Preparing for Birth: The Impact of Written Word

Knowledge is power. Information is liberating. 
Education is the premise of progress, in every society, in every family.

Kofi Annan

Informed consent does not begin in the hospital room when the laboring mother is at a 6. It starts 6 months prior, when she expands her view of birth through the reading of quality words. The words that she pours over and ponders, inhales and imagines, reiterates and remembers, believes and becomes are formidable agents throughout the birthing time. With every pregnancy, I have read about two new books regarding the physiology and psychology of birth. Some books are twaddle: their discussion of pregnancy is succinctly pat and intrinsically irrelevant steeped in telling a woman how to feel rather than asking her the right question and revealing what she believes. 

Quality books stretch the woman mentally before she must be stretched physically. 

They call her to an elevated view of birth, grasping what her body can do and reiterating what she must do in her and her partner's endeavor towards a noble birth. 

Now, in all fairness, when I am pregnant, I always trot out the pet pregnancy book we're all so familiar with: What To Expect, When You're Expecting. There is something so soothing about counting my weeks alongside that book. However, that book doesn't make this list because I believe it does a good job at cursorily covering the basics of each month and stage and some complications, but its adherence to the western medical model does not challenge women to think about their choices; and there is power in choice as well.

Therefore, in no particular order, my top recommendations for pregnant couples:

*The Birth Partner by Penny Simkin- A fabulous guide, especially for partners, which talks through each stage of labor and how to assist the mother. Introduces the very important idea of "Three R's" Rhythm, Relaxation and Ritual. Also has a portion of the "Take Charge Routine" should a mother start to teeter on the edge and need someone to help restore calm from crisis. Incredibly readable--is more like a manual for operation. Highlighted page edges for the important, "oh crap, I didn't read fast enough and now we're in labor" parts of the book. Just all-around fabulous. (If Dad only reads one book, it should be this one!)

*Ina May Gaskin's Guide to Childbirth by Ina May Gaskins- Let's just start by saying, I love Ina May. Ok? I dream about a pilgrimage to The Farm; so, yes..I'm going to be gushy. And yes, she is a hippie. In the true sense of the word (we can have the so-called "modern-day hippie" conversation another time…)  It does delve into the existential at times; however, it is not as "New-Agey" as Birthing From Within. And although I did try and eat my own placenta, I still shave my armpits, so I feel pretty balanced.  WIth that disclaimer, this is the book to read if you need to find your growl. Once you finish this estrogen -packed puncher you will be both crying your eyes out in response to the beautiful births and readily able to flip the switch to Mama-bear mode (it's like Beast-mode, but specialized). This book is all about identifying and banishing fear. Fear is the #1 enemy of birth (and #2 is the hospital bed). Ina May discusses the "Sphincter Law" and her own development of the "Gaskins Maneuver" (yes, the woman has an obstetric maneuver named after her) for optimal birth positioning in OP (occiput posterior) babies and breech, and how kissing and generally making out during labor can help release tons of oxytocin decreasing labor time and increasing birth satisfaction. Communal living, the lowest Cesarian birth in the nation, how breast augmentation impacts birth and "letting your monkey do it" are highlighted! 

*Pregnancy, Childbirth and the Newborn by Penny Simkin, April Bolding, Ann Keppler & Janelle Durham- A tome of pure information. Fully-faceted, pretty much like a information-junkie's What to Expect. I like the dimensions of midwife and doula throughout and legitimate alternatives to interventions and procedures that might not be readily known to the general population. Start here if you can't handle the hippie factor but you want to move beyond general birth data. 

*Naturally Healthy Pregnancy by Shondra Parker- A beautiful born-again believer who is extensively versed in the use of herbs and whole foods to cure most pregnancy woes. Shondra focuses on nutrition and troubleshoots common prenatal predicaments including nausea, hemorrhoids, headaches, uti and more. She also discusses infertility issues and offers holistic suggestions for improving and maintaining fertility. Mama to seven children, she offers "sage" guidance in herbal health for possibly reversing miscarriages, improved pregnancy, and postnatal support. (Come on, I had to…)

*Natural Childbirth the Bradley Way by Susan McCutcheon- This book probably needs a revision soon, but it is still a great help in preparing to labor naturally. I like the indications of stages of labor based on emotional response. Early=elated, active=self-doubt, transition=solemn and of course, nothing is so ecstatic as feeling that hot, squishy newborn crown with incredibly intensity and then slide out into waiting arms. This works is based off Dr. Bradley's Husband-Coached Birth and is a little more aggressive in its intention versus other natural preparations such as Lamaze, but not as novel as Hypnobabies (Klein's "Painless Childbirth) or Hypnobirthing (the Mongan Method)

*Birth Matters by Ina May Gaskins- Ina May discusses the impact of BIrth, Feminism, the Mother-Friendly Childbirth Initiative, the Safe Motherhood Quilt Project, and adds lots of empowering birth stories and historical context for midwifery and obstetric practice in the US. This is for the mother who might want to be a doula or midwife one day. 

I still have many, many books to read, but I can only afford so much at one time! 

If you have a book that you'd like me to read, send it my way. 

In the meantime, browse your local library, download to your reader, join paperbackswap.com or hit up your currently-not-preggo-friend for some loaners and expand your mind to the possibility of a joyful, noble birth.

Why Do We Need A Doula? (I Already Have My Husband…Partner…Mom…Nurse...)

Many couples prepare diligently for their upcoming birth by attending childbirth classes, reading good books, practicing coping measures and facilitating an open dialogue about their hopes, fears and ideals for their birth. Especially when the couple has a healthy loving relationship and the partner is enthusiastic and involved with the pregnancy, the pregnant woman likely asks, "Doesn't it seem redundant to hire a doula when I already have an amazing labor partner?" Likewise, the partner might be concerned that a doula will replace him; the husband thinks that if his wife expresses a desire for an additional labor partner, that his role is diminished, or worse, that he is not a sufficient source of strength for her. Let me just clarify one thing: a doula cannot replace the husband, for that is impossible. To even consider that one is interchangeable for the other is unthinkable.

A doula is like a coach, she cannot do the work of the mother and father, but she can remind them of their game plan, help make changes mid-game, support them over difficulties and celebrate the couple's hard work afterward. Often, couples who are pregnant with their second or subsequent child seek out the support of a doula. Why? Because, they understand the difficult task before them and--possibly because of disappointment, complications or experience--hope to expand their birth team with a person who is focused solely on assisting them with no other obligations.  They no longer hold onto a some-what innocent and romantic ideal that, "We don't need anyone, we can do it alone". Unfortunately, come delivery-time this pressure often overwhelms the partner who is distressed at seeing the reality of labor and at that point, the mother is vulnerable, susceptible and might choose against her ideal desires to alleviate the discomfort she faces. Not always, but often first-time parents need more support than those who have delivered before.

It's easy to consider this in other aspects of life, especially athletics, which lends itself so well as an analogy. Few people set out to run a marathon, complete a rigorous exercise routine (like Insanity or P90X) or excel in professional sports without a team of people around them for support. It's far easier to exercise with intention, even with a video coach than it is to try and figure out a routine by yourself. Even if you have a great partner who is exercising with you, it is just natural to consult online research, buy equipment and possibly hire a digital nutritionist or a device (like a scale, Fitbit or Jawbone) that will help you achieve your goals. It's no different in labor: in preparing for the monumental task of birth, you buy equipment, you read the newest research, you hire a care provider to make sure you are more likely to deliver safely, you drill through practice of visualization and relaxation, you decide who is going to be on your birth team (a mother? a friend? Facebook? other children? a midwife? your OB or another? an anesthesiologist? your doula!) and ultimately you train -to the best of your ability- to deliver to the best of your ability. Now, who wouldn't want their own personal cheering squad that not only had enthusiasm,  but also lots of knowledge and care for just you, your partner and your baby? 

In this article, Penny Simkin does a great job in addressing this very concern in hopes of disarming misconceptions about the role of doula in relation to Dada; enjoy!

The Doula and the Partner: 

How They Work Together to Help the Birthing Woman by Penny Simkin

When a doula discusses her role with women or couples, she may feel a little uneasy when asked exactly what she has to offer. She may find it difficult to give an answer that reflects her usefulness without seeming that she is bragging. The most common question regarding doula care for birthing couples: what about the woman's husband/partner/loved one? There are many valid concerns often raised by couples considering doula care for childbirth. For example:

1.      Partners who have taken childbirth classes may wonder, "Why bother with a doula?" The classes theoretically prepare the father or loved one for that role, and it appears that a doula is redundant.

2.     The doula might interfere with the couple's intimate experience, since she is nearly a stranger to them.

3.      The doula may try to make the woman have the kind of birth the doula wants, not what the woman and her partner want.

Some couples worry that the partner will be pushed out, that the doula will assume that she can do the job better and will relegate the partner to a minor role. On the other hand, some women worry that their partners will not be able to help very much, but are hesitant to suggest a doula for fear of hurting the partner's feelings. And some partners want help, but they feel insecure about their ability to meet all of their wife's or loved one's needs.  Here I will discuss some of the myths or concerns about doulas, along with the realities. They may clarify how a doula works with a woman's partner.

Myth #1: If a woman has her partner, the doula becomes redundant.
Reality: The doula may be the only person at the labor beside the partner who is there solely for the emotional well-being of the woman. The nurse, the doctor, the midwife have other priorities that compete with the emotional care of the woman; for example, breaks, shift changes, clinical responsibilities, office hours and hospital policies. The doula has few or no other priorities. She stays through shift changes, and until after the baby is born. She is not just another stranger with the couple. She has the woman's needs as her sole priority. In some cases, the couple will bring several other friends or family members into labor with them. Sometimes these people can be uncertain of how to help, which leads to confusion and actually adds to the woman's stress. The doula can direct and coordinate the efforts of a group of people, giving them all something useful to do, so they work as a team on the woman's behalf.

Myth #2: The doula "takes over," displacing the partner and interferes with their intimate experience.
Reality: The doula can actually bring the couple closer. By making sure that the partner’s needs are met (food, drink, occasional back rubs, and reassurance), the woman and partner can work more closely together. The doula allows for the partner to participate at his or her comfort level. Some partners prefer to be there only to witness the birth of their child and to share this experience with the woman they love. They may not want to play an active role and do not want to be responsible for the woman's comfort and emotional security. The doula can fill in and allow the partner to participate as he or she wishes, without leaving the woman's needs unmet. When the partner chooses to be the major source of emotional support, the doula can supplement his or her efforts by running errands, making suggestions for comfort measures, and offering words of reassurance, and comfort. During a long tiring labor, she can give the partner a break for a brief rest or change of scene. For the partner who is shy, uncertain, or unversed in his or her role, the doula suggests simple but truly useful tasks, such as timing contractions, holding the woman, supporting her in a particular position, massaging her. In such situations, the doula might take the lead, but the partner plays an important secondary role. While the doula probably knows more than the partner about birth, hospitals and maternity care, the partner knows more about the woman's personality, likes and dislikes, and needs. Moreover, he or she loves the woman more than anyone else there. The combined contributions of partner and doula, along with a competent, considerate and caring staff give the woman the best chance of an optimal outcome.

Myth #3: The doula has her own beliefs about how the birth should go, and imposes it on the woman or couple.
Reality: The doula's true agenda is to help ensure that the woman's or couple's agenda (their birth plan) is acknowledged and followed as much as possible. If the doula is thoroughly familiar with the couple's wishes and their birth plan, she may actually think more about it than the couple, especially when labor is intense and things are happening rapidly. The doula can remind the staff or the couple of some items on the birth plan that are forgotten, but which later might be important. Sometimes if a birth plan is not followed, the couple later look back with regret or disappointment. The doula helps with decision-making by asking questions that will ensure that the right information is given to the woman or couple so that they can make an informed decision. She may also suggest alternatives (like waiting awhile) for the couple to consider. She does not, however, make decisions for the couple.

In summary, the doula helps make the birth experience to be as rewarding and satisfying as possible. As one father said, "I heaved a big sigh of relief when she (the doula) walked in. I hadn't realized how much pressure I had been feeling. She not only calmed my wife, she calmed me down."

What is a Doula?

The word "doula" is from the Greek word doulos (δοῦλος) which means a bond-servant. A bond-servant is one who serves with no regard for their own rights. For Christians, we understand the irony of being an abject slave to another coupled with the dignity and honor associated in giving our service to another in love (Galations 5:19). 

At first, I was a little put off by the word for it doesn't have a magical sound. It sounds like "doolittle" to me, which I have always associated with a doodle-brain. Or even worse, a "doo-doo". Or even a "dodo". But now that I understand what a doula does, and how she is there to serve the mom and dad--not with her own ideals for birth--helping them achieve their ideal birth and offering empathetic support if that ideal doesn't play out; I think there is no better word that could be used in defining my role.

A doula is usually always a woman, trained in childbirth and labor techniques, who assists the mom and partner through labor and delivery of their baby. She does not replace the partner, for that is impossible; she is there to augment the labor team, and her role is distinctly different in that she is unswervingly devoted to her client without distractions, obligations or functions. 

What she does*:
-Recognizes birth as a key life experience that the mother will remember all her life.
-Understands the physiology of birth and the emotional needs of a woman in labor.
-Assist the woman and her partner in preparing for and carrying out their plans for the birth.
-Stays by side of the laboring woman throughout the entire labor.
-Provides emotional support, physical comfort measures, an objective viewpoint, and assistance to the woman in getting the information she needs to make good decisions.
-Facilitates communication between the laboring woman, her partner, and the clinical care providers.
-Perceives her role as one who nurtures and protects the woman's memory of her birth experience.

What she does not*:
-Offer medical advice.
-Perform medical exams/checks.
-Tell you what your ideal birth should look like.
-Speak for you.
-Impose her ideal birth upon you or your partner.

*DONA Manuel 2012

A doula can be a trusted family-member or friend, though it is especially nice to have woman who is familiar with hospital protocols, physiology, and an objective view point. Some women prefer a doula who has birthed her own children, others who have not had their own children come to the birth with no prior expectations, so they don't have any assumptions. A doula may be more familiar with home-births, while others feel more helpful with epidural or VBAC clients. Just as faceted as couples, doulas have differences to match. Finding the right doula for you and your partner takes a little time. If you are considering a doula, remember that a good doula recognizes her role in a sisterhood. She is not an isolationist, hunting down clients. Doulas are all on the same team; we are not trying to outdo the other and we often refer to each other or work as back-ups for each other. You should feel confident in hiring a doula as a team player: she understands she is part of a community.

Ultimately, a doula is a servant; in heart and in mind and in hands. Her service is one of love. Just as a freed bond-servant would remain under the master because of loyal allegiance, so a doula remains because of her love for her clients, their partners, their birth, their children, their story…she is a servant because of love. 

Love, Lauren

Welcome to Baby Love Birth Services!

Over the weekend, I had the privilege and pleasure of gaining a whole new role in this wonderful, crazy journey called LIFE. My mom and I went through the transformation into DONA trained doulas. My beyond-amazing husband took our three littles for three full days (oh, and we weaned Luke this weekend too…) allowing me a literal "girls" weekend in Irvine in pursuit of my 20-year midwife plan. 

Step 1: Become obsessed with BIRTH. Check.

Step 2: Become a doula. Check. 

Although I promised him I would only do what was needed to achieve the credential, I've decided to try running the business from the start --like a business-- and not just a glorified hobby. Hence, the readmittance to the Facebook, the new blog, a business card on the way, and of course, the "grand opening" incentives for potential clients. 

Baby Love Birth Services is a solo operation serving the greater Temecula Valley. My grand opening special is service at three qualifying births in exchange for evaluative feedback and some barter/trade compensation which will be negotiated with the pregnant party. (And we know pregnancy is a party!) The first three pregnant families to sign a contract with me will be on a barter basis. 

It's an exciting time for me as I anticipate serving pregnant families. Thank you for supporting me in this wonderful work; I envision many beautiful days ahead as a birth doula. 

Love, Lauren