Everyone is biased. Yes, even doulas.

There is a movement that has been taking over the doula community, and that is the idea that doulas provide unbiased support. Maybe some do. Maybe some doulas have completely purged themselves of every ounce of bias they’ve ever possessed. However, I am not there yet, nor will I claim to be 100% bias-free. I believe that most people are unable to be completely, 100% bias-free, and so does Brené Brown. And because Brené Brown said it, it must be true.

“Most credentialed professionals do indeed receive some type of training regarding objectivity, but there is ongoing debate about what is truly achievable. Some are taught that objectivity is possible, and they are trained to try to replace their personal lenses with professional lenses when they are with clients or patients.

Others, including me, are taught that pure objectivity does not exist and that people can’t ever completely put away their personal lenses. We are trained, instead, to understand the biases and power of our experiences so we understand how they might affect our interactions with clients. We believe this is the most ethical way to work with clients.”

-Brené Brown. I Thought it Was Just Me (But It Wasn’t). 119.

I can’t promise that I will ever be 100% bias-free, but what I can promise is that I will do my best to not let my biases affect my work in a negative way. And just to be completely transparent, here are some of the biases I am working on.

1. I think natural childbirth is the bomb dot com. 

I will choose that route for any children I ever have as long as it is safe for me to do so. And lest I tempt the universe to bless me with more children, I won’t say anything about whether or not I am planning to have any future children.

I feel like my niche as a doula is working with those who are at least planning to have a natural childbirth. This is not to say that I won’t work with people who are planning other types of births, but rather, most people who hire me are at least preparing to have a natural childbirth.

looking in workbook from behind

2. I think labor should start on its own.

This is a biggie, and I am still working on this one. I’ve just seen way too many clients who were induced struggle much more to achieve their birth goals than those who went into labor on their own. Induction of labor is truly a game-changer. Is it possible to beat the odds and have an amazing induction without even thinking about an epidural? Absolutely! I’ve supported plenty of clients as they did it. They beat the odds.

Odds are, a first time mom whose labor is induced will have an epidural. And if her body really just was not ready for labor, she will have a Cesarean birth. This is not to say that I think inductions and pitocin are the devil (because we all know there is a time and a place for interventions), but that inductions are a whole different ball game.

Because of what I have seen and read, I still believe that going into labor on your own increases your odds of having the birth you want.

3. I like some care providers more than others. 

This one is pretty simple. If a care provider treats my clients like crap, uses fear-mongering, and doesn’t practice evidence-based care, I really don’t like them very much.

If they support my clients’ wishes, I like them.

Very Important Note: Personality has NOTHING to do with whether or not a care provider is supportive.

Let me repeat that another way.

Amazing personality DOES NOT EQUAL supportive care provider

I’ve known some really cool care providers who have sweetly coerced clients into interventions they didn’t want, all while telling the best jokes and just plain charming the pants off of everyone in the room. I’ve known some real stinkers who behaved as if they hated their lives (or at least that moment of their lives), but provided some of the most supportive care in Houston.

If you find a truly supportive care provider who also has an amazing personality, that is just icing on the cake.

4. I think home birth is super spectacular. 

I have chosen to have two of my babies at home, and I can’t imagine doing it any other way. I believe women give birth the best where they feel the safest, and I feel safest at home. I gave birth to my first baby in the hospital, and I couldn’t have felt safer in any other place for that birth. I loved my home births, but I also loved my hospital birth. That birth was amazing and inspired this doula journey of mine.

However, I can’t help but wonder sometimes how some births would have gone if they would have started at home. Home births are just different. The only way that anyone can really tell how they are different is to attend several. Doulas have a unique viewpoint because they attend births everywhere. I’ve attended births in hospitals, birth centers, and homes. They all have their own flavor, so to speak.

I think it would be really awesome if home birth midwives could spend some time attending hospital births as part of their education and OBs and hospital midwives could spend some time attending birth center and home births as part of theirs. I still have this crazy idea that hospital and out-of-hospital  care providers could help each other out. It could really benefit families. And it’s not like hospitals would be losing much money. Most people still prefer to give birth in the hospital setting.

Melissa Birth Talking in Birth Tub

5. I don’t judge your choices, but I do kinda hope you make certain choices over others. 

If you have a notoriously crappy care provider, I really hope you switch to a better one. Because I know you will have a better birth with a better care provider. It isn’t because I think I know better than you how your birth should go. It’s really just a simple matter of numbers and past experience.

If there really is no medical reason indicating you need to be induced, I really hope that you choose to go into labor on your own. Because I know you are more likely to have the birth you want if you choose to wait for labor to begin on its own. I’ve seen lots of inductions, and it really does make a difference.

And when my clients are expecting a boy, I always hope they choose to leave him intact. Because there really isn’t a medical reason to do it. (Unless there is, but that is such a super small proportion of people.)

But with those biases out in the open, here is what I won’t do:

I won’t tell you that you need a new care provider. I won’t tell you that your care provider is awful. I will never say a bad word about them, and I won’t fight with them in labor (I’m not that kind of doula). I will be kind and respectful to everyone on your birth team.

Instead, I will:

Ask you how your appointments are going. I will ask you how you feel when you are with your care provider and what concerns you might have. I will let you know what supportive care looks like so that you can decide for yourself if that is what you are getting. If you feel happy and confident with where you are, I will trust that you know something I don’t and try not to cause you to second-guess yourself. If you mention to me that you aren’t feeling great with your care provider, I will ask questions and share options with you if you want them.

I also won’t:

Tell you not to get induced (or insert other medical intervention here). Because I don’t know your full medical history, and I am not your care provider. It is not my place to steer you one way or another.

Instead, I will:

Trust that you know something that I don’t. You know your body, your baby, and your care provider better than I do. I will do my best to help you have the best induction possible. I will ask you questions about how you are feeling, and if you are happy, I won’t try to cause you to second-guess yourself. If you are not happy, I will ask questions, share options, and act as your sounding board. I will always encourage you to trust your gut.

And finally, I won’t:

Even bring up the circumcision thing unless you ask me for my opinion on it. In which case, I’ll tell you. But at first, I’ll be all doula-like about it, until you say, “No, really. I want to know your opinion.”

Because it really boils down to the fact that my opinions don’t matter when it comes to your choices regarding your birth. My job isn’t to have opinions. My job is to help YOU feel supported in YOURS.

Couple holding hands with logo

6. I have the best clients. 

No, seriously. I really do. When I was a newer doula, I had different opinions about birth than I do now. Back then, I thought C-sections were the worst thing that could happen during someone’s birth.

  • Until I saw how C-sections can make the difference between a tragic outcome and a joyous outcome.
  • Until I saw my fierce, warrior, highly-educated clients do “everything right” and Baby still decided it needed to be born that way.
  • Until I saw amazing care providers do everything they could to help my clients achieve the birth of their dreams, but hard decisions had to be made.

I used to think that epidural births couldn’t possibly be as cool or satisfying.

  • Until I saw the most beautiful cases of giggles and tears all wrapped into one, over and over and over, reminding me why I keep doing this job despite all the hard parts, when mamas and papas finally have their babies in their arms and time stands still and you forget about the fact that your client even has an epidural because they are just so happy.
  • Until I saw too many times that sometimes an epidural really is the humane thing to do. When birth has been relentless and sleep hasn’t happened for days or when pitocin is just TOO much and the hard work of labor has turned to suffering. And the epidural helped that mama finally ENJOY her birth.

And I used to think that inductions meant an automatic epidural and more-than-likely Cesarean birth.

  • Until I saw so many of my clients kick major pitocin butt and do it without any pain relief whatsoever.
  • Until I saw warrior women defeat the odds and push babies out of their bodies with pitocin, epidurals, and threats of Cesareans looming over their heads.

I have seen fierce, amazing, warrior mamas and papas. I have seen joy and heartbreak, tears and laughter. I’ve seen grief and hard decisions and “easy” butter births. I have seen things that made me swear I was never going to attend another birth again, followed by a glorious, “redeeming” birth precisely when I needed it.

And it may not be clear which of the clients were amazing. The answer is, “All of them.” They all have inspired me. They all continue to inspire me. No matter where their birth journeys took them, no matter what happened, they never quit. They kept going, they dug deep, they made hard decisions, and they put their desires aside for their babies. Because they had no other choice. Because quitting is not an option in birth. My clients inspire me. They are amazing and truly the best!

So, as you can see, I am not an unbiased doula. I am totally biased. I am biased toward amazing care providers and evidence-based and compassionate care, and most of all, my amazing, super-fantastic, the bomb dot com, awe-inspiring clients.

 

What to do if you have low amniotic fluid

More and more I am seeing my Birth Boot Camp students and doula clients being diagnosed with low amniotic fluid levels as they near the end of pregnancy.  It has gotten to the point that if they are in my class during the summer months or if they have a due date near any major holidays, I prepare them beforehand that their odds of induction are increased, and that most likely the reason will be because of low fluid levels. I always have to include the caveat, “Of course, I am not a care provider. I could always be wrong. In fact, I HOPE I am wrong. However, just be prepared to have a conversation with your care provider in case this comes up.”

What should you do if you are given a diagnosis of low amniotic fluid near the end of pregnancy?

First off, know that you are not alone. Many people experience this, and like I said before, I am seeing this more and more.

You’ll want to have a conversation with your care provider in which you both are very clear about your preferences for labor and what will be the safest route for you and your baby. If you’ve taken a quality childbirth class, you may be familiar with informed consent. An easy acronym to remember when you are being faced with any intervention is BRAIN.

  • B- Benefits. What are the benefits of proposed intervention?
  • R- Risks. What are the risks of proposed intervention?
  • A- Alternatives. Are there any alternatives to this proposed intervention?
  • I- Intuition. What is your intuition telling you?
  • N- Nothing/Need time. What if we do nothing? We need time to discuss.

 

Helpful hint: There is a big difference between needing to get baby out NOW and having plenty of time to talk about it first. If you are able to have time to discuss things with your birth team, that is a big clue that you are not in the middle of an emergency. Doctors, midwives, and nurses are REALLY GOOD at moving quickly during an emergency. The only times that I have seen clients not given time to discuss things first were during emergencies, which thankfully have been rare.

Ask your care provider WHY you may have low fluid.

Some reasons for low fluid may be:

  • It may be normal. At the end of pregnancy Baby runs out of room.
  • You are within two weeks of your delivery.
  • You are dehydrated. (Which tends to happen during summer months and busy holidays. Especially in Texas.)
  • You may have some other health issue.
  • Baby is ingesting more amniotic fluid because that’s what they do at the end of pregnancy.
  • Baby may have issues with its kidneys or urinary tract.
  • Baby may have some other health issue.

You will definitely want to rule out any health issues with yourself or your baby. Discuss with your care provider ways to rule out any health concerns. If everyone is healthy, then discuss your preferences for labor to begin on its own and if there is any harm in waiting.

Ask your care provider to explain what constitutes a diagnosis of low fluid. 

Care providers can test for low fluid in different ways. Two of the most common ways to measure amniotic fluid, which use ultrasound, are: the Amniotic Fluid Index (AFI) method and the Single Deepest Pocket (SDP) method. The SDP method is also sometimes called the Maximum Vertical Pocket (MVP) method. Some sources say that one method is “better” than the other, so you will have to decide with your care provider which method works best for you. An AFI of less than 5cm and an SDP of less than 2cm is often considered low fluid.

Ask your care provider for ideas on how to safely increase your amniotic fluid.

There may be some ways to increase amniotic fluid, including drinking more fluids. However, it is a good idea to ask your care provider what they think are the best methods for increasing amniotic fluid and if it is safe to do so in your case.

Do some research about low amniotic fluid during pregnancy. 

I always send the following articles to clients and students who tell me they have been diagnosed with low amniotic fluid.

Dr. Rebecca Decker. What is the Evidence for Induction for Low Fluid at Term in a Healthy Pregnancy?

Dr. Rachel Reed. Amniotic Fluid Volume: too much, too little, or who knows?

Dr. Elizabeth Dubil and Dr. Everett Magann. Amniotic fluid as a vital sign for fetal wellbeing.

These are merely a few articles to get you started on your research. I encourage you to check out the footnotes and sources listed throughout these articles, and even read information that does not support what you are looking for. For example, if you want to avoid induction even if you have low amniotic fluid, not only do you want to read articles that support avoiding induction, but you’ll want to read articles that conclude that inducing may be the safer route for a diagnosis of low amniotic fluid. It may be confusing, but in my opinion, it is important to consider as many angles as possible.

It is important to gather information from reliable sources. Many library websites have articles explaining how to know if a source is credible or not.

Continue to keep the lines of communication open with your care provider. 

Once you have read all of the reliable information that you can, it is important to discuss things with your care provider who you hopefully trust and that shares your philosophies regarding birth. If you feel like your care provider is not a great fit, it is never too late to switch. After all, one of the most important things you can do to have the birth you want is to pick an amazing care provider.

Armed with all of the information you need and a fantastic care provider, you can still have an amazing birth, even with a diagnosis of low amniotic fluid. Good luck and best wishes on a happy birth!

5 Must-Have Playlists for Labor

Sometimes my two worlds collide. I have a background in music, so I often use what I have learned from that world with my doula clients. Most people understand the power of music; from the mood-enhancing benefits to the intelligence-boosting. Music calms, energizes, inspires, and beautifies our world. It helps people accomplish things they didn’t think was possible. This holds true for athletic feats, the everyday mundane tasks, as well as miraculous events such as giving birth. Here are a few must-have playlists to help you prepare for your upcoming and amazing birth.

Music for Relaxation

First, you will need a playlist containing music that always relaxes you during times of stress. This could be instrumental ambient music such as what you might hear at a yoga studio or the latest popular music. It doesn’t matter what you choose as long as the music evokes a sense of well-being and relaxation. Consider this playlist “home base.”

A few of my favorites:

August Wilhelmsson Now is the Time to Leave

Temmy Lewis Far Away

Hans Zimmer Earth

Beast Mode Music

Most of the time, the music for relaxation playlist will be all someone needs during labor, but sometimes a change of scenery becomes necessary. This playlist needs to be one that makes you feel like a badass and like you could conquer the world. This needs to include music that makes you want to take off running or do something really hard. It needs to pump you up and make you think, “Yeah! I’ve got this! I’m doing this!” This could be any genre that gets you motivated to do hard things. I even have a playlist called, “Badass Orchestral” on my Spotify app.

A few of my favorites:

Sky’s the Limit (Sasha Banks intro)

Imagine Dragons Whatever it Takes

Two Steps from Hell Protectors of the Earth

Music for Making Love

I’ve written before about how the hormones during sex and birth are the same. Giving birth is just a continuation of the reproductive process. It would be nice if it felt like one big drawn-out orgasm, but it doesn’t. However, it is important to set the scene as if giving birth WAS like preparing for a big drawn-out orgasm. This playlist needs to include music that gets you in the mood for sex or at least makes you think of sex. It needs to be able to get those oxytocin juices flowing. It needs to be something that makes you want to move your hips in nice, big circles without even thinking about it. This will be a great playlist to have if you feel like your contractions need a bit of a boost for whatever reason.

A few of my favorites:

Berlin Take My Breath Away

Foreigner I Want to Know What Love Is

Klaus Wiese El-Hadra

Marconi Union Weightless

Comedy Playlist

Okay, this isn’t a music playlist, but you’ve heard the saying. Laughter is the best medicine. Sometimes the best change of scenery is to smile and laugh. I love the PG Comedy playlist on Spotify and listen to it often. Jim Gaffigan and Brian Regan are two of my favorite comedians, especially since they are dads. I feel like they understand what it is like to be in the thick of parenthood.

A few of my favorites:

Ismo: Ass Is the Most Complicated Word in the English Language

“Two Chips”/A Short Animation

Jim Gaffigan: Mr. Universe – 4 Kids

Affirmations Playlist

It helps to have someone telling you that you are amazing and that you’ve totally got this whole giving birth thing. Childbirth programs such as the hypnosis-based programs as well as Birth Boot Camp have awesome affirmation downloads available for purchase that are designed for birth. It helps to put a hand over your heart as you repeat affirmations to yourself. It makes them feel more believable.

Music is such a wonderful tool to use during difficult times. Even with my background in music, I often forget it is available to me. Once I remember to add music to whatever I am doing, it helps the thing I am trying to accomplish become more manageable or even pleasant. It is worth a try! As you pack those bags or get those birth kits ready for labor, remember to prepare your playlists.

Did you listen to music during labor? Was it helpful? What were your favorite songs for labor?

 

Now Offering Birth Planning Sessions in Houston

Have you ever wanted to pick a doula’s brain about your birth but did not want to hire a doula to attend your birth? In these sessions, we meet to answer any and all questions you have regarding your upcoming birth.

In these sessions, we can:

  • Create a stellar birth plan
  • Discuss policies and procedures at your chosen birth location that can influence your birth outcomes
  • Formulate strategies to help you have the best birth possible
  • And more…

You bring the questions. I bring the answers.

This session takes approximately 2 hours and occurs at a meeting location listed on my Contact page.

Fees: $100

*Should you decide you would like to work with me as your doula after this session, I will apply this fee toward your doula services balance.

When everyone else is too busy

Sometimes it seems like everyone else is so busy. Sometimes it feels like, no matter how busy I am, I still have more downtime. In any case, it seems like everyone is too busy for me. What are they doing? Are they all hanging out without me? Am I a loser because I have free time right now? Why is it that, no matter how busy I am, everyone else is busier? Why is it that they just don’t have time for me. Am I not very important? Why is it that when a friend wants to connect with me, I have time for them? Why is it that I can’t seem to find people who have that same kind of time for me?

These are a few of the thoughts that run through my mind during certain times of the month. During my luteal phase, which lasts roughly two weeks, all of my insecurities that I can usually ignore the rest of the month, come to the forefront of my mind.  Today, while I am in the follicular phase and feeling great, I want to remind my luteal self of some things.

This morning I remembered a certain man I used to know that I really admired. This man, who was like a father figure, had a certain way of making me feel like I was the only person in the room when he talked with me. I knew his position in my church meant that he spoke with lots of people throughout the week, but I had a suspicion that he was able to make every person he met feel like they were the only person he was thinking about in that moment. I admired that about him, though I never thought to develop that skill myself. Until this morning.

Have you ever been around someone who seemed too busy for you, even when you both set aside some time to spend together?

I have. I never really know if people are genuinely that busy or if they are trying to appear busy. In our society, busy-ness and productivity are praised while rest and free time are mocked. While I was in the presence of those who seemed super busy, I felt like they didn’t have time for me. I felt like I could never measure up in the amount of busy-ness I had compared to them. I felt less than.

One way I try to give people my undivided attention is to put my phone away when I am with others. I want them to know that I am with them. During my precious time with friends and loved ones, my phone can wait. Even when I am on-call, as I often am, I am not constantly checking it. I try to make a point of setting it in a place that is close enough to hear and go about spending time with those I am around. My off-call time is my treasured time to put my phone on silent and give my entire attention to those in my presence.

I didn’t realize until this morning, that in order to help people feel like they are the only person I am thinking about when I am with them, I will need to practice. I need to reframe my lack of busy-ness as a skill-building exercise rather than evidence of my losery-ness. (Thank you to some precious women in my life who encourage me to reframe, especially during times that that is the last thing I want to do.)

I asked myself, “Who do I want to feel like they are the only one in my presence when we are together?”

I want my friends to feel that when we are together, that I am truly with them. I want them to feel like I want to know them and that I treasure those rare stolen moments that we get to spend time together. I want them to feel loved and special around me. I want them to feel like I am interested in them. I want them to know that I am concerned about them and that I really am here for them to hear those deep questions about life. I want them to know that I am always ready to have meaningful conversations.

I want my clients to feel like they are my only client. I don’t want them to have to worry where my mind is while I am attending their birth. I don’t want my clients to have to worry about my “behind the scenes” or my “busy-ness.” I don’t want them to feel rushed when I am around, and I want them to feel like I am giving them my undivided attention. I want them to feel like I truly care about them as people and want them to have an amazing birth.

My poor unfortunate family hasn’t always gotten my best, nor my undivided attention. I want to work on that. I do try to put my phone away in a place that I can hear it, though. They know that I am a doula, and they know that means I may need to leave at a moment’s notice. But I do not need to constantly check my phone in order to be able to leave at a moment’s notice.

And if I do have some free time? I need to treasure those moments as time I can spend on myself. I can finally do those things I am usually too busy to do. I often wish I had time to just do what I want, such as finally read those books that keep piling up on my nightstand. Losing myself in an awesome novel used to be one of my favorite activities, but I haven’t had the time to do that as much as I used to since having kids. Now that they are getting older and a little more independent, I’ve been able to read more often. Instead of chiding myself as being a loser who just doesn’t have enough to do, I need to embrace those sacred opportunities to fill my cup. I am worth it, and I am finally starting to realize it.

I still treasure connecting with my friends. I am an introvert, so it isn’t quite enough for me to distract myself with small-talk. I want to really connect with others. My bids for connection aren’t very grand. Usually it is a simple text asking, “How are you doing? What are you up to?” Really what I want to ask is, “Can you tell me about what you are really feeling right now? What thoughts have you had about life today?” I truly want to know.

Sometimes I don’t want to think about those things that haunt my mind.

Sometimes I need a break from those racing thoughts, but I am learning that “busy-ness” doesn’t cure it. I am learning that connection with others is what cures it. I hope that during those times that everyone seems too busy, I can remember to not give up on connecting with others. I need to keep searching. I need to remember that I am not actually a loser who doesn’t have enough to do, but that I have been given an opportunity to help others feel like they are special to me. I can practice helping people feel like I do not have anything better to do in that moment than to give them my undivided attention. Which, if they are anything like me, helps them feel pretty loved and special. Spending a lifetime learning how to love others sounds like a pretty un-losery thing to me!

How to make mom friends…an experiment

Remember when you were in grade school and all you had to do to make friends was waltz up to another kid and ask, “Will you be my friend?” I do! Sometimes I miss those days and how easy it was to make friends. Somewhere along the line, we grow up, and it goes against social norms to walk up to people and ask them to be your friend. There is a ritual to making friends as an adult and it tends to involve several awkward meetings of assessing one another to see if you are indeed friend material.

Making mom friends

Making mom friends is especially difficult because your meetings must revolve around crazy schedules, nap times, and feeding times. Parenting opinions often differ so dramatically that someone could be deemed unworthy of friendship with a mere glance. The great paradox of modern motherhood is that we have so many social networking sites and gadgets to keep us connected, yet we are increasingly lonely. Even though we are never alone, many mothers suffer from chronic loneliness. No one seems to have any answers.

Finding your tribe

For one reason or another, whether relocating or having your first baby, you might find yourself needing to enter the mom friend-finding scene. One of the first women who seemed like “my people” had kids much older than mine. She became like a mentor to me. While I didn’t understand the importance of this advice at the time, I understand it now. She often encouraged me to find my tribe. I thought it was strange at first that she used that language, but it really is great advice.

The longer I spend on this motherhood journey of mine, the more I yearn for a tribe of women to share this journey with. I ache for their support and encouragement. I need reminders that I’m not crazy, that it really is that hard, and that I am doing a great job. I need people to tell me that it’s okay to be imperfect and that  we all are.

I don’t necessarily need advice-especially the unsolicited variety. That first mentor mom was great about advice. I say she followed the “Vampire Rule of Advice.” Vampires aren’t allowed into your house unless you invite them in. However, once you invite them in that first time, they can enter your home any time they want. She patiently waited until I asked for advice before offering it. I appreciated her patience. I welcomed all of her future unsolicited advice because she respected me enough to wait until I asked for it that first time. After awhile, I began to take her advice and search for my tribe.

Houston BBC Instructors
I met these wonderful ladies through Birth Boot Camp. 

An experiment

Recently, I participated in an experiment for a course I am taking. I was supposed to violate a social norm and report on my findings. At first I wanted to go up to unsuspecting mothers and ask them if they would be my friend. Instead, I decided to tone it down a bit and spend the day walking up to mothers in Target and Walmart and ask them to just talk with me for a few minutes. I asked, “Hi! I am just a mom trying to get out and get some social interaction today. Will you talk to me for a few minutes?”

In order to blend into my surroundings, I secured my 3 year old little boy in a shopping cart and walked around with him for a few hours. I strolled back and forth between the school supplies, toys, baby sections, and children’s clothes sections. I approached 5 women in Target and 6 women in Walmart, for a total of 11 women. I looked for women who were walking around with children but no other adult. If they did not have any children with them, I looked to see if they had items in their shopping cart that would suggest they were shopping for a child. Only 1 woman I approached did not have any children with her.

The results

All 5 women I met in Target talked with me for about 5-10 minutes each. I ended up exchanging information with 3 of the 5 women, and 2 of those 3 women gave me their business cards. Everyone was friendly, though some women seemed more comfortable than others stopping to chat with me. The women with more than one child, whether or not all of their children were with them, were the most comfortable with me. They gave me great advice on potty training boys, communicating with teens, and preparing older kids for school. Everyone was kind and seemed sympathetic to my plight as the mom “who just needed to have some adult conversation.”

Only 3 of the 6 women in Walmart spent some time talking with me. One of those 3 women was a mother who spoke very little English but allowed her daughter to translate. The last 3 women I approached were the only ones of the day that said no to talking with me. I hypothesize it had more to do with the fact that it was around the same time many people were getting off work. I may have found those moms who were trying to make a quick stop before going home.

Surprising consequences

I began this experiment nervous, yet excited. I had a positive and optimistic attitude that I might actually find a friend during the experiment. Once the experiment was over, I felt tired and morose. I felt extremely lonely even though I had spent the day with my family and had a ton of social interaction. I feel like I began to identify with that poor lonely mom that I was acting like. The only word I could use to describe how I felt was pathetic. It took me a few hours to recover from those feelings.

Conclusion

The moms I met seemed to be kind and compassionate toward me and seemed to identify with needing social interaction. I just needed someone to talk to, and I seemed like a non-threatening individual walking around with my 3 year old son. I was surprised at how quickly people trusted me enough to have a conversation with me.

Where to find mom friends

The aisles of Target and Walmart are definitely not the best place to find mom friends, but stranger things have happened. I have had the best luck finding mom friends through more formal organizations like MOPS and La Leche League. I have found a few friends through more informal playgroups and babywearing groups. I have found friends through my church and just interacting with other people through my work as a doula. I have made a few mom friends at local library story times and even play areas at some fast food restaurants. Whatever your interests, there is probably a group for it.

Sara and Kristi donuts
I met this awesome lady at MOPS over our mutual love of birth and donuts

Finding mom friends is not always easy, but it is well worth the effort. Those few friends who “stick” are definitely worth their weight in gold. I am thankful for the amazing mom friends who have mentored me, encouraged me, and made me laugh when I needed it. They “get me” like few can. Hoorah for mom friends!

 

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.