t there. I was so hyperfocused breathing through the pain. Contractions are on top of each other. I can hardly breathe. My doula says “breathe.” I breathe in. 

As I sit in the hot water I lean back. Worst idea ever. I almost throw up it hurts so bad. I lean forward into almost a squat. Doula pours hot water on my stomach. It doesn’t help much. These contractions are so much more painful than with my daughter. My husband comes back. I cry “I can’t do this. I need pain medication” My doula says “you are doing this. You can do this.” I didn’t know that I was so close to having the baby. This was transition. I wish someone had told me, in retrospect, because I know the stages of labor. I thought this level of pain was going to go on for hours and I started crying. I started to not know what to do with my limbs. Almost flailing from the level of pain. 

“I need to stand. I can’t sit here any more. I have to stand.” 

6:15 am I stand and get out of the tub supported by my husband and my doula.

Yanno how they say when your water breaks it is never like it is in the movies? This was like the movies. WHOOSH it splashes everywhere. The bathroom floor is coated in amnion. Sorry about the shoes guys! (Never wear shoes to a birth if you can help it. Feet are washable.) 

As soon as I stood up I started to push. When natural labor is unencumbered and progresses on its own a beautiful thing happens. The body pushes on its own. No orders. No instruction to push. I have to stop every foot on my way to the bed to push. I half-squatted every time and groaned that gutteral, earthy groan, down into the floor using my husband and doula for support. 

I reach the bed. I feel I need to sit up with my breasts right against my knees. I begin to push and the team gets ready. No one counts this time. I push as the contractions tell me to. Which is a wonderful thing.

My son was a big boy so the nurses and our doula keep saying “pull those legs wider” I do. I hear my hip pop slightly out of socket and feel the pain of that. But I know this is the end of it so I keep going. I push that pain to the back of my mind and focus on the goal. 
Something crucial happens. My doula tells me to “relax”. When a person tenses while pushing she tears. If she relaxes then the baby does their work and they don’t tear. That tissue is supposed to stretch and it will if you relax it. This was the ticket for me. Every time she said “relax”, I did. I am ever grateful for that. My son slowly corkscrews out. On his way out, I didn’t know it, but he split a vein with his shoulder. There was a lot of blood. And my doctor, being the calm man he is, says “Don’t look down” even though there was a lot of blood. My husband retained composure holding my hand even though he said it was a lot of blood and freaked him out a bit. He said nothing. That is an amazing gift he gave me so I wouldn’t panic.

6:37am Graeme is born. He cries and they place him skin to skin on my chest. He latches like a champ. I cry tears of joy at the instant ability of my eager baby to nurse. We had a long trial with my daughter and his gulping noises fill  my heart to brim.  I rotate my hip back into place after my doctor stitches my vein and minor tears. We wait for the cord to stop pulsing before cutting. I deliver the placenta which turns out to be huge and my doctor says “I’m sorry” as it comes out because it is folded over on itself. It’s like birthing another baby. Kudos to you twin moms out there, you rock. The placenta weighed in at just over 6 lbs. This is not uncommon for moms with active autoimmune disease during pregnancy. The placenta had to work extra hard to keep my baby boy safe. I am grateful for this organ and what it did for my son. 

 He is here. He made it. Hello baby boy. 

As a postpartum doula and birth educator one of the areas I see a gap in our maternal care system is postpartum follow up, particularly when it comes to birth trauma. Most expectant mothers imagine what it will be like the day their new baby arrives. Others are afraid of what will happen on their birthing day, and try to put it out of their minds. Some women have a plan of how they would like their birth to go and some even put the words down on paper to give to their care provider. 

When a birthing day does not happen the way a mother envisions, it can result in shattered expectations and the loss of dreams. Any situation that a person is put into where they are forced to make a decision under duress (or without their consent) can result in guilt and second guessing.  Many of these mothers have difficulty forming the essential bond that new mothers have with their baby in the first days of life. Some develop perinatal mood disorders. They are not typically seen by their care provider until their six week follow-up, and even then new mothers struggling to manage birth trauma are often missed, and continue to fight their feelings alone. This is my story of a time I was able to help one of these mothers dealing with birth trauma by facilitating a rebirthing.

I received a call from a new mother, who was still in the hospital after she experienced a traumatic emergency caesarean section. She described to me that throughout her pregnancy, she envisioned seeing her son enter the world in a gentle way, surrounded by love and met with joyful anticipation. Unfortunately the birth had not happened according to her plan and after many long hours of labor, her doctor decided that it was time for her to meet her baby and sent her for a caesarian. I knew she needed to see her birth in a new way, and to have a second chance to have the birth that she wanted.  Physically, her recovery was difficult, and she and her son had difficulty establishing breastfeeding. He had been separated from her for over an hour after the birth, and was having trouble staying latched on and was often fussy at the breast. Mama was feeling hurt and powerless and she told me about the loss she had endured. They were all home from the hospital on the fourth day after her son was born, and I met with her soon after they arrived at their house.

I had heard about the idea of a rebirth, and I suggested that it may be a way for her to begin her healing. I had her prepare a letter written to her baby, telling him the story of the birth she had imagined for him. She spent some time talking through this with her husband, and when they were finished I ran a warm bath for them, lit some candles, and dimmed the lights. She and her baby got in to the bath skin to skin and I read her letter. Her eyes gently closed as she held her baby close and I saw them both relax almost as if they were melting into each other. She helped her baby to her breast, and he was able to latch on. He seemed like he was almost asleep, maybe he was just finally relaxed enough to nurse. They stayed in the bath for some time, and I encouraged her husband to stay and sit with them. 

I waited in another room, and when they all came out to join me, something had shifted. There was a stillness and peace that was tangible and I could feel their deep love resonating though their home. I stayed with them long enough to see baby latch on again. I saw her eyes fill with tears of relief, smiling as she looked at her husband beside her. This was the new start that they needed. 

Everyone who was there that day experienced their own rebirth, and I am forever grateful that I was able to be a part of such a special day for this new family. Every mother with birth trauma deserves a chance to find healing and peace, and I am humbled to have a role in that journey.

Tuesday night I was called to the home of N and J – N had been having contractions since 2 pm and now, 9 hours later, they decided it was time to go to the hospital.  After being monitored and checked, and N being pronounced 1 centimeter dilated, they were sent home.

N continued having contractions and the next morning they were starting to pick up. Around noon, they headed back to the hospital and this time they were admitted – N’s dilation was now 3-4 centimeters. N coped beautifully, and J was one of the most connected partners I have ever seen.  We took a walk around the hospital campus and noted such things as the cell phone tower that looks like a tree.  N would pause during a contraction and lean into J, and then we would continue forward once the contraction had passed.  

Around 6:30pm N was checked again and found to be 5 centimeters.  Not what we wanted to hear!  But N was motivated to stick with it even though she was tired.  The shower worked well until the Jacuzzi tub was filled, and from about 8 until 10 that evening we were all stationed in the tub room.  N was getting more relief than before, moving in the water to a hands and knees position during contractions, and then to a sitting position to rest.

N had been having intense back labor this whole time.  It became obvious her little guy was in a posterior position.  At 10pm, 32 hours into the process, N was checked and found to be 6ish centimeters open. Her midwife offered a couple of suggestions --one being to break the bulging bag of water to see if this helped labor and dilation, the other to assess the pressure of the contractions to see if, after all this time, their strength was adequate to make the necessary cervical changes.  As their midwife spoke with N and J, answering questions, encouraging them to make the decisions they felt most comfortable with, and assuring them they had time to think about it all, she then left the room to let N and J talk it over. They decided to have N’s water broken, and N also wanted to try some pain medication.

With the bulging bag of water N was dilated to a 6.5, but once it was broken, she went back down to 5. This was disappointing news for N and J. After all these hours, though, the fast-acting narcotic pain medication was giving N a little bit of respite. Thankfully, N’s baby finally moved into a better position, relieving that unrelenting back pain. After 70 minutes or so of J and I standing vigil at the bed, and with the medication mostly worn off, N was found to be 8-9 centimeters. Her contractions never decreased in intensity or frequency and she was getting so close to being done!

At this point, J and I got her into the shower to sit on the ball.  This is where the last of her cervix would melt away in preparation of the baby’s birth.

When we came out of the bathroom, J was feeling like pushing, and we were all happy to learn that yes, her cervix was gone.  It was finally time to fill the birth tub!

J climbed in and, as she had many times before, she settled in to listen to her body’s signals.  She began pushing. Their midwife said to Dad, “Hey, J – once the baby starts to come, do you want to help him out?”  I don’t think this was something J ever imagined, and if the idea had been brought up at any other point than this precise moment, I wonder if he would have agreed so quickly?  But the right question from the right person at the right time was the perfect set-up for this dad to help catch his baby.

N pushed on her hands and knees. In no time we saw the baby’s thick, dark hair waving in the water.  Unlike the movies or television, N’s midwife relaxed and watched N follow her body’s cues.  There was no “Push, push, push, pushpushpushPUSH!” –ing involved.  All was quiet and peaceful as we eagerly waited to meet this baby.

At 3:05am, Baby Austin was born -- his daddy’s secure hands brought him up through the water to the safe harbor of his mommy’s chest.  37+ hours after labor began for this couple, they held their new baby and whispered elated words of joy and love to him.  

The birth team worked incredibly well together,  and the midwife was aptly soothing and intuitive.  All of that aside, though, this couple was exquisite.  When it's all said and done, this new family has their own story to tell, a story where no one else stood out as heroes except Mom and Dad. This couple shared an experience they will forever treasure:  a long labor, on the longest day of the year, that brought them their summer solstice waterbaby.