Doula Work and Motherhood

Chasing the Pot of Gold in the Rainbow of Balance

It’s not unusual for the call to join a doula family at their birth to come in the dead of the night.  In fact, it’s so common that I was talking to the kids’ babysitter today about how for once *I* was finally here to greet her when she came to get the kids instead of my husband doing the handoff just before leaving for work.

When I am summoned in the middle of the night, in the sleepy dim light of my home I give myself time to get ready in a way that centers me and helps me enter the birth space in a focused and open mindset.  Some of the steps might include…

• feeding myself healthy, nourishing food and hydrating
• using a mindfulness practice like Breath Awareness or Circular Breathing to calm my mind
• praying for guidance for myself and a positive experience for the family
• reviewing notes I took during prenatal appointments on which pain coping methods the mom finds most helpful, what kind of touch she likes from her partner, if she likes aromatherapy, candles, a rebozo, etc.

Today the call to a birth came in right after a scooter ride around our neighborhood with my children and their friend.  We were wrapping up a little post-scooter playtime with family friends when the message came in...time to head to the hospital.  This is what preparing for a birth looked like with my children home and awake…

• feed children lunch.  Tell children to stop hitting/chasing/teasing each other and eat their lunch before the sitter got here.
• oh yeah and finding some food for myself while waiting for water to boil.
• taking a shower to wash off Texas summer scooter ride, joined by my son who totally invited himself.  This shower was interrupted by the scalding water of a flushing toilet (because why would he go potty BEFORE getting in the shower?) and my daughter bursting the shower door open to ask me which day in July it was.  
• Getting my work clothes on in between gathering swimming clothes and a regular change of clothes for my kids to take to the sitter’s house with them.
• explaining why my daughter couldn’t pour herself a glass of pomegranate juice while she had a glass of milk and a glass of Honest Kids juice still sitting on the table.
• talking to/lecturing my son about how to clean up the full glass of milk he spilled on the floor.
• installing two car seats in the babysitter’s car at 2 pm in the aforementioned summer heat.
• brushing my teeth and running out the door, stopping to turn off my daughter’s light on the way.

So yeah, there are a few differences between getting ready for a birth with kids around vs. kids tucked snugly in their beds.  It was a good opportunity to see how easy I have in when the call comes in at 3 am, and also to remember that birth and parenting are all about being flexible and rolling with what comes.  So while I may not have taken the zen spirit out the door with me (that’s what the car ride was designated for today) I did get to take the spirit of resilience, adaptability, and love for myself and others regardless of the circumstances out the door with me.  Thanks, kids!

No, I’m Not Going to Teach You How to Breathe

Disspelling Myths About Childbirth Education Classes

Sometimes I’ll get calls from people inquiring about my Birthing from Within or Birthing Again classes where the interested party asks if I teach moms how to breathe.  No, I’m not going to teach you how to breathe.  That is a skill that you learned a long, long, long time ago when you were just a little older than your own gestating baby.  

Controlled breathing patterns are what we have seen in movies and heard from our own parents for decades as the go-to way of coping with labor pain.  Interestingly enough, Lamaze does not even teach these trademark breathing patterns anymore.  

So does that mean we skip the breathing and pain coping thing all together?  Quite the contrary.  In Birthing from Within we spend about ¼ of the class series on pain coping alone.  That’s 3 hours of my class series spent doing hands-on practice of coping with pain and working with your partner to support you through practice contractions.  

I will not teach you how to breathe.  I will, however teach you how focusing on your breath can diminish the emotional suffering that is often linked to painful physical sensation.

I will teach you how to incorporate the sensations around you, including your breath, to help you not get thrown off by external stimuli as you work through contractions.  I will teach you an ancient practice for using the breath to bring energy back into an exhausted body.  I will teach you the power of using your voice to cope with pain with every exhale.  

I trust your body’s innate wisdom to know how to breathe during birth.  I will help you work with what your mind and body already know about breathing (and coping, and working through difficult situations, and collaborating with your partner, and and and…) to work toward your own focused, mindful place.  

Surviving Postpartum

Three Tips to Help Moms Through the First Six Weeks After Birth

So much build up, so much excitement at the end of pregnancy about meeting your new baby!  The nursery is decorated, the onesies are organized, and the car seat is installed.  The anticipation is palpable.  

Immediately after birth there is a sigh of relief...it may be a sigh of a mother’s heart being overwhelmed with love for her baby, or a sigh of gratitude that the labor is finally over.  Either way, there is usually a certain light feeling in those first postpartum hours and days.  

Until the hormone drop.  At three days postpartum mom’s hormones take a big drop and she may feel overwhelmed with baby’s intense needs, unsure about breastfeeding, or tired from waking up with the baby several times overnight.  80% of moms will experience baby blues in the first few weeks...feeling weepy, anxious, or overwhelmed at times.  So what can be done to ease the transition for everyone?

1) Allow yourself time to rest.  In Mexico women practice the tradition of the “cuarentena”...40 days of rest where mom’s only jobs are to heal and care for the baby.  Family members take care of the cooking, cleaning, and other chores while the mother has a chance to recover.  

After birth there is a wound in your uterus the size of a dinner plate.  Even if you feel good, allow your body time to heal itself.  Nursing allows many opportunities to sit down and put your feet up.  In fact, crawling into bed for some skin to skin time with your little one will be beneficial for you and your baby.  Take advantage of any opportunities to catch up on sleep during the day.  The laundry and dust bunnies can wait.  Which bring me to my next point…

2) Accept help from others.  Make a list of chores that regularly have to be completed in your family - laundry, dishes, sweeping, walking the dogs, taking older children to extracurricular activities, etc.  Hang it up on your refrigerator so that visitors can choose an item from the list to help you with.  This can help take some of the awkward feelings out of asking other people to do things for you.

Remember that oftentimes people WANT to help!  Welcoming a new baby into a family is a very special time and friends and extended family love to be a part of that.  It’s a favor to both of you to let them support you in these early days.  You get an extra set of hands and they get the satisfaction of being a part of your family’s transition.  If you don’t have friends or family around to help you, consider enlisting the services of a postpartum doula.

3) Adjust your standards of yourself and others.  Don’t try to hit the gym two weeks postpartum or host Thanksgiving dinner days after giving birth.  You don’t have to keep a spotless house or put everyone else’s needs first to be enough.  Getting through your day with baby is all that you need to do.  Set realistic goals and be gentle with yourself if getting back into the swing of things take longer than you expected.  

While you are accepting help from others, keep in mind that your mother-in-law won’t load the dishwasher the same way you do and your husband won’t fold pants like you.  Ask yourself, “Do I need this done the “right” way or do I need it done?”  In most cases getting things done will be adequate, even if it’s not up to your usual standards.  

Dear mother, know that you are deserving of rest, assistance, and relaxed expectations during this time.  The postpartum period calls for COMPASSION above all else.  

The Greatest Birth Story Ever Told

What Pregnant Women Can Learn from Jesus’ Birth

It may seem odd for a Muslim doula to be writing about the birth of Jesus, but believe it or not, Muslims share the Christian belief that Jesus was born to a virgin mother.  In fact, Mary is one of the most beloved women in history for Muslims.  

At this time of year, I think it’s very interesting to reflect on Mary’s birth experience and what modern birthing women can learn from it.  In surah Maryam in the Qu’ran, the story of Mary’s labor is reported as:

“[22-26] Accordingly, Mary conceived the child, and with it she went away to a distant place. Then the throes of childbirth urged her to take shelter under a date palm. There she began to cry, "Oh! would that I had died before this and sunk into oblivion.” At this the angel at the foot of her bed consoled her, saying, "Grieve not at all, for your Lord has set a spring under you; as for your food, shake the trunk of this tree and fresh, ripe dates will fall down for you; so eat and drink and refresh your eyes; and if you see a man, say to him, `As I have vowed to observe the fast (of silence) for the sake of the Merciful, I will not speak to anyone today.”

Whether you believe Jesus was born in a manger or beneath a date tree, the concept of taking shelter, finding a safe, private birth space, remains the same.  In order for oxytocin (the hormone of birth, breastfeeding, love, and trust) and endorphins (the body’s natural painkillers) to work most effectively, they require a sense of privacy and security.  

How powerful to know that even the most revered mother in human history cried out in pain while bringing her baby into the world!  In Birthing from Within classes we talk about how pain, doubt, and fear are a normal part of the journey and that in times of struggle, moms can connect with the 300,000 other women around the world who are giving birth at the same time - in hospitals, birth centers, houses, woods, fields, cars, and mangers.  

Modern mothers share the struggle of succumbing to transformation so profound and shattering that it bring them to a place of surrender...of crying out in pain, moaning, resisting and then letting go, of doing whatever it takes to give birth...with all of the women who came before them, including this beautiful, amazing soul specially chosen by her Lord.  

My favorite part of this story as a doula is that Mary was told to eat and drink during labor.  Not only was it nourishment for her body to fuel her through the process, it was also presented in response to her labor pains.  Staying hydrated and fed during labor helps to ease the intensity of contractions.  

While we can’t all have an angel speaking to us on God’s behalf during labor, I think we all have some version of that in our intuition.  Women were created differently from men in body and mind.  We all have deep rooted God-given knowledge that goes back to the time of Eve.  Tuning in to that inner voice can help us navigate our way through labor - telling us what to eat, how to move, and what needs to be done next to get through each threshold in our journeys.  

Finally, Mary’s vow of silence on that day.  Many women partially or completely lose the ability to communicate as they move into slower brain waves that take them into a deeper mindspace.  It speaks to the importance of a woman’s support people attuning themselves to her needs and cues instead of relying on her to give directions on the kind of help she needs.  

These few sentences about Jesus’ birth provide us with so much helpful information as mothers.  Eat and drink during labor, know that you are not alone in your struggle, listen to your intuition, find a birth space that makes you feel safe and protected, and surround yourself with people who understand your needs.  And if you are a person of faith, thank God for the wisdom imparted through His scriptures.  

Birth and Parenting...

...And the Ability to Make a Recovery

One of the things I stress in Birthing from Within classes is how childbirth preparation is also parenting preparation. 

- Want to learn how to cope with labor pain?  Those skills will come in handy for coping with fussy babies and trying toddlers.  

- Want to foster flexibility to ride the waves of whatever twists and turns your birth may bring?  That will come in handy when your ideas about breastfeeding, baby sleep, cloth diapers, etc. are challenged while traversing uncharted territory with your newborn.  

- Working on bringing a spirit of compassion and self-acceptance to yourself and your partner as you do whatever it takes to get your baby out?  Oh boy, are you gonna need that one for parenting!

Another thing I stress in childbirth classes is this importance of making a recovery when you get off track.  That could mean finding your way back to a place of focus after getting overwhelmed by an intense contraction, or returning to a place of finding connection with your partner and your baby during the disappointment of an unplanned cesarean birth.  

Yesterday my four year old son had an hour long knock down, drag out tantrum.  I'll spare you the details, but suffice it to say that it all started over not knowing what he wanted for lunch.  O.o  I tried to be as patient as I could, but after a while I found myself not being my best self as a mother.  

Later on when the dust had settled and his tummy was full, my son and I reconnected with kisses and cuddles and he said to me, "Can you kiss me until morning?"  I realized in that moment that together we had practiced what I always preach...we had made a recovery.  

It's impossible to be a perfect mom all the time.  Mistakes happen, tempers flare, but it's never hopeless.  There's always an opportunity to come together, to get back on your feet, to find one small way of showing up for yourself, for a loved one, or for your relationship.  Occasional mistakes are inevitable.  Recoveries are always possible. 

A Map for Birth

What if someone could give you a map...an emotional guide...to birth?  What if someone could normalize feeling scared, elated, so bleeping over it, plugged in with their partner, overwhelmed, and strong BEFORE the birth so that parents knew they were on the right track when they passed through these gates during birth?  What if parents could even, for a few moments, go into the slower brain waves and altered state that will be waiting for them at the threshold of active labor?

The labyrinth is a tool we use in class to give a more realistic map of the labor process than perfectly round cervical diagrams increasing from 1-10 centimeters or a graph of how quickly labor should progress.  No one gives a damn about a graph in the middle of labor.  What they do care about is that they feel scared right now, and not sure that they can take this much longer.  Wouldn’t it be wonderful to find out ahead of time that those feelings were a sign of progress instead of a sign that you’re not handling labor well?  How freeing would it be to have permission to feel the way you need to feel, and to move, grunt, throw up, cry, dance, moan, tense up, let go, and do whatever it takes to get your baby out?

Self Knowledge is as Important as Practical Knowledge for Birth

What is just as important as gaining information about birth?  Gaining awareness.  Does that sound like some hippy stuff?  Well, guess what?  Most of the practical information moms pick up before birth will fly right out of their heads during labor, and with good cause.  During birth mothers make a shift from the thinking part of their brains into the instinctive, creative, non-verbal part where they have a diminished sense of pain and of time.  Have you ever wondered how a mother can have a 48 hour unmedicated birth?  That’s how.  So wouldn’t it make sense to nurture the intuitive brain during pregnancy at least as much as the processing part of the brain?  Practicing mindfulness techniques, doing birth art, increasing awareness of your own patterns and beliefs, and engaging in experiential learning will serve you in those foggy, faraway moments of birth when you can’t pull facts and data out of your brain because it’s too busy maintaining an altered state that will help you cope through the process.  

Fear and Childbirth

Is fear making you freeze, or are you using it as a learning opportunity for birth?

What a Doula Doesn't Do

There is a lot of talk about what doulas can do to help families, backed up by anecdotal accounts of how helpful doulas were to birthing parents and even statistics showing better birth outcomes for moms who had a doula.  But can we talk for a minute about what doulas don’t do?

Doulas don’t save you from a care provider who isn’t a good fit.  On message boards and in moms’ groups when I hear a mom talking about her feeling uncomfortable with her care provider’s beliefs and priorities not aligning with hers, oftentimes the next thing I hear is someone chiming in that she should get a doula.  While I certainly won’t argue with someone wanting the support of a doula through her birth experience, that mom’s most important task is getting herself a doctor or midwife who is on the same page as her.  

This could mean having a conversation with your current doctor or midwife to clarify where you’re coming from and making sure everyone is working toward the same goal, or changing care providers altogether.  If you’re worried about having a difficult “break up” conversation with your current doctor or midwife, I have good news.  After you interview and find a care provider who is a good fit for your family, schedule an appointment with them.  They will request your records from your previous care provider, and the most uncomfortable thing you have to do is call the receptionist and cancel the appointment you had set up with your old doctor/midwife.

Your choice of care provider is the biggest decision you can make to affect the course of your birth.  It’s very important to create a birthing environment for yourself where your support people want the things you want.  If you feel like the people in your birth space are your adversaries, it will be much harder to let go and drift off to Labor Land.  It could even make it more difficult for your body to labor effectively if you’re feeling defensive.  

A doula’s scope of practice does not include arguing with care providers or speaking on your behalf.  She should not be the intermediary between you and your doctor/midwife.  What a doula CAN do is remind you of important questions to ask and conversations to have as circumstances arise in your birth, based on the talks you have had prenatally about what is important to you.   She should be there as someone who’s got your back.  Someone who can help you think clearly in a moment clouded by fatigue, pain, and hormones.  Someone who will show up for you physically and emotionally regardless of what happens in your birth.  She is not there as a gatekeeper, body guard, or proxy for your voice.  

So by all means, hire a doula to help you cope through contractions, stay home longer during labor, bring comforting words and touch, help you navigate the unfamiliar terrain of birth, and bring continuous, loving care throughout your labor.  But please, don’t hire her to be your knight in shining armor to defend you against the system.  Take a step in self-care by setting yourself up for success in your relationship with your doctor and hospital, or midwife and birth center.  

Repeat After Me: "I am Enough"

Hey you! Yes, you...the one who replays decisions you made during your birth over and over again. The one who ponders the “what if’s” when you’re alone in bed at night. The one who wants/wishes for a do-over birth so you could do it the “right” way this time… You are enough! The decisions you made, the actions you took were the sum of labor pains, exhaustion, hormones, and a lifetime of events and conditioning around birth that only you know the full extent of. Decisions do not happen in a vacuum. They are influenced by our entire lives, and no other decision can be made in that moment because of every. other. thing. that has happened in your life. You were strong enough then and you are strong enough now. You were brave enough then and you are brave enough now. You were a good enough wife/mother/woman/human, worthy of love and respect, then and now. You don’t need to re-do your birth to prove that you are enough. You need only change the story you are telling yourself, to a truer story...one that comes from a deep knowing women have in their bones as old as time. Repeat after me: “I. Am. Enough.”

Some Facts About Cesarean Birth that You Won't Find in Most Books

1) It IS still a birth, a rite of passage, a life-altering transition. It is the birth of a mother, father, baby, and family, not just a surgical procedure. 

2) Moms who birth by cesarean did not take the easy way out. It takes incredible courage, selflessness, and love for your baby to allow someone to cut through your body for your child to be born.
3) It is ok to feel sad about your cesarean birth and to grieve the birth you didn’t have. Please don’t ever tell a mom “at least you had a healthy baby!” Of course she is grateful for her healthy baby. She may also be disappointed about the experience that she planned for, worked for, strived for, that did not come to fruition.
4) It is possible to retrieve moments of connection, humanity, and transformation during a cesarean birth.
5) ICAN (International Cesarean Awareness Network) consists of many local support groups who are there to listen to helps families who have experienced a cesarean birth.

A More Realistic Term Than "Due Date"

Did you know that only 4% of women give birth on their due date? In fact, the average gestation for a first time mom to birth her baby is 41 weeks and 3 days. Thinking about a "due date" makes me think of library books. Library books are due on a definite day, and if you go past that date and are still holding onto those books you're in trouble! Fines start to accrue as soon as you pass that date, and if you wait too long to release those books you'll lose your library privileges. Semantics matter, my friends. A mom's uterus, placenta, umbilical cord, fluid, and baby don't expire on her due date. The normal range for a full-term birth is anywhere from 37-42 weeks. 'Tis but a guess...which is why I use the term "guess date." Doesn't that feel different when you say it? GUESS DATE. Did you feel the parameters opening up for when your baby "should" arrive? The 37-42 week range also makes "due month" a semantically sound term. 4% isn't a very accurate rate. 4+ weeks is.

PSA For People Attending a Birth - The Etiquette of Labor Land

Birth has a very definitive set of etiquette, some of which is quite different than that which you would find in normal social interactions.  Many people wonder what is ok to do and say at a birth, especially if they have not had any formal training as a birth worker.  Here are a few simple tips that could help you keep mom in her labor zone and keep things running smoothly.

- Moms usually like to labor in quiet, dark spaces and do not like to answer questions or process information at births (especially during contractions)...it pulls them out of their primitive brain, which is exactly where they need to be.  If you must speak to mom, keep it short, gentle, and to the point.

- Be willing to change plans.  If mom told you that she would be happy to have the entire extended family in the room during her birth, be prepared (and help the family be prepared) for plans to change.  The mom may need something different while she’s in her primitive brain than she thought she would when she was in her analytical brain.  Wear a thick skin and let it roll off your back.  

- No chit chat unrelated to the task at hand.  If you have something to say that doesn’t pertain to the birth, step outside to have your conversation.  

- It is rarely a good idea to talk about your own birth at someone else’s, unless the mom specifically asks about your birth.  Even then, keep the details about your birth minimal so as not to unwittingly project any fears or expectations onto the parents.  This also goes for sharing information about other births you have attended.  Unless you are convinced that this story is really going to help the mom get through her labor, keep it to yourself.  Honor their sacred space, the fact that their own unique story is being written today, and let today be about the laboring mom.

- Do not offer your opinions about the birth.  It isn’t helpful for mom to hear that it was the longest labor you’ve ever been to, or that you were alarmed by how loud she was during labor.  Some well-intentioned people will go on and on about how great the birth was.  Even this can be damaging.  If mom didn’t think the labor went very well, you could be invalidating her perception of it and unknowingly denying her the space to process her feelings.  A simple, “Congratulations! You did it!” will suffice.  She will almost certainly have some things to say about her own labor.  Let her direct the conversation.

Love yourself and love the parents.  Forgive yourself for past mis-steps.  Do your best, keep it simple, and enjoy witnessing the miracle of birth!

Blindsided After Birth

“Birth is a rite of passage!”  “You will never forget the day you gave birth!”  “Spend as much time preparing for your birth as you did for your wedding!”  We’ve all heard about the importance of birth…choosing the right care provider, class doula, birth space… but what about the moment it’s all over?  How are mothers in our society preparing for the time when the grand event is finished, the confetti is all over the floor, the lights come on, and everyone has gone home?  There is such a buildup to your day, or perhaps days of birth, but not much emphasis is placed on the 6570 days you will spend raising the child thereafter.  

A few days after giving birth, there is a big drop in hormones, which leaves 80% of moms dealing with baby blues.  It’s also the time that most families are sent home from the hospital to care for their baby on their own without the safety net of the hospital staff, and the time when moms are waiting for their milk to transition (or “come in” according to popular terminology.)  Moms may begin to experience nipple soreness from the newness of breastfeeding, and are usually still experiencing pain as they recover from birth, whether vaginal or cesarean.  Meanwhile, family and friends may not register the fact that you have a wound on your uterus the size of a dinner plate from where your placenta detached and that you are leaking fluids from your breasts and vagina.   

So what can be done to cope with all of this physical, emotional, physiological, and social intensity?  

Allies.  Set up allies ahead of time to help you after the birth.  Keep a list of all the minor tasks that need to get done in your day to day life on the refrigerator.  When someone says, “Well, if you need help with anything…” direct them to the list and let them know that any of those things would be incredibly appreciated.  In addition to meals, cleaning, laundry, pets, and dishes, arrange for a shoulder to cry on.  Someone who knows that empathy doesn’t mean saying “at least…”  Someone who can just listen and validate whatever you’re going through with love and compassion.  If you’re going to have a shoulder to cry on, you may as well set up an ally to laugh with as well.  Arrange friends ahead of time who will raise your spirits and brighten your mood.  

Remember, most people want to help you and see the baby after the birth.  Accepting their help is not just a gift to you…it’s a gift to them.  Allowing someone into those dreamy newborn days for a little while is a treat for many people.  Letting them hold the baby while you shower or change a diaper while you grab a snack is a treat for them as well.  

Be sure that your allies understand before the birth that you will probably need to stick to short visits at first so that you and baby have time to rest and get the hang of breastfeeding without an audience, although their flexibility would be greatly appreciated…not just with length of stay, but how often they will visit, what you will need help with, which times work best for you, etc.  When people arrive at your house, answer the door in your bathrobe, even if you have regular clothes on underneath.  Have your partner let guests in and let them come greet you in bed.  This is not a time for you to be the hosts…your allies need to be there to offer physical and emotional help, not receive it.  Having these conversations before the birth can help your allies have realistic expectations when the baby arrives.  

Make time to connect with your partner, even if it’s just for a quick hug when you have a free arm.  You are a team working towards the challenging goal of getting through the days, weeks, and months.  Remember what brought you together to make this baby in the first place.  Be forgiving with yourselves and each other.  Understand that stress, confusion about how to navigate being a new parent (or new parent to 2, 3, 4, etc. kiddos), and lack of sleep don’t bring out our best selves.  Doing your best and bringing a healthy dose of forgiveness and compassion to everyone involved is the best medicine for the postpartum journey.  

Prepare with the practical knowledge that you’re able to.  A breastfeeding class is a great idea if you’re planning on nursing.  (An IBCLC and your local La Leche League chapter are great allies to set up during pregnancy!)  Educating yourself about car seat safety is also super important.  (80% of kids are not fastened in safely.)  Don’t let your shopping around for the best team stop at birth…shop around for the people with baby care know-how as well.  

Of course, not every moment of the postpartum period can be buffered by allies.  There are ways you can show up for yourself too.  Mothers learn breathing techniques, relaxation practices, and comfort measures to cope with the intensity of birth.  Guess what?  These resources are still useful during postpartum!  You can use the things you have learned during your childbirth class and birth experience to help you cope with difficult moments during postpartum.  If you find yourself pacing with a crying baby in the middle of the night, help yourself to calm down while you help the baby do the same.  Focus on your breath, notice the parts of your body that are holding tension and release anywhere you can, count to ten, move through your struggle one moment at a time, just as you would move through one contraction at a time.