It Happened Again

I guess when I imagined being a doula, I imagined other women's births through the lens fashioned by my own experience. The moment when mama meets baby. Working hard, breathing through contractions, pushing baby out. No drama, no worry, no tubes and cords and beeping and whooshing. Just warm water, soft voices and gentle hands. Trust in a woman's strength and wisdom. Trust in the natural process.

I'm not sure how my head got so far up my ass.

My births were beautiful, memorable, empowering. In fact, I can honestly say I love giving birth. I would do it again in less than a heartbeat. I am finding out first hand that most women don't have that experience.

The urge in the medical world to do MORE to "help" a woman birth her baby, to "help" a woman start her labor, to "help" things along a little is just utterly baffling to me. And it should be baffling to every single person in this country. Our c-section rate is abysmal-more than twice what is recommended by the WHO. Our maternal and infant mortality and morbidity rate is unacceptable for a first world country. I am at a hospital today that has 50% c-section rate for their induction patients. FIFTY PERCENT of women they try to "help" into labor end up with a major surgery instead of a vaginal birth. One would think that such a sad, sad statistic would beg some review of their standard procedures. Such as not "allowing" women to go past 41 weeks. Because...? A client of mine was actually told that there is no benefit to allowing a pregnancy to go past 40 weeks. She's a first time mom. Meaning she was likely to gestate to at least 41 weeks, if not more. The baby was doing great, the placenta was healthy, blood flow and fluid was good. All indicators that her pregnancy was continuing in a healthy, productive, safe manner. And yet...

This is the second time this month my first time mom ended up with a c-section. The first one as a prostaglandin induction. Sort of sneaky. They didn't tell her it was an induction. And these were midwives. Very, VERY disheartening. The second was a full-on, strong-armed, get-your-ass-to-L&D bully induction. She knew she wasn't ready. Her body knew it. And then, after 31 hours of going through the meat grinder ("going through the ringer" doesn't actually capture the spirit of it), the baby knew it and told everyone else what mama knew from the outset -this was a bad idea. And yet, the OB's act like they had nothing to do with it! One actually said "sometimes this happens when a baby truly won't fit, and it's not your fault, it's not anyone's fault." I know they say this to make the mom feel better, but it is just not true. It is the fault of the OB who said "You are not allowed to continue this perfectly healthy pregnancy because I think you've been pregnant too long."

So what is a doula to do in the face of this? I can't make the decisions for the family. I can't change the minds of the doctors. I usually can't even outright say "I think this is a terrible idea." Toeing the line between helping the client get all the information and being respectful of their choices - even when I don't agree with them - is really really hard. At what point do you shut up and let something happen? How do you stand by when everything you see is headed the wrong direction and there is absolutely nothing you can do to change the course of events? How do you do it?

So it happened again. And I believe even more strongly about the importance of my role in the process than I did a month ago. But how can you hold a sacred space for the most beautiful, challenging work she will ever do when those responsible for her care and physical well being won't just leave well enough alone?

This is not a rhetorical question. Someone answer it for me. Please.

 

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My First Birth as a Doula

I've had two babies the all natural, old school way. And when I say old school, I mean like in my home, with a midwife, doing my own thing however the hell I wanted to old school. But I had never watched another women give birth before. Until Friday.

S's labor was atypical. She is a first time mom and so didn't really know what to expect from labor, but hers started weird and just never settled into something she could recognize from all her study and preparation as labor. She had contacted me around 8:45 am on Wednesday saying she thought her water was leaking since the night before and that she was having what she thought were contractions. But they weren't in her belly, they were deep below, her thighs were shaking and tingling and they were lasting for "no more than five minutes, about once an hour". Five minutes? Once an hour? I didn't really know what to think of it, but said that it sounded like she was feeling her pain as pressure on the cervix (that is where all the action is, after all). I told her to try to rest and that her midwife could tell her if it was amniotic fluid or not. They went into the birth center, were told the baby had dropped and that was why she was in such discomfort. She got no information on dilation or effacement, so assumed there was none. They sent her home.

Besides an email expressing some doubts as to whether she could handle a natural birth, given that the pain she was now experiencing was apparently not labor, that was the last I heard from her until 3:38 am on Friday morning.

You would think this little scare would have prompted me to get my doula bag together, get a pair of clothes set out and ready. Alas...

I heard the phone ring through the veil of a dream. I had turned the ringer down earlier that day (thank GOD I hadn't accidentally turned it off!) so it was barely loud enough to wake me. As soon as it registered what I was hearing, and seeing S's husband's name on the missed call screen, I was immediately awake, adrenaline pumping, blood whooshing in my ears. I called A back and he said they had thought it was a false alarm, but definitely not. I asked if they were on the way to the center, and he said they had just arrived. Holy cow! At the birth center! This is it!

I pretty much flew out of bed. As I brushed my teeth and put my contacts in, I mentally gathered all my stuff. Rebozo in the office, honey sticks on the shelf in the living room, toiletries on the kitchen table, tennis balls by the front door, birth ball in the basement. And crap. If I wanted this birth to count towards certification, I needed the midwife evaluation form with me, which was somewhere on my computer. I gave myself three minutes to try to find it before giving up and getting in the car. The damn computer is so damn slow, so I after two and a half minutes I shook my head and said "What are you DOING?!?!? Get out the door!" I left the house at 3:49 am and headed to the birth center.

My mantra in the car: don't get lost, don't get in an accident.

I pulled into Special Beginnings at about 4:25 am and went to the back door. They were the only family there that night, and I was met by the nurse who told me S was in the tub, and the midwife who told me that she was 9+ when she arrived an hour earlier and there was just a small anterior lip left.

The lights were low. S was laying on her side in the tub, eyes closed, holding A's hand. A was sitting on a stool by the tub. Each contraction came and went, and S breathed slow and deep, moaning through each one. When she tried to run from the contraction, the nurse gently reminded her to slow her breathing and focus on her breath. I felt slightly superfluous at first. Clearly this was a place where the mother is honored and supported, doula or not, and they had been laboring for an hour here together, getting their rhythm. I was coming in late to the party. But S wanted me there, so there I was. I had to find my rhythm, too. I put a cool rag on her head. I gave her a drink of water. I reminded her to breathe slowly and deeply. Keep her sounds low and deep. Rest between. Quietly, somewhat tentatively, reverently, I melted into her labor dance as best as I could, reminding myself this was not about me.

An hour floated by in labor land. The nurse checked her, the midwife encouraged her to push. She did. The baby's heart rate began dropping. Without making it too much of a deal, they quickly got her out of the tub and into the bed to better be able to monitor the baby and make sure he was safe if he needed extra help when he was born. After several more contractions, the heart rate was much better and the air of tension lifted from the midwife and nurse. S said she doesn't want to push so hard because it feel like she has to poop. Me, the midwife and the nurse all say pretty much the same thing using different words, all at once, "Perfect! That's exactly what you should be feeling! The baby's right there!"

S was exhausted. She'd barely slept since Tuesday night and it was now Friday morning. Each push is a battle for her. A and I have to hold her legs, put her hands on her knees, remind her to work her hardest. She needs the midwife to tell her when a contraction is building and tell her it is time. She is so tired. I massage her hand between each contraction. S asks us to shake her hips between contractions to relieve some of the pressure. I gently pressed my hand on her forehead and whisper "relax...rest...breathe...that one is done, you never have to do it again." And another one rolls around, builds, peaks, disappears. Relax, breathe, rest, let it go. A started to tell me about the last two days and nights. S said "Baby, please stop talking. I just want to get this done." A smiled at me and stopped talking. She pushed through another contraction and another and another. The baby starts to move down, decisively. He stays down, we see the hair, the head...and more head and more head. This baby's head is a perfect, long cylinder! S says "the pressure...there is just so much pressure". One more push, the midwife says, almost there. I can actually see the baby rotate as he comes out. He was trying to get out sideways, but turned at the last possible second to come out the right way. I am in awe. There is a picture of S in the throes of a contraction, the baby's beautiful little cone head 90% out, me, holding her leg, smiling like a complete dope. I am amazed by this woman, this baby, this birth.

The head comes out. The baby seems to be stuck. The midwives seems to be yanking, pulling, twisting to get this child out. S is pushing with all her might. The contraction is over, she says "I can't, I just need to rest. Can I wait for the next one?" She does, the baby is still not out. She pushes, the midwife pulls, the baby is born. He is purple and silent.

Oxygen, rubbing, oxygen. Closed eyes. Silent. The nurse is telling S to talk to her baby, let him hear her voice, as the midwife resuscitates the tiny boy. She's looking at her watch, getting his heart rate. It feels like an eternity, though it may have only been one or possibly two minutes. And angry cry, a pink baby. All is well!

S holds her son. A sits by his wife. Kisses her head. They admire their boy. He latches on and nurses like a champ. I take pictures.

Amazing.

I was only with them for a little over two hours before the baby was born, so the form I was searching for frantically at 3:30 am was completely unnecessary anyway. They were almost as unprepared as I was and have no food for breakfast. I offered to go to Safeway to buy some yogurt and bananas for a snack. I do...and them in the parking lot at the birth center, I somehow manage to lock my bag, keys, phone and the food in my car. Nice.

I called Kevin at 7:30 am. He found my spare key by some merciful act of God, packed up both kids and drove the 40 minutes out the Arnold to rescue me. While I waited for him I had a cup of coffee, chatted with a remarkably chipper new mama, helped a little with breastfeeding, talked a bit about the birth and held the tiny boy after his newborn exam (6 lbs, 11 oz - so much smaller than either of mine!). They were a little at odds on the name, with A telling family one name and S smiling as she rolled her eyes and saying they would discuss it in the car.

When Kevin got there at around 8:45, I passed the bananas and yogurt on to the nurse to give to S (since now I had a hungry toddler in tow) and headed out to the car. Malcolm was groggy from an almost-nap, so I nursed him in the car and then headed home. I haven't stopped thinking of them since. I can't wait to hear the whole story of what transpired between Wednesday morning and Thursday night.

I think I could do a lot of this.

 

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An Evening with Penny Simkin

Penny Simkin (as our hostess, Claudia Booker, said) is the "Ina May of doulas". She was in DC in late April and it was such an honor to meet her! As a new doula, I am looking for as many sources of information and inspiration as possible. Having read many of her books, I was excited to be able to hear Penny speak in person. The majority of her talk focused on the topic of helping survivors of childhood sexual abuse (CSA) to give birth feeling empowered and safe. It is a topic I have not yet begun to explore and have not encountered, but since so many women have been the victim of such abuse, it is certainly something I am bound to encounter in my work as a doula.

After the presentation on CSA, we moved on to some fun stuff!

Demonstrating the Lap Squat for the pushing stage and an exhausted mama. This allows e benefits of a squatting position, without the mom having to support her own weight.

This is a supported squat position

Penny demonstrating the Take Charge Routine for difficult moments in labor

Hip Sifting with the rebozo

Using the rebozo for the belly lift

Me and Penny!

 

 

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A Simple Birth Plan

I'll just admit it.  I am a doula and I had no birth plan for either of my births.  I was giving birth at home and I just assumed that "Home Birth" inherently covered all the things I wanted in a birth.  I toyed around with a document with birth preferences, but it was just for the people I imagined would be there ("I have no idea what I'll want or who I'll want around me.  If I ask you to go see a movie please, it isn't that I don't love you!"), and to please not tell me what time it was or how long I had been at it.  I assumed that if I needed to go to the hospital, it would only be because I needed this intervention or that one.  It may have been naive, but it all worked out fine.

But I am in the minority.  The vast majority of women birth in the hospital and if these women want a natural birth, a birth plan is not just a good idea, but essential to making sure they are on the same page as their caregivers.

So what does the doula who has never written a birth plan have to say about writing birth plans?  My recommendations to my clients for birth plans are based on the words of the L&D nurse who attended my doula training workshop.  She said (and I quote): "Oh, I usually read them.  I definitely read the first page, then depending on what's happening on the floor, I'll scan the second page.  If there's any more than that, I just don't generally have time for it."  She also said (and I paraphrase) that she hates the birth plans that have all the little checks of I don't want this or I don't want that, and there is one important point no one ever puts in that she would tell all her doula clients to add.  More on that later.

Keep in mind, this is from a nurse who was at a doula training workshop so she could be as supportive of natural birth as she could.

So let's deconstruct her statement.

"I usually read them."  

Note the word usually.  That means, of course, that sometimes she doesn't.  Is it because she doesn't care? She doesn't want to make sure you get the birth you want?  Of course not - remember, she was at the doula training to learn how to be more supportive of the natural birth process.  Moving on:

"I definitely read the first page, then depending on what's happening on the floor, I'll scan the second page. If there's any more than that, I just don't generally have time for it."

So this shouldn't come as a shock, but hospitals are often sadly understaffed.  And in the DC area, we have a lot of baby-factory hospitals churning out babies by the hundreds every month.  There is a lot going on at any given time and one nurse will often monitor 3 or 4 mamas at once.  She doesn't have time to read a 20 page birth plan.

So based on her statement, this is what I suggest.  And of course, all of this is predicated on the health of the baby and the mother.  I can't emphasize strongly enough that your caregiver must be on board with your plan.  If s/he is not, you may consider switching providers to one more supportive of your choices

Keep it Simple.
There are things that are worth fighting for.  Waiting for labor to begin naturally is a biggie.  It is one of the best ways for you to ensure that you get your natural birth.  But other little details may not be worth fighting about.  This L&D nurse said that a mom agreeing to have a heparin lock in place is viewed as a mom willing to compromise on the little things, and so some of the harder-line nurses are more willing to work with her on the big things.  (This is just an example - if not having a hep lock IS deeply important to you, by all means, mention it).  So keep it simple.  Narrow it down to the things that are really truly deeply important to you.  And see if you can get it all on one page.

Keep it Positive
This goes back to getting the nurses on your side.  In a perfect world, we would have "sides" when it comes to birth.  But sadly, mamas wanting a natural birth in a hospital setting often have to fight the hospital powers that be to get it.  So instead of handing a group of over-worked nurses a list of "I don't wants", try using positive phrases, such as "I know there are pain medications available.  I will ask for them if I need them" instead of "I don't want an epidural."  Or "I would like to use the position that feels most comfortable to me during the pushing stage" instead of "I don't want to push on my back."  I sort of equate this to talking to my kids.  If you use all negatives - Don't run, don't hit, don't throw your brother down the stairs - all they hear is the "don't" and the "no" and miss the actual message.  Make your plan an expansion of the statement "this is what I want from my birth experience" instead of relying so heavily on "This is what I don't want".

Get Attached
This is from NATURAL HOSPITAL BIRTH by Cynthia Gabriel (and GREAT book that I cannot recommend enough!).  Get attached to your plan.  Be willing to fight for it.  Yes, birth is unpredictable, and you have to be willing to shift gears if something goes awry, but be committed to it.  Be dedicated to getting your natural birth.  It is the same in life.  You are not going to get that which you don't set your heart on.  Obviously, if an emergency comes up, you will go with it.  No one - not even us dirty hippie home-birthers - is putting the birth experience ahead of a healthy baby.  But in the absence of an emergency, you need to be attached to the idea of natural birth.  Otherwise it is too easy to be swayed by the "this" and the "that" that the staff could do to make things "easier".  Get attached.  Be passionate.  Be informed.

The One Important Point
This L&D nurse told us at my training that if you are started on Pitocin to help with progress during labor, the nurses will routinely up the level of the drip at regular intervals - REGARDLESS OF HOW YOUR LABOR IS NOW PROGRESSING.  Pitocin makes contractions hard.  I mean HARD.  She said that if the patient requests it, they will not do that.  So consider adding a line that says something to the effect of "If I need Pitocin to augment my labor, please do not routinely increase the level after it has been administered unless absolutely necessary," or "If Pitocin is needed to augment my labor, I would prefer that the initial dose not be raised unless absolutely necessary and only with my knowledge and consent."

So that is my simple guide to a simple birth plan.  Here are some suggestions of what to include:
* A short message to your care provider/nurses a la "I'm really committed to and excited about a natural birth. Anything you can do to help me achieve this would be greatly appreciated!"
* Preferences about letting labor begin on its own
* Who you want in the room
* Whether and/or when you want to be offered pain medication
* Being able to move freely and eat/drink throughout labor
* Avoiding vaginal exams
* Pushing positions
* Preferences on coached pushing
* Whether and how long you want to delay postpartum and newborn procedures (cord clamping, vitamin K shot, eye ointment, weigh/measure, bath, etc) while you bond with the baby
* If you plan on breastfeeding

Heidi Thaden-Pierce (a doula in Texas) has a wonderful resource called Things to Consider.  It is a pretty comprehensive list of things to think about while formulating your birth plan.

Stuff I Learned from Being a Mama #1

I wrote this for my mama blog in 2010, about 9 months after my first child was born.  I think it bears repeating on the doula blog!

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My friend is having her first baby in September.  I had my first baby last September.  She recently asked me if I had any words of wisdom for her.  My immediate reaction was "WISDOM?  What wisdom?  I am making this up as I go!"  Of course, upon further reflection, I realize that IS a sort of wisdom.  It is a trial-by-fire-in-the-trenches-let's-see-if-THIS-works kind of fearless (sometimes) experimentation that has yielded some good results.  It has, admittedly, steered me wildly wrong a few times.  But the path of parenthood seems to me to be an old-dirt-road-looking sort of thing.  Lots of people have passed before me and the path is very well worn, but everyone takes a slightly different course and leaves a slightly different mark in their wake.  Also it's bumpy.

So here it is.  Everything that I have learned in the last 19 months since I conceived my daughter.  Okay, not EVERYTHING, but some little tidbits that I wish someone had told me beforehand.  I am also realizing how long-winded I can be, so this wil be first in a series.   Some of this might qualify as TMI.  You have been warned!

PRENATAL ADVICE FOR MAMAS-TO-BE

You just can't worry about everything.  Everyone has another thing that could be harmful, that will be dangerous, that should be avoided.  And the list is twenty miles long.  You simply can't worry about everything.  I am not saying ignore the list altogether (or the advice of your caregiver), but if you accidentally eat some non-pastuerized cheese or forget to nuke your deli meat till it steams, chances are everything will be fine.

Eat.  Eat.  Eat.  But eat WELL.  Don't be obsessive about the weight you gain.  Your body needs to gain weight to support the pregnancy.  As long as you are not packing on Haagen Daz or donut pounds, you are doing okay!  Lean protein, veggies, fruits, grains, eat the good stuff.  And then don't worry about it!

Don't look at the scale when they weigh you.  It is just better that way.

That being said, there is only one time in your life that eating a pint of Ben and Jerry's in one sitting is cute (and pregnancy is IT), so if your health permits it, don't be a food nazi either. 

Make lots of food beforehand and freeze it in single-serve portions.  Or buy a bunch of microwave dinners (though the "real" food will be nicer - it will be like your mom is there cooking for you:-).  Fill the freezer.  Don't skimp.  You will bless your forward thinking when Baby is 2 weeks old and there is not a scrap of fresh food in the fridge.  And you will bless your forward thinking when Baby is 6 weeks old and there is not a scrap of fresh food in the fridge.  Seriously.  Freeze everything.

Consider your birth options.  Do some research.  Consider using a midwife for a home or birth center birth.  

Studies show that home birth - for healthy, low-risk mother and babies - is as safe or safer than giving birth in a hospital.  The American College of Obstetrics and Gynecology (ACOG) and the insurance industry want people to believe that home birth is at best risky and at worst recklessly engangering the life of mother and baby.  But this is simply not the case.  The midwifery model of care (as opposed to the medical model of maternity care) is based on allowing a woman's body to work naturally.   The link above explains it much better than I would, but midwives allow the process of birth to unfold naturally.  They are well-trained professionals who know, understand, and HAVE WITNESSED the process of birth from beginning to end without intervention and therefore are an excellent judge of when something doesn't look right or when something is perfectly normal.  My labor took 50 hours from onset of contractions to the birth of my daughter.  FIFTY hours.  Contractions were 5-8 minutes apart for more than 30 hours.  I was dilated past the "you shoud go to the hospital" stage for about 24 hours.  If I had been at a hospital, I firmly believe I would have had a c-section.  Lucy's head was tilted up slightly and was therefore not pressing and opening the cervix as effectively as if her chin had been tucked.  But mymidwives knew that everything was fine.  The baby's heartbeat was fine.  I was tired, but not exhausted.  I was eating, I was drinking and labor was progressing, however slowly.  So we let it keep going.  And everything was fine.  She was perfect (Apgar score of 9 at 1 minute).  She was beautiful.  She was born in our family room, among our family, gently, beautifully, naturally.  I also firmly believe that our breastfeeding relationship would have been toast if we had been in a hosptial.  We had so much trouble at the outset that if either of us had been drugged, it would have been a lost cause.  I could go on about this for a long time, so maybe I'll save the rest of it for another post.  That you have a choice.  Know your options, and make an informed decision.  Some books to read:

The Thinking Woman's Guide to a Better Birth by Henci Goer.  Very informative look at hospital vs. birth center vs home birth.

Obstetric Myths vs. Researc Realities by Henci Goer.  Just what it says.

Ina May's Guide to Childbirth by Ina May Gaskin.  Beautiful natural birth stores along with...well...a guide to childbirth written by one of the country's best midwies.  Also includes a CRAZY picture of a baby coming out FACE FIRST!  Not for the faint of heart.

Journey Into Motherhood - Inspirationl Stories of Natural Birth Beautiful, inspiring stories of women giving birth on their own terms.

Baby Catcher: Chronicles of a Modern Midwife by Peggy Vincent.  This book clinched my desire to have a home birth.  Wonderful, moving, inspirational, heartbreaking, uplifting.

Spiritual Midwifery by Ina May Gaskin.  More from Ina May Gaskin - wonderful.

Consider breastfeeding.  Do the research.  Best for mamas, best for babies.  Get prepared.  It is natural, but almost never instinctual or easy to begin with. Attend La Leche League meetings - they have them all over the country and the leaders are well informed and very very helpful.

The Nursing Mother's Companion by Kathleen Huggins is a great breastfeeding reference.  I still reference this book from time to time, and it was a lifesaver in the early months.

Ask questions of your caregiver.  Get REAL answers, not the "that's just how we do it" crap I got from my OBs before I switched.  If you don't like the answers, or if you liked what you initially heard and they start to change to something less palatable the closer you get to birth, switch caregivers.  IT IS NEVER TOO LATE TO SWITCH.  My friend switched at 37 weeks when her OB insisted on a scheduled c-section for her breech twins.  37 weeks.  She found an OB willing to let her try a natural vaginal delivery, and that is just what she got.  You are a consumer, not cattle.  You have rights.  Birth is a HUGE business.  HUGE.  A lot of hospitals are baby factories and you will just be another bed they want to empty out as fast as possible.  Doctors want to cover their asses (often with good reason in our overly-litigious society), but it usually comes at the expense of mamas and babies.  KNOW YOUR OPTIONS and YOUR RIGHTS.  Make a decision, make a birth plan.  Be willing to be flexible, but ask questions, ask why, be an active participant.

No matter where you choose to give birth, consider taking a birthing class.  Even if you intend to show up at the hospital and immediately get an epidural, chances are you will be laboring at home for a number of hours before you are permitted to check in.  If you have no relaxation or breathing techniques at your disposal, these are likely to be very long, uncomfortable hours.  I took a Hypnobabies class and my labor - while inordinately long - was generally very comfortable.  I had no pain (only what I would call discomfort), I didn't feel the baby crown (no "Ring of Fire"), and even though I tore, I didn't feel it at all.  People swear by the Bradley Method, and there are many MANY other classes out there.  Just don't think taking the class the hospital offers will be good preparation.  From what I have heard, it is a "here's the epidural needle, who wants to sign up?" and admission procedures.  I am sure this is not the case for every hospital, but everything I have heard from moms who have taken these classes leads me to believe they are not worth the time.

Take some time with your spouse/partner before the baby comes to talk about who you are and how you see yourself as a parent.  It helps to be on the same page.

Spend some time with your spouse, just the two of you.

Unpackage, wash and put away everything you have for the baby.  Nothing is worse than having a poop blowout and a crying baby and all the clean sleepers are on hangers, stapled together with those stupid unbreakable plastic tie thingies.

I liked taking baby bump pictures every week.  Now I have a visual record of my changing body - and it is really cool!  I also had a fun pregnancy journal called The Belly Book.  It is a really cute and sweet keepsake of my pregnancy that I'll give to Lucy one day.

Get a fork lift to help you out of bed in the morning during your third trimester.  Heh.  If only.

Braxton-Hicks contractions can last for a long time.  I walked around with a rock-hard belly for an hour at a time on occasion.  Call your caregiver if they are coming on regularly or they hurt, but your uterus is warming up and conditioning itself for the marathon of birth.  Don't let it freak you out.

Chamomile Tea will calm BH contractions if they are bothersome.  My midwife said that the Amish have been known to keep an antsy baby inside for weeks just using chamomile tea.  I would make an extra-big, extra-strong cup of tea, mix in some honey, pour it over a liter of ice and sip it all day long.  Once again, always call your caregiver if you are concerned, but if she says you are okay and the BHs are irritating, chamomile is a lovely aid.  And it helps you sleep.

Ask for help and accept help when you need it.  Seriously.

More later on what I learned from labor and birth and the postpartum experience.  If any of you other first-time moms have anything you want to add, leave a comment!  I'd love to hear the things you've learned!

Karma Doula

I am a new doula. Still waiting to attend my first birth. The waiting is killing me! I volunteer at Family Health and Birth Center in DC and I'm on call once or twice a week. And the phone never rings. Seriously. It's killing me! I have some clients lined up for the spring and summer, and a number of potential clients with whom I'm interviewing, so it's just a matter of time...but I am really getting impatient.

So I'm trying to use this time to do the reading required for my certification, going to workshops to gain new skills and techniques, trying to really crystallize my philosophy and bring my reasons for going into this line of work into sharper focus.

The main thing I have been struggling with is how much to charge clients for my services during my training. I know from experience that people don't tend to value that which they have gotten for free. "It was free, so I didn't mind missing it." "Well, it's not like I paid for it, so...", etcetera, etcetera. I have even had a few potential clients just blow me off completely, assuming that because I am not charging for my services, they must not be worth anything. A few times the conversation has come to a complete, awkward halt when I tell them I am not charging them for what will likely be a great deal of time and effort on my part.

This is a problem I have dealt with my entire adult life, since I repeatedly find myself in employment situations that require me to name my price or set the monetary value for my own time. I have gotten better at it as my experience in the field has grown and I have learned that my time is in fact worth charging for. Coming from a theatre background, I know it is so hard to get a living wage because so many actors would do what they do for nothing simply because they love it. The more people offering services for free or extremely low cost, the less the service is valued by society. This doing a disservice not only to myself, but all my sister doulas - who have embraced and supported me in a truly doula-like way since I made the decision to enter the world of the birth worker.

And yet...I keep coming back to providing free services for a time. This doesn't gel well with the fact that I need to earn a living. But I can't shake the feeling it needs to be done, and I finally figured out why.

My two births were just wonderful. Peaceful. Quiet. Gentle. Natural. At my daughter's birth, I was attended by two nurse midwives. At my son's birth, I had one nurse midwife and one student CPM. Besides the fact that they are highly trained and extremely skilled at what they do, they treated me with respect. They listened to me. They answered my questions. They calmed my fears. They encouraged me. During my births they were gentle, patient, encouraging, funny, down to earth. Yes, I paid for their services. But I paid for their skills and training. I paid for the opportunity to give birth at home. The rest was their passion for birth and their dedication to making sure that I got the birth experience I wanted. I got more than money could ever buy - two beautiful home births, and a deep well of confidence in the power of my own body.

So, in honor of my midwives, I am paying it forward. I'm doing my karma doula work. Three births, free of charge, in honor of those three amazing women. When I offered my free services with this explanation, it felt right. And suddenly, the fact that I wasn't charging because I was paying forward a deeply appreciated gift made my services seem not less worthy, but more. These women I am serving are also giving me a gift - letting a brand new doula attend their birth is an incredible honor and a leap of faith on their part. Another gift I will never be able to repay. I wish I could just be a karma doula and serve those who couldn't otherwise afford it, but I do eventually have to make a living. So I will have to make do with my three karma births and then bring that spirit of service to the women I serve.

 

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Rally to Support HB 1202 - Certified Professional Midwife Pilot Program

What a great day for a rally! The sun was shining, the babies were cooing and tons of people turned out to support licensing CPMs in Maryland. I was so excited to see my own midwife there (I think I need to have more babies just so I get to hang out with her more often!) and many other friends and fellow home birth mamas!

Lucy with the first of several buttons she swiped during the event

Super cute lil home birth baby, totally oblivious to her awesome sign

Delegate Kelly with some home birth families

 

Lucy hiding behind her well-stickered sign

 

 

I never saw Thing 1, but I assume she was somewhere close

 

 

 

I tried so hard not to photograph any of the dozens of Amish who where there, but there are their legs

 

Beautiful day for a rally!

 

Lucy spent a lot of time wandering around in circles and dancing to her own private music

 

Wonderful speech by Claudia Booker, CPM

 

 

I thought this baby was a sweater.

 

I accidentally got some Amish faces in this one.

 

New friends, impromptu play date

 

 

 

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