When we work with women it is a resounding subject that comes out… POWER. Let me try to explain…

  • “I want to be in control.”
  • “I want to be heard.”
  • “I want to be informed.”
  • “I want to make my own decisions.”
  • “I do not want to be coerced or bamboozled.”
  • “I want to choose my position for labor and birth.”
  • “I don’t want to be induced or have my labor augmented.”

OR

  • “I trust my doctor will not do anything that will harm me or my baby.”
  • “I do not want to feel any pain. I am scared of feeling pain.”
  • “I just want to go in and have my baby out.”
  • “I just want to go with how it is supposed to happen and not worry about taking classes.”
  • “I hope I don’t loose control in labor or make a lot of noise.”
  • “I want to enjoy my labor and birth.”
  • “I like my doctor and want to just do what he tells me to do.”
  • “I don’t want any conflict in labor- I plan to just go with the flow.”

OR

  • “I have had emotional trauma in the past, but I don’t want to share about that with my care team.”
  • “I have had physical trauma in the past, but I don’t want to share about that with my care team.”
  • “I have a lot of baggage with my mother and it makes me afraid to become a mother, but I don’t want to share that with anyone.”
  • “I want to eat whatever I want in pregnancy and disregard how that may effect my baby.”
  • “I don’t want to exercise or care about the things I am doing to effect the position of the baby.”
  • “I don’t want to take an informed choice childbirth class because the less I worry the better.”

Do you see how all of these statements are about power? You either work hard to have it or you let go of it and let someone else end up having it.  But the truth is, you already have the power to have the birth that you want within you. But you either are holding that power captive by allowing fear to keep it locked up. Of you are blind to it because you have allowed others to take it away from you for a long time and you are unaware you even have it.

What can you do to regain your power? In order to have a great birth you must prepare and plan to have a great birth. It does not usually just happen. You need to prepare your body and mind. You will not be able to endure a normal length (19.5) hour labor if you have no endurance. You will not be able to move and position yourself effectively for a natural birth if you have not become aware of the positions or practiced them. It is best to have always visualized yourself having that type of birth. You need to clear your fears and unpack the baggage that inhibits you from having that type of birth. This could mean discussing your previous abuse with those who will support you. It means sharing any physical problems that could inhibit your body from letting go. It means surrounding yourself with a care team who supports your dreams.

  • Hire a doula. Sit with her and share your dreams and your nightmares. She can help you prepare for your birth in a positive way. Communicating with her regularly helps you develop a relationship where you can be open and vulnerable.renee 3
  • dancing 3Take a childbirth class that helps you work through your fears. If the class dismisses your fears and concerns and says that if you focus on them it will inhibit you- realize you must focus on them to be able to truly work through them before your birth. Recently I met with one of my clients and she says she understands she has fears. But she realizes that she has the power to set those fears to the side, having looked at them and being fully aware of them, and take hold of her power and move past it. I loved that!
  • dancing 1Take a fitness class to learn how to move now in your pregnancy to help you increase your endurance. Dancing for Birth classes and prenatal yoga are great ways to enjoy this time with other pregnant women. Walking each day or swimming is super good. Practicing optimal fetal positioning is a good insurance plan.
  • See a chiropractor and body worker to keep your body healthy and aligned. Being more comfortable in your pregnancy will help you be more comfortable in allowing your baby to come when they choose and not feeling rushed into an induction. dizznbonn
  • yogaSpend time daily meditating and visualizing your birth and this baby. Allow your mind to be flooded with positive affirmations and avoid negative people sharing their negative stories.
  • booksRead fabulous birth preparation books and stories that really help you prepare to make good informed decisions rather than the ones that teach you to be a good patient.

We have doulas who are available at different levels of experience and fees. We offer several types of classes to help you in your preparation for birth. We have a massage therapist/body worker who can help and have several chiropractors and body workers we can refer you to. We can provide you with wonderful affirmations and our list of suggested reading is on the left side of this blog listing. Let us know how we can help you find your power for your birth.

The short answer is YES. The long answer is not always. What I mean is if you want to use a care provider that we do not feel will give you the type of birth you desire, we will tell you the truth. If you want to continue with this practice, we will support you knowing you have made an informed decision. You need to remember we have the experience of over 1000 births. This means we have either worked with that group or at that hospital before more than likely. We also are networked with lots of birth professionals and we hear the good and the bad about care providers. When someone mentions they are having a VBAC and using a doctor who is not known for supporting VBACs, it sends up a red flag. Trust me, if there is a doctor supporting VBACs we know about him or her!

There is a group at Dekalb that is associated with one particular doula group. They have established a relationship of referrals. This does not mean we don’t work with that group. It does not mean that they only work with that group. It means they have developed some type of relationship of referrals. This may be because the doula group has worked hard to set that up. Or it may mean that this group practices in such a way that the care providers really like them. It does not mean others have not. It could mean that others really don’t go to that hospital very often for whatever reason or has not decided to try to work with this group specifically. So, just because a group is not on a preferred list does not mean they are not welcomed by the practice, it may be that the practice has not worked hard to be known to that group or feels no reason to do so. If you choose this practice, you can choose any doula you like.

There is a group at North Fulton that is associated with only a few select birth professionals. The person who manages the group website and events has bylaws that says doulas and childbirth educators who are part of a group can not be a part of their events. Why? Well some think it is a way of only promoting her practice. She states that it is in the best interest to not allow groups to be a part. But whose best interest?  In doing so it eliminates a lot of wonderful groups of doulas and educators who may provide doulas and classes who would be a perfect fit. They only show one type of childbirth classes. This has caused a lot of confusion on the part of folks who choose this group of care providers. I get questions as to whether they can choose a doula who is not an affiliate and also do they have to take “their” classes.

The answer is NO. We work with this group all the time. We enjoy working with these midwives. We wish the family liaison was welcoming of different groups, she is not. And unless this changes, you will not see any of the doulas who are part of groups in the metro area attending these events. Understand it is not our desire to not support and work with this group of midwives. If you desire to work with different doulas and desire to have freedom in selecting the type of childbirth class you connect with- realize you are able to do so.

2013-02-06 19.35.10

We love attending the Meet and Greets of practices that welcome doulas as wonderful support members to the birth team. If a group is offering this opportunity it is because they believe in the evidence based medicine that doulas really do make a difference in birth outcomes. When a group who offers a Meet and Greet type event and does not invite a multiplicity of doulas, it should also speak to their philosophy. We love practices that list a large selection of doulas and educators they work with- they understand that every one is an unique individual and should be able to choose the right birth team for her. Keep that in mind when selecting a group.

Someone recently asked me if using a doula was really needed if you had a midwife.  How about if you plan to have a home birth? I thought I would share roles as determined by some internet sites (the title is a hyperlink to go to the site) for each type of job that the labor support folks offer. In our area it is not unusual for a midwife to have multiple women in labor. She can not be everywhere at the same time. It is not unusual for her to be on for 24 hours straight- so she may be eating and sleeping some of that time as well. In our area most nurses are assigned to two patients at the same time. Her role limits her contact with the mom during a lot of her labor. As far as home birth midwives, some come once labor is well established and others may send their apprentice initially to assess how you are doing if she has another mom in labor. Some will have a back up midwife in case more than one mom is in labor. A home birth apprentice at a birth acts more like the nurse in a hospital birth- assisting the midwife. She may have been a doula before, but her primary role is to learn the art of midwifery by assisting the midwife- not being the primary support to the mom. The doula has one role- to be there for the mom or couple. Her role is to be fully attentive to the emotional and physical needs of the mom. So look over the roles- they may differ within your practice, and determine who you want to have with you in labor. think about your needs and I am sure you will make the right choice for you.

homebirth midwife in labor

“If you choose home birth for delivery, your midwife’s role will begin long before your due date. A midwife will provide regular checkups and refer you to a doctor for prenatal exams, such as ultrasounds. Your midwife will see you throughout your pregnancy, tracking your baby’s growth and checking you for any possible complications. Because prenatal visits with a midwife are longer and more relaxed than in a traditional medical setting, you and your midwife will develop a much more personal relationship than is typical with a doctor.

When it’s time for your baby’s birth, your midwife will come to your home with any equipment that may be necessary during the birth. She will monitor you throughout childbirth, typically checking the baby’s heart rate with a hand-held Doppler, as well as monitoring the baby’s position and the progress of your labor. She will stay with you throughout your entire labor, helping to keep you comfortable and making sure your labor is progressing as it should. After your baby is born, your midwife will clean up any mess, examine you and your baby and help you to try to start nursing. She will stay for a little while to make sure you and your baby are happy and healthy. She will visit you a day or two after your birth for a postnatal checkup, as well.” (more…)

decisions

I love for women to really allow themselves to dream about their birth experience. I like them to visualize it and imagine. If she can not dream it she won’t know how to achieve it. If she is painting a picture that is not the experience she is setting herself up for, she needs to know that. Often a mother does not know what she does not know. This is where she may seek advice from others.

It is important to really feel totally secure in labor. Otherwise you may have adrenaline rushing through your veins instead of endorphins which will allow you to relax and open up to your baby. I have written about picking your team and location carefully. Recently I had a mom come to me who had selected her doctor based on her girl friends recommendations. But the birth she desired and the birth they had were two different kinds of births. She realized she may need to change care providers.

I met a woman at our Meet the Doula Tea recently who had selected her location for birth based on the local hospital that was only two miles away from her home. But then she shared how it was imperative to hire a doula since she wanted to stay home until the very end and may need protection when she got to the hospital. I reminded her that a doula would have no means of making sure she and the baby were doing great while at home, and although it was up to her- would it not be better to be able to birth in a place she felt safe and have a doula for support rather than protection. She agreed and recently changed her birth location to one that is a bit farther but not one she will need protection from.

I recently had a student that I really clicked with. She mentioned that she wished she had considered me as her doula. She likes her doula but realizes that she was given the advice to hire a “sister” doula- one who is her age rather than a “mother” doula. But when she heard the term “mother” doula it made her think she did not want to have her mom there.  When she attended the tea, she only talked to the doula whom the friend had referred her to. I think it is imperative that potential clients attend the tea with an open and intuitive mind to select the doula she feels best drawn to. Last night at a class a student asked if I ever paired up doulas to potential clients for best matches. I definitively said no. And shared this last story. I love that folks love their doula and want to tell others she is the one they should hire- but I think it is best for the woman to decide that herself.

I think just like water birth vs bed birth…. medication vs natural….hospital vs home…. midwife vs doctor… instrumental music vs vocals…. those decisions are best made by the mom for herself.  Certainly give her your input and your experience, but let her learn to trust her instinctive voice.

 

Yesterday I received a call from a third time repeat doula client. She felt something different was happening from her normal braxton hicks contractions. She has FAST labors and is 40 minutes from the hospital of choice, so watching and being mindful is imperative for her with two little ones to settle first. She chose to go into the office for a labor check first. So, the exam was inconclusive. She was dilated to 4 cm and was 40% effaced and definitely contracting, but could it be early labor or prodromal labor, who can tell. Oh I forgot to tell you, her usual behavior in labor is to contract without any real pain until transition- then she speedily gives birth. She is a no mess around, get her done kinda birther. So the fact that she is not moaning, not swaying but contacting every 2 to 3 minutes with a firm belly is her normal labor. So she decided to wait around the area of the hospital for another hour and sure enough the pattern became stronger and closer together, so she decided to check into the hospital. Her dad and mother in law were called to come help with the kids and she enlisted me to come meet her and her husband.

I took more than an hour to get there due to the rain and nearing after work traffic but found her the way she is in the middle part of her labor. She would stop and breathe heavy ever so few contractions and then begin to talk and chat about wishing she had eaten more since she was now hungry but feeling a bit nauseous at the same time.  She would sway, stand by the bed, sit in the bed, eventually eat a sandwich and chat. She began to be frustrated with the lack of progress and eventually at the recommendation of the midwife on call, decided to try to sleep. And exam 12 hours after the first one- with another offered somewhere in the middle- showed no further dilation. We had kept hoping that something would break loose and she would be having a baby quickly like the previous times. (more…)

Do you consider yourself the consumer, the client when you are hiring your physician? Do you feel they need to listen to you and help you have the birth you want? When did we as women give our rights to choose the birth experience we want to achieve on someone who is not in labor? When policies do not make sense- are not evidenced based- are not open to being changed based on you as an individual but instead are based on what fits their schedules the best- when will you speak up? I wish every woman would take back her birth. I wish she would educate herself early on to what her options are. I wish she would take an early pregnancy class to understand how to select a care provider that is right for her.  And the question I would begin with – is to have a mom tell her doctor what an ideal birth experience would be like and then ask,

“How will you be helping me to facilitate that experience?”

If they are clueless or simply dismissive, walk out then! They should be honest about what they can do. They should be willing to help you. They should be willing to give you names of childbirth educators and doulas who they know will help you on that journey to an ideal birth. If they can not do that- why are you giving them your money? Remember you are the consumer. If you demand it, they will provide it. Money speaks. The way we will change birth is to quit giving money to those who are not supporting us in our journeys.

Dollar-sign

Our local perinatologist extraordinaire, Dr. Brad Bootstaylor created an ap for us to consider when choosing a care provider. I love that he feels women should know the answers to these questions in deciding if this provider is the right one for them!

1.  Does your Provider believe your pregnancy is normal, despite any co-existing medical problems that can be managed expectantly & safely?

2. Does your Provider believe you can go into spontaneous labor after the EDD (estimated date of delivery) while monitoring your pregnancy safely?

3. Does your Provider listen to you?

4. Does your Provider discuss  your concerns with you like an adult?

5. Does your Provider encourage a “patient centered” approach to labor support (e.g. Doula, Childbirth Education, Breastfeeding)?

6. Does your Provider support “Birth Options”, despite some not being available at the facility of choice?

7. Does your Provider support and encourage VBAC, which is consistent with ACOG recommendations?

8. Do your feel comfortable and well informed after speaking with your Provider?

9.  Does your family, friends, or acquaintances support your Birth Options?

10. At or near term, do you sense a “change” in your Provider’s temperament towards you?

Each “yes” answer = 100% and the probability of having a safe, empowering, and life-enhancing vaginal birth.

Ask your Provider today; Know the score!

Brad shared that he felt if the provider did not score a perfect 10, then you needed to consider a different one if you wanted a safe, empowering, and life-enhancing vaginal birth!

Today I had a postnatal meeting with a mom who had recently had a successful VBAC- vaginal birth after a previous cesarean. She reminded me that the phrase I used when helping her to decide whether or not to change practices late in her pregnancy was the question of whether the practice she was in was being only tolerant to her having an opportunity of a trial of labor or were they truly supportive of her VBAC. She said as time went on she realized that the enthusiasm they offered initially was short lived as each month passed. She would hear more doubt each appointment up to the appointment where the midwife she thought would be the most supportive came right out and told her she was very doubtful if the baby this mom was carrying would come out vaginally. That was the straw that sent her out of that practice and into the supportive arms on the midwives who supported her in a wonderful vaginal birth only a short while later.

It made me wonder… if we told our care providers what we wanted and they followed it up with a negative or even just a placating comment. why do we believe they will be supportive later? For every time an OB said, “yes, many first time moms think a natural birth would be good, until their first contraction!” I wish a woman would turn on a dime and say, “you do not sound like the doctor for me!”  I would love for a woman to state what her birth ideals are and then ask her provider how he or she plans to help them achieve it. Perhaps then they would reach for that business card of a great childbirth educator and say this class she offers will help you prepare. And then they reach for another list of doulas who they find work best with moms who want a natural birth. And perhaps they will even find a way to help make insurance companies see the benefits of paying for these services.  Perhaps the pediatricians would pass out LLL meeting schedules for their breastfeeding moms and the card of a good lactation educator or counselor. Am I dreaming?

The only way a woman is going to get the care she desires is to demand it! When my daughter and I drove five hours from the Atlanta metro area to seek the best breast reconstruction for her bilateral mastectomy, it spoke to why we felt the need to spend hundreds of thousands of dollars elsewhere. If enough women stand up and turn on a dime and refuse inadequate, substandard care for our labors and birth, when we flee to other facilities that offer more options like water births, if we do it in enough numbers, guess what? The dollar screams at the other care providers and locations for births. They may not listen immediately but we need to let them know they are loosing our dollars!

We have a voice. Join the facebook page facebook.com/GABirthActivists to hear more about how you can have your voice heard!

I recently received an email with these questions and comments- and thought it would make a great blog article!

Hi there: I’m just at the beginning stages of considering a doula. I’m giving birth in a local hospital with a doctor . I have a couple of concerns and I was wondering if you could give me your opinion.  I’m thinking about hiring a doula because my mother and sisters don’t live in the United States.

 

We doula mostly in hospitals, although we love supporting women at home births as well. And often folks have family that either does not live close or they do not plan to include for a number of different reasons. Having a doula provides one more set of hands to support and certainly can act as a bit of information guidance along the way. Even with a sister or mother along for support, often women find a doula a wonderful addition to the labor support team.

 

I told my doctor I’d like to try to give birth without an epidural and she asked me if I would also have a root canal without anesthetic- which I wouldn’t. She also said since this is my first baby, it’s more likely to be long and difficult. So now my husband thinks I should have an epidural too. But I don’t want to give birth laying on my back etc.  (more…)