Lately on many private doula pages I am on, there have been doulas discussing watching their clients being abused and what the role of a doula is when that happens. And it is a difficult situation. We can not give medical advice nor be disrespectful to a care provider, but when we see abuse and have to stand quietly out of the way it is very difficult. What many doulas have done, and I personally have chosen to do is to step away from taking clients who have abusive providers.

Recently I had to decline being the doula for a client whom I have been the doula for twice before. She continues to go to the same provider although she is not listened to and is even abused in my eyes. I wanted to be there for her but I can not enable her to continue on the path she chooses. And I am not going to get into why women allow this to happen to them… the vulnerability and issues behind it are outside of my understanding.

We watch women being lied to…outright lies. They are told things that are not evidenced based and are totally biased. We watch women have their cervix stripped after asking to not have it be done. We have women have rough vaginal exams in labor only to be told that is why they need to choose an epidural. We have women have their amniotic sac broken without consent and sometimes even after telling the doctor they did not want that to be done. We watch their perineum being sliced without consent. We watch women get bamboozled into inductions that are not warranted and into medication they did not desire. And for some of us we see worse. When we see women shut down- not listened to- not being heard when they speak- not having a say in their births, we want to yell STOP! But we can’t. We can stand by her side and remind her of what she desired and try to help her find her power. But some women give their power away. They know what they wanted but they are quick to give it away. It makes us go home and cry for that woman and that baby and that birth experience.

I have attended over 600 births and I realized after the first couple of hundred that I had to put my foot down and protect myself from burning out. I had to say, no I will not be party to watching that abuse, that birth rape occur in my presence again, feeling powerless and being damaged emotionally by watching it. So there are providers that if a mom chooses that provider, I have to decline being her doula. There are only a few- one at Gwinnett Medical and two at Northside.  I am reminded of something an OB told me years ago, “ObGyns are either one of two kinds of people. Those who hate women and want to control them, and those who love women and want to support them.” I have found this to be true.

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Recently our local hospital that does more births than any other facility in the country came out with a form that is required by the patient and doula to sign. It is attached for you to see it. It must have come after doulas stepped outside of their scope of practice. I only did one birth there in 2014, so I have not heard the scuttlebutt of what caused this to happen. But it is a shame. The scrutiny of the doula in the support team is sad. If I go as a friend or family member I am not held to signing this agreement. But it seems that although the parents want a doula to accompany them, a nurse can decide that that doula has to leave. How do you feel about a hospital that can control that aspect? And this form is not about overstepping medical advice- it is about support – things your family members do and most nurses prefer for us to help with- but someone decided to make doulas sign it- controlling your choice in having a doula.

I have only been asked to leave by a doctor once- when he wanted to control the mom and dictate who she could have in the room, inviting some who were not invited and then saying too many were in the room and I had to leave. The mother watched in horror but without her voice. Later as she clung to my neck and cried about the horror she had just experienced at his hands, she broke my heart. I had a midwife decide the room needed to be cleared once and ask everyone to leave. She thought that was best. But again, the mom was voiceless. It breaks my heart when care providers feel the need to control the birth room without regard with the mom’s desires. That is about as dis-empowering as it gets.

I think women need to have their voices heard in labor and birth- but I also feel doulas have to know when to say no. I have cried many tears for women who allow their births to be taken away from them. It is always about control. And watching women give their birth choices away to someone else to control breaks my heart.

Here is the form that is now required to be signed if a doula remains in your labor room at Northside Hospital. If you can not read it from this pic- let me share some of the verbiage:

The role of the doula is to provide labor support, which may include emotional support and coping strategies for your labor and birth. The role of the labor doula does not include performing clinical task such as assessing your medical needs for those of your baby, diagnosing medical conditions affecting you or your baby, offering medical advice, operating any monitoring or medical equipment, removing or applying monitors, assisting you out of bed to the bathroom, making decisions regarding your care and treatment or providing instructions or information that would be required by a licensed professional registered nurse or medical provider. 

If at any time your doctor midwife or nurse believe that the doula is not adhering to his or her role in providing you with labor support or if your care providers believe that you’re doing is intrusive in the care and treatment provided to you during your stay at the hospital, we reserve the right to instruct the doula to leave the hospital. You may dismiss your doula as well.

10978551_10153121460466789_4188755323257192461_nSo although a doula should not be giving or providing medical advice or treatment, the document seems to possibly restrict us helping our clients get informed consent. The words like “being obtrusive in the care” and we are told all of the time to unplug a mom to help get her up to the toilet… and when we ask about this we are told of course we can- but if we do- this is grounds to have us dismissed… could be treading on tricky waters. So be aware of the situation your doula may be being put in by supporting you at this facility.


I wrote this initially in 2013 but feel it needs to be back at the top of our blog. So often folks come to our Mingles to meet us and say that they want to avoid a cesarean. Yet they are choosing a hospital where the cesarean rate is over 40%. They do not plan to take classes or they plan for a hospital based class or a one day abbreviated one. Please realize that today with the high levels of intervention, you have to do a lot of things to avoid the interventions that lead you to the OR. There are lots of ingredients that go into making a gentle birth pie:

  1. Provider
    1. Your gynecologist may not be the best one for your pregnancy care- well woman care vs pregnancy and birth care
    2. Communication goes both ways- can you discuss things and be heard and feel listened to now?
    3. Back up is important- who covers what- do they share call- will you get to meet them beforehand?
    4. Midwifery model vs the medical model of care=What do most women choose? Obstetricians are by far the most common choice in the United States, although certified nurse-midwives are becoming more popular: In 2006, CNMs attended almost 8 percent of deliveries in the United States and over 11 percent of vaginal births. provide handout
    5. CIMS questions to ask
    6. Marriage – then date- can lead to divorce- when is it too late? Don’t stay where the rules of the games are different than the game you want to play.

“Midwives see birth as a miracle and only mess with it if there’s a problem; doctors see birth as a problem and if they don’t mess with it, it’s a miracle!” Barbara Harper in Gentle Birth Choices

“Unfortunately, the role of obstetrics has never been to help women give birth. There is a big difference between the medical discipline we call “obstetrics’ and something completely different, the art of midwifery. If we want to find safe alternatives to obstetrics, we must rediscover midwifery. To rediscover midwifery is the same as giving back childbirth to women. And imagine the future if surgical teams were at the service of the midwives and the women instead of controlling them.” Michel Odent, MD

“When meeting with my OB, I described—in a light way—the feeling I had about the baby telling me he was coming out vaginally. Unfortunately, this kind of thing does not provide confidence to everyone in the medical community! And much to my dismay, they wanted to schedule me for a C-Section, just like that. Thankfully, at least one very important local midwife did believe me and believe in me (and my baby). She encouraged me to do what I needed and go where I needed to get my try at a VBAC. “– Jenna’s story

“Switching practices mid-pregnancy was perhaps the best decision we have made. Last week I was so fed up with being pregnant that I just about begged her to induce me. Had I stayed with my old practice, they would have scheduled a date right then. But not Janet. She just calmly reminded me that no one stays pregnant forever and that my baby would come when she was ready. She talked through natural things we could do to help get labor started and walked us through what would happen if she doesn’t come by 41 weeks.

As we left her office I turned to D and said, “We picked her for a reason. I don’t really want to be induced. But I was desperate. And instead of letting me cave to my uncomfortableness, she talked me out of it. Gently. I’m thankful for that.” She has been a rock for me during the last half of my pregnancy. I’d recommend her to anyone. {This is Janet Fedullo with Alpharetta Women’s Specialists}”- Chrystal Rowe from the blog (more…)

We all hear the stories of women nesting before labor. They get their house in order before they feel they can bring a new being into that space. But have you heard about women who need to nest in order to really get going in their labors?


When women are in early labor there are some things that will interfere from them getting into active labor. It can be they need to feel secure and really nested into their space. For some moms that means they need to get to their birth location prior to really active labor so they can get settled in a bit first. My daughter arrived just before pushing with her first baby and wanted to get there earlier with her next two so she could settle in a bit before birthing.  And for some moms it means they need to have their birth providers and supporters nearby… their midwife at their house or on her way, their doula in place, etc. We had a mom recently who had an on again off again type of early labor. In her exhaustion she decided to head in to the hospital- still not regularly contracting. She arrived to be told she was already five centimeters and her labor unfolded quickly. I had a mom who arrived in active labor only to find out there were no labor rooms avaialble. She slowed her labor down until a room was available and then flew the end of her labor. I have had moms pushing and not make great progress until their mothers/sister/friend there before the baby was born. For moms who have other children, it means they need to be off and cared for by others or already tucked in bed, so they can become mothers again without having to be mothering. Moms are distracted by taking care of their children and do best when their minds can be about this baby and not them.

So for some women nesting is not just for pre labor times- but can certainly play a role in labor and birth. Build your nest and make it a place you feel safe and supported for a gentle birth.

I recently attended a birth where the mom wanted to decline getting an IV access. This was not news to her doctor. She had told her doctor numerous times that she wanted to decline this procedure. My client was well informed and knew that evidence did not show this was an essential intervention for a healthy mom birthing. She had done her research and read the articles like this one in Evidence Based Birth.  She had planned to keep well hydrated and felt it would restrict her.

When she arrived to the hospital she was well rested, hydrated and contracting regularly and moving along in her labor. She was put on the monitor for her twenty minute strip and within 40 minutes was told the baby looked great and she would be coming off the monitor. BUT when the nurse went to set up for placing the INT – IV access and the mom declined the nurse changed her tune and she was told she had to remain on the monitor until the doctor who was in a delivery would come in to talk to her.

choppy waters

So we waited another twenty minutes or more for the doctor to arrive. She sat on a stool and discussed the reasons for doing an INT. She mentioned that she once had a mom who needed a cesarean and did not have an IV and they almost had to use lidocaine on her belly to do the cut for the cesarean. THERE IS NO WAY that would have occurred. The vein in the bend of the arm is almost always accessible and can be done in an emergency. And this mom would have been put under general anesthesia before doing such a procedure.

Then the nurse decided to chime in. She said that if the mom who had desired to get in the tub wanted to stay in the tub as she once had agreed upon (Not funny how the nurse had to agree to allow this mom to get in the tub), she instead of staying in the tub for 50 minutes and out for 10 for a monitoring strip ( she said the one telemetry unit was in use and did not  work well with the jets on in the tub) she would instead have to get out every 20 minutes for a 10 minute strip. She said without the INT she would be worried about the wellbeing of the baby. And she reminded us that it was about her license.

I knew this mom had just been told two LIES to try to manipulate her. Coercion has no place at a birth. Then the kicker- her doctor is going off call after saying she felt the mom could stay in the tub for the full 50 minutes of every hour. And the new doctor coming on is not happy that the mom does not have an INT. This is a doctor in a completely different practice- one she has never even had an opportunity to meet. Did you know that your practice may be one of the practices that shares call with another whole group or two or three of doctors? This doctor said they would not have accepted a patient who was not willing to allow an INT.  So of course he wants her to get it. So now the nurse is still making the 20 minute rule stand.

The dad was fabulous! He said, “So wait. because my wife is declining the INT you are going to punish her?” I had to bow my head to hide the huge smile that spread across my face. This is not my battle to fight for them. I can remind them of what they desired and support them but my words should not enter into this negotiation. So this dad stepping up with such raw honesty was fabulous.

The mom and dad talked about having some time away from the manipulators and decided to get the INT. The freedom of being in the tub for longer lengths of time was more important in the end. What is sad about this story is this should never have happened. Having an INT IV access is not essential to a birth. If the mom had been dehydrated or wanted medication she could have gotten it early on. This was not this situation.

Sometimes you make a decision to use a provider or birth location you will find more choppy waters to negotiate than others. This couple was well prepared. They had had several discussions about what they desired in their birth. Their provider never said that they HAD TO HAVE an INT. She only asked them to keep considering it. The dad said he felt the doctor had been a push over or conflict avoider. I feel that she was a bait and switcher. She never told them what she knew she would inevitably make them do. The nurse who had lied and been manipulative all of a sudden found the telemetry unit and started to be kind after the INT was placed.  She even told the mom she was lucky she was the one placing the INT since she never put it in the moms hand so she has more mobility and she used lidocaine so it was less painful. Gee- you mean the other nurses if she waited would not honor those same desires? Thanks!

I respect this couple for standing their ground- although I do think all of that adrenaline and lack of ability to relax and go to her laborland space interfered with her labor. I do think that when they repetitively asked her why she was declining and she repeated herself over and over, she was not being respected or heard. I do think that having to fight in your labor is counterproductive. I think they were worn down a bit but I feel in the end they chose their battles. But why do we have battles in labor to begin with?

When will informed decisions by a woman in labor be respected? Several times the word dead baby was used in the conversations about this procedure. When you use such phrases as sick or dead baby, it makes women fold. That was not true in this case because this couple recognized the lie. I hate that this couple had to even have any of these conversations taint their beautiful birth.

This couple negotiated the choppy waters of this hospital. They knew there would be some battles when they learned that this hospital had protocols that were not evidenced based and were more interventive. I am unsure if they knew that several practices shared call with their practice.  Negotiating beforehand does no good at all in this case.  Making a concession to get the INT for more freedom in the tub was one I would have made as well if I had been in this same situation. Having her husband as her protector and extra emphasis to her voice was priceless.

Understand the choices you make may mean you need to learn how to negotiate choppy waters in labor to get closer to the birth you desire. Ask your questions long before you get into the last months of your pregnancy.

This was a question posed on a birth professional group I am a member of online. I wanted to share the top ten things that birth professionals- midwives, doulas and educators had to share.

(One person said it was hard to pick just one since there were many issues.)

one thing

  1. staff was shared- the lack of education on their part and the lack of desire to support laboring women.
  2. many said it was the lack of education on behalf of the woman- about her choices, her options and even the birth process itself, leading to a lack of informed consent. And women not knowing what they do not know until it is too late- and women not taking responsibility to make sure they know.
  3. induction was sited by many, the lack of trust women had in the birth process and allowing someone else to intervene in the process.
  4. profits and lies was mentioned- lies between women talking to women, lies between medical professionals to women, lies between parents to children.
  5. laziness, passiveness and apathy- it is easier to just show up- get the epidural or the planned cesarean than it is to learn what you need to learn to actually labor to birth- looking for a reward without putting in the work.
  6. power over instead of power within- women giving up their power.
  7. fear- fear of the unknown, fear of failure, fear of not being accepted, fear of being treated badly if you do not obey.
  8. fear mongering by pharmaceutical and medical professionals- and preying on this ignorance of the consumer.
  9. lack of support- being more focused on machines to tell us how a woman is doing rather than looking at and supporting the woman.
  10. the medicalizing of birth and women no longer being taught to trust birth and own their birth and their decisions.

I do realize that all women do not want a non interventive natural birth. but as a birth professional I will say that often we say many women do not know what they do not know. Now this is not every woman- but I will say it is the majority of women today. They may read a few books- many of them instilling more fear with a splash of comedy but no real truths revealed. They may watch some youtube videos and maybe even get one from netflix but they do not really seek out information about their particular community from those who will reveal the truth. Birth has become a business. Women are looking for quick appointments with no waits. They want a fancy office decorated beautifully. They want a local hospital to be a close drive that is beautifully decorated with the newest of all the gadgets. They want to be directed by their doctor and told what to do so they do not have to take much if any responsibility for the outcome of their births. They want a nursery with the highest level of NICU for the just in case, not realizing that many of the interventions is what causes their babies to be in the NICU. They want someone to help them perfect breastfeeding with one quick visit since they did not take the time to take a prenatal class. They want a comfortable bed for their partner and great food for them both while being taken care of in both labor and postpartum. The idea and benefits of getting home quickly are not something they would fathom.

What we do know- for a healthy mom- the fewer interventions the better outcomes for both her and her baby. The shorter the stay, the better outcomes with breastfeeding and less intervention for the baby. Healthy mom and healthy baby relies on less intervention not more.

do not disturb

Birth will not change until women change birth. Doctors and hospitals cater to the consumer. If you demand a different experience, they will begin to listen and offer you options you desire. Birth will not change until women take back their birth responsibility. Preparation is up to the woman. You can not expect an outcome without putting in the effort to make that ideal birth happen.

Change is happening. Inductions were at such an increase that cesarean rates rose so high insurance companies started to look into the situation. Why was birth costing so much more? Women were getting more drugs, having more surgical birth and babies were spending more time in the NICUs across the country. When the cesarean rate is upwards to 40% something is really wrong. When women begin to believe that an induction at 37 weeks gives them a full term baby to only find that baby born prematurely and needing NICU support for weeks, something is really wrong. When women elect to have major surgery after their first birth ending in a surgical birth, not realizing the risk to their bodies and their baby’s because of the fear put in them to have a VBAC, something is wrong, especially since the rate of rupture increased only due to doctors fiddling with a woman’s body after having done so the first time leading to that cesarean.

If you want to change your birth experience from the “normal” birth today, you have got to take responsibility in doing so. Take a childbirth and breastfeeding class that is taught by an independent educator- not where you pay the hospital or your doctor.  There is control over what those educators can teach. Get your team together- your partner needs some classes too! Hire a doula- not just a friend but someone who is trained to help you have a better chance for a better outcome. Eat a nutritious diet, growing a baby with a healthy diet and get exercise. Learn about optimal fetal positioning and help your baby line up for an easier birth. Choose your care provider wisely. Does he or she listen to you in a respectful way? Do they guide you to explore options that are right for you? Do they encourage you to investigate choices that are available?  Choose your location for birth carefully. Every hospital is not right for every woman. Find out what the stats are at that hospital. It is great if your doctor has a low epidural rate if you want a natural birth, but if the staff only sees medicated births, how supportive will they be or even know how to be for you?

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.”


  • “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.”


  • “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.


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…)

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!

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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…)