I recently moved my office around and took out some bookcases. I rearranged my personal library by topic. One case has only birth books… one is special situations- breech, twins, etc… one is medical dictionary and baby books and the final one is breastfeeding books.

So today I was looking over the books that it has been a while since I read them. I pulled “Birthing Normally” by Gayle Peterson off the shelf. Thought I would just open it to a chapter and begin to read it… found exactly what I needed to share with you today!

page 38 in the second edition- Psychophysiological Integration

 

This big word means the “integration of mind and body.”

“Unhappy, dissatisfied mind states are reflected in body posture and movement. Our feelings can be read in our movements, as we physically relate to the world in context of our perception of ourselves in relation to others. the importance of getting familiar with our bodies and of making such information accessible to ourselves is reflected in the body experience of birthing. The more a woman can cooperate with her body to push her baby out, the smoother the journey through the vagina becomes. Being aware of tension, being able to relax and to let go of tension in a particular part of the body, becomes the process of yielding and working actively with the physical labor of  birth.” (more…)

Labor of Love Doula and Childbirth Services Alexandra Joy Laing, a UGA journalism student interviewed me a few months back. She also interviewed Laurie Nicole Hickman Olinger and Julie Howard Moon in the article.

She just sent the link to the article is on the page! Here it is for you to read online: Article on Teresa I am proud of the article!

Thanks to Laurie and Julie for their contribution and to Alexandra for her expertise!

Many years ago, I read a book called “Operating Instructions” by Anne Lamott. The book was the result of a diary Anne had kept, chronicling her son’s first year of life. It was a totally honest look at having a baby – depicting every messy, joyful, anxiety producing moment of having a newborn. She was a single mom who had the support of a loving friend, but was mainly winging it on her own. Because let’s face it, as the title indicates, these little people do not come with manuals. Thinking back on that book, I realize that Anne could have really benefited from a postpartum doula.

Many times when I tell people that I’m a postpartum doula, they ask exactly what do I do. Well a postpartum doula is like a mom, sister and friend all wrapped up in one. She will make sure the new mom is taking care of herself: napping, drinking water, eating snacks and meals prepared for her. She will also help with nursing: getting a good latch, trying different nursing positions, increasing milk supply etc. We teach various soothing techniques for the baby, what Dr. Harvey Karp – “The Happiest Baby on the Block” author calls the 5 S’s (swaddling, swaying, sucking, shhshing, sling wearing). We do laundry, light housekeeping, and organizing the nursery. While a mom, sister, or friend might do all of the things I have mentioned above, they might also bring their own baggage along and I’m not talking about their suitcases. Friends and family mean well, however they may let their own experiences dictate what they think you should do and what they believe is best. A postpartum doula supports you; she doesn’t tell you what to do. The information she gives has no agenda and is strictly evidence based. So when do you start thinking about hiring a postpartum doula?

Just as you wouldn’t hire a labor doula when you are in labor, you don’t want to wait until you have the baby to consider postpartum help. Before the baby arrives, think about the kind of help that you might need and would be most beneficial to you. Think about whom best would provide that help. It may be a mother, aunt, sister or friend or you may want a postpartum doula. Planning ahead who will support you after your birth will go a long way in making the transition into parenthood much smoother.

By Patricia Schultz

Paul said in 1 Corinithians 9:22b, “I have become all things to all men so that by all possible means I might save some.”

As doulas we become what a woman, what a couple needs us to be for them in labor. When you meet a doula at a party, she may be in her party mode – not her birth support mode. When you meet her at a function where she is facilitating a meeting or a class, she is in teacher or facilitator mode, not labor guide mode. Just as you do not plan to have your party mode on during your labor, realize you will be different than you “normally” are during that time as well.

Sometimes women will say, I will need someone strong in my labor – that is you. Or they may say, I need someone to mother me in labor- that is you. Or I want someone who is gentle and quiet in my labor- will that be you? I think it is imperative to say that we become what you need us to be in that moment in labor. You really have no idea what you may need. We have no idea what you may need either. But our job is to rise to the occasion and be what you need.

Sometimes your partner will determine what they need in labor as far as labor support. Perhaps they want to be very hands on and want to make sure that the labor support does not take on their role. Perhaps they want to be very hands off and do not want to feel forced into a role they are not comfortable with. This just needs to be communicated prior to labor. But realize this role may need to be changed in labor or you may desire to switch gears without prior knowledge as well.

So, let your doula know what you may desire. Also think about the setting you met her in… realize that is not her all the time- that is one facet of her personality. Just as you are multifaceted, so are we. We truly try to become all things to all women as to support their needs in labor.

I recently talked to a new mom. She was having her baby blues moments and felt a bit lost. She said she felt she had lost herself – the woman she had been for three decades of her life was now gone- she was a mother. Her identity as her old self she felt was gone.

As she talked she also was mourning the time she once had with her husband as a couple… just the two of them. She felt she missed him so much. He had gone back to work and she was taking care of the baby on her own now during the day.

I remembered something I had read by Thich Nhat Hanh where he shared about a father who at one time felt he had to divide or compartmentalize his life into his time, his time with his wife, his time with each child. And somehow he never had enough of his time. How often do I hear parents say this? But this father went on to share with the monk that indeed he had more time now since he no longer separated himself out of the time he spent with others. He felt it was his time when he spent time with his son– not his son’s time. He felt it was his time when he spent time with his wife- not just her time.

I shared with this new mom the thought of metamorphosis. We can still see the caterpillar when we look closely at the butterfly. She is not gone at all- only changed. She is still present in the butterfly… only made more beautiful now.

If we look at motherhood as a loss of our maidenhood and our couple status now changed to one of family loosing the couple we have failed to see the beauty of metamorphosis in our lives. Change is not something to be afraid of- it is something to be embraced.

I am an “empty nester” now- but still a mother- and now morphed into a grandmother as well. My relationship with my husband has changed once more as our roll as parents have changed. It is one more passage on our journey of life.

I encouraged this mom to consider a water color picture… one where the colors blend one into the other. Instead of seeing our lives as static colors not merging into one another- when we blend the colors as they meet, it makes a beautiful flowing picture.

The emblem of the butterfly has always meant something really special to me. Our company logo is a metamorphosing warrior woman. Not a loss of the maiden- but the new birth as a mother. Nothing loss at all- only changed to be made more beautiful.

I wanted to share some quotes by Thich Nhat Hanh that I think convey this message as well.

“Life can be found only in the present moment. The past is gone, the future is not yet here, and if we do not go back to ourselves in the present moment, we cannot be in touch with life.”

So when I read this I think we can not dwell on what has been lost at all- we must move ahead in order to embrace life- but we need to be still and feel where we are right now- in the present to fully feel alive. As parents we are usually in such a hurry to get our children into the next stage of life that we don’t fully appreciate where we are right now in their lives. We need to be still and present where we are- knowing it will not last forever- but will be changing quickly enough.

“Everyday we do things, we are things that have to do with peace. If we are aware of our life…, our way of looking at things, we will know how to make peace right in the moment, we are alive.”

As new mothers we are also competitive.. “is your child sleeping through the night yet?” “does johnny have a tooth yet?” “is sally eating solids yet…” You get my drift? We need to be at peace with where we are and our children are- one day at a time. Peace comes with acceptance. Not being compliant about the things you hope for and want to change- but acceptance of where you are now so you can begin to live and make the changes you desire.

“We cannot enjoy life if we spend a lot of time worrying about what happened yesterday and what will happen tomorrow . We worry about tomorrow because we are afraid. If we are afraid all the time, we cannot appreciate that we are alive and can be happy now.”

I love what the bible says, Matthew 6:34, “So don’t worry about tomorrow, for tomorrow will bring its own worries. Today’s trouble is enough for today.”

As new parents we are full of worry. We worry about the kind of parents we will become. We worry about our children’s future. We worry about their health and ours. We worry about our finances and providing for our children. But if you look back on your life- notice the things that brought you happiness and joy. Worry was not part of that. Living is what brought happiness.

“The beginning of wisdom is wonder, and the spark of wonder is kindled in the person who sees the world as new.”

As new parents if we embrace the newness with wonder instead of fear and anxiety, we will see some things about ourselves and our children that would have been missed otherwise. Looking back we notice how we managed to get through events that made us afraid before doing them. Embrace newness of events with this wonder that the monk refers to here and you may find an excitement you failed to see before.

“Every morning, when we wake up, we have twenty-four brand-new hours to live.What a precious gift! We have the capacity to live in a way that these twenty-four hours will bring peace, joy, and happiness to ourselves and others.”

Yes as a new parent morning may come sooner than you wanted with little sleep from the night before… but I love the way God brings the darkness at night and the sun in the morning as a way to remind us it is new day- a new time to start over- to move forward on a new journey.

Peace is present right here and now, in ourselves and in everything we do and see. The question is whether or not we are in touch with it. We don’t have to travel far away to enjoy the blue sky. We don’t have to leave our city or even our neighborhood to enjoy the eyes of a beautiful child. Even the air we breathe can be a source of joy.”

So hold your baby in your arms- sniff that beautiful baby smell into your nostrils. Realize it is a new day, a new journey, a new experience… and live!

“We can smile, breathe, walk, and eat our meals in a way that allows us to be in touch with the abundance of happiness that is available. We are very good at preparing to live, but not very good at living. We know how to sacrifice ten years for a diploma, and we are willing to work very hard to get a job, a car, a house, and so on. But we have difficulty remembering that we are alive in the present moment, the only moment there is for us to be alive. Every breath we take, every step we make, can be filled with peace, joy, and serenity. We need only to be awake, alive in the present moment.”

I was thinking about the role of a doula today. Sometimes folks say they want a doula to “protect” them or “intervene on their behalf” or “advocate” for them or “play interference with the staff”. I am not sure that is the real role a doula needs to have at a birth. Ideally you have met with your doula and given her an idea of the birth ideals you have. What you feel strongly about and those things you are more flexible about allowing to unfold within the journey of your birth. She also can help you to explore some ideas you may not have considered yet for your birth dreams. But in the labor itself, her job is to support you.

If you feel the need to be protected- you are probably not in the right location and have not chosen the right folks to be at your birth. If you need her to intervene for you, I wonder where your voice is during your labor- and did you communicate your desires beforehand to the support team you have? Yes things may change along the way- and she can help you communicate the changes if they occur- but intervention on your behalf is edging on speaking for you and that may be a bit dis-empowering to you. She may help you to communicate your thoughts at times you are unable to do so clearly- but a doula must be careful to not speak for the woman because it may not be accurate to what the woman feels and it is can be construed as overstepping her bounds and making your decisions for you. This is where advocating for a woman gets a bit tricky. I have written about this before. I advocate by reminding the mom of her options- reminding her of her original birth ideals- helping her to formulate her questions in order to get the answers she seeks and supporting her in her decisions.

I feel my job is to support- to offer encouragement and ideas to help facilitate the kind of birth outcome she desires. My job is to make sure she is getting the information she needs to make the right decisions for her. Recently I had a mom make a decision in her labor to move forward with a cesarean birth. Whether I agreed with her decision or not was not important. Whether I would have done the same thing was inconsequential to her making her decision. What I want to walk away knowing is that she made this decision by gathering information and assessing in her situation if that is what she wanted to do. I want to make sure she has been given options and then been able to determine what is the right thing for her. My job is to try to make sure she is not bamboozled or bullied or driven by fear that has been pushed on her in making this decision. I feel that the role of the doula is that of support- not second guessing or berating the mom herself by in not agreeing with the mom doing her own bamboozling of the mom. If she has been able to make good decisions all along, what makes us think given the space, opportunity and information, she is unable to make good decisions now?

marsflashb_alltheskyIn the midst of the chaos
When the wind is howling I hear
the ancient song
Of the ones who went before
And know that peace will come
-Susan Stauter

May the sun bring you new energy by day,
May the moon softly restore you by night,
May the rain wash away your worries,
May the breeze blow new strength into your being,
May you walk gently through the world and know its beauty all the days of your life. –Apache blessing (more…)

Relationships take time to develop. When you pick a doula it is best to hire her as soon as you can so you can develop a relationship with her. She needs to be someone you feel you can be honest with and share your inner most thoughts regarding your birth fears and ideals. It needs to be someone you can trust. This is a double road though- it is up to you to make this happen as well as the doula.

We had a client who hired a doula several months out. Although they discussed things and chatted along the way, some things were said or shared that made her question her decision in her selection of her doula. She did not address these concerns. She did not ask for clarification or share her thoughts about what was said or misunderstood. And just like when your partner does a bunch of little things that bother you and you do not address them, the group of them together makes for a sore spot between you. This did not make for a relationship that would foster a great doula-client relationship.

We see women select care providers and find out along their journey that this care provider was not going to be supportive of their ideal birth. But instead of addressing their concerns, they either dismiss them or they decide that perhaps it won’t really make a difference. But this is a relationship that will not foster a great care provider-client relationship.

Do yourself and your doula a favor… in fact do everyone in your life a favor and share with them the thoughts that make you uncomfortable when they occur. Address them so they can either be resolved or so a decision can be made early on to switch doulas if the doula is not a good fit. Sharing early on may have been something that could have allowed the relationship to grow and flourish rather than falter. After all it is about the relationship. Every match is not one made in heaven. But being honest is the best way to maintain relationships that will bring the blessings to your life and your birth!

We had a client tell their doula they did not want a particular doula to be their back up. When questioned about it, they did not feel she would be a good fit since her personality when they met seemed different than what they felt they may need in their labor. We have enough back up options that we certainly are able to accommodate that request. But keep in mind, just as Paul states in the Bible that he became all things to all people to win as many as possible, a doula can become what you need. For instance I have had clients want me to be gregarious and fun in their labors. I have had some ask for almost complete silence in their labors. I have had some who loved the casual conversations in the background that insured them all was normal. Doulas become what you need in your labor. But you need to let them know what you need. Since every woman has her own particular needs, your doula needs to know what you think you will need. But ironically that may change when you are actually in labor. She knows how to be flexible as your needs change.

A doula who is gregarious and funny at the Meet and Mingle may be the quiet, calm spirit who holds the sacred space of labor and birth for you. So, remember just as you may have a different personality at a party than at your labor, so she may as well. Ask questions that will enlighten you to her full personality before deciding she may not be who you are looking for to support you.

I often tell women not to lie to their care provider- don’t expect them to be truthful if you are not willing to be truthful to them. I feel if you can’t be vulnerable and honest with them, your relationship is not one of trust for your labor and birth. This is certainly true for your doula as well. Be honest, be vulnerable, be open- it will help your relationship become what will be most beneficial to you for your birth experience. Understand that misunderstandings occur, but share your feelings if they do so it can be cleared up. Communication is paramount for growth in this relationship.

I spoke to a friend who is a bit older than me. I said the bad thing and the good thing about getting older is you don’t care what people think of you. But the truth is you should always care how others feel from your actions or words. But again, sharing how one makes you feel will help resolve any negative feelings you may have from someone else’s actions. She said that sometimes when we get older we know things, we feel we need to speak the truth- even bluntly- and that those who are not in the same place are unwilling to hear the truth. I think about the phrase, “folks don’t care how much you know, they need to know how much you care.”

Sometimes I think in an effort to share what we know from our experience, we have our comments come across too emphatic and opinionated. I used to think that if you did not fully believe something, then you could not really have a strong opinion worth sharing. Now with age I realize everything is not so black and white. Fully supporting women sometimes means not sharing your opinion unless they really ask for it. As a doula that is often hard to not feel the need to share what you feel is truth that will protect them. But sometimes too much information can overwhelm a mom. It is a fine line in this relationship. We begin to feel responsible for them instead of to them.

Polly Perez a friend of mine- and an internationally known birth advocate shared this with me recently. ”

I had to remind myself the difference between feeling responsible TO or FOR many times….
That is why I wrote the following handout and even put it in one of my books hoping it might be helpful to others.
Hope this will help your in some way in your current situation….

Here is the handout—
The Difference in Feeling Responsible TO and FOR

When you feel responsible TO others….
You show empathy, encourage, share, confront, level, are sensitive, listen.
You feel relaxed, free, aware, high self-esteem.
You are concerned with relating person to person, feelings, and the person.
You are helper/guide.
You expect the person to be responsible for themselves and their actions.
You trust and let go.

When you feel responsible FOR others….
You fix, rescue, control, carry their feelings, don’t listen.
You feel tired, anxious, fearful, liable.
You are concerned with the solution, answers, circumstances, being right, details.
You are a manipulator.You expect the person to live up to your expectations.

So, find a care provider and a doula who will feel responsible to you. And be responsible yourself and share your feelings- after all it is about developing a relationship. Be open and honest. Let her know what you think is important and will need. And then know you will be fully supported in your labor and birth!

Recently I received an email from a potential doula client that started like this, “I am looking for a doula to advocate for me and my husband’s wishes in the hospital, and for the baby during labor.”

When I replied with a statement, “Why do you feel you will need an advocate to share your wishes in your labor? A doula will not speak for you- you can speak for yourself- if you can’t then your partner will do so- we support you- we remind you of what you wanted- we help you find your questions to find your answers- but if you feel some need to be protected we need to discuss why that is- let’s talk more about this.” She was taken a back and emailed me back this, “I think there has been a misunderstanding, I have no problem speaking up for myself; I don’t know where that came from. I have a list of questions to help me find a doula. What I’m looking for is a good fit, the optimal organization, because I am assembling my team, and would like a doula present. And I don’t know where this inference of needing to be “protected” came from? “

This made me think about the word advocate. Perhaps there was a misunderstanding of that word. When someone says initially something like they need an advocate to be with them- it sends up a red flag. My thesaurus lists these words: supporter, backer, promoter, believer, activist, campaigner, and sponsor. One who would support, encourage and be in favor of. I do think a doula can be these things. I do think there was a misunderstanding.

But this email came on the cusp of hearing from one of my doulas about a couple who had hired her. The father to be was initially one who was gun ho on having a very medicalized birth where all decisions were given over to their doctor. And then as they began to examine more of the birth journey- they had begun to explore options available to them and find out more about birth; he had changed quite a bit. The mother to be wanted a low intervention birth and was hoping to have a gentle vaginal birth in the least and was considering going natural.

Well after going a week past her due date and sharing how her care provider was not pressuring her to do anything to push this labor along, she went in for her 41 week prenatal appointment. After doing a non stress test and biophysical, it was determined that the amniotic fluid level was low- actually he admitted it was just what they expected it to be- well within the normal range- but lower than weeks earlier- but he suggested that they go straight to the hospital for an induction.
Her cervix was not ripe- but they could ripen it with cervidil. And after less than the suggested eight to twelve hours, it was removed and pitocin was started to bring on contractions although her cervix had not changed nor was it any more ripened than it had been the day before. The consideration of a second dose of cervidil was not discussed. And sometime in the night, her water had either been broken or had released due to the cervidil.

The pitocin was bringing on mild contractions initially since the couple had been requesting a slow start to the pitocin. But by mid morning, when the doctor made the decision to bring the pitocin up to normal management levels, the mom was struggling with the pain and the baby showed a few signs of also not being happy with the plan. The doctor had even said these contractions were like those of a mom who was close to pushing, but her cervix remained closed and unchanged. An epidural was placed and the doctor told them he would give them until 2pm to make some progress or she would have a surgical birth. I am unclear as to why this time was determined to be the magic hour of calling for the surgical birth- ACOG says a mom should have eighteen hours to be in active labor after her water was broken- perhaps he had broken her water at 8pm the night before.

Now mind you, they were in very little contact with their doula, and she was not with them- she was awaiting them inviting her to come be with them- whenever they needed her- she was ready- but they felt they did not need her yet. For inductions it can be tricky. Cervical ripenings is usually done while the mom sleeps. And the early onset of a pitocin induction can take hours before a mom even feels the first “real” contraction. So not having a doula present for the early parts of an induction is normal. But after several calls to them to help her know what might be occuring, she was finally able to find out at 3pm that they were going in at 4pm to have a surgical birth.

The doula was disappointed to have not been invited to be a part of this birth. What had happened? She was trying to be that supporter, believer, campaigner and encourager that they had wanted. But no phone calls had invited her to do so. And this care provider who was not going to push her into labor was now pushing her bed into the OR. But this was not the doulas’s birth. These were not her choices to make. She could not make these decisions for them. But had they been adequate advocates for themselves in the midst of this situation?

It is hard to be an advocate if someone will not be their own advocate. A doula can not step in and throw herself over your bed and say no. She can not give you medical advice. She can not speak up when you fail to do so. She can not save you from the choices you make freely along the journey. And sometimes I think folks hire us to do just that. I was trying in this email to be clear about our role. The antonym to advocate is opponent and discourager. Sometimes we find the folks we choose to be with us may very well be those things- whether it is the care provider or a friend or family member.

I can reassure you that will not be us- we will support the choices you make in your pregnancy and labor. We will remind you of what you desired. We will assist you in getting your questions answered and considering what your options are along the way. If you are desiring that, then we can be your advocates.

Recently a local childbirth educator made a comment that students in her classes had the average cesarean rate of consistently 10-12%. I thought wow that is great- I have never kept statistics on my students. I have kept statistics on my doula clients- over the last year my primary cesarean rate has been 8% and all of the cesareans- not including planned ones for things like placenta previa- but including women who had previous cesareans had only been 12%. But it made me think of all of the pieces of that go into the puzzle that makes for a “good” outcome. I realize “good” is a subjective word- so for the sake of this blog article, I will classify “good” as non interventive or at least having only the interventions you as a consumer choose.

Often times a couple who chooses our classes- certainly different than the “normal” hospital “how to be a good patient” classes. So they are usually looking for a different approach- perhaps in an attempt to have “their” birth experience- not the hospitals or their care providers. They are usually open to hearing new ideas that will help expand the ideas they are already developing on their own.

Often times a couple who chooses our classes are not choosing the “normal” birth experience and therefore has either chosen a care provider who is open to stepping outside of the “norm” or soon figure out from the class and their own exploration that the provider they have chosen will need to either get on board or they will need to find a new one. (more…)