"compare labor to running a marathon"

Taken from a fantastic book titled: "The Birth Partner" by Penny Simkin, PT, CD, DONA founder.

"Childbirth has many similaritites to a marathon or other physical endurance event.  Both include pain and psychological demands for the participant.  Both  require stamina and patience.  Both become much more manageable when the participant is well prepared and flexible and has the following:

• Knowledge of what to expect.
• Prior planning with a knowledgeable guide.
• Physical health and fitness.
• Encouragement and support before and throughout the event.
• Confidence that muscle pain and fatigue are normal side effects of such effort.
• Fluids and adequate nourishment.
• The ability to pace herself.
• The availability of expert medical assistance, in case it is needed.

The meaning of the event (the race or the labor) varies among endurance athletes and childbearing women alike.  For some athletes, running a marathon means not only finishing, but also trying to come in at the front of the pack.  For others, finishing is the goal and the reward.  For some childbearing women, labor and birth mean not only having a baby, but also doing it without medical or surgical intervention.  For others, having the baby is the goal and the reward.

It is true for both athletes and birthing women that if they develop complications, or begin to worry about the tough challenges ahead, or become preoccupied with their pain, or lose confidence, or become overwhelmed, they will have to adjust.  The athlete may have to slow down or drop out; the laboring woman may have to change her plans and rely more on her caregiver to help her give birth in a safe and satisfying way.

The analogy between an endurance sporting event and childbirth breaks down, however, when we look further.  One of the greatest differences is the matter of choice.  Marathon runners do not have to run the race.  They choose to do so.  Healthy pregnant women, however, must go through labor and delivery (or another demanding and painful process -- cesarean delivery) if they are to have a child.  The other enormous difference between the two events is their degree of predictability.  The marathon runner knows when the event will take place and how long the course is, and can study and jog the course ahead of time.  The course doesn't change and is th same for all participants.

The most predictable thing about childbirht is its total unpredictability.  A pregnant woman does not know when it will begin, how long it will take, or how painful it will be, and she certainly does not know whether or how how it might be similar or different from her mother's labors or the labors of other women.  She cannot even be sure she can get a good night's sleep beforehand!  And she certainly cannot predict what her postpartum course will be like.

....[Mothers and] birth partners would like to know exactly what to prepare for, but it is simply not possible to answer these questions precisely.  Variations are inherent in childbirth because each human being and each labor are unique.  The key is to accept the unpredictability and pace yourselves while the labor unfolds." 

Penny then goes on to describe the basic process of labor, something that every woman can indeed count on.  I love this analogy and I love this book; birth is not something that should be feared by the mother or the partner.  Learn all you can, and then trust your body.

doula defined

This is an excerpt from my DONA Birth Doula Workshop manual.  I think it is the best, most simple definition I've found:

"The Greek word 'doula' means 'woman caregiver'.  We now use the word to describe a trained and experienced labor companion who provides the woman and her husband or partner continuous emotional support, physical comfort and assistance in obtaining information before, during and just after childbirth.

A postpartum doula provides care to a family with a newborn baby. 

A birth doula:

• Recognizes birth as a key life experience that the mother will remember all her life.
• Understands the phusiology of birth and the emotional needs of a woman in labor
• Assists the woan and her partner in preparing for and carrying out the plans for the birth.
• Stays by the side of the laboring woman throughout the entire labor.
• Provides emotional support, physical comfort measures, an objective viewpoint, and assistance to the woman in getting the information she needs to make good decisions.
• Facilitates communication between the laboring woman, her partner, and clinical care providers.
• Perceives her role as one who nurtures and protects the woman's memory of her birth experience.

The acceptance of doulas in maternity care is growing rapidly with the recognition of their important contribution to the improved physical outcomes and emotional well being of mothers and infants."

BABIES - Official Trailer [HD]

I loved this movie. So interesting to see the different perspectives!

a wonderful medical birth

I really like the birth story of my friend Rachel for two reasons:  first and foremost, you can tell by her writing that she felt in control and respected.  Secondly, every intervention was far from routine; it was cleared first by her and went extremely smooth.  I think this is the kind of birth the majority of American women hope for today:

"So on Friday I woke up about 4:30 am with contractions, but they weren't consistent, so I decided to just sleep. They were only about 30ish seconds long so I figured that I had some time, and I had a scheduled doctor's appointment that morning, I would just talk to her then.

D and I had to go to my work to get "health screened" for insurance at 8 that morning, so we went there the whole time with me having contractions. It was kinda funny getting my blood drawn while in labor. D wasn't going to go to the doctor's office with me because it was supposed to be just a normal appointment, but with the contractions and all I asked him to come with me.

When we got to the office, the MA hooked me up to the monitor for the non stress test I had scheduled, 20 minutes later the strip showed that I had been having pretty good contractions (they had gotten to be about 45 seconds long and about 5 minutes apart), so the MA said that she wanted me to wait until the Dr. got there to check me out. Once Dr. Carillo got there, she came in to check my dilation. Just as she got in there to check, my water broke all over her and the table! I felt terrible! D says that I made a very strange noise when my water broke. haha She advised me to dry off (ha! like that is possible) and head over to the hospital. We decided it was easier to walk since it was just across the parking lot. I think I threw up about 3 times before we got to the maternity entrance. After every contraction I would get extremely nauseous! So we got to the hospital, and my Dr. had called in a direct admittance, so I didn't have to go through all the checking in, etc. It felt just like the movies; they came and got me with a wheel chair and took me back to the labor delivery place.

Once in our Labor and Delivery room, they asked if I wanted to have an epidural and I said yes, since I was at a 5 when I was at my Dr's office, and I had no idea how long I would be in labor, I said yes, but I didn't know when I wanted it. I didn't want it right then if I was going to be in labor for hours and hours more, but I did eventually want one. They started the IV and needed to get one bag of IV fluid in me before they could start the epidural. The contractions made me really nauseated and I actually puked really bad on the nurse one time. It got all over her and I felt terrible when that happened. Within an hour of being at the hospital I was dilated from a 5 to a 7 and the nurse kept telling me I sounded like a woman in transition (whatever that means) so they called in the anesthesiologist to get the epidural going since my labor was moving so quickly. I had always been afraid of the epidural hurting, but this guy was amazing!!! He timed it perfectly, I was having a horrible contraction as he asked me to curl my back so he could get the epidural in, he said a few things (I don't remember them since I was in such agonizing pain from the contraction) like, "you'll feel a little pressure," etc. I didn't even feel a thing! After the epidural got flowin, life was so much better. I could still feel the pressure of the contractions, so I knew they were happening, but I was numb from my tummy to about my knees. I could still feel my legs for the most part, so I could hold them up, which was really nice. I have to say that I really am grateful that I was not completely numb. At the beginning of my pregnancy I had actually wanted to give birth naturally, but slowly I had decided that an epidural was the way to go for me. So, having the best of both worlds was great for me, because I could feel all I needed to, but I was not blind with pain.

After I got the epidural, I figured it would be a while, so D decided to go grab some lunch so I could nap a little. After he was gone for about twenty minutes and I had had a few more contractions, I really really felt like I needed to push and I told the nurse that and told her we needed to call D from the cafeteria. After he got back, the nurse checked me again and told me I was "complete" and told me to roll on my side and start pushing because the Dr. would be right there. So I pushed that way for about a half hour when Dr. Carillo came in and started getting ready. The cool thing I had no idea would happen was the half of the bed at the bottom just unhooked and moved out of the way so I would be on my back.

I pushed a few more times (about a half hour more), the whole time having D and the Dr. telling me how much of her head was out, etc. It was very helpful to me to have that knowledge, even though I didn't want to see the actual birth from a mirror; it kept me motivated. After a while of pushing, Dr. Carillo asked if I wanted her to help me and of course I said yes, so she pumped me full of lidocaine and gave me a small episiotomy-she said about 3 mm. And out came Leila! They right away placed her on my belly and she was so perfect! For journals sake, I have to say, afterward Dave told me that he cried when he saw her. I didn't notice because I was too busy staring at my little angel, but he said that he did cry. Which makes me love him more.

The second that I met this girl I knew it was all worth it. I never knew I could love anything or anyone so much. I knew that she would be my whole life and I would do anything for her.

D got to cut the cord. Then they took her away to measure, weigh, etc her. It felt so good to have the whole thing over with and have her here with us, but then I felt like I still needed to push. I told Dr. Carillo that and she told me that I needed to wait a second and then started to pull out the rest of the umbilical cord and let me push out the placenta, etc. That was the real relief. The pressure was finally gone from my abdomen.

We were sent up to recovery pretty quickly after Leila was born and stayed there for the next two days. I think I left the room twice.

We are so happy we have our little girl in our lives now. She is such a blessing to us."

Thank you Rachel, and congratulations!

a historical look at birth

In my doula training, we watched a movie entitled "The Timeless Way".  It was amazing.  Very well done.  I wish I could post clips from the film on here, but I cannot.  For this post, I will be drawing from notes I took from that movie, as well as things we discussed as a class.

In nearly every ancient culture, there was a goddess of birth.  She was a goddess of intense passion, ferocity, and mystery.  Pregnant women were considered to become daughters of this mighty goddess.  In the woman herself lay the power to bring forth the child.  Midwives and birthing assistants did very little besides support the mother, unless difficulties arose.  Today we are lucky to have many interventions that save the lives of women and their babies, but sometimes they are used as a routine, disrupting a process that has worked for hundreds of thousands of years.

When looking at artwork from years passed, across all cultures there are an amazing amount of similarities.  Most notable is that the woman is completely upright.  Whether standing and holding onto the husband -- when he was culturally permitted to attend the birth -- or birthing partner and the midwife kneeling behind, or sitting on some sort of chair or stool with the birthing partner at the head and the midwife at the knee, every culture worked with the aid of gravity and movement.


 It is interesting to note the differences in the artwork as time moved on.  In the 1600's men began to replace midwives, but usually only for the difficult births.  Medical journals consisted of drawings of the woman, the midwife, the birthing companion, and the surrounding area.  A doctor named Witkowski studied birth among the native Americans, and drew many such pictures including postures and facial expressions.  They were wonderful sketches.

As time moved on and these doctors became increasingly skilled at fixing things, the artwork began to change.  Medical journals no longer showed pictures of the birth as a whole, but were extremely compartmentalized.  Typically the woman was completely covered -- even her face -- so that only the birthing canal could be seen.  In any picture where the woman's face was left uncovered, the women appear alone and fearful verses early pictures depicting a fierce, passionate woman. With the rest of the laboring woman ignored, the focus on one specific area allowed doctors to learn much about what happened during birth, which lead to many different interventions.  Here is where we also begin to see women laboring flat on their backs versus upright, now still and working against gravity.

Up through the 1930's midwives still came to the homes of low-income families, but those who could afford it went to the hospitals.  Most women had been told that the pain they suffered during childbirth was a curse stemming from Eve, as she was the first to partake of the forbidden fruit.  When the women's rights movement was well underway, feminist activists demanded the use of newly-developing pain killers.  Most notable was a drug-induced "twilight sleep".

Women did not remember anything about the births, and so thought it was a painless process.  The drug did not actually diminish pain, but it did diminish the mother's memory and ability to control herself. There were many instances where women seemed to go mad and attack doctors and nurses, and so they were blindfolded and tied to the beds.  Babies were kept in the nurseries for several days, until the drug wore off enough that the mother could care for her child.

By 1945 most women were convinced of the safety of hospitals.  The fear of infection drove many to these sterile buildings, and babies were delivered without ever touching another human being's skin for several hours.  They were delivered with rubber gloves, bathed with rubber gloves, and brought to their mother carefully wrapped.

At that point midwives were thoroughly discouraged, even for low-income families.  Many advances were made to save the lives of women and their babies, and birth became a medical instead of natural process.  Husbands were not allowed in rooms until the sixties, when the hippies demanded the right to have their loved ones experience the process with them.

Today midwives are still mostly looked down on in our country, and illegal in some states.  One third of all our births end in c-section.  Out of 224 countries, the US ranked in the 180th spot for infant mortality rate.  The three with the lowest infant mortality rate for the year 2010 were Singapore, Bermuda, and Sweden in that order.  Most American women fear birth, and look to avoid the experience in varying degrees.  That option is available in much safer measures today, and most hospitals allow at least one person in the room during labor.  With all we have learned in the medical field, there have been many advances and we understand the process fairly well. This new-found knowledge has taken the ability from the laboring woman and given it to the machine.  The doctor became trained in everything that could go wrong, and the body is often distrusted and dangerous, switching out the goddess of childbirth for the god of medicine.

However, this knowledge has also improved the ability of midwives and the trust in the body in many countries.  Around the world doctors attend high risk or difficult births, and are there for any woman who may be fearful.  The birth of the family is becoming an extremely controversial event with countless options for those who seek them out.  Whether selecting a midwife or a doctor, laboring alone or with family, make sure you feel confident in your choices so your family can be everything you want it to be.

skin to skin contact

If at all possible, try for immediate skin to skin contact with your baby.

VBAC

Vaginal births after cesarean section seem to be pretty rare, if not looked-down on today.  In my experience, talking to friends, once you've had a cesarean surgery you will always have a cesarean.  It seems to be the way most women think.

If you prefer a repeat cesarean, that is just fine -- again, this is your baby, your birth, your family.  But make sure you have done your research before deciding one way or another.  This is important no matter what you choose; preparing to welcome a second baby into the world after your first was delivered surgically tends to heighten the emotion and tension already present.  You must be confident in what you are deciding to do.

I have a wonderful pamphlet bursting with information that you can order at www.choicesinchildbirth.com, and one article by Nicette Jukelevics MA ICCE deals directly with VBAC.  She says that as recently as 1995, one out of four women with a prior cesarean had a vaginal birth.  Today that has jumped to one in ten.  Why the change?  A frustrating but realistic truth is that obstetricians do meet a lot of resistance with their malpractice insurers to cover a VBAC, and cesareans are quite a bit more profitable.  They must also consider that repeat cesareans are a far simpler procedure than initial cesareans.  For us, there are many fears that have been widely publicized and blown out of proportion.

Probably the most well-known fear with VBAC is that of a uterine rupture.  This actually only happens in 0.01% of women.  Many of us also think that the more children we have or the longer we wait, the weaker and weaker that scar becomes.  This is not true.  If you deliver a child vaginally after a cesarean, your likelihood of delivering vaginally greatly increases with any subsequent children.  This could partially be due to the confidence in your own body's abilities finally won.  When deciding, it would be a good idea to ask what kind of stitching your doctor used when repairing the cut.  My trainer, Ellie Shea, R.N., told us that most doctors do a double-layered suture, but today more and more are doing a single layer to save time.

There are many pros and cons to having a VBAC or a repeat cesarean, and it is important to list them out and rate what matters most to you.  If I were in the situation, this is a list I might make:

VBAC
pros

• Gain confidence in yourself and your body.
• Number of children you want will not depend on the number of times your uterus can be cut and healed
• Time required to heal decreases.
• Opportunity to breastfeed immediately, have skin-to-skin contact, and be able to care for your baby immediately is more likely.
• Fewer visible scars.
• Be an active participant in the birth of your child.

cons

• Fear of a cesarean could slow labor, making cesarean more likely.
• An epidural might be necessary should a quick cesarean be needed (this could be a pro, depending on your point of view).
• Feelings of failure/inadequacy should the labor end with a cesarean.
• If the uterus ruptures, there is a 5% chance the baby will suffer loss of oxygen or death.
• Pitocin and cytotec should not be used, as they can increase the risk of a uterine rupture.  A natural labor decreases the risk of uterine rupture far far below 0.01%.  (Could be a pro, depending on your point of view.)
• Limits your option of hospitals; many refuse to do a VBAC.  A hospital that has access to quick cesarean surgery will be your best option.

REPEAT CESAREAN
pros

• Will not feel labor pains.
• Emotional stability -- when you plan on a cesarean, you will not feel cheated out of a vaginal birth.
• Guaranteed your doctor will be available.
• Can schedule your time around the birth.

cons (taken from the article by Nickette Jukelevics)

• Higher risk of infection, adhesions, intestinal obstruction, chronic pain, ectopic pregnancy and placental problems compared to mothers who have a successful VBAC.
• Increased risk for hemorrhage severe enough to require a blood transfusion due to placental problems from accumulating cesareans.
• Higher likelihood of being re-hospitalized for complications related to the surgury
• Decreased fertility and increased risk of miscarriage in future pregnancies
• Greater likelihood of difficulty with mother-infant attachment as well as establishing and continuing breastfeeding.
• Elevated risk for prematurity and serious neonatal respiratory problems in baby.

There is a lot to contemplate when deciding on a VBAC or repeat cesarean.  Once again, I cannot stress enough the importance of doing your own research so you can feel confident in the choice you made.  However your baby enters the world, there will always be risks.  Should something happen, more than anything, the baby will need you.  Be sure that you are emotionally and physically taken care of, so you can take care of that little one.

Websites with more information:
http://www.pregnancytoday.com/articles/complications-cesareans/the-pros-and-cons-of-vbac-4853/
http://www.dangersofcesareanbirth.com
http://www.vbac.com
http://www.childbirthconnection.com
  

a thought on caregivers

When choosing your obstetrician or midwife, keep in mind that he or she is indeed human, and has a certain way that he is comfortable about doing things.  It really is important to find one that is in line and comfortable with the type of birth you are expecting.  If you wanted a c-section, you wouldn't go to a doctor or midwife without any surgical experience.  Likewise if you are leaning toward the more normal route, you aren't going to want a doctor who flies into surgery at the drop of a hat.

My doctor was known as king of c-sections.  He was very skilled at what he did.  I did not end up with an c-section, but I had an episiotomy.  It wasn't what I had in mind, but it was what he felt was best, and everything turned out alright.  Just know that every doctor has a process that they use to go through birth, and every hospital has a procedure.  Get to know yours before deciding if it's a good fit for you.

doula research

DONA (Doulas of North America), an international organization, has a fantastic in-depth description of what doulas are.  Read it here.

This is an excerpt describing the research behind doula care.

"In the late 1970s, when Drs. John Kennell and Marshall Klaus investigated ways to enhance maternal-infant bonding they found, almost accidentally, that introducing a doula into the labor room not only improved the bond between mother and infant, but also seemed to decrease the incidence of complications.(6,7) Since their original studies, published in 1980 and 1986, numerous scientific trials have been conducted in many countries comparing usual care with usual care plus a doula.

Table 1 summarizes the findings of North American trials and a meta-analysis of all trials of continuous labor support.(12) Obstetric outcomes were most improved and intervention rates most dramatically lowered by doulas in settings where the women had no loved ones present, the intervention rates were routinely high (as indicated by the data for the control groups) and the doulas were not health care professionals.


Results of 7 North American Trials of Labor Support including 2259 women
(comparing continuous labor support by doulas with usual care)

Author Year (# subjects)	Cesarean Rate	Oxytocin Use	Epidural Rate	Narcotics Use	Instrumental Delivery	Maternal Emotional Distress	5 min. Apgar <7 NICU
Cogan (13) 1988 (25)	N.A.	No diff	N.A.	decrease	N.A.	N.A.	decrease
Hodnett (14) 1989 (103)	No diff	increase	N.A.	decrease	No diff	N.A.	N.A.
Kennell (7) 1991(616)	decrease	decrease	decrease	No diff	decrease	N.A.	decrease
Kennell (8) 1993 (570)	decrease	N.A.	No diff	N.A.	N.A.	N.A.	N.A.
Gordon (15) 1999 (314)	No diff	No diff	decrease	No diff	No diff	decrease	N.A.
McGrath (9) 1999 (531)	decrease	decrease	decrease	decrease	No diff	N.A.	N.A.
Trueba (16) 2000 (100)	decrease	decrease	decrease	N.A.	N.A.	N.A.	N.A.

KEY: No diff- no statistically significant difference between groups;N.A. – not assessed; increase – statistically significant increase in the supported group; decrease – statistically significant decrease in the supported group.

The results of 3 North American Trials 3, 17, 18 including 8052 women (comparing continuous labor support by NURSES – not doulas – with usual care) showed no differences in any outcomes listed in Table 1.
Findings of Hodnett’s et al meta-analysis of 15 trials from N. America, Europe, and Africa(10)

Women cared for during labor by a birth doula, compared to those receiving usual care were

• 26% less likely to give birth by cesarean section
• 41% less likely to give birth with a vacuum extractor or forceps
• 28% less likely to use any analgesia or anesthesia
• 33% less likely to be dissatisfied or negatively rate their birth experience"

"The Business of Being Born" 2007 Trailer

Dani turned me on to this movie ... amazing. It is a great new perspective on your birthing options.  Most of what is in this movie people haven't heard of before ... definitely worth watching to at least learn a little more.

labor pains

More and more women seem to be exploring the option of a natural birth for their child.  Excuse me ... we'll call it normal childbirth instead of natural, as normal includes the use of minimal hospital interventions, which are sometimes needed and even life-saving.  We are learning that normal birth is healthier for us women and our babies, that birth is indeed a perfect process in and of itself without our human meddling, and that major abdominal surgery is just that: major abdominal surgery.

But cesarean rates are still climbing; today one in three women will end up with one.  We know that any medical intervention -- induction, pitocin, epidural, etc. -- greatly increases the likelihood that a cesarean will be necessary.  So why don't we abandon it all and welcome that little one into the world the way nature made us to?  Well, it's simple, really.

Pain.

Pain, pain, pain.  For a woman without high risks, it generally boils down to pain.  As women, we hear over and over again how hard and how painful it is.  In my growing-up years, most of the experienced women I knew had epidurals, and so from what I heard, any feeling of anything most definitely felt painful, especially in comparison to the blissful state of numb.  Epidurals do not last forever, and so at some point something will likely be felt.  How could I not be scared?  I learned about the process, I obsessively watched the births that were dramatic enough to make the cut to Baby Story on TLC, and asked everyone I knew what birth was like.  "Like a cramp on steroids."  "Like knives cutting you up from the inside out." "Ring of fire!"  These were all common responses I heard.  I went into the birth of my son scared but determined to push through, my brain completely muddled as to the decision of medication.  I knew narcotics could effect my baby and make me drowsy.  I knew epidurals could slow labor, keep me from being able to push like I should, give me a 50% greater chance of a c-section (which I was mortally terrified of), and in rare cases cause breathing problems, nerve damage, or heart damage.  (Most recently I learned that there is no real research on the effect epidurals have on infants. Why ...??)  But more than all of that, I knew it would hurt.

There were, however, two women in my life who told me it really wasn't that bad.  They said in was hard for sure, but really not that painful.  Were they superwomen?  Insane?  They both ended up doing home births for a couple of their kids, so in my mind they might have been.  Did they just have the perfect hips/uterus/cervix to birth a child?  Maybe.  But I think something else came to play.  I think, more than anything, it was their perspective.  They knew what birth was in its entirety and planned to just do it.

According to my handy-dandy DONA workbook, under periods of stress men are instinctively geared to resort to "fight or flight".  We've all heard of that.  But according to this, women resort to "tend and befriend" (meaning protect offspring and seek supportive networks).  That's new to me, but it makes a lot of sense.  This has some major effects on our bodies:  dilated pupils, increased oxygen uptake, blood supply taken from internal organs and pumped to the muscle, increase in heart rate, increase in blood sugar, and an increase in estrogen.  If you are in labor, this results in:

• Decrease in blood flow to uterus
• Decrease in uterine contractions
• Increase in duration of first stage of labor
• Decrease in blood flow to placenta
• Increase in fetal production of catecholamines, which results in fetal conservation of oxygen and heart rate deceleration
• Increase in negative perception of events by woman
• Increase in need for reassurance and support
• "Fetal ejection reflex" (rapid expulsion of the fetus)

Crazy, right?  In the beginning of labor, too much anxiety stops it altogether.  That makes sense though.  If you're a neanderthal in labor and a sabor tooth tiger shows up, you're going to want to run away.  If your today's woman and you get to the big hospital and feel more nervous than comforted, your body will have the same effect.  In either case, anxiety equals more pain.

Is there any way we can conquer that cycle?   Two ways:  numb the pain, or calm the mind.  Every woman has to make her own choice; the birth will be whatever she says it is.  If it's wonderful because she couldn't feel anything, or wonderful because she brought that baby into the world with her very own body, it's still wonderful.  We are lucky enough to live in a time where we can choose between the two.

But for those that want to do it themselves, it's a bit trickier.  My training as a doula involves all sorts of massage, encouragement, and information.  To get the first two, you'll have to hire a doula (or convince your partner to study and practice like mad).  But the whole purpose of this blog of mine is to share some of that information.  So let me share two things that really changed my perception of pain.

First is that the perception of pain is just that, a perception.  It is completely in your head.  There are all sorts of classes like hypnobreathing, lamaze, and yoga that help prepare you to respond to the contractions in a more positive way.  Ellie Shea, my trainer said to us:  "It seems our society really fears pain.  Which is interesting, because they will go through all sorts of pain to run a marathon, or even just to go to the gym.  Pain in childbirth is more similar to that than anything else."   She also talked about a doula who's client started voicing frustration at how hard it was, and her doula replied: "They don't call it labor for nothing."  Which is true; it is hard, hard work.  But it is just that: work.  Work your body is built to do.

That brings me to my second point: your body is built to give birth.  It just is.  I happen to be a religious person, but if you are not, call it nature or the cosmos or whatever -- we have been created to be able to give birth.  It's just part of life for us, ladies.  Birth is a perfect process, every part of it was put in for a reason.  When you are in labor and your back aches, move.  It's usually the baby trying to get in the right position.  If squatting on something relieves some pain, do it.  It could be that it's opening up your pelvis.  Labor pains are pains with a purpose.  They get you somewhere.  Somewhere a lot more important than the finish line of a marathon.

So, as cliche as it sounds, trust your body.  Expect it will be hard.  But know that you can do it, however you decide to.  Don't be afraid.  That baby needs you to be confident, empowered, and full of love.  You are about go through the most intense moment of your life, physically and mentally.  The life of you, your partner, and your little one changes forever.  Human beings are incredibly resilient and can bounce back from anything, but your family deserves to start out right. 

book list

• Hands of Love -- Dr. Carol J. Phillips
• Nursing Mother's Companion -- Kathleen Hughs
• A Guide to Effective Care in Pregnancy and Childbirth -- Murray Enkin, Marc J.N.C. Keirse, Mary Renfrew, James Neilson
• Nurturing the Family -- Jacqueline Kelleher
• The Medical Delivery Business -- Barbara Bridgman Perkins
• Mind Over Labor -- Carl Jones
• Pushed -- Jennifer Block
• When Survivors Give Birth -- Penny Simkin
• HypnoBirthing -- Marie F. Mongan
• The Thinking Woman's Guide to Better Birth -- Henci Goer
• Ina May's Guide to Childbirth -- Ina May Gaskin
• The Childbearing Year -- Susan S. Weed
• The Labor Progress Handbook -- Penny Simkin and Ruth Ancheta
• The Birth Partner -- Penny Simkin
• Understanding the Dangers of Cesarean Birth -- Nicette Jukelevics
• Birthing From Within -- Pam England and Rob Horowitz
• The Doula Book -- Marshall H. Klaus, John H. Kennell, Phyllis H. Klaus

a plug

I am a trained doula.  A very newly trained doula.  But I am excited, available, and ready to work.  In time I will be posting a resume of sorts with more of my qualifications and information.  My main goal with this blog is to just get information out there, but if you think you might be interested in the services of a doula -- whether that doula be me or someone else -- please contact me at:

allisongunn50@yahoo.com

So, if you are like 80% of America out there (including me till fairly recently), you are wondering what a doula is.  To gain a sense of the word's history, it is an ancient Greek word meaning "woman caregiver".  It is a modern take on an ancient practice.  Today's doulas are there to provide emotional and physical support, as well as information during your labor.  

But let me start at the beginning, so you have a general idea of what you can expect if you decide to look into this.  We begin with an interview.  In that interview we get to know one another, and decide if there is a connection for you and your partner.  This connection is very important, given the nature of the role she will be playing.  If it does not feel like a good fit, there will be other doulas she can refer you to.  If you decide to continue on, you will make payment arrangements and schedule two prenatal interviews.

The first interview will consist largely of more discussion.  A birth plan will be put together, a pain scale figured out, and expectations will be clarified.  At the second visit, you will go over more hands-on techniques you and your partner can do to alleviate pain, focus, and ultimately empower yourself to be an active participant in your own birth.    

Then the birth.  You are welcome to call your doula whenever you think labor might start, and arrange for her to either meet you in the hospital or at home.  She will remain with you, without leaving, until the baby is born.  Her goal is to keep you focused and your partner involved to the degree that has been earlier set.  Her place is not to come between you and your care provider.  She does not handle anything clinical.  Her concern is you.  Depending on what you have earlier agreed on and what feels right to the mother in that moment, she can provide massage, positioning options, or simply picture taking, or constant presence.  She is trained to be flexible.

After the baby is born she will remain with you for about two hours, and can help with breastfeeding.  Once your new family is settled, she will leave.

Your business relationship will end with a postnatal visit, where you will process what went on at the birth.

And that my friends, is a doula.  I cannot properly express the passion that I have for this role.  I will simply say that it makes sense mentally, physically, and spiritually.

edified

My name is Allie, and I am a young mother of one.  My husband is going through chiropractic school, and that school recently hosted a doula training session.  I had heard a little about doulas, but they were quite foreign to me and in my mind consisted of incense and chanting and renouncing modern medical progress.

Turns out that is possibly true, but only if that's your image of an ideal birth.

Digging a little more, I learned that the main mission of a doula was to help a woman and her partner achieve her ideal birthing experience.  That sounded pretty neat, especially as my husband and I would've really appreciated a little extra attention, direction, and information as we welcomed our son into the world.  So I signed up, and attended a weekend training conference by Ellie Shea, R.N. C.D.  It was incredible.

These women were as diverse and amazing as I could've possibly hoped for.  We had chiropractors, nurses, yoga instructors, acupuncturists, and housewives.  And the class?  I could not believe the information available.  There is so much out there that too many women do not know.  I am at a stage in life right now where a lot of my friends are beginning their families and have mentioned many concerns.  With their voices in my mind I took notes like a mad person ... there were so many things I wanted to tell them.
I took about forty full pages of notes, in addition to book lists, web links, movies, etc.

I think my brain might burst.

So, instead of calling each and every person I know is/will be pregnant and attempting to overload their brains with every option, technique, and resource that is actually available to them, I thought I would start a blog.  I will post links, books, facts I have learned, great people to refer to, and of course a few of my own opinions.  My hope is that this could be a blog that couples could read, learn, and empower themselves to welcome their child into the world in the right way for them.

I feel very passionate about this.  It is my belief that the well-being of the human race begins in the home, and the work of a doula helps that family unit get off on the right foot.  Having received this information, I would feel selfish not sharing it to those who are searching.