The Epicurl

Might sound like a funny name but we (us birthy chics at www.TranquilSeasons.com Doulas in San Antonio) made it up based on the position and the fact that we use it with moms to curl into a happy C shape and stabilize them while laboring with an epidural.

Now keep in mind, changing positions every 45 minutes a least is very important for progression. Side lying with top leg up and over (with hip and shoulder behind) is another great one to use as long as you have plenty of pillows *grin*

Show you that one another time!!

But obviously, using gravity is best. However it can be tricky!!  When you can't feel your legs or help balance yourself on a yoga ball (because of an epidural) this position, the Epicurl, might just save the day. 

Here's how you make the magic happen:

1. Move bed into throne position. 

Head of bed up, foot of bed down at least 6 inches, depending on how comfy mom is, lower for less flexible mommies. 

2. Have her sit with foot soles together so her legs make a diamond shape. 

3. Here's the most important part: get her bun-cheeks open and tailbone behind her and open those hips wide so she's sitting in a very wide open pelvic stance.

4. Putting a rolled blanket in the small of her back or lower can help wonders with maintaining this position comfortably. 

5. Place the yoga ball in the diamond of her legs. Put a sheet over the ball and maybe a pillow so she can rest comfortably leaning forward. She can hug the ball or just put her arms over the top. If you're finding the ball wants to roll away, roll up a towel and wedge it in front of ball to keep it where you want it.  I've even had moms fall asleep like this. (Nailed it!)

6. Bolster her in with extra pillows where needed, under knees/thighs, like Tasha has in the pic or more behind back, but try to keep her leaning forward. 

7. Don't forget to put the bed rails up. They can help wedge pillows or just give the staff a greater sense of safety - which can help them trust your crazy positioning techniques more ;-)

Labor here for 45 mins or so. Then change position. You can return to this position as often as you want, just remember to change it up. We haven't had to change too many times with moms cause they tend to dilate quickly like this. So keep an ear out for the "I feel pressure/pushy" cues. :)

For those of you like me, who need a visual, my client Tasha (who is all about education) was gracious and let me snap a pic to show others. She pushed out a gorgeous baby girl just a few hours after this was taken. 

Thanks, Mama!

Hope this helps some laboring mamas out there  :)

Don't forget to read some of our other posts, like the Sneaky Psychology of Birth.

Blessings,

Anne

www.TranquilSeasons.com 

Giving Birth Again

You gave birth.  It didn't go the way you expected, the way you planned, the way you wanted...

Now you find yourself pregnant again and you're a little scared.  Maybe you're really, really scared.
What can you do to make sure that things go better this time?
Did you stuff the trauma you experienced deep down, not realizing it would surface (ever)?
Now you've got a toddler, and your pregnant and there's a lot of emotional work you need to do, but really don't have time or energy for it.  You're not that mom.  You want better and you will find a way.
 Why? 
Because your birth experience isn't just for you - it's your baby's only birthday.

One of my kids told me (you may have heard it somewhere too) that if you repeat the same thing over and over, you will get the same result over and over.

The same goes for birth:
If you were uneducated last time, get educated.
If you were out of shape last time, get in shape.
If you ate a lot of junk last time, get healthier food.
If you were hurt emotionally, physically, mentally last time, get healed.

So you get the idea.  You agree.  
Where do you start?

1. You must swear off the drama.  Don't fall into the drama-trap.  Birth is not a crisis.  You are not sick.  When you look at this process truthfully, you will find that there is no reason for fear and drama, and that will only make you vulnerable to deception.
2. Next, I would sit down with a cup of raspberry leaf tea and a lovely book that will encourage you while educating you: "Ina May's Guide to Childbirth" by Ina May Gaskin (a birthy, hippy hero of mine)  In this book you will find healthy, happy, normal birth stories.  Read it!
3. Get shopping for a doula.  Find one who has excellent training, current certification credentials, and lots of experience.  Don't settle for the lowest price.  This is your baby's birth.  If you want care that will change your experience for the better, don't be a cheapskate.
4. Start eating right and exercising immediately.  Drinking lots of fluids and eating loads of protein every day is of utmost importance.  Those are your top priority.  Your prenatal vitamin cannot make up for a poor diet.

If you have issues still rising in your mind about your previous birth(s), please talk to someone about it.  Residual anxiety can have a heavy impact on how your next labor will go.  One way to work through those feelings is to use your 5 senses.  Explore each sense and ask yourself questions about it.  Often when we experience trauma we don't always store it with words.  Sometimes we store memories of them in the form of sensations.  Those sensations need to be tapped into and cleared away - you don't want them to pop up and surprise you when you're in labor!

If you're in the San Antonio area, consider taking a class to help you prepare.  Tranquil Seasons offers classes monthly on a variety of topics.  Check out the list and see if any draw you.
You can find the list on the website: Doulas and Childbirth Education in San Antonio

If you're not in San Antonio, I can get you into our private, online birth mentoring program.
Just ask me!
210-548-8800

Blessings,
Anne Croudace

Delayed Cord Cutting - What's All the Fuss?

Healthy start for newborns safe in mothers' arms

Originally published by the BBC:

A new study shows that newborn babies can reap the health benefits of a delay in cutting their umbilical cord - whilst they're safe in their mothers' arms.

It had been thought that gravity was necessary for the blood to drain from the placenta to the baby - who had to be held lower than the mother.

But research carried out in Argentina has shown that babies can still benefit from this "extra" blood during their first cuddle.  More from Health Check

-----------------------

So... I have a question.  If moments before birth, baby was essentially on top of mom, and receiving it's blood supply then...  How does it differ, if he is now on top of mom (albeit on top of her skin, instead of under it) in terms of the blood flow of the umbilical cord?  

If a cord has enough strong pressure pumping through it, to prevent a true knot from cutting off baby's blood supply as demonstrated by this little boy's internal acrobatics and the result thereof...  how is this small difference of on top of mother or not, going to make a significant impact?

Sure, I get how gravity may make placental infusion of a newborn's blood happen faster, but who is in a rush and why?  I think the true question here is how long to wait before interfering in the natural process?  Can you watch this beautiful process unfold or must you control it, manage it, and interrupt it...?  And why would you?

Is anybody asking these questions?

Parents, Are you?

Do we really need to leave it to Argentina to tell us what is best for our babies?  (No offense, Argentinians!!)

While you're writing your birth plan, read up on early vs delayed cord clamping.  And then ask yourself the questions of how logical is any of it.  Is there another mammal on the planet who cuts or clamps the cord of their young before the placenta is even expelled?  I'll give you the short answer: No.  So why are we?

Sometimes nature already does what scientists just haven't had time yet to discover.

Just sayin... The world HAS been peopled after all.

Become a certified doula.  Attend a doula training, and be better equipped to answer these questions!

How nice! Massage in Labor...

Did you know....?
Massage benefits laboring moms in a lot of ways!

When was the last time you had a massage? It may have been a professional massage at a spa or it could have just been a quick backrub from your honey, but didn’t it feel good?

According to research, massages can actually assist mothers to labor faster and more comfortably. Even a quick and simple massage can do wonders for decreasing a mother’s anxiety and pain. 
Just check out the findings from this study:
“Twenty-eight women were recruited from prenatal classes and randomly assigned to receive massage in addition to coaching in breathing during labor, or to receive coaching in breathing alone. The massaged mothers reported a decrease in depressed mood, anxiety and pain, and showed less agitated activity and anxiety and more positive affect following the first massage during labor. In addition the massaged mothers had shorter labors, a shorter hospital stay and less postpartum depression.” (1)

During labor, sometimes the focus can all be put on having the mother breath and push. Without a relaxed body, however, focusing all energy (emotional and physical) on these important tasks becomes difficult for mom. Having nurturing support she can trust and feel safe with is important.  Massage facilitates this.

That’s where a well-trained, certified, professional Doula comes in. Having a doula there who knows how to massage and comfort a mother with touch throughout the labor process means that mom can receive that much-needed massage any time she needs it! Find a doula who is certified and specifically trained in maternal-fetal positioning, and the best techniques for helping mom relax her muscles. A massage during labor (whether from Dad or Doula) also allows the mother to breathe easier and keep her rhythm. The results? A less-stressed, less-depressed mom and a shorter labor process and hospital stay. 

Who can say no to that? 


Resources:
(1) Field, T., Hernandez-Reif, M., Taylor , S., Quintino, O., & Burman, I. (1997). 
Labor pain is reduced by massage therapy. Journal of Psychosomatic Obstetrics and 
Gynecology, 18, 286-291.

Pregnancy and Birth are Normal Functions of the Female Body

Pregnancy and birth is a normal physiological function of the female body.  In general, the female body is as capable of pregnancy and birth as it is breathing, digesting food or passing urine.  It is logical to assume that interference is not necessary unless and until a problem presents itself, and not unless or until there is evidence that the body’s self-correcting restorative capabilities are not meeting the need of the problem.

It is also very important to remember that the variety and ability of the female body to conceive, carry and birth a baby constitute a large range of “normal”.  For example: Just because one woman labors best in a certain position does not mean that all women labor best in that position.  That “best” position may not suit the same woman in subsequent labors, either.  The ways in which they can “get the job done” is as varied as the women themselves and the babies they carry. 

Everything in a woman’s life changes when she gets pregnant.  Her body’s changes are the most prominent because we can look at her and it's right there.  However, change is also present in the way she sees and thinks about herself and the world around her - as well as the way the world sees and thinks about her.  The mothering instinct is quite strong and predominant in some, while it is more subdued or delayed in others.  

No matter what the mother thought or felt about herself before, she will now envision herself with another person in her life depending on every breath and calorie - unlike any relationship before it.  That transition will manifest in beautiful ways when she is supported properly during pregnancy, labor, birth and the postpartum period.  But hey, you already knew that!   Congratulations!

Have you ever considered becoming a doula?  Are you good at smoothing things over and keeping things calm when others around you are freaking out?  You might be a doula on the inside.  :) 

Our job as normalizing anchors…

We as doulas are meant to be a sounding board for mothers.  They will usually tell us how they are feeling, in detail.  We are so lucky to get a glimpse into the intimate part of a woman’s journey, whether this is her first or 10^th pregnancy.  

It is always our responsibility to have an accepting, nurturing attitude toward the mother.  I call it “putting on love” toward her.  As we do this, we can help to normalize things she is concerned about or may cause alarm in others when truly it’s not a crisis.  She needs someone to be sturdy, and someone she can count on to provide her with reassurance.  

Tell her all you know, while focusing on the positive, and being realistic about the negative – that women have been growing babies and giving birth for eons, and she’s not broken or strange.  One thing I say is to look around, the world has been peopled!  

You’re not the first, and you probably won’t be the last to experience ____________.

Doulas are not all the same, but a well-trained, professional doula who has the integrity of being certified is going to have the skills to nurture and keep you calm when labor gets difficult, and all the times before that too.  

Be picky about who you choose, and remember...  Experience (in years and number of families served) is valuable and it's is worth paying for.

May your birth be blessed with peace and rest.

Anne Croudace

New Mothers Speak Out

What do you think?

The New Mothers Speak Out (PDF) report presents postpartum results from both surveys and gives a ground-breaking view of experiences of mothers with young children in the United States at this time. The surveys were conducted by Harris Interactive and carried out in partnership with Lamaze International.

New Mothers Speak Out reports that life is challenging for many women at this time, who Report highlights include:The report also includes dozens of comments from the mothers themselves about these topics.· experienced new physical and emotional problems following technology-intensive births with high rates of surgery and other interventions:

· struggled to get exercise and rest, eat a healthy diet and manage stress

· did not return to their pre-pregnancy weight

· got limited support from husbands/partners and others

· were unable to start or continue breastfeeding as they wanted

· wanted but did not have the maternity benefits that women in other affluent countries take for granted

· returned too quickly to employment due to financial pressure.

Extent to which mothers experienced 26 health conditions as a new problem in the first two months after birth, and extent to which the problems persisted to six months or more

 Net weight gain above mothers' weight just before pregnancy over the first 18 months after birth

Results of two validated postpartum depression screening tools

First national data about post-traumatic stress with reference to women's childbirth experience, using a validated screening tool:

· Breastfeeding patterns and whether mothers achieved their goals for exclusive breastfeeding and for duration of breastfeeding

· Baby co-sleeping with mother or others in first six months

· How women and their husbands or partners shared child care

· How women rated the support they received from their husbands or partners and from others

· Extent to which women who were employed in pregnancy received paid maternity leave benefits versus their ideal length of paid maternity leave

· Patterns of staying home with baby and transitioning to employment over the first 18 months after birth

· Whether employed women were able to to stay home with their babies as long as they wanted

· Challenges in the transition to employment after birth

What do you feel about these assessments?

http://www.tranquilseasons.com

210-548-8800

What is a Labor Doula?

Labor Doulas

A Certified Labor Doula is an assistant or coach, who provides various forms of non-medical support (physical, informational and emotional) during pregnancy and in the childbirth process.  She may attend a home birth or might support the mother and her partner during labor at home and continue while in transport and then remain with the mother until settled after the birth at a hospital or a birth center.  Tranquil Seasons only hires Certified Doulas.  We always require doulas, previously certified or not, to go through our training, because the standard of the organization we use for labor doula certification is head and shoulders above any of the others we have seen out there.

During delivery, doulas are in constant, close proximity to the mother at all times. They can provide comfort with pain relief techniques, such as breathing, relaxing, massage and laboring positions. Doulas also encourage participation from the partner and offer reassurance.  A doula acts as an advocate for the mother, encouraging her in her desires for her birth.  Tranquil Seasons are also trained in-depth on maternal fetal positioning.  This is a specialized skill that helps promote the swifter, easier and more comfortable dilation of the cervix and more efficient descent of the baby.

The goal of a doula is to adapt to and support the mother’s philosophy and help her to have a positive and safe birth experience, whether the mother wants an un-medicated birth or is having a planned cesarean birth. 

The doula is the ONLY one outside of family, who is hired by and there specifically for the mother, and has no conflicts of interest such as employment by the physician/midwife/hospital or any other reason for bias.

After the birth, Tranquil Seasons Doulas will spend as much time as needed helping mothers begin the breastfeeding process and encouraging bonding between the new baby and family members.  Our jobs are not done just because the baby has arrived!  :)

Hiring a Certified Labor Doula will decrease your chances of cesarean. Tranquil Seasons owner Anne Croudace, has cared for over 270 families.  Out of all the births she has attended, only 3 ended in an unplanned (though very necessary) cesareans. That's a pretty encouraging statistic. While she cannot make you any guarantees, you have more than a good chance of avoiding a surgical birth when you've got Anne or one of the doulas she has trained, by your side.

Call for more info:
210-548-8800
or visit our website:
http://www.tranquilseasons.com

Sample Birth Plan

Look into your options...
Here is a sample, offered by one of our clients to give other moms a good starting point.

Feel free to use wording from it, or even copy and paste.  If you have questions about any of the preferences listed, please let me know and I will be glad to explain the family's intent as well as further resources regarding each item.

Remember, your birth plan should be 1 page long and include a categorized list of your wishes and preferences in each stage of your childbirth experience.

 

Birth Plan

Labor:

·         I would like my husband, Jason, and doula, Anne, to stay with me at all times.

·         I request that pain medication NOT be offered to me; if I decide to use pain medications, I will request them.

·         In the event of labor augmentation, I would like to try alternate methods prior to use of Pitocin.

·         I prefer no IV fluids unless I am dehydrated such that juices, electrolyte water, and other drinks do not properly hydrate me.

Pushing:

·         I request the freedom to choose various pushing and delivery positions; to include squatting, hands & knees, or whatever may feel right at the time.

·         I ask that no episiotomy be performed; I would like warm compresses and perineal massage prior to delivery.

·         When it is time to push, I’d like to be allowed to progress free of stringent time limits as long as my baby and I are doing fine.

 

Immediately Postpartum:

·         I request that the umbilical cord not be clamped, or even touched until it is white and limp. I request to be allowed to naturally deliver the placenta; I request to have the placenta stored safely and unaltered so that we may take the placenta home for encapsulation.

·         I request that the immediate care of my baby be done on my abdomen or chest with skin-to-skin contact for as long as possible.

·         I plan to exclusively breastfeed and request that no supplements or pacifiers be given. If my baby needs to be fed by bottle or other means, I would like to pump my breasts and provide breast milk throughout the hospital stay.

Newborn:

·         I ask that all newborn care be done in my room.

·         If my baby requires special nursery care, I request access to him at any time.

Special Circumstances:

·         If the above ideals must be altered for medical necessity, I ask that we be given as much time as safely possible to consider all our options before procedures are done.

·         In the event of a cesarean delivery, I would like my partner and doula with me.

·         If cesarean is necessary, I would like contact with my baby as soon as possible and during recovery.

·         In the event of a stillbirth or death of my baby, I would like contact with him as long as desired afterwards.

Simple Summary of Our Care

So, you've probably read a lot about doulas by now...
Not all doulas are the same.  Tranquil Seasons Doulas have specific, ongoing training in several modalities.

What is a good, simple summary of our care?

During Childbirth…

During labor and delivery, we support you at all times with emotional, informational and physical care.  We provide you with education and resources before and during your childbirth experience to help you stay comfortable and to relieve anxiety.  We provide non-pharmacological pain relief including massage, and maternal/fetal positioning to help keep you relaxed and to allow the baby to descend quickly, easily, safely.  We never take the place of your partner.  In fact we encourage participation and offer reassurance and guidance so that this experience is positive for both parents!

After Childbirth…

After birth, Postpartum Doulas help with breastfeeding, infant care, and understanding newborn feeding and sleep habits.  The calm, loving, gentle presence of a doula alleviates stress and helps mothers recover from birth

 in a positive, healthy way.  This assists in preventing or recovering from Postpartum Depression and Anxiety as well as Post-Traumatic Stress - which some mothers and babies experience after a difficult birth.

To speak with Doulas in San Antonio:
www.TranquilSeasons.com
210-548-8800

Birth CommUNITY - Can we all just get along?! :)

Over the years, I've taught many different aspects of birth work.  I've taught maternity care ethics, doula certification workshops, midwifery prep courses, parenting classes, gentle infant "sleep training", childbirth preparation and lactation education, support group facilitation, small business marketing and even helped form a few birthy co-ops along the way... 

There's a lot to be said about the birth communities I've become acquainted with.  The variety is astounding.

Some are catty and awful - like a corporate scene where everyone steps on the others in order to get to what they imagine is the "top" of the pile.  Others are peaceful, encouraging, cooperative and truly sisterly.  What is interesting is that all groups want to see birth practices change.  They want to see improved outcomes.  They all would stand up for women's rights.  So how can they be so different in this thing we call a COMMUNITY...?

I think the main answer is where did they come from, and what's the undertone of the "oldies" in their area?  Let me explain.  If they are moms who come from a high-level corporate background, they are more likely to treat this new career with the same growth and glass ceiling mentality as their previous corporate America jobs.  So back-biting and one-up-manship is the norm.  Likewise, if the women who have been around a long time, doing birth-work in your city have a superiority complex or a corporation complex, you will see the younger, newer women taking on that same mentality.

Isn't it interesting that as women-servants - whether midwives, doulas, childbirth educators etc. - we are meant to be modeling love, acceptance, nonjudgmental attitudes, and most of all, self-sacrificing promotion of the best in others.  We "oldies" who have been around a while should really be the best models of this since we have had more time to practice.  :-)

So, how do we do it?  Practically speaking, what does this kind of care model and commUNITY model look like?

First of all.....
1. Stop the gossip.  Don't do it and don't listen to it, or you'll be tempted to share it.  This is the number one problem, tearing apart birth communities today.  People can smell a gossip a mile away.  You're only spreading a stinky reputation about yourself.

2. If a client tells you something about a previous caregiver, GO to that person, and encourage your client to be honest with them as well, if appropriate.  Don't text the other provider or email them, for heaven's sake.  Set a time to sit down over lunch or coffee and tell them directly, what the client's concern was.  How can we grow if we don't know where we failed?  When you speak directly about an issue to another provider, it shows that you are committed to not gossiping and that develops trust.  If you don't have the nerve to talk to them, you certainly should have the scruples to keep it to yourself.

3. Have a humble heart.  Serving requires humility.  Be willing to look at faults and mistakes and change.  The last and least helpful thing you can be is defensive.  It makes you look bad, too.

4. A BIG one - Stay out of other people's drama.  Even your clients' - if you can help it.  Don't expend your energy on anything that is not uplifting you, your family and others close to you.  You don't want to be labeled a busy-body or a drama queen. (this also applies to sharing your drama with others who aren't in your tightest circle of family/friends - just don't do it!)

5. Commit to getting to know your fellow birth workers.  Join or start a local birth collective group where the community can be built up.  Working together helps immensely!  Plan events, educational opportunities, and ways to promote each other as well as healthy birth.

6. Don't segregate.  Midwives need to get to know doulas, doulas need to get to know childbirth educators, etc, etc.  The birthing community is smaller than you think.  You all need to know each other, learn about each others' strengths and offerings so you have resources to provide your clients and yourself as you seek to improve birth practices in your area.

There are lots more tips I could give, but the main thing to consider is how you view your fellow birth workers.  Think long and hard about this.  Is there someone specific in the community that you don't get along with?  Don't fall off your chair now... You should bless her.  Send her a card.  Take her out for lunch.  Invite her to an event you're going to.

It's possible.  We are obligated to be models of love and acceptance.  We should help create and then celebrate each others' successes and when we do, the birth community as a whole will be lifted up.

Looking forward to more UNITY in birth.
Anne

Doulas - San Antonio
http://www.sabirthcollective.com

So there was this dad...

There was this dad, who wanted to be involved.  He was optimistic.  He was excited.  He was totally fantastic.

http://tranquilseasons.com/DadsAndDoulas.html

Then, labor commenced in the middle of the night and he had just returned home from a grueling double shift.  Mom woke him after doing her best to allow a 45 minute nap and he was groggy.  So groggy, he is later reported to have grabbed Nintendo charger cords in place of phone chargers.  He forgot to put pants on.  He might not have had his eyes open while driving to the hospital.  He barely said a word.

He was perfect.

Standing with his hand on mom's arm...  She relaxed into a puddle.  He didn't have to speak.  His love and support filled the room.  Her group of guardians encircled her while her body and mind did all the hard work of natural labor.  When she couldn't go farther, he gave her strength with his touch.

Dad didn't have much to say, but was a steady, calm, pillar of security for his family.

Then, we met to talk about the birth a week or so after they returned home from the hospital.  Dad shouted "What about me?!  I gave birth that day!  I went through it all!"  We all laughed, but I know deep inside, it's completely serious.  He did.  All dads do.  That's what makes them great.  They are often silent, but it doesn't mean they aren't laboring.  Their kind of laboring is not outward, but inward.  It's amazing.  How often we overlook the daddies.

You, dear dad...  You are the unsung hero.  I couldn't be more proud of how you gave birth that day.

Historical Doula

Couldn't have said it better myself:

"Having someone by your side during the marathon we call childbirth is not only helpful, but it's historical.
What do we mean by that?

 

Well, for as far back as there are birth stories to be told, you will hear about women attended by other women, supported, encouraged, and often times physically held by the strong arms of this wise, nurturing companion.

Doulas are nothing new, but they have found a name for themselves in the Greek. To be simple, it means servant. With a humble heart, these precious women patiently wait with the mother while actively assisting her to labor more quickly, easily, and safely. Doulas provide information, reassurance, positioning and pain relief without the use of drugs."
Thanks, MaternityWise International, for that!!

To get more familiar with doulas, please read my other blog posts.
If you feel an urge to become a doula yourself, feel free to send me an email and ask some questions about the process.
You can also find more here:
http://www.maternitywise.com

 

Who is Anne Doula - Part 2

Part 2:
Finally, Anne Doula is a woman who is on a mission to challenge the ideas about what doulas are... When you walk down the street and see a pregnant woman, do you automatically offer her a drink of water? How about when you're in a store and you hear a newborn crying and the mother looks haggard. Do you have to refrain yourself from going over, picking up the baby and saying, here, I'll help you get through the last items on your list....?

A doula is a servant. We wake up thinking about how to take care of people and we go to bed exhausted every night, with a smile on our face knowing we gave every last drop of ourselves to those around us. We are love in action. We nurture. We help, we feed, we carry, we DO love.

If you're thinking about becoming a doula, consider an organization that we feel is the very top notch education and certification program: MaternityWise International http://www.maternitywise.com
They have a standardized curriculum, so your training will be as comprehensive as everyone else's. it's a stepping stone / midwifery prep program. The pricing is reasonable and the staff is flexible and friendly. The organization is owned by it's members and therefore you will not have anyone micromanaging your personal doula company, telling you what you can and can't say and do. They also teach how to start and build your birth business. From real life, successful doulas. There just simply isn't an organization like this out there.

Are you feeling led to become a doula? My aunt once told me that it was my "calling" to assist pregnant and birthing women. I wondered what that meant. Now I'm living it.

I have this cute little book that my kindegarten teacher Mrs. Baumgartner made waaaaay back when... It was a self-portrait on each page of all her students, and on a page in the back, she listed all our names and what we wanted to be when we grew up. Many children put president, or firefighter, or doctor or astronaut. After my name was 3!! ha ha She listed that I wanted to be a "Mommy, a teacher and a nurse."

As a doula, in a sense, I am kind of playing all 3 roles. Doulas mother the mother, and teach her how to love her baby and care for herself. She also has a knowledge of medical, anatomical and physiological processes involving the pregnant, birthing and postpartum mother as well as fetal and newborn internal mechanics.

It's so important, for the families we serve, to get a well-rounded education and complete a credentialing process from an internationally certifying body. You can help set the standard. You can be one of those special women who assit mothers to get the care they need, even when they cannot afford it. You can be the change in the birthing world. One of the ways you can do that, is to be pro-active in education.

We need more top-level skilled doulas in the world, to keep making a difference!!! So what's stopping you from getting certified? Start your program today! You are worth it, and the families you will serve in the future will be so grateful you took this step.

-Anne

Who is Anne Doula? (Part 1)

Client:  "Hey Grandma, come meet Anne.  She's my doula!"

Client's Grandmother:  "Hello Anne Doula.  That is a curious last name.  Is it French?"

hahahahaha
and so I became Anne Doula.

Doula is actually a Greek word.  It's used in the Bible when describing Jesus, as He washed his disciples' feet.  He took on the form of a "Doulos" or male servant.

Doula generally referred to the woman servant, who helped the mother of the household with pregnancy, birth and childrearing in the early years.  She was a hand-maiden, a personal assistant, a second mama, a close friend, confidant, and often she was also a wet-nurse.

These days, there are women who call themselves doulas, yet have no training, or even any idea that doula = servant.  They hear the term, want to attend births cause it sounds exciting, and then off they go, calling themselves a doula...  hmmmmm.....  not cool.

Why is it not cool?  Well, for several very good, very important reasons: 

1. Mothers hear about doulas in the media, or from books about pregnancy, and they kind of have an expectation of what sort of value and skill-set a doula will bring to their experience.  If all doulas are on different levels as far as education and philosophy, how can mothers know who to choose, what is a reasonable amount to pay, what to expect, etc.?
2. Birth isn't always easy, fast, or safe.  Don't get me wrong, I birthed my last 2 of 5 babies at home, and one arrived before the midwife, so I'm probably what you'd call a "Birth-Truster" and I believe that birth is normally safe, and that interference and intervention is normally risky.  However, we do know how bad information can lead to bad choices which can lead to bad outcomes.  This is a HUGE reason why doulas - who give advice and help mothers to educate themselves - need to know their role, when to refer moms to a specific professional, and what is a silly trend and what is serious medicine.  Untrained, uncertified women who call themselves doulas are not qualified, and often do not know or understand the bounds of what their role entails as a complementary care provider.  Because of this, you often find they lack the information parents really need, and sadly, they also lack the ethical standards as well.
3. Unfortunately, women who feel they don't need training, or are above attaining a certification, are many times, the same women who have their own birth trauma or other serious personal issues to deal with.  I was just speaking to a dad yesterday, who said he had interviewed half a dozen doulas in our city, and each one revealed through their philosophy, personal stories, or unsolicited advice their own resentment toward a doctor or nurse during their own experiences.
4. Women who claim to be "trained" but cannot provide you with their credentials are basically women who are shortcutting the system.  They took a workshop, but they didn't have the integrity to complete the rest of their training.  In my opinion, they should not be calling themselves "trained" simply because they did not complete the entire "training process".  Parents are getting savvy to this however, and more and more families are turning down doulas who don't have those coveted letters after their name or a certification award to prove they completed a course to become a true doula.
5. When a woman cannot afford doula care, there are a few states where it is mandated for insurance companies to reimburse a portion of their care expenses.  Why would insurance companies want to reimburse for care that has no value to them?  Saving them money is how doulas look good to the insurance company.  How would having a doula save them money?  By lowering the cesarean risk, for starters.  So it's important that certified doulas continue to seek out insurance reimbursement.  That, and the fact that mothers who want doula care, but cannot afford it will be more likely to receive that care including better outcomes for themselves and their babies, if insurance companies were on board with paying a portion of that expense.  Some states like Minnesota and Pennsylvania already do.
6. The last and perhaps most upsetting reason (to me) of why it's not cool that women take on the title "Doula" without completing a certification process is that is blows the stats of good doulas out of whack.  For example, the Cochrane report from the 1990's showed that having a doula by your side reduced the rate of cesarean by almost half.  In the late 2000's, after being a doula became trendy, that rate in another Cochrane review showed that the stat was now hovering around 25%  Why?  Because women who are not properly trained are out there practicing and mothers are not getting the benefit of having a skilled woman by their side.  Those numbers, by the way, tell me that having an uncertified doula means your rates of cesarean is no different that those of the general public without a doula.

Part 2 coming soon............

Becoming a Doula-Minded Birth Advocate

Many years ago, I was holding hands of friends in labor, and walking the halls with newborns so mothers could sleep.  I was changing diapers of babies with RSV and cuddling moms who cried over their birth stories. 

I gave birth to my first baby at age 17.  I didn't know anything.  I never had any idea that someone might think I wouldn't succeed at delivering vaginally.  I didn't know the cesarean statistic or that women still gave birth at home.  No one ever bothered to tell me that my breasts would fill with milk, whether or not I chose to breastfeed.  I didn't wonder how I would ever push a baby out or if I could manage the discomforts of labor.  Nor did I think about whether I wanted drugs or not for pain.  I honestly did not have a clue they were even an option.  I just figured you had a baby and that was that.  There was so much I was ignorant of.

There was so much I didn't know, that I had no time or inclination or reason to question the natural processes my body went through.  I didn't question my weight gain.  Never thought about how much amniotic fluid I had or if I might catch the flu.  I went on my way, carrying my baby and eating, eating, eating, dancing and walking and enjoying every kick and flutter.  Can you imagine a pregnancy like that nowadays?  That was only 1992/1993.  Not really that long ago.  Over the last 20 years, what has happened in our society, in our medical care system, in our circles of friends and family that has turned the perception of birth into such a frantic, frightening, and frustrating scenario?

Ask yourself these questions: 

• When I've heard about birth, what was a main theme in each story? 
• Did I feel fear upon hearing the story? 
• What has shaped my ideas about birth?  Mother? Aunts? Sisters? the Media?
• When I've spoke of birth, what has been the tone and intention of my story? 
• Have I told a Hollywood version of my experience, looking for the oohs and awws or have I told the boring details right along side the exciting ones? 
• Have I been truly, completely honest when talking about my birth with people?

Consider your answers and consider also what part you've played in influencing the women and girls around you and their perception of birth.  Perhaps you've built healthy ideals, or perhaps you are now recognizing that you can do better.

I'm interested to hear how you might make some changes in your own birth-speak, or how you feel we can better affirm our societies' positive ideas on birth.

-Anne

Questions New and Expecting Parents Ask

Questions New and Expecting Parents Ask...

- How can I avoid a cesarean?

- How can I avoid tearing?

- What are the drawbacks when using pain medication in labor?

- What is the best way to labor without drugs?

- What is water birth?

- What are the fears of other American women in birth?

- How can I prevent SIDS?

- Will I be able to breastfeed?

We will cover these topics and more, over the course of this blog.

If you have questions you would like to see asked, please contact me

and I'll be happy to include them.

For now, take deep breaths and remember - the world has been peopled.  :o)  You aren't the first to face childbirth and parenting newborns, and you certainly won't be the last. 
If you are reading this, it's safe to say you're living in a situation where information is at your fingertips.

Warmly,

Anne Croudace