Cyndi's Doula Service

Expectations

2014-02-11T10:45:00.000-08:00

What are the expectations of a family facing childbirth?

For some moms - it is the hope that she will not have to feel much of the labor and that she will have the time to get an epidural in fairly quickly. With some it is the hope that no interventions will be needed and the birth will proceed unmedicated.

Some have a breech baby at 37 weeks - expecting the baby to turn - or others expecting to schedule a surgical birth.

Especially for a first time couple - expectations can be high. And with some families - can feel very rigid - concerned that if something doesn't go as expected, there will be a domino effect into difficult decisions.

Because birth is an unpredictable process, expectations can easily be unrealized. Perhaps the due date is passed and an induction starts the labor. Perhaps a mom's water breaks with no labor following. Perhaps the baby gets into a difficult position causing a slower labor. Perhaps the day the labor starts, the favorite doctor is not on duty, etc, etc.

So is it a bad idea to have expectations for a birth? No - a vision or goal is always a good idea when facing childbirth. I think it is very helpful for a family to envision how they would like their labor to proceed. Having a vision can cause a family to have more patience in allowing labor to happen or can encourage a family to include a support team such as a doula for the birth.

But having a "frame" around the vision that is very inflexible or solid can cause expectations to be unrealized and therefore a family may have a bad feeling about the birth later - an unhappy birth memory. What can you do if expectations are not realized? Check out my next post.

Showing Gratitude

2013-10-29T11:10:00.002-07:00

I have a friend who used to tease me that I was always waiting for the "I couldn't do it without you" speech from a family I had helped. Well - maybe just a little - but there are so many ways to show gratitude.

From the doula's perspective, we can show gratitude for being invited to a birth by being respectful of the room. Keeping our area cleaned up - keeping our voice soft when it needs to be - keeping ourself still when the couple is working well together and don't need any extra hands.

We can show our gratitude by being responsive to their messages as quickly as possible, making them aware when we will not be available. But trying to be available as soon as they have a need.

And don't forget to let the laboring mom know how amazing she is - and the supportive dad how much help he is providing. Commendation is such an important part of a labor.

From the laboring family's perspective, they can show their doula gratitude by keeping them informed, giving them updates regularly. You can show gratitude by being willing to listen to suggestions and being open to trying them.

I'm always appreciative of a thankful note - or knowing that the family is telling others the value of a doula. Many doulas are listed on websites that require references and jotting a few lines down about your doula that she can use is very helpful. Some moms have taken the time to write a letter of recommendation. Some dads have written comments that I could post on my website for other dads to read.

I think the best sign of gratitude is inviting me back to the next birth - when I know the family has valued my help enough to bring me back, I'm so very grateful.

Lastly, in some cases families have given a nice gift or additional funds to the fee and these are unexpected but lovely signs of gratitude. Please know that these are never expected and not required, but when they come I can feel the gratitude from that family.

What made me think of this topic? Three years ago I was brought into a first birth late in the pregnancy. I think the dad felt noncommittal at first about what my role would be in their birth. But halfway through the process, he was sold on the value of a doula. Their son arrived safely and the family was grateful. Now every year on the "anniversary" of that day, I get the nicest note from the mom and a $50 check. The latest one arrived yesterday. I feel humbled by her gratitude and grateful that so many families have invited me into their birth experience. Thank you!

Traumatic Markers

2013-09-11T07:49:00.004-07:00

Birth memories can contain traumatic memories to some families. So a certain date can carry a traumatic marker in the family's thinking.

When you hear a date like September llth - does it leave you with a smile or a sigh? The same can be true when a family is anticipating labor.

Whether the date will carry the memory of losing a favorite aunt - a mother - or even tragically a child, the family may be very concerned that labor and birth will fall on that date. One family years ago worried about an entire month. Or the date one spouse discovered a terrible secret, etc. There can be so many reasons a certain date leaves a pain in your heart.

What can be done - many times we can't change the date the birth begins, but we can change how we look at it. Could we rewrite the feeling we have about that date - loss of a favorite aunt can be now replaced with the birth of a dear child. The child doesn't "replace" that person, but the feeling about the date can be changed. It takes focus and effort but how you perceive that date can be changed. It may also take time for the pain to soften.

But in anticipating the birth of a child, try not to focus too much on the date that baby "should" or "should not" arrive but rather be excited to see what date the baby picks! And you'll have a date with a great memory and feeling.

The Waiting Game - Part Two

2013-09-03T13:10:00.001-07:00

I know that 9 months can seem to fly by until the last week or so - then each day seems to drag waiting for that first signal of labor. Not only is the expectant couple in anticipation but so are their family and friends, workmates and neighbors. Everyone it seems needs to check in and see if there are any signs of labor.

But the waiting game I was thinking about today is in the life of a doula. It starts with that first phone call or e-mail or text that says "today might be the day". If it is not an urgent message, then the doula has time to figure out how to rearrange her day - is there mail to be sent - messages to be returned - appointments to be rescheduled - backup to be alerted - laundry to finish - etc, etc.

It may seem that this waiting time can be very productive - but in fact - it is usually not time well spent. Sometimes it is much harder to be by a phone waiting for the signal to head out - than to be sitting in a labor room. Why? Because when you are at home - you really don't have a sense as to how strong the contractions are, how the family are handling them, if they are in the hospital already - what is the medical team presenting to them? You don't know if you'll have time to make it to the store - keep an appointment - or take a nap.

Being on alert can be exhausting. Have you seen runners in a race at the starting block - in that tense starting pose - waiting to hear the starting gun go off? Sometimes that is how a doula can feel - when will I be needed? How long will I be needed? Will things suddenly change before I get there? What is happening now - when it has been several hours since you've had an update. Are there suggestions I can make over the phone - or reminders of signals to watch out for that labor is progressing?

The hardest job of a doula - is being on call - but not in the midst of the labor. However, I will say that ask any doula if they would like to have another job? And they will answer quickly - NO. We love our job - the waiting game is just a way for doulas to develop patience, which is needed for birth. Thanks for listening - now it's back to waiting for that phone call to head out.....

Quiet Confidence

2013-03-27T11:15:00.001-07:00

Recently I heard from a mom that I had worked with more than once and what I remember the most from her births is her "quiet confidence"....so I have tried to encourage other families to imitate that feeling.

What do I mean by "quiet confidence"? When she entered the hospital, she felt secure in her knowledge of her baby inside her. Not that she didn't follow medical direction in most cases, she wanted a safe birth. But when a decision had to be made with her medical team - if she safe and wanted more time for things to progress or to decline an exam - she felt confident in expressing her feelings. She did not argue - she just expressed how she felt - and the medical team in the end respected her choices. Obviously in an emergency situation, she would have proceeded with the medical recommendations. But these were not time sensitive choices.

The birth was peaceful and safe - and everyone was happy. But there were a few times that she quietly declined an exam or starting a procedure because she felt inside that things were changing and her baby was moving closer to the delivery.

I try to encourage families to share in the discussion of decisions - not from a medical standpoint which is generally not their expertise - but from a sense of themselves and their babies. When they feel quietly confident to at least share in the conversation, the decision feels better to everyone. And in the end, they need to trust their medical team to provide a safe delivery.

So when you are facing a decision in labor, share in the conversation with a quiet confidence and you should feel better about the direction of the birth. That is - if the baby cooperates! My hope is for families to have a safe, peaceful birth.

The Cost of a Doula

2013-02-09T12:13:00.001-08:00

Recently, several families have mentioned after a birth that having a doula was definitely worth all the money spent. One mom said a doula is worth her weight in gold. In today's market, that's quite a lot!

A birth is a lifetime journey that leaves a lasting memory on families. So if that memory can be smoothed out, supported, ending up in a great memory, what is that worth? A baby is worth the journey - but the journey imprints your memory also.

So what is the memory most families have when they have doula support - usually a good one. That is why I started doing labor support - to help one family at a time leave with a great memory.

I have found over all the years, that even the most reluctant dads who are concerned about the cost of a doula, have felt it was worth every cent after the birth. Why? What does the fee cover?

A doula's fee can range from a donation to several hundred dollars. Each doula is unique in what she offers for that fee. But I feel the biggest part of the fee is that a doula has to live her life on call. It is a difficult way to live but if you really love what you do - you are willing to sacrifice your time and scheduling for that family who needs your support. We never know what doctor's appointment we will miss, family dinner, sleepless night, missed vacation, leaving a movie early....I missed a root canal three times due to births.

The fee covers the prenatal support - a good listening ear when there is emotional support needed, suggestions, referrals, preparing for the birth - all part of a doula's role.

The birth itself - some have taken a few days - being ready to run when the family has a need - phone support 24 hours a day - and physical support during the birth. That is part of a doula's role. We want to support the laboring mom and the laboring dad - and sometimes the laboring grandmother, sister, aunt, friend, etc.

So when you are considering a doula - it is important to consider the cost. But please don't let cost stop you from having a doula. There are so many caring, energetic, responsive women wanting to provide labor support - find one that will be a good fit for you!

Vacation

2012-12-10T21:43:00.000-08:00

Yes, even a doula takes a vacation. I have been involved in attending births for 26 years now. How have I kept myself from getting burned out from my stressful job? I plan two vacations a year.

I have found that it is not enough to just be off-call because if you are in the vicinity and a labor starts, you will still want to attend. if the phone rings with a new inquiry, you are going to take it. mif a client has a question, you are going to respond. So twice a year I call in a backup, make plans with different friends and have a "change of pace" in my schedule. This also gives me something to look forward to, especially if I have attended several very long births in a row.

When I'm entering hour 30 of a labor that still has time to go, I start remembering i have an upcoming trip.

Living life on call 24/7 for months at a time can wear on you, and cause a lot of stress. But having a brief time away with no worry about the phone ringing at 2am can have a refreshing effect. A friend and I recently went to Kauai for 5 days. Not a long trip but many hours were spent just staring at the waves and sand crabs. A definite change of pace!

Of course it is costly to take time off but the other downside can be that you worry you have forgotten how to work through a labor. Tonight I had my first birth after six weeks and was delighted to see that I had not forgotten what to do....and also it was the 795th birth I have attended.
So I guess I have no excuse not to remember how to help.

The next time you are finding yourself in a rut, follow my plan. Have a vacation! I highly recommend it.

Storms vs Full Moon

2012-11-28T23:03:00.000-08:00

We have often heard moms looking at the calendar and declaring their birth will no doubt come on a certain day because there will be a full moon.

Although I'm sure there is some scientific evidence to prove that this may be true, i.e., barometric pressure changes, I have been in labor floors before with the place empty on the night of a full moon. I've had moms who were almost 42 weeks and the night of the full moon passed with no labor beginning. I have actually seen more labors start during storms.

Of course this seems very inconvenient since the doula is racing through the rain and wind on wet streets in the early morning hours to reach the laboring couple - but such is the nature of the job. And then we can be in a lovely labor room enjoying the birth while the rest of the area has to deal with the storm's fury.

I really don't mind the rain - what I like the least is fog. There is nothing more scary to me than navigating the causeway at 2am with the fog so thick that you can barely see a foot in front of the car. I can still remember getting a frantic call from a client at about that time - obviously labor was proceeding rapidly - and I'm trying to get to Davis in a thick fog - quickly but safely - and half asleep. I'm happy to report I did make it before the baby arrived - but barely.

It would be so handy to be able to predict when a labor is going to begin by looking at the weather report or the full moon listings on the calendar. But it just isn't that simple. Babies don't seem to have those at their disposable to use to coordinate their appearance.

So the next time you are starting to drift off to sleep with the rain and wind pounding outside, imagine the doulas navigating the storm to get to a birth. And rest assured your doula is willing to meet the challenge of dealing with all these situations to be at your side as quickly as possible to welcome the arrival of your little one!

When Your Doula Is Away

2012-11-16T08:02:00.001-08:00

As I'm finishing up a well earned vacation, I'm reminded of a common question I am asked. "What happens if you are not available for my birth?"

Good question. Having supported families for decades I can say that having to bring a back up doula into the process is rare. All hard working doulas take their responsibility to be available very seriously. That means any plans we make are always "tentative". We know we are on call 24 hours a day, 7 days a week. Dental appointments, parent teacher conferences, giving family a ride to the doctor, special dinners out..all have to be cancelled if a family has a need.

But this continuous schedule can be stressful after a long period of time, a break is needed. I try to get out of town twice a year. When I return, I'm happy once again to be on call for the families who have chosen to have doula support.

But while away, I make sure that I have a dedicated doula on call for these families. So what happens if I'm not available? Another hard working and qualified doula will be available to support them.

I'm back on call at midnight and continuously until the next great vacation is planned. Thanks to all those wonderful doulas who provide backup so I can get away and regroup! Thanks to all the families who have chosen doula support but also support my getting away for a vacation!

Induction

2012-11-07T13:51:00.000-08:00

The word "induction" can strike fear in the heart of many expectant moms. There are two main fears - that the pain will be unmanageable and that starting with an intervention will lead to many more.

So when is induction a good plan?

No matter how wonderful our plans can be for an intervention free birth - sometimes a mom's health or a baby's health dictate a change in plans. So when either mom or baby are compromised, an induction can be a good plan.

In working with your medical team, make sure you understand the details. How will the induction start? Are there several options in beginning this process? If one doesn't start labor - what is the next step? Will this be a slow process allowing labor to kick in - or are there medical reasons that it needs to be moved along more quickly?

Will you be allowed to eat up to a certain point, if labor does not start by evening, do you have the option to turn everything off, shower, eat and sleep before starting again.

What will your limitations be with the method of induction chosen? Will you be able to move around? Will you need constant monitoring?

These are all questions to discuss to come to a medically sound, safe process of induction.

I've seen many families go through an induction unmedicated and with a happy ending. There are definitely inductions that don't lead to many more interventions. But if that happens, just keep asking questions so that you feel informed of the choices made.

Having a doula to support you through this process can be a great help. But in any case, be well - and try not to fear that induction can lead to a bad memory of your birth.

PATIENCE

2012-09-12T10:20:00.001-07:00

All parents know how important the quality of patience is needed when raising children. But where does that lesson start? Soon after conception.

Are you not sure you are pregnant? Perhaps you have to have patience in having this reality verified. Then patience on having the pregnancy become well established. Patience on telling family and friends may be needed.

Patience on learning if you are expecting a boy or a girl - or even more patience if you decide to delay that information until the birth itself.

But the most patience has to be exercised when the due date is approaching. Allowing labor to start on it's own can be so helpful to having a safer, easier delivery. Each day may seem like a year - the phone may be ringing off the hook from family and friends who are just "checking" on you. This can make it more difficult to be patiently waiting.

When labor does start - being patient in allowing it to increase at it's own pace is important.
But this can also be difficult. This can be difficult on the doula also - to be on alert but not needed yet.
But in the end, the more labor is allowed to set the pace, the better the birth can turn out.

So learning this lesson of patience in pregnancy/labor can be a great starting point for your new life as a parent. Take a breath - enjoy the lesson - and have a great day!

The Sounds of Labor

2012-07-24T06:09:00.000-07:00

In the movies, labors are very noisy with moms screaming at her support people, the medical staff or to no one in particular. But is that an accurate depiction of a labor? No. However, labor does have it's own unique sounds.

Some moms find it best to stay very quiet during contractions and just sink into a quiet world while their body and their babies do the work. Some use rhythmic breathing patterns to focus during contractions. Some find low moaning to be comforting. And some are more vocal with loud expressions.

I feel all the above are fine. A mom in labor has to figure out what works for her - and in some cases their own sounds have to give them some type of a platform to stay above the "noise" of their labor going on inside. The down side to this is that they usually notice a throat that feels a little raw once the baby is in their arms.

How should support people react to the sounds. First of all - allow her to do what feels best to her. But there are times when added direction can be helpful. If a mom's sounds are in the high, nasal range, I encourage her to bring them low and deep - describing it like a "mama bear in a cave".. Upper range has a more hysterical feeling whereas the lower range has a more powerful feeling.

If a mom is making sounds that are heading in a more "desperate" direction, describing that she is feeling "lost", "scared", "in pain", then I try to direct her in a more positive direction of sounds. When she is saying "no", I encourage "yes"....when she is saying, "this is painful", I may suggest, "this is working" and if she is expressing feelings that she is scared, I acknowledge her fears but then suggest that she is surrounded by support and that she has the ability to do this. That she is okay.

So - whether you are at a birth that is very quiet - or in a room filled with sounds, remember to respect laboring moms' right to make sounds. And enjoy the end result - the sound of a newborn baby!

Medical Team

2012-07-15T08:40:00.000-07:00

I was attending a birth yesterday and it reminded me of the contribution a good nurse can make to a great birth outcome. This nurse was friendly, helpful and loved to support natural births. She really brought a sense of teamwork to the room.

This birth, as noted by the doctor who caught the baby, was such a peaceful birth. It was so quiet in the room during the pushing (and there were about 6 members of the medical staff present) that it was funny when someone's pager suddenly announced "low battery". In the end, everyone was able to share a wonderful birth.

The laboring mom and dad contributed the most to this working process. But having such caring support from doctors and nurses can make such a difference to how the birth feels.

So if you are delivering your baby at a hospital, bring the nurses a gift (they love food) and invite them to share their experience and knowledge with you to support your birth. I always view the nurses as a wealth of information and creating a cooperate team for the laboring mom is so important. Don't view them as someone to keep out of the room - but someone who can help give you the experience you are working to achieve.

Is this Labor?

2012-05-21T08:31:00.000-07:00

As the due date approaches and anticipation builds, an expectant mom is looking for any signs of labor. It is not just due to her own anticipation, but all the many friends and relatives who are calling, stopping by, and asking, "Are you in labor?"

Don't dare bend over and hold your breath - the onlookers will be quickly dialing "9ll". Expectations are high.

But labor is a combination of many factors. It is typically not just contractions. And as it progresses, the reality that "this is labor" usually becomes very clear without the insistent questions.

Sometimes one of the signs that things are loosening up is the loss of the mucous plug. Although exciting, does it mean labor is imminent. Unfortunately no. I had one client who didn't go into labor for a couple of weeks after losing it. And she was having her 4th child. I've also had clients who did go into labor that same day.

So although it doesn't clearly tell you "this is labor", it is none the less a fun sight to share with others in the house (oh yes, many dads have been subjected to observing this progress), and a topic to share with all the many anxious family and friends who are asking "is this labor?"

Hang in there - a day will arrive soon when you can answer "YES".

When Storm Clouds Form

2012-05-01T22:18:00.000-07:00

Pregnancy is an emotional time. There seem to be many moments when things don't appear to be going in the right direction. Are you dealing with nausea for days - or weeks? Are the many bathroom breaks starting to wear on you? Sleep is becoming a distant memory.

Bigger issues are dealing with doctor's appointments, what will the hospital policies be and how will you cope with everything? The expenses climb - the anxiety climbs - storm clouds forming on the horizon.

But I was thinking about literal storm clouds tonight. I see many labors start when there are big storms. The change in the barimetric pressure can cause the water to break - so during some of the worst storms - families and doulas are heading to a hospital. But it also makes for a great story.

Just as a storm passes and clears the air - emotional times of pregnancy pass and settle into a calmer time. So literally as the "sun will come out tomorrow", keep moving forward, have a confidence about the future. When storm clouds form - a bright sky is in the future!

When A Doula Misses A Birth

2012-04-03T08:00:00.000-07:00

This might seem like a strange topic, but in almost every interview I've attended, one of the questions is "Have you ever had two moms in labor at once?" After over 750 births, the answer is a resounding "yes". A few times, 3 moms in laboring stages at once. What does a doula do?

We have to have qualified backup to make sure that families who are expecting doula support for their birth - have doula support for their birth. So a doula's backup is a very important person. She allows a doula to take more than l birth a year - or a vacation once in awhile. Or even to get through something like a bad cold.

Expectant moms understand that even though they may have a primary OB, many, many times they are uncertain that the doctor doing the delivery will be their primary or even perhaps a doctor they have never met. It will be the doctor on call that day. That is one reason some families look for a doula - to have a person in the room that they know, have developed a trust in before the birth. It is a privileged responsibility that doulas take seriously.

In many years of attendiing births, I have a very small amount of times I have had to use a backup. Thankfully. But it can happen and having someone who is willing and able to run to an unexpected birth, of a family that they've not met, is amazing. And in my experience, families love the backup and are grateful for the support.

But how does the doula feel when she has to send backup. Sad. After months of preparing to support a family through their birth, it is so disappointing to be somewhere else and get the messages of the progress of the birth. That has happened to me twice in a month and I have to say it has been hard to miss the births. Of course the families have loved their birth and their doula support - which tells me that the wonderful doulas I use as backup are well qualified - and great! But it has been so disappointing to not be the person in the room sharing the journey. I'm just glad I'm the disappointed one - not the clients. I'm looking forward to many more exciting birth journeys - and to hopefully making the rest of my births this year without need for backup! But if I do need to send someone else, know that it will be a wonderful doula.

Re-framing A Birth

2012-02-22T09:00:00.000-08:00

Birth memories can leave us with a smile on our face - or we could be left with a sense of trauma that we don't want to remember. I began this journey of supporting families through labor to help a family "re-frame" a birth. Since birth, like life, has ups and downs, how do we re-frame it?

During a labor, there are usually moments of frustration, concern, tears....when a family's memory highlights those moments, it can damage their birth memory. There are usually also moments of laughter, joy, excitement. Though these may be momentary (such as between a contraction), what if that is your overall memory of the birth. This feels valuable to me. We carry our birth memories the rest of our lives.

So I like to remind families of those light moments - even sharing in them during the birth. I have found over the years that moms are so powerful when working through labor - and dads are so supportive and concerned. Why not emphasize these characteristics? What if a couple who had to make very tough decisions during the birth, still came out of it with a sense that they made good decisions for this particular birth and this particular situation? Would that not "re-frame" their overall view of the outcome?

Birth memories are important - not as important as your healthy child in your arms - but important still. So if you want help in "re-framing" your birth, I hope you'll consider adding a doula to your birth team.

A Female Voice

2012-01-20T22:19:00.000-08:00

I've always felt the most important support person in a room is the dad. But one thing they can't bring to the support is a "female voice".

Why does that seem so important? Moms in labor can feel very isolated and although they need reassurance and guidance, there are times when they need a female voice. Your husband saying "you'll be okay" does not have the same impact as a woman who has been through labor who says "you'll get through this - it'll be okay". Could be compared to you and your husband backpacking on your own into an isolated area - versus having a trained guide helping you navigate the path.

This does not discount the need for reassurance from the dad - not at all - but having a female voice can be that added support that helps a mom over the rough spots.

Does it matter who the female voice is? Henci Goer in "The Thinking Woman's Guide to A Better Birth" put up a comparison chart of labor support from a female relative or friend or a doula. One of her comparisons is that a female relative or friend "may have beliefs and experiences with labor that may color her behavior and bias her advice". However, a doula "knows you but the fact that you have no ongoing relationship means you don't have to perform for her or worry about what she might think of you." Also a doula "knows about labor, techniques to promote good progress, and comfort measures. She can help facilitate communication between you and your caregivers. She too provides a loving touch." Of course, some relatives or friends can provide great support, and a female voice. You know best who you want to provide support during this journey.

So when you are planning your birth team - give consideration to a female voice, along with your husband. And talk to other families who have added a doula to their birth team and listen to their experiences. Here's hoping the voices you hear in labor will guide you to a wonderful experience.

Special Needs Births

2011-12-05T11:43:00.000-08:00

When I say "special needs", I'm not talking about a physical or mental disability. It is a disability of trust.

Dads can feel that they'll be too queasy to make it through a birth process. I've been hired many times because the dad felt he would faint and wanted his wife to still have support. But dads are amazing support, and they step up to the challenge of labor and the fear of fainting disappears with the excitement of the birth!

A larger category of special needs families are the couple who had a traumatic first birth. Over the years I've worked with many families with this background. Perhaps they went into their first birth experience, feeling ready, but then quickly felt all control/decisions were taken out of their hands and the result felt traumatic for them. Some of them ended up with many interventions, some ended up in surgery. Some moms felt no one paid any attention to them or their needs and the dads felt useless. The couple felt helpless, and ultimately were in love with their baby but unhappy with the birth.

When the second baby was on its' way, they looked for help, a doula. I think one of the greatest benefits of a doula is a confidence in birth. We've seen birth hundreds of times work out beautifully. They provide a support to the couple that their voice matters. So as they approach this next experience, they have a lot of fear that the birth will be the same - but it never is the same! This is a different baby, a different time of their lives, a different approach to the process. Ultimately whether the birth results in interventions or even back to surgery, the couple feels they made good choices, that they participated in the process, that the feeling of the experience was different, better.

So if you are looking at a birth and feel you have special needs in the trust area - consider a doula. Birth is such an amazing journey - my hope is that you have a great birth memory.

The Waiting Game

2011-11-19T14:27:00.000-08:00

The excitement of discovering you are expecting is replaced usually be a few months of the "morning sickness", followed by several months of energy and a growing belly, followed by the realization that labor will eventually come....Lastly it is the 9th month and for some reason this turns into a 9th year. Especially when it is the first baby, days become months, hours become weeks.

The phone calls increase - lots of family just checking on you. Friends pass you and ask "when are you due" - strangers pass and ask "when are you due". All this builds in you a watchful eye for every feeling you have. And everyone expects you to be the expert on when your labor starts - and yet you feel so uncertain that you'll know.

Each night you secretly wish for labor to be delayed because you feel so tired - each morning is followed by disappointment that there are still no signs of labor.

Week 39 approaches and the fear that you might need an induction looms higher in your thoughts. And now you are definitely sick of the "when are you due" question. No one is satisfied with a reply that expresses a desire that the baby pick the due date if possible. Sometimes not even you! Thoughts go to "it would be nice if the baby came today" or "I hope the baby waits until the weekend".....

This waiting game can wear on you quickly. Here are some suggestions: Enjoy the time you have that allows you quiet movie watching, an afternoon nap, a quick trip to the store, an uninterrupted dinner with your husband. These are the last days that you still have control of your time and energy. Don't wish them away.

Schedule something that will nurture you - a pedicure, a massage, a lunch arrangement with friends. See a movie you've wanted to see, visit a museum, read a book. These are adventures that will not be available to you for awhile.

Put an updated message on your answering machine. I had one friend who would give updates each day of his wife's progress in the pregnancy. It was fun to call and just hear the update - and not disturb them. Or a message that says "no baby yet - we'll let you know" answers their ever present question to you.

So enjoy your pregnancy, enjoy the 9th month, and hopefully feel great about the birth. Babies are worth all this effort - be creative in playing the "waiting game".

When Births Go Right!

2011-10-07T15:46:00.000-07:00

I have worked with many families over the years who have a very specific vision of their birth - they have a strong desire to go unmedicated - they are wanting a certain doctor in the group - they don't want dad to be at work 4 hours away when the labor starts - their mom is arriving on a certain date and they want the baby to wait - their mom is arriving on a certain date and they want their baby to come early - etc, etc.

So when everything falls into place, it is such a joy to relive that birth over and over again. The hazard of memory is that we can be imprinted with the good outcomes from a birth - or we can be imprinted with the bad issues on a birth. I have always felt that a doula's role is partly to "reframe" the vision. The fact is that in birth, as in life, there are ALWAYS goods and bads in the experience. But what do we choose to focus on afterwards. Isn't it better to keep your eyes on the highlights, rather than the low parts of an experience? Especially since we live with birth memories for decades?

Recently I've worked with several first time families who achieved the birth goals they had envisioned. They stayed home for most of the labor - they worked through the contractions well - they were able to go unmedicated which had been their particular goals. It is so great to see a mom and dad after such a birth excitedly tell their friends/families how amazing the experience was. Of course, I was at the birth also and there were definitely moments that were difficult but overall their vision is one of accomplishment and joy. Isn't that how birth should be remembered?

I've worked with some families lately who chose to use an epidural. They also excitedly tell their birth stories to their friends and families in glowing terms. But once again - there were definitely low points during the process. Those points, however, were momentary - whereas the good parts were foremost in their memory - and thus in their story.

What is the common denominator of such births - that go right for whatever their goals and choices were? I think it is having a doula - who helps a family weigh their options - remind them of questions they might want to ask - guides them through the process so that they feel informed and part of the decisions. Empowerment can come from different directions - and this can lead to a good experience.

So here's to the next birth that goes right - medicated or unmedicated - and at the end of the day, my hope is always that the family will tell their birth story with a smile on their face and happiness in their heart!

25 Years and Counting

2011-09-15T11:20:00.000-07:00

Well today is a very special day for me - 25 years ago today I attended my first birth as a labor assistant. Over these 25 years I have accompanied hundreds of families through their births. I've even worked with mothers and daughters in their own births. It's amazing to see these children grown up - and remember that I was there when they entered the world.

So what have I learned after 25 years. I started with such a devoted passion that each mom should have an unmedicated birth - it just felt right. I had experienced that myself 3 times and just knew that any mom who could have an unmedicated birth would be forever changed. Well, I do still believe that a mom who is able to meet the challenge of labor unmedicated - is profoundly changed. BUT I have also learned that an unmedicated birth is not the right path for every mom. Sometimes the option of medication or interventions are just what is needed for a birth. And more importantly - no matter how focused a mom is on having an unmedicated birth - babies can change all our plans. I've seen so many moms work through days of labor only to face the tough decision of a surgical birth - through no fault of their own magnificent effort - it was just the way it was going to have to be to have a safe delivery.

I've also seen time and time again the power a dad plays in the whole process. His presence is always welcome and needed. They are the strength of the room in so many ways and it is a joy to see a couple rely on each other to bring their baby into their arms.

I've learned that age can diminish your stamina but not your passion. I will attend a birth tomorrow, #744, and yet I will be as excited to be there as I was with my first birth. I feel so comfortable around labor.

Labor is a unique challenge - but one that can be met head on with support and knowledge. It is a path women are equipped to walk - so the more we can remove the fear from this process - the better off all moms-to-be will be. A healthy fear of this amazing process is normal. But a dreaded, worried fear of labor needs to be changed through more and more great birth stories.

So - 25 years and counting - thanks for the memories!

When Birth Plans Go Astray

2011-08-06T14:21:00.000-07:00

Have you ever seen or written a birth plan with words like "I want to have a natural birth", "Keep the lights low" "I want to be free to change positions" "I don't want to use pitocen"....etc. Having a birth "goal' is a great start - I think it matters that you have some vision of your ideal birth.

But have you also written a birth plan and in the end...none of it happened. Perhaps you felt like it was a waste of time. You were probably also very disappointed and disillusioned with birth. Does this mean we should never try to make plans?

Although we can't "plan" birth, we can have some control over certain parts of it. You have some control over your care provider, you have some control over the support people in the room. You have some control over the lighting, the music you play, even the clothes you wear. You have some control over positions you try. You have some control over when you head to the hospital, over the thoughts you are focusing on in labor.

So start with a vision of the birth you would like to have - and then make sure you have great support. And ultimately realize that the baby has the largest vote in the process. Hopefully some of your vision will be realized - and hopefully you'll leave your birth with a great memory, even if it doesn't exactly match your original "plan".

Should I Consider a Doula for the Next Birth?

2011-07-02T08:20:00.000-07:00

I wasn't sleeping one night and thought about all the birth stories I had heard from moms - when they went through labor the first time and came out of it with a bad memory of the experience. So I put together a poem as if I was a mom thinking about having another child. Here is my poem.

Beauty is in the eye of the beholder, so they say

So why don’t I feel about my birth the right way.

That moment was supposed to be so treasured for life

But is only a memory of trauma and strife.

I know my son is healthy and for that I am grateful

But the memory of his birth is still very painful

I thought I was so prepared for what I would face

But then labor started with an out of control pace.

The classes, the books, all our desires became a blur

As I fell into a mindset where I felt so unsure

I didn’t know what to do, what to ask for, my rights

And the end result felt like a cascade of frights.

So next time how do I make the day more cherished.

Wait, am I crazy, I felt I almost perished.

No, that’s not true, and my boy is so amazing.

Another precious child is definitely my craving.

So what can I do this time that last time I didn’t try.

Is there a different class or a book I can buy?

All my friends’ birth stories are locked in my head.

How do I move past all the fear and the dread.

I’ve heard that a doula can give you great aid

Can help when your worried, or frustrated or afraid

She can remind you of positions and choices you could make.

But the decision is still mine, this is my journey to take.

My husband and mother can make me feel bold.

They will not be replaced by a doula, I’m told.

The room will feel calmer, peaceful, and informed.

Isn’t that what I wanted when my first son was born?

I’m feeling stronger about this, what I’d really like to do

I know I can speak up and should be listened to

That my voice really matters – wow my thinking has changed.

I’m now looking forward to childbirth again.

So perhaps I’ll look into doula support for this birth,

And I’ll talk to my husband and explain why she’s worth

Bringing her into our team, a doula will lighten our journey.

With my husband and a doula I can have a wonderful memory.

Long, Long Labors

2011-06-07T08:09:00.000-07:00

Have you ever heard mom say, "I was in labor for 3 days" and you wonder, "How is that possible?" or more often "Poor lady".... Technically, medically the medical field does not like to start the clock counting until the contractions are so close and strong that you feel you have to head in to get help.

I however have always felt that the clock started when a mom has to deal with contractions which continue on until a baby arrives. Contractions, even l5 minutes apart, can interrupt your sleep, eating, life cycle. Everything takes a back door to a normal life once labor contractions start - no matter how hard you are trying NOT to focus on them.

I have been a part of supporting moms through days of contractions - but in the end, once the baby is in your arms - the process becomes a distant number - impressive absolutely - but a number. That is why we are able to have another baby - to consider the possibility that a sibling would be a great plan....

Of course, once you are pregnant again, you suddenly realize you will again be going through labor. My hope is that you consider getting professional labor support so that your birth memory will be a wonderful memory - even when it takes several days. Labor brings our children to our arms so don't be afraid of the journey.