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.

em·pow·er
/əmˈpou(ə)r/
verb   
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.

-Teresa

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.

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. 

What makes us unique? This is an article that shares more about what makes us different.

What do you do when you are pregnant and need maternity clothes? They can often be quite expensive. When you are already making budget cuts for the baby’s expenses, what is a pregnant woman to do? Well one mom wanted to make a difference for others!

21129[1]Who is this mom? Katie Roe,  she is a stay-at-home parent of a 14 month old son who she coparents with her husband Richard.

Why did she come up with this idea? She took a course with Landmark, a personal and professional growth, training and development program called the Forum. After taking the initial program, Katie took this course and went on to take an additional leadership program. Part of the challenge was to come up with a project. She was six months pregnant and had to come up with something quick. She considered how she loved being pregnant and had been blessed with being gifted a lot of beautiful maternity clothes that helped her feel even more beautiful. She started thinking of the short time of wearing maternity clothes and the expense and thought of this idea. She wanted to help other women feel beautiful during their pregnancy. So she gave birth to The Beautiful Bump Project, ” creating the possibility of feeling beautiful, sexy and vibrant during pregnancy without spending a fortune on a temporary wardrobe.”

How does it work?  Her facebook page says, “The Beautiful Bump Project is a maternity clothing lending co-op serving the Atlanta area. We think every woman should be able to dress as beautiful, sexy and vibrant as they feel during pregnancy, without having to invest hundreds of dollars in a temporary wardrobe. It’s 100% donation based.” She spreads the word via a strong facebook presence. She has a facebook page for the project and is involved in several local community groups. She picks up donations of gently used maternity clothes. She then sorts them and hangs them up in a large walk in closet in her home, reserved specifically for this project. She then invites women to set up a time and come shop. They can return them when they are no longer needed or share them with others- there are no strings attached. She perfers getting a facebook message for shopping inquiries. You can message her from her page.

20160821_215025_2[1]How can you help her help others?  She has already invested a lot of money into this project and is not ready to invest much more at this time. Space is limited and so she would love to have more storage space. If you know of someone who has storage space to donate, she would love to hear about it! She does not have a website, although she knows how to maintain one, if you want to donate your services to help her build one or the money to host one, she would love that too!

The area you can help with the most is to donate your gently used maternity clothes. She would love help if someone wants to volunteer to occassionally come to help her organize it as well. She currently has over 1200 pieces of clothing. She has all sizes, seasons and styles, but more donations are always welcome. And one of the most helpful things would be a more efficient way to organize them. She would love someone to help with building out a closet, donating rolling racks or the closet wall wire racks.

I love this idea. And I love Katie’s heart in making this project. If you are wanting to shop, contact her. If you want to help, contact her. This is a worthy project to be associated with for sure!

 

I get asked this question sometimes. It is usually more like, ” Have you worked with my doctor? Did you get along? Do you work well in this hospital? Do you get along with the nurses?”

My job is not to get along with your care providers. My job is to serve you. That means helping you achieve the birth you desire. Not the birth they have planned for you neccessarily. Not the birth your friends or family feel you should have. Not the birth I even think you should have. It is all about you! But that does not mean we don’t get along with the staff. We do. But we are well loved by those who practice evidenced based medicine, have low induction rates, have low cesarean rates and support many options for your labor and birth like water birth and family centered cesareans.

I will say we would like you to be an informed consumer. We will ask you questions about your desires and help you understand the ramifications of certain desires. We will encourage you to take classes so you understand your options fully. We will encourage you to practice some pain coping skills beforehand. And we will offer you some ideas you may not have considered.

Lately there have been a lot of articles about supporting you in your decision to have a medicated birth by other birth professionals. And although I understand that sometimes labors do not go as you had planned and you may choose medication, without any judgement on my part, I do think it is important to consider unmedicated births.  There are several ways we can support you even if you choose medication. Here is an article about just that. And here is another. I do think these types of article have merit. But I also think they may be a means for doulas to get business in areas where epidural are common place. So, why do we encourage you to consider an unmedicated birth?

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What is ideally best for your baby is to have no synthetic drugs passing through their system. You know how your doctor or midwife prefers you do not use medications unneccesarily when you are pregnant, the same goes for labor and birth. Ideally it is best. So if you can birth without any drugs in your baby’s system, that is best. It makes for a healthier baby and getting breastfeeding off to a good start. We don’t always get to have the best, so we do the best we can in the situation. And we accept that we did just that- our best.

What is ideally best for most moms is to have no synthetic drugs passing into their system. Organic and natural foods are considered the best for that very reason. So although drugs are sometimes needed, they are not without negative consequences sometimes either. But again, we do the best we can in that situation.

Recently I spoke to another birth professional who told me that the majority of her clients plan to have a medicated birth. Medicated births have become the norm in our area. In fact they are such the norm that many moms do not prepare with classes and assume all will go fine if they go that route. But in the busiest hospital in the US, the cesarean rates have climbed over 41%. Why is that? I believe it is because birth is seen as a medical emergency about to happen so medications and inductions have become the norm. Women are not even exploring other options.

Our practice is not the normal practice. I would guess that over 90% of our clients plan and hope to have an unmedicated birth. We plan to support them in doing so. We know this may mean being with them for longer doula support hours. It means that we do not  sit and wait quietly while the mother sleeps after receiving her epidural for most of our clients. Usually if an epidural is received it is after she has tried with all her might to avoid it. And then there was a time and a place for it.

Does this mean we are anti-epidural? No, we just feel what is best is to try without one if possible. For some women it is just not possible. They can not comprehend not getting it. For those women we will encourage them to be in active labor before doing so as to not increase the risks to them and to their baby.  It is also what causes us to not charge more after 12 hours like some doulas. We understand our role may be increased if you are seeking an unmedicated birth.

I would guess again that over 80% of our clients end up with an unmedicated birth. And our cesarean rate is in the teens- not the forties. So our practice model is not for everyone. Although again, we support all types of birth and can be any woman’s doula who desires us. We may lean toward women looking for natural births, and encourage education and information and options, but we are also a group of doulas who fully support your choices- including medications, without judgement. You are inside your body in labor- not us. You have ideas in your mind, they are not ours. So, know that if you are looking for a doula group who offers and supports all options, but perhaps specializes working with women who have natural, unmedicated births, we are your doula group to consider.

This is a one day workshop to prepare couples for birth. We begin in the morning with a lunch break and finish before dinner.  You will learn pain coping skills, how to use a rebozo for comfort and other comfort measures as well as how to know when labor begins, when to go to the hospital, and even how to begin to parent your new baby!

This class is also a great refresher for those who are birthing again.

This class is taught by Teresa Howard who offers more than 25 years of working as a birth professional and birth and lactation educator.

The Couples’ Workshop Covers:

  • Holistic stages of labor & birth
  • Signs of labor starting and timing contractions
  • What do you pack?  When do you go?
  • Pain coping skills
  • Positions for labor and birth
  • Creating a supportive birth environment
  • Partner support- how to be a great partner
  • Learn how to ask questions of “white coats”
  • Contingency plans…what if it doesn’t go like we expected
  • Natural birth vs. unmedicated birth
  • Medications & interventions
  • Cesarean birth factors
  • Baby options & procedures
  • Preparing for the new baby
  • Introduction to breastfeeding

Classes are taught in Atlanta and Athens. Cost of the workshop is $180. See the class schedule here: CALENDAR

Register for the Wisdom for Birth Couples class HERE!

Recently we had a mom who chose to have an induction due to the concern that her baby was over 9 1/2 pounds as of the previous week. The doctor, a family friend, was concerned that the baby was just too big to allow her pregnancy to continue although she was 2.5 weeks from being at her due date. The perinatologist disagreed and did not feel it was a medically neccessary induction, but the mom chose to do so anyway.

She entered into the hospital with induction plans using cervidil, cytotec and the foley catheter but her cervix remained unfavorable and unresponsive to allowing the birth to happen vaginally. Eventually it was determined after Pitocin proved ineffective, to have a cesarean. The baby was born, a 2.5 weeks early and ended up going to the NICU. And he weighed a pound less than the doctor suggested.

It happens. Inductions lead to more cesareans. A baby can not always be forced to evacuate on demand. This mom realized that she could not force this to happen after the fact. So she ended up with the unexpected surgery. We hear so often about inductions, that we consider them benign. And cesareans at many of our metro hospitals hover around 40% so they have become very common place.

Many women approach their births believing that a cesarean could never happen to them. Some students tell me they don’t even pay attention to the part of class on cesarean preparation because they believe it can never happen to them.

Recently I supported a mom in her third birth. The first two were out of state and several years ago. Her first was a labor that was that was long, ended up with an epidural and then pushing for four hours. It was tramatic. But the baby was healthy, born vaginally and she recovered. Her second was an induction with an epidural early on and pushing was cut in half. The next time she chose a different route. She was adamant about her exercise and took preparation classes in her strong desire to have a natural birth. This time she hired me. On her due date she woke to her water breaking. After heading to the hospital to get antibiotics, she eventually had a foley placed with low dose Pitocin and after she began contracting, called me to come. Her midwife commented that the baby was ascyncltic entering the birth canal and was quite high.

I went to work with the mom and we did inversions, and the “ketchup bottle” to back the baby out so it could reenter more aligned. We used the rebozo and did asynclitic stances and movements. We tried every position and movement I could think of using. And she labored for the whole day. We tried the tub for pain relief but when she got out and had to have more Pitocin added, she felt she could not continue without some relief. She got a little narcotic and then slept for a while. But the baby did not budge and her cervix remained the same most of the day. An epidural was placed and we hoped that this baby would move down. But after 12 hours of no change, and the baby beginning to not be as happy with the methods being used to facilitate his birth, a decision was made to have a family centered cesarean.

Yes, two vaginal births and then the third being a cesarean. This is not fair! And when the baby was born with his hand and arm above his head and his head showing little molding except for the asynclytic bulge on one side, it was clear he had gotten wedged into a baby position as soon as her water had released and he was unable to change that position. He was the lightest of all of her babies by almost two pounds. What? How can this happen? We were all disappointed and a bit dismayed at the outcome. But we also knew we had worked together as a team to try to have this baby come vaginally and had tried all we knew to do.

Today I texted with the mom and she feels confirmed she had done all she could. That this was a beautiful birth since she was able to view the birth herself and have him skin to skin nuzzled in immediately after he was born. But this was certainly the unexpected cesarean.

All cesareans are not created equal though. One mom was coerced to have her baby early due to the fear that was planted inside her. She felt she understood the risks, but did she? She was separated from her baby immediately after the surgery and with a almost preterm baby will probably face issue with breastfeeding. The separation and healing from surgery could take its toll on her abililty to bond. One baby chose the time for his birth although not optimally positioned. The mom labored and had a supportive and patient team with her. She was able to be actively aware during the surgery and bond with her baby immediately.

Unexpected is just that. Each birth is different from the next. But having a voice and an active participation in the birth can make a huge difference for the family. Here is a picture of the birth of the second mom. They used a clear drape so she could see her son emerging from her womb. It was a beautiful albiet unexpected birth experience.

fcc

Surrounding yourself with positive affirmations and mantras is so beneficial for labor and birth. You can go online and find lots of affirmations to look at and even some that have videos with music, but making a mantra your own, surrounding yourself with affirmations that speak to your heart are really what’s important.

What’s really great is finding something that really speaks to you. I like the idea of sliding some of these affirmations written out on cards under the lining in a water birth. So that the woman can look down through the liner and see the things that speak to her. It is also helpful for those in the room to see what speaks to you, so they can recite some of those same phrases back to you.

I had a mom many years ago make her affirmations on large index cards and then she had her oldest daughter to decorate them with pictures. I have another mom take large index cards and take them around her labor room almost like a border. The doctor was so fascinated when she saw them, that she said she wondered if they needed them in every room.

Renee Wymer, one of our educators, takes affirmations that the moms have said speak to them, and makes them into pennant banners for the moms for their labors. I’ve seen many moms make signs and hang up around their rooms in pennant style or just in posting them onto the wall.

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I made a pennant banner for my class space. I thought I would share the folder with you so that if you wanted to copy some of them and print them you could. Feel free to share this link with others. Thanks.

Here is my banner picture from my class space. 2016-03-28 14.09.32

Here is the link. There’s some that are blank so you can put your own affirmations there as well. These would be great to hang in the nursery when you’re pregnant so that you can go in there to focus and visualize the kind of birth you want you could have these affirmations there reminding you of what’s important to you.

Labor of Love has been offering classes and services for over 25 years. We began teaching our classes in Lawrenceville over 17 years ago and expanded to Roswell a few years ago. But we heard from many of you that you wanted classes closer into the city. So, we listened. We moved our main classes and most of our additional classes to Atlanta. We teach within the Atlanta Birth Center.

And several of you love the yoga nidra we offer in our Wisdom for Birth classes, so Charlotte is bringing her expertise to offer group and private yoga nidra workshops as well as bringing her yoga and massage techniques into the Nuture the Couple workshops .

So, I wanted to let you know that moving inside the perimeter has allowed us to offer more to you- more for your families and more for your babies! Please share the new schedule with your friends and sign up for classes soon!

Our schedule can be found on our monthly calendar on this website but also this link will bring you to the most up to date list of the year. To read about all of our offerings you can find them on the classes link.