The topics of pregnancy and birth seem to be open season for anyone and everyone to give an expectant mother information; solicited or otherwise.
All of a sudden your mother, mother-in-law, Great Aunt Mildred, your barista, cashier at Whole Foods, and yes, your doctors and nurses and doulas have become experts on what kind of birth is best for you.
"Both you and your sister were big babies, it's genetic, you'll need a c-section too."
"I wanted a natural birth, too. But after 5 hours of labor, I bet you'll be screaming for an epidural."
"An epidural is safe, and it allows you to rest during your labor."
"The drugs are there for a reason!"
"Don't be a hero, you don't have to have a natural birth!."
With so many choices, how are you supposed to decide what's right and what's wrong? You use your B.R.A.I.N.
I've often seen the B.R.A.I.N acronym used in relation to the labor process when interventions are offered to a birthing mother, but I think it has merit in pregnancy as well.
So what is B.R.A.I.N anyway? I'm glad you asked :) When someone (anyone from your neighbor to your provider) brings a suggestion for your birth or pregnancy ask yourself the following questions:
B-What are the Benefits
R-What are the Risks
A-What are the alternatives?
I-What does your Intuition say?
N-What happens if you do Nothing.
It's my opinion that no one is trying to scare you or deter you from your wishes when you are pregnant. Most unsolicted suggestions come because some cares, or they want to share their story. It can get pretty loud with all of these suggestions coming at you at once. So, this Tuesday Tip is to use your B.R.A.I.N
What more information that's Evidence Based. Check out one of my favorite resources, Evidence Based Birth.
Happy 2016 Readers!
I feel like my mother saying this, but it seems like 2015 FLEW by! I can't believe it's already 2016-The year that I aspire to take my doula business off the ground! So many goals, so many dreams, so many opportunities to improve who I am as a woman, wife and doula and I'm SO excited to start!
I'm thrilled that I have my first 2016 birth booked for March. These clients are interested in having a HypnoBirth, which means I've been doing research and reading all I can shove onto my mobile's already stuffed memory on the subject. I'm excited to be working with this couple and am excited that the birth they want to have is a natural one. It should make for amazing learning for all three of us.
I'm also excited about Postpartum Doula training in February. I've been wanting to do more PP training since I had my first mother with serious nursing issues almost 3 years ago now! It was a humbling experience to realize that while I'd been trained to a degree, my training didn't prepare me for her issues.
My other goals for 2016 are to train and certify as a Child Birth Educator and to FINALLY become a yoga instructor. I think that these three additions to my birth work will make me a premier, well-rounded birth educator in the South Puget Sound.
If you're due to give birth in April, May or June of 2016
fThis year I'd like to try something new. I'd like to share an article or blog post that I think is interesting, has important information for birthing families to consider, or is just plan awesome. I think this one falls into the important information range. Birth Stories.
As a part of the generation that grew up watching shows like "A Birth Story" on TLC I seriously FEARED childbirth. My own birth story was one of a long (50+) labor that ended in an emergency cesarean. To add a bit more drama, my mother often tells of looking over at me from the operating table and watching my little body heave, trying to catch my first breath, and then stop. And in her words, I was "whisked away."
When I look back at my first pictures, I see a fragile baby with tubes attached to it's body, flushed palms and feet with pale skin.
I determined that when I got pregnant that I would avoid all of that drama and go straight into the OR for a beautiful, forgettable cesarean birth resulting in a nice, round headed child.
It wasn't until much later that I realized that a cesarean section wasn't "easy", but that it was major surgery. Basic knowledge of anatomy teaches us that! So I learned about birth, considered becoming a midwife and decided that I wanted to be a doula.
One of the first questions I ask my clients is to tell me birth stories they've heard. And while some of them tell stories of cesarean births and others of blissed out natural births, it's how we tell stories that it's important. And the understanding that no two births are the same.
There are benefits to hearing "good" birth stories where mothers feel empowered and partners are connected. Hearing more of these stories, I think, over stories of panic, pain, and fear, are a vital step to creating the births moms and birthing people want. Life happens, births can veer off course, but in the span of human existence it's only been in the past few decades that we've dis-empowered women and our ability to give birth. Let's take our power back, trust our bodies and trust birth.
I'm thrilled to share a site I recently found called Good Birth Stories. Below is a snippet from a positive birth story. I hope you enjoy.
Vanessa’s story – Matheo’s birthThe Spanish phrase for ‘give birth’ is, brilliantly, ‘dar a luz’ (give light to). I gave light to Mathéo Zen at 7.30pm on a late May evening in St George’s hospital in Tooting, London.
The room on the delivery ward was luminous with mellow evening sun and crackling with energy; the air iron heavy with the raw smell of blood. I’d used hypnotherapy and my sheer bloody-mindedness to achieve a birth of my first baby that was natural, vaginal, drug-free (except gas and air – woohoo!) and seeing our miniature creature on the outside for the first time was mind-blowing.
He was the softest thing I’d ever touched; a tiny peach; deliciously creamy and a little bit fuzzy all over. He had come in his own sweet time and was very pleased with himself indeed. He was calm, bright as a button, and he seemed to suckle contentedly – if painfully, but that’s another story – when I put him to the breast.
I pride myself on being a black, queer Jewish doula, but does that mean I'm the right doula for someone who, say, identifies as a white, heterosexual Christian? Yes, maybe.
According to an article about Black Midwives in the LA area, "Nationwide, black women are at the greatest risk of pregnancy-related death, have the highest rates of C-sectionsand, compared with whites, black infants are four times as likely to die of complications at birth and twice as likely to die before their first birthday."
This disparity in maternal care along racial lines is something that can't be ignored. When a woman of color in the hospital birthing system is possibly surrounded by doctors and nurses who don't look like her, having a black doula to help her advocate for herself can be the difference between a natural birth and an emergency c-section. I want to be clear that this isn't to say that a white doula couldn't provide a woman of color care that is just as comprehensive and caring, it's just different. A black doula shares a similar life experience as her black client, even if they come from two separate worlds.
So what about religion? Is it important that my doula matches my personal religion? Again, I can't say, though I've personally doulaed for couples who shared my religious background and those who did not. For some, the religious/spiritual aspect of birth is important. It can mark a new life cycle event that requires special prayers or affirmations be recited. Having a doula who is familiar with those rituals can be helpful. For others, birth is just a part of life that doesn't hold any specific religious significants, but has a spiritual element that a doula can help facilitate. Mother blessings, placenta burying, and similar are all rituals that a doula can help plan.
Lastly, what about sexual orientation. Would it be weird to have a lesbian doula at my birth if I'm not a lesbian myself? Again, I can't answer this question for anyone. However, I will say that all of my clients to date have been straight couples or single women and it hasn't been an issue. Like race and religion, having a doula who understands differing pronouns, gender presentation, language, and processes can be helpful for couples and singles in a hospital setting, where awareness and sensitivity may be limited.
So what does this all mean? Should I only accept clients who are like me? No, not at all. I love that my client base has been an incredibly diverse mix of single women, couples, friends and strangers. I love that I've been able to whisper tehillim (Psalms) while a woman labors and mimic "Thank you, Jesus" when an exhausted mother holds her baby for the first time. I always encourage clients that I meet for consultation to interview at least two (or more) doulas to find the one that "fits". And if the one that fits happens to be similar to you, great. If the doula does not, well, that's great too.
One of the things I often hear is that doulas cost a lot of money.
And I get it.
When you see a one-time, often up-front price ranging from hundreds to thousands of dollars, it can be intimidating. Add to that the fluctuation of prices from doula to doula, and the process can become overwhelming.
So why are we so expensive? Truthfully, we're not. I say that as a person who would gasp (okay, maybe faint) whilst forking over a thousand dollars (or more) for a doula when my time comes.
So where does your doula fee go?
Experience and Training
Most parents who are looking to hire a doula start with where she was trained as well as how much experience she has. Doulas who have been through multiple trainings and have attended a great deal of births tend to charge more for their experience. But, that's not to say that a doula who has only attended a few births doesn't also charge "market price" for her services. While most of the money we earn for births goes towards logistics (more on that later), a chunk of it (at least for me) goes towards advanced training. This ultimately makes for better doulas.
The average cost of doula training is about $600, though I have seen it higher for week-long retreat-style trainings. Postpartum training can also range between $600-900. If you want to become a Certified Lactation Consultant, trainings can be as much as $900, and if you'd like to take it further to become an Internationally Board Certified Lactation Consultant, testing costs money as well. Becoming certified in Placenta Encapsulation, Child Birth Education, and Essential Oils and Herbs are trainings that most doulas want to add to their business. We earn these certifications and attend trainings based on our income.
Most doulas go on 24/7 call at least two weeks, but sometimes as early as a month before the time of a client's Estimated Due Date. This means they are essentially "on the clock" 24 hours a day. If I divided my current doula fee* of $850 by two weeks, I would average about $2.52 an hour without counting the amount of time doulas spend with their clients during their birth. Like most doulas, when a client calls me for their birth, I stay by their side until 2 hours after the baby is born and the parents are settled. This also means that we are not taking new clients. We are usually not going on initial consultations or meetings because we could be called to a birth at any moment. We are committed to our clients.
Gas, Food, Etc.
Doulas pay for their own gas or fare for public transportation to all consultations and prenatal visits. We also make postnatal visits (up to 2, or 3 in some cases) without charging a "postpartum doula fee." While we don't get lunch breaks, we do pay for our food, water, and supplies that we bring to each birth. This can range from books we loan to clients to birthing balls, rebozos, etc.
When a doula goes on call, she/he does so with the knowledge that at any time we could be called for a birth. This means we miss family time, vacations and trips, or nice dinners with our significant others. And when the time comes for baby to be born, we leave our full time jobs (if we work outside of doula-ing), family, and children for an undefined amount of time.
Is it Worth it?
I can't say that for anyone (typical doula answer). The evidence shows that having a doula-attended birth results in less intervention, fewer cases of unplanned c-section, better management of labor pains, shorter labors, and healthier breastfeeding relationships.
Like most doulas, I'm not in it for the money. I do what I do because I'm passionate about it. I love helping people become parents. There is still nothing more awe-inspiring than watching a baby be born. I get a rush from the sheer power and determination of women in labor and nothing beats the smell of amniotic fluid clinging to your clothes. The oxytocin that baby and new parent emit is intoxicating and contagious. I always tell parents that I interview with that they should pick a doula not by how much she costs, or her experience, but by how you feel when you are in her presence. And to my mind, that presence is priceless.
The microbial population living in breast milk and the transport of bacteria between mother and child play a crucial role in regulating health.
With no more intimate moment between a mother and child, breastfeeding provides nutritional, immunological and emotional nurturing. However, recent discoveries have revealed an even deeper connection that suggests breastfeeding is far more precious than we first thought. The secret lies within microbial populations living in breast milk. Whilst bacteria hardly sound like an enticing gift, the transfer of a mother’s microbial inhabitants appear to be the most valuable gift a mother can provide to her child.
Definitely not sterileNot so long ago, it was thought that breast milk was completely sterile. Any sign of bacteria was attributed to the presence of infection in the breast, such as mastitis, or to contamination by skin flora. However, advances in understanding of the vast microbial populations that live within our body, dubbed the ‘human microbiome’, paint a completely different picture.
Healthy breast milk has been found to be crawling with bacteria.DNA sequencing technology is now identifying 400 species living in the breast with many more likely to be accompanying them. To make things even more complicated, they are constantly changing over time with measured shifts in microbial presence between pre- and postnatal samples, as well as between months 1-6 of breastfeeding.
A mother’s inner highwayFor a newborn, the first encounter with bacteria occurs with the placenta. Then, natural vaginal birth is designed to provide a ‘starter pack’ of microbes for the child.
The mother’s body doesn’t stop there: it will prepare a rich and diverse microbial population to be delivered during breastfeeding. Bacteria, as it turns out, seem to be traveling from the mother’s gut to her breast milk. New and exciting research is showing how the immune system moderates this process in the stomach by selecting microbes to transport to the breast via the lymphatic system.
Like a microscopic highway, studies have also shown that breastfeeding women given a capsule of bacteria to swallow can later have the very same species isolated from their breast milk. A fascinating picture of how a mother cherry picks microbes from the outside world to give to her infant.
Continue Reading on BreastfeedingToday
The air has finally grown crisp and the weather is wet here in Tacoma. This weekend my partner and I tried to take care of the leaves that have fallen in our side yard. There always seems to be a project when you own an old house. The leaves were an easy one! This is a photo of me and our black cat, Leroy who was more than happy to keep my toes warm while I raked.
There are many exciting things coming down the pike. For one, I'm re-launching my doula business which will include Belly Butters, Hand Salves, Massage Oils and Room Sprays like before, but I'm also hoping to add alternatives for baby powder and vaseline for little ones. And down the line, some hand-sewn gifts for babes. I've changed the name to Pine and Willow.
I've been talking to some doulas in the South Puget Sound area about creating a cooperative doula collective that would include an ethnically and racially diverse group of birth workers, massage therapists, acupuncturists, and CBEs. This is a late fall 2016 plan that I'm SO excited for, it's been my dream since I became a doula.
And in terms of my own education, I'm looking forward to getting some Postpartum Doula training, starting prenatal yoga training, and working on becoming a Certified Lactation Consultant.
I currently have openings for January births in the South Puget Sound Area; any where from South Seattle to Gig Harbor!
So that's what's happening in my world, what's going on in yours?
Do you Instagram? Be sure to follow me at @kavanahdoula and @pineandwillow
There's a stereotype that only one kind of person hires a doula. The image is usually of a woman who is white, in a higher socio-economic bracket. She is, perhaps, a professional with a hippy edge. She is educated and informed about her birth. And it's true. Women like the one I have described may opt for a doula to attend their birth or hire a postpartum doula. But other people hire doulas as well:
Trans people hire doulas.
Black and Latino (and Asian, and, and and) hire doulas.
Jewish women hire doulas.
Muslim women hire doulas.
Stay at home parents hire doulas.
And yes, folks who are "poor" hire doulas.
One of the reasons that I decided to become a doula and to train with Ancient Song Doula is because ASDS is an organization started by a woman of color and an organization focused on training women of color as doulas. ASDS spends time in the community it aims to serve, educating people about birth.
Doulas aren't just for the rich, they're not only for white folks, or for straight people. It's my philosophy that ANY PERSON giving birth not only needs, but deserves to have a doula by their side. And ANY PERSON who has given birth not only needs, but deserves the support of a postpartum doula in the weeks following birth.
Less than one hundred years ago, people birthed surrounded by their mothers, grandmothers, aunties, cousins and friends. We birthed in Red Tents, in Birthing Huts, in low-lit rooms of homes. We roared our babies earthed from our bodies without fear, because we'd seen birth. A doula's job is to help provide that tribe we've lost. And while we're only one person, rather than the mother, grandmothers, and aunties of the past, we stay by your side. Reminding you of your strength, telling you that you're beautiful, and holding space for you to birth your baby in the way that's best for YOU.
To produce breast milk, mothers melt their own body fat. Are you with me? We literally dissolve parts of ourselves, starting with gluteal-femoral fat, aka our butts, and turn it into liquid to feed our babies.
Before and after giving birth to my daughter 10 months ago, I was inundated with urgent directives from well-meaning, very insistent health practitioners, parenting book authors, mommy bloggers, journalists, and opinionated strangers that "breast is best." The message was clear: In order to be a good mom, I had to breast-feed.
But breast-feeding is more than being a good mom. And breast milk is much more than food: It's potent medicine and, simultaneously, a powerful medium of communication between mothers and their babies. It's astonishing. And it should be—the recipe for mother's milk is one that female bodies have been developing for 300 million years.
Breast-feeding leads to better overall health outcomes for children, which is why the World Health Organization and the American Academy of Pediatrics recommend that babies be exclusively breast-fed for a minimum of six months.
Those outcomes, though, are relative: A premature infant in the neonatal intensive-care unit or a baby growing up in a rural African village with a high rate of infectious disease and no access to clean water will benefit significantly more from breast milk over artificial milk, called formula, than a healthy, full-term baby born in a modern Seattle hospital.
We're also told that breast-feeding leads to babies with higher IQs and lower rates of childhood obesity than their formula-fed counterparts. I understand why people find this appealing, but I don't plan to raise my daughter to understand intelligence in terms of a single test score, or to measure health and beauty by body mass index.
More compelling to me are the straightforward facts about breast milk: It contains all the vitamins and nutrients a baby needs in the first six months of life (breast-fed babies don't even need to drink water, milk provides all the necessary hydration), and it has many germ- and disease-fighting substances that help protect a baby from illness. Oh, also: The nutritional and immunological components of breast milk change every day, according to the specific, individual needs of a baby.
Keep reading on The Stranger
It is understood around the world that women of color, specifically black women, face the most complex challenges in maternal, birth, and breastfeeding support. Maternal death, black infant mortality, and black breastfeeding rates at their peak, are still considerably low regarding initiation and continuation, although these rates have improved in comparison to numbers from the past. Black women in the United States are plagued with obstacles every day that help them to decide to quit breastfeeding and prevent them from continuing to nourish and nurture their children – our children. The obstacles are plenty, however the ones that stick out like a sore thumb are breastfeeding in slavery and the ignorance about it among the privileged, the way these horrific images of human bondage still affect the community of black breastfeeding mothers, and the evidence that the black breastfeeding mother has yet to be incorporated into modern breastfeeding literature in the form of positive breastfeeding media and imagery, which in turn alienates black women at the time of birth discouraging them from pursuing breastfeeding because they may be the only one in their family to ever do so.
Hi there! I'm Erika Davis and I'm a doula working in the Seattle and South Puget Sound area.