Jodi the Doula

Birth Plans for Birthworkers

06 Apr 2013 3 Comments

by Jodi in Most Popular

If you are a doula, or are in the process of becoming involved with the work of labor support, it is imperative to consider in advance any possibilities that may arise, and be prepared with a plan ahead of time. Just as you encourage your mamas to communicate their birth wishes ahead of time so that you can offer the best support possible, outlining your needs through your conversations and written agreements is like writing your own birth plan.  In the same way that birth can be full of surprises, there are always unexpected moments that can arise in doula work, and it’s in our best interest to be prepared for them. Proper planning and good communication is essential in our verbal and written service agreements with clients. Rather than being in an unanticipated position and scrambling to figure out what might be best for you in the spur of the moment, giving this serious thought now can help you navigate the twists and turns with grace as they arise.

The more you think this through when defining your boundaries, the better you will be prepared to provide stellar service in any birth scenario. The importance of knowing your own physical, financial, mental and emotional limits cannot be overemphasized. Clients cannot be expected to honor boundaries that you do not know you have.

With that in mind, consider the following as suggested points to ponder for yourself.

 

Establishing clientele: 

Who will you accept as a client?

What are your feelings about having client relationships with people who are an ongoing part of your personal life?

Will you offer birth services to friends, family, or co-workers?  What about members of your church, parenting support groups, or other parents at your children’s school?

Do you accept online friend requests from clients?

What is your comfort level with forming friendships with your clients during or after their pregnancy?

What personal biases (about birth choices, parenting choices, spiritual practices, etc) do you have that would make you turn down a client as “not a good fit”?

What if you have met a woman or a couple who isn’t a good fit for you? How will you handle declining a potential client?

At what point in pregnancy will you contract with a client? What if she’s three weeks along? What if she’s 41 weeks when she calls you for the first time?

How many clients will you take on within any given time period? Under what circumstances would you make an exception?

Do you require a face-to-face consult prior to being hired? Are you willing to accept a contract from someone you have not yet met in person? Do you require a consult prior to hire from someone you already know socially?

Do you have a requirement to meet a mama’s  partner prior to the birth, or prior to being hired?

Establishing a Service Area:

How far are you willing to travel for a birth or postpartum care?

Under what circumstances, if any, would you consider traveling beyond your service area? How will you adjust your fee accordingly? Who pays your travel expenses, parking fees and tolls?

Are there areas where you would not prefer to travel, even if they are within your mileage range, due to heavy traffic routes, an unsafe commute, or a lack of parking?

Choosing Birth Practices and Facilities: 

Are there OB or midwifery practices with whom you would not attend a birth?

Are there hospitals at which you would not be willing to provide service?

Will you attend births in hospitals, teaching hospitals, birth centers, or home births?

Will you attend unassisted births?

 Interviews and Prenatal Meetings:

Where are you comfortable meeting for an initial interview – a client’s home, a public location, or their doctor’s office?

What would you choose to do if a client’s home seemed unsafe to you?

At what point will you meet with a mama with her other support people present?

How many prenatal meetings will you offer?  At what point in pregnancy will they occur?

Do you require a minimum number of prenatal visits? Do you have a maximum number of  visits you are willing to offer?

Do you require an in-home visit prior to the day of birth?

Will you offer meetings by Skype or phone?

Will you conduct meetings with a client’s other children present, or will you ask that childcare be arranged for your visits?

What do you think about arranging prenatal meetings as playdates with your children during their pregnancy or after their birth?

When do you choose to be available for consultations, prenatal visits, or postpartum care? Will you schedule meetings on weekends, during evenings, daytime only, evenings only? Do you permit your clients to choose any day and time for your meetings or do you set a specific schedule for when you are available?

Financial Arrangements: 

What is your fee?

Have you calculated your own expenses for mileage, meals, childcare, trainings, uniforms, taxes, and your time?

Under what circumstances are you willing to negotiate for a lower fee?  (Adoption placement, deployed spouse, etc) What is the lowest you will go? What will you do if someone cannot work with your minimum?

Will you accept a signed contact at the time of interview? Do you request that clients take a night to sleep on it before making a decision?

How long after an interview will you hold a spot on your calendar for someone who has not yet made a decision or has not yet given you a signed contract & deposit? What if someone has said  she intends to hire you but hasn’t contracted with you within this set time period?

What are your financial agreements about receiving your deposit and balance due?

Are you willing to attend a birth for a client who has neglected to pay you? Will you be on-call for someone who has a balance due?

What is your refund policy? Is a portion of your fee non-refundable? What will you do if someone has a fast labor, or doesn’t call you, or there are circumstances beyond your control?

Do you have a specified bounced check fee, or late payment fees?

What will you do if someone chooses to break your contract?

Are there circumstances under which you are willing to release someone from your contract agreement?

If you have fulfilled your contract agreements, what steps are you willing to take to ensure that you are paid?

Clear Communication:

How will you handle communicating the code of conduct and scope of practice for your profession?

How will you make it clear what your professional boundaries will and will not allow?

What hours are you available by phone for non-emergency questions and check-ins?

Will you communicate via text and email? Phone only? A combination of the above?

What is your preferred mode for contact?

Under what circumstances MUST a client contact you voice-to-voice?

How often do you prefer to get updates from your clients during pregnancy? Do you have a minimum standard for frequency of checking in with updates? Once a week? Once a month? Once during the pregnancy?

Within what time frame can you be expected to return non-emergency calls or emails? Do you need ten minutes, an hour, a day?

Who is responsible for initiating and maintaining client contact?  Do you have a schedule for calling clients, or are they responsible for remembering to call you?

What limits do you need with how frequently clients may call you? Do you have a limit on the length of phone calls? Can she call you every day for an hour, or do you allow ten minutes to talk before asking to make a phone appointment fora longer conversation?

Have you set aside times of day or days of the week when you are not available to answer your phone except for labor or emergencies? Are there times when you are intentionally not available by email, facebook, or text message? How do you let clients know this?

What situations might require you set a boundary with a client about contacting you and how would you enforce it?

Within what time frame can you be expected to return calls in an emergency?

Labor Support: 

When does your on-call time officially begin? When are you available until?

What would you do if someone went into labor prior to your on-call time?

What are the necessary steps for notifying you of labor, and letting you know when it’s time to come?

What would you do if someone chose to notify you in a different way, such as through email, facebook, or text message?

How do you decide that it’s time for you to join the mama in labor?

How much time to you need between the “come now” call and your arrival time?

Are you willing to provide labor support at home, or do you only provide in-hospital support?

Under what circumstances would you NOT meet someone at home?

What is your guideline for deciding when to go to the hospital in labor?

Under what circumstances would you recommend meeting at the hospital?

What is your plan for times when a client is in labor or having an emergency and is for any reason unable to reach you?

What are your guidelines for attending an induced labor?  Are you there from the beginning, or will you be called in once active labor has begun?

What if a mama says she needs you “right now”?

What will you do if you aren’t sure that a mama is in labor?

What is your protocol for when a mama’s water breaks before labor has begun?

What will you do if a mama decides that she is not comfortable with a particular staff member (doctor, nurse, or midwife) in her birth place?

How would you handle a mama changing her mind about having one of her chosen support people in the room?

What is your plan if a mama changes her mind about any of the birth wishes she has expressed to you?

Will your offered services be different in any way for a mama who has a planned cesarean birth?

How will you support a mama who has an unplanned cesarean birth?

Red Flags:

What will you say to the mama who says that she doesn’t need childbirth classes if she has you?

What concern would you have about a mama who has “interviewed every doula in town”, and you’re “the only one she likes”?

What is your advice for a mama who says that she doesn’t trust the practitioner she has chosen?

What will you recommend to the mama who tells you that she is terrified of giving birth?

What would you suggest to the mama who is sure that her labor will be easy and quick?

What will you say to a mama who informs you that her doctor or midwife doesn’t want to work with doulas?

What are your thoughts if someone other than the mama calls to tell you that the mama is in labor, and that you should come now/not come yet?

What is your plan when a mama suddenly refuses to leave for the hospital?

What are you able to do if a request is made that would require you to breach your code of ethics?

What would you say to a mama who tells you that she is secretly hoping to “accidentally” have the baby at home?

What will you say to a mama who asks you what she should do?

What concerns would you have for a mama who is a survivor of abuse or assault?

Under which circumstances will you not attend a birth?

 

Home and Family Life: 

What personal events are you not willing to miss for a birth (birthdays, holidays, weddings, funerals, school functions, etc)?

How and when do you notify clients of the times you are unavailable?

What personal events are ok for you to miss? How would you deal with any response from your family or friends in this situation?

How can you support your partner and your home life while you are away for births?

What concerns do your partner or children have about your doula work? How will you address these concerns, should they arise?

What childcare arrangements do you need to have in place? Do these arrangements change with the time of day, day of the week, or weekends and holidays?

What will you do if you or your own child is sick?

Backup Arrangements:

Do you have arrangements in place for back up?

What will you do if two clients are in labor at the same time?

How will you handle paying your back up? Does this arrangement change based on how many hours she is there, or what you have been paid for this birth?

Do you provide clients with the opportunity to meet, interview, or have phone contact with your backup?

What will you do if a client would prefer a different backup person than the one with whom you have made arrangements?

What would you do if a mama thinks your backup “didn’t do the job like you would have”?

Postpartum Support: 

How much time do you allow to be on call after a baby has been born?

How much postpartum contact are you willing to provide?

Do you have a limit for how many hours or weeks you are available by phone after birth?

How many home visits are you willing to allow before requiring a separate postpartum care contract?

How early or late in pregnancy are you willing to negotiate a postpartum care contract?

What would you say to the mama who is unhappy with her birth outcome?

Who will you call for a mama who needs more help than you can give?

Do you provide a resource list for postnatal support,  such as support groups for postpartum depression, cesarean support, etc?

What will you recommend for a mama who has experienced birth trauma, from this birth or from prior births?

Self Care: 

Do you have a plan for births that happen very close together? Would you make arrangements to provide yourself time to rest in between, or will you go from one birth directly to another?

What is your personal limit for how long you will be away from your home or family?

How long are you willing to go without sleep? What will you do to get home safely after a long stretch with no sleep?

After how many hours of labor support would you call on another person to provide you with the chance to take a break, nap, or eat? Will your client provide an alternate support person, or do you make this backup arrangement for yourself?

How will you manage a situation that arises when an extended family member, partner, or client becomes verbally abusive to you?

What will you do  if a staff member at the birthing facility becomes verbally abusive to you?

Do you have a support system in place for your own needs?

What other doulas, birth professionals, or counselors can  you can process birth experiences with without breaching confidentiality rules?

What can you do to provide yourself time and space to focus on non-birth priorities, such as family time and self care?

 

In considering your thoughts, feelings, and wishes now, and deciding in advance what you will do, you pave the way for smoother births and happy client relationships for years to come. This will help you build strong client relationships, foster trust in you as a birth professional, and prevent you from feeling frazzled and burned out when the inevitable bumps happen. Use the personal guidelines you have uncovered here to write clear service agreements to be shared with and signed by your clients. Revisit them in your prenatal visits, and whenever the need arises. Clear communication can resolve many potential conflicts, and having this “birth plan” in place will go a long way in keeping you and your clients happy. Just as a birth plan is a useful tool between birthing mama and her practitioner, clear guidelines about your personal and professional boundaries can help keep everyone on the same page, figuratively and literally. As you continue to learn and grow, you may gain more clarity along the way about what your own boundaries are. Commit now to using this learning to define your own boundaries for the benefit of your future clients by continuing to hone and define your own service agreements. Blessings on the journey, and happy doula-ing!

 

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Body Parts, Bloopers, and Blunders, Oh MY!

31 Mar 2013 Leave a Comment

by Jodi in Most Popular

Thursday’s Huffington Post featured an article about an Idaho teacher who is being investigated for using the word “vagina” in a Sex Ed class. There seems to be much to-do now about Sex Ed in schools, and what may or may not be appropriate to say. As for me, having been in a similar situation once, I say good for him. It’s OK for a group of tenth graders to hear parts called by their proper names. I don’t get the controversy.

What I do understand is how difficult it can be for a teacher to cover a blushworthy topic in a no-nonsense way. Faced with a group of young people who have been raised with calling their parts “hoo-hoo” and “willie”, sending the message that “it’s ok to call things what they are” can be a challenge.

Before I was a doula, I worked with a program through the state of Texas that taught social topics for at-risk teens. We covered subjects like anger management, conflict resolution, gang prevention, and, yes, human sexuality. “Call parts by their proper names” was the first lesson of the first day of this particular course. The goal was to eliminate the embarrassment and awkwardness right out of the gate, so that then, the kids would be able to really listen to the information that was being shared.

I was a brand new teacher, and this was my first out-of-office assignment for this program.  I was in the school as a guest, in a classroom that wasn’t being used during this class period. I was nervous, but as ready as I’d ever be. My lesson plan had already been laid out for me clearly. “Start by writing PENIS on the whiteboard in the front of the room,” my instructor had said. “Make it really clear and visible – use uppercase letters that are a good foot high.”  Then, I was to invite the young people to think of every word they knew that meant this word. “Go ahead, have a good giggle, get it out of your system”, I said,  “And now, in my class, we’re all going to agree that the word on the board is the only word that will be used here. It’s not a word we’ll need to giggle about. This is the proper name. It’s the only word for this body part that that Mrs. Smith and I will be saying.”

While actually leading the lesson, I’ll admit that my palms were sweaty and my hands shook a little, though I don’t think the students noticed. They were too shocked by the writing on the board to pay me much attention. I was only a few years older than most of the students in this class. I was trying to ooze confidence from every pore, but  I’m sure I was trying harder not to blush than most of them were. I had no idea at the time that, one day years later, I’d be talking about body parts every day as part of my normal routine. I’m not exactly sure what the students learned that day. I hope that they got something good as a takeaway from the class. The biggest lesson that day, I’m sure, was my own.

I learned that before writing PENIS on the whiteboard of a borrowed classroom, you must first be completely certain that the marker in your hand says DRY ERASE on it.

Because if you don’t, somebody is going to have to call the janitor before the next class period starts. They might even have to take the board off the wall.

I hope the teacher in Idaho is having an easier time than I did.

 

Do Enough, Be Enough, Have Enough

21 Mar 2013 2 Comments

by Jodi in Most Popular

Today, before starting my official work day, after dropping my daughter off at school, loading the dishwasher, filling the wild bird feeders, tossing another load of laundry in the washing machine, and tucking away the last of the winter decorations, I had a moment. It wasn’t a glorious moment. It wasn’t a “Hey, I did it!” moment. It was a “Wow, I’m really tired” moment. It was an utterly exhausted “I’m never going to get this done” moment. It was a moment in which I briefly thought that someone should invent a “Rent a Marching Band” service, so that I could call and say, “Hey, I did housework!”, and they would come right over and parade through the house. Just for a minute – wouldn’t that be nice? Except, if they did, I’d have to sweep the floor when they were done, which would make me feel even more tired. Also, I’d probably feel a little silly. It could also get expensive.  I daydreamed briefly about asking a friend to be my “celebration buddy”, so that I could call and say, “Hey, I got the dishes done!”, and have her cheer me on. I’d do the same for her, of course. And then I think (and this is why my mother says that my motto seems to be “When in doubt, start a group”) that it would be great to have a support group for Standing Ovation Night. We’d all gather in a circle, and have the opportunity to stand in the center of the circle and proclaim our accomplishments and take turns giving and receiving applause and cheers for one another. (That one, I’ve actually done before as part of a class series I was teaching. It was great, though perhaps not practical on a daily basis.)

Then, I remember a time when my daughter was tiny, and my boys were very young. Oh, I was tired – truly bone-weary. I wrote in my journal, “What is it new mothers do that is so exhausting, when it looks like we are doing nothing at all?” Yup, “nothing at all”… I was homeschooling two kids, tending my home, baking my own bread and making cheese, nursing a baby, running an organic food co-op, and co-leading a holistic parenting support group. I was active in my spiritual community and my local neighborhood, and finishing Naturopathy school. THIS was what I was willing to look at, and judge as “nothing at all”, because I still had the massive to-do list, that never got to done.  There was no joy in what I was doing, because I knew before I even started that no matter what I did, it wasn’t going to be enough.

Oh, right,  I recognize this feeling. It’s the Inner Critic at work, again. Everybody has one. Actually, I don’t have just one – I have The Critical Chorus (further demonstrating that clearly, everything work doing is worth doing as a group, even when it comes to self-criticism.) My friend Katie calls hers the “Itty Bitty $#itty Committee”. Another friend calls hers “The Manager”. Whatever name you know it by, it’s that voice running on the hamster wheel in the back of our minds repeating every negative thing we’ve ever heard about ourselves from birth until last week. “You don’t do enough.”  ” You don’t have enough time/energy/money/brainpower/looks/gumption.” “You’ll never get that done.” Not enough… not enough… not enough… on endless repeat.

I hear it from new mamas all the time, “I’m not getting anything done!”  I always remind them that, with a new baby, if you’ve brushed your teeth by noon and changed your shirt by dinnertime, it has been a good day. I pass along the wisdom shared by my own great-grandmother, who said, “Be grateful for your dirty dishes. They mean that your family is eating well.” Having lived through times when families having enough to eat was a struggle, she knew what she was saying. She told me to pay the dishes no mind – to just walk by the kitchen and wave at them once in a while. Dishes didn’t mind waiting while I held the baby.

Behold, the power of Gratitude! Such a big shift, from changing our thinking in such a small way. And so, I share with you what has worked for so many others:  You do enough. You have enough.  You are enough. Right here, right now, just the way you already are. The Manager, the chorus, or that nasty committee? They’re just doing their job. At one point in time, they thought that what  they were really doing was keeping you safe, or encouraging you to be your best. You listened to them and let them call the shots because you believed them. You don’t need to do it that way anymore. You now have a choice. It’s ok to thank these critical voices for their opinion, and send them on their way. Catch them in their chatter. Acknowledge them, thank them for sharing, and tell them to stop. Shift. What are you grateful for? Can you name three things, right now? I’m grateful for the home I live in, and for the people I love who dwell here in safety and comfort. I’m grateful for the food on our table that has been on the dishes that just went into the dishwasher. I’m grateful for the birds that fill our yard, and brighten the day with their songs. Ahhhh, better. Choosing this better feeling thought might not get your list any closer to done, but it sure feels better while you’re doing it.

And so what if the list doesn’t get done? Turns out, the “Should Police” have never actually shown up at my door to carry me away for a load of unfinished laundry. How about, just for today, we make a list at the end of the day of all the things we actually DID do, and then check them off, one by one? We can tell ourselves and each other, “Hey, you did it. Good job.” Then, if that feels good, we can do it again tomorrow, and the next day, and the one after that, too. No marching band required. You can do it. You already are.

 

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Meditation. Sort Of.

16 Mar 2013 1 Comment

by Jodi in Most Popular

Once people hear I’m a doula, they tend to think that I’m a master of all things New Age and hippiefied. They’ve got me pinned as an organic-or-nothing, crystal-waving, “om”-ing, swirly-eyed Yanni-loving Yogini who has mastered inner peace and the ability of sitting in impossible positions until my legs look like they don’t have any bones.

Let me set this straight.

While doulas are, indeed, a giant ball of awesome, I’m a giant, caffeine and cheez-it and applecake powered ball of awesome. I own several pairs of yoga pants that have never been near a yoga class. I sometimes say bad words. I listen to show tunes and talk radio. High heels and motorcycle boots make my heart go pitter-pat, and I think Earth Shoes are ugly. I’ve read more Stephen King novels than I have anything by Eckart Tolle. I did not come from the progressive upper East Coast.  I grew up in Arkansas, where we certainly never heard of tofu, and frozen yogurt didn’t exist as a “thing” until I was 14 years old.  Heck, even drinking decaffeinated coffee made one worthy of suspicion and meant that you probably didn’t really love Jesus.

I just love birth. That’s all that being a doula really says about me.  If you’ve met one birth worker, well, you’ve met one birth worker. We’re all different. There are as many styles of doula care as there are women who are doulas. That’s one good reason to make sure you’ve chosen the doula that’s right for you.

So, as a personal challenge, I recently joined a 21-Day meditation-for-beginners group online. Every day, the short “meditation of the day” email arrives in my inbox, and it’s my responsibility to listen to the ten minute podcast and Om along.

The first day went something like this:  Ok, hands in my lap, sitting comfortably, let’s begin. Clear the mind, take a deep breath. Om… (did I remember to set up the coffee pot?) Om… Om… (Is that the cat throwing up?) Om… Om… (Come on baby, doooo the locomotion! Ack!  Singing! Not supposed to be singing! Clear the mind! Remember the mantra! ) Om… (Wow, my stomach is growling really loud) Om… Om… Om… Om… (Oh, hey!  Am I doing it? Wait, I’m thinking again. Drat!) Om…

It was only a few minutes, and it was harder than I thought – way harder. I could so easily go into the self-judgement of not doing this right, which could quickly become “I can’t do ANYthing right”.

Ah, but then I remember what birth has taught me. There are some things I think I know, and there are some things I KNOW that I know, and this is something I KNOW.  We’re all learning, all the time. We’re all growing every day. I’m not who I used to be, and I’ve already grown a lot to become who I am. In my work and in my mothering, there has been a lot of learning as I go. I’m still a work in progress, just like everybody else.  It’s not about being right enough for anyone else, ever. It’s about being the best “self” we can be, and accepting ourselves in this place, right here, right now. I don’t need a guru to teach me that. I’ve had hundreds of mamas model it perfectly. I’m not perfect. I don’t need to be, and that’s ok. There are people who love me, and people who never will, and that’s ok, too.

I’m responsible for loving myself enough that I have more than enough love to give to others. That’s all that matters.

Om. (Do we have any chocolate?)

 

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No Free Births!

02 Mar 2013 90 Comments

by Jodi in Most Popular

“I’m offering service for free until I’m certified, then someday I’ll have paying clients.”

“I don’t charge for more than gas money now, but one day…”

“I’m looking for a student doula, or somebody who is willing to do births for no charge…”

Doulas, Mamas, I’m going to be blunt, here:

KNOCK IT OFF.

Now. I mean right now.  Cut it out.

“One Day” is not a day of the week. “Someday Isle” is a fantasy destination.

This mindset is not doing anyone any good.

If you are a doula, whether you identify as a student doula or an experienced doula, whether this is your first birth or your 401st, it is time to recognize that your work in the world has value, and begin treating it as such. You were given the gifts you have – the same gifts that make you well-suited to this doula thing –  to make it easy for the universe to bless you with abundance. So stop saying, “No thank you, Universe, I’m not good enough for that yet.”

You have been called to this work. You have capabilities and knowledge and skills that affect someone’s most precious memory – that of her child being born. You add value to the lives of others.  It is time to know this about yourself. You deserve an abundant life so that you have more to offer. Your playing small serves no one. It sends the message that you are unworthy, and that what you have to give is of no value. None – as in, less than a Happy Meal toy. This is not the message befitting of the services we provide.

Doulas deserve to be recognized within our culture and our medical system as having worth. We lower the cesarean rate, lower the percentage of interventions necessary, lower the use of pain medications, and leave mothers feeling more satisfied with their birth experiences and their babies.

Even if you have only served a handful of births, when you meet with an expecting mother for the first time, chances are that you already know more about birth than she does. That’s part of why she wants you there! Whether you’ve served one birth or many, you provide families with  information, physical comfort, and emotional support. In the very first studies proving “the doula effect”, the doulas did nothing more than sit in a chair with a clipboard, observing and taking notes. That’s it! If you’re doing at least that much, you are providing a worthwhile service, and it is only fair that you be compensated in exchange.

When you diminish yourself by giving your work away, you affect not only yourself, but every other doula in your community. Those who are charging a fee adequate to make a living wage  – which you someday hope to be – are questioned about the validity of their fee, because it’s something that others are willing to simply give away. (See What’s In a Fee? for a more in-depth breakdown of what a doula’s living wage fee entails.) Sending a message of being worth nothing denigrates the value of doula service as a whole, and begs the question, “If someone else will do this for free, why are you charging me at all?”

Another interesting point to ponder:  If you do hope to someday make a living wage with this work, it will not ever happen as long as you are willing to give yourself away, or charge less than your service is genuinely worth. I hear student doulas frequently saying, “I want to make myself appealing to clients, so I charge a lot less.” This may surprise you to hear:  This actually works against basic human psychology.

Human beings  make financial decisions based on a “set point” for what they believe something to be worth. Let’s think about this a moment. Let’s say that you want to buy your beloved a romantic getaway, and you’ve decided that a night in an oceanfront bed and breakfast would be just right. In your mind, from recommendations you’ve had from friends and a little bit of looking online, you know that the sort of place you’d like is going to be about $150 for the night. That’s your set point. That’s what you believe a nice night in a bed and breakfast to be worth. Now, as you are looking, you come across an ad on Craigslist offering a a night in a bed and breakfast for $40. Is your first response, “Yes! Sign me up for that!” If you’re anything like most folks, no. Your first response is more likely to be, “Eeew! I bet it has bedbugs!” What if curiosity leads you to call to ask a few questions, and upon hearing your hesitation,  they’re willing to give it to you for $30? Is that better?  NO! Oh, well what if they let you stay for free? In fact, what if they’re willing to pay YOU, just so they get the benefit of the experience of having you for a customer?  At that point, you’d be questioning the sanity of anyone who chose to stay there, right?  So, why do this with the value of our own services?

“But, Jodi,” I can hear you saying, “Don’t you believe in ‘a doula for every woman who wants one’?” Without question, yes, I do. Are there people who truly cannot afford a doula’s fee? Yes. Even then, I believe in the equal exchange of something of value for something of value.  I’ve known doulas to barter for meal preparation, for childcare, for piano lessons, for cleaning service, for moving help… there are many possibilities. Brainstorm with your client, and get as creative as you need to, but convey the message clearly that you are offering something of worth, and an equivalent exchange of worth is absolutely necessary. This is not negotiable.  Even the Wall Street Journal has recently published that when businesses offer “pay what you want” policies, customers are more likely to pass up the opportunity altogether than they are to accept something for free. Everybody knows that we can’t get something for nothing. It’s a gamble, like playing the lottery. It’s a nice idea to think about, but it’s not a realistic expectation. That which we have worked for, have earned, or have invested in has far more worth to us. So, if you want more clients, charge what you are worth! Starting today, starting now, no excuses.

This benefits not only your business and your doula colleagues, but our clients, as well. A woman who has spent more on bubble bath at the drugstore than she has on your service has also expressed a belief in her own worth, and in the worth of her birth. An “empowered birth”, like winning the lottery, might be little more than a nice idea. She has invested nothing, and is at no risk of losing anything in the process. In the heat of the moment, very few women are going to put much trust in the opinion of someone who has offered her something-for-nothing. Nobody really wants  the input of someone who has already declared herself worthless. Please, doulas, think carefully about the message you are sending about yourself, the women you serve, and the work we do. Birthing women, know that a doula’s service to your birth is of great worth, and so are you. Birthing with a doula’s support is a beautiful gift to yourself, your partner, and your child.

Together, we can create a culture that supports doula care as a valid and sustainable path for those who are called to it, and a valued service for those who benefit from it.

 

 Like this article?  Come “like” Jodi the Doula on Facebook for more! 

Edit on 7/25/13:  Are you now one of the many asking “But what about the low-income mama who truly can’t afford a doula?” Come take a look at “A Doula for Everyone…But How?” 

With Woman

24 Feb 2013 2 Comments

by Jodi in Most Popular

If you want to serve a woman’s birth… Begin with loving her.

Ignore the checklist of what birthing and mothering should be, and love her beyond reason.

Open your ears to her heart, and hear her stories that she carries of her own birth, her own mother, of the lineage of a hundred grandmothers before her and of the journey that has brought her to this place where your lives now intersect.

Hear the songs of her hope and strength, the melancholy of her fears, the strands that tie us all together as mothers, as women, as sisters

And if you have not yet heard where your own heart answers “yes, yes, this is mine too”, you have not listened long enough.

If you want to serve a woman’s birth… Love her.

Love her beyond your shoulds, beyond your concept of right and good and beautiful,

Beyond her own expectations of herself and her beloveds

Beyond your own fears of manipulation and control and imperfection

And remember that the journey of transformation from resistance to empowerment must be hers, and believe in her completely and love her fiercely through it.

If you want to serve a woman’s birth… Love her.

Love her in her unclaimed shadows, in her stumbling, in her victories, in her vulnerability

and remember that her choices have nothing to do with you.

Love her through her screaming and her doubting and her sweating and her swearing

as she passes through the fire of her own soul, surrendering the only life she has ever known and emerges, herself, reborn, as Mother.

If you want to serve a woman’s birth… Love her.

Love her in her divine feminine life-growing Creatress self that dwells within her and within you and around each and every woman

in our working and our doing and our creating

in our instincts and our innate wisdom and our visions and our voices

that surpass our illusions of power and greatness and quest for enlightenment and our perpetual search for a life more beautiful when  already we are blessed beyond measure.

If you want to serve a woman’s birth… Love her.

Love her in compassion, honor and believe in her

in her holy sacred messy vulnerable powerful raw life-giving self in body mind and spirit

until she knows the story of strength and courage and wisdom that is  Her Own as the new story that she now carries forward for the sisters and daughters and mothers and grandmothers yet to come

for it is this way, one birth and one woman at a time, that together we weave the web that changes the world.

Doula, Nurture Thyself!

22 Feb 2013 2 Comments

by Jodi in Most Popular

Birth workers are an amazingly dedicated bunch. The phone rings, day or night, and we answer, ready to roll. We offer comfort for the aches, balm for the fears, and remind our mamas to believe in themselves, find their power,  love their bodies, and nurture their babies. We wipe away tears without judgment and celebrate joys without holding back. We are passionately committed to learning and growing. We offer the gift of our unending compassion, which continues to call us to this work we do. For many of us, this life of service to others includes the responsibilities of tending our own households, nourishing our own relationships, and parenting our own children. We are often asked, “How do you do it?” Is it any wonder that burning out is the biggest risk that doulas face?

Anyone who has ever been on an airplane has heard the pre-flight instructions,  “In the event of an emergency, an oxygen mask will drop down. If you are traveling with  someone who needs help, please place a mask over your own face, before assisting others.”  Make sure to tend to your own survival first, so that you can support someone else without putting your safety at risk. It’s a pretty basic formula, and yet, how often in our  working, our loving, and our daily living do we forget to put our own masks on first?  This is where burnout comes from. Because we love so deeply, want so much to be  “good enough”  and  offer the best service we can, we give our all and then some, with no complaining. We don’t want to be seen as selfish or indulgent, or any of the other negative labels that our  mind chatter might stir up about “Self Care”. So, we get used up and worn out. Reality bites back hard, with anger and resentment and exhaustion.  We begin to feel fizzled and hollow, with nothing left to give.  We reach the point where quitting seems to be the only option.

It is time, now, to re-write the negative and limiting belief that excellent Self Care is wrong. Self Care is not an indulgence enjoyed by the lazy and selfish, but the responsibility of anyone wishing to have a joy-filled life. It is absolutely essential to make sure that your needs for nurturing and comfort are met. It is imperative to feel nourished and sustained enough to provide you with  enough resource to give to others who are looking to you for support.  Further, when we model this way of living for our mamas, we give them permission to love and accept themselves and meet their own needs, supporting them not only in birth, but in living more balanced and fulfilled lives.

Healthy Self Care begins with checking in, with love and kindness, to discover your own basic needs, and then working to meet them. In sharing the following list, I invite you to take a mental snapshot of your own lifestyle and your care provider style, and consider where some new Self Care baby steps might be beneficial. Please hold in mind that the intention here is not to guilt or shame about how you’ve been doing it so far, or to make you “feel bad”, but to encourage you to take a good, honest look at how you are caring for yourself while providing care to others, so that you have more than enough energy over a long period of time.

1)  Sleep well.  Six to eight hours a night, in a pleasant and relaxing sleep environment, is ideal. Having a good sleep routine and a consistent daily schedule helps make sure your body is rested and strong, so that the occasional all-nighter won’t leave you a total wreck. Learn to power nap, and if you have enough of a heads-up before the “come now” call, make time to close your eyes for twenty minutes so that you arrive fresh and rested.

2) Remember to eat, drink, and be well.  Long births can mean stretches of time with little more than crackers and small cups of coffee. We encourage our mamas to drink 4 oz an hour, and snack frequently to keep their strength up. We encourage dads to take a break to eat something. It’s easy to get caught up in the idea that “I have to be here right now!”, and forget to do the same for ourselves.  Remember to keep some healthy snacks in your bag. Eat something non-processed and good for you before you leave home. Bring your water bottle with you.  It’s ok to tag-team with Dad or another support person to take a short break, step out, and eat something. While you’re at it, brush your teeth, splash your face, check your deodorant, and stretch for a minute.  It might be hard to pull yourself away, but in the long run, your mamas will thank you. A grumpy doula suffering from hunger, exhaustion, and a need to pee isn’t doing anyone any good.

3) Be gentle with your body. Labor support is physically demanding work. We use our muscles to help mamas into different positions, and to provide massage, counterpressure, and a body to lean on in labor. It’s not unusual to leave a birth feeling like you’ve just completed a marathon. Be good to your body in the between times. Take your vitamins. Find fun ways to exercise. See your chiropractor regularly. Remember your yearly physicals from your doctor and gynecologist. If you can swing it, schedule a session with a personal trainer or physical therapist to talk about the physical maneuvers you use most often, and learn how to perform them in a way that uses your body to your best advantage, to avoid strain or injury. This is the only body you get. Treat it well!

4) Be prepared for quick change. A full-time doula must be ready to go at any moment. The last minute scramble to get yourself together and get out the door can be stressful, but there are things you can do in advance so that it goes as easily as possible. Keep your birth bag stocked and ready to go, and replace what you use up after each birth. Have a change of “hospital clothes” in your car, and another ready to go at home, so that you don’t have to think about it after getting a “come now” call. Have a support network lined up in advance, so that you already know who to call for your children. Keep a couple of easy-to-prepare meals on hand at home at all times, so that there’s no need to think about what your family will have for dinner while you’re away.

5) Know where your support network is, and reach out to them. Some births are hard. You might have questions, or your own need to process your feelings. Having a strong support system in place in advance can help you get through the bumpy moments with more peace and ease. You might find comfort in a qualified counselor. A more experienced colleague can be a good resource for calling when you need wisdom and advice. A support group for birth workers might already exist in your area, or you might find others willing to help you start one. Nobody has to go through this alone. We’re all in it together.

6) Know your triggers and your coping skills. The more deeply you know, love, and accept yourself, the better you will be able to provide support for others in their own times of vulnerability and learning. Knowing in advance, from experience, what hasn’t worked well for you before will help you communicate clearly to your clients what your own needs are. How you respond to the more challenging moments that life brings your way is what builds your strength and shapes your character. It’s hard to come up with creative solutions in the moment when you’re in the middle of a crisis. Having pre-rehearsed coping strategies on-call for yourself will help you provide better care for everyone.

7) Watch your self talk. We tell our mamas to be mindful of critical self-talk because their bodies and babies are listening. The same is doubly true for us. “I’m no good at this”, or “I’m not as good as (some other person) is”, does nothing to make us better at what we do. It tears us down and takes the wind out of our sails. Remember to affirm that you’re doing your best, and you’re learning all the time. The same can be said for “I’m better than this other person because…” Don’t compare yourself to others – compare only to the self that you were before now. None of us can learn everything at once, and all of us have something we can learn from one another.

8) Create a Re-Entry Ritual. When we are present to the miracle that is bringing a new life into the world, we get to experience the Birth High that is one of the most enjoyable parts of this work. The Doctor is so proud, the Mama is ecstatic, Daddy is weeping, Grandma can’t stop hugging everyone in the room, and there’s warm fuzzy love flying all over the place.  It’s easy to forget that it took us hours to arrive at this state, and that the rest of the outside world might not be experiencing it with us. It’s very easy, in this state of being, to get emotionally bumped. We can get completely thrown off by traffic on the way home, or dishes in the sink upon our arrival, or a partner who needs to tell us right away that there are crayons in the toilet and oh, by the way, your mother called. We can go from the highest of highs to a very grumpy low in a matter of seconds. After leaving a particularly challenging birth in my first year of being a doula, I once paused at an intersection for several seconds before realizing that I was waiting for the stop sign to change! A re-entry ritual is simply and intentionally taking a minute to get back to center and  adjust ourselves to be ready to deal with the outside world again. Stop, take a deep breath. Acknowledge the wonderful experience you just had, and allow yourself to transition back to the daily world now. Stomp your feet on the ground to wake yourself up. Eat something with protein. Drink some water. Then, you can drive yourself home again. Get in the shower, take a nap. It doesn’t need to be complicated – just make sure it works for you, and follow through with it every single time.

9) Practice gratitude. Attitudes are easy to catch and easy to cultivate. We cannot be in a state of gratitude and a negative frame of mind at the same time. Gratitude is one of the best tools we have at our disposal to increase happiness and satisfaction. Being grateful for the goodness that is already evident in your life will bring you a deeper sense of contentment every day (see: More Like This, Please! for more on how this works.)  Make a daily practice of beginning and ending each day by naming three things you are grateful for, and watch how much easier the interactions with your family, your friends, and your clients will become.

10) Make time to laugh. Make time to slow down and enjoy the joy.  In a doula’s world of birth among the stimuli of flourescent lights and beeping monitors and constant comings and goings of people and staying on top of the latest research and remembering to return a phone call and reschedule the two appointments that had to be changed for today, we can forget to embrace life’s enjoyable experiences.   The simple things in life can be the most rewarding when we remember to fully experience them. Make time to read funny books. Giggle with your kids. Make time to honor your friendships. Do something just for fun. It’s ok to be silly. Birth is serious work, but not every moment must be intense.

11) Know how to release the negative.  Forgive yourself for your shortcomings. Forgive others for the buttons they pushed. Your brain doesn’t know the difference between an emotion you are currently experiencing, and a past experience that you are vividly recalling. So, when you have a negative thought stuck in the hamster wheels inside your head, they are constantly wearing you down. They tear holes in your energy, eat away at your endurance, and weaken your immune system. It’s very hard to take care of yourself and provide care for others with this going on. Learn what works best for you to let it go – whether that’s through prayer, meditation, writing it out, calling a friend and having a good cry – whatever it takes, release it. Everybody benefits.

12) Remember that life is bigger than you. Take a moment in each day to notice something beautiful, and stop to be fully present with that feeling of appreciation. Take time to connect with nature, whether it’s letting the sun hit your face for a minute, taking your shoes off and standing barefoot on the earth, or keeping a flower in a vase where you will see it. Find a moment in each day to do something to remember that life is bigger than you. Let go of the silly notion that you are the biggest thing going on.  You are not responsible for anyone else’s decisions. You are present in service, but not in control. You are part of someone’s story, but not in charge of it. Embrace your connectedness as part of a greater whole. Especially if you are doing work with your life that you feel passionately called to do, finding a moment to connect with  that calling can provide you with the strength and comfort to get through even the most difficult days.

Doula-ing is challenging work, and immeasurably rewarding. Take the time now to cultivate the Self Care habits that will serve you well, and you will be better able to have what you need to provide support for others for years to come.

 

So, doulas, midwives, docs, birth workers –  let’s hear it!  How do you avoid burnout? When do you feel most susceptible to it? What keeps you away from it?

Dads and Doulas

16 Feb 2013 2 Comments

by Jodi in Most Popular

By now, it has become pretty well known that doula care provides plenty of benefits for mamas and babies. Women who birth with doulas on their team have lower c-section rates, use less pain medication, are less likely to need pitocin or intervention, and feel happier overall about their births.*  As well and good as that may be, it’s very normal for dads to wonder, “Ok, so what about me? I’ve read the stuff I’m supposed to, and went to the classes, and I think I’m going to do a pretty good job. What am I, a third wheel?”  Sometimes, dads are a little embarrassed to even ask this question – it seems that many think it at least a little bit, and yet they all wonder if they’re the first to have this thought. Really, it’s ok, I get it.

The thing is, in the last twenty years, dads have become more involved in birth than ever (as in, more than ever in the history of “ever”.)  This is a great thing – mamas need the comfort, companionship, and support of the partners who love them, especially in a time that’s as vulnerable as birth can be. Our current system is still figuring out what to do with this, and while the system has come a long way, the kinks aren’t quite all worked out yet.

There’s a pretty huge set of expectations for partners and husbands these days. You have nine months to learn to speak fluently the language of labor support – “surges”, “waves”, visualization,  counterpressure, what will help, what will hinder, what to do and when to do it. Meanwhile, you are also learning to speak fluently the language of “Hospital” – intermittent monitoring, hep lock, cord clamping, Erythromycin. You’re in a strange room, with unfamiliar equipment all around you, each piece of which beeps and dings at random intervals (Is that a “this machine is out of paper” ding, or an “emergency-come-here-now” ding?) Chances are, the birth of your own child is the first (or maybe second or third) birth you will have ever seen. There’s a lot that happens in normal birth that isn’t very normal in any other context – there’s some pretty primal moaning going on, and hot flashes, and cold sweats, swearing, and blood, and fluids, and throwing up.  The doctor or midwife and nurses will be there, but they’re usually only in the room for a few minutes at a time, with hours sometimes passing in between. You might be at the hospital for a very long time, and chances are that at some point you’re going to get tired or hungry.  Let’s just throw into the mix, while we’re at it, that while her instinctive  brain tells her body to go into groaning-baby-having mode, your instincts might be more inclined towards “Protector mode” (another human instinct, left over from the time when this meant standing outside the cave with a big stick, ready to keep away saber-toothed tigers).

So, putting this all together: On one of the most important days of your life, you are completely responsible for remembering everything you’ve learned, providing comfort and support to a woman in the intense throes of labor, communicating all of the important stuff your beloved wants you to remember, in a strange place, with unfamiliar faces, with a whole lot of potentially nerve-wracking stuff going on, ALL WHILE PREPARING EMOTIONALLY TO SEE YOUR CHILD’S FACE FOR THE VERY FIRST TIME. You’ve got one shot at this, and you’d better get it right. No pressure. Good luck.  Not a very good set-up, is it?

Now, consider what having a doula will do for you. She knows all the labor support tricks, and will suggest the ones that are likely to work. She’s talked with you and the mama about what’s important for both of you for this birth, and will help you remember who to tell and when to tell them. She’s  going to talk you through any of the parts that make you a little nervous. She knows the machines well enough to tell you which beeping thing is which. If she’s familiar with your hospital, she knows their rules, and she probably knows your nurse and your birth attendant. She knows where the vomit basins and the extra towels are. She knows when to say, “This is normal. You’re doing fine.” Your doula has no interest in being in the spotlight, or stealing your mojo. She’ll cover for you if you need to go eat, or make a phone call, or catch a power nap.

The love that you are able to provide for the birthing mama is immeasurable. The connection between the two of you is one of the most important things going on in the birth room. Your doula helps take the pressure off, so that you can show up and love your wife and your baby fully, in the way that only you know best. If the two of you need some alone time together, that’s fine. Your doula won’t mind. Likewise, she’ll probably also be pretty skilled at knowing when to gently step in for a little more support.

Dad, here’s the thing:  I think you’re going to be fine. I have no doubt that you’re going to do a great job. I’m not there to watch and tell you what you’re doing wrong – I’m there to see that you don’t feel lost in the shuffle. We’re in this together,  in a way that is going to benefit you, the mama, and your baby.  Think of your doula as part of your tribe, your walking Birth Wiki, and the best wing-chick you will ever have.

Go team!

 

*(DONA 2001)