Monday, December 5, 2011

Special Needs Births

When I say "special needs", I'm not talking about a physical or mental disability.  It is a disability of trust.

Dads can feel that they'll be too queasy to make it through a birth process.  I've been hired many times because the dad felt he would faint and wanted his wife to still have support.  But dads are amazing support, and they step up to the challenge of labor and the fear of fainting disappears with the excitement of the birth!

A larger category of special needs families are the couple who had a traumatic first birth.  Over the years I've worked with many families with this background. Perhaps they went into their first birth experience, feeling ready, but then quickly felt all control/decisions were taken out of their hands and the result felt traumatic for them. Some of them ended up with many interventions, some ended up in surgery.  Some moms felt no one paid any attention to them or their needs and the dads felt useless. The couple felt helpless, and ultimately were in love with their baby but unhappy with the birth.

When the second baby was on its' way, they looked for help, a doula.  I think one of  the greatest benefits of a doula is a confidence in birth. We've seen birth hundreds of times work out beautifully.  They provide a support to  the couple that their voice matters.  So as they approach this next experience, they have a lot of  fear that the birth will be the same - but it never is the same!  This is a different baby, a different time of their lives, a different approach to the process.  Ultimately whether the birth results in interventions or even back to surgery, the couple feels they made good choices, that they participated in the process, that the feeling of the experience was different, better.

So if you are looking at a birth and feel you have special needs in the trust area - consider a doula.  Birth is such an amazing journey - my hope is that you have a great birth memory.

Saturday, November 19, 2011

The Waiting Game

The excitement of discovering you are expecting is replaced usually be a few months of the "morning sickness", followed by several  months of energy and a growing belly, followed by the realization that labor will eventually come....Lastly it is the 9th month and for some reason this turns into a 9th year.  Especially when it is the first baby, days become months, hours become weeks. 

The phone calls increase - lots of family just checking on you.  Friends pass you and ask "when are you due" - strangers pass and ask "when are you due".  All this builds in you a watchful eye for every feeling you have.  And everyone expects you to be the expert on when your labor starts - and yet you feel so uncertain that you'll know.

Each night you secretly wish for labor to be delayed because you feel so tired - each morning is followed by disappointment that there are still no signs of labor.

Week 39 approaches and the fear that you might need an induction looms higher in your thoughts.  And now you are definitely sick of the "when are you due" question.  No one is satisfied with a reply that expresses a desire that the baby pick the due date if possible.  Sometimes not even you!  Thoughts go to "it would be nice if the baby came today" or "I hope the baby waits until the weekend".....

This waiting game can wear on you quickly.  Here are some suggestions:  Enjoy the time you have that allows you quiet movie watching, an afternoon nap, a quick trip to the store, an uninterrupted dinner with your husband.    These are the last days that you still have control of your time and energy.  Don't wish them away.

Schedule something that will nurture you - a pedicure, a massage, a lunch arrangement with friends.  See a movie you've wanted to see, visit a museum, read a book.  These are adventures that will not be available to you for awhile.

Put an updated message on your answering machine.  I had one friend who would give updates each day of his wife's progress in the pregnancy.  It was fun to call and just hear the update - and not disturb them.  Or a message that says "no baby yet - we'll let you know" answers their ever present question to you.

So enjoy your pregnancy, enjoy the 9th month, and hopefully feel great about the birth.  Babies are worth all this effort - be creative in playing the "waiting game". 

Friday, October 7, 2011

When Births Go Right!

I have worked with many families over the years who have a very specific vision of their birth - they have a strong desire to go unmedicated - they are wanting a certain doctor in the group - they don't want dad to be at work 4 hours away when the labor starts - their mom is arriving on a certain date and they want the baby to wait - their mom is arriving on a certain date and they want their baby to come early - etc, etc.

So when everything falls into place, it is such a joy to relive that birth over and over again.  The hazard of memory is that we can be imprinted with the good outcomes from a birth - or we can be imprinted with the bad issues on a birth.  I have always felt that a doula's role is partly to "reframe" the vision.  The fact is that in birth, as in life, there are ALWAYS goods and bads in the experience.  But what do we choose to focus on afterwards.  Isn't it better to keep your eyes on the highlights, rather than the low parts of an experience?  Especially since we live with birth memories for decades?

Recently I've worked with several first time families who achieved the birth goals they had envisioned.  They stayed home for most of the labor - they worked through the contractions well - they were able to go unmedicated which had been their particular goals.  It is so great to see a mom and dad after such a birth excitedly tell their friends/families how amazing the experience was.  Of course, I was at the birth also and there were definitely moments that were difficult but overall their vision is one of accomplishment and joy.  Isn't that how birth should be remembered?

I've worked with some families lately who chose to use an epidural.  They also excitedly tell their birth stories to their friends and families in glowing terms.  But once again - there were definitely low points during the process.   Those points, however, were momentary - whereas the good parts were foremost in their memory - and thus in their story.

What is the common denominator of such births - that go right for whatever their goals and choices were?  I think it is having a doula - who helps a family weigh their options - remind them of questions they might want to ask - guides them through the process so that they feel informed and part of the decisions.  Empowerment can come from different directions - and this can lead to a good experience.

So here's to the next birth that goes right - medicated or unmedicated - and at the end of the day, my hope is always that the family will tell their birth story with a smile on their face and happiness in their heart!

Thursday, September 15, 2011

25 Years and Counting

Well today is a very special day for me - 25 years ago today I attended my first birth as a labor assistant.  Over these 25 years I have accompanied hundreds of families through their births.  I've even worked with mothers and daughters in their own births.  It's amazing to see these children grown up - and remember that I was there when they entered the world.

So what have I learned after 25 years.  I started with such a devoted passion that each mom should have an unmedicated birth - it just felt right.  I had experienced that myself 3 times and just knew that any mom who could have an unmedicated birth would be forever changed.  Well, I do still believe that a mom who is able to meet the challenge of labor unmedicated - is profoundly changed. BUT I have also learned that an unmedicated birth is not the right path for every mom. Sometimes the option of medication or interventions are just what is needed for a birth.  And more importantly - no matter how focused a mom is on having an unmedicated birth - babies can change all our plans.  I've seen so many moms work through days of labor only to face the tough decision of a surgical birth - through no fault of their own magnificent effort - it was just the way it was going to have to be to have a safe delivery.

I've also seen time and time again the power a dad plays in the whole process.  His presence is always welcome and needed.  They are the strength of the room in so many ways and it is a joy to see a couple rely on each other to bring their baby into their arms.

I've learned that age can diminish your stamina but not your passion.  I will attend a birth tomorrow, #744, and yet I will be as excited to be there as I was with my first birth.  I feel so comfortable around labor.

Labor is a unique challenge - but one that can be met head on with support and knowledge.  It is a path women are equipped to walk - so the more we can remove the fear from this process - the better off all moms-to-be will be.  A healthy fear of this amazing process is normal. But a dreaded, worried fear of labor needs to be changed through more and more great birth stories.

So - 25 years and counting - thanks for the memories!

Saturday, August 6, 2011

When Birth Plans Go Astray

Have you ever seen or written a birth plan with words like "I want to have a natural birth", "Keep the lights low" "I want to be free to change positions" "I don't want to use pitocen"....etc.  Having a birth "goal' is a great start - I think it matters that you have some vision of  your ideal birth.

But have you also written a birth plan and in the end...none of it happened.  Perhaps you felt like it was a waste of time.  You were probably also very disappointed and disillusioned with birth.  Does this mean we should never try to make plans?

Although we can't "plan" birth, we can have some control over certain parts of it.  You have some control over your care provider, you have some control over the support people in the room.  You have some control over the lighting, the music you play, even the clothes you wear. You have some control over positions you try.  You have some control over when you head to the hospital, over the thoughts you are focusing on in labor.

So start with a vision of the birth you would like to have - and then make sure you have great support. And ultimately realize that the baby has the largest vote in the process.  Hopefully some of your vision will be realized - and hopefully you'll leave your birth with a great memory, even if it doesn't exactly match your original "plan".

Saturday, July 2, 2011

Should I Consider a Doula for the Next Birth?

I wasn't sleeping one night and thought about all the birth stories I had heard from moms - when they went through labor the first time and came out of it with a bad memory of the experience.  So I put together a poem as if I was a mom thinking about having another child.  Here is my poem.

Beauty is in the eye of the beholder, so they say
So why don’t I feel about my birth the right way.
That moment was supposed to be so treasured for life
But is only a memory of trauma and strife.

I know my son is healthy and for that I am grateful
But the memory of his birth is still very painful
I thought I was so prepared for what I would face
But then labor started with an out of control pace.

The classes, the books, all our desires became a blur
As I fell into a mindset where I felt so unsure
I didn’t know what to do, what to ask for, my rights
And the end result felt like a cascade of frights.

So next time how do I make the day more cherished.
Wait, am I crazy, I felt I almost perished.
No, that’s not true, and my boy is so amazing.
Another precious child is definitely my craving.

So what can I do this time that last time I didn’t try.
Is there a different class or a book I can buy?
All my friends’ birth stories are locked in my head.
How do I move past all the fear and the dread.

I’ve heard that a doula can give you great aid
Can help when your worried, or frustrated or afraid
She can  remind you of positions and choices you could make.
But the decision is still mine, this is my journey to take.

My husband and mother can make me feel bold.
They will not be replaced by a doula, I’m told.
The room will feel calmer, peaceful, and informed.
Isn’t that what I wanted when my first son was born?

I’m feeling stronger about this, what I’d really like to do
I know I can speak up and should be listened to
That my voice really matters – wow my thinking has changed.
I’m now looking forward to childbirth again.

So perhaps I’ll look into doula support for this birth,
And I’ll talk to my husband and explain why she’s worth
Bringing her into our team, a doula will lighten our journey.
With my husband and a doula I can have a wonderful memory.

Tuesday, June 7, 2011

Long, Long Labors

Have you ever heard  mom say, "I was in labor for 3 days" and you wonder, "How is that possible?"  or more often "Poor lady"....  Technically, medically the medical field does not like to start the clock counting until the contractions are so close and strong that you feel you have to head in to get help.

I however have always felt that the clock started when a mom has to deal with contractions which continue on until a baby arrives.  Contractions, even l5 minutes apart, can interrupt your sleep, eating, life cycle.  Everything takes a back door to a normal life once labor contractions start - no matter how hard you are trying NOT to focus on them.

I have been a part of supporting moms through days of contractions - but in the end, once the baby is in your arms - the process becomes a distant number - impressive absolutely - but a number.  That is why we are able to have another baby - to consider the possibility that a sibling would be a great plan....

Of course, once you are pregnant again, you suddenly realize you will again be going through labor.  My hope is that you consider getting professional labor support so that your birth memory will be a wonderful memory - even when it takes several days.  Labor brings our children to our arms so don't be afraid of the journey.

Tuesday, March 29, 2011


Ask any mom about her childbirth and she will have "snapshot" memories of moments during the process.  I know for my own first birth - I can remember being pushed past the waiting area on their way to get me to the delivery room and I saw a few of my dearest friends who had waited all night to support me in the birth of my first precious boy.  I also have no memory of my husband telling me they were opening a donut shop in the town soon - he said he told me this to encourage me during labor as he knew I loved donuts.  Such selective snapshot memories....

Birth is that way - our own endorphins drug us down to forget so much of it.  Unfortunately,  many moms' memories are of small traumatic, unsupported, unheard moments.  So her overall memory of the birth can be a negative one.   That story - told over and over again to expectant moms - can produce such an atmosphere of fear.

I actually started to pursue doula support decades ago to help correct this "memory".  I have seen the benefit of labor support in producing great "snapshot moments" of a birth for a laboring family.  Adding a few well chosen photographic moments can only enhance that memory.  Since we live with our birth stories in our memory, my hope is that having a doula will reframe your experience into a memory you will look forward to telling over and over again - with a smile on your face! Here's to good memories!

Monday, March 21, 2011

Dad's Role When a Doula Is Present

I think many dads are very unfamiliar with the role of a doula in their upcoming births.  So they may be apprehensive as to how everything will work - how will they be a coach when a professional one has been brought into the room?

I would like to stress that the dad is irreplaceable!  I approach a birth assuming the dad is the coach - and want to strengthen that bond of support with his laboring partner.  A doula is trying to figure out how to help the room feel comfortable and relaxed, while not being an imposing presence to disturb the partners.

I know there are times in a birth where I sit in a corner trying to be obscure  or leave the room so that the two laboring people can spend some quiet time together - or I'm running to get the dad coffee or food or update family so that they have some privacy.

I also know little techniques that can help a mom feel more comfortable in the process and like to show these to the dad so that he can now be an even stronger support person.   His presence is so important to the laboring mom - so it is his hand she wants to hold, his touch she wants to feel. A doula  adds to the support from a female communication point - woman-to-woman speech is very different than man-to-woman so hearing a person who has not only labored but seen it hundreds of times can help a laboring mom feel listened to or comforted.  But it never replaces the presence or support of the dad. I have seen hundreds of dads work through labor - and have always felt they did an amazing job.  They are essential to the room. I realize that is not true of a doula to every birth.  But ask a couple what their experience was with doula support - and you will usually get an enthusiastic birth story from both partners.

So basically - what is the dad's role when a doula is present - it did not change - it is to be the support person - the one the laboring mom leans on during this intense process, if that is the couple's desire.  A doula's role is to support the laboring unit - not to replace anyone.  I hope more dads will feel comfortable adding a doula to THEIR birth team and in the end feel both of their birth experiences were enhanced by her presence.

Friday, March 11, 2011

Time & Unforeseen Occurrences

Planning an unmedicated birth today seems almost impossible.  Most friends, family members, co-workers  will share that an epidural is the only way to give birth.  Having attended births for almost 25 years now, I will say that for some moms, an epidural birth is a perfect birth for them.

Recently I've attended a few first births that have definitely been "marathons", not "sprints" lasting over 30 hours.  What have I witnessed?  I think a longer labor really strengthens a couples' sense of endurance and capabilities more than the quicker ones.   Their determination to continue to change positions, move forward through the wee hours of the night is a privilege to witness.  I've seen dads crash for a 20 minute power nap and then continue on for hours giving support.  I've seen the laboring moms doze off in a certain position only to then continue on for hours of walking, lunging, showers, etc.  Of course, having an additional support person has helped them both to continue through those hours of work.  But this lesson of strength helps these families when they bring their newborn home and are dealing with many sleep deprived days...they have experience to look back on and know they can handle the demands of a newborn. In some cases, those families have re-evaluated their goals after many hours and decided to change their plans.  Those families are still amazing because they worked well beyond what they thought their limits were, and in the end were comfortable with choices made.

The one predictable thing about labor - is that it is totally unpredictable.  Two factors that are helpful to having an unmedicated birth are:  no major medical issues develop and baby cooperates in achieving a great birthing position.   Develop goals for your birth, hopefully add a professional support person (doula) to the team, and then enjoy the journey.  Whether you end your labor medicated, surgically or unmedicated, holding your newborn will still make the journey worth the effort!

Friday, February 18, 2011


Many don't link the thought of "laughter" with a birth.  But I have found many births to contain moments of laughter - and those are great memories.

Recently, the couple and I were rolling in laughter about an event during the labor - and kept retelling it and laughing throughout the day.

Of course, everything is funnier at 4am.  Once a nurse walked in on a dad and I laughing heartily and said, "There is entirely too much happiness in this room."  Yes - and labor rooms can be happy rooms!

A treasured memory is a birth where this couple had several family members visiting.  And the moms began to tell this couple's childhood stories.  Oh my - we laughed for hours.  Still remember this birth fondly.

Once a first time mom had been pushing for almost 3 hours.  It was going very slowly. Then, someone told a joke and the mom started laughing hard.  Guess what - that baby's head quickly delivered - so we said she 'laughed the baby out'.  Isn't that a great memory?  

Some worry about bringing a "stranger" into their labor room so they are cautious about adding a doula. But my experience has been that sometimes those long hours can be filled with a couple retelling their life stories - they've heard them many times - but telling a new person seems to be a pleasant passing of the time. And I have worked with so many interesting people and enjoy hearing their life stories.

So when I think of labor rooms - laughter is definitely a part of my description of that room. I even have two jokes I have told in labors before - just to keep the atmosphere light and pleasant.  If I work with you - I'll be happy to share them!  

Sunday, January 30, 2011

Take A Breath

I have found over the years that as much as breathing is essential to life - it is just as essential to birth.  A mom who is losing focus can be brought back to her pace by monitoring her breathing.  Either her coach or doula can guide the pace to a nice slow steady beat and she can continue to progress in labor.

Recently on a birth - I had the mom resting on the bed.  I would watch the monitor and when a contraction started, I would just gently say, "Okay, take a breath".  The laboring mom realized this was her signal to start working through a contraction.  The benefit to her was that in between contractions she could actually doze off and not be "rudely" awakened by a contraction that had already raced ahead of her focus. She felt more rested while laying down.

Breathing is a key part of working through labor - having a nice steady pace to it - keeping the focus of "in through your nose, out through your mouth" to work with the process.  When you focus on the depth of your breathing, the pace of your breather,  it gives you a tool to use to keep your mind occupied in a positive way to support your labor.

So whether you are in labor - or having a tough day - my gentle reminder is "take a breath".