Doulas and pain meds

It has come to my attention that there may be some misconceptions out there about how doulas support clients in labor. I want to clear those up.

Doulas do NOT try to prevent clients from receiving pain meds in labor.

 

This bears repeating. Doulas do NOT try to prevent their clients from receiving pain medication in labor.

Doulas do not seek after unsuspecting people and try to force them to give birth a certain way. Doulas do not have any goal other than to support a family how they’ve been asked to support the family. They’ve spent several hours together before labor even begins discussing birth goals and brainstorming strategies on how to meet those goals.

While there are people in clients’ lives who try to influence their decisions, clients can rest assured that their doula is not going to be one of them.

 

A doula is an encourager and comforter. Doulas remind their clients that, “You can do this!”  “This” could mean many things. It could mean to handle one more contraction without an epidural because Baby is RIGHT THERE or switching gears to something as far away from the original birth plan as one can get.

Doulas are a sounding board. They can share options and explain risks and benefits of interventions. However, a doula won’t make decisions for the client. Clients must give consent for everything that happens to them because they are the ones with the power over their bodies and health care. They are the ones that must live with the consequences of the decisions made during labor.

Speaking of power. The only other person in the room other than the client that has any power to influence outcomes is the care provider. A doula will not try to usurp the power of the care provider nor attempt to have a position of power over the client. Doulas remind clients of THEIR power and THEIR voice and encourages them to use them.

Doulas are not medically trained individuals, and professional doulas understand their role on the birth team. They will not try to take on a role outside of their boundaries.

Doulas  want their clients to have safe, healthy, and satisfying births.

 

Just to be clear, if a client decides that pain medication is a part of the birth plan, whether that is an epidural or IV pain medication, a doula supports that decision. A doula won’t say, “I don’t think you should do that.”  Professional doulas will not abandon, judge, or be disappointed in their clients should they decide to use pain meds in labor. It is a mistake to confuse encouraging a client to keep going as forcing a client to avoid pain meds. People hire doulas because they want encouragement when labor starts to get hard. People seek out a doula’s support because THEY are they ones hoping to avoid pain medication in labor.

Doulas do not try to stand in the way of clients receiving pain medication. Ever.

 

Doulas are similar to personal trainers. Personal trainers have a special way of motivating people to exercise when they really don’t want to in the moment. People hire personal trainers because they need someone to help them stay motivated. They know they might lose their resolve during the activity. They know they might not feel like exercising some days. They know they need that extra knowledge and encouragement that personal trainers have.

If someone had diabetes, they would need a team of people to help them meet their health care goals. They would need a doctor to help them manage their health care and perhaps prescribe medication that can help control blood sugar levels. They would need a personal trainer to help them implement a fitness routine. They may need a nutritionist to help them formulate a healthy eating plan. A doctor can’t follow people around and encourage them to exercise each day and personal trainers can’t prescribe medication to help control blood sugar levels. But together, they can help an individual reach their health goals by staying within their prescribed boundaries. Just like doulas and care providers can work together to help people reach their birth goals.

Breastfeeding a toddler

Breastfeeding a toddler is something I never thought I would do. Long before I decided to have children, I knew that I wanted to breastfeed my children for one year. I am not sure how I came to this decision, but when I was around 9 years old, I learned that babies were not supposed to have cow’s milk until they were a year old. Using my kid logic, I decided that, if that were the case, then babies should be breastfed until they were a year old. At 9 years old, I decided that any babies I would have would be breastfed for one year.

I do not remember being exposed to breastfeeding at any point until I became a breastfeeding mother myself. I think I must have been pretty lucky to know at such a young age that breastfeeding was even a thing. I honestly can’t recall how I learned about it. I filed away my breastfeeding knowledge for later.

Fast forward nearly 20 years, and I had my first baby. We breastfed through mastitis, blebs, clogged milk ducts, engorgement, and many tears. I took my first doula training when she was 11 months old. I still managed to pump a ton of milk throughout that training. This was before I realized that I had a bit of an oversupply problem- which reoccurred with each baby.

One of my first doula clients hired me for her second birth, and she told me that she breastfed her first child for 2 years. I thought that was amazing. And completely unimaginable. I did not plan to do that, and 2 years seemed so far away. Needless to say, we were still going strong at my first child’s second birthday. I couldn’t believe it. I did not plan it. I wanted to wean her gently, but it happened more abruptly than I was hoping. It also happened way later than I expected. We breastfed for a little over 2 years. I weaned her shortly after I became pregnant with my second baby. It began to hurt too much after the first trimester was coming to a close.

I planned to breastfeed my second baby for 2 years- just to be fair. Our journey together was delightfully uneventful as far as the mechanics were concerned. However, this child was a ruthless twiddler. There was nothing I could do to dissuade her from twiddling the other nipple. Like my first child, I weaned her when I became pregnant again. This little girl loved breastfeeding, and I bet she would still be breastfeeding if I let her.

Again, I decided to breastfeed my third baby for 2 years. I wanted him to have the same treatment as the other two. This being my last baby, I tried to hang onto this breastfeeding relationship for dear life. I wanted to cherish every moment- like they say. I cherished many moments, but this was my most challenging experience yet. I was supposed to be an expert by now, but apparently, I gave birth to a piranha. I never breastfed comfortably. His latch never felt great. He had such a strong suction that I never breastfed without a tiny bit of discomfort. I breastfed through oversupply, 3 bouts of mastitis, clogged milk ducts, engorgement, mangled nipples, gymnurstics more violent than the other two combined, more garlic “pills” than I could stomach, and even a round of antibiotics when I suffered such bad mastitis at 18 months in that half of my breast turned red. It was a bittersweet relationship. It hurt, but I hung on. I kept thinking, “He’s my last baby. This is the last time I get to do this.”

His 2nd birthday came and went with no sign of stopping. A part of me was ready to close this chapter of my life, but another part just wasn’t ready to let go. I nursed him through people asking, “When are you going to wean him?” I nursed him even after people stopped asking. I knew I needed some sort of closure. Some event.

So I signed up to take photos with the amazing Joanna Booth. We took family photos, but I asked if we could take a few breastfeeding photos to mark the end of an era. I’ve been either pregnant or breastfeeding for the past 8 years, so I needed to make it special. I wanted to have something to help me remember this time.

AndyBFColor
My wiggling, active breastfeeding toddler

I wish I could say that I knew the exact day that my last baby weaned. We had our photo session on March 24th, and it has been at least a month now that he hasn’t asked for “ninnie.” I wanted to breastfeed until he finally asked for “ninnie,” which was only about a month or two before we took those photos. Before that he called it “bite.” (Because he wanted a “bite” of milk like he takes a bite of food)

I used to tell myself when my first was a baby that I wanted to enjoy it so much that I wouldn’t need to look back and miss that time. I tried to do that with each baby. As I am typing this post, I am thinking back about all of my time breastfeeding my children. I think I did a pretty good job “enjoying every moment”- even though, let’s be real, there were so many moments that I did NOT enjoy. But I enjoyed enough moments that I am content that I can close this chapter of my life and look forward to all the great moments yet to come.

How having a baby is like having sex

Childbirth and sex are a lot alike. From the hormones that are involved in both processes to the mental aspects of each one, the similarities are quite astounding once you take the time to really think about them. Besides the obvious fact that one act often leads to the other, most people do not think about the fact that childbirth and sex are both reproductive functions. Somehow in our society, birth, babies, and breastfeeding are about as far away from sex as one can get, even though biologically they are much the same. Here are a few ways that having a baby is like having sex.

Hormones & Chemicals

Oxytocin

One of the biggest hormones at play during both of these acts is oxytocin. Doulas love oxytocin! Oxytocin is the love hormone and is present anytime a person is in a bonding situation. For example, oxytocin is present when you are falling in love, sharing a meal, having a pleasant conversation, hugging, kissing, snuggling your baby, having sex, having a baby, and experiencing an orgasm. Oxytocin is the hormone that causes uterine contractions as well as the hormone that makes you feel bonded with your loved ones. The more oxytocin that is flowing in labor, the better your contractions.

Melatonin

Melatonin is another hormone that can be present during both childbirth and sex. While this is not always the case, many people like to have sex at night. Many babies like to be born at night. Melatonin increases at night and is responsible for helping people feel ready for sleep. It encourages people to want to head to bed, and perhaps certain other activities that often happen in bed. Melatonin helps oxytocin work better during labor. In order to encourage melatonin to show up to help its friend, oxytocin, turn the lights low. Melatonin works better in dim lighting.

Endorphins

Our bodies produce endorphins during orgasm, exercise, and childbirth. This is our body’s own natural pain-relieving chemical. Isn’t that amazing? If you’ve heard of the Runner’s High, what you have heard about are those amazing endorphins that make runners feel AWESOME after what would have been a long, extremely painful run without endorphins. Give that runner time for those endorphins to wear off, and that pain will come a’runnin. See what I did there?

During childbirth, oxytocin tells the brain that contractions are happening, and the brain goes, “Whoa. Contractions? Let me help you out with those. Here are some endorphins to make those a bit easier for you.” Endorphins are also released during sex and orgasm. That is why people can tolerate more pain during sex when ordinarily, doing those same things outside of the sex act would be extremely painful. It stands to reason that incorporating pleasure and sex during labor could help lessen the pain of labor.

Adrenaline

One of the hormones that you want to AVOID during both acts is adrenaline. Adrenaline scares contractions and orgasms away. This is the hormone that helps you get ready to run from a tiger or prepare to kick that tiger’s butt. The last thing that someone would want to do when a tiger is licking its lips and getting ready to eat you is to stop to have sex or have a baby. Thankfully, Mother Nature has given us adrenaline, which pretty much does not allow labor or sex to work properly when adrenaline is present. Our modern brains and bodies often don’t know the difference between a tiger getting ready to pounce, scary white coats, or bright lights in a clinical birthing setting. If you feel nervous or scared, or your body is flooded with adrenaline, your oxytocin can’t do its job.

Safety

People give birth the best where they feel the safest and with people that help them feel safe. People have the best sex of their lives when they feel safe. No one has great sex when they are being faced with being eaten by a tiger. I think maybe most people aren’t even thinking about sex when they are being faced with being eaten by a tiger.

Privacy

Both sex and birth tend to work better when those involved feel unobserved. While it is possible to do both while being watched, it often takes longer. It has been said that for every extra person who is at your birth who does not have a specific job, it adds an hour to your labor. While that could just be an old wives’ tale, I have observed this concept in action at many births. Support is lovely, but if that support is only observing and not helping, they may be doing more harm than good. I have also read many stories of people who can orgasm quickly on their own, but once they are with a partner, it takes much longer or sometimes doesn’t happen at all. Both birth and sex require a sense of privacy.

Vulnerability

Both sex and birth need people to be able to “let go” in order to fully enjoy the process. Both of these acts are extremely vulnerable, and you are showing your most vulnerable self to other people. Both acts can be very emotional. You might cry. You might feel fear, anger, joy, and many other emotions. You might get naked. People see your most intimate parts during both acts. You might behave in ways that you wouldn’t during any other time. You need to feel “okay” with whatever happens, being whoever you are, moving, sounding, looking, smelling, saying, thinking whatever you are thinking. It is important to surround yourself with people that you can be vulnerable with during both acts. You need to be surrounded by people that you can trust won’t take advantage of your vulnerability.

Trust

The best sex and childbirth experiences both have trust present. When you trust your partner, doula, care provider, and other support people to keep you safe- both emotionally and physically- during labor, it goes so much better than when you don’t. I believe that sex is better when you can trust your partner completely. The more trust you have with that person, the better the sex. This is not to say that you can’t have great sex with someone you don’t trust, but I believe that trust makes sex better. Do you trust your care provider to advise you properly and be truthful about your health so that you can make the best decisions for your birth? Will you second-guess them later?

Sounds

Funny story. One beautiful spring afternoon, I was watching the Orgasmic Birth documentary with my windows open. I lived in a second story apartment, and the neighborhood kids would get dropped off at the bus stop at 3pm each day. At 3:01pm that day, I heard a large group of kids approaching my window at about the same time a woman was pushing her baby out of her body on my TV screen. I came to my senses quickly! I ran to shut the windows because to an unsuspecting outsider, someone having a baby sounds very similar to someone having sex. To paraphrase the great Ina May Gaskin, someone who is giving birth well sounds like someone who is having great sex.

Movement

Getting into the right positions and moving around to find the best positions is important for both sex and childbirth. The exact movements needed can vary between people, but it is a pretty common theme that movement helps during both acts. It has been said by many doulas and midwives, “What gets the baby in, gets the baby out.” This is especially true with moving around during labor. It is really helpful to exaggerate those hip movements and to dance that baby out like you are trying to seduce a birth ball. It really helps!

Pleasure

If given the opportunity, both having a baby and having sex can be some of the most pleasurable experiences of one’s life. Although giving birth does not have the reputation of being pleasurable, why not? Why can’t people enjoy their births? What is stopping people from experiencing pleasure during childbirth? Pleasure does not necessarily mean pain-free. Many wonderful experiences in life involve pain. It is extremely pleasurable to finally hold a long-awaited college degree in one’s hand, but it often takes a lot of blood, sweat, and tears to get to that point. Even so, there can be pleasurable moments along the way. Finally holding one’s baby is often one of the most pleasurable things we will ever experience, but that does not happen without some pain along the way. We still consider meeting our babies as pleasurable even though pain was involved. Is it possible to consider childbirth a pleasurable experience even though pain is often involved? What can we do to invite pleasure into our birthing experiences? I am on a quest to figure this out. I invite you to join me on this journey.

Resources:

Orgasmic Birth book & DVD documentary

Come As You Are by Emily Nagoski, Ph.D.

Ecstatic Birth– I have not taken the birth practitioner training yet, but I want to some day. It seems amazing! I will, however, take a webinar tomorrow that I am super excited about. Hopefully I will be able to share more later.

 

 

What to do if your water breaks before labor begins

Research shows that about 10% of labors begin with the water breaking. Usually, if left intact, the water will break on its own shortly before pushing. This could be around 8-9cm or more and is very different from what is portrayed on TV and in movies. More often than not, people will have their water broken for them at some point in labor.

Just in case you are one of the few who may suddenly find yourself in a situation where your water has broken, here are a few options and observations I’ve learned over the years.

Membrane Sweep

This procedure goes by several names: membrane sweep, sweeping of the membranes, or stripping of the membranes. This is a procedure in which the care provider inserts a finger into the cervix and attemps to separate the bag of waters from the inside of the cervix. This is intended to stir things up and try to convince the body that labor is beginning. It may or may not put someone into labor. Some studies have shown that it doesn’t necessarily put people into labor, but that it will shave off a few days from when they would have gone into labor in the first place. I’ve noticed that those who call me saying their water has broken have more often than not had their membranes stripped that day or the day before. This is merely my observation, but it is worth researching the risks and benefits of membrane sweeping.

Full moon

I have not noticed this myself, but I’ve had a few conversations with nurses who swear that they see more people coming into Labor & Delivery with membranes ruptured when there is a full moon. I’ve asked them if they have noticed if the full moon puts people into labor, and they usually respond with, “No, but I notice that more people show up with their water broken when there is a full moon out.”

Communicate with care provider

I recommend finding out long before labor begins what your care provider likes to do in the event your water breaks before labor. Some care providers want you to go straight to the hospital and start pitocin immediately. Some care providers want you to go straight to the hospital, yet are willing to wait several hours before starting pitocin. Some care providers are willing to wait much longer, even up to 24 hours or more, before starting any methods to get labor going. The good news is that most people go into labor on their own within 24 hours of their water breaking.

Consider risk of infection

You will likely hear the words “risk of infection” several times during your communications with care providers and hospital staff. They are worried that your risk of infection increases the longer you go with ruptured membranes. The bag of waters has spent 9 or so months providing a barrier between your baby and the outside world. Once it breaks, that protective barrier is no longer able to protect against infection. One of the biggest causes of increased infection is vaginal exams. Even though they use sterile gloves in order to perform vaginal exams, their fingers can push the bacteria that is already in your birth canal further up into the cervix.

Antibiotics

This may or may not be an option in some cases, but ask your care provider if antibiotics can be used to decrease your risk of infection during labor with ruptured membranes. Antibiotics are often used during a labor with someone who is GBS positive, so it stands to reason that they could also be used in a labor where other risks of infection are present.

Take temperature

If you’ve discussed with your care provider beforehand about staying at home for awhile if your water breaks before labor begins, they may ask you to take your temperature every few hours. If you are in the hospital, they will monitor your temperature. A fever can often mean an infection is beginning. If someone has an epidural, there is also something known as an “epidural fever.” You may need to ask them to explain how they can tell the difference between a fever caused by an epidural or a fever caused by an impending infection. A temperature of 100.4 is usually the magic number where other options will need to be discussed.

Breast pump

If you are interested in waiting for labor to begin on its own and do not want to start pitocin immediately, a breast pump may be an option to try to encourage contractions to begin on their own. Your care provider can guide you on exactly how long this should be done in order to stimulate contractions.

Walking

Getting up and walking around may help contractions to begin on their own once your water has broken. Even if you are in the hospital, you may be able to walk the halls for awhile.

Affection and Orgasm

This is similar in nature to the breast pump in that it helps get your own naturally-occurring oxytocin flowing. There is one important rule when your water is broken: nothing should be inserted into the vagina, including fingers and/or penis. Intercourse may be out of the question at this point (unless your care provider gives the green light), but there are other creative ways to experience an orgasm. If having an orgasm seems like something you are not interested in doing, kissing, hugging, and snuggling can also stimulate your own oxytocin.

Massage and comforting touch

Massage is great for getting oxytocin flowing. It may be helpful to get a massage before heading into your birth facility if you and your care provider feel there is time to do so. If there is not time to get one outside of the hospital, some hospitals offer massage services. It may be something to consider. If that is not an option, your loved one and/or doula can offer comforting touch in order to help your oxytocin to flow.

Informed Consent

All of these ideas boil down to making sure that you have enough information in order to make the best decision that you can. The earlier you have these conversations during pregnancy, the easier it will be to make decisions if the situation actually comes up. If you have not had time to discuss these options with your care provider ahead of time, and easy way to remember which questions to ask is the acronym BRAIN.

B- What are the benefits of proposed procedure?

R- What are the risks of proposed procedure?

A- Are there any alternatives to proposed procedure?

I- What is my intuition telling me?

N- What happens if we do nothing?

Pitocin

Even if it comes to the point of you needing to use pitocin in order to stimulate contractions, that does not mean all is lost if you were planning to have a natural childbirth. It does not mean an automatic epidural. It is still possible to have an amazing birth, even if you have pitocin.

How to get the most out of your doula services

Hiring a birth doula provides so many benefits to your birthing experience and is definitely an investment worth careful consideration. I understand that hiring a doula is a big decision, and it is important to me that my clients feel like they have gotten the most out of their investment. Providing outstanding care to my clients is very important to me, and I always hope that my clients are satisfied with the services they receive. Below are a few suggestions on how to get the most out of your doula services.

Take a quality childbirth education class

Doulas know all about birth. They research constantly, and many of them also teach childbirth classes. They are happy to educate their clients on episiotomies and stages of labor. However, one of the most important aspects of doula care is relational support. On average, a doula spends about 3-5 hours with each client before attending their birth. This usually includes 1 interview as well as 2 meetings at the client’s home before the birth. Ideally, these precious hours are spent getting to know each other, building a trusting relationship together, and learning about those things that will make your birth special. A childbirth class is a great place to learn things like the stages of labor, what episiotomies are, the different degrees of tearing, breastfeeding information, and more.

Stay in touch

I can’t stress enough how important it is to stay in touch with your doula, especially during labor. It is up to you to decide how much help you want from your doula. The more your keep in touch with her, the more she can help you. I ask my clients to touch base with me after each of the prenatal visits with their care provider just to let me know how they are doing, if they have any questions or concerns, or if there is anything they need me to help them with. Once in labor, letting your doula know how you are feeling and whether or not you are ready for her help is important. If you are unable to talk on the phone or respond to text messages, a partner, spouse, or loved one can respond instead. That also usually means that it is time to ask your doula to join you in labor.

Hire early

It is never too late to hire a doula, unless the baby is already born. Even then, there is a doula for that! (Postpartum doula) In order to get the most out of your time with your doula, hire her early. Many experienced doulas book up quickly, so it isn’t out of the question to start making calls as soon as you find out you are pregnant. That way when you get ready to hire someone, you know exactly who you want to work with. You’ll be able to open the lines of communication with her and secure your spot when you need to. You’ll have more time to communicate with her and get to know her if you hire her earlier in your pregnancy.

Be clear about your wishes

Let your doula know exactly what you expect from her. Many doulas have wonderful intuition, but some things still need to be communicated. How do you envision your birth? In what ways do you typically find comfort? How do you like to be touched? Do you even like to be touched? Are there affirmations that you love and/or hate? Do you like aromatherapy? These are just a few examples of what can be shared with your doula so that she can do her best work for you. Doulas are some of the most caring and compassionate people on the planet. They want to do a great job serving you!

These are just a few ideas on how to get the most out of your doula service. As with any other service, you are able to utilize the service in a way that helps benefit you the most. Not everyone will utilize their doula services the same way, but hopefully you will be able to get the most out of your investment by following these suggestions.

How doulas provide emotional support and why it matters

I have had the privilege of meeting with many couples throughout my doula career to chat about their births. Sometimes I will get a question that I am not sure how to answer. Even after all this time, I still have a lot to learn.

I interviewed with a couple recently, and the dad asked me an interesting question. What exactly is emotional support? Why does it matter?

I answered that question as best as I could in the moment, but I did not feel satisfied that I answered that question in a way that helped him understand exactly how doulas provide emotional support and why it matters. The standard definition of birth doulas is someone trained in birth who provides emotional, physical, informational, and relational support before, during, and after labor. That has always been the definition, but I have never taken the opportunity to explore exactly what emotional support means until now.

What is emotional support?

I met with someone recently who happened to work in the field of mental health. After I gushed about Brene Brown with her, I began to ask her questions. I explained to her how I was stumped by being presented with this question. She said something to the effect of, “Emotional support is being able to identify what another person is feeling with accuracy and is able to respond in an appropriate, compassionate, and empathetic manner.”

I thought that was a perfect definition. It encapsulated everything I tried to explain in a direct and concise way. I loved her definition!

I’ve asked several people in the past few months what they believe emotional support is and whether or not they believe it is valuable. Everyone has said yes. They feel that having another person to be there for them, to have their back, to listen to their concerns without trying to offer advice or fix them, listening without judgement, offering compassion and empathy in a world deficient in it, and having someone who just gets it, is immensely valuable in all aspects of life, not just during birth. I’m sure most of us can think of times in our lives where we longed for emotional support and didn’t receive it. I’m sure we could identify how emotional support could have improved those situations.

How do doulas provide emotional support?

Doulas provide emotional support during birth in much the same way as a good friend would provide emotional support during any other time that you would want emotional support. In addition to listening to your concerns without judgement, caring about you, and having your back, doulas offer the following:

  • They have no other concerns or agenda- they do not need to chart or keep notes, or worry about keeping anyone alive.
  • They do not try to convince anyone to have a certain type of birth or accept interventions. In other words, they won’t say things like, “Just get the epidural already. There is no need to be a hero.”
  • They encourage, uplift, and never stop believing in their clients’ abilities to totally rock their amazing birth.
  • They see the person underneath all of the technology.
  • They provide warmth in a sterile environment.
  • They smile, tell jokes, or share affirmations when others are asking about pain levels, fixing monitors, or asking about the last time someone ate or went to the bathroom.
  • They remind their clients that they still have time when they feel pressured to answer NOW.
  • They provide calm reassurance which rubs off on those around them.
Melissa Birth Laughing at Jokes
Photo credit: Joanna Booth Photography

Why does emotional support matter?

The first studies done on doulas showed that just having another woman in the room helped women have better births. These women were not family members nor hospital workers. They also just sat in a corner. They did not do all the neat things that modern doulas do, yet they still helped women have better births by their presence alone.

Evidence shows that the best kind of support during birth is someone who knows about birth, is unaffiliated with the hospital, and is also not a member of the birthing person’s family. Doulas are immensely helpful in this area because there is no need to worry about offending a family member that you have to continue a relationship with later. Doulas don’t mind if someone rejects their suggestions or has a hard time staying polite. They understand that is just how labor goes. Doulas help relieve the pressure that many partners now face to know everything and be everything, especially if things begin to deviate from the original plan. They are an extra person that can answer questions if staff gets too busy to answer, and clients can also be assured that their doula will not  omit any important details from their answer.

A doula is in a unique position to practice loving detachment. Think about how hard it is to watch a loved one in pain, whether that is physical or emotional pain. I stink at seeing my husband and children in pain. I’d make a terrible doula for them!

People struggle with seeing loved ones in pain, and as such, have their own pain to deal with. A doula is able to provide support and encouragement without being caught up in anyone’s family dynamic. It is important to have someone that you can vent to without that person getting mad, upset, or taking things personally. It is important to be able to get angry or scared. It is important to have someone you can fall apart around without that person also falling apart. Doulas are used to being that mountain in the emotional turmoil of labor. Being able to weather the storms of labor can mean the difference between a low-intervention or high-intervention birth. It can also mean the difference between a traumatic or satisfying birth.

 

How being miserable and pregnant can be a good thing

I love being pregnant. I love the way my hair looks so thick and lustrous, how steady my moods become, and how I finally have an excuse to let my belly hang out. I love how maternity pants fit me. I love how I feel on a deeper wavelength and more at one with the universe. I feel like I am co-creator with the divine when I am growing a baby. I am a goddess. A warrior woman. My boobs look amazing. I never feel so beautiful as when I am carrying a new life in my womb. I love pregnancy.

Until I don’t.

After 9 months of feeling glorious and lovely, I loathe pregnancy. I. am. DONE.

DONE.

There are several midwives in the Houston area that will tell their clients, “I don’t think you are miserable enough to go into labor this week.”

I am beginning to see a trend with myself and my clients as well. Everyone thinks they are done at various points in pregnancy, but there really is a big difference between “done” and “I am so beyond miserable what was I thinking I hate this and I will do ANYTHING to get this baby out of me.”

I think nature does us a favor in that way. The thought of experiencing contractions might be terrifying to someone who is 5 months pregnant. To someone who is 41 weeks and 5 days pregnant?

Bring it. Bring it like 3 weeks ago.

I’d love to share examples about my transformation from Happy, Glowing Pregnant Lady to Get This Baby Out Now Lady in order to illustrate what I mean.

First Pregnancy

39 Weeks 1 Day

“Still no baby. Yesterday I had an exam and I am 40% effaced, almost 2 cm dilated, and the baby is at a -2 station. I’ve probably been this way for awhile and will probably be like this for awhile. Out of everyone around me, I may be the least eager to get her out. I’m feeling a little nervous about going through labor and delivery, especially since I am attempting this without medication. It’s important to me to have a natural birth, and I know I will be disappointed if I end up needing medication. I’m just scared that I won’t be strong enough to deal with labor. I included on my birth plan that if I ask for pain medications, that those around me will encourage me to try other methods of dealing first. I think that’s what I’m afraid of. I won’t necessarily want the medication, it’ll just mean that I need more support or help dealing with it. It’s weird; I’m not really scared that it’s going to HURT, I’m scared that I won’t make it without being overcome by it.

I’m keeping my fingers crossed that I’ll have an uplifting birth story to be able to share soon!”

39 Week 4 Days

“Last night I finally started feeling impatient with being pregnant. I’ve been pretending that I’m ready for my baby to come out for the sake of being nice to the well wishers that think it’s funny to joke about it. With three days until my due date, I think I’ve done a great job being patient and sweet throughout this pregnancy. But in a snap, I got fiercely angry…” Read more about my “done-ness” and doubts that I will ever going into labor here.

39 Weeks 5 Days

“It’s getting more and more difficult to keep a positive attitude about the whole thing. Who am I kidding? My positive attitude is gone now…I’m getting to the point where I don’t trust my body anymore. I still have no prelabor symptoms…unless you count moodiness, crampiness, and fatigue to be prelabor symptoms. I think it’s just symptoms of being two days away from your due date. I think I’m so mopey today that I broke down and ate a Sonic coney and mozzarella sticks. I haven’t done anything right for the past few days….especially when it comes to food.”

40 Weeks 1 Day (6:32am)

“Yesterday was my due date and I did not have my baby. I went to the midwives yesterday and I am dilated 3cm. My little due date ticker says to take heart because first babies are on average 8 days late. Nice. How come just about everyone else I know had their babies early? Am I doing something wrong? I mean, I AM a little nervous about giving birth, but isn’t everyone? That can’t possibly be keeping me from having my baby.”

This was the day that I truly thought I was going to be the first person in the history of ever to stay pregnant forever, and I gave up on the idea that I would ever go into labor. I went into labor that night. My baby was born at 2:41am the very next day.

Second Pregnancy

This process went much faster during my second pregnancy. I was not ready to go into labor until the night of my due date. That day I told my midwife that I was going to go to the grocery store the next day to buy ingredients for an “induction tea.” I went to bed that night thinking about my grocery list. Early the next morning, I woke up in labor.

Third Pregnancy

My 3rd baby threw me for a loop by coming a week earlier than I expected. That just goes to show you that, with everything pregnancy and birth, there are no hard and fast rules. There are trends and rhythms and ebbs and flows, but no rules. Babies don’t know anything about rules.

I truly believe that nature makes us so miserable at the end of pregnancy that we are willing to go through anything to have that baby in our arms- even the pain of contractions. We might even yearn for the pain of contractions. When we start to experience those first tightenings, we rejoice. Finally! Finally the day has come to birth my baby.

I am ready.

For those who are in that place of in-between where are you are tired of being pregnant but not yet experiencing any labor symptoms, read this. This is my favorite article about that place of waiting.

Houston Childbirth Classes

Another amazing Birth Boot Camp series began in Houston last night. It is not too late to join in! There is still space available for the next two weeks if anyone wants to take a top-notch childbirth class.

I have been teaching childbirth classes since 2014, but I still get those first-night jitters. I am always excited to learn about the couples who join the class. I love how they get to know each other throughout the series and start to relax more as we progress through each class. I can see their confidence grow. I always find it interesting how most people come to Class 1 nervous about birth and by the end of Class 10, they are excited.

Birth Boot Camp has really grown over the past several years. It has gone through many changes and has developed some new and exciting classes. I have listed the new classes I will begin offering this year in more detail under the Services & Pricing page. The current Birth Boot Camp series will be my last Comprehensive (10 week) course for 2018. I will offer the 6 week Hospital course for the rest of the year. I am very excited about helping people prepare to have an amazing birth in the hospital setting.

These classes always come full-circle. On Saturday we were finally able to have our reunion for the Summer 2017 group. I love meeting the new babies and seeing the new parents in action. They are amazing! At the end of every single Class 1, I worry if the couples will bond. I worry if they will feel comfortable in the class. I worry if what they learn will be helpful to them on the big day. By the end of Class 10, and then again at the class reunions, I wonder why I worried in the first place. They are excited to see each other and swap advice and stories.

And so it will be with our newest group of Birth Boot Camp students. Join us!

How doulas help with epidurals

Most of my clients are seeking a natural childbirth and are planning to forego the epidural during their labors. However, for various reasons, some of my clients will utilize an epidural during their birth experience. From time to time, one of my clients or their partner will ask me a question like, “Now that we have the epidural, what is your role? Do you need to stay?” It makes me realize that I did not do enough to educate my clients on how a doula can help them have an amazing birth with an epidural.

So how can a doula help you have an amazing birth with an epidural?

Physical Support

Doulas are amazing at offering physical support during any kind of birth. Even though those with epidurals are usually confined to the bed once they receive an epidural, there is still so much that can be done to help labor stay on track. Doulas help with position changes, comforting touch, and other physical techniques during labor with an epidural. Sometimes someone might still experience discomfort, and they’ve received as much pain medication as they can safely receive. Doulas might still need to apply counter-pressure during back-labor or squeeze a painful hip. There are techniques to simulate walking and squatting, just to name a few. I know sometimes the hospital bed receives a bum rap in the birth community, but there is so much that can be done with a hospital bed! They really can be a helpful tool during any kind of labor.

Peanut ball with logo
Peanut balls are a favorite tool doulas use to help make room for baby to descend during a labor with an epidural.

Emotional Support

Many of my clients have certain fears surrounding how their bodies might react to an epidural, and it can be frightening when those fears are realized. Doulas provide a calm and confident presence and are masters of reassurance. They can explain what is going on and how birth tends to progress once an epidural is administered. They can still work on creating a positive and comfortable environment and are still there to support you through anything that happens.

Informational Support

Once someone has received an epidural, they tend to be more aware of their surroundings. They notice the baby’s heart rate on the monitor more and they now notice every single sound and beep from all of the machines. Sometimes clients become anxious because their minds now have more time to anticipate what comes next or what can go wrong. Doulas love to answer any and all questions to provide more information and if they don’t know the answer, they are happy to help you communicate with your nurses or care provider.

Relational Support

By the time you are in labor, you have built a relationship of trust with your doula. Just her presence alone gives you a particular kind of confidence and comfort to help you have an amazing birth. It may seem like she isn’t doing as much as she would if you were having a birth without pain medications, but she is still serving you much the same way as she does with all of her clients- with her very best work. She is giving you her heart and soul in her support for you. She is giving you her confidence in YOU and how amazing you are.

These are just a few ways a doula can help you have an amazing birth with an epidural. Speak with your doula about how you would like her to support you in the event you receive an epidural, even if that is not your goal. It is helpful to know what you would like just in case, so that you can have your very best birth.

#sharethestruggle

This is a personal post.

When I was pregnant, I took especial care of myself. I ate a diet full of healthy and nutritious food. I exercised nearly every day. I read good books. I practiced relaxations. I took Epsom salt baths. I did everything “for the baby.” My babies always motivated me to take care of myself. Even when I was not pregnant, I prepared for the next time I would become pregnant. My entire motivation for taking care of myself was so I could grow a healthy baby and have an amazing birth.

I am no longer planning on having more children. My “baby” is now 2.5 years old. He is the age that my other two children were when they became an older sibling. It’s funny, if I were planning on having more children, I’d probably have a new baby by now. I still don’t feel ready to have another baby. My “baby” is the babiest baby I’ve had so far. He is so baby-like, and he is not ready to become a big brother. Even if that was what we were planning on doing.

I struggle with self-care. I’m not sure how to fit it in most of the time, and I struggle to feel worthy of self-care. And sometimes, because I take care of people all day long, I just wish someone else would take care of me. I don’t want to add another chore to the to-do list, and, most of the time, self-care seems like a chore

But who could take care of me? Everyone is overwhelmed. Everyone needs to practice self-care. Everyone has too much to do. I have a feeling I’m not the only one who is confused by this whole self-care thing.

The other day I decided I would try to find a guided relaxation for boosting energy. I was so exhausted, but I didn’t have time to rest for very long. I wanted to see if I could take a quick pause to get through the rest of my day. I loved practicing relaxation during my second pregnancy with the Hypnobabies program. I thought, “Why not try it now?”

Then I wondered why I haven’t tried it before now. I explored that question.

Why haven’t I tried to practice guided relaxation before now?

Because I am just a mom now.

I kept exploring.

What does that mean, “just a mom now?”

I figured out that somehow I felt less worthy as a person because I wasn’t growing a baby. There is a lot of affirmation and validation during pregnancy. Everyone is interested in you. Sort of, anyway. There is something special about being pregnant. Even if you don’t get a whole lot of attention, and even if some of that attention is stupid and annoying, there is some attention. And odds are, there is a bit of good attention. Maybe someone throws you a baby shower. Maybe you take maternity pictures. Maybe you get massages and pamper yourself, because after all, you are pregnant. You deserve it. And I mean it, someone growing a baby really does deserve to be pampered. It’s hard work!

And then the baby comes out, and there is a quick celebration. Then life goes back to normal for everyone else, and you just become sort of forgotten.

To much of the world, being a mother is no big deal-nothing to be celebrated. But somehow it is still one of the hardest things on the planet to do. You have to validate yourself. You have to affirm yourself. You have to find meaning in the everyday mundane. There is no lack of judgement and criticism, and nearly 8 years into this gig, I am still not used to it. Some days it just wears on my soul. Some days I just need some affirmation that I am a worthy human being and there are good things about me.

So all of this leads me to the amazing workout I just had with the MommaStrong program. I treated myself to this program. (Self-care) I was tired of having chronic back pain, and I wanted to figure out what I could do to make it go away. (Self-care). So nearly everyday, I exercise in some way. (Self-care) I’ve been doing something each day, whether it is yoga, lifting weights, running, or walking, for nearly eighteen months. (Self-care) I practiced another program (that I liked a lot) to heal my diastasis recti for about a year, and I decided it was time to try something new. I’ve been hearing about MommaStrong for awhile. I decided to take the plunge.

I am so glad that I did! I was in ugly tears after the first few workouts. It was not just the physical healing that was leaving me in tears. I love her life lessons at the end of each workout, and some of them are exactly what I need to hear that day. Some of my favorite lessons could make wonderful hashtags. Maybe they are already hashtags. I don’t understand hashtags. They look like sharps to me. #musicreference #beabeginner #winugly

I’ve been struggling with some negative emotions lately, and I can’t pinpoint where they are coming from. I feel like I need a lot of help from my friends, yet nothing is helping. I don’t know what will help. I keep telling my husband that I am birthing an Anger Baby and I am 8cm. Because when you are 8cm, you just don’t know. You don’t know what you want or what will help. If someone asks you a question, you don’t know. They can ask, “Would you like to get in the tub?” You’ll respond, “I don’t know.” They might ask, “Did you feel pressure with that last contraction?” You’ll respond, “I don’t know.” Because you are 8cm. Or more! When a baby is about to exit your body, it takes too much brain power to come up with words and answers. You just don’t know.

And the partner doesn’t know. It is hard to watch your loved one going through something so difficult and not be able to take the pain away. All you can do is just be there and do the best that you can. Your presence and willingness to just be there means the world.

So here I am, 8cm with difficult emotions that I don’t know what to do with, for about a week now. My poor husband has no idea what to do for me. My friends have no idea what wisdom they can impart. And I have no idea how to help myself because none of my usual self-care tactics are working. I can’t “just think positively” out of this nor can I “choose to be happy” my way out of it. I have to surrender to it.

Which brings me to my amazing workout today. Courtney talked about how the workouts often feel harder the stronger you get.  This happens because you are engaging more of the right muscles and you are doing it more correctly. So your body shakes more and it feels harder. She talked about when you are going through something hard, not to try to condemn it or try to stop it, but to look at it with curiosity. And to reach out to others. And to share the struggle. So many of us suffer in silence until we have it all figured out, then we share what we learned. We don’t share the struggle.

I’m not a fan of sharing the struggle. I want to look like I have it all figured out. Which is funny because no one thinks I have it all figured out. Just this morning I told my husband, “I don’t want to talk to you about it because I don’t understand it yet. I want to think about it, to figure it out, and be able to explain it in rational and reasonable words.”

But here I am. I really just don’t know. I am 8cm. I just don’t get it. I don’t know what to do about it. I’m just going to have to go through it. #surrender #sharethestruggle