Recently I attended an event where couples came to meet potential doulas. There were a few things that were said that made my ears prickle. One was from a very enthusiastic, young doula. She said repeatedly in her conversation about empowering women, that being her job. I do not empower women. A woman has power within her. My job is to help her find her power. It seems like semantics- but I find one way a doula can disempower a woman is to make her dependent on you as her doula to find her power. I want a woman to learn how to find her own power. Then it is my job to encourage her to use it.
give (someone) the authority or power to do something.
make (someone) stronger and more confident, especially in controlling their life and claiming their rights.
The second thing that was said was from a much more experienced doula. She was describing their services. She said that they attend the last three prenatal visits with a client. She said that when the care provider sees the doula in attendance they will not bring up things like “big baby”, inductions and encourage interventions. She is there to kinda protect the mom from the provider. Now this at first sounds nice. To feel protected. But is that what a doula’s role really is?
I used to attend prenatals years ago when I was new and needed to meet providers. When the concept of a doula was new, I went to help them to know my role and meet me. I asked a dad his opinion this week of doing this. His wife had been led to believe that their baby, although not officially late, needed to be induced because the ultrasound had projected the weight to be over 9 pounds. She had a three-day induction, emergent cesarean and a baby that was only 7 1/2 pounds. He said yea it sounded nice. But then he said prenatals were kinda private and he was not sure the doula needed to be there. I wondered if pregnant couples would see the benefit of this added service.
Ironically over the next few days the topic came up on a facebook birth professional page.
“Do any of you go with your clients to a prenatal appointment with their care provider? I’ve heard of this and wonder how common it is? It seems like a good way to build rapport with providers. Any downsides to this?”
And Maria Pokluda wrote,
“I will, but I can’t do it instead of a prenatal since I have other things I need to do at those. However, they can pay for me to go to an appointment if that is important to them.
However, my better question is why is that important to them? We would chat about that because really, the time they have with their provider is important too for the things that happen there and the questions they should be asking.
Also, most providers share call. Also, I don’t want my clients thinking I will “protect” them from their provider. If that is the case, we have even more chatting to do. :)”
Maria said it exactly as I thought. Sure, I might attend one prenatal if they felt they wanted me to meet a solo provider, but in a group of providers, how would this benefit? But more so, if a woman feels the need to be “protected” from her provider, why is she still with them? If she feels she can not say what she feels, ask questions, discuss her beliefs with them… then change providers!
Nope, my job is to help a woman find her voice, know her options and choices and let her know she can find her power. I will attend a solo practitioner prenatal meeting if my client wants to introduce us. But if a mom wants to have me come as her protector, I will not. That is not my role. I pray she will not feel the need to be protected but is she does, I will give her questions to ask, ways to gather more information to make an informed decision. This is the beginning of lots of decision making for her future. She will be making tons of decisions for her child soon. Giving her tools now will help her in the present and the future.
Sometimes couples will not make decisions that I would have made. The mom who chose an induction for a projected big baby was just such a situation. But I offered her evidenced-based information and then supported her in her decision. It was not my decision. I reminded her of the risks. I told her she needed to be able to live with this decision and it needed to be fully hers. She chose a path that her sister, her husband and I did not agree with, but it was hers. Many times during the induction I let her know her options. She made her decisions that felt right for her. I stood beside her in full support of that.
My job is not to do the very thing that we accuse some providers of doing. I can not have a hidden agenda. I can not bamboozle her into my way of thinking. I can not protect her from her own decisions- inclusive of who her provider is and their plans for her birth. I will remind her early on of the path she is headed on- choosing an interventive practice or hospital… encouraging her to look elsewhere if what she tells me she wants is different than what they usually provide.
I encourage women to find their path just as I have found mine. I choose to rarely go to hospitals and work with providers that I find go strongly against what most of my clients are looking for. Perhaps this is one of the reasons I do not need to protect my clients- as I have done the work on the front end, stepping away from the places that leave me shell-shocked and beaten up. I even provide rewards in my fees for couples who do the work of full preparation. I do my prenatal meeting with couples after they have completed their childbirth class preparation so that this meeting is not a mini-crash childbirth class, but a time to dream about their birth ideals and learn how they plan to implement the tools they learned in their class.
Class preparation helps them to find their tools and their voice. A prenatal meeting is a time to discuss the tools they want to use and how they see their journey unfolding. Birth is a time to trust and believe and allow themselves to become parents. Those around them should be supporting and encouraging during the journey. Hopefully, they will not feel the need to be protected from those who are there to support them.
Think about your best friend. It could be a childhood friend or a newer friend. Think about what you love about them. What made them your friend? Think about how they will tell you the truth but lovingly so as to cause you little pain in hearing the truth. They support you. They encourage you. They are there no matter what- true unconditional love. I have a few friends like this.
Now think about being a friend to yourself. Think about how you talk to yourself. Are you being gentle, supportive, encouraging and loving? We need to talk to ourselves as if we are our best friend. Our bodies and minds are listening to the things we say internally to ourselves.
Change the way you speak to yourself and you will find your body and mind will respond in a positive way. Affirmations and positivity go a long way to rebuilding our brains synapses. We can begin to heal the negativity that we fed ourselves for so long.
Client #1: Finds out that the provider she has used as her gynecologist does not feel the same way about birth as she does. She has concerns that the hospital where they practice is not offering as many options either. She researches her options and changes practices.
Client #2: Has had some early pregnancy issues that caused her to be considered high risk. Those risks have resolved, but she is loyal to her original doctors since they were with her early on. Although she realizes that staying with them causes her to have to compromise what she had hoped her birth would be like… she continues with their care. It is more convenient to do so.
Client #3: Had fertility issues and she had IUI or IVF at a particular hospital referred by her current physician. She wants a low interventive birth although she struggles with the thought that her body was a bit “broken”. Due to that, she will follow all protocols at her current practice which are very interventive. They induce at 40 weeks, although that is not ACOG recommended. She understands that inductions lead to more cesareans, but she will forgo the dream birth she desired for an interventive birth. After all, this is a “premium” pregnancy. (What pregnancy isn’t?) She gives way to fear and lets it lead her.
Client #4: Had fertility issues and she had IUI or IVF at a particular hospital referred by her current physician. She wants a low interventive birth although she struggles with the thought that her body was a bit “broken”. But she has a birth she has always envisioned. She determines to get that birth she has to make some changes. She determines the location that offers her options she has always wanted and changes practices. She determines she needs to work on the “broken” mentality and move forward with her hopes and dreams.
You must take responsibility for the outcome of your birth when options that were available were not taken.
Clients #1 and #4 could end up with very interventive births in the end. But it will not be because they did not do her their due diligence and seek out options. Sometimes in spite of doing so, births need interventions. Clients #2 and #3 could end up with marvelous births despite being driven by convenience or fear. But the chances of those births being empowering are somewhat limited as their options are also limited. And the odds are stacked against them having the birth they desired originally.
As doulas and educators, we offer truth when someone calls us for input. We want women to be aligned with locations and care providers that align with the birth they desire. If you say to us that you want options and low interventions but then share your birth location or practice that years of doing this has led us to believe are not aligned with your desires, we will tell you. It is up to you to do with that information what you will.
But, you must take responsibility for the outcome of your birth when options that were available and were aligned with your desires were not taken.
Sometimes a new client comes to us and tells us what type of birth they desire. They want a gentle birth with as few medical interventions as possible. But herein is where the issues come up. They have been going to their gynecologist for years and do not want to change. But their gynecologist, who may very well be an excellent one, is not a low management obstetrician. Or their doctor will only be doing births at the hospital that has the worse statistics for natural vaginal birth in the area. Or they are too busy to take classes so they have watched a few videos and skimmed through a couple of books and feel that will prepare them enough. Or they have invited their mother to attend as well. She had a horrible birth experience and talks about it often. She is unsure why her daughter does not just elect for a scheduled cesarean birth.
Do you see a pattern of issues? We have a ton of birth experience. We understand what the environment will be with these compounding issues. We want to guide them gently toward the integral keys to helping them achieve the birth they desire. We know it will take some preparation and some evaluating the best possible environment to help achieve it.
The questions are: do we just lay out the truth as we know it based on years of experience? Do we just move forward with their plans although we know it will be difficult if not impossible upward climb to have the birth they desire? Do we hope they will do the preparation in order to be able to advocate for their birth dream?
I have been known to lay it out clearly to my prospective clients. I often ask them if they want me to be totally honest. But if they say yes, I don’t hold back. I explain the 95+ epidural rates at area hospitals, ob anesthesia that needs to stay busy and therefore epidurals are constantly being offered, the nurses who rarely get to see a natural birth, therefore, are not usually equipped to support them, the 40+ cesarean rates, the docs who share call with other groups whom you will never see in pregnancy but could be with you in labor. I explain the medical model of birth vs the midwifery model. I share evidenced-based practices vs convenience based practices. I encourage them to take a non-hospital comprehensive based class which will equip them with many tools for labor and birth and even postpartum.
Sometimes they take this information to heart and do their research and change the trajectory of their labor and birth. Sometimes they do not. We can’t want their birth dreams to become reality more than they do. We can not protect them from fear being spoken to them at every prenatal- too big of a baby, placenta getting older- without any evidence, their age causing them to be categorized high risk, etc. We can not teach them the tools they need in the midst of labor. We can not help them work through fears that they refuse to have dealt with during their pregnancy. We can not make their support team truly supportive. We can not speak for them in an attempt to protect them.
I am a gardener. When I go to the nursery to buy a plant. I read the tag, I speak to the horticulturist, I read my gardening blogs. If I want that plant to do well, I need to set it up to win with the right soil, the perfect amount of water, the suggested amount of sun. I can not expect the plant to do well if I don’t follow the suggestions on how to make it flourish.
We believe it truly does take preparation and research to reach your dreams. We feel strongly it takes a gentle birth pie in its entirety to help make that work. We are there to support you- but we employ you to listen to the years or experience that we have to offer guidance to help you achieve the birth you tell us is your desire.
This week I spoke to a client. She is a first-time birther and giving birth at the Atlanta Birth Center. She had told one of her co-workers about her birth ideals. This co-worker decided to share it over lunch with a large group of others whom she works with. They began to berate her, tell her what they thought of her wanting to go to the birth center and not get an epidural. They were rude and quite discouraging. She felt discouraged and needed to get encouraged by me. They also nicknamed me her Dalai Lama! She liked that one thing enough to change my phone number in her phone to just that.
But I told her you would not seek courage from someone who had no courage. How did she expect those who did not understand her ideals, who were clueless on her path of preparation, who only sought to be medicated in the journey to offer any courage? They had no courage, no understanding, no desire to even understand- they only chose to sit in uneducated judgment. You don’t ask a blind man for directions. He may know how to get there using counting steps or sounds, but he does not understand the directions you need.
I had lunch with an upcoming client a few hours after this phone call. This first time birther- also giving birth at the same birth center, made an astute comment, “You do not need courage if you never do anything that scares you.” Wow, I thought, exactly!
Often times folks offer opinions out of their lack of understanding or knowledge, but with good intentions. They do not know what they do not know. But when they do, you can choose to recognize their heart and thank them without any intention of following their advice. But when folks try to push their agenda on you- disparage your ideas- and are basically rude imbeciles, I think it is appropriate to call them out on it! “You may not have intended to be discouraging or rude, but I find your comments just that. Could you please keep those ideas to yourself?”
Be careful who are you listening to. Seek encouragement from those who had shown courage. Eleanor Roosevelt said, “Do something every day that scares you.” I can guarantee that doing so will be a way to grow your courage! We need to fill women with great courage when it comes to birth and parenting. We need to share our courageous stories to help their courage grow.
I have been thinking a lot about what is the most important thing that i can impart to a pregnant mom to prepare for labor. As a crone ( the older,wise woman, healer and guide). I would have to say it is learn to let go of fear. We have clouded birth with so many fears and horror stories, it is no wonder that women enter this time with such trepidation. At one time it was a mysterious time that was not discussed. Those women were often given drugs so that they had little memory of birth and therefore it was indeed a mystery. Then for a short time, natural birth was promoted and it was a time of wonder and power. But then medical advancements allowed medication to be safer and women did not even venture into the time of being able to find their power and strength.
If I were to sit with you, talk openly about birth- what I personally experienced and the over 670 births I have witnessed, I would tell you about how strong you become during labor. I would tell you that you are stronger than you ever imagined you could be. I would tell you that as your labor unfolds, you will know what to do- whether it is to move, or howl or ask for medication and intervention.
I can tell you stories of watching women become warriors. I can tell you of incidences where women reached down deep within and found a strength they had no idea even existed. My advice as an experienced crone is to tell you begin to look at birth as a mystery that will unfold. You need not know the journey’s path to be able to walk it. Just walk it with courage. Let go of the stories you have heard. Don’t listen to the naysayers. Move into the mystery with curiosity and openness. Embrace the unknown and step into your labor without fear.
You were made for this. Your body is ready. Your baby is ready. Let go.
What a weird title! You want a doula who you connect with easily. Perhaps one you can build a bit of a relationship with prior to birth. You may be looking for one you can afford. However, you may also want an experienced, trained and perhaps certified doula. You may want one who is part of a group of experienced doulas who back each other up in rare cases when it is needed. You may desire a doula who will be with you throughout your whole labor no matter how long. You may want a doula who charges a flat fee, no additional charges for longer labors and for “false starts.” You may want a doula who is available to chat on the phone or via email during your pregnancy that offers tips to help you along the way. You may hope that your doula will assist you in considering your labor options prior to labor beginning. She may even provide a private prenatal meeting with you and your partner to discuss your birth ideals in depth. Some may want their labor doula to follow up with a postnatal meeting to check in on how having a new baby is going. Guess what? Labor of Love provides doulas who fit every one of those desires.
There are different doula offerings in the metro area. Some charge a fee for interviews. Ours are free. Some follow shared call- meaning you do not know for certain who your doula will be. Some provide services as a package to classes that they offer- meaning you must buy the package. Some charge for extra meetings or if you call to meet them at the hospital and are then sent home. Some will charge you a fee for your labor up to 12 hours and then it is an hourly rate after that without a cap. Some will have a trip or event that pops up, becomes their priority and they will find the last minute back up doula whom you have never met.
There are a few medical groups in town who feel so strongly that a doula can make a difference- as does the evidence in the studies- that they offer a reduced rate or help offset the fee or even have volunteer doulas. This is wonderful. At least it is wonderful if you are not looking for some of the things mentioned earlier. Many of these provider doula offerings are a great way for the inexperienced, new doula to get some experience. That is great for her. But if you are looking for experienced doulas, this may not be what is offered. Some of the provider doulas are regulated by having a 24-hour call. They are told when to meet the mom in labor. They have no prior relationship with the doula and no postnatal contact either.
So the saying, “You get what you pay for,” may be true here. Consider all of your options. All doulas do not work the same. Understand that everyone is not following the same code of ethics, sharing the same philosophy. Experience, continuous support prenatally and during birth, a one-on-one relationship and birth philosophy may not be as important to you. However if it is, we hope you will consider Labor of Love doulas.
We will soon begin to teach this class in Athens. We are excited to offer a hybrid type class- BOLD techniques, rebozo work, a little bit of Dancing for Birth and a smidgen Spinning Babies rolled into a full day. This is a women only workshop.
If you like this workshop you are bound to love the BOLD Wisdom for Birth offerings. And if you want a little bit more focus on the alignment and psoas release, be sure to add the Aligned and Ready workshop to your schedule as well.
This is a circle to learn some wonderful tools that may accompany your regular childbirth series that you may have chosen, whether it is the BOLD Series, the FUNdamentals, a hospital class or a hypnobirthing/baby class.
This is also a great refresher class to get a woman refocused for her next birth.
The More BOLDness class is one of the BOLD Wisdom for Birth offerings that is usually offered quarterly
Natural birth takes a lot of preparation. What are you doing to prepare? Taking a childbirth class, but need more tools? Want to add to what you already know or refresh yourself for this next birth? We have a six hour workshop that packs in the tools to help prepare for a more gentle and natural birth to become a reality. Come together to be BOLDTM and move with us toward your birth vision. You can come alone or with a partner.
Recently I had two different moms who I attempted to help with adjusting to breastfeeding with a new baby. Both moms had had difficult labors and births, but both avoided cesareans. But both babies ended up spending a week in the NICU on antibiotics. Meconium aspiration was the culprit for both. They do not allow a baby to be roomed in with its mom if the baby has an IV. So separation, although not continuous, is a problem. It becomes increasingly problematic when trying to recover and also develop a milk supply and learn to breastfeed since the baby is also being given bottles along the way.
The first mom returned home and her baby was discharged after the week. The baby was nursing some and also being given formula. The mom was only nursing some of the time- some of the time she was pumping and some of the time the baby was being bottle fed. She was concerned about her supply- and rightly she should have been. It is important that a baby nurse from the mom at a minimum of 8 times a day and ideally more like 10 to 12 times a day. The baby had been on a 3-hour feeding schedule in the NICU.
I encouraged this mom to take a babymoon. Crawl in the bed shirtless with only a diapered baby- and nurse around the clock- doing nothing but being waited on by helpful friends and family- fed but doing nothing else but having skin to skin time with the baby and nursing as frequently as possible for 24 hours.
I encouraged this mom to do just that- and give me a call in 24 hours with the number of wet diapers, the number of poops and number of times she nursed.
24 hours later she texted me, “Hey! we didn’t do it today. I had too many people over today.” I replied, “prioritize.” I did not hear from her again. But I saw on social media pictures of the family giving the baby a bottle.
Hey, that works- the baby is being fed, right? Well, sure- but ideally the mom had wanted to breastfeed. I think visitors were fun, but they sabotaged her ability to get a good supply going. And not having a good supply, having nipple confusion with bottles and the mom being a hostess instead of resting is not the way to help her make breastfeeding work. The mom could not find her voice to tell her family what she really needed.
The second mom worked hard to be with her baby in the hospital and was also able to bring her baby home after a week in the NICU. She had great family support in every way except with breastfeeding. Neither of her moms had breastfed so when the first problem with latch began, rather than helping to pay for a lactation support person, they undermined her breastfeeding.
How? By stating how they had dried up their milk quickly with ice packs- only took a few days. By saying how formula and bottle feeding had worked fine for them. By holding the fussy baby and giving him a pacifier when he was showing signs to nurse, but they were attempting to “help” the new mom by doing so.
I wish the family would see that the best way to help is to find supportive solutions that are in alignment with what the ideals of the mom are instead. The second mom reached out to me. I was able to provide postpartum help. The mom realized quickly some things to improve the baby’s latch and also was reaffirmed on what a great job she was doing. And how normal her baby was acting. And she was given time to share emotions and feelings with acceptance.
So, what does a new mom need? REST: Rest. Encouragement. Support. Time. If you want to come and help, then help do the things that need to be done- meals, cleaning, errands, holding the baby while she showers- but otherwise- keep the baby with the mom! Encouragement means giving her courage to move toward her ideals. That means getting her help if you are not an expert in the area she is struggling. Gift her a postpartum doula, a lactation consult, a ride to a breastfeeding support meeting. Encourage her to call an expert rather than undermine her ideas. Support her emotionally by allowing her space to share her feelings without judgment and without dismissing her feelings as invalid. Feed her- make sure she has her physical needs met as well. And remind her it takes a time to adjust to a new situation- to heal from the birth, to learn her baby’s cues and to figure out what works.
If you do not agree with what she is doing, keep your opinions to yourself unless you are concerned for her well being and her baby’s. Then reach out to an expert for advice and input.