Archive for the ‘doula’ Category

Dear Clients,

I am writing this letter to you, my clients, to thank you! Thank you for showing me strength, grace, power and absolute fortitude during the labor and birth of your beautiful daughter. I was honored to witness this fundamental power during your recent birth! It has changed me forever.

I remember when we met to discuss working together at the birth of your baby. You shared your fears, your concerns and your doubts. Tears were shed. As I got to know you, I listened as you expressed your thoughts and self doubts about your own strength. So many things to worry about, so many unknowns.

As you neared the end of your pregnancy, so many deadlines and obstacles arose that required you to prove that you and your baby were doing well. As your due date came and went, you wondered why you were still pregnant, yet you knew that your baby would choose the date of her birth. Balancing doubt and belief became a daily struggle, and you still forged on, waking up each morning, surprised that you were still pregnant. Acceptance and peace settled slowly, and you found your rhythm to wait for your daughter. thank-you

And then, labor started. Contractions regular and intense, starting as midnight drew near, needing to breathe through them and pay attention….this continued, throughout the night, with little sleep, during the day and onwards through a second night. Exhaustion was huge and the question about why things were not progressing? and still you soldiered on! Another day and evening, and then a spontaneous release of water after 48 hours, and things kicked into high gear. Active labor started and you never looked back! Strong contractions dilated your cervix and you found your groove. You got down to the hard work of birthing your baby, without complaint, without question, so calm, so intent and so intentional! The questioning, uncertain woman who expressed doubts during pregnancy was nowhere to be found. In her place, a strong, powerful woman, loose, fluid and laboring. Internal and composed. Accepting and strong.

And when things were at their most intense, you looked inside and found strength to advocate for yourself and your daughter. During the most vulnerable, most intense, final hours, you were composed and grounded! I listened and watched as you found your voice, in a way that few women do, ever in their life, never mind at 9 cm in labor! I was and continue to be in awe of your actions and thoughts and your conversations with your health care providers, speaking your mind and your intent. You are woman who can do anything! I hope that as you reflect back on this experience, you recognize how powerful and capable you are! Your daughter should grow up knowing what a strong, capable woman her mother is, and how lucky she is to have you as her mom.

Thank you for letting me support you and watch you in all your glory, as you brought forth your daughter! I am in awe of your power! Thank you!



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The Waiting Game

Being a birth doula involves waiting. Waiting for babies! Babies who come in their own sweet time! Babies who have their own secret, internal clock that we mere mortals can only hope to understand! Here I sit. On call! I am usually on call. I am on call for most of the year, probably 48 out of 52 weeks. What that means is that at any time of day, or night, I can expect a phone call from a client telling me she needs me. Or telling me she doesn’t need me, but just wants to update me. Come now. Come later. What that means is that my phone is always on and always close. What that means is that I need to always be sure to get enough sleep, go to bed at a decent time, so that I can be ready for a 1 AM phone call. I am waiting now. A woman will be asking me to join her soon! This I know, as she is now admitted to a local hospital for an induction after spontaneous rupture of membranes in the pre-dawn hours of yesterday! And no labor, as of yet, so a push to get things rolling. Hopefully, a gentle push. hourglass1

Since the news of yesterday’s events, I have been on “high alert.” High alert, I suppose is more alert than normal, of which I already am always on alert. Is that possible? With every action, with every errand, with every event of my day, I calculate, “What do I need to do, in case I get the call NOW!” Sometimes, this can be exhausting. Very exhausting. Emotionally draining. For the doula and also for her family. Thankfully, I have been doing this for more than 6 years, and my family rolls with the punches well. But, the waiting doesn’t get easier. Not for me, not for the pregnant mama and her family, and not for my own family. Yet, the thrill of the call, the rush to join a laboring woman, the chance to help and witness women trust in their bodies and their babies, to participate in that age old labor dance, that brings a new baby earthside! There is nothing like it! Nothing! And I suppose, that is why many birth professionals do it. Over and Over!

And still I wait. Restless, unable to complete anything, drifting from task to task, unable to really focus, while I wait. So many things still undone, yet I can accomplish almost nothing. Should I go for a walk on this lovely day? Make a yummy casserole for my family to eat this evening, as surely I will be gone? Will I??? Will I be gone? Rest? Nap, in case tonight is a night of no sleep?? Sometimes denial is a good state of mind. Be ready, really ready and then forget about it! Just forget about it! That works for a while, but now as I sit, and wait, I reassure myself that this baby will come like all the others, in its own sweet time! I remind myself of this a million times! And so, it goes. Wait with me, and help me by sharing your own stories of waiting, for babies, for something else? What was your experience like?

As for me, I will go and put together a new, tasty mac and cheese casserole from the Splendid Table’s newest cookbook! And leave it in the fridge, as I suspect my family will be enjoying it this evening without me. Or will they?

Share your stories of waiting for babies with us! Post a comment!

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I received a call from my doula student last night, updating me on her clients! I am ever so pleased to report that this woman gave birth non-induced and non-medicated and non-intervened with to a happy, healthy baby on Saturday!

And now for for the rest of the story…the doula met up with them the evening before the scheduled induction, and was really present for their discussion and decision-making process. The doula shared The Problems and Hazards of Induction CIMS information sheet from her doula training manual. Using her wonderful, reflective listening skills, she heard the mom say that she wanted to go into labor on her own, that she did not want to be induced and felt like she might want to switch doctors, but who would “want” her, as she was past her due date. As the parents talked, they realized that they would not go in the next day for the induction and would wait for labor to start on it’s own.

The morning of the now-cancelled induction, the mom started having some contractions! It started to look more and more like active labor. Amazing how removing emotional issues can be freeing for some women and tip them into labor. Alas, the evening saw things slow down and peter out. The parents went to bed and woke up Friday morning with no sign of any labor at all. Discussions with the doula involved re-affirming that her body and her baby knew what to do and that her baby will pick it’s due date and be born when it is ready. Friday night, labor started again, and this time, kept on going, a late night trip to the hospital, several hours in the tub and a wonderful baby landed earthside! Mom gave birth in an upright position, unmedicated and oh so powerful! The doula reports that the parents are thrilled with the experience, so thankful for the support and listening ear of their doula, who helped them to clarify what was important to them.

I was proud of this new doula, and told her so! I am glad that she sought out my help when she felt she needed it, glad she was there for her client and supportive of the couple as they found their way. And oh so happy this mom got to have a wonderful, empowering birth on her own terms.

The most recent class of new birth doulas from Seattle Midwifery School

The most recent class of new birth doulas I have had the privilege of teaching from Seattle Midwifery School

I am so lucky to have the opportunity to teach birth doulas as part of the faculty of the Simkin School for Allied Birth Professions at Seattle Midwifery School. I know I can help one family at a time as a birth doula, but I get the shivers when I think of how many families the doulas I have trained can go on to empower! I always tell my doula students, that if they ever need to bounce ideas off someone, or find themselves “stuck” and need some help, they can call me 24/7. I am always happy to help! I remember what it was like when I was starting out and was grateful for my experienced doula sisters who made themselves available to me. And now in turn, I can do the same! The circle of life continues!

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I had a newer doula call me yesterday for some advice. She had been in a recent doula training class at Seattle Midwifery School and wanted to talk over a current client situation. Her client was less than a week overdue with her second child and her first baby was a vaginal birth with no complications. Her doctor told her that she needed to be induced, sooner rather than later! Like…tomorrow! And when this client inquired as to why, the reasons provided by this surgeon were: 1) most women are done being pregnant by now and just want their bodies back, 2) the baby is only getting bigger and bigger every day, and pretty soon your baby’s head will not be able to fit through your pelvis. Remember, this is a mama who has a “proven” pelvis, meaning that a baby has already found it’s way out through this very same pelvis, that now is getting more and more unable to birth her second baby by the minute! When the client asked about waiting a few more days, the doctor replied that the client could only be induced on days that the doctor was on call, even though this is one practitioner in a large, well established practice with doctors on call 24/7 for the unlikely event that a labor actually starts on it’s own.

Since this multip’s (woman who has already birthed at least one baby) cervix was already dilated and effaced, the method of induction would be pitocin or if the client preferred, they could rupture her membranes. No discussion of the benefits or risks or alternatives of any of these interventions, no discussion of the evidence based research that supports the appropriateness (or not) of these interventions, nor any reason that indicates this induction is based on a valid medical reason.

The parents were confused, scared and nervous. Maybe the obstetrician was right, maybe it was best to induce the next day! They asked for more time to discuss this privately and told the OB they would call with more questions. They called their doula, using her as a resource to help them make this decision. And the doula called me. The more I listened to the comments allegedly made by the doctor, (and I do realize I was receiving this information second-hand!) the more I could feel myself shake my head in disbelief. How is this behavior ethical? Even The American College of Obstetricians and Gynecologists, (a professional organization, mind you, not a research institution) in their own literature and patient pamphlets states what is a valid medical reason for induction! And “wanting your body back” is not on the list! No evidence of improved outcomes following induction of labour for non-diabetic women who are thought to be carrying large babies has been found that warrants an induction for macrosomia in this case.

What is up? Where is the information about informed choice, benefits and risks? Where is the truth? A great resource for anyone facing an induction for non-medically supported reasons (and even for the medically supported ones!) can use the Coalition for Improving Maternity Care Problems and Hazards of Induction as a great guide. CIMS Problems and Hazards of Induction Fact Sheet

An extremely valuable resource was published this fall by some powerhouse organizations, including Childbirth Connections that I think should be required reading for all women of childbearing age, particularly, the pregnant ones: Evidenced Based Maternity Care: What It Is and What It Can Achieve You can read a pdf on-line, or you can order copies for free! What a fantastic resource. If you are a doula, childbirth educator, or other birth professional, consider ordering some for your practice to share with clients!

As for the woman mentioned in the original paragraph, at last report, she has been in early labor since this morning, all on her own and with the support of her partner and doula, waiting for things to pick up! Maybe it was that beautiful full moon over Seattle that “induced” her baby to come! May this baby arrive safely earthside before the moon sets again! phinney_moon

Moonset over the Olympics, from Seattle.  Photo by Karen

Moonset over the Olympics, from Seattle. Photo by Karen

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A day just full of birth, from morning to night! First off, a postpartum visit with a mama and four day old little girl! It is so nice to help get breastfeeding off to a good start and reassure the new parents that things are going well, even if they feel all topsy-turvey, which is so normal.

Then, a PALS Doulas board meeting, with lots of exciting plans and ideas for this wonderful Seattle based doula organization, the oldest doula organization in the country!

Later this evening, it is time for ICAN Seattle to meet, and we are having a local Certified Nurse Midwife come and share some of the current issues for VBAC women that she sees in her practice and at the hospital where she works! I am a co-leader of this group, and am enjoying it very much. ICAN has a wonderful video on women who have gone on to have vaginal births after cesareans (VBAC) after they were told they had CPD (Cephalo-pelvic Disproportion), meaning no baby would fit through their vaginas. I find it so inspirational, and you should check it out!

The day is full of good things, good people and birth! What could be better!

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I just returned from helping a wonderful couple welcome their little girl into the world! This baby had remained stubbornly frank breech since about 35 weeks, despite every attempt to turn her. Mom even tried an external version, along with all the acupuncture, chiropractic treatments, positioning, hot/cold, talking, bright lights, music, slant board, and visualization anyone could dish out!

And the little girl did not want to turn. The originally planned homebirth became a cesarean in the hospital. So different then the parents imagined. Mom had such grace and confidence as she slowly came to terms with the surgical birth. They wrote a birth plan to honor the things that were still important to them. Selected a facility and surgical team who were respectful and sensitive. Played their own music in the OR, walked into the operating suite, delayed newborn weighing, got skin to skin while on the surgery table, took lots of pictures, and remained skin to skin for hours after surgery back in the room. The little girl was healthy and happy and snuggled up at her mama’s breast when I left.

Yet, I can’t help but wonder? Isn’t breech just another variation of normal? Why are providers not being taught the skills to assist at a breech birth? (“Hands off the breech” being the first one!) Every breech birth puts the mom on the path to navigating the VBAC journey in the future, and choices around VBACs are getting slimmer and slimmer, at least in my community.

Why is breech birth considered safe and the standard of care in many communities and in others, it means automatic surgery? How can that be evidence based medicine?

Here is one of my favorite resources for breech birth, The Coalition for Breech Birth! Check them out!

And welcome earthside baby girl, you are loved, no matter how you arrived!

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Sipping coffee, getting ready to leave the house to go teach for a few hours at the Seattle Midwifery School Labor Support Course doula training.  A whole new fresh crop of doulas ready to start working in our community!  If you are ever looking for a doula and are worried about the cost, please let me know, as I have several resources, and can also ask at the doula trainings for someone just rarin’ to go and on the lower cost side of things!

Every woman who wants a doula at her birth should have one, and I am committed to helping that be true here in my community!


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