Thursday, August 11, 2011

Monday, August 1, 2011

Send Me Your Birth Story!

To celebrate A Mom Is Born’s new logo and website, I’d like to honor women and their amazing power in birth. Something that is generally done in private in a hospital, birth is a secret, and it is not uncommon for pregnant women and their partners to have never seen an actual birth themselves. What is more frightening than the unknown? It’s tough to feel confident when navigating new territory – no wonder women’s expectations of themselves are that they are powerless. What we do see of birth on TV confirms that – women crazed or hysterical, narrowly averting death and danger, women lying down in bed under a tangle of wires and tubes with the soundtrack of beeping and flashing medical equipment.

Do you have a transformative birth story to share? Tell us your story of how YOU gave birth to your baby, not how your baby was delivered by the doc on-call. These stories should be real. Your story may include pain, but tell us about your perseverance. Your story may include fear, but tell us about your bravery. All kinds of stories are welcome.

You did it. Tell us the amazing story of how A Mom Is Born.

I will publish your birth story on my blog as a Birth Story of the Week, using only your 1st name.

Wednesday, June 1, 2011

About Doulas Behaving Badly

I was thrilled to see this resurface from Mother Wit Doula Lesley Everest. I, too, have been told by nursing and OB staff that I'm one of the only doulas they like -- those "other ones" have hidden agendas, or think their wishes are more important than the mother's, or are argumentative. 

In my professional support network, I don't have colleagues who see their role as agitator. And most of us have a preference for what  the mother in the room is showing us, so much so that we don't use information from the fetal monitor, let alone tinker with the machinery.  Do those doulas really exist? Who knows?  Everywhere, but particularly at the larger hospitals where I work and may not be a familiar face to the enormous staff, I mind my place within the hierarchy of hospital culture, and exercise my greatest skills in grace and diplomacy while still meeting the emotional and physical needs of my client. In the eyes of hospital staff, I am only as good as the doula they met before me, whether she is real or a stereotype, and so I am careful. Not only do I love my job, I also care deeply about my profession and the visibility of my professional community, and I envision a day when doulas are a valued, readily accepted part of maternity care

But sometimes it is tricky. As a doula, I have the benefit of a prenatal relationship with my clients, whereas the nurses and OB/midwives don't. There's a lot that I know about what sorts of meanings a woman has associated with her pregnancy, labor, birth, and post-partum. A few weeks ago, my client gave birth to her beautiful baby girl. My client had had a breast reduction some 15 years prior, and it was a goal for her to have as much of a breastfeeding relationship with her baby as she possibly could. She'd done so much reading about Breastfeeding After Reduction, perhaps even more than she'd read about birth.

She knew about the benefits of immediate, uninterrupted skin-to-skin, and it's correlation with higher breastfeeding rates. She reviewed it with her OB, who assured her that skin-to-skin was preferable also from the hospital's point of view, and that as long as there was no need for the baby to go to a warmer or be evaluated by pediatricians, skin-to-skin was the plan. And it did happen. Immediately after the baby emerged, she was placed right on her mother's naked, warm, receptive chest.

For seven minutes.

At seven minutes of life, definitely not an hour, and certainly not before the OB was done even repairing the perineum, the nurse said "Let's weigh her. Of course you want to know what the baby weighs, right?"

A doula's best advocacy tool is to remind her client about choices. If it isn't feasible for the mother to absorb that in any moment, then the next best person is her partner. My client's partner, her husband, was within my reach at that moment. I tapped him on the back and whispered in his ear -- "Do you want to know what the baby weighs, or do you think they'd like more skin-to-skin time?"  He moved quickly from behind his camera and asked the nurse, very politely, for more time, since mom and baby seemed so cozy,  and the nurse agreed.

At 20 minutes of life, so 13 minutes later, the nurse indicated that she needed to weigh the baby  in case she was over 9 lbs and needed blood sugars tested. Baby weighed in at 8.13, and the nurse began to diaper the baby, cover her sweet head with a hat, and then laid out swaddling blankets.

This time the dad was out of my reach, so I couldn't whisper a reminder of all that the mother had read and wanted. It is usually my last option, but I had to exercise it -- and I asked my client in my normal voice, "You can hold her again. Do you want her swaddled, or do you want her naked on your skin?"

The mother's eyes lit up with excitement. "Oh, naked for sure!"

The nurse's jaw stiffenened tight as she began to undo the swaddle. She was definitely displeased and looked at me sternly as she said, "Just be sure the baby is warm enough."

So is that the equivalent of taking a patient off a monitor? Is that the same as undoing an IV? Am I a doula behaving badly? That nurse probably thinks so, and I don't think I've done much to advance my field in her eyes.

But I can live with that.


Friday, February 11, 2011

Less is More

We all know the black and white, or red and blue, of politics. As we quarrel our polemics, so much rich grey gets lost in-between. Birth politics is no different.

Consider this article which appeared in yesterday's news: less is more. It's not all or nothing, one way or the other. It's actually more sophisticated than that: Less Is More. Not only the quantifiable Less Is More, in that when women are in control of their anesthesia doses, they will use less. But Less Numbness is More Satisfaction. Imagine the larger implication: women who have epidurals can also have satisfying birth experiences.

It silences all the propaganda, from both sides: "Why feel pain in an age of modern medicine?" and "Women must completely relish all the sensations of this most natural rite of passage into motherhood!" 

There is such vastness between those two corners into which we paint ourselves for the sake of a sound argument. And who gets to explore that vastness? With this finding about Less is More, the laboring woman gets to explore it for herself, and she gets to define her own world amidst those corners. Even if she has an epidural.

I have attended to women who were certain they would approach their birth in one singular way, they prepared for it, practiced, and knew -- just knew -- that this was how they wanted to give birth. And when labor came around, things changed. It wasn't what they thought it would be. And they found themselves facing decisions they didn't think they would encounter. And they find that they are not actually black and white, they are a whole spectrum of color and shades and textures -- and a whole birth experience exists that is so much more layered than what they thought.

Central to this experience, of course, is autonomy. Mom can choose if Less is More. Or she can choose if More is More. She can decide if None is Bad. or if All is Good. She can circle all those option if she wants, because there is no single right answer, and no one way to give birth. And when she makes her choices from an informed and educated place, with supportive caregivers and loved ones holding her hand, then she can define Satisfaction, as she sees it.