Jodi the Doula

Make the Best Choice in the Moment

09 Sep 2012 1 Comment

by Jodi in Most Popular

Sometimes, no matter how much preparation a person has done, things happen differently than expected. Someone can choose a great medical team, take informative classes, educate herself on her options, hire a doula, and still face interventions or difficult decisions. Feelings can come up of guilt, or shame, or betrayal. She may have doubts, or may even lose faith in herself – that if she had just done it right, her birth would have happened a different way.  An unrealistic belief system sometimes seems to exist in birth circles, that if a mama just “trusts” enough, she’ll have the “right” kind of birth.

As a doula,the perspective I share may be shocking. Here’s a truth:  Sometimes, birth needs help.

Not every time. Perhaps not even most of the time. Certainly not with the “36% cesarean rate” frequency that is currently our cultural norm. But, it does happen. Babies engage in positions that they can’t get themselves out of. Birthing people develop medical concerns that place health at risk. Infections happen. Distress happens. Life happens, and  it’s unpredictable.

There is no routine intervention – internal exams, iv fluids, fetal monitoring, medications, epidurals, forceps, surgery – that is categorically, inexcusably wrong 100% of the time. There are valid reasons that each of them came into being. There remain valid causes for each to still be in use. There is a time, place, and circumstance in which each one can and has been health- and even  life-saving for a mother and baby. A birth activist’s opposition is not to the existence of these interventions, but to the routine overuse of each of them, as though every mother and baby pair is the one in imminent danger.

So, what is a laboring person to do?

Education, information, and strong continuous labor support all go a long way in avoiding the steps that can lead one down a path of unnecessary or premature intervention. Choosing a medical support team that tends to offer low-intervention birth essential. Asking good questions throughout pregnancy, learning more about the options that exist, and saying “no, thank you” to the ones that are unnecessary is a key component. And then, the time comes to let go.

So much of the birth process revolves around the power to surrender – not the surrender of one’s voice or the right to speak and be heard, but surrender to the process that is birth.  

Sometimes,”trusting in the process” includes trusting her own intuition in knowing that something isn’t right, and that it’s appropriate to ask for and accept help. When and if the unexpected circumstance should arise, which they sometimes do,  then and only then comes the time to make each decision as it comes.

Know your wishes and priorities, discover your options that are available in the clear and present reality, and with that in mind, make the best choice for you in that moment. It is this, and not the mental checklist of do’s and do-not’s, that is the hallmark of a truly empowered birth. In the end, it’s not about whether your birth measures up to  anyone else’s judgement of  picture-perfect and ideal.  It is by being an active and informed participant in your own experience that you can know that you created the right experience for your own birth and your own baby.  You can be at peace with knowing that you made the decision, unique to your individual birth, that your judgement indicated was wisest in that moment. That’s the very best birth experience that anyone has the power to create.

How’s Your Oxygen Mask, Mama?

01 Sep 2012 Leave a Comment

by Jodi in Most Popular

Anyone who has ever been on an airplane has heard it… the announcement over the speaker that says “In the event of an emergency, an oxygen mask will drop down. If you are traveling with small children or someone who needs help, please put your own mask on first, before you assist them.”

Make sure that you are breathing, so that you have what you need to assist someone else. It’s a basic need, one that we know and commonly accept as necessary for our survival in an emergency. And yet, how often in our parenting, our working, our loving, and our daily living do we forget to put our own masks on first?

Self-care can stir up a lot of negative mind chatter. Just the question, “How’s your self care?” is enough to make some feel anxious and edgy. It’s wrong. It’s selfish. It’s indulgent. For some, it’s even guilt provoking. We are told, and accept, that a “good enough” parent, or spouse, or friend, or lover, or community member will give their all and then some, with no complaining. Then, reality bites back  – sometimes very hard – with anger, resentment, fatigue.  We get burned out. We feel hollow, with nothing else to give.

Self-care is not the indulgence of the negligent parent, but the responsibility of any loving and caring adult. It’s ok to make sure that your needs for nurturing, comfort, and care are met. It’s good to feel nourished, sustained, and fulfilled. It’s ok to love yourself enough that your “cup runneth over”, giving you enough resource to assist those who are traveling with you in this life journey.

Healthy self-care begins with checking in, with love and kindness, to see if you are meeting your own basic needs, and then working to fulfill them. Jennifer Louden**, in her book The Woman’s Comfort Book, shares a basic needs checklist that is an excellent starting point for taking a snapshot of your own lifestyle, and considering where some new self-care baby steps might be beneficial. Please hold in mind that the intention here is not to guilt or shame, or make you “feel bad”, but to take a good, honest look at how you are loving yourself.

So, with a deep breath, let’s begin:

Which needs are you meeting regularly?

Do you usually get six to eight hours of sleep?

Do you eat something fresh and unprocessed every day?

Do you allow time in your week to touch nature, no matter how briefly?

Do you get enough sunlight, especially in the wintertime?

Do you drink enough water?

Do you see your gynecologist (or the equivalent) at least once a year?

Do you see a dentist every six months?

Do you know enough about your body and health needs?

Do you get regular sexual thrills?

Do you feel you get enough fun exercise?

Are you hugged and touched amply?

Do you make time for friendship? Do you nurture your friendships?

Do you have friends you can call when you are down, friends who really listen?

Can you honestly ask for help when you need it?

Do you regularly release your negative emotions?

Do you forgive yourself when you make a mistake?

Do you do things that give you a sense of fulfillment, joy, and purpose?

Is there abundant beauty in your life? Do you allow yourself to see beauty and to bring it into your home and office?

Do you make time for solitude?

Are you getting daily or weekly spiritual nourishment?

Can you remember the last time you laughed until you cried?

Do you accept yourself for who you are?

How does that feel, to look at where your basic needs are? Would you be willing to choose one need, just one, where you can take a baby step today towards taking excellent care of yourself? The people you love need you nourished. The people you love need you vibrant and fulfilled so that you have enough to give. Today, give yourself permission to put your own mask on first, Mama, and take a deep breath.

Blessings on the journey.

**Special thanks to Jennifer Louden for letting me share her work. I don’t think she knows that I’m her biggest fan. You can find Jen online at http://jenniferlouden.com/blognews/ where you can sign up for her list to get her wonderful freebies about self care. The Pregnant Woman’s Comfort Book was just released in e-book format, too. Well worth a read. Go find it on amazon.com!

“No” is a Love Word

28 Aug 2012 Leave a Comment

by Jodi in Most Popular

All three of my kids could be described as spirited, high need, or intense. So am I, so they come by it honestly. 

 I have come to believe that my children are my mirrors. They show me, through the feelings I have in response to their action, the work I need to do within myself. Sometimes, this means pushing my buttons to show me where my buttons are, so that I can learn how to shift and work on them.

Case in point:  Cole, now 14, was and is my non-sleeper. At 3, he would go to bed, and get up endlessly for hours to ask for a snack, a drink of water, another hug, nursing, had a question, had another question. For a long time, my internal process would sound something like, “What kind of mother would send her child to bed thirsty? Hungry? In need of nurturing? Squelching his curiosity?” So I would attempt to redirect, or distract, or comply, and comply, and comply. In the retrospective wisdom that only hindsight can provide, I see now how my inner waffling (“I don’t want to do this”/ “What mother wouldn’t do this?”) contributed strongly to his tantrums. He felt the energy of my struggle and resentment, and it was confusing and overwhelming to him, as well. I didn’t want to deal with the tantrums. I’d silently resent the hell out of the demands on my time and attention, and was tapped out from my unmet need for alone time and rest.  No matter how much I tried to avoid it, most nights ended in meltdowns for both of us before anyone could get sleep.  He developed the mistaken core belief of “My role is to get this negative/undue attention”. He acted almost as if his thoughts were, “This is a confusing thing when I push this button.  What happens if I do it again?  And again?  And again?”  He was exploring his part in the dynamic as much as I was mine. 

  At the heart of Attachment Parenting is the knowledge that children are happiest and healthiest when their needs are met. As helpless infants, needs and wants are one and the same. As children grow, a new need – one of learning to live under the same roof in health and harmony as part of a community unit – begins to emerge.  When I gave myself space to sit with my own feelings of frustration, and was honest with myself about what my feelings were, and considered what I really needed, I realized that while I was responsible for meeting my child’s NEEDS, I was in no way obligated to gratify every WANT.  As a parent, it was going to be my responsibility to teach my children that not every want had to be fulfilled immediately. It was my job to help them learn patience. It was my job to help them learn that they did not need to be in the spotlight, with me at wit’s end,  to feel loved and accepted.

I learned (eventually) that it was my work to discover and communicate where my own boundaries were. Otherwise, I would use myself up, wear myself out, give more than I had to give, and be burned out.  It was part of the children’s work, as people learning how to function in the world, to be aware of and respect the boundaries of others. They might not like it, but really, they didn’t have to. There is NO RULE that says that children have to like an adult’s decisions. “It’s ok to not like things” is, in itself,  another valuable life lesson. Learning to discern the difference between dislike that is A Big Deal vs. dislike that is little enough to let go is another valuable lesson that I could help my children learn, as is the ability express their dislike in a respectful way. I learned to let go of my own expectation that others (including my children) would like and accept my boundaries with no resistance.  I learned that someone else’s approval of my boundary was not necessary.  I became aware that I could be compassionate to their experience of not liking it, and stay abundantly clear on what I would do. Deciding what I would do, I realized, is the only power I have in any relationship, including my relationship with myself.

My parenting mantra became and has remained “Decide what I will do”.  

 I decided that it was ok to communicate to Cole that I needed time  for rest. My self-worth was strong enough to be firm in meeting this essential need. We were done with today, it was bedtime,  there was no more time for snacks (he had a good dinner and a bedtime snack, and going to bed without more food would not harm him), there was no more time for questions (we would have all day tomorrow to talk about every thought that crossed his mind).  I was clear that setting the stage for sleep with a good bedtime ritual was in no way bringing him harm, even if it wasn’t his desire.  I decided that I would not stand at his door with endless explanations of WHY the answer was no (because I don’t owe him an answer that he likes, and that was just another way of engaging my time). 

   When I reached this place of clarity in myself, a powerful shift that happened. I was surprised to find that my children responded differently when they sensed that my own internal compass was clearly focused.  Affirmations I found myself repeating in my head were “‘No’ is a love word” and “‘No’ is a complete answer”. I never, ever wanted to tell my kids no. To avoid tantrums, I simply avoided saying the word. I was all about “Yes, as soon as…”, or looking for a distraction, or giving a longer explanation about what we would do. I realized that sometimes, I was contributing to the problem, frustrating them, and making it worse, as well as creating the belief within themselves that they could endlessly needle me until I gave an answer that they were willing to accept.  It was frustrating to me, and teaching them disrespectful behavior towards others. So, if my inner answer was a very clear NO, I actually started using that word.  I learned how to say it simply, without an emotional charge. I realized that “no” was going to be a part of their lives, and that I could teach them with love how to honor someone else’s clear “no”. This is a valuable life skill for the healthy adults (which I hope they will one day be) to have.

 In learning to communicate my boundaries with compassion, and sticking to them with love, I could be compassionate to my children without “giving in” and losing myself. I could say, “I understand that’s different than what you’d like, and it’s bedtime now.” I could be firm in the moment of conflict, and talk with them with kindness at neutral times (not in the middle of bedtime resistance!) about what options they had.  As a team, we got a lot better at problem solving. Cole learned to go to bed and stay in bed. Though he still needs less sleep than I do, we have harmony in our home because both of our needs are met.  Boundary setting with compassion continues to be a successful strategy with Cole to this day, and at 14, our relationship with one another is often respectful and easygoing because we both know that we’re in it together, and we trust that both of us will navigate to have our needs met in healthy and functional ways.

 I’m not intending to imply that this is exactly where any other mama is in her own learning.  There are no “shoulds” here. I share it because this is the story of the lessons I am learning in my mothering path, and it might resonate with someone else.  Blessings on the journey, for us all.

What’s in a Fee?

19 Aug 2012 19 Comments

by Jodi in Most Popular

Every doula has heard it at least once…

“So, if my birth is really fast, you’ll refund part of what I paid you, right? Because then you didn’t really have to work that much.”

“How can you be ok with charging so much?”

Or, my personal favorite, “You know, what you’re doing is an act of service. It’s really special. It’s like doing The Lord’s Work. So, don’t you think it’s wrong to not do it for free?”

The money questions… it’s enough to make any doula want to crawl under a rock, or wish we could go live in a yurt, in a nudist colony, on a self-sustaining  farm, so that our living expenses could be lower.

How a doula sets her fee is an unclear concept to many people who are seeking or offering birth services.  On the surface, it may seem like a doula’s fee is a lot of money for what amounts to one big day of work. I offer this so that new parents and new doulas have greater clarity of what a doula’s fee really includes.

A Typical Work Week:  Booking one “due date” per week is more than just one day a week at work – it’s a full-time workload.  Consider this – for every client I take on, I offer up to three face-to-face prenatal meetings, unlimited phone support throughout pregnancy and the first week postpartum, and an in-home postpartum visit.  This means that an average work week for me will have four to six home visits (about two hours each), six to ten hours of phone time, and eight to twelve hours of travel time. Throw in a couple of hours for recordkeeping, appointment scheduling, text and email support, and the extra hours it takes to call everyone and reschedule when I have a mama in labor. That’s typically a 37 hour work week, before I’ve spent even one minute at a birth. When all is said and done, each client, on average, has had the benefit of 30 to 42 hours of her doula’s time, and most of those hours have been when she hasn’t been in labor.

 Birth Hours: The average number of hours I support an individual labor, from the “this is it” phone call, through birth, and the first hour of recovery is 16 hours. Some labors are short and fast, and some are measured in days.  The shortest and fastest births have still had me returning home eight hours after I left. The longest I’ve spent at one birth is upwards of fifty hours. This unpredictability is why I do not charge an hourly rate. I make myself available to provide support for however long a birth takes, and know that on my end, things will average out in the long run.

Commitment and Availability:  When a due date is added to my schedule, I plan to be on-call at any time from 38 to 42 weeks – two weeks to either side of that due date. This means that if I plan a dentist appointment or dinner with a friend, or schedule myself to attend a training, the commitment I have made to my mamas is taken into consideration. I am responsible for making financial arrangements with my backup in advance when I know of days that I will be unavailable, or if I were to have an emergency.  No matter what I think my plan for the day may be, if I have a mama in labor, she takes priority over anything else I may have going on. Classes that I teach are  either rescheduled or another facilitator is paid to take over for the evening. I rely heavily on my on-call sitters to fill in the gaps when I’m not there to pick someone up at school or get dinner on the table. What this also means is that any fees I am paid for a birth cannot be counted toward my living expenses until after the birth has happened, since parts of this fee may need to go to my sitter, another instructor, or my backup doula. Even a doula who is consistently booked has a monthly income that is highly unpredictable.

The Cost of Self-Employment:   Doulas have typical professional and office expenses, required continuing education expenses every year, high transportation and communication expenses, website fees, professional organization fees, insurance expenses, and parking fees at most hospitals.  For a self employed doula, there’s no sick leave, no medical insurance, no benefits, no paid vacation, and no days off. The living income of any self-employed professional, after taxes and business expenses are factored in, is only about half of what they earn. So, the annual living income that a doula must live off of is half of her fee per birth, multiplied by her number of clients per year. For a doula  to earn the equivalent of the US minimum wage of $7.25 per hour for full-time work, she would need to charge $580 per birth. That is if she was willing to be on-call all year, no days off, no weeks in which she wasn’t booked, while taking on a responsible client load of one birth per week, AND if she did not miss one birth due to illness, emergency, or having two mamas in labor at once. That’s just to earn minimum wage!  Even with her years of training and experience,  your doula might be making a better living by asking if you’d like fries with that.

Though clearly no doula is likely to make a fortune from doing this work, it’s fair to expect that a doula should be able to take on a full-time client schedule and make a livable wage. The options are to charge a fair price to empower a doula to work for a living, or to leave birth work, as most ultimately do, to accept a conventional job with a predictable schedule, a decent wage and benefits.

If one looks for them, there are doulas that can be found who will attend births for free, or who accept significantly reduced fees for their services. These are often student doulas who have attended only a few births, or are women who are in a financial position to offer free services. Regardless of her reasons for asking for less than her services are worth, I strongly encourage any mama to pay her doula a fair price, so that the doula may continue to be available for the mama’s next birth and the births of others. I urge all doulas to consider asking for a fair wage, to treat our services as having value and worth, so that ours may be a profession known for attracting and keeping highly skilled and talented individuals.

Wisdom and Experience:  To every birth she attends, a doula brings her knowledge and the lessons that have come from each birth she has witnessed.  On a personal level, I have learned something new with each birth, over 400 times, in 14 years. I have worked in 15 different hospitals, and keep up-to-date on all of the latest research on birth policies and procedures. Having had the opportunity to work with so many different practitioners, I witness the wide variations from one hospital to another, and one practitioner to another. Studies have shown repeatedly that doula support helps lower the chances of a woman having a cesarean birth,  lowers the use of anesthesia in labor, shortens labor time, and results in mamas who are happier with their birth experience. A doula’s head, heart, and hands are completely committed to supporting each woman in creating the birth that feels exactly right for her. Her wisdom and dedication are valuable resources. Her fee is an investment made  toward creating a positive birth experience.

Burnout and  Balance:  Most people who become doulas stay in this field for less than two years.  Burnout runs rampant among birth workers. The unpredictability and demands on ones’ time and energy are more than most people can bear for very long. Balancing home and family connections with birth work takes mindfulness, flexibility, patience and commitment not only on the part of the doula, but from her spouse, her children, her family and friends.

Being on call requires a level of personal sacrifice that few are willing or able to offer.  I have left my own birthday party to spend the night at the hospital with a laboring mama, while my friends remained to celebrate without me. Each of my children’s birthdays and many holidays have been spent at births. I have rescheduled countless parent-teacher conferences. I have cooked Thanksgiving dinner at 4am because a mama’s water broke and I knew I’d be leaving soon. Vacations are few and far between. I go to bed every night with my phone by my head, not knowing how long I might get to sleep before someone is in labor.

I never know what may happen after the “come now” call. There are long days and nights without rest. I might catch a nap while sitting upright in a chair. I may go hours without nourishment, munching on the occasional granola bar.  My body gets tired and sore from supporting a woman through laboring positions and applying counterpressure. I’m usually the one who ends up holding the vomit basin. I go home with amniotic fluid soaking my pants, or blood on my shoes. When the day is done, I’m messy, and tired, and hungry, and fried… and happy – deeply, completely, truly happy.

I do it because I love it. I do it because I cannot imagine my life without attending births. It’s my calling and my life work. I hold space for women in a scenario more  intimate than others will ever have the opportunity to see. All facades melt away. There’s no pretense – just the genuine, intense, authentic energy of a woman giving birth. It’s raw and sometimes unlovely. I witness the transformation of modern civilized professional women into primal birth goddesses, and see the strong love that their beloveds hold for them. It’s an honor, always, to be a trusted caregiver in a space so sacred. It’s an honor, always, to offer love and affirmation in the face of such vulnerability, and to see it through to the other side – to witness the accomplishment and victory that happens when, after reaching the end of all that she thinks she knows, a woman stands toe-to-toe with her fears and chooses to take just one more step into the mystery, and emerge on the other side victorious, with her wet, squalling newborn naked on her skin, and her newly-born mother-self rising up as never before. This is what this work is all about.

I hope this has helped you in making your decision.  Happy birthing!

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

10 Tips to Create a Positive Hospital Birth

12 Aug 2012 2 Comments

by Jodi in Most Popular

As a doula, I am occasionally asked, “So, do you only attend home births?”  Far from it. Though I am a strong advocate of home birth, I believe that labor support is absolutely necessary wherever a woman chooses to birth, and that a woman has the right to choose to birth wherever she feels safest.  For approximately 98% of birthing women in the US, this means choosing a hospital birth.

What is also true is that, nationwide, our hospital cesarean birth rate is 36%, with my home state of New Jersey ranking the highest,  and our maternal mortality rate in the US ranks 50th in the world. 95% of birthing women are choosing to have epidural anesthesia for labor. These numbers don’t reflect a very high incidence of warm-fuzzy natural births. So, if this hospital setting is where the majority of women, including those who want a low-intervention natural birth, feel safest, then the question must be asked, how do we as mamas and papas and partners and practitioners create a sacred experience in the birthplace where we feel safest?

There may always be circumstances beyond our control. That’s a given, and making the best informed choice in that moment is a necessity. There is much, though, that can be done to create a natural, gentle birth while still being in a hospital setting. You’ve no doubt been told to take a good childbirth class, and that’s a great place to begin. The following suggestions are the “beyond the birth class” pointers that I have taught to expectant families and birth professionals for the past 14 years.

10 Tips to Create a Positive Birth in a Hospital

1. Hire a doula! If you desire a natural birth in a hospital then having a doula for support is essential. Doulas are the “Walking Wikipedias”  for all things natural birth. Experienced doulas know the doctors and midwives in their area.  They may also know your hospital staff, and have built harmonious bridges there. They can refer you to  good childbirth classes, lactation consultants, pediatricians, chiropractors, and are a wonderful resource for many other prenatal and postpartum services. They often have connections with support groups and other parents in your area.  Your doula will support you with every step along the way as you prepare for your birth, and will remember what is important to you when your birthing time comes. A good doula has immeasurable value!

2. Imagine your positive birth.  The part of the brain responsible for memory does not know the difference between something that actually happened, or something that is vividly imagined.  This means that spending time with imaginative visioning provides you with stored memories of positive birth experiences. Take time to picture clearly the details of yourself feeling peaceful and safe, your body opening, your baby emerging with ease.  Take in positive birth stories through books, film, and other women who feel satisfied with their births.  These positive stories will provide you with confidence and comfort. With good experiences now stored in your brain as a resource when you are in labor, it’s as if your brain says, “Oh, remember that time I had a baby and everything went easily and was just fine? If I’ve done that before, I can do that again right now.”  Oh, and stop watching  the Birth Story shows. Normal, uncomplicated  birth doesn’t make for good high-drama TV, and takes much longer than half an hour. Your memory is taking those in, too, and they won’t serve you well.

3. Figure out your fears. Name them, and if you can, take time to examine and re-write the core beliefs behind them. Our “core beliefs” are what we hold to be true about ourselves. They are the deciding factors behind most of the choices we make in our lives. A person with the core belief of “I am worthy, loved, and safe” is going to have a more positive experience than a person who carries the core belief of “I have to struggle to get what I need”, regardless of their birth outcomes. Preparing to give birth is an opportunity to not only understand the physical process of growing and birthing a baby, but also to explore the mental, emotional and spiritual aspects of preparing yourself for parenthood.  Now is the time when working with a childbirth educator, doula, counselor or therapist to heal the negative core beliefs that may undermine your ideal birth is an excellent way to support yourself.

 4. Know the policies and procedures in your hospital. Understanding your options in a hospital is critical in order for you to feel empowered and to create a safe space. Ask your doctor and your doula about their experiences with natural birth in your chosen birthplace. Call your birthplace and find out who can answer your questions about their policies. If the birthplace of your choice does not offer options that you find acceptable, find another one that does. They do exist!

5. Write a birth plan. Notice I did not say “Write a five page list of demands and make fifty copies and hand one to everyone you encounter”. People don’t typically like being told what to do in black and white before they’ve had a chance to show you their best. The process of writing a birth plan is a shared exercise between expectant mama, her partner and other support people who will be present for her birth.    Thoroughly considering all of your birth options via a mental “dress rehearsal” can help you understand your options and  clarify your wishes and intentions for your birth. This exercise then becomes a tool that will help you communicate clearly with your doctor or midwife.  If you do choose to put a birth plan into writing, keep it short and simple – a single page, with your top ten utmost priorities bullet-pointed, phrased in the positive (“Thank you for…” and “I would prefer…”, rather than “DO NOT EVER…”). Review it with members of your birth team prior to your birth, so that everyone is on the same page.

6. Thank the hospital staff upon arrival with a gift. Perhaps you bring the banana bread that you baked while passing the time in early labor, or maybe you have a basket of cookies ready to go. Stop for doughnuts on the way to the hospital, if that’s what works for you.  Attach a thank you note with your name on it, and a copy of your birth plan. Most hospital nurses work really hard.  It’s long hours, a lot of demands on their time and energy, and not a lot of thank-you’s to go around. People are nicer when you begin your interactions with showing kindness and gratitude. (They’re also nicer when you feed them.) This may not inspire anyone to bend the rules on your behalf, but it will certainly start things off on a positive note between the hospital staff and the laboring family in room 16. They will notice right away that this is a different experience for them, and that opens the door for your entire birth experience to be different than “the usual”.

7. Find subtle ways to make your hospital space your own.  Consider making a sign to hang on the hospital door that asks that people knock and enter quietly, or even just make one with your names – “Jane and Tom and BabyQ say thanks for your support”. Choose your own clothes to wear, rather than the hospital gown that looks like every other patient. Bring positive birth images to tape to the wall. Bring an aromatherapy spray that you like the scent of.  Anything that may lead someone who is entering the space to pause for a brief moment and notice that “Oh, this is different” helps create the space for your birth to be recognized as unique, and treated as such with respect.

8. Bring music into the labor and delivery room. This not only helps with making the space more comfortable, but serves a myriad of other purposes, as well.  Rhythmic music can be calming to your mind.  Rocking and swaying, often helped along by music, helps move the baby down more comfortably and with greater ease.  Singing along can help you use your voice in a powerful way to cope with strong surges (no matter how well you think you can carry a tune). Music creates a sound barrier between your room and the room next door, if the hospital walls are thin. This helps you have a greater sense of privacy, making it easier for you to let your own guard down so that you can surrender deeply to your birth process.

9. LOVE, LOVE, LOVE!  Ina May Gaskin says that the energy that created the baby is the energy that will get the baby out.  Oxytocin, the hormone produced during lovemaking, is the same hormone responsible for labor.  So, anything that would be conducive to good lovin’ is also going to make for an easier birth. Sweet music, hugs and kisses, loving words, soft lights – these are all helpful. Likewise, anything that would be a mood zapper can have the same effect on labor. Keep the hospital room door closed. Keep people in the room to a minimum. Turn the phones off.  Let love lead the way.

10. Practice meditation to invite calmness and well-being into your daily life. Meditation isn’t about learning to sit like your legs don’t have any bones. Meditation isn’t about seeking and finding peace and stillness. Rather, it’s about making room for the stillness that is already within you, under all of the layers of busy-ness. In that place of stillness dwells the part of you that already knows how to have a baby. Just like your baby knew how to grow the right number of toes without taking a class to learn how, your body knows how to birth, and your baby knows how to get born. In being able to tap into your own stillness, you will find your strength. Start now. It’s ok to start with a minute – just one minute – of sitting and smiling. Your thoughts may wander, and that’s normal. Just recognize this, and bring yourself back. Take a breath, in and out, and then another breath.  Take one minute to take a deep breath and name three things that you are grateful for today. Take one minute before sleep to replay a happy memory from this day. A minute here, a minute there – it adds up. Find your stillness. Trust your body. Trust your baby. You can do this.

It is my hope that you benefit from these pointers and share them with others. If you have any of your own suggestions  on what made your hospital birth positive, empowered, and sacred, please share them here in the comments.

Like this article?  Come “like” Jodi the Doula on Facebook by clicking here!

Choosing Your Doula

25 Jul 2012 1 Comment

by Jodi in Most Popular

A doula is a woman trained in the physiology and psychology of birth, and in the art of providing labor support to birthing mothers during pregnancy, the birth process, and immediate postpartum period. Choosing to birth with a doula is a wonderful way to support yourself in having a positive birth experience.  It has been well-researched and documented that women who birth with doulas have shorter labors, are far less likely to have a cesarean birth, are less likely to use pain medication during labor, and report being much happier with their births.  Women who have birthed with doulas are typically more likely to describe their birth in positive terms, and feel more attached to their babies.

A good doula is an asset to your care team.  She will accompany you in labor and birth as a support person, helping to gather information and facilitating communication with your birthplace care providers.  She will provide reassurance and perspective, suggestions for comfort and labor progress, massage, and help with relaxation and positioning.  She will be continually present throughout your labor until after your baby is born.

There are as many styles of doula care as there are women who are doulas. Each doula brings her own talents and experiences to your birth.  Finding a doula who is a good fit for you can go a long way in helping you create a birth that you feel really good about, so choose wisely. Ask your doctor or midwife if she has worked with a doula that she might recommend, and then schedule a few interviews to choose the doula who is just right for you. 

The following questions may be helpful for you to ask in the interview process:

Why did you become a doula? What is your philosophy about birth and supporting women and their partners through labor?

 Hearing a doula’s reasons for choosing her career will help you get a feel for who she is and the style of care that she provides.  You may not agree with every word she says, and that’s ok. Hearing her philosophy of childbirth will help you get a feel for whether she is someone with whom you can work comfortably.

What training have you had? Are you certified? If so, by what organization, and what was required in order to receive this certification?

If a doula is certified, you might consider checking out her certifying organization.  Looking them up online  might give you a stronger understanding of the kind of training that they offer, or the standards of practice that their certifying doulas are encouraged to uphold.  Some training organizations are very hands-on, and others may be more textbook-based. Each also has different standards that must be met for certification.

How long have you been in practice?  How many births have you attended?

 An experienced doula is a wonderful find.  Her wisdom and years of experience can deeply enrich the support she provides for your birth.  In the birth world, having a wide range of experiences can help a doula maintain a calm and steady presence throughout your birth.  Do not, however, automatically rule out a doula  who is a newbie, especially if she has had good training.  A new doula’s energy and enthusiasm might make her an excellent fit for you. Ask if she is working with a mentor – you might benefit from having her mentor’s experience in the advice a newer doula offers.

Do you have education and experience providing any other type of care for childbearing women, such as childbirth education, midwifery care, nursing care, breastfeeding support, or postpartum doula support?

Many doulas also have experience teaching classes in your local community, helping new mamas with breastfeeding issues, or providing in-home care for new mothers and babies. Your doula might have a wide variety of experiences and services to offer that will enrich your work with her.

Do you have anyone else due near the time I’m due? Do you know of anything now that may cause you to be unavailable around the time of my birth?

Most doulas limit the number of clients they accept to two to four per month, and consider carefully the commitments they are making when agreeing to attend your birth. Doulas who work full-time in doula service have lives that are structured around being on-call for your birth.  Doulas who work part-time might have other commitments, such as other jobs or small children at home, that they take into consideration.

How do you view your role at the birth?  How would you work with and involve my partner?

Most doulas are comfortable including partners, family members, and other non-medical support people on your team to the fullest extent that others are willing and able.

How do we get in touch with you when labor begins?  When do you prefer to join women in labor? Do you come to our home or meet us at the place of birth?

Some doulas regularly meet you at home in labor, when it’s too early yet to go to your birthplace. Others typically meet their clients in the hospital or birth center after labor is well established.  It’s important to learn what your doula’s standard practice is, and to know if this is a good fit for you.  Some women prefer to have support at home at the first twinge of labor, while others who may have given birth before are more comfortable going through their typical daily routines until labor is too strong to continue to do so.

What services do you provide during labor and birth? What do you bring with you? How do you help women cope with labor?

Doulas may be trained in many different modalities of labor support.  Some offer massage or reflexology, some may know hypnotherapy techniques, while others are well-versed in using different labor positions for comfort and labor progress. Your doula is a valuable resource – learn what she has to offer!

  What is your view on the use of pain medication in labor?

The point, here, is to know that your doula is realistic.  It is important that she offers your support unconditionally, regardless of your plans, and irrespective of anything unexpected that may happen in your labor.  Medication is a tool – as with any other tool in labor, there are appropriate times and places for its use.  A competent doula will likely assure you that her interest is in your satisfaction with your birth experience.

Which labor coping techniques do you think tend to be the most helpful?

Here is where a doula’s training or special interests may again come into play. Most doulas are knowledgeable about many different childbirth methods and comfort techniques, and can offer valuable input on their effectiveness, in her experience.  If you have a particular method in mind, ask her about her experience with it, so that you know her ability to support you in this choice.

How long would you stay after the birth?

Some doulas have a set time frame, such as one or two hours, that they continue to provide support after your birth.  Others use guidelines such as “when you’re cleaned up and ready to rest”, or “when you’d like to be alone with your partner and baby, I’ll ask you to send me home.”  Others have their own guidelines that fit within your birthplace’s policies.

Do you offer any special services?

Some doulas may provide massage, photography, aromatherapy or other add-on services — such as writing out your birth story — for no extra charge. 

Do you provide any services in the postpartum period? What about reviewing my labor and birth experiences or helping me with breastfeeding? Are you available by phone? In person?

Some labor doulas also work as postpartum doulas and offer care after the birth. This may include breastfeeding support, light housekeeping, errands, and help caring for older children as well as the new baby.

Do you have a backup arrangement with another doula or group of doulas in case you’re not free when I go into labor? May I contact them?

Doulas are real people with lives of their own.  As responsible and committed as even the best doula may be, there may be times when she is unavailable.  Knowing that she has a solid backup arrangement will help put your mind at ease.

May I please contact other women who have recently worked with you as their doula, to ask about their experience with you?

 It’s  a good idea to check a few references. Ask what they liked most about the doula and whether there’s anything they wished she had done differently.

 Are you familiar with my doctor/midwife/hospital/birth center? What have your experiences with my practice/facility been like?

It can be especially nice when your doula and other practitioners know one another and have a harmonious relationship.  Your doula may have valuable insight on what it may be like to birth with the practitioner you have chosen.  If the doula you choose does not know your practice, ask if she is willing to have her contact information shared so that your doctor or midwife may contact her if they would like.

When will we meet again to address any concerns or questions I have and to review our birth wishes?  How often are we in contact with one another between now and the day of my birth? May we call you with questions or concerns before and after the birth?

Good communication with your doula will help her provide the best possible care for you. Find out now how and when she prefers to be contacted, and how to best remain in contact with one another between now and the time of your birth. This will help avoid any confusion or missed communication down the line, and will help your confidence in your doula to remain strong.

What is your fee, and what does it cover? What is your refund policy?

Doulas’ fees range from about $400 to $1,600.  Some charge a flat fee that covers all prenatal visits, phone support, and labor and postpartum.  Others charge an hourly fee, and still others  charge an hourly rate that is capped at a maximum point. Refund policies may vary widely – know in advance what your doula’s policies are, so that you are clear with one another.

Do you have any experience with reimbursement from health insurance plans?

As more and more insurance companies are providing coverage for doula service, this may be another area where your doula has experience that can be a big help.  Some doulas have standard receipts and letters that will be provided for you, and others may have their own Insurance Provider Numbers (the same sort of code used by doctors and nurses). She may even be able to help you learn about how to be reimbursed, even if you are not sure what your insurance company will cover.

Do you accept alternate payment arrangements, such as sliding scale, time payments, or barter?

If finances are a concern, many doulas are able to accept alternate payment arrangements, or may be able to help you find another doula, such as a doula in training who is working for reduced fees.  It can’t hurt to ask!
After the interview, try to imagine the doula at your birth with you and see if you feel good about that.

 Ask yourself:

Do I feel comfortable around this person?

Is she warm, enthusiastic, and knowledgeable?

Does she communicate and listen well?

Will she support my choices or does she have her own agenda?

Your doula will support you in feeling safe, secure, heard and included in the process of your birth. Your own empowerment is her priority. Finding the right doula for you is an excellent step in having a happy birth.

Good luck, and blessings on the journey.

Choosing Your Birth Attendant

15 Jul 2012 1 Comment

by Jodi in Most Popular

 
If your desire is to create a positive birth experience for yourself, and a gentle birth for your baby, finding the right birth attendant for you is essential.  Your birth attendant, whether you find a doctor, midwife, or a group of doctors and midwives, are the people you choose for your birth team who will monitor the medical wellbeing of you and your baby in pregnancy and birth.  When seeking out the right practitioner for your team, it is key to ask good questions.   Hearing responses that feel compatible with your preferences, and having clarity in your understanding of your chosen practice’s style of care will ensure that you are working with a well-chosen birth attendant.  This will contribute significantly to your feeling safe and secure at the time of your birth, and will support your ability to trust and be open to the process of labor.  It is of the utmost importance to know that you have chosen a practitioner in whom you are comfortable placing your trust.  You will find security in knowing that your birth attendant is respectful of your wishes, and willing to include you in the decisions necessary for yourself and your baby.  Following are some sample questions that may help you make your decision in choosing the right doctor or midwife. 
 
At what facilities do you have privileges?
Some doctors and midwives practice at more than one facility, and where you are to deliver may depend on where the person on call is at the time you go into labor.  Be sure to interview each facility as thoroughly as you do your doctor or midwife, as birthplace policies may vary widely.  Some homebirth or birth center midwives also have hospital privileges in the event of an emergency, some may work alongside doctor practices that are willing to provide hospital services when necessary, and some do not, making it necessary for you to make your own contingency plan. 
 
 
 What will happen during a typical appointment?  What tests or procedures do you normally recommend in pregnancy?

Every practice has different guidelines and recommendations for standard procedures during routine prenatal care. It is important that you know what will happen in typical appointments.   Regardless of what testing your practice may recommend, it is important that your practitioner is willing to thoroughly explain each test to you, discuss with you the risks and benefits of each, and explain which tests are considered optional.  Now is the time to feel out what your practitioner’s response may be should you choose to decline testing or seek alternatives. 
 
How much time do you allow for each prenatal visit, and how long is a typical wait in the waiting room?

This may not be a question you even need to bring to your practitioner. Look around the waiting room and ask women who are well into pregnancy how long they usually wait. If your stress level rises at every visit because the wait is making you late for the next part of your day, your pregnancy will not be enhanced by this experience.  Knowing also that you have adequate time to ask questions and understand what is going on with your body and your baby will increase your satisfaction with how you feel about your pregnancy and your provider.  Office schedules vary widely, with some docs allowing seven minutes for each visit, and others allowing as much as an hour.  Find out what your practitioner’s policies are. 
 
 
What pregnancy books or websites do you recommend I read?

Educating yourself about your birth options is a necessary step in creating an empowered birth. Practitioner’s styles may vary widely when it comes to advocating that his or her patients educate themselves. Some have lending libraries in office, while others may believe that a mother is best off doing as she is told.  Your doctor might have a recommended reading list that is readily available.  If so, look it over and see if he suggests any books or websites that you have already found and like. 
 
 Do you recommend any specific childbirth classes?

There are a myriad of choices available to consumers when it comes to childbirth class options.  Some doctors and midwives insist on only one method, and if so, it is important that this is one that one that feels right to you.  Some practices advocate hospital-based classes only.  Some hospital or birth center classes are supportive and informative, taught by certified childbirth educators,  and others are classes taught by hospital staff on “how to be a good patient”.  Others may suggest out-of-hospital classes that they consider good, and may even know instructors in particular that they recommend.  Knowing that your practitioner speaks the language of whatever method you choose will help ensure that everyone is on the same page at your time of birth.
 
 
How regularly do you attend births with doulas?  Which doulas have you worked with? Who would you recommend?
 
Using the services of a professional labor doula has been shown to significantly reduce the likelihood of a mother having a cesarean birth. Women who use doulas report experiencing less pain in labor, and typically express greater satisfaction with their birth, regardless of the use of necessary interventions. A good doula is an asset to your support team, and if you are choosing to birth with a doula, then finding a doula-friendly practice is essential.  If your doctor or midwife has a doula that they work with often, or even have a doula on staff with their practice or their hospital, this is even better! You may wish to avoid practices that discourage doula care.  Some practitioners have been known to say that doulas are unnecessary, or that your doctors and nurses will provide the same services as any doula would. This is not possible.  A doula’s training and expertise is specifically in the non-medical support of the physical and emotional experience of labor and birth. She is trained to work alongside – not in conflict – with the medical care providers on your team.  Find a practitioner who will support your right to have excellent labor support.  You might consider asking your doula who she recommends. 
 
 How will you encourage me to manage and cope with the intensity and discomfort of labor?
 
 Doctors and midwives can offer a host of options for pain relief including medication such as narcotics and  epidural anesthesia.  Some may be very supportive of keeping you up and moving to ease birth, and are willing and able to provide access to a shower or tub.  Others may advocate partner and doula support for massage, encouraging words, and effective non-medical relaxation techniques. (As a doula,I have a fond birth memory of a doctor who sat on the bed next to a laboring mama and said, “I’m your doctor. I know medicine. If you’re asking me what to do for pain, I’m going to talk to you about what I know. I’m happy to do that, but you’ve told me that you don’t want that, and that’s ok with me. You have a doula and your partner here who can get you through this without medication, and I think I’m going to step away now and let you have this conversation with them.”)
 
 
What role will my birth partner play?

It is standard now for a father or partner to remain with the laboring woman throughout labor and delivery, although the amount of participation varies. Ask if he or she is welcome at prenatal visits and whether he or she can stay with the mother in the event of a cesarean, or if they may stay with the baby in the event that nursery care is needed. Some hospitals consider doulas to be visitors, and others may not, allowing your doula to remain with you in addition to your partner. Find out what the boundaries are at your birth facility for having your doula remain with you. 
 
What do you recommend for normal pregnancy aches and pains?

There are many common discomforts associated with pregnancy, and many can be relieved with simple non-medical remedies.  Perhaps  you have found a practitioner who is willing to talk about these comfort measures.  She may recommend chiropractic care, homeopathic remedies, and common-sense solutions, or her answer may be written on a prescription pad. If limited medication is important to you, it is significant to learn where your practitioner’s style of care falls, as well. 
 
 Will you be my attendant at the time of my birth? If not, who will be there with me? Who are your back up practitioners? Will I meet them before my birth?

It is important to know who will be in the room with you at the time of your birth. Even if the possibility of another practitioner is remote, you may be more at ease knowing who might be there during your birthing time.  Some practices share on-call schedules with all doctors in the practice, some have one-on-one relationships between doctor and client, and others share their responsibilities with other practices.  Some hospitals have laborists who attend all births, regardless of what practice you have seen during pregnancy. If you should choose to hire this practice, will you know who will be at your birth? 
 
 
What interventions do you routinely recommend in labor?

There are no routine interventions that have been proven to be necessary in every labor or birth scenario.  There are practitioners who may have preferences for some interventions to be used routinely, and it is important to learn this long before having this conversation in your birthing room.  (I once heard a doctor exclaim to a mama, “But hardly anybody’s water ever just breaks on its own.”  This was hardly a surprise, given that rupture of membranes is typically the first thing she does routinely at the time of admission into the hospital.) Informed consent is a must in any birth situation, with each intervention being considered on an as-needed basis.  By having these conversations in advance, you may be sure that you have found a practitioner who will involve you in your own care.
 
 At what point do we talk about the artificial induction of my labor?

Induction of labor may be necessary when the medical facts show that your baby would now be safer on the outside than on the inside.  However, induction for a myriad of reasons may vary widely from one practice to another. Some doctors will recommend induction if you are one day past your due date, while others are willing to wait a full two weeks past that point as long as mother and baby are healthy and well. Some will suggest induction after one minor concern, while others will insist first upon further testing to confirm that all is well before going the induction route. Your doctor or midwife should also be willing to discuss their recommended method of labor induction, taking the time to explain the options you have and the reasons for each step along the way. 
 
 What are your vaginal birth rates? At what point do you recommend a cesarean birth? For first time moms? For moms who have had previous cesarean births?

Let your doctor know that you are committed to having a normal birth, and ask questions about the likelihood of this happening.  Be sure to ask specifically about Vaginal Birth After Cesarean (VBAC) if you have previously had a cesarean birth. This is another area where standards of care vary widely. Some practices are willing to allow for a trial of labor only if labor occurs spontaneously before a specific date, such as “before 39 weeks.”  Some doctors advocate for a c-section if labor progress seems to have paused for an hour or two, where others are willing to allow more time as long as mother and baby are fine.  Some practices or birth centers or hospitals have specific time limits for pushing, allowing “two hours for a first baby, one hour for a second baby” before a cesarean is ordered, whereas others are willing to continue as long as mother and baby are doing well. It is important to know in advance what your practitioner’s guidelines are. If you are planning a home birth or a birthing center birth, knowing at what point transfer to a hospital would be considered necessary is also important. 
 
What is your rate of episiotomy?  Forceps birth? Use of drugs and anesthesia? What percentage of births in your practice are unmedicated?

 Many practices keep their own statistics on these aspects of birth. These statistics can help you in comparing practices by indicating the amount of intervention during a typical childbirth with this midwife or doctor. Some may avoid answering these questions directly, by saying that they do the procedures only as necessary – the definition of necessity, however, can vary widely. There’s no harm in asking for specific numbers or a “best guesstimate”. Remember, you are the consumer choosing to pay for these services, and you have the responsibility of knowing what to expect. What are your chances of beating the odds if half of their births are cesarean, or if most births “require” episiotomies? On the other hand, there are many practices who no longer use routine episiotomy at all, and perhaps you have found one. Don’t wait until your baby is emerging to find this out – ask now. 
 
 
 If  I have a question, who do I call?

Some practices have a dedicated “warm line” that their mamas may call any time of day or night.  Some have nurses in the office who will return calls during the day, and some doctors and midwives have a “phone hour” planned into their daily schedule. It is important to know what you can expect your experience with your practice to be. 
 
Are there any special risks that I should be aware of with this pregnancy? Do you recommend that  I change my diet?  Are there other lifestyle changes that I need to be making?

Your doctor or midwife can be a treasure trove of information that will assist you in having the happiest and healthiest pregnancy that you can.  The more you ask, the more she can offer. Don’t just ask the internet – ask your doctor!
 

 It is unlikely that all of the above will be answered in one fell swoop on your first visit.  I encourage you to ask the questions that are most important to you at your first appointment, and if you are reasonably comfortable choosing this practice for your care, continue asking more questions at each appointment. If you feel rushed or intimidated asking questions, or if you get the sense that asking questions is unwelcome, it would be unwise to think it will be any different several weeks down the road when you want to know about concerns regarding your pregnancy or wish to discuss your hopes for your birth. Remember that you deserve to be treated with respect as an active participant in your own pregnancy and birth.  A good practitioner will welcome and encourage this.  Even if you are just now learning this later in your pregnancy, there are many good practices who are willing to take on a new patient, even if you are quite far along. Find one! Ask your friends, your doula, your childbirth class teacher,  and your community members who are happy with their births who they chose and why.
On the other hand, if you find yourself getting more excited about the pregnancy as you speak with your midwife, and if your doctor inspires your confidence and trust more at every visit, congratulations! This will be an excellent care provider for you! With this step, you can have the confidence of knowing that you are well on your way to creating a positive birth experience.

A Better Birth – Cole’s Birth Story

05 Jul 2012 1 Comment

by Jodi in Most Popular

Cole is my second child. You can find the story of my first birth here: Zack’s Medical Birth and the stories of my learning and preparing for a better birth experience here: Part 1 and here: Part 2

It was Easter weekend, 1998, and I was a week past my estimated due date. I had already talked with my doctor, and let him know that I was comfortable with waiting a while longer, as long as my baby was ok and my body remained healthy. I started having erratic contractions on Friday evening.  Taking my doula Kathy’s advice to “just do life until labor gets too strong for that”, I played with 21-month-old Zack, and spent the evening at the park with take-out food for our dinner.  We brought stale bread for feeding the ducks. The spring in Texas hadn’t gotten hot yet, and the bluebonnets were out in gorgeous full bloom. I pushed Zack in the stroller down the bike path by the lake, went home for a bath, and went to bed.

On Saturday afternoon,  my then-husband (who denied being in his mid-thirties by playing basketball with college students) had yet again managed to injure himself enough to require medical attention. By this point, my contractions were a steady ten minutes apart, and still light enough that I could “do life” in between. So, I drove us all to the emergency room. When we walked through the doors, the person attending the desk was surprised to hear that we were there for him, not me. For the next four hours, I walked the hospital hallways with Zack in the stroller, chatting and singing to keep my bored and highly active toddler entertained, and pausing to breathe through contractions which were getting stronger.

It was a holiday weekend, which meant that the ER was incredibly busy. By the time the sprained (again) knee had been tended, it was after midnight. My contractions were a good 6-7 minutes apart, but still bearable. So, what did we do? Go to the hospital across the city where I would have a baby?  No, we went home so I could dye Easter Eggs. The following morning was Easter, and by golly, my little guy was going to hunt Easter eggs if I had anything to do with it. Spending the afternoon in the ER was not going to stop me. So, I put both of them to bed, and got busy with the egg dye before turning in sometime in the wee hours.

Contractions, steady but still manageable, woke me up in the morning. I called Kathy to check-in, and reached out to my friend Julie to ask if she would be willing to take Zack to church with her before taking him to her house during my birth. I wasn’t in labor enough to head out the door yet, but I was past the point of sitting quietly in church. I continued to feel calm and unhurried, just “doing life”. We had Zack’s Easter Egg hunt, took pictures, got him out the door, and pseudo-napped (as close to napping as one can get between contractions).  We walked around the park. I got a shower, baked banana bread, and and watched a movie while I rocked on the birth ball. Closer to evening, I was pretty tired and my body knew it. My surges had fizzled and spaced much farther apart. I called Kathy to check in – I was having a moment of fear, worrying a little that this was like the time before, when things had stopped and needed help getting going again.

Bless my doula, who talked me down from the ledge. She reminded me that my body was wise, had been doing a lot of work for two days now, and knew that I needed rest. Things were likely slowing down so I could catch a break before the next leg of the journey. So,  I decided to go out to dinner, figuring that spicy cajun food couldn’t hurt.   The waiter’s eyes grew as big as saucers when I told him I was in labor – our order sure was handled quickly. After dinner,  I called Kathy again from home, told her I was having a glass of wine and going to sleep, which I did.

The following morning, steady five-minute-apart waves woke me again.  This time, there was blood (just a little) and I could tell that the baby had changed positions. “Ok, here we go”, I thought. I called Kathy, who stayed on the phone with me long enough to have our conversation interrupted by my moaning. She decided then to head right over. In the next few hours, I got in and out of the shower, and paced around the living room. Kathy took beautiful pictures, reminded me to eat and drink, offered me encouraging words, helped me keep my hands relaxed and breathed deeply with me. Sooner than I had expected, she told me that my last several contractions had been only three minutes apart, and that we should leave for the hospital. I could hardly believe it – this was already farther along than I’d gotten without an epidural for Zack’s birth, and I was still feeling pretty good.

We drove the half-hour to the hospital uneventfully, with Kathy following behind.  Walking into the hospital at 3pm, I was offered a wheelchair, and respectfully declined, though they reminded me that the birth suites were on the third floor, and a long walk. Up in the elevator we went, and down the long and winding hallway to the adjacent building, pausing and grabbing the handrail every few minutes to stop, sway, and breathe. When I finally arrived at the desk and smiled and told the nurse that I was in labor, she asked if I was sure, and commented that I looked “too happy”.  I just laughed. I was happy! Kathy commented that laughter is good for labor, and that I could just laugh the baby right out.

Kathy dropped off banana bread for the nurses, and I was soon settled in. My favorite music was playing, I had the birth ball set up to sit on while being monitored, and my aromatherapy oils were sprayed around. I stayed in the clothes I had chosen to wear – my favorite comfy long t-shirt. A heparin lock, not an IV, was put in place so that I could continue to move freely. My doc came in for a quick exam, and found that I was dilated to 6cm. He mentioned that my membranes were still intact, and offered to break them for me.  I made quick eye contact with Kathy, and asked him if he had to. “No”, he said, “It can just help things move along, but I don’t have to. We can talk about it later if you want.”  There was no argument, no conflict – I had asked a question, and gotten a reasonable answer. This was, in itself, a victory.

The first two and a half hours passed quickly. I wasn’t in the bed for even a minute. I was only monitored for ten minutes out of each hour – another compromise that the nurse made willingly. In between, I sat on the ball, rocked in the hospital rocking chair, and walked the hallway with Kathy offering encouraging words and putting pressure on my hips, which helped so much. Kathy looked into my eyes and breathed with me. The nurse noticed and commented, “You two are really good at that.”  Occasionally, I would  dance, slowly swaying through the surges.  Suddenly, I was so very tired, and had to rest. I climbed into the bed, lying down on my side.  Kathy covered me with a sheet and began stroking my back. The nurse popped in to ask if I was ok. Kathy answered, “She just had a huge oxytocin rush and is feeling a little sleepy, so she’s just going to rest a minute.”  At that moment, my water broke, just as it had in my first birth, soaking the bed and everything I was wearing. The nurse helped change the sheets, put me in a dry gown, and then… meltdown.

“Kathy, this hurts.”

“I know”, she said softly.

“No, Kathy, this really hurts.”

“I know, and you can do it.”

“No, no, I don’t think I can”

“I know you can. Skip knows it, too.”  She motioned for him to come stand in front of me, to give me his eyes, for comfort.

“No, no more. I want drugs.  I want drugs RIGHT NOW.”

A few more minutes passed in this way, and at last I said, “You don’t understand.  This really hurts, and I’m really tired. I don’t want to do this anymore.  I don’t even want to have a baby today!  We are getting back in the car, and going home!  We can all come back later, and I WILL HAVE A BABY TOMORROW!”

My doula, bless her, wisely nodded her head, paused a moment, and just said, “OK”.

A silent minute passed.

“I think I need to push.”

She laughed. “Ok!”

The nurse was called in, and I was checked – complete with a just a tiny rim of cervix. Kathy’s smile beamed. The squat bar was brought in and attached to the bed. The nurse told me that my doctor had been called, but that he wasn’t on the floor yet, and I’d have to wait a minute.

I looked her square in the eye and growled, “You… have GOT… to let… me PUSH.”  Then I looked at Kathy, and said, “I’m going up and over”, and I flipped onto my hands and knees. Kathy stayed by my ear. “If your body is pushing, I know you can’t stop it”, she whispered, “but don’t push hard. Just blow. Let your body do the work.”  One surge passed. I blew. Another, and I blew. Then, I gave a warrior’s cry as I felt every muscle in my body get behind a mighty heave. Why this is called an urge to push, I cannot understand. This was an imperative. My body was pushing, and nothing in the world could have stopped it.

A second nurse came into the room and saw me on all fours.

“What is she doing?”, she whispered to my nurse.

“Having a baby”, answered my nurse.

“Well, shouldn’t we tell her to turn around?”

“No.”

Another powerful heave, and out came the baby’s head! I could feel it, there touching my thighs. I reached down with my fingers. Oh, so soft! A moment later, and out the rest of him flew, right into the waiting hands of my nurse. The doctor hadn’t even made it down the hallway yet. I don’t remember the cutting of his cord, or turning over, or exactly who laid him on me, but I know that my son was immediately placed directly on my naked belly. No nursery, no NICU staff, just my baby skin-to-skin on his mama. Seconds passed… minutes, maybe. And then, my baby began to crawl. He pushed with his tiny feet up the length of my belly, found my breast, and latched on, all by himself. Watching human instinct in action was one of the most amazing moments I’ve ever known.

He was here. Nicolas Wesley was here. My baby was here. All was well.

My doc made it in, minutes later. My placenta came out easily on its own. I had a tiny tear, just a little bit, where my scar from Zack’s birth had been. My newborn never left my arms. There was no question that he was mine. This was exactly the birth I had wished for. I did it. With the birth of my son, I felt as if it was me who had been reborn.

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

A Better Birth Story – Finding the Way

05 Jul 2012 Leave a Comment

by Jodi in Most Popular

While preparing for the birth of my second child, I had hopes for a different experience for the second time around. Don’t get me wrong, I knew I got a great kid out of the deal the first time, but somewhere in me, I knew that it was possible to have something… different. I just wasn’t exactly sure how.

From my son’s birth a year before, two moments stood out in my memory that gave me an inkling of possibility and hope.  I remembered the few minutes after my membranes released, in which I suddenly felt peaceful and calm, and wasn’t in pain. I remembered thinking clearly, “hey, maybe I can actually do this.”  I remembered also the words of the wonderful nurse who let me know in no uncertain terms that she could not tell me what to do, but that I could let her know my wishes. I remained grateful to her for giving me the words that brought my newborn son to my arms for even just that five minutes.

I wondered if it was possible to connect more deeply and intentionally to that place within myself; if there was a way to get to that feeling without it being fleeting, and birth without fear. I believed that, even if it were necessary to face every intervention from my first birth for a second time, if I could be in that place of knowing what was happening and not being scared, I would feel completely differently about my birth.

Having already found comfort in Dr. Sears’ The Baby Book, I looked into The Birth Book to learn more about my childbirth options from his medically-balanced perspective that also honors intuition and instinct. It was there, in a small sidebar on the right-hand margin of a page, that I first came across the word doula. It was just a brief snippet about a doula being a person trained in labor support to take the anxiety out of the birth process. Given that this was the pre-Google stone age of 1998, I called the 800 number given, asked for a list of doulas in my area (snail mail!), and began my search.

Finding my doula Kathy was one of the best decisions I have ever made. Her brilliant smile and her passion for birth put me at ease. She listened to my birth story, helped me uncover my fears and desires, provided reassurance and perspective, and encouraged me to believe in myself. She pointed me in the direction of good educational resources, provided information about different options available to a laboring woman, and helped me know what questions to ask my doctor long before we were ever in the birthing room. She was available as a sounding board throughout my learning. I would call her to ask questions, like “Hey, Kathy, I read today that when you reach the point of saying ‘if it gets harder than this, I can’t do it’, that’s as hard as it’s going to get. Is that true? Because if that’s true, I think I can do this.” She didn’t do the work for me, and held me completely responsible for my own choices without judgement. What she did do was ask good questions and offer unconditional acceptance and support.  She helped me discover the pieces that I had been missing. She shared with me in the “a-ha” and “oh, wow” moments along the way.

I chose a different hospital that was farther from home, but smaller and more intimate, with a birth center environment and more non-medical options available to laboring mothers. I found a different doctor; one with privileges at this smaller facility. I took an out-of-hospital childbirth class, which helped me learn about how natural birth happens. I learned about alternative comfort measures that I could use, and how to reprogram my own negative self talk with positive affirmations and belief statements. I began to integrate the belief that the body growing my baby would know how to get my baby born. I began to believe that I was strong. I was still scared sometimes, which is normal anytime someone is dealing with the unknown, but I was not terrified.

To be honest, I wasn’t completely sure yet that I would have an unmedicated birth. I was ok, though, with taking myself as far as I could go, and then taking just one more step. That was all the expectation I had, and I knew I would have the support to take it.