Expectations…

 

You may have noticed that my blogging has become much less regular since I’ve been pregnant with my second… You would think that a new pregnancy would bring a new wave of birth enthusiasm, eagerness to write about it all, a more public exploration of my plans and anticipation for this baby…

But instead, I feel that I have become a little more quiet about it all. This has been a hard pregnancy for me- compared to my son, anyway. Way pukier at first, raging hormones, far more emotional, more frustrations with physical limitations, and a much more difficult time with exercising self-control.

I find that I’m much more nervous this time. Will I be able to birth naturally again? Will I lose it in labor? Will the baby be born safely? Will I keep calm? Have I prepared enough? Will I remember how to push? And if I need surgery for some reason, what will that be like? Will I cry with joy when I meet the child, or just feel relief that it’s over?

And then… once the birth is done… Will I ever sleep again? Can I deal with the exhaustion this time? How do I get into real life  once my husband returns to work? How will I go grocery shopping? How will I get them both safely from the parking lot to the store? Clean the house? Get exercise? Bathe? Can I possibly do the stay-at home-mom thing successfully?

Will I be able to mother two children? Will I give them both enough time? How will my son’s life change? Will J like helping Mama with baby-care, or will he resent the creature that took away much of his mother’s attention? Will I have the chance to give my baby the same love and attention I gave my first? Can I teach them & love them well, bear with them and show them patience and grace daily?

The list goes on and on… More “what ifs” loom over me than last time, more fear.

But there’s also anticipation. Who will this baby be? Will it be a brother or sister? What will we name the baby? Will he or she look like Dada or Mama or Big Brother? What will J think of the baby? How will the children interact? What kind of adventures will we have together?

And, by the grace of God, there’s hope… Hopes that I will make it through, that I won’t feel discouraged 100% of the time, that I will maintain sanity. That millions of mothers before me have managed with far more than two children, and I will learn to manage as well. That everyone says that you are indeed able to love all of your children with just as much fervor as you loved your first. That other women have had the same fears as I.

And finally, I have certain knowledge that this baby has been made perfectly by his or her Creator. He or she will come in the right timing, and we will adjust to being a family of four.

I know that God will give me the grace I need to love and serve my family well- and there will be joy. Joy inexpressible at meeting this new little life and welcoming him or her into our family with open arms.

The Professional Doula: Maintain Your Role!

Calling all doulas- aspiring and experienced alike! Welcome to Part 3 of a short series on developing professionally as a birth doula. The goal of this series is to help you learn how to better serve the mother, work with care providers, and develop a good rapport while you’re at it. Be sure to visit the other parts of the series:

Part 1: Dress the Part

Part 2: L & D Ettiquette

The last installment of my short series is going to be brief and to the point. (Sorry it took me so long to write it!)

Doulas, what is your role? We’ve all heard many versions of the answer to the question “what is a doula?”, but generally they are all pretty similar. Here’s my own definition:

A doula is a non-medical, trained labor assistant who provides physical, emotional, and informational support to families before, during and after childbirth.

You may have your own variant on this definition, but one thing that almost everyone unanimously agrees on is that a doula is not a medical caregiver (unless she is a medical caregiver already who is simply acting as a doula at the time).

And yet, it seems that far too many doulas have a very difficult time restraining themselves when it comes to giving medical opinions, “cheating” at births by sneaking in food, etc., and other “infringements” on the non-medical restriction on our job. So how do you avoid the temptation and stay within your realm?

1) Give women information- not advice. If we really do believe that we stand behind evidence based care, then wouldn’t it make sense to let that evidence speak for itself? Give women resources and information to inspire them to do their own research. Always encourage them to come to an informed decision together with their caregivers.

2) Don’t argue with a doctor during a birth. Ask questions instead. As I said in Part 2 of this series, you need to keep your cool during a birth, even if you are in direct disagreement with a doctor. Phrase your disagreement as a question.

For example, instead of: “This mother doesn’t need pitocin! Her water has only been broken for an hour,” try something like, “How long after the waters are broken does the risk of infection increase dramatically?” Even if you already know the answer, starting with a question opens the doors to suggesting that the parents and doctor (not you!) can perhaps come to a decision on how long they feel comfortable waiting before beginning pitocin. 

3) Learn  policies & ask questions about them beforehand. Don’t be the one to break them. Your job during a birth is to provide informational, physical, and emotional support to the mother. It is not to disregard the hospital policies that the birthing family has already agreed to by choosing to birth there. Of course, you can encourage the families to ask for exceptions to the rules, but don’t blow them off. You don’t have the training, the authority, or in most cases, the financial resources to take on this sort of liability during a birth.

Remember, I am all for helping to change the face of birth in America. However, this should be done outside of your role as a doula through various methods of advocacy. When you are a doula, stick to the support you should be giving the family to ensure a job well done from all perspectives.

How do you maintain your role during a birth? What suggestions would you add to this list? How do you walk the fine line of doula and birth advocate?

The Professional Doula: L & D Etiquette

Calling all doulas- aspiring and experienced alike! Welcome to Part 2 of a short series on developing professionally as a birth doula. The goal of this series is to help you learn how to better serve the mother, work with care providers, and develop a good rapport while you’re at it. Be sure to visit the other parts of the series:

Part 1: Dress the Part

Far too often I have overheard hospital staff talking about “the nerve” of other doulas, or listened to doctors talking about doulas getting in the way. Don’t be that doula! It’s still possible to serve the mother well while also cooperating with the staff. Here are some quick tips to having good etiquette in L& D.

1) Introduce Yourself. You are aiming to form pleasant relationships with the staff for the duration of the mother’s labor. Be friendly. Act professionally. Don’t be a standoff.

2) Ask questions. Show genuine interest in the staff & their activities. Make conversation as appropriate- obviously remembering that the mother is your first priority. Ask them how long they’ve been at this hospital. Ask if they have children. Ask if the day was busy for them. You’d be surprised how earnest and pleasant small talk can soften staff members that have a poor preconception of doulas.

3) Ask permission. Yes, ultimately, the mother should be able to get what she needs to labor comfortably. But the best way to do this is not by recklessly raiding the cupboards. The supplies are still the hospital’s, not yours. Just pop your head out to the nurses’ station and say, “Hey, do you mind if I grab a washcloth out of the cabinet?” or, “I know you’re busy right now, but when you get a chance could you point me in the direction of the extra blankets?”

Better yet, ask the nurses when you first arrive if they mind if you grab what you need as you need it. Doing so ensures that you won’t be stuck in a hard place when the mother is in transition and needs you there almost constantly.

4) Think ahead. For that matter, try to ask a little bit ahead of time about as much as possible. It helps keep stress levels down and leaves everyone feeling prepared. For example, try to gently remind the staff about the couple’s desire for delayed cord clamping in between pushes, rather than right as the baby is being born.

5) Keep your cool. If you are faced with opposition, be polite. Don’t be mean-spirited in your replies. I understand that many of us are very passionate about birth issues. However, starting a fight in the labor room doesn’t help the mother or yourself. If there is disagreement over a procedure or policy, you need to stand behind the couple’s desires while still upholding respect for the staff. I would suggest the following format for your conversations with staff when a conflict arises:

• I understand there is a disagreement over [such and such a procedure].
• When the couple and I spoke prenatally, I know they were hoping for [such and such an alternative].
• Would you be willing to present your concerns with the couple and discuss possible options with them? (Provided this is not an emergency, of course.) Perhaps a compromise can be reached.
• Thank you for your understanding. I know this may not be your standard protocol, but as long as mom and baby are both healthy, I know they would really appreciate your flexibility in this matter.

Maintaining your professionalism will help your client’s case, not hurt it. And it will help you to develop rapport at the hospital while you’re at it.

6) Let the staff do their job. There are certain times in which you need to allow the hospital staff to take center stage. You should not have a problem allowing them to do what they need to do in these situations. Here are three examples:

• They won’t want you near the doctor’s instrument table during pushing. Make sure you are not in the way.
• If the baby needs resuscitation, you will not be allowed to hover over the baby until he or she is stable. Respect this.
• If there is a true emergency, staff may need to move quickly. Step back and allow them to do so.

7) Say thank you. The hospital staff works very hard for a lot of women. They are usually on 12 hour shifts, on their feet for much of it, and are often being snapped at by stressed families. Many times they are left un-thanked for their work. Even if you weren’t particularly fond of a particular nurse or doctor, make sure you tell them thank you for their hard work! They deserve it!

Okay, experienced doulas… what have you learned over your time working in hospitals? Share your wisdom in the comments section!

Photo Credit

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Breastfeeding Expenses are Tax Write-Offs!

Please pardon a brief  interruption to my “professionalism for doulas” series. I like to repost this every year as a reminder to ladies to make sure that you count your breastfeeding expenses when you do your taxes. That means pumps, storage bags, nursing bras, nursing pads, etc. Don’t forget!!! Click here to read more:

Breastfeeding Expenses are Tax Write-Offs!.

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The Professional Doula: Dress the Part

Calling all doulas- aspiring and experienced alike! Welcome to Part 1 of a short series on developing professionally as a birth doula. Come back in the following weeks to read more on how to better serve the mother, work with care providers, and develop a good rapport while you’re at it.

Part 1 of our series deals with how you should dress when you attend a birth. I’ll be the first to tell you that appearance isn’t everything, but it certainly can either help you or do a great deal of damage to your professional image.

Remember that every single job, whether it’s in a kitchen or a business office, requires its employees to dress in a certain way. Even if you have a strong sense of fashion, work may not be the time to express it fully. As self-employed doulas, we don’t have any boss to give us hints on our clothing, but that doesn’t mean you should just wear whatever you want. Let’s start with a couple of big no-no’s.

Into natural birth, real food, and “green” living? Me too. But please make sure your apparel doesn’t reflect your inner hippie too much. As much as I resent it, showing up to a birth with long unkempt hair and a t-shirt with a “believe in birth” slogan will earn you nothing but disrespect and being talked about at the nurses’ station.

On the other hand, you probably don’t want to arrive at a birth in a blouse and business suit. You will be doing hard, sweaty work that often goes for odd and long hours. So don’t try to impress anybody too much with fancy clothes. Now is not the time, and the staff understands that.

When you attend a birth, do not:

• Wear ripped up, old, or torn clothes.
• Wear heels or uncomfortably dressy clothing
• Wear a dress or skirt. This will be rather difficult to work in.
• Show cleavage.
• Wear t-shirts or sloppy jeans.
• Wear anything that would confuse you with staff- scrubs, etc. You are not medical and should not give that impression.

Please do:

• Wear well-kept & neat clothing.
• Bring extra hair ties. It’s nice to be able to get it back out of your face when you need to.
• Wear shoes that stay comfortable for hours.
• Bring a toothbrush and a full change of clothes. Face wash is always nice too. If it’s a long birth, you may need to freshen up at some point.

While there is no strict dress code for doulas, I find it best to maintain a well-kempt, clean & comfortable appearance. Usually for me this means comfortable dress slacks on bottom (easy to do when they have a maternity top!), or a pair of “dressy” black yoga-style pants. I have been known to wear nice jeans or khakis when I’m in a rush to get to a birth, but so far I haven’t had any complaints with that. On top, I usually wear a sweater, tunic, or casual blouse that will hold up to long hours of wear. Again, look nice, but stay comfortable.

Fellow doulas, let me hear from you! What do you wear? If you’re a member on hospital staff, what do you usually see doulas wearing to a birth?

Photo Credits: Mother Earth Photo

Businesswoman in Conference Room

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Choices in Childbirth- Before You Write Your Birth Plan!

Happy 2013, everyone! While my blogging is much less regular than I’d like it to be, I am still happy to come and post as I can. I hope that your holiday season was peaceful and cheerful, and that you have started the New Year with new vigor and fresh perspective.

Today, I’d like to touch on a topic that is particularly relevant to me today as I am pregnant with #2: developing a decision making process for planning your birth.

I’ve often tried to make the case for making a birth plan ahead of time, but many women may not know where to begin. How do you know what your preferences are? What factors may change your original ideas of the perfect birth? And then how will these apply to your birth plan? Let’s break the process down into five steps that you can follow prior to planning your birth.

1) Research what is healthiest for you and your baby.

Check out some great reads on evidence-based practices in birth. (You can look at my resources page for starters, though it’s certainly not a complete list of all the great information out there.) If you have a question about a specific practice in birth, you should take some time to go on Google Scholar and search for information on it. It’s not that hard! Though you may not have access to full medical journals without paying for them, you can almost always read the abstracts from certain studies. They will give a summary of the study’s findings, and it’s usually pretty understandable. If you don’t know what something means, look it up! You can read and understand the majority of studies out there on birth practices, even if it takes a little extra research. (Make sure you double check your findings with a knowledgeable care provider- sometimes checking with two different care providers of differing perspectives can be enlightening.)

2) Figure out what your personal preferences are.

The Birth Book by Dr. Sears has a great section on developing your own birth philosophy and making some general birth choices. Here are some good questions to get you started:

• How much do I want to be involved in the decision making process, and does my doctor support my preference?
• Do I want to be an active participant in my labor, or would I prefer it to be managed by the hospital staff?
• Do I prefer to go with or without pain medications? How much do I want to feel? What type of medication is right for me?
• Who do I want present at the birth? How much control do I have over this in my planned birth setting?
• Do I have strong preferences on any of the hot button birth controversies (e.g. episiotomy, birthing position, delayed cord clamping, etc.)? If so, is my care provider/birth place supportive of my preferences? (If you don’t know what you’d like, look up information on it to help you decide.)
  
• Where and with whom am I most comfortable laboring and birthing?
• Is there anything that I would be extremely disappointed about if it did or did not happen? If so, what can I do to maximize my chances of achieving my desired outcomes?

3) Discuss options with your care provider.

Next, take your research and your preferences to your care provider. Always double check with your provider on things before making a medical decision. Find out if you have any specific medical needs or concerns that would affect your choices for birth. Then talk about it! See if the two of you jive or not. Make sure you have a trusting, mutually respectful relationship. You should be trying to get the most from your care provider’s knowledge and experience, and he or she should be trying to accommodate your preferences as much as possible within medical possibility.

4) Do a reality check.

As your due date approaches, do a reality check. If you want a lovely natural birth with no wires or needles but are facing induction due to health concerns, you may need to step back and reevaluate your plan. Likewise, if you plan on getting an epidural at 2 cm and feeling nothing but have a history of quick, intense labors, you may need to prepare for the possibility of not having time for pain medication. You are setting yourself up for disappointment if you blindly expect that things will go a certain way when you have clear indicators to the contrary.

5) Be flexible.

As I always stress, realize that unplanned surprises can always come up. Plan a Plan B. Plan your worst case scenario birth. What would you do in that situation, and how would you feel? How could you make the best of it? Think about these things now so they don’t undermine you if they do come up later.

Now that you’ve thought through these five steps, you are well on your way to making decisions for your birth. Make these decisions before you write your birth plan to ensure that you are well informed and prepared. Then sit back and enjoy the ride!

Photo Credit

It’s Been a While!

Hi folks,

For those of you who are regular readers, I’m sorry I dropped off the face of the earth for a while- we’ve had a lot going on though!

Here are a few updates of what’s been going on in our lives recently:

We bought a house! And though it’s got great bones, it needs some love as it’s a little rough around the edges. We’ve been sanding, spackling, priming, painting, putting up light fixtures, and trying to figure out where to put everything. It’s still a wreck, but we are accomplishing projects one by one.

It’s the most wonderful time of the year…. and that means lots of traveling, singing, going to concerts, supporting friends at different events, figuring out how to gift everyone without breaking the bank or focusing too much on the materialistic version of Christmas.

And lastly…

I’m pregnant with baby #2! Some of you may know this already, but I’m making the news blog official. I am 14.5 weeks along now and almost entirely out of the sick stage of pregnancy. I’m also popping way sooner with this baby that my first:

Baby is obviously not as high up yet this time, but that makes sense because my uterus isn’t that high up yet. But wow, I am certainly pre-stretched and ready to go! I may be quite the sight to see by the end of this pregnancy.

This is just a short post to give an update… I will get back to blogging as soon as time allows again! If I’m not on beforehand, Happy Christmas to you all, and have a very wonderful New Year!