BREAKING NEWS!!!

“Partner’s Touch Reduces Pain For Laboring Woman”

receiving-hands-1920865_1920In a recent study published in Nature, it was discovered that a partner’s touch resulted in something the researchers termed, “physiological coupling.” The same study also found that empathetic touch from the partner contributed to an analgesic effect via the woman’s autonomic nervous system.

In other words, when a partner held the hand of the woman they cared for and a pain stimulus was activated, the couple would begin to synchronize their breathing and heart rate patterns, otherwise known as physiological coupling. In addition, the woman would report that her pain lessened while holding hands with her partner. If they were sitting next to one another, but not holding hands, her pain level would not be affected.

Obviously, this has implications for the families I teach, which is why I joke about this study being big news and something I didn’t already know about. But it’s important to share this news far and wide, because even though I’ve been preaching it for close to 20 years – “Everything you do for your partner while she’s in labor makes a difference! Even if all you do is hold her hand!” – partners still don’t seem to believe it!

Labor is not just something that a birthing woman experiences. Her partner experiences labor too, just in a very different way. For far too long, we’ve either diminished or ignored the partner’s experience of labor – to everyone’s detriment.

I’ve mentioned many times before that I have a soft spot in my heart for the partner’s experience. I realize that it makes sense to pay close attention to how a woman experiences and moves through her pregnancy, labor and birth. But if we’re not paying equal attention to her partner’s experience, we’re not setting this new family up for success. In fact, we might be doing the exact opposite.

I spend a lot of time discussing the second stage of labor (pushing and delivery of the baby) using my uterus and baby doll props to share what to expect and what it will look like from the partner’s perspective. At this point, the nurses and provider have their attention focused on the laboring woman and baby – with good reason. They need to be aware of any changes in the heart rate as the baby moves through the birth canal, and they need to remain alert as the baby’s shoulders make their way through the woman’s pelvis.

But not enough attention is being paid to what the partner experiences during this critical time. Partners need to know what a newborn baby really looks like and what the process entails so that the moment their baby enters the world it’s a moment full of joy for the whole family! When we forget about the partner’s experience, and they have no idea what to expect, that moment can result in a partner frozen with fear and in a state of shock at what they’re seeing and what’s happening – and this can negatively impact their transition as a new parent in a significant way.

Likewise, if partners don’t realize the importance their words, actions and touch can have on the laboring woman’s experience, many partners will freeze up and feel helpless as they witness the power and intensity of labor and birth. They may end up feeling as if their efforts and suggestions for comfort measures are without any effect. But this couldn’t be farther from the truth!

Sometimes I use a marathon analogy to discuss how important the efforts of the partner can be in helping a woman through labor and birth.

Imagine you’re running your first marathon. You’ve heard from friends and family how challenging it can be, but you’ve also heard about all of the “extras” along the race route that will help you make it across the finish line: the excitement and camaraderie of other runners, the music blaring at checkpoints, the mileage post signs marking your progress, the water stations providing hydration, snacking on energy-packed gummies, reading signs of encouragement from strangers, and awaiting you at the finish line, cheering crowds and some of the best peanut butter sandwiches and chocolate milk you’ve ever tasted! Now, these “extras” might not seem very important – until we take them all away.

What if I painted a very different picture of your marathon experience?

You’re told to stand at the starting line alone and when the gun goes off, run for 26.2 miles toward the finish line with nothing to help you along the way – no water stations, no music, no snacks, no encouraging crowds, no one waiting for you at the finish line… nothing.

The difference between the first scenario and the second is stark. Without all of those “extras” even the experienced marathon veteran would have a hard time completing the race. Let alone, crossing the finish line with even a hint of a smile.

So it is that every little thing a partner does to make the laboring woman more comfortable matters, and it matters immensely. Every sip of water offered, every new position suggested, every word of encouragement, every reminder to breathe, every single touch, provides comfort to the laboring woman. And partners need to know this and believe in the power that their undivided attention and connection can bring to the laboring woman.

I’m reminded of this when I think back to being in labor with my first, some seventeen+ years ago…

I had two doulas – one for me, and one for my husband! I came prepared with a full team of support for this birth. They all worked so hard to support me in what ended up being a long labor that began, as most labors do, in the wee hours of the morning. I wasn’t the only one exhausted some 20 hours into the experience – my husband had been awake and working hard just as long as I’d been. And he was getting tired.

I remember hearing my two doulas talking in a stage whisper with my husband: “Go ahead and lie down. Try to get a quick nap in now before the really intense labor begins. We’re both here – we can take care of her.”

A statement that was completely true! One of my doulas was an L&D nurse (soon-to-be-midwife) and the other was my best friend who knew my husband and me almost as well as we knew ourselves! They were more than capable of helping me through contractions, which up to this point I’d been handling really well.

Upon their urging, my husband walked about three feet away and lay down on the daybed in the labor and delivery room. And then strangest thing happened – I completely lost my rhythm and my ability to breathe through contractions! It was as though I’d lost my way, somehow. The next handful of contractions felt incredibly painful to me. So much so, that I cried out in anguish which woke my husband up and he hurried to my side and held my hand once more. And then, just as quickly, I found my rhythm, my breathing returned, and I was able to continue and handle my contractions, until I gave birth several hours later.

I know from talking with my husband and other partners about their own experiences how challenging it is to watch the person you love go through labor and birth. It pulls strongly on the heartstrings and can leave partners feeling incredibly helpless to do anything that will be effective in increasing their partner’s comfort level.

But here’s why I think the findings from this latest study are so important: it’s the feeling of shared empathy between the laboring woman and her partner that causes the physiological coupling and analgesic effect that help a woman when she’s experiencing pain.

That’s why I’ve always told the partners in my classes that even if they hired an army of the world’s greatest labor doulas, if the partner provides the laboring woman with their unwavering, focused and empathetic attention during the labor, she will tell everyone that she could not have made it through without her partner – even if all they did was hold her hand!

I love it when someone else does the research and publishes findings that support what I’ve been teaching my families for the past twenty years!

Because, let’s face it… Some partners in my classes may think that I’m just trying to make them feel better or elevate their role in the birth experience. (Which is exactly what I’m trying to do, by the way!)

But I’ve also known forever that empathetic touch – combined with all of the other wonderful comfort measures partners learn in our time together – really can help a laboring woman when she needs it the most.

And now, I have the science to prove it.

Can you relate to this post as a laboring woman? Did your partner’s touch (among other things) actually make labor and birth easier for you? What about partners – have you felt helpless in labor? Does this information about how your words, actions and touch really helped her through labor and birth make you feel any better? Let me know your thoughts. I love hearing from you!

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EnCouragement

Encourage

Interview with Jennifer Fisher of EnCourage Doula Care

(NOTE: While I hope that this post will provide information and be a positive resource for women and families, it’s important to note that the subject matter of this post involves pregnancy loss and bereavement.)

B: Jen, I’m so glad that you agreed to an interview for Birth Happens. There are lots of things that we could discuss, but I wanted to interview you about your latest venture into the world of Maternal Health as a Bereavement Doula. This idea might be something that’s new to my readers, and an important offering that people might not even know exists.

First, tell us a little bit about yourself and your family. When, how and why did you begin working in this field?

J: When I introduce myself, I say that I’m working in this field because of my family. My career started when I became a mom, with a great birth. I began volunteering with Nursing Mother’s Counsel when my oldest daughter was 6 months old. She’s now an ambitious freshman in high school!

Motherhood allowed me the time to volunteer additionally with Birthright of Vancouver, Washington where I listen to women while they take a pregnancy test or come in seeking resources. I always qualify my work at Birthright, while listed as a pro-life organization, as simply pregnancy support. I have no more ability to make a mom keep her pregnancy than I have to fly to the moon. I support moms wherever they’re at. The nurturing that I learned there, encouraged me to reach further in my career to become a certified childbirth educator over a dozen years ago, and now more recently, to become certified as a doula.

Baby number two came along two and half years after big sister. She taught me patience and that pregnancy and birth goes the way it wants. That birth also showed me how women working and supporting women during labor can be life altering! I had a doula, I had a nurse who believed in my goals, and I had a partner who was willing to watch me dig deeper and fight harder for this unmedicated birth. That support broadened my expectations of what we can do for each other.

Our miscarriage occurred less than two years later and I knew at the time, while we wanted and loved this little angel, his or her birth was there to teach me compassion for other women. It was then that I learned birth is not all rainbows and unicorns. While I knew this from a Childbirth Educator’s standpoint, it was in experiencing it myself that I really understood. Our baby’s name is “Eliti” which means “gift of the sun,” and I’m so clear in my work that this baby was a gift to us.

My sweetie and I were brave a few years later and got pregnant again. And this is where support from other women who had walked similar paths carried me through the pregnancy. I distinctly remember a conversation with my good friend Mary, who had experienced numerous miscarriages, when I asked, “When will I feel safe?” And she answered, “Maybe not until you hold that baby in your arms.” Our shared stories helped build up my courage.

My last kiddo was born at home as the sun came up, his 7 year old sister there to welcome him, and his almost 4 year old sister dragging her blanket into our room wondering what all the cheering was about. My family story is so intertwined with my career, it’s hard to tell where one starts and the other ends.

B: When did you start considering doing something “extra” in this field, in addition to your work as a Childbirth Educator?

J: Expanding my career to midwifery came while pruning the heather in my backyard! Heather is one of the flowers that struck me while I was on my pilgrimage in Spain, the Camino de Santiago, and I had planted some to commemorate that experience.

I realized in Spain that my career was intended to be about the babies. While pruning the heather in my backyard, the realization was it’s about the babies… and their mommas. So midwifery became the plan. Last year, I had to let that dream go as balancing school, tending to 3 acres, and my work as an educator did not equate to me functioning at my best, for everyone involved.

B: So, how did you make the move from midwifery to what you’re doing now?

J: Well, at the same time, a beloved friend endured a pregnancy with a fatal diagnosis. It was heartbreaking. I just kept racking my brain with the question, “Who is supporting her through this?!” She had a loving partner and family, but they were in the midst of dealing with their own grief. Who was supporting her?! That marked my transition to becoming a bereavement doula.

B: Why does this work matter to you personally?

J: I have always said that if I was not in the “beginning of life work” that I would be in the “end of life work.” Both have incredibly spiritual, profound moments that our culture as a whole does not recognize. I’m now able to do the work of witnessing both – and support the family whose world has been transformed by pregnancy and death.

B: How do you think your work as a bereavement doula will impact women and families?

J: When women and families acknowledge life and death, they can integrate these experiences and begin to process the emotions around them. For some, this may be more simple than others. I’m not here to judge women and families on how they do it. I’m here if they want support doing it. Yes, family and friends will be there, but even than that does not constitute best care practices. Maya Angelou says, “When you know better, do better.” By being trained to be a doula for both birth and death, I can assist families moving through their mourning and grief. Inevitably, when we are grieving, we seem to turn on those who are closest to us. With concerted support from a professional that sits outside the circle of family and friends, maybe the blow to ourselves and our loved ones can be lessened.

The other aspect of this work is integrating subsequent pregnancies and births. When we’re mourning, and we begin to assimilate the experience and move on from the loss, that has its own set of emotions. If, and when, we get pregnant after experiencing a loss, guilt can flood in and override our emotions. As a doula, being at the next baby’s birth, even with an expected positive outcome, is as important as the prior birth. This family may have a spectrum of emotions that need to be understood and they need to be reassured that what they’re feeling is normal. Experiencing happiness is okay – it doesn’t mean we love any less.

B: How do you envision working with families in this way? What does the model of care for EnCourage Doula Care look like?

J: EnCourage Doula Care was developed this year to offer birth and bereavement doula care in the Portland/Vancouver area. I’m happy to attend births wherever this family is ready to meet – home, hospital or birth center. It’s such a privilege to witness the birth of a baby and, a new family. My philosophy is, whoever can love this baby is the perfect parent. I’m happy to support any birth and family combination.

As typical for a doula, I would like to meet first, have a conversation about birthing ideals, then attend the birth and follow up with a postpartum visit. However, in loss, especially when it is sudden, attending birth to provide emotional and physical support is my first priority. Then we would meet postpartum as well.

EnCourage Doula Care is a community resource. I see working with families, maternal fetal medicine clinics and family birth centers as my primary focus. I envision my role as a bereavement doula as backup for the nurse who may have many additional jobs that need to get done when a family is experiencing loss – and I can be there to provide the emotional and physical support to help this family as they try to make sense of what has happened.

B: What are the next steps for EnCourage Doula Care?

J: The next phase is grant writing, so I can be paid for on-call bereavement care. I’d like to try and roll this out at a local family birth center so women who are having unexpected loss have bereavement doula support as an option. Lastly, I want to design a study to look at the impact bereavement doula support can have on the birthing family. Can we lower stress? Can we integrate care to lessen the negative postpartum impact such an experience can have on a family? Can we increase options of support for this mom and family so the processing of their birth and loss are complete?

B: What do you know for sure about the work you’re doing as a bereavement doula?

J: What I know for sure about this work is that I have no inhibitions about it. When midwifery was the end goal, I spent quality time stressed out about how I would manage school/work/kids/family. Now with this doula work, I feel completely at ease, that all needs will be met and that this is the path I was meant to be on. When we discussed it as a family, my husband and kids were so supportive that this work needs to be done, and thankfully – they believe I have the courage to do it.

B: Jen, thank you so much for taking the time to provide my readers with this information. I really believe in this work and in you! I also think this is the path that you’re meant to be walking and I’m thrilled to be able to refer my families who have experienced loss to you so they can better process and integrate this experience into their lives.

How can readers get in touch? Where can they find you?

J: I’m happy to answer any questions or meet to discuss care options. Please call, text or email me at Jennifer@encouragedoulacare.com 360-241-0277. You can look me up at www.encouragedoulacare.com or find me on Facebook at EnCourage Doula Care where I share all sorts of birthy things!

Being Present

Being Present

Or, “The True Gift of Labor Support”

I got called out of retirement and had the privilege and honor of being the doula at the birth of Baby M born just over two months ago.

I’ve been asked by many couples over the years if I would consider being their birth doula. It’s always a bittersweet moment for me, as I love being a witness to birth almost more than anything else in the world. But with four kiddos, two part-time jobs, a relationship with my hubs that I like to see flourish, and this writing gig of mine – I have ZERO time to attend births.

So, when M & A asked me if I would be their doula at the end of the first night of our 4-week series, I told them what I usually tell all of my students making this request: “Oh, that’s so sweet – but I’m not really doing births. My life is just a little bit too full to consider this a realistic option right now…”

They were a little bit disappointed – but said they understood and they’d see me next week. I promised I’d send them an email that included thoughts on hiring a doula, what to look for, what questions to ask, and a few referrals for local doulas that I thought were really great.

The next week, I asked if they’d decided on a doula yet.

“Ummmm, no. We only want you.” This flattered me, but I knew when their due date was and not only would I be teaching a ton of classes around that time, I was also scheduled to leave town to go to my niece’s wedding. There really was no way.

“I really wish I could be your doula – but it’s just not going to work out. I think you should contact some of the people that I’ve referred you to and we can chat more about this next week.”

I’m guessing you’ve figured out what happened next.

Every week they’d come back and say that they hadn’t talked with any of the referrals and finally they decided that if I couldn’t be their doula, they’d be just fine on their own.

Now, I think couples can do really well on their own, but it’s hard to deny what the evidence shows about having the continuous presence of a doula during labor and delivery – statistically better outcomes for both Mommas and babies!

On the last evening of class, M & A gave me a book and a thank you card which read, in part: “We would be remiss not to formally ask you to consider if you would attend our birth. We completely understand your busy teaching schedule and travel plans and if it relieves any hesitance or pressure, we wouldn’t plan to rely on your presence. In our minds, the structure would be that if it worked out such that you were free and available, we’d love it if you would join.”

I mean, really, how could I say no to that?

This was a couple that I believed would be just fine if I wasn’t able to be there on the big day – I didn’t for a second think they were trying to say the right thing to get me to agree. They were being completely sincere and were speaking my language… I’ve always felt that when labor begins, the people that are supposed to be there to witness the event somehow end up being there. If I was meant to be at their birth, I would be there.

So, we came up with a really interesting split-fee set-up: one amount for the pre-birth “Phone Doula” work that I would provide for them which included: a formal interview about their birth wishes, some assistance creating a template for what really mattered for them in their birth experience, some questions to spark discussion with their provider, and the availability to answer any questions and advise them as they came ever closer to the birth of their baby. And if I ended up being able to be at the birth, there would be an additional fee.

The real gift of labor support is being fully present to an expectant family.

And for me, that began when they hired me. It wasn’t as if I dropped everything I was doing, but we had some regular text check-ins and a few phone calls to see how M & A were doing as the due date drew ever closer. I slept with my phone on and next to my headboard at night (I usually have it turned off, far away from where I sleep and covered up as any “Ping!” noises or even the battery light is enough to keep me awake!)

I kept my phone with me at all times and was checking it much more often than is usual and I’d get back to M & A as quickly as possible after receiving any contact from them.

And on Saturday, April 8th, I began my formal “it could happen at any moment” doula-watch. M called to report that A was having contractions and that “It might happen tonight!” While I appreciated his excitement, after hearing that they were both scarfing down Mexican food at 11 o’clock at night, I encouraged them to get some sleep as I didn’t think that they were going to have a baby anytime soon.

I received word from M in the early morning hours that A had slept soundly through the night – confirming what I thought was happening… Great early labor, but nothing to be getting too worked up about.

Over the next several days, I was in pretty close phone contact with M & A as they navigated what seemed to be prodromal labor. They were handling it so well and really only needed quick check-ins for reassurance that they were on the right path and that everything they were experiencing was normal and good work for what was to come.

On Thursday April 13th, the call finally came: A’s water had broken! I think they were both excited for this very positive sign of labor finally happening, although the contractions hadn’t progressed enough to call it “active labor” yet.

I was excited for them as well – I’ve had prodromal labor myself and I know just how frustrating it can be if it continues past a couple of days – and we were closing in on six days at this point! I was also thrilled they’d gone into labor before I left to go out of town – but, I was scheduled to teach a class that evening and I hadn’t arranged for a sub yet.

It took some finagling on my part (and a small bribe of chocolate and beer) to enlist my friend and colleague Jen to take my class for the evening – but the details weren’t figured out until about 4 pm that afternoon. During the day, M & A made their way into the hospital and I continued playing Phone Doula for them, encouraging them at one point to try some exaggerated marching through the hallways to see if they could get the labor to pick up speed. Apparently, this was a hit with all of the nurses – they loved it!

I finally arrived at the hospital around 6 pm and after saying hello, A had what was, by the reaction, her first real-deal contraction, saying “Whoa! That one was really different!” I laughed and said, “Well, now that your whole birth team is here we can get serious and have ourselves a baby!” And, in fact, about eight hours later that’s exactly what happened!

I won’t give a play-by-play of the entire labor, other than to say that, I fell in love with this couple as I watched them work together to bring their baby into this world!

The act of giving birth, watching partners support the one they love giving birth, and witnessing the birth of a family is sacred work to me. And in this sacred space, time stands still as we are all present to one another, living only in this moment together.

And while it’s nice to know a few things about breathing, and positions and other comfort measures – the real gift of labor support is in being present.

Some people might doubt how having continuous labor support can make such a difference in positive labor outcomes for Mommas and babies – but in our ever-increasingly-barely-ever-present culture, I think it makes more sense now than ever!

As a birthing woman settles into her rhythms and rituals, making claim to the strength she might not have been aware of until this moment, she’s able to ask for whatever she needs – RIGHT NOW – to realize this act of co-creation. She opens herself, both figuratively and literally, to bring forth this new life from within.

And in this moment-by-moment experience, everyone focused and working for one purpose, a miracle occurs: it’s not just a baby that is born, but also a mother, a father and a family. These people are now connected to one another, and they will be, for their whole lives! To witness this in whatever role – doula, nurse, provider, friend or family member – is also a gift that connects all of us in this one moment in time.

I was really exhausted after this beautiful birth! And I couldn’t figure out why at first – I mean, I was only there and working hard from 6 pm until about 2:30 in the morning. In the world of birth, that’s not a lot of time! And then I realized why… It had been awhile since I’d been so focused and present in a continuous way for such a long period of time. And it’s intense to be truly present to the sacred for any period of time.

But oh, what a gift!

I dedicate this post today to M & A and Baby M. I’m so honored to have played a small part in witnessing the birth of the three of you as a new little family! Thank you for your persistence in hiring me, and for giving me the idea of being your “Phone Doula.” I’m so happy to be connected to you in this way.

PS – We’re also connected in one other very important way… Baby M and my son, Alejandro, share the same birthday (only 15 years apart)! I’m pretty sure that this is another sign that I was meant to be fully present at this birth.