Tag Archives: doula clients

VBAC the hell up

31 Jul

Over a third of women in the US are meeting their babies for the very first time in a sterile OR, while being stitched up from surgery.csection

Many of these women never asked for surgery. Many of them even planned to have a natural, drug free birth. Some of these women did everything right.

Sometimes cesareans have to happen. Often times, they could have been avoided.

Either way, a good amount of these women will then plan a VBAC, or at least want one. This is a problem for many women.

THIS SHOULD NOT BE A FUCKING PROBLEM!! If a woman chooses to have a VBAC, then why should anyone stand in her way? Who gives anyone that right? Hospitals, Dr’s, midwives, even States just simply “Don’t do VBAC”! VBAC’s are BANNED in places, BANNED!!! WHY???

As a doula, I get a lot of VBAC inquiries. So many women at 28, 29, or 30 weeks, who want a VBAC, are with an unsupportive provider, and want me, the doula, to save the day. I can’t save the day. I wish I could. I wish I could give every woman who wants a VBAC the opportunity to get one, but realistically, I can’t.

36917033Realistically, it really sucks for women who are in this position. It really sucks because not everyone is ok with a home birth, and not all birth centers will take VBAC’s, and there are more unsupportive hospitals and doctors than there are supportive ones. It really sucks that most of these women, wouldn’t even be needing to seek out support for a VBAC, if people had been supportive of them the first time around, and if women weren’t made to fear birth in the US.

I hate that people need to fight for VBAC, they shouldn’t have to!

I am a doula. I want you to have the birth you want. I want you to come out of this birth feeling like a fucking rock star.

It really sucks when that doesn’t happen.

It really sucks when you work so hard for a VBAC and you end up with a repeat cesarean. It really sucks for me, and it really sucks for you. My hope is that my clients still feel like rock stars. My clients are fucking rock stars, regardless of how they birth.

But sometimes they feel like shit, and when my clients feel like shit, so do I.this-is-a-job-for..-crap-im-not-wearing-my-costume

And no medical care provider should get to make the decision that leaves me and my client feeling like shit.

This is the not so glamorous part of being a doula. Sometimes you have to feel like shit. Sometimes you have to walk through a really shitty, frustrating and aggravating birth with a client, and feel like shit because you couldn’t save the day.

I can’t save the day.

I can support you though. I can support you even when you feel like shit. I will still think you’re awesome, and I will still tell you that I am proud of you. I will shove my own shit feelings down, so I can talk to you. I will talk to you and tell you all the things you did right.

I will be your rock when you need me, and I will be there to cry with you. I am here if you need to bitch about your shit doctor who wouldn’t even give you a chance.

tumblr_mddhgj6Az01rqlibwo1_500I am here for you, because I am a doula.

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An open letter to prenatal care providers

21 Jul

To my dearest OB, CNM, CPM, LM,

Please feel free to assume that if your name is not on the aforementioned list, and you  provide medical care for pregnant women, that I am talking to you as well….

I have come to learn in the 10+ years of Birthwork as a Doula, that regardless of the fact that I spend more time with the moms you are providing care for during their prenatal, birthing, and postpartum time that I am at the very bottom of the totem pole in the birthing room….  I get that… I don’t think it’s right, but I get that my existence has very little importance in your world…  BUT I want to shed a little light on the situation…  while a mother largely depends on her medical care team, she also greatly depends on her Doula, who she hired to guide her through the birthing experience.  I’m sure you are wondering WTF my point is here, and be patient my friend…   I am getting to it….

I am fully aware that every provider gets nervous when their patients go post dates (past 40 weeks) and even more nervous when the idea of a mother being Post Term (past 42 weeks), but for the love of all that is

3527-nervous good…   can you stop ROUTINELY stripping membranes of all your patients?? Especially BEFORE 40 WEEKS!!!!!  I realize that trying to make a mom start her labor on your clock is way more convenient (because we are all in this business for convenience right??) but please just take one considerate moment out of your life to think about the other people in the equation…  you are not the only one with a proverbial clock here! (Hard to imagine…  I know…  you may need to sit down and take a breath…    let me help you with this one…  close your eyes, relax your brows and your jaw, start with a deep breath in through your nose and out through your mouth…   low moany sounds can really help…See? It helps right?  I’m really good at this.)

Okay, now that you are nice and relaxed and ready to focus, let me list the people that your intrusive actions affect when you try to rush a mom and baby…

1~  most importantly…  BABY!  While yes, many mothers birth as early as 35 weeks and their babes are fine…  and yes 37 weeks is considered “full term” ( a statement I wish every pregnancy book would delete in their upcoming additions), not every baby is ready 28612003at 39 weeks, or 40 weeks and sometimes or even by 41 weeks!!!   Maybe one baby needs some extra time to get into a good position, while another is still has developing lungs and isn’t quite ready for the outside world…  There are so may reasons that a newborn might not be ready to make their entrance into the world…   How can you live with yourself when you are interrupting the beautiful and natural process of a person’s journey earthside??

2~ mama!  Maybe YOU didn’t get the 2 AM calls for the 3 days with mama crying on the other end saying she has been having on and off contractions ever since her provider did a cervical exam and stripped her membranes…  no no..  why would YOU get the call when she hired a DOULA?  So you aren’t the one that has to tell mama through her tears of discomfort and frustration to trust her body even though her care provider doesn’t….    you aren’t the one who may possibly get up and travel in the middle of the night to rub a mamas back while she copes with uterine irritation that doesn’t turn into real labor. So since you aren’t the one who gets to witness all of these things, let me explain to you, that you are indeed causing unnecessary pain and  emotional rollercoasters..  You know those births that you go to, that mama has been up all night 15-best-cat-memes-ever-meow--3283dd863ebefore her labor started, and when you get there she is battling maternal fatigue??  Did you ever stop to consider that it MIGHT be linked to the unnecessary membrane sweep you did the day before…

3~ Dads! Surely you know that men are completely out of control in a birth situation…  (unless you are a controlling male OB in which case you could possibly have no idea what I am talking about, but let me assure you that out in the real world…  men are not the ones that call the shots when it comes to birthing)  so when these dads are having to miss work because their wives keep thinking they are in labor because their care provider told them that stripping their membranes would likely start labor and then nothing happens,…..    they are usually taking time away that they have when the baby is actually here…   when the moms REALLY need the help…  Not to mention that NO MAN likes to watch his wife suffer, and MOST MEN are very nervous when it comes to contractions and babies, and broken water and the like…  this causes a lot of unwarranted hysteria….  Let me tell you…    THOSE 2 AM phone calls REALLY make me love you!

not impressed4~ The Doula~  ah yes now we get to my original point…    maybe you THINK that doulas  have nothing else on their plate than this one mama, but I would like to clear that thought out and remind you that Doulas not only have usually more than one birth client that she spaces appropriately, but they also have their own families, sometimes another job, and their own personal lives…  and if you cause a mom to labor earlier than necessary, I might be at another birth…  I’m sure you are sittin there thinking “what’s she complainin about, doesn’t she have back up? “  well, yes I DO have backup…  But have YOU ever had to call a mom to tell her that you can’t make it to her birth even though she has been visuallizng her birth experience with you there for months?  No…  my guess is that you likely just have your back up do the talking for you…  but it doesn’t work that way for me…  Hearing the sadness in a mom’s voice when you have to explain that is heart wrenching…  it changes her experience…   maybe that doesn’t matter to you…  (which would make you a mean person just to clarify) but it DOES matter to me!!!  When one woman’s unnecessary membrane strip or unnecessary induction affects someone else’s birth, there is a problem here!! (inductions / membrane strippng for medical reasons or as a last resort doesn’t apply here…)

YES we live for our doula clients and their births. YES we are passionate and don’t mind hearing from these families in the middle of the night…  YES we knew what we were getting into when we got into it…   but it can be very frustrating when the root of these multiple calls (and hours of conversation) is simply because YOU CAN’T WAIT!

So let me ask you…   DO YOU live for your clients and their births?  ARE YOU passionate about your job? DID YOU know what you

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were getting into when you got into it?? If not, then maybe you should reassess your situation and decide if you are equipped to handle the pressure of spontaneity… THIS IS BIRTH!!!!  An industry that SHOULD be based on spontaneity and mystery & WE HAVE TO STOP PLANNING BIRTH!!!

I encourage you to take a moment to just enjoy the progression of a natural birth, just how it stands..   Take your ego out of the birth experience…   YOU!  The OB, the CNM, the LM, the CPM….   YOU WERE INVITED!!!!  So honor the process and only step in when necessary …. (and I assure you that a routine membrane sweep is unnecessary regardless of the gold game you want to make, or your cousin’s  wedding that you might miss)…  maybe just try to be supportive of the parent’s wishes for their birth, even if it is something that you would choose to do differently…   recognize that your opinion is just a recommendation and that each mother has the option to take it or leave it…

All of that being said….  Yes I understand that some situations are different… but I’m not talking about the “different” situations, I am talking ROUTINE..  and if you are doing a sweep on more than 10%-20% of your patients, (or routinely encouraging labor to start in other ways), and if ANY of those patients are less than 40 weeks, you should seriously evaluate why you do this job…  if you can’t handle your patient load without managing labors that haven’t even started, then you should possibly consider taking on less so that you can provide more…  this isn’t a factory line…   this is the miracle of life and you get the golden ticket to be a facilitator…

OH!!!   And one more thing….  If you are the type of provider that just shows up to catch…   then why aren’t YOU the low man on the totem pole???

The saddest part of this post (to me anyway) is the need to direct it at more than just OB’s…    hey MIDWIFE!!!  Stop meddling!  Start supporting and empowering the women you work for!  (yeah that’s right!  You work for them!)  start practicing your preach…

Sincerely and in the most loving way possible,

The Doula

 

by Sable Swirl

Grab your bucket

16 Jul

…Because it’s gonna get sappy up in here.

So much of the time, doulas spend the days and weeks following a birth (especially a difficult birth) going over the fightclub“what if”s and “I should’ve…”s. We doulas are empathetic little beings, that’s part of what makes us great at what we do. So when a mom doesn’t cope with labor well, gets an intervention she didn’t plan on, or just flat out has a shitty fucking birth, a lot of us blame ourselves.

We’ll talk more about doula guilt in a later post, because right now I’m going to talk about the opposite of that. Sometimes… awesome birth, shitty birth, doesn’t matter… a client or former client says something to you that fills you with warm fuzzies, switches on the waterworks and makes you beam with Super Awesome Doula Pride.

That happened to me today. I’m still a relatively new doula, as I’m a couple days away from my first doula baby’s first birthday. The very first birth I attended was a fucking incredible, short, intervention-free hospital birth of an enormous baby boy. I could tell when her courage-wolf-fear-reflex-confidence-choicetransition hit, I could hear the “pushiness” in her birthing sounds, and was a great support to the couple – especially for it being my first birth. It was so easy, so amazing. I was on a birth high for weeks, and felt absolutely invincible.

Then the next 9 or 10 births were hard as fuck. Seriously, I almost quit about eight times. A 24 hour birth. A cesarean. A forceps delivery. Two births in three days. A Christmas Eve morning induction…where the baby wasn’t born until evening on Christmas day. Yep, I’ve had a challenging first full year as a practicing doula.

Today one of my former clients from one of my first births who had a particularly difficult situation and a rough labor e-mailed me. I won’t say what she said, but what she wrote in one sentence was enough to flood my body with the warm fuzzies and my face with tears. I did the ugly cry, y’all.

For a second I felt like the stars aligned, the universe and I were on the same wavelength, and a burning bush affirmed what I often wonder: “Should I even be puppiesInBasketdoing this crazy ass work?” And the answer was, “Yes, yes you should. And dude….stop beating yourself up for things you have no control over, and worry about the shit you CAN change.”

And so I shall begin year two of doulahood at peace with the fact that every mama isn’t going to have a perfect birth… but that the affects we doulas have on these mamas births lasts long after the cord is cut.

So give yourself a high-five (clapping works too), go grab your doula bag, and rock some fucking births.

by P

Being empowered is a choice

10 Jul
As a doula, I have a bit of a pet peeve with clients.  It bugs the shit out of me when they ask my advice, and then do the exact opposite or just do what the doctor says.  WHY THE FUCK DID YOU BOTHER HIRING ME?

 

I am a doula.  My job is to lay out all your options, talk you through it, support you in your choices, and tell you when you are not making choices that are going to get you the birth you claim to want.  Take this example. “I want a completely natural birth, but my doctor said I have to have constant monitors, and stay in bed”.  Ok great, so what are you going to do  to get a natural birth?  When LetMeDoMyJobyou picture your labor do you see yourself laying in a hospital bed, strapped to monitors?  Probably not!   I get this ALL THE FUCKING TIME!!  Here it is! If you want a natural birth, you need to find a provider that is supportive of that.  There can’t be a huge list of rules you are expected to follow.  And don’t tell me that you’ll just labor at home and then go in, and think that’s the answer.  It might be, but you know what a better answer is? FINDING A DOCTOR THAT SUPPORTS YOUR CHOICE!  Holy shit, what a fucking concept!!

 

If you want a completely intervention free birth, hire a midwife.  Did you just come up with like 10 reasons why you needed to be in a hospital? Oh, then hire a hospital midwife, but just being in a hospital is going to decrease your chance of an intervention free birth by a huge amount.   Oh, your baby had to go to the NICU last time, so you think it’s safer to be in a hospital. Ok great, then go to a hospital, find a doctor that will support you, and decide what you want to make compromises on, because there WILL be compromises!!!

Do you see where I am going here?  There are a million options, be an informed consumer.  Seriously, it pisses me off when people hire me, tell me they want a natural birth, and then stay with a doctor who dictates how birth is done.  If you want a natural birth, then make choices that support it.  You can still have a doctor, but probably not the doctor that your neighbor who had a cesarean suggested to you.  If you don’t care about a natural birth, you want an epidural, but you don’t want a cesarean, then listen to me about the steps you can take to reach your goal.

 

I am a doula.  I do not make decisions for you.  I do not tell you not to get an epidural, or that you have to have a home birth….but I am going to tell you when your choices and your goals DON”T FUCKING MATCH!!  There is a reason I am telling you this.  It’s not because I am mean, and just want to piss you off….it’s because I have seen it happen, over and over and over again.

 

I don’t want to hear, well my doctor knows me, and she knows I won’t do it if I don’t want to.  You know what? You will, because

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 you’ll be in labor, and because the nurses will come in and tell you it’s time to get an IV, and that because your water broke you need to stay in bed, because it’s against hospital policy to walk with your water broken.  And you know what? You aren’t going to want to fight it, because you are going to be fucking exhausted, and scared that anything you say or do is going to hurt your baby.  When you are in labor, you do not want to fight, you want to just focus on being in labor.

 

Ok, let’s change the direction of this a little bit.  Why did you hire a doula?  Because you want support? Because this is your first baby and your doctor is difficult? Great, now when your doula tells you things, LISTEN TO HER!!!  Don’t write a birth plan and be all excited about it, only to turn around and change your birth plan because your doctor says you “can’t” labor without IV.  Who says? I did it, thousands of other people do it all the fucking time! Why do you need one? You are an individual person, and should be treated as such.

 

So here’s the deal.  Hire a doula, because doulas are fucking awesome.  Hire the right doula, the one how is going to give you what you need.  Hire a great provider who supports your choices.  Make decisions about what you want, what is most important to you, and find a provider who supports YOU.  A great doula can’t work to her full potential if you are willing to give in to all the pressure from rocketsurgery_fullpic_artworkyour unsupportive doctor.  You hire a doula because you want a great birth, I can’t ever guarantee that for you, because you ultimately make the choices, but I can offer suggestions on how to get it.  If you really want it, you’ll make the choices to get there.  If you choose to stay with an unsupportive provider, then you’ll get the birth you signed up for.
by Robin Sparkles

Work for free? Ain’t nobody got time for that.

21 Jun
I haven’t been a doula for all that long, a couple years, give or take.  There’s been a common theme that I have noticed; Free or Low Cost births.  Moms want them, and Doulas are offering them.

 

I happen to live in a large metropolis, where there is a ton of options for the birthing mother, and there are a ton of doulas.  There is a doula out there for every woman, and that is never so true as it is right now.  There are doulas to meet religious requirements, doulas to meet distance requirements, training requirements, birth history requirements…you name it!!

 

Now we have seen a huge increase in the amount of doulas over the last few years, probably worldwide, nationwide and definitely city-wide.  Doulas are popping up everywhere!  They all have a different history, and reason for wanting to get into doula work.  And each and every one feels like offering free or low cost births is what will be best for them as they get started.

 

Ok, confession time! I did births for free, and I did births for low cost.  I did it! I know! But now I am a couple years in, I have some really great experience behind me, and I am having a hard time finding clients.  Me! The doula that everyone says is awesome. Me! The doula that the new doulas come to for advice.  Why am I having a hard time finding clients? Well it would be my guess that since a huge amount of the doulas in town are doing my job for free, people just aren’t really ready to pay me for it.

 

Because here is the reality.  Money is tight, for a lot of people.  That’s reality.  So why would they pay for services that someone beside me is giving away?  If I had to get my oil changed and I had a choice to take it to a mechanic with 20 years experience and pay like $50 or I could take it next door to a new mechanic who was doing it for free, who would I choose? Who would you choose?

 

Doulas are worth every penny they charge, most of the are probably worth way more than they charge.  We are trying to make ourselves a respected part of the birth team.  We can’t do that if we are doing our job for free.  And we certainly can’t do it, if the doulas who have experience and who do charge can’t get clients.  New doulas are just that; They’re NEW.  They don’t have experience, some haven’t taken training, or ever seen a birth.

 

So here is the main point to this whole thing.  STOP! Stop running yourselves around stressing out, paying for expenses out of your own pocket to give a service to a woman for free.  The women who really benefit from a doula are the ones who pay for it.  The ones who are invested in it.  When I did free and low cost births, I had more moms getting cesareans, more moms getting induced and less respect.  I can only say that’s because once I started really getting in there, finding people to pay for my services, getting more educated on how to be helpful in situations, my clients listened to and valued my words.

 

Doulas need to be valued, if we aren’t then we aren’t making any headway here.  We aren’t going to make changes.  The only way we are going to make an impact on birth is by recognizing our value.  Now I told you already that I did free births. I did low cost births, so I get it.  I get where the thinking is.

 

My thinking  as a doula with experience is that, while you are out there getting your experience for free, are the women who truly needed a doula getting the care they need?  Is that mom going for a VBAC really getting a doula who can help her achieve that?  If that woman who ended up with a cesarean for exhaustion, gotten a vaginal birth if an experienced doula worked with her?

 

I understand that sometimes shit happens.  I get that.  But don’t let your need for experience interfere in a woman’s true need for a doula.  I have put a lot of time and money into training, and learning and asking questions, and walking through each birth, step by step, with doula’s who have more experience than me. I still do that.  I still question whether I missed something or could have done something different.

 

A lot of women are brought to this work after having a really great birth. That’s great! I love when women get really great births, it makes me smile.  What doesn’t make me smile is when that woman who had a really easy, really great birth, ends up with a client getting a cesarean because she thinks that everything that worked for her will work for this woman too.  It doesn’t work like that.  You need to know when a woman needs to rest and when she needs to work, when she needs a rebozo and when she needs some time alone with her partner.  You need to be able to take a step back, accept that sometimes women make choices we don’t agree with.  You need to know how to help a woman after she’s decided to get an epidural, even after you had a really awesome home birth.  This is hard work! It’s unpredictable, and it really sucks sometimes.  You need to be ready for that.

 

So to all the new doulas out there, to all you eager, sweet women with your empowered births.  Know your boundaries. Know when you have taken on more than you can handle.  Know that this work is a family sacrifice.  Know that when you are starting out, a woman with a huge amount of emotional baggage, who is suffering from birth trauma, who needs to have a healing birth, needs a doula with experience.  Let your own needs go.  Put that woman’s need for a good birth be more important than your need for experience.  Maybe suggest she hire an experienced doula, and you can shadow, be a part, without being in charge.  Know your limits, your families limits, and know that you are worth it.

 

by Robin Sparkles