Cyndi's Doula Service

Re-framing A Birth

2012-02-22T09:00:00.000-08:00

Birth memories can leave us with a smile on our face - or we could be left with a sense of trauma that we don't want to remember. I began this journey of supporting families through labor to help a family "re-frame" a birth. Since birth, like life, has ups and downs, how do we re-frame it?

During a labor, there are usually moments of frustration, concern, tears....when a family's memory highlights those moments, it can damage their birth memory. There are usually also moments of laughter, joy, excitement. Though these may be momentary (such as between a contraction), what if that is your overall memory of the birth. This feels valuable to me. We carry our birth memories the rest of our lives.

So I like to remind families of those light moments - even sharing in them during the birth. I have found over the years that moms are so powerful when working through labor - and dads are so supportive and concerned. Why not emphasize these characteristics? What if a couple who had to make very tough decisions during the birth, still came out of it with a sense that they made good decisions for this particular birth and this particular situation? Would that not "re-frame" their overall view of the outcome?

Birth memories are important - not as important as your healthy child in your arms - but important still. So if you want help in "re-framing" your birth, I hope you'll consider adding a doula to your birth team.

A Female Voice

2012-01-20T22:19:00.000-08:00

I've always felt the most important support person in a room is the dad. But one thing they can't bring to the support is a "female voice".

Why does that seem so important? Moms in labor can feel very isolated and although they need reassurance and guidance, there are times when they need a female voice. Your husband saying "you'll be okay" does not have the same impact as a woman who has been through labor who says "you'll get through this - it'll be okay". Could be compared to you and your husband backpacking on your own into an isolated area - versus having a trained guide helping you navigate the path.

This does not discount the need for reassurance from the dad - not at all - but having a female voice can be that added support that helps a mom over the rough spots.

Does it matter who the female voice is? Henci Goer in "The Thinking Woman's Guide to A Better Birth" put up a comparison chart of labor support from a female relative or friend or a doula. One of her comparisons is that a female relative or friend "may have beliefs and experiences with labor that may color her behavior and bias her advice". However, a doula "knows you but the fact that you have no ongoing relationship means you don't have to perform for her or worry about what she might think of you." Also a doula "knows about labor, techniques to promote good progress, and comfort measures. She can help facilitate communication between you and your caregivers. She too provides a loving touch." Of course, some relatives or friends can provide great support, and a female voice. You know best who you want to provide support during this journey.

So when you are planning your birth team - give consideration to a female voice, along with your husband. And talk to other families who have added a doula to their birth team and listen to their experiences. Here's hoping the voices you hear in labor will guide you to a wonderful experience.

Special Needs Births

2011-12-05T11:43:00.000-08:00

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.

The Waiting Game

2011-11-19T14:27:00.000-08:00

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".

When Births Go Right!

2011-10-07T15:46:00.000-07:00

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!

25 Years and Counting

2011-09-15T11:20:00.000-07:00

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!

When Birth Plans Go Astray

2011-08-06T14:21:00.000-07:00

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".

Should I Consider a Doula for the Next Birth?

2011-07-02T08:20:00.000-07:00

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.

Long, Long Labors

2011-06-07T08:09:00.000-07:00

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.

Memories

2011-03-29T13:40:00.000-07:00

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!

Dad's Role When a Doula Is Present

2011-03-21T11:09:00.000-07:00

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.

Time & Unforeseen Occurrences

2011-03-11T09:00:00.000-08:00

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!

Laughter

2011-02-18T08:23:00.000-08:00

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!

Take A Breath

2011-01-30T23:07:00.000-08:00

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".

The Business of Being Born

2010-12-26T22:33:00.000-08:00

So tonight I was wanting to just sit on my couch, listen to the rain, and hope for the phone to ring from the client I have who is postdates. Decided to rewatch The Business of Being Born.....probably not a good idea because it made me anxious to be on a birth again! Seeing so many moms pull their newborn to their chest, and realize that the sky's the limit as to what they could do next - they had just birthed their babies!

This experience is minimized by so many today - people who feel they are supporting an expectant mom by reassuring her that there is no need for her to "feel" anything - yet at the end of the road of interventions, won't there be feelings? Will they all be positive? Is it necessarily feeling pain in labor that is to be avoided at all costs? Or feeling that no one is listening to you?

I've attended over 700 births and watched so many moms and dads meet the challenge of labor and come out the other side feeling empowered and excited and joyous - even the families who had to make tough decisions and wisely chose in some cases that interventions were the right choice..

It is not the use of medication or even surgery that is the problem, it is not being given choices in the first place. So as I wait for the next birth to begin, I'm thinking happy labor thoughts for all those expectant families who are hoping to have choices in their births.....come on birth - I'm excited to see you again.

Mom's Intuition

2010-12-12T09:17:00.000-08:00

Who knows the best about the baby - than the mom-to-be. She has an instinct about her baby that no one else shares. So when a mom-to-be feels something is wrong, we take it seriously, check it out - hopefully with the result of a reassurance that all is well. Some moms worry more than others, this is their own nature. But we still should take it seriously.

So when a first time mom goes into labor - she feels unequipped to know what is happened. She feels, "I've never done this before, I don't know if this is labor, I don't know if I'm progressing....." Those feelings are very normal, but stop for a minute. You have just spent 9 months with a baby growing inside of you and each day you have learned your baby's habits, sleeping, waking, which side they like best. You have had a 9 month learning experience to use in understanding your labor.

I learned this lesson years ago while on a birth with a first time mom. The midwife walked in, observed for a short time and then asked the mom - "how far dialated do you think you are?" The mom clearly replied, "I think I'm about 3cm." The midwife said, "I agree" and never did an exam. Later the exam was done - mom was 3cm. This mom truly knew herself. It didn't really matter, honestly, if she was 2cm or 4cm, the fact was she realized she was still in early labor. That was the point - she KNEW what was happening. She trusted her instincts.

So with each first time birth, I try to emphasize, "trust yourself", "find your path"....labor is a journey that has exciting twists and turns, tap into your own instincts and trust them. Just because you have never been through labor before, does not discount that you do know your own body and your baby's habits. Don't hesitate to speak up when you have concerns or think you need help. And speaking on behalf of doulas, just know that we are ready and willing to listen and support your needs.

Weather - labor?

2010-11-27T15:45:00.000-08:00

It's a lovely rainy day - which made me think about all the times labor seemed to come when the storms came. I have always heard that a full moon can bring labor on - gravitational pull being stronger and all of that reasoning. But I've had so many postdate moms who looked on a calender for the next full moon feeling that would be the day we would head to the hospital....and didn't.

But I've had many times where a huge storm came through town and it brought labor with it. Such an interesting drive to the hospital at 3am during a driving rain storm trying to avoid the limbs on the street. Of course I will take rain over fog anyday! Still remember a 2am drive over the causeway to Davis with visibility almost zero....arrived in time to push a baby out-but the drive was not fun.

So can we rely on weather to help encourage the timing of labor - perhaps. But I would prefer to remember that it is the baby who signals the start of labor so the more we can be patient to allow labor to happen on a baby's terms, the better the birth will be.

Are you waiting for labor to start? Sit back and relax and enjoy these rainy days - and hopefully the baby will cooperate in your hopes of labor beginning soon.

Back Up Doulas

2010-11-08T08:29:00.000-08:00

I was reminded this week of how vital it is to have good backup for our work as doulas. I got a call in the morning from a doula who was on a birth at one facility, just heard from a 38 week client who was being admitted to the hospital in another facility, and this doula's backup was out of town. I had enough time to throw on my shoes and run out my door. I was very glad I could help this family have doula support but it actually caused me alot of anxiety about my own clients.

That weekend, I had 3 possible births who could need help. And made many calls to my backups to make sure someone would be available. We all have our own lives, and some were travelling, some were not feeling well, some had family obligations, some were on other births, etc. Thankfully I am surrounded by many dedicated and hardworking doulas so I had assurance I could call if I needed someone.

Then - my fears were starting to come true. One mom starts labor Friday morning but didn't deliver until Sunday around midnight.- another is to be induced Sunday morning and ended up delivering Sunday afternoon- and the 3rd mom who thought she might be in labor on Sunday - has not delivered yet.

All doulas realize that when families work so hard to interview and select a doula, they want THEIR doula. It can be very concerning to learn that someone you don't know might come through that door. So we all work very hard to make sure we are available for our clients. But life - and birth - happens. I am grateful to say I was able to attend both my births on Sunday (with a 2 hour window between them). And they were wonderful families who had amazing births.

I would just like to reassure all families who are concerned that they might end up with the "backup", that doulas are a special breed of women. They come into this work with a concern and passion for labor and support. They are invested in supporting families to the best of their ability. We try to pick backup that we know and have confidence in their abilities. So feel comfortable that if your doula has to send a backup, she will be an amazing support to you through your labor and although your doula will have to mourn the loss of attending your birth, you'll be happy a backup doula was there!

Dads and Doulas

2010-10-26T08:29:00.000-07:00

When I first meet a couple - many times I notice the dad has very little questions of me - his eyes start to glaze over about 30 minutes into the conversation - and I just know he has an overall view of my work - but not a clear picture of how I might be able to help HIM.

I do understand that - it's very hard to describe what a doula does in the labor room - or even in those phone calls during the hours of early labor. I make suggestions, provide reassurance of what is normal, try to give them a clearer idea of what things might look like to say "let's head into the hospital". In the labor room, it can be a position change suggestion, changing the bed, offering a drink of water to the mom, a soothing voice, but I'm definitely concerned about the dad also! Does he need a chair, does he need some reassurance, does he need a suggestion of how to better support her, does he need some coffee or food, does he need to leave for a minute and know that his wife is still supported? Do the family in the waiting room need to be updated? Does the car need to be moved?

Again- hard sometimes to describe what I do. But recently when I was with a first time dad whom I had actually just met the week before - I was so pleased to hear him enthusiastically tell me how much I had helped them on the birth - that he felt he owed me so much. And I was reminded once again that after a birth, dads really are my biggest supporters, my best advertising. So thanks for the hundreds of dads who have allowed me to share their magic moment of birth, and come out on the other side with a great birth memory and a better idea of the value of a doula - to the dad!

Brennen's Birth, October 2010

2010-10-20T15:50:00.001-07:00

Baby #700

2010-10-01T19:15:00.000-07:00

When I started to attend births 24 years ago, I never imagined I would see so many babies come into the world. What has been the toughest part of this passion? First of all - remembering everyone's name! Honestly, the older I get, the worse it is to remember names. But after all these years, I can still remember something from almost every birth I have ever attended.

Today was a real treat. I had worked with this couple on their first birth and felt privileged to be asked back for number 2. And this was a very typical second birth. Mom called me at 5:30am, 30 minutes after going into labor. And baby was born about 80 minutes later. All went well and I was so happy to share their journey again.

And today was a milestone for me - baby #700. Some have teased me that after l000 I'll quit - but who knows. I just know I'm thrilled to have had a part in so many birth stories over the years. If you are expecting - I hope you'll consider having a doula as a part of your birth. It will not only add to your cherished memory - but hers!

Natalie's Birth

2010-08-22T09:54:00.000-07:00

With permission of the mom, I wanted to share a first time mom's birth story - in her own words.

"I was well past my due date, but there were no problems detected with the baby so my OB had let me schedule induction soon as she would be out of town. Up to that point I hadn’t felt any contractions or anything hinting that I was any closer to giving birth. I’d also been 50% effaced and 1+ cm dilated for over 2 weeks with no progress.

We were watching a movie Saturday night just before 11pm when my water broke. I had been planning to labor at home for as long as possible so this kind of threw a wrench in my plan. I couldn’t decide whether to rush to the hospital (as my OB recommended) or trust that since nothing looked bad (amniotic fluid was clear, etc.) and I had only mild contractions to try and labor at home for a while. Jon called our doula, Cyndi, and let her know what was going on and that I was unsure about whether to head to the hospital or not.

I got in the shower since many moms said they liked laboring in the shower, hoping to delay a bit, but standing through contractions was horrible. Jon encouraged me to call Cyndi and talk to her. We discussed everything and I decided to stay at home longer and see how things progressed. Having her reassurance and support was invaluable to me at that point! She asked that we call her by 7am if we were still at home but encouraged us to call her at any point during the night if we needed to.

Throughout the night, contractions continued to get stronger and more frequent but never consistently reaching 3 minutes apart, my goal that would have sent us to the hospital. I sat on the birth ball for most of the evening but was too nauseous to attempt any poses that might have turned my stomach. Although I was sure that I still had a long labor ahead of me (my contractions were bad when they were happening but still of an inconsistent frequency and I was prepared for much worse!) as the sun rose I felt I’d done as much as I could at home. (Since I was unable to even keep the water I was drinking down my concern was that I was becoming too dehydrated and needed to go to the hospital for an IV.) At about 7:10am, dad got in the shower while I called Cyndi to let her know that we were packing up the car and she said she would head out and meet us in at the hospital in about a half hour.

When we arrived at the hospital there was hardly anyone there and we were taken immediately to triage. My contractions had been coming faster since we’d arrived and when there was finally enough of a pause in my contractions for the nurse to check me she said I was already at 5-6 cm dilated! Surprised and relieved, she said she’d take us to labor and delivery do the paperwork once we got to our room. We got into our room about 8:15am and Cyndi arrived within a few minutes. She was excited to hear of our progress and began to help me get settled into the room.

After the IV hook up and initial monitoring I was allowed to get up and Cyndi encouraged me to try standing for a while to help the baby’s head progress further down. I hated this, but she promised it would be short lived and then I could move to the yoga ball. I continued to have nausea and threw up a couple more times—ice chips were no better than water—but with the IV I started to feel a little bit better. I focused on breathing through the contractions and moving rhythmically in circles sitting on the ball until I was given the ok to get into the bed for a little while. Cyndi wet a few washcloths for my forehead (I spent the whole time with my eyes covered with wet washcloths!) and she and dad held my hands as I continued to breathe/moan through contractions. The nurse came back to check me again and said I was at 8 cm and the baby was very low—hooray again! Every contraction after that I would focus on Cyndi’s soothing voice reminding me that this wouldn’t be too much longer and that I was doing really well and squeezing dad and Cyndi’s hands.

Things are a bit fuzzy but I do remember some discussion of calling my OB (who hadn’t left on vacation yet) and letting her know how close I was and the nurse setting up the bed while dad and Cyndi remained at my side. The contractions consumed my entire focus and it was so helpful to know what Cyndi meant without thinking about it when she said to use my yoga breath! With the washcloth over my eyes I could tune out most of what was going on around me and just focus on trying to stay relaxed and getting through each contraction one at a time. As the contractions continued to get more frequent, I really began to feel the urge to push and I heard one of the nurses ask if there was another doctor available in case my OB didn’t make it in time. I could tell things were moving fast but had no sense of time at that point. At one point, I was being told not to push and having Cyndi say “breathe like this…” and show me so that I just had to repeat what she was doing gave me something else to focus on and got me through that contraction.

My OB did arrive in time and I was finally able to push. The fast pace of the contractions did not give me much of a break between pushing but it wasn’t until Cyndi said “push where you feel pressure” that I could tell I was making real progress. I’m told it was only about 30 minutes of pushing but it was one of the most intense things to experience and the ring of fire is no joke! She came out fine despite the umbilical cord being wrapped around her leg three times. I made it through with only a first degree tear and Natalie was born at 10:44am.

My husband noted that we were barely in the hospital 3 hours before she was born—had we waited much longer we may have had an accidental home birth! I can’t say enough how enhanced our birth experience was by having Cyndi there—having Cyndi there as a calming, knowledgeable and experienced doula was a great resource from the moment we hired her and relieved undue amounts of stress off both Jon and I and our labor expectations. I wasn’t even committed to an unmedicated birth, but I’m so amazed that I was able to do it. Best of luck to all the mommies on a quick and easy labor and, more importantly, a happy healthy baby!"

Taking Care of Ourselves

2010-08-16T10:57:00.000-07:00

Recently I had my sinuses affected by an airplane flight - a struggle I have dealt with before. The insistence of my nose to dominate my thinking reminded me that I had to take time to take care of myself. So long nights of sleep, relaxed days, plenty of fluids - all efforts to get well were started.

It reminded me that as moms or even moms-to-be, we can try to ignore the signals our body gives us to take care of ourselves. It is so easy to put our own needs on the bottom of a long list. Everything seems like a priority in our lives - the job - the house - the bills - the family - what gets neglected when we don't feel well? So often we just plow ahead and ignore our body's needs.

But if we are not at our best, we can't give our best to others. So the next time you get a wake up call to take an extra nap - have a long relaxing bath - or just get a massage - why not place taking care of yourself at the top of the list? I highly recommend it.....back to resting for me......

Postdates

2010-07-18T14:07:00.000-07:00

When a due date is given - and usually there is more than one given - a sense of anticipation follows - until, that is. it gets near that date. Then anticipation turns to anxiety as moms fear their baby will not come on that date and induction may have to follow. Will she have to have pitocen? Will the baby be too big?

It's a difficult journey to take when a mom goes postdate. Today I attended a mom's birth - she was 4l weeks. She had been lcm dialated for weeks with no change. Her doctor was going on vacation tomorrow and her doula in 5 days. The anxiety was building. But last night her baby decided to end the suspense and start labor. After weeks of no change - her body dialated quickly her baby arrived less than 4 hours after she reached the hospital. A lovely unmedicated birth. Next month, as she looks back on her birth - the days of anxiety over being postdate will have faded with the cherished memory of her birth. But hindsight is always easy - it is being in that period of postdate that is difficult. Of course - the "real" due date is already decided by your baby.

So if you are coming up to your due date, try to remember that your baby is very smart and your body knows what to do. Trust them both. Try to stay relaxed, hydrated, and rested. Best wishes on your lovely birth - when baby is able to choose his "due date".

Genetics

2010-06-25T13:09:00.000-07:00

How many times have we heard a mom ask "If my mom had short labors, can I hope to have short labors like my mom?". I asked a doctor once if genetics could predict the process of labor in a family. I was told that the only affect would be the shape of a pelvis inherited from a mom. Also I was told that if we looked at a person's sister, we could better have an idea of what this mother's labor would be.

My mom had extremely long labors and so did I for the most part. Was it genetics or just circumstances? I used to think this was genetics - but I don't know that I agree with that anymore.

After attending almost 700 births, I have not seen genetics to play as high a role in the outcome of a birth as I had thought it would.

I have worked with moms who told me their mothers had very short, easy labors - but we have worked through more than a day of labor for this mom. I had a birth recently where her mom had had 3 c/sections and her sister 2. So this mom was concerned that her outcome would run in the same direction as her family - but she tried to prepare well, added a doula to her team, and had a great doctor. Her birth actually went very quickly - pushed only 20 minutes - no problem.

A few years ago I had a family who e-mailed me on her due date that she had agreed to an induction in 2 days. Out of a need to have information - not a criticism of her choice, I wrote back to ask "is there a medical reason for the induction?" This sparked a discussion between the couple - and they opted to decline the induction. Labor came on it's own, we had an unmedicated waterbirth. Only after this did I find out that this mom's family history was a series of inductions - for her mom and sister. So she just assumed that was her lot in childbirth.

So gaining birth stories from families can be interesting to a mom facing labor - but try not to base what your path will be on the history of your family - unless they had wonderful short births - then go with that vision!

Birth = Empowerment

2010-06-08T09:27:00.000-07:00

When you first discover you are expecting, the birth stories start flooding in on you. But do the majority of them contain the word "empowerment"?

When a mom makes a goal of an unmedicated birth, and achieves it, I can say that the sense of empowerment is huge! There is so much anxiety before the event, but once they were in it, it was just putting one foot in front of the other until the baby arrived. They now feel have the strength to do anything.

I have also seen this sense of empowerment by moms who have chosen to use medication. They have made goals to reach before getting medication - and have reached their goal - or gone even further than they thought possible - and have come out of their birth feeling so strong.

Why do I think this is important? Labor is a day or two of our lives. But motherhood is a lifelong rewarding challenge. Starting motherhood with a strong sense of our own power really makes a difference.

So the next time you talk to a mom who used a doula on her birth, see if she felt empowered by the experience. Birth is an amazing journey - let it show you the strength you have inside.

Generations

2010-05-23T08:57:00.000-07:00

After almost 24 years of labor support duties, I can honestly say my joy is supporting families through several births. I realize being invited to a birth is a privilege - and when families see the value of inviting me again - I'm thrilled and humbled!

Recently I had the chance to continue to share the journey of birth with a family for the 3rd time. Nine years ago I was with this couple when they were having their first baby. It was a long labor supported by her family, his family and me. And in the end, mom and dad were amazing in birthing their baby.

Within 8 months, I had the joy of supporting her mom through her fourth birth - again surrounded by the same family members and concluding in a waterbirth. Within another l8 months, in the same room, I again shared the birth experience with the original couple in their 2nd birth. I remember thinking what a joyous journey I had experienced with this family.

Last week, I was again invited back - this time the couple choosing a homebirth in the water for their 3rd birth. I arrived in the early morning hours where we sat in the living room and chatted. As the sun came up, mom and I walked to visit family a few blocks away, then back home. Mom took a nap and within an hour was in "labor land". Everyone arrived including the midwives. Tub was filled and just after noon, mom delivered her child into her arms with the family sharing the moment.

I've seen generations of this family arrive. And I have learned that birth is always a challenging, exciting event. It is never the same, even with the same families. Worries change with each birth - and circumstances. But in the end, if you feel safe and supported, your birth memory can be a joyous one.

So thank you to all the families who have invited me on their journey. Thank you for sharing your memory with me. My hope is that as the generations of your family arrive, I can be a part of your happy event.

Who Should You Invite Into Your Labor Room?

2010-04-06T20:44:00.000-07:00

I'm asked this question alot - and it is always a discussion at prenatal visits. Who should you include in your room - especially since so many family and friends these days are hoping to support you through the birth.

The easiest answer is - whomever you feel you want in the room.

If your goal is to go unmedicated on the birth, it is usually best to minimize the number of support people in the room in the active part of the labor. This is true for a couple of reasons - moms in labor "feel" everyone's eyes on them. Too many people focused on the mom can cause her to feel like a "watched pot". She starts believing it is up to her to move things along - and if it is moving slowly, she starts feeling the pressure - she can have "performance anxiety". I have seen first time moms stall out because the room is full of caring family. One first time mom was 9cm for several hours. When dad asked the family to step out for l5 minutes this was the key to helping mom finish up her labor and enter the period of excitement - pushing! Family were brought back in and everyone was thrilled to share the birth.

There is also the issue of a mom feeling the freedom to deal with contractions in any way that she feels she needs to do it. For instance, if moaning through a contraction makes her feel better - would it make other family members feel nervous or helpless assuming it is a cry for help - when actually it is a coping technique. Would their nervousness cause her to not deal with labor well?

What if she feels a need to move during contractions and yet feels too self-conscious of certain positions - will she be exposed during the movement, etc, and would this be uncomfortable with others in the room. If so - would she hold back from dealing with the labor the best way for her?

For a mom on an epidural - generally she is encouraged to get some rest before the big moment of pushing. Here again - this can be very difficult with alot of visitors in the room. Sometimes it even begins to feel like birth has been forgotten - it is just a time to eat, laugh, and visit. Of course, if the mom is wide awake - she may really enjoy the diversion. So--again, mom has the final say.

Now - having said all of that - do I feel it is bad to have family or friends in the room? Of course not - some moms have been supported by alot of people and felt their care and concern and support and they blossomed under this umbrella of love. I have fond memories of a first time mom - on her knees leaning over the back of the bed in a hands and knees position - and her husband, dad, mom and sister all had one hand on her back gently rubbing her. She told me later that was her favorite memory from the birth.

I have fond memories of sitting on a stool in the corner, while the mom's mom and husband played the support role beautifully. Having a doula does not mean your family and friends are not welcome - or needed!

So - birth is a journey and there are times the journey needs to be minimized in the room and times it can be expanded. Early labor is a great time to visit, laugh, feel everyone's support. Pushing is usually a time of loud encouragement and energy - great to have family and friends for support (if the mom and dad are comfortable with that). I feel it is a gift you give to your loved ones - a wonderful gift of sharing the birth. It is just that middle part that seems to necessitate a smaller room of support in many cases.

So having an honest conversation with family and friends in advance is the best policy - letting them know there may be times you will need them to leave. (And that of course includes the doula!) It may be you need to tell them in advance that their greatest support role will be after the baby arrives, not during the labor.

A doula's role in this is not to make rules of whom you should have in the room or to be the person sending people out of the room - she is just there to fill in the needs of the laboring family - and sometimes those needs are to give them privacy.

So who should you have in the room - give it some thought - have honest conversations and then relax - it's wonderful to have so many who want to support you in this wonderful journey! (And I'm included in that group!)

ANOTHER FIRST BIRTH EXPERIENCE

2010-03-10T21:15:00.000-08:00

Recently I attended a birth with another first time family. The mom later posted her birth story to her childbirth group. With her permission, I'm posting it on my blog - one more story to say birth can be an amazing journey! Enjoy the story:

"I went into early labor around 2 am Monday the 8th, but it just felt like period cramps to me, so I went on with my day, continuing to cook, going to the grocery store (where the clerk told me that during my contractions, someone came up to him and was worried that I was going to "pass out." He replied, oh, no, she's just pregnant (I'm there every day so they know me), and all the other silly things I scrambled around doing in the weeks leading up to the delivery. By about 10 pm, things got serious and by midnight, I called my mom and doula to come over. Thanks to my husband, mom, and doula, Cyndi Whitwell, I labored at home as long as possible, so when I arrived at Sutter Davis at 3:30 am, I was 7 cm dilated. They immediately filled up a birthing tub for me - oh - that warm water felt so good! My husband got in with me and just about exactly 3 hours after I arrived at the hospital, I gave birth to our son in the birthing tub, with his bag of waters still intact, at 6:29 am. I scooped him up out of the water and held him, with his eyes locking in with my husband's behind me and his little finger grabbing on tight to my husband's finger, for about 20 minutes until the umbilical cord stopped pulsing.
We had a magical experience at Sutter Davis, and I must thank Vickie for opening my eyes to natural childbirth, the power of having a doula, Sutter Davis, and the Sutter West midwives. All the preparation I did paid off -- without it and my support structure, I would not have been able to reach my goal of natural childbirth - and would not have been able to do it without the birthing tub! For your next birth, do whatever you have to do to hire Cyndi Whitwell as your doula and deliver at Sutter Davis. I couldn't do it again any other way."

Due Dates

2010-02-13T08:04:00.000-08:00

I read an article once on how 40 week gestation cycles were first figured out. It seemed very "unscientific" to me when I finished reading the article. But it confirmed what I already knew - it's like throwing a dart on a target. If it lands anywhere within the many circles, you have hit the target. Same is true with birth - there is a built in leeway of 2 weeks on either side of the "due date". And we all know gestation cycles vary per woman, just as ovulation cycles and menstrual cycles are unique to the mom.

When I was having my own sons three decades ago, we weren't sent through emotional turmoil with several due dates, like moms face today. Really, what is the first question people ask, "When are you due?" How do you respond? Years ago it used to be, "in the spring", now it's April l2th. But was April l2th calculated by the first day of your last period? Or was it the 20 week ultrasound? Or was it the followup 30 week ultrasound?

Why does this matter? Because moms facing labor today have enough stresses to worry about - without having to be hung up on a certain day. Moms who delivered at 38 weeks with their first, use their due date for #2 to say - I could go into labor anywhere from 37 weeks on. And if they reach the 40 week mark, they feel so overdue they can't stand it anymore. Moms who are worried about induction, use that target date to start stressing over labor not starting as the date approaches. And of course, if they are stressed, they are suppressing the ability to go into labor also.

So what is the answer? I have always felt the baby was the only one who really knew the due date - it was their choice - they are designed to know when they are "ready" to come. In almost 24 years and almost 700 births providing labor support, when moms have been allowed to go to 42 weeks, I have only seen about 3 or 4 inductions. So I trust that babies just know when they should come.

When someone asks, "When are you due?", what's wrong with saying "mid-April", "early June", etc? Or even "soon".

Having said all of this, since I base the amount of births I take by the calender month of the due date, if I ask when are you due, I really do need a "due date" - so pick one you like and let me know, and then we'll leave it up to the baby to pick the right one.

First Time Birth - In Mom's Own Words

2010-01-20T22:23:00.000-08:00

I've been asked a few times to include some birth stories. This mom was quick to write up her story to share with everyone and with her permission I am posting it to my blog. I would like to point out - length of labor is NOT the requirement for having a good birth memory. :) So please enjoy her experience! (And note the photo of the hands was a photo I took - I'm so glad it came out)
...................
Jolyssa's Birth

From the very beginning I wanted a natural child birth. I spent weeks researching my options when I first discovered that I was with child. We moved to Sacramento and were fortunate enough to find a birthing center and a group of doctor's and midwifes that specialized in natural child birth. I had a routine pregnancy, with no complications and was fortunate enough to see a midwife. She was amazing at each appointment, and was always so nice and positive. She never doubted me, and always offered advice that made sense and encouraged me when I doubted myself.

A few months before my delivery, I decided to add a doula to my birth team. A doula is... (Labor/birth support doulas are labor support persons who attend to the emotional and physical comfort needs of laboring women to smooth the labor process. They do not perform clinical tasks such as heart rate checks or vaginal exams, nor do they provide advice. Rather, they use massage, positioning suggestions, etc., to help labor to progress as well as possible. A labor/birth support doula joins a laboring woman either at her home, birth center, or hospital and remains with her until a few hours after the birth. Some doulas also offer several prenatal visits, phone support, and one postpartum meeting to ensure the mother is well informed and supported. The terms of a labor/birth doula's responsibilities are decided between the doula and the family. In addition to emotional, physical and informational support, doulas work as advocates of their client’s wishes and may assist in communicating with medical staff to obtain information for the client to make informed decisions regarding medical procedures.) After interviewing a couple of people, I decided to hire Cyndi. Cyndi, not only made me feel comfortable but she had years of experience that would prove vital for me.

New year's eve started like any other day. We didn't really go anywhere, and decided to stay home that night since I was so far along in my pregnancy. Around 11 pm is when I would say that my early labor started. I noticed some changes in my body but decided to ignore them because if it was labor, I knew that it would take days for it to kick in.

On New year's day, we lounged around the apartment. Went to dinner and watched a movie. I kept feeling contractions but nothing that would have killed me, or that I couldnt ignore. They went on all day and were starting to get consistent. But the movie, took my mind off of them and I really didnt see the point in paying attention. That night I slept well and didnt mind it.

January 2nd- Adrian went to work, and I woke up with pain. It was a nagging pain but nothing unbearable. I emailed Cyndi and described what I was feeling, she confirmed that she believed was early labor. I decided just to relax that day and not tell Adrian because he would freak out. The contractions at this time were about 8-9 minutes apart but again were not unbearable or painful. Before bed, I emailed Cyndi again, and told her that I would update her if anything changed thru the night. The pain did get harder to ignore but I slept well until 4-5 am. When I woke up with stronger pains and could just not sleep anymore

January 3rd- I awoke at 4-5 am with contractions that I could no longer sleep thru. At this time they were 6-7 minutes apart. I emailed Cyndi and she suggested warm baths, walks and keeping busy. We did all of them but soon the contractions started coming 5 minutes apart.... still not completely unbearable or painful. At this point, I told Adrian that I wanted a turkey wrap from Costco, so we drove there and this is when things got interesting. Contractions started to come every 4-5 minutes apart. I got my turkey wrap and we came home... I called the birthing center and described what was happening and my midwife instructed me to stay home until my contractions were 3 minutes apart lasting a minute for an hour. I agree, thinking again, that I was in very early labor.

Around 4pm, I started to get more uncomfortable and contractions started to come stronger. Now they were about 3 minutes apart, we decided to wait the hour and thats when I finally agree with Adrian that it was time to go. On the way to the birthing center, my contractions seemed to slow down. I got worried because I thought that they were gonna send me home with news that I was only 1-2 cm dialated.

We arrived at the birthing center at 5:20 on January 3, 2010. The admitting nurse put me on a fetal heart monitor and we were supposed to have Jolyssa monitored for 30 minutes to check her heart rate and was also connected to a monitor that was measuring my contractions. Jolyssa decided not to cooperate and what was supposed to be a 30 minute monitoring procedure turned into 2 hours. Finally after 2 hours, I got checked and little did I know.

At 7 almost 8pm I was told by the first Labor and Delivery nurse "This cant be, there is no way this is true."
Me: "What?"
Nurse: "I must be wrong, because from what I see, you are 9cm dialated. I need to have someone verify what I see, because there is no way that you can be laughing and cracking jokes and be this far along in your labor."

At this point my midwife came and verified that I was in fact 9cm dilated and that I would be staying. At that point we called our doula, who arrived shortly and were placed in a delivery room with a birthing tub. I was shocked and happy. Everyone was amazed at my high treshold for pain.

The birthing tub was the most amazing thing during my labor. It soothed me, and helped me manage the last stretch of my birth. Unfortunately, when my membranes ruptured, we discovered that Jolyssa had passed meconium in her amniotic fluid, and was told I would have to get out of the tub to deliver her. I was sadden but understood the importance of having to get out.

As I was getting ready for the pushing stage of my labor, I got out of tub. I can honestly say that up to this point, labor was a piece of cake. The pushing, was the most challenging. At this point, it was almost 3am on January 4, 2010. I had been in labor since December 31, 2009 or so and I was exhausted! Adrian had been exhausted too, he even fell asleep during different points in my labor. I swear I wanted to kill him when I saw him sitting there asleep while I was in pain! lol, but having Cyndi there helped me get thru those times. She was a vital part of this success story, I don't know where I would have been without her help. She was there the whole time, making me and Adrian laugh. Walking me thru some of the difficult contractions and helping Adrian to help me.

The Labor and Delivery nurse, Loise, was amazing but like everything else she was not in the room with me the whole time. She would come in and out to check up on me but she would have to leave. This is where Cyndi definitely helped. She was there the whole time and even allowed for breaks for Adrian.

After 2 hours of pushing, I began to panic. I thought that if I didn't make progress soon, someone would show up with interventions such as a C-section. But that was not the case, the midwife, the labor and delivery nurse and my doula all helped me thru the last part of my labor... and an hour later... I gave birth to Jolyssa at 5:08 am on January 4, 2010.

They whisked her away to the warming table where the nurses worked to clear the meconium from her air passage ways and as soon as she was clear they placed her on my belly. I have never seen a more beautiful sight in my life. I could just not believe how beautiful she was and how amazing this whole process was!!!! I was fortunate enough to give my daughter the gift of a medication free birth. I felt a sense of empowerment as a woman and confident as a new mother. The joy I feel in my heart cannot be described in words!

I owe it all to my wonderful birth team!

Adrian- who despite falling asleep (uummm 3 times) was there for me thru the whole process and who I love to death, without you, I dont know where I would be Love. :)

Jessica- Our wonderful midwife! She was so sweet and understanding, never ever pushy. She respected my wishes down to the letter, and gave me sense of empowerment by letting things progress at their own rate.

Cyndi- Amazing, Amazing doula. I dont know where I would be without her. She walked me thru a cloud of pain and made it seem like I did it alone. Thank you so much for being there for me!!!

Loise- Amazing Labor and Delivery nurse, I am amazed at how professional and understanding she was. All L&D nurses are angels!!!

Next baby, I am having at home!! LOL

Labor of love... I got to use the birthing tub for most of my labor, if you ever decide to have a baby... I highly recommend a water birth! It is amazing!!!!

Tired but so worth the wait!

QUIET CONFIDENCE

2010-01-16T12:19:00.000-08:00

I had a client who had this quality - quiet confidence. She knew herself and her baby and had confidence in the directions she wanted to go in labor. So even though her doctor wanted to do an exam or break her water, the mom held firm to what seemed right to her. These were not medical issue discussions, but more pushing the time allowed to labor normally. This couple were so well suited to supporting each other and moved through their labor at their own pace. It was interesting to watch the discussion between staff and this mom - she just held her ground for what felt right to her - of course, with no medical concerns being involved. It didn't become a heated argument or challenging the doctor's medical ability, just a firm stand on issues that were important to this mom, in a quietly confident voice.

Is that ability possible for any mom - I think yes. But it has to start in pregnancy, really getting to know yourself and your baby. Trusting your instincts even if you have never labored before - you are still the best person to know your child. Testing out your voice at your doctor's visits - the sky won't fall in on you if you choose not to have a routine exam--if there is no medical reason for it.

When facing labor, many moms ask "will they let me" whether it comes to positions, clothing, music, lighting, etc. Remember, you are a part of the decision making process. Your voice is still valuable. It still matters how you feel - what you think. So a better way to ask these questions is: "would this enhance my birth, is there a benefit to the lighting being low, playing music I like, using my own clothing, standing instead of laying down". If there is a medical reason this is not to your benefit, the staff will be happy to explain it to you and you can re-evaluate your choices.

Be quietly confident and your birth will feel more like your own journey, one that you contributed your voice to accomplishing.

WHEN DO WE GO TO THE HOSPITAL?

2010-01-06T21:27:00.000-08:00

This post addresses that age old question (well decades old question), when does a family decide it is time to head to the hospital in labor? Of course, this assumes you are not having a home birth. (With my own two homebirths, it was my midwives that had to juggle this question - I had no worries about when to go - I was there!)

If it is your first birth, the bigger issue will be, how do you stay home as long as possible? A first labor can many times be a marathon, not a sprint. So trying to just ignore labor for the early part is essential. Do you have a drawer that needs to be cleaned? A list of thank you notes from baby showers? Some project on your computer? Or just an old movie you have been wanting to see.

If it's daytime, take a lovely walk - if it is inclement weather, make it a walk through the mall. Or go to the grocery store to get the ingredients for a nice dinner. How about making muffins or cookies for the hospital staff later? Think outside the box and be creative about the use of your time.

Once the contractions take over your focus, then you will need to concern yourself with position changes and relaxation - but that is usually many hours into the process. Take as many naps as possible during this "down" time.

So what are you looking for to head to the hospital? There is no one answer. And you have to factor in any medical reasons to go in earlier. If this is a normal progressive labor with no medical issues, you might want to wait until 3-l-l which means 3 minute apart contractions, lasting at least a minute each for an hour. That needs to be combined with feelings of nausea, shakiness, lots of bathroom needs, and a hot/cold temperature change.

Another reason to head in is that the mom doesn't feel safe. Something in her instincts says that she needs to get herself or her baby assessed. Then head in with a view that once you are reassured, you will happily head home to continue your labor.

If you are bleeding excessively, you need to get medical attention.

There are a few other reasons to go - but if you can change your thinking to your home being your "labor room" and the hospital being your "delivery room", your stay in the hospital will be lessened. If you are still needing to talk to someone about this - add a doula to your birth team~

VBAC - TOLAC

2009-12-17T12:08:00.000-08:00

Recently, while attending a wonderful VBAC birth (vaginal birth after cesarean) at a local hospital, I was reminded of the power of words. And more specifically acronyms. I have always called a family trying for a vaginal birth after cesarean as a VBAC birth. But on this day - all the medical personnel used the term "TOLAC" or Trial of Labor After Cesarean. They told me until the birth ended, it was not technically a VBAC but a TOLAC. (I think sometimes it is a medical mentality that all births are a TOL which again may be true technically but we used to just call it labor for the work at hand, not for the pass/fail conclusion).

It always seems that a negative spin is put on birth - especially for a family facing tough or unexpected paths. Why do we call the need for surgery as a FTP (failure to progress)? I know it may be technically accurate - but it seems to say to the family "you have failed" in what is a normal process. Perhaps surgery became necessary due to a baby realizing it wasn't safe to proceed in a vaginal process. Perhaps mom's health would be compromised if it proceeded vaginally. Could it be that the family actually were extremely successful in their decisions and a successful outcome of a healthy baby/healthy mom was achieved? But moms many times end up feeling they are a failure - does that start from the words used?

I'm just thinking out loud here - but I prefer to always believe a birth will work and I feel with good information, decisions, patience, etc, births do work. It is just that we forget, babies have the ultimate say. So THEIR stamp of success on the birth could be a surgical ending but a wonderful beginning for a family of a new baby. So for the next VBAC/TOLAC birth, I think I will just call it what it is - "a birth".

Water births

2009-11-12T19:17:00.000-08:00

I was contacted tonight by a wonderful client that I had the privilege to attend two births for almost a decade ago. And in between those two births, I attended her mom's fourth birth as her doula. So fun to be part of a family's growth. She is now due with #3 - yeah! But she brought up the thought of waterbirth in a comment she made to my blog. So I thought this might be a great time to discuss the value of a waterbirth. Her 2nd birth and her mom's fourth birth were both done in the same birthing room - and were waterbirths.

Sutter Davis, the Birth Center and homebirth are the 3 places you can achieve a waterbirth currently in our area. If there are more places available - please let me know! But I see such a great value to waterbirth. First of all, the tub is relaxing to the laboring mom - she can get lost in the flow and feel of warm water and with low lights and quiet voices, it can be so calming to the birth.When a contraction rises, a mom can have movement in the water while feeling supported by the water, almost acting like another support person. Also dads have entered the tub and provided physical support and enjoyed sharing in the birth of their child up close and personal.

So some of the basic elements for dealing with labor are presented by a water birth - heat from the temperature of the water, physical support from the bouyancy of the water, movement, lower lights, and a more intimate sense for a mom to give into the labor process.

And when a baby finally emerges and is put up to mom's chest to be snuggled, there is such joy and peace in the room. The babies seem calmer and when allowed to float on their back in the water with mom or dad supporting their head, they literally unfurl. So amazing. See the comment on my last entry that Julie made - she says it better than I can.

So are waterbirths worth working for? I say a resounding YES.

The Value of Water

2009-10-30T08:01:00.000-07:00

Water is such an important component of labor support. This will not be a statistical/medical discussion, just my observations. Hydration is extremely important during labor, so coaches need to be vigilant about encouraging the laboring mom to consume lots of liquids. Unfortunately, labor also brings on nausea so there are definitely times only ice chips or IV fluids are invaluable.

Water is an important component to getting an epidural. By flooding the system with fluids, it can benefit blood pressure level. And it is really amazing how much hydration is needed during labor - the body is working so hard!

But what I love about water in labor is the use of a tub or shower. Imagine the sense of warmth and privacy a shower can provide. I really like to keep lights low in the bathroom and with dad supporting through either physically holding the shower head, pressure on the back, verbal coaching, moms can let go in a shower. As the steam builds a mom can feel warm and fuzzy and relaxed and contractions feel less intense. Gravity, if she is standing, can help move babies down while moms are more relaxed. If there is back labor, having the warm water on her back can provide relief through the water temperature or just the feel of the water on her lower back. And if a mom's water bag is ruptured or she is bleeding a little, hopping in the shower can give her a sense of cleanness. When a mom has worked through the night of labor, getting a shower at the beginning of morning just gives her a sense of renewed commitment.

If a family is home, using a shower to relax a mom for sleep or to help her regroup from feeling overwhelmed is a wonderful support tool. Many moms have had several showers during labor because they loved the result.

I have always felt that a shower is a great exchange for a narcotic - same effect of relief but no side effects. There have been so many times a mom has used the shower only to see amazing results in dialation or progress.

But many times it is still a struggle to get a laboring mom is be open to the idea of a shower in labor. She is not sure her ability to cope with labor will continue if she is getting up, undressed, etc. I can only say in 99% of the cases, moms have said it was wonderful, and we have a harder time getting them out of the shower, than we did getting them into the shower. So next time a doula suggests a shower, don't be afraid to try it. You'll be so glad you did.

Stay tuned for a blog on waterbirths - another great use of water.

First birth - Experience

2009-10-26T13:13:00.000-07:00

When first time parents are facing their birth,some have found the support of a doula to be a nice addition to their team. This first time birthing couple had plans to go unmedicated, feeling it would be a safer birth for mom and baby. When labor began, dad did a great job of coaching mom through positions and breathing at home. Doula was able to give suggestions by phone and with labor going fairly quickly, the team regrouped at the hospital. Mom arrived already dialated to 7cm which was exciting. In the hospital room, dad and doula helped mom try different positions including using the birth ball and within 3 hours mom was ready to push. Different positions were tried for pushing and their baby girl arrived safely in less than 2 hours of pushing. This unmedicated vaginal birth was an exciting ending to their pregnancy journey.

There was a downside to this birth - having personality issues with the first nurse who was there the first 3 hours. You never know in labor whom your medical staff will be - having a continuous labor support person in the room can make a difference to having a calm labor room for mom and dad to enjoy the birth.

The mom made this comment after the birth : I concentrated on getting through each contraction rather then the entire process and what was going on around me, or what was going to happen next. I stayed in the moment of each contraction.

This birth will be a great memory to myself and the parents!

FEAR OF LABOR - Part 2

2009-10-07T06:26:00.000-07:00

Do we need to rid ourselves totally of all fear of labor? Realistically this is probably not going to happen. But we can reduce the fear. Knowledge helps us reduce fear - if I know that babies actually do emerge from moms' bodies all the time, it really does work, I have seen it over and over in videos and talked to other moms, then that knowledge should work in my favor when I suddenly face fear in pushing. When my mind is suddenly saying, "How am I going to get this baby out?" If I tell myself with each pushing contraction, "I can do this" or "This is working", I will be working with the natural forces inside of me to produce the baby and pushing the fear aside.

If I know in advance that there will be sensations that are normal to labor - nausea - shakiness - hot/cold flashes - then could I use that information to remind myself that these "normal labor" sensations are telling me that labor is progressing, that my body is doing exactly what it is supposed to be doing to complete this task?

So knowledge is one way to reduce the fear. What doesn't help is hearing numerous negative birth stories from everyone we meet. A mom's memory of her birth is her own - good or bad. But we need to remind ourselves that each of us will uniquely experience this journey and that others' experiences are their own - not ours - this knowledge can help us to move forward to build our own birth story, hopefully with less fear and more determination of the job ahead.

Comments?

2009-09-24T12:26:00.000-07:00

I am hoping that my postings will be helpful to others so I would love to have some feedback. If you have any comments, questions, concerns, would love to hear from you!

"650"

2009-09-24T11:03:00.000-07:00

No, not six dollars and 50 cents. I had the pleasure of attending my 650th birth on Tuesday. And I do mean my pleasure. It was hard to get that first l:30am phone call when I had not slept well the night before, but once I was up and moving, the day moved quickly.

Although this is definitely a milestone in my doula career, each birth still has such special meaning to me. I am in awe of the laboring mom and dad working their way through the process, weighing decisions, grabbing at the "anchors" I provide in a position, a touch, a word.

The strength women show in labor is always encouraging and remarkable and a pleasure to witness. The power a dad shows in his hold, his touch, his presence is a joy to watch. Two people coming together for a common goal - a healthy birth.

And if anyone has any comments on my blog, I would love to hear them. This is a journey I hope to share with many families. I would love your feedback.

So when this 650th baby emerged into the arms of her mom and and dad that morning, I was just as amazed as I was the first time I attended a birth. And so grateful for the privilege of being asked to serve as a guide, a witness, a participant in the process. Thank you to all the wonderful families who have allowed me to share their journey. I'm ready for the next birth!

I'M SO TIRED!

2009-09-11T18:45:00.000-07:00

Hmmm, After 2 births in 24 hours, these words could definitely apply to my own level of energy. But I was actually thinking about the condition in labor where a mom feels she would do just about anything for a little sleep.

It is very common for me to hear a mom observe that she is just so tired. She has usually missed a night's sleep from contractions, anxiety over labor beginning, excitement, etc. She would like to just lay down for a little while, but once she is reclined, the contractions can be so much harder to deal with and her resolve to go forward unmedicated can be challenged.

I have always looked at that "sleepy" attitude as a good sign of active labor. When a mom looks very shut down and sleepy, I know her endorphins are kicking in and helping her deal with her labor. But how do you handle this situation and continue to support a mom "moving forward"? Keeping the reclining period to no more than 30 minutes can help - allowing a mom to rest her legs and body while actively supporting her through contractions can give her a break. She may not come out of it feeling that she is "rested" but she has allowed her body to relax between contractions. And reminding her of the reason she is laying down, to take advantage of the time in between the contractions to just sink into the bed and rest her mind and body.

Using a shower for 30-60 minutes can help a mom to relax and feel "restful" before laying down for that 30 minute period. I have seen moms actually snore between 2-3 minute contractions catching seconds of rest during the last of labor. Low lights, soft music, gentle touch, and lots of pillows can all aid her in feeling that she is resting.

Feeling tired is definitely a part of labor. Being exhausted and fighting contractions is not where you want to end up. So continue to look for little windows of opportunity to recline or rest while keeping your mind on the ultimate goal of accomplishing the birth of the baby in a healthful, happy way. And having a doula support the mom and dad in this journey can feel invaluable.

PATIENCE

2009-09-07T07:54:00.000-07:00

When we prepare for parenthood, we can be overwhelmed by the many responsibilities and requirements coming our way. But that preparation is enhanced by facing pregnancy and labor. In dealing with the many changes and demands of pregnancy, we are starting to learn how to make decisions with the baby as first priority. For first time parents, there is a wonderful training ground that pregnancy provides. And one of the important lessons is patience.

There can be many goals and dreams we develope in the first 8 months of the pregnancy as to how we want the labor to go. And then those last weeks or days seem to just drag by. Each minute becomes an hour watching for labor signs. Life seems to stop until that big event unfolds and we find that patience is now running out. All those great plans of letting labor happen when the baby is ready can be changed in an instant with a simple suggestion - induction. (Now, of course, I'm talking about induction for non-medical issues.)

I have seen expectant moms receive multiple calls from their physicians offering that "they are on call that day and there is a bed available at the hospital for them" and the temptation to just get labor over seems great but they have been firm in their determination to have patience. And the very next day labor begins and quickly a baby is in their arms. Would their trust in their own bodies have been as richly rewarded if they had succumbed to induction?

There is the issue of patience in labor. When those first contractions start, the big question is "Now when do we head to the hospital?" It is very difficult for a family to determine the right time to go even though moms are equipped with such a great instinct as to the best time. Those who had said they wanted to stay home as long as possible, find that quickly they are puzzled with how that will happen. (In those instances, having a birth doula can really help!)

And why is patience such a great lesson? How patient do you have to be to establish breastfeeding? How patient do you have to be when your baby's schedule of sleep differs from your routine? How patient do you have to be when your baby is teething, learning to hold objects but dropping everything quickly, and even later, learning to tie their shoes? Patience is vital to a parent and it begins in pregnancy. When we view pregnancy and labor as a wonderful training ground, it can add so much to our own qualities as a parent. So take a breath, let go a little, and relish the peaceful quality of patience!

TO EPIDURAL OR NOT TO EPIDURAL - THAT IS THE QUESTION!

2009-09-02T23:21:00.000-07:00

Today the majority of women in this country facing labor feel comfortable with the choice of an epidural. Many women don't have any friends or workmates who have tried to go without an epidural in labor - or they have talked to women who started with that goal but abandoned it during the labor. After over 600 births, I do not feel that there is one way to have a baby - I feel it is important for women to be comfortable with their choices and realize this is not a "pass or fail" process. I'm really most concerned that moms feel they have made informed decisions. And one of those decisions could be to avoid pain medication.

I have worked with many moms who were upfront that they planned to use medication in birth. They wanted a support person who was comfortable with their choices. I provided support for the birth with their choice in mind.

I have also worked with many moms whose goal was to go unmedicated. Is this possible? Yes! Is it valuable to pass on an epidural and get through the labor process unmedicated? Yes! But is it the only way to birth a baby? Of course not.

We never know the challenges a mom will face in labor - and babies have to cooperate with the process also. Sometimes they are the smart ones, knowing it was safer to come through surgery than vaginally. We just never know until we get into the process.

Why do some moms choose to avoid medication? It's certainly not that they want to be martyrs. Many times it is hoping to avoid the risk of medication or what they feel will be a domino effect - starting one process that leads to the next, etc. Some feel their body knows how to birth a baby and they want to trust the process. Some want the challenge of working through labor and having nothing to dull their senses or the experience.

Whatever the motivation, I am happy to support the goal. I have seen so many unmedicated births where the value of that choice was not realized until later. And when I ask after the birth - are you happy you did it this way - almost every mom has said an emphatic YES.

Does that mean moms who choose medication are not happy with their choice. Not at all. Again - the biggest issue is informed consent. Has the mom weighed the risks and benefits and made a choice with this given birth and circumstances that she is happy with. Then it is probably the right choice for that birth.

Having a goal for birth is wonderful - it is a dream to reach for - having a great birth memory is a happy memory. Should it be unmedicated or medicated? Ultimately it is usually your choice. Having a support person or doula is also your choice - and I'm hoping it is a choice you will definitely consider!

Fear of Labor - Part 1

2009-08-28T20:50:00.000-07:00

What I have found to be the biggest issue of moms-to-be is "fear". For a first time mom, it is usually the fear of the unknown. How long will labor take, how hard will it get, can I get through it okay? For the 2nd, 3rd, etc mom, it is the fear of the "known". How will I make it through labor again when last time I labored for 2 days, pushed 3 hours, etc.

Now in generalizing feelings, I am also well aware that there are definitely moms who have no fears and moms whose first births are short and sweet.

But fear is still a big issue for many expectant moms. As a doula, I'm always trying to explain enough about labor to eliminate some of the "unknown" for first timers, and some of the "known" for multips. The reality of labor is that the less fear we have, the easier it is to handle labor. But how do we get rid of the fear or do we even really need to get rid of all of it?

Tune in for part 2.

Greetings

2009-08-27T22:05:00.000-07:00

I'm embarking on a new journey - one of sharing my thoughts on birth. I have done this on an individual basis for the last 24 years. But now I would like to give more families encouragement and hope and lessen the fear of labor.

Are you ready to start this journey with me? This is your personal invitation.

Cyndi
A birth doula