Happy World Doula Week!

WDW

I can’t let this week go by without a shout-out to all of the wonderful women I know personally, and professionally, who’ve taken up the call to become a doula. A doula is a woman trained to assist other women in childbirth and/or to support a new family following the birth of their baby. And this is the week we are celebrating women all over the globe who do this incredible work!

Over 20 years ago, I was working as a temporary office monkey between jobs and wondering what it was that I wanted to do with the rest of my life. Across my desk one day came the company’s monthly newsletter and on the front page was an article about “doulas.” I’d never heard of this word before, and the concept intrigued me.

A few days later as I drove home during my lunch hour, there was a story about doulas on NPR’s show, “Talk of The Nation.” I had a “driveway moment” and couldn’t get out of the car until the story was over. My curiosity was growing. 

But it wasn’t until my best friend announced her pregnancy and asked me to be at the birth that I got serious about this idea: “Maybe I should become a doula!” I’m not an overly woo-woo person, but all of these things seemed to be pointing me in the direction of birth.

After some searching, I found out that The Seattle Midwifery School (300 miles North of my home in Portland) was offering a doula training that would conclude before my friend’s due date. Everything seemed to be lining up – so I signed up. I was hooked on birth immediately, and the rest, as they say, is history.

I never went so far as to complete the work of being certified as a doula. Finding scheduled evening and weekend hours as a Childbirth Educator kept me in the world of birth and allowed me to focus on having my own family. But every now and again, I’ve had the honor of being a doula at the births of friends, neighbors, or women who had no support or financial ability to pay for a doula.

It is such a gift to be with a woman when she’s giving birth. Helping her find her inner strength and witnessing the parents and the baby lock eyes on one another for the first time – it’s one of the most awesome experiences ever (that word is so overused in our culture, but this is one area where it’s completely appropriate)!

So,thank you to all of the women who’ve answered the call to become doulas. You are very special women, indeed. You have an immense capacity for nurturance, calm, strength and advocacy. You’ve got incredible stores of flexibility, skills and knowledge and you’re somehow able to continue to do the hard work of labor support on little sleep and not a lot of food. You are the best example of how continuous physical and emotional support can make all the difference as this couple transforms into a family.

I have nothing but the utmost respect and praise for the work that doulas do in the world of birth. But don’t just take my word for it. Google “benefits of doulas” and you’ll get 359K hits in about a half of a second. There aren’t any studies that I know of that show anything other than positive results of having a doula with you in birth. If you’d like to read more about the benefits of doulas, read this article written by Rebecca Dekker on Evidence Based Birth.

Having a doula at your birth can be linked to:

  •  Reducing the incidence of c-sections      
  •  Shortening the length of labor      
  •  Reducing epidural and analgesic requests      
  •  Increasing breastfeeding initiation and continuation     
  •  Increasing mother’s satisfaction of birth experience      
  •  Reducing the incidence of postpartum mood disorders     
  •  Increasing new parents’ confidence in the care of their newborn

There’s really no downside to having a doula with you in birth or postpartum! A doula is worth her weight in gold. If you’re interested in finding a doula for your birth or for postpartum, one place you can look is the DONA International website. Other places to look would be your friends and co-workers. A lot has changed in 20 years! Many more women are using doulas in their birth and postpartum and personal recommendations can give you so much more than a website directory! Many CBEs also have referrals they can provide, if you ask.

My tips for hiring a doula: Don’t get stuck on how many births they’ve attended, or what “extras” they might provide (photography, massage, etc.) These might be wonderful additions, but I think it’s more important you feel you can hang out with this person for 24+ hours. A professional doula won’t have an agenda for what your birth “should” look like. She’ll be willing to support you, and your choices in birth. Make sure your doula and your partner can work together. If you’ve chosen well, your doula will help your partner feel like they had just the right support so they could be involved in the birth at the level they were most comfortable with.

Doulas can be an amazing support when a birth goes really well, but even more so they when a birth goes rogue. Your doula can help you remember what matters most to you in this birth experience and help you get as close to that as possible. On the other side of giving birth, you’ll share a bond with this woman forever and she’ll be an important part of the birth story you’ll remember for the rest of your life.

Doulas are amazing women and I’m happy to publicly honor them in this way! A special shout-out to Liesl & Kathie (doulas) and Beth & Marilyn (midwives) for all of the doula-ing they provided me and my husband during the birth of our four children. I mean this honestly when I say it – we couldn’t have done it without them!

If you know a doula, please take time to honor them in some special way this week!

Making Predictions During Birth – About as Magic as the 8 Ball!

Magic 8 Ball

Did you ever have a Magic 8 Ball? I did. I loved that thing. I loved being able to ask a question, any question, and have the almighty oracle predict my fate. Inside the little window floated a single die, with twenty possible answers to life’s biggest questions. Some of which included: “Signs point to yes” and “My sources say no.” When the Magic 8 Ball was certain, yes or no, then that was it. But sometimes there would be the confounding response of “Cannot predict now.” That always meant another hard shake of the ball and the search for a more straight forward answer. No matter how many times it took to get one!

I think too many of us are looking for straight forward answers to one of the biggest questions of all time. We want so badly to be able to predict what is by it’s very nature unpredictable – birth.

Today, I want to speak directly to those of us who work with pregnant and birthing couples.

Could you stop setting them up? Stop making predictions? Please, I’m begging you!

I recently had a reunion with some of my families. More than once I heard the report that someone on their birth team tried to make a prediction during their birth experience. I groaned and asked, “Why do they do that?”

One new Momma said, “so then, the nurse said to me “You’re really cooking! I bet we’ll have a baby before lunch!”

A second Momma said “the doctor came in and told me to get ready for a really long night, because he didn’t think I was going to have the baby until the next afternoon!”

Guess what really happened with these two women?

The first Momma’s labor came to a complete standstill about thirty minutes after her nurse had predicted a late morning baby. She started watching the clock and when the lunch hour came and went unceremoniously, no baby to be found even considering entering her birth canal, she became despondent and discouraged. She started to freak out that something was wrong with her body – with her baby. Given the strong connection between the mind and the body of a birthing woman, it’s no wonder all of this extra anxiety shut her body down for hours! It took an incredibly long time (and a new nurse at shift change!) before this woman’s labor started moving again. She ended up giving birth close to midnight – twelve hours longer than had been “predicted.”

The second Momma and her partner settled in for their “really long night.” But soon after she started second guessing her ability to handle the contractions that felt like they were right on top of one another. Instead of recognizing that her labor had kicked in big time and she was almost fully dilated, she thought that she was “just wimping out.” She was feeling very disappointed in herself and her ability to cope with what she’d been told by her provider was supposed to be early labor. Imagine the surprise when her husband had to run out of the room to grab someone to come catch the baby! It had only been about ninety minutes since she was last checked. So much for their marathon labor!

Birth is unpredictable. It can slow down, and appear as though it’s stopped altogether. It can speed up in the blink of an eye. The issue is not the unpredictable nature of birth, it’s our intense desire to make it predictable that’s the problem! There are way too many unique variables in every labor experience to make it impossible to predict consistently what will actually occur.

But we all still do it! Why?

Pregnant Mommas and their partners hear the due date and create an expectation that this is the day the baby will arrive, instead of recognizing their due month as closer to the reality of when the baby will actually be born.

As a Childbirth Educator, I’m guilty of it as well. I teach, as most do, textbook averages for birth. But do I explain that as a first time Momma, it’s completely within the range of normal to have a birth go super fast? Do I adequately prepare them for an ultra marathon labor experience? We all need to be more on top of this, so our students understand it is possible to have active labor begin almost immediately! And it’s also possible to be in early labor for three days before any changes in their cervix occur. As Childbirth Educators we need to provide our students with realistic expectations of the unpredictable nature of the birth process itself.

But once they’re at the hospital, too many nurses and providers think they’re doing a service for these women when they try to predict what will happen next. I know that this is not born of ignorance. These are professionals who have been at this job for a long time – decades in some cases – and they’ve seen an awful lot. The laboring woman in front of them is presenting as many have before her. The mind just wants to go there. “Here’s a pattern that I’ve seen before. So I’m going to predict what will happen next.” And in a lot of other areas of life, this might not be a bad policy. But not when we’re talking about birth.

This unpredictability of birth (and our refusal to embrace it) is what trips all of us up when it doesn’t have to. In fact, I would argue that we’re missing out on the most important aspect of birth while we’re busy trying to predict what will happen next.

As expectant couples, you go into birth with a rock solid Birth Plan that you wrote a month before your first contraction. But due to circumstances you could never have predicted, your birth has gone rogue. If you’re still clinging to the plan of your ideal birth (as opposed to participating in your real birth) you’re setting yourself up for disappointment instead of moving through your birth as it unfolds. When you’re able to adopt this attitude of flexibility, you’ll be surprised at what you’re really capable of! “Wow, this is not at all what I expected, but look at us and how we’re handling this completely unpredictable experience together!” It matters how you respond to your birth in real time, as it really happens. Not based on what you had predicted (hoped, wished, or expected) would happen.

As Childbirth Educators and Doulas, we are hurting ourselves and our couples when we try to make predictions about how we think our couples will move through their births. Let’s not prejudge how the people we work with will cope with their labors. Let’s give them all the benefit of the doubt in that they will have births that are, by nature, unpredictable. Let’s try our best to prepare them better for that reality.

As for the L&D nurses and providers who encounter these women in labor and try to make predictions about what will happen next, please understand how much that undermines a woman’s confidence in her ability to know her own body. For the woman before you, it doesn’t matter one little bit how many times you may have witnessed what she’s currently experiencing. She doesn’t need predictions from you about how much shorter or longer her birth might be. She just needs your support and your listening ear – right now. Even the least experienced laboring woman will be able to provide you with clues about what is actually happening in her body. And this is so much more valuable than what you think might be happening in her body.

I completely understand why we do this whole thing of planning and discussing averages and making predictions – all of us are wanting to avoid vulnerability. But vulnerability and birth are inseparable. They have to be. Birth without vulnerability lacks the key ingredient that’s necessary for deep and lasting transformation to occur.

All of us who work in this field should be experiencing that transformation on a regular basis. That’s why most of us got into this whole thing in the first place – the beauty, the mystery, the surprise, the unpredictable nature of birth stirs something in our soul. After each encounter, we should leave that new family feeling grateful we were once again able to witness their transformation – and be transformed ourselves at the same time. This is how we can continue to best serve our families, when we recognize the sacredness of our own work with them and strive to preserve that sacredness for our families no matter how unpredictable their birth ends up being.

There is magic in birth – it’s just not of the 8 Ball variety.

Experienced parents: Did you try and make predictions about your pregnancy, birth or parenting? Did any of them come true? Did anyone on your birth team try to make a prediction about your birth? How did his make you feel?

Giving birth was a view changer for me!

View

My personal view of giving birth when I was pregnant with my first baby was different from a lot of the pregnant women I knew. I think this was probably because I taught Childbirth Education classes for almost 2 years before I ever had any babies of my own.

I know what you’re thinking, “I’ll bet your credibility rating went way up after you started pushing babies out yourself!” And it did. I came into this field of Childbirth Education in kind of a backward way. Teaching Childbirth Education was never on my radar. I would never have imagined doing what I do. So how’d it happen? Well, my best friend was having a baby.

Liesl & Andy were our first friends to make this huge transition of becoming a family, and he asked me to be there for her birth. Not one to ever do anything half-way, I found out what a doula was and took a 4-day training at the Seattle Midwifery School. I wasn’t just going to be at her birth, I was going to be her doula. By the end of that first afternoon, I called my husband and announced, “I’ve found what I’m going to do with my life!”  That’s a pretty strong statement, but it was completely true. I came home full of ideas about how I was going to rock this birth and be the best damn doula anyone had ever seen!

I’m not going to lie to you – I was not the world’s best doula at that birth. I kept my calm, and I think Liesl was happy to have me there. I’d like to think I provided her with some help, but in retrospect, there were lots of missed opportunities from a doula’s point of view. It was a successful and beautiful birth – but there were some bumps along the way.

During those 24+ hours together, I fell in love with birth. I fell in love with Liesl – her power and strength amazing to witness as she labored for hours to open her body and bring a brand new human into being. I fell in love with Andy – feeling helpless and wanting so badly to do anything to make her feel better in the midst of the contractions. I fell in love with Olivia – the squirming, squawking little newborn who looked like she held the key to all the secrets of the universe. And I fell in love with the feeling of witnessing not just the birth of a new baby, but the birth of a new family. There was a high in that room after Olivia was born, a sense of having witnessed something sacred that I could not get enough of!

I couldn’t figure out how I could make this my life’s work, though. The hours were rough and I wanted a family of my own someday. Plus, I couldn’t actually charge someone after they’d allow me to witness their baby’s birth and I got to feel that high again. It just didn’t seem fair. So, I became a Childbirth Educator. I could still work with expectant couples and do a few freebie births on the side.

I had no fear of giving birth when it was my turn. I’d witnessed it first-hand several times, and while it was definitely hard work and probably painful, I still believed birth to be a normal, healthy process. My body was designed to do it and do it well.

I was happy that I didn’t fear birth. But after I gave birth to my daughter, Elisa, my view of what birth could be changed dramatically.

Now I’d love to tell you that I’ve always been a completely unbiased Childbirth Educator. That I’ve never had any notions about the best way to give birth. But that would be a complete lie. I will tell you that I was able to not bring any bias into my teaching, but I still had some pretty strong ideas about the “right” way to give birth for me: no medications, no interventions, grunt my baby out and head home two days later.

The birth I actually had, helped me realize something very important. There is no “best,” “right,” or “perfect” way to give birth. In the hours that you’ll be laboring hard to bring your baby into this world, the only way to give birth is your way. And on that particular day, with that particular set of circumstances, with that particular baby, and that particular birth team – the way to bring your baby into this world might involve: medications, interventions, even surgery.

If we enter into this experience of birth with a rigid idea of what it should look, sound and feel like in order for it to be the “best,” “right,” or “perfect” we can sometimes block our own view of all that it could be. We can shrink our own view of birth to include only the desired elements in sharp focus and leave all other possibilities blurred along the edges. When these other possibilities become our reality, we declare this birth to be less than – less than “best,” “right,” or “perfect.” But this doesn’t mean that the birth we actually had has to be any less sacred, less beautiful, or less empowering. Even if, maybe especially if, it doesn’t line up with our personal view of birth before we’ve ever gone through it ourselves.

If we can expand our own view of birth, not only of what we want, but what might become necessary, we can move into this experience with a richer sense of possibility and witness all the gifts that are available to us. It’s this shift in our own view of birth that can allow us to receive the full measure of what birth really is: messy, wild, intense, spontaneous, intimate, powerful, vulnerable, full of awe and wonder.

Shifting my own view of birth not only made me appreciate the birth I actually had for all that it contained – which was so much more than I could ever comprehended before I was in the middle of it – but it made me a much better Childbirth Educator. I can honestly say that my own birth experience allowed me to drop any and all bias about what a great and positive birth could look like for any individual woman. I had a birth that didn’t look anything like my “ideal.” Yet it was still sacred, empowering, and positive.

How did your own view of birth change after your first experience?