Summer nights are precious; so are summer plans. To accomodate all the summer and early Fall babies, I be teaching a quick as a summer storm Childbirth Education series at Grow.

When does it start?
We will meet on four Thursdays starting on 6/5. Our class will start at 6:15. You can be getting an ice cream or a frozen yogurt treat for the way home by 9pm.

What will we learn?

This is an interactive class. My teaching focuses on practical skills and evidenced based care.

We will cover: The physiology and hormones of birth, practical tools for all the stages of labor, labor challenges, and the benefits and risks of typical labor interventions.

Plus: newborn behaviors and appearances, postpartum planning for family wellness, and getting breastfeeding off to a great start.

What do we need to know?

Call Grow directly and ask to register for the June childbirth education series: 413-341-5282

Come dressed comfortably. Practicing good birth positions is an important part of class – and we will start on week 1!

Please bring food or drinks to keep your energy up.

I look forward to seeing you there.

The post Childbirth Education Summer Session in Downtown Northampton, MA appeared first on Gentle Balance Birth.

This is not a question about baby care, usually, although I am happy to help with that. I am a certified childbirth educator and able to teach about typical newborn care and procedures.
Mostly what families want to know when they ask “What happens when the baby comes?” They mean, what about you, our doula? How long do you stay with us? What kinds of things will you do to help us during this time?

This is such a great question. As your birth doula, we will spend much of our time together talking about your birth, how you feel about it, what you are hoping and expecting and how I can help you.
After your baby comes, I will stay with your for a few hours, unless you are ready for me to leave sooner.

Your baby can spend the time after birth enjoying skin to skin contact with you. Normal newborn procedures can wait while you focus on this time together. I can help ensure that your wishes are respected, that your baby only gets care you have asked for, understand and have chosen during this time.

Many newborns may breastfeed right away but it is normal for them to breastfeed anytime in the first 24 hours. Nevertheless, allowing the baby remain skin to skin with his or her mother for at least the first hour after birth gives moms and babies the best breastfeeding start they can have.

You and your partner may be hungry. I can help by ordering food for you. I can help by communicating with relatives as necessary and helping you find a comfortable position for a much deserved family nap.

Once I leave, we can keep in touch by phone or texting. I remain on call for you for 5 days postpartum. During that time frame if you want to talk to me about your birth, your baby or the care you are receiving, you can call me at any hour.

Postpartum, we will arrange a visit to reconnect. We can use this time in whatever way best serves you. Some families are looking for resources like postpartum doula care, support groups, and expert lactation support. Other families are interested in basic tips for soothing baby and getting a little extra sleep at night. Other families like to process their birth experience with me and offer me feedback about my services. I appreciate this time to connect with my clients and value my role as part of their wider network of support as they care for their baby.

The post Doula Interview Question #7: What happens when the baby comes? appeared first on Gentle Balance Birth.

From my top ten list of birth doula interview questions:

#6. What are the most important things you think I should be doing right now to prepare for my birth?

Families often ask me what books to read, what class to take and how to get ready for birth. While I am happy to recommend books, resources and movies to my clients and students, the most important thing you can do right now is to take care of yourself.

Eat well, sleep well, stay hydrated.

If you can and it feels good, exercise. If you were walker before pregnancy, walk. If you jogged, keep it up until you don’t feel like jogging anymore, or until your care provider recommends stopping. If you swam, swim. If you hiked, hike. If exercise wasn’t your thing before, check with your care provider about starting a new exercise plan. Most will agree that prenatal yoga, swimming or walking are all perfectly safe to pick up during a healthy pregnancy.

Why do I think self-care and exercise are such good birth preparation?

Birth is a powerful event. You are asking your body to do something amazing but difficult. In the weeks beforehand, treat your body with as much care and respect as you can. Get a massage, photograph your beautiful pregnant self, eat yummy foods and rest up. During your labor, movement will be a key ingredient to finding comfort and rhythm during labor. Keeping your body movement during pregnancy will make moving during your labor that much easier, comfortable and familiar.

If you want more specific recommendations about movement for labor, I invite you to sign up for childbirth classes. I teach at Cradle in downtown Northampton. I would love for you to join me for 5 weeks of learning with other families about safe, supported birth.

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Many of the women who call me up to ask me about my doula work have already thought long and hard about medical pain relief. Most tell me that they have a strong desire to avoid epidural pain relief but have not ruled it out completely. Most report to me that are hoping doula support will help them go through birth without it. Their question for me is this:
How will you respond if I choose to have an epidural or other intervention that doesn’t fit into the “natural childbirth model” way of doing things?

I believe birth can unfold in a many ways. Women who want unmedicated birth can very often experience that if they are in a setting that accommodates their need for freedom of movement and if they are given high levels of emotional and physical support. Bringing a doula to provide that is just plain old good planning. Sometimes clients even surprise themselves, going without an epidural when they were sure they would want one.

However, I am not categorically against medical pain relief. My default response is to trust women. If you tell me you want an epidural you will receive my unflagging support to go as far as feels right to you without one. And you will receive my unflagging support when you are ready for medical pain relief. We will make a strategic plan for using the epidural to your benefit while making every effort at minimizing its potential risks.

Women have the right to high quality information about any medical procedure offered to them during their pregnancy and labor. Along with that, providers are obliged to offer quality information and give women an opportunity to freely consent or refuse or delay interventions and treatments. Every intervention has its risks and benefits. Epidurals are no different. There some labors that seem to truly benefit from a woman having the opportunity to sleep. Occasionally, epidurals are used to manage high blood pressure. Epidurals are sometimes an accompaniment to medical labor induction with pitocin. I teach most typical hospital interventions in my childbirth education classes, but I bring that information to your birth.

So, how will I respond? I am your doula. I will be there to support you. I will fluff your pillow, turns out the lights for much needed rest, and help you rotate positions in the bed to help your baby move down. Perhaps I will even help you get on hands and knees in the bed to encourage your baby to turn. And I will be right there when it is time to push, giving you all the physical and emotional support I can.

The post Can I hire a doula and still get an epidural if I want one? appeared first on Gentle Balance Birth.

I don’t know! Maybe it’s surprising to hear me say it, but I don’t know what your partner’s strengths are – what is the skill set he or she brings to this experience? Most likely the critical thing that a spouse, partner or family member brings is his or her love for you and your baby. The comfort and support of someone who loves you is invaluable – and research indicates that women who have free access to this support throughout their birth have a higher rate of satisfaction with their childbirth experience. Research does not indicate that having a person from your social network (sister, friend, etc) will reduce your risks for interventions. In other words, it is emotionally satisfying but does not appear to change birth outcomes.

The other thing I don’t know right now is what support you will want from a spouse, partner or friend and what support you will want and need from me. I can tell you a few things. When I am at a birth, there is plenty of work to go around. What you need from each person in the room becomes clear to me as I watch, listen and make adjustments to what is happening. I can also tell you that the same research from the Childbirth Connection website also indicates that women who have professional labor support – a doula – have lower intervention rates -yes, fewer cesareans, less pitocin, lower usage of pain medications. In addition to those benefits, women who labor with a doula are most likely to report having a positive birth experience.

Once I was at a birth that included – among other things – the doing double hip squeeze for about 9 hours. Apparently, I have the knack. (If you don’t know how the double hip squeeze helps during a contraction, ask anyone who has experienced back labor.) During this adventure, the laboring mom needed plenty of other support – juice, cool washcloths, and emotional encouragement – which she received from her husband and her midwife. At a different birth in the same hospital, I=important medical decisions were being made and I helped create a safe place for both parents to experience truly informed consent as they get all their questions answered from the care provider team.

So, what I do for you that perhaps your spouse, friend or sister cannot? So much depends on how your birth unfolds and what your needs are. One important thing I ask my clients to remember – I will be there, I will stay with you for whatever you need – not to rescue you, fix you or save you but to support and empower you during your birth.

The post What can you do for me that my partner or friend cannot? appeared first on Gentle Balance Birth.

Continuing on with my top ten list of interview questions for a birth doula, many couples ask if doula support is beneficial for women who have medical induction of labor or planned cesareans. Some women know ahead of time if they carry a special risk of this occurring and others have just heard stories from friends of “birth plans” that have not gone according to plan.

There are several important conversations buried in this interview question. The most important thing I want to express that I value all births equally. No matter how your birth unfolds, you are becoming parents and welcoming your child into your arms. You deserve emotional, physical and practical support. I can provide that to you.

The informational support I offer can help you feel in control of your health care decisions. I will use all my resources as a certified childbirth educator and experienced doula to get you the evidenced based information you need to help you determine if a medical induction or cesarean section is in your best interest. Once you have made a decision with your care providers, we can create a plan together that you feel good about. It is okay to acknowledge that this might be your plan B. Even if parts of your plan B might be disappointing to you, we can create a plan that feels safe to you.

You deserve your doula’s best efforts on your behalf for a safe, supported birth no matter how your birth unfolds. If you want to talk more about this topic, call me. I’d love to sit down and talk in person.

The post Doula support is for every type of birth appeared first on Gentle Balance Birth.

Back to our top ten list of interview questions for a doula

This is a question that not everyone asks but it does sometime come up. Occasionally, inquiring families perceive themselves to be extremely private. They might feel that they are only considering inviting a doula into their labor and birth for “practical” reasons – the chance of reduced interventions, the chance to have comfort skills demonstrated to birthing woman and support partner, in case family members giving support need a break, and for knowledgeable decision making support. A doula can also provide emotional support and stability to both a labor woman and her team, but not all families feel certain they will want or need constant support.

One of the most common reasons people who are interviewing me for their second birth tell me they did not hire a doula for their first birth is they wanted to be alone together as a family. Birth can be a very bonding time for families. Everyone is leaning towards the experience with hope and joy.

As an experienced doula, I tell all the families that there are times when privacy might be the very best thing to help a labor progress. This is why time alone in a hot shower does wonders for some moms whose labor has slowed down a bit. Entering the cave-like atmosphere of a dark bathroom can feel like the safest thing for some moms as they get ready to push their baby out.

When I am with a laboring woman, there are times she may ask me to leave her some space. This means different things to different people. It may mean she feels most comfortable with me knitting in the corner while she finds her way to the best position to help her with contractions. She may want me just outside the bathroom door should she need me to wipe her face or move from one spot to another. She might even want an hour or so with only her partner and ask that I take a walk or a short break with my cell phone on hand.

Some families surprise themselves when they discover that their privacy circle widens to include their doula. By the time they are in labor, families have met with me two to three times at least. We have often spent several hours laboring at their home before moving to the more public sphere of the hospital. Their need for privacy is being met by the intimacy developed among us as a team devoted to a healthy, progressing labor and a mom who feels supported.

Since my only plan for your birth is to support you, you cannot hurt my feelings by letting me know what your needs are. I will ask just enough clarifying questions so that I know with certainty how to best serve you. Hopefully what this means to most families is that they can both have high quality labor, professional labor support and the just right amount of privacy for their birth. Rest assured that if you need some extra privacy, I will go enjoy a hot cup of tea and hold you in my thoughts until I re-join you with fresh energy and enthusiasm.

The post What do we do if we decide we need some privacy during our birth? appeared first on Gentle Balance Birth.

I’m interrupting my series for the online doula interview to share a post I wrote in response to yet another dust-up about public breastfeeding and advocacy.

After a post went up from a Babble blogger that shamed mothers who breastfeed without a nursing cover, and piece over at Slate that indicated the simplest way for us to move forward as women in society would be for lactivists to care less and the market to over better nursing covers, I was invited to write a guest post for Annie at PhD in Parenting. I hope you will visit me over there and join our conversation about misogyny, the female body, judgments and the mommy wars.

The post The Walking Wounded appeared first on Gentle Balance Birth.

Working off my list of top ten questions I have been asked in a doula interview, I’m addressing first the most commonly asked question:

What is your relationship to my other caregivers? How will you help me make your presence as my doula work for everyone in the room?

Prospective clients ask this question for a few reasons. Some come to a doula interview unsure of exactly what a doula does. Families are usually looking for concrete information about the different roles that are played in a birth setting. Some are unsure if obstetricians allow doulas. Some are wondering if there is a need for a birth doula when there is also a midwife. Others wonder if their partner will feel like an extra in the room.
One of the simplest ways to answer this question is to say that a doula is the only person at your birth who is there just for you, the laboring woman. Every other person in the room has layering responsibilities and experiences during your labor.
Your partner and fellow-parent:
Your partner is there to give you love and support but while also remaining present to the experience of witnessing the birth of their own child. I am happy to share to work and model the tasks of massaging your back, brushing your hair and offering you physical support. There are also ways I am able to help you because of my training and experience that include finding the best positions tow work with your body and techniques for counter pressure to help with back pain – and much, much more. Through all this I can provide quite reassurance to you and your partner that the noises, sensations and discomforts of your labor are normal. For loving partners, concern for their family can easily take over their ability to offer support. With reassurance from a doula, your partner can continue to enter in to your experience and help meet your needs.

Your nurse
Studies have shown that continuous support -the way a doula provides it – from hospital staff personnel can have benefits for laboring moms. There are a few potential problems about counting on a nurse to help you all the way through labor. The first is that your nurse’s primary obligation is to monitor the condition of the laboring mom and her fetus. At times and in some hospital settings, nurses will have the time and opportunity to provide high quality labor support. Many that I have worked with over the years have the experience, skills and passion for this work. However, labors do not follow the shift schedule of a hospital. Change of shift will happen at regular intervals no matter where you are in your labor.
At times your nurse will have to step out because of other patients, will have to update an incoming nurse about your condition, or will have to communicate with an OB or midwife. Your nurse’s job is a very important one because should you or the baby have a change in your condition having access to your history throughout the entire labor is a extremely valuable tool for how you and your medical care provider will decide if any medical intervention needs to be considered.
If you want to read a bit more about the evidence of doula support having an edge of support from a hospital staff or a family member you can find that at the always helpful Childbirth Connection.

Your midwife

Your midwife is highly invested in giving you quality support throughout your labor. If you are birthing in a hospital with a Certfied Nurse Midwife, you midwife will most likely meet you there for your entire labor. She may or may not have other laboring patients at that time but her goal is to help you progress through your birth to delivery feeling safe and supported. Women report a wide range of experiences with their midwives – it is important to know that some quality that may irk one person about a particular provider might be the exact quality someone else appreciates the most in that provider. Some midwives may appear to be more hands on than others with regards to labor support. Some of that is dependent on the standards of care and expectations in your care setting, as well as factors outside our control such as how many women are delivery babies the same day as you, and your CNMs on training and preferences.

One important fact that is often not immediately clear to expectant families is that a Certified Nurse Midwife must record and document your condition, your fetus’ condition and you care because all CNMs in the United States work under a supervising Obstetrician, who is available for surgeries and consults. Of course, you are hoping this will not be necessary for you, as is your midwife but it is her responsibility to make sure that all the information is available to the OB should any situation warrant consulting them. It has been my experience working at many births with CNMs that there is plenty of labor support to be done. The room simply does not feel crowded or chaotic when people are working together in harmony to support a laboring woman.

Your obstetrician

Even with both home birth on the rise and increased awareness about hospital based midwifery, the vast majority of babies born in the Unites States are born under the supervision of an obstetrician. Some obstetricians may have heard of doulas. Others may not have. Some may have reservations about doulas and wondering if adding an extra person in the room is beneficial to the birthing process, Or perhaps they have had little experience with natural childbirth and view it (and doulas) with some suspicion. Others have more varied and positive experiences and may welcome you taking some ownership of your care and hiring a doula. No matter the situation, if you hire a doula, she works for you. Whether you obstetrician is thrilled with her presence or wary, she is still there to meet your needs. Ideally you have a chance early enough in your pregnancy to talk about labor and birth. If you feel your current provider does not have the ability to support you through a safe, healthy,low-intervention birth, you have the right to look around for a new provider. One thing is for sure, obstetricians do not specialize in hands on labor support. Depending on the length of your labor you may see an obstetrician from your practice once or twice during your labor before you are pushing – and in some settings, not at all. For families seeking a low intervention birth a doula becomes a necessity to provide continuous labor support.

All this makes it sounds like I am anti-obstetrician, when I am not. I have worked with many wonderful OBs in the last decade. I have seen some completely changed their minds about the presences and value of a doula, about low intervention birth and even some some wonderful champions for woman-centered birth. I have even had a chance to congratulate new residents on attending their first non-epidural birth, or first birth with a woman not leaning back in the bed. Having meaningful, honest communication with your care provider is the most important thing.

Weaving it all together
As an experienced doula, I weave all these factors together when I come to you in labor. If you could be a fly on the wall at your own birth, you’d see me:
– squeezing over to make a little extra room near you if your partner is holding back
– stepping in close when your midwife has to stepped away for a moment
– listening along with you to something the nurse is suggesting and looking into your face so you know you can voice any concerns or questions you have about that
– showing your partner the exact spot on your hips to squeeze to provide the most benefit to you
– stepping out to refill my water bottle, and yours, and your partners.

You would also hear me:
- Asking you out loud, “Are you comfortable with that? Do you have any questions about what your nurse/midwife/OB just said?” Or “Do you need more time to decide?”
- Thanking your labor nurse by name each time she shuts down the lights, brings us a fresh cold cloth or warm blanket.
- At your request, updating any family you may have waiting for you -or by phone – so you don’t have to be distracted by this task and they can be well assured that you are doing fine.
- Checking in with you to see if your silence means you are feeling safe and calm or alone and needing more support.
- Encouraging your deep vocalizations sounds, letting you know that you have our support and are free to work with your own body to birth your baby.

As your doula, I hold the birthing space for you in tangible ways. I will make sure those lights are dim, that your door is closed, that your music in on if that is you desire. But you also need an emotionally safe space in which to birth. Many women are trained from an early age to be concerned and take responsibility for the emotions of others, the responses others are having to them and the ways that others are getting along. On the day you are birthing your baby, you do not need to take care of everyone in the room. I am there to take care of you and to work harmoniously with your team so that you have the safe space you deserve to have.

The post What is my doula’s relationship to my other caregivers? appeared first on Gentle Balance Birth.

Like many of you who freelance, I spend a good deal of my professional time looking out for my next gig. It is the invisible work behind all the actual work that I do. And it is takes up a decent amount of time and energy. All that effort is meant to lead up to the interview for my next birth doula client.

It is not uncommon for me to go to a job interview several times in a month. Many people are unsure how to interview some for a job. This is probably because most of us don’t have much opportunity to practice. I often walk people through it because I want to make them comfortable enough to speak their mind. I ask them how they found me, what made them decide to interview me, what they are looking for from a doula. I reflect back what I heard from them – addressing any or concerns they may have.

There are a series of typical questions people ask me – how long I have been a doula, how I became a doula and how many births I attend during a month. Many people ask happens if they are in labor at the same time as another client or if something prevents me from being able to attend their birth. This is a very important question and everyone should ask it.

Yesterday at an interview I was asked the best question I have ever been asked at an interview. It made me think back on nearly a decade of interview questions and consider which ones fostered the best communication between me and potential clients. I highlight them here not because I think I have the best answers but rather because I think these particular questions provide a window into any doulas personality, style and way of working. Open ended style questions give you a chance to find out if you can connect with particular doula. If you believe your communication styles well work together and that the connection is established, then you can grow that into a trusting relationship.

Here are my top 10 doula interview questions:

1. What is your relationship to my other caregivers? How will you help me make your presence as a doula work for everyone in the room?

2. What do we do if we, as a couple, decide we need some privacy during our birth, even from you?

3. How will you support me if my birth for any reason becomes more medical than we hoped? For example, what if I need a plan induction or planned cesarean?

4. What are the things you can do for me that no one else might be able to do, such as my partner, a friend, or family member?

5. How will you respond if I choose to have an epidural or other intervention that doesn’t fit into the “natural childbirth model” way of doing things?

6. What are the most important things you think I should be doing right now to prepare for my birth?

7. After the baby arrives, then what? How long do you stay? What are the ways you are helping us in that time period? Do you just go poof?

8. What is my labor is super, crazy long? How will you help me? How will you have the energy? When is too much, too much? Do you leave?

9. What do you know about postpartum depression?

And my all time favorite question to be asked at an interview,

10. What do you love the best about being a doula? What motivates you and excites you about this work?

I am sure there are hundreds more interesting, insightful, open-ended questions to ask when interviewing a doula. What would you add? What kinds of answers have you heard. Stick around to hear mine in the coming weeks. If you are a doula, share yours in the comment section.

The post Top ten questions I have been asked at a birth doula interview. appeared first on Gentle Balance Birth.