Monday, August 14, 2017

How to cope when things happen that are outside of your control

Part of my job as a doula is to help others to feel confident in their birth choices. We have more power than we realize, but we do not have control over everything that happens to us during the birth process. That is one of the amazing, yet frustrating parts of giving birth. It is so unpredictable. We can do "everything right" and still not have the birth that we want.

So many things happen, on a daily basis, that we can't control, but affect our lives anyway. Much of it feels unfair. Much of it IS unfair. I hate that familiar feeling of powerlessness and rage that fills my mind and soul. It makes me want to do things that are uncharacteristic. I want to kick, scream, and cry. I want to hit and hurt. I want to run away and hide. I want to punch something. I want to do something, anything, to make these feeling go away. They suck.

I'm honestly no expert on how to cope with these feelings. I've tried some things that may help someone, but I keep having to deal with them myself. Here are a few things I've tried.

1. Keep breathing

I said it like that on purpose. Things have gotten so bad before that I've wanted to cease to exist. It feels like there is nowhere to turn. No one understands. What is the point of being here? No one cares. Everyone would be better off.

Please. Stay. You would be missed tremendously. You matter. If all you can do today is survive, to take one more breath, please, keep breathing. Just focus on breathing in, and breathing out. That's all you have to do today. Keep breathing.

Breathe in.

Breath out.

Repeat 672, 768, 000 times.

2. Cry

It is okay to cry. Really. Sometimes we work so hard to stifle our emotions, that the tears won't come. If you're not ready to cry, that's okay too. Sometimes a sad movie helps. Sometimes music helps. Whatever has worked before, it is worth trying again. Crying is healing, and it is a way to cope.

3. Move

Do something to move your body and get your blood flowing. Walk, run, dance, punch a pillow, go for a swim.

4. Go outside

Enjoy the sunshine or the shade. Go commune with nature. Nature has a calming influence.

5. Create

Get creative. Play the piano, drums, or whatever instrument you play. Sing. Color. Paint. Compose. Play with play doh. Crochet or knit. Build a bookshelf. Everyone has something they can create. I can hear it now. "I'm not creative. I don't know how to do anything." Sure you do. Can you clean something? You can create a cleaner space. Can you cut with scissors? Use glue? Cut out pictures from magazines that convey how you are feeling and glue them on a poster board. Draw a picture of some flowers and trees and make a collage. Make some yarn art. Take pictures on your phone. Start a blog. Make a meme. Participate in a video challenge. If you honestly can't think of anything creative to do, do this:

Make a video about three things you are thankful for today. Leave it in the comments if you'd like to share.

6. Serve others

This doesn't have to be extravagant or difficult. Smile. Bring someone a meal. Visit someone who is sick. Write a letter. Listen. Validate. Seek to understand. Babysit their kids. Look for the good. There are so many ways to help others.

7. Laugh

I often forget that laughter is a way to help me feel better about things going on in my life that I can't control. I love watching a good Jim Gaffigan video. He always makes me laugh.

8. Take a social media break

There are some great things about social media, but sometimes it just plain sucks. It often brings out the worst in people. Need I say more about this? Take a break.

9. Seek support

Confide in trusted friends or family members. Get some real life social interaction with real life people.

10. Practice gratitude

I have been a student of gratitude for a few years now. What I am starting to learn is that it is an action word and not just a feeling. I am no stranger to practice. Sometimes gratitude takes practice. Some days it might be difficult to feel thankful for things. It is okay to not FEEL it, but expressing it, even if just in your head, is a perfect starting point. What are three things that you are thankful for today? They can be the same three things as yesterday. After some days of practice, expressing gratitude will start to become easier.

Monday, July 24, 2017

Wanting vs needing pain meds in labor

Deciding on how to manage the sensations of labor is probably the most discussed topic surrounding childbirth. Do you want an epidural? Do you want a natural birth? Do you need a childbirth class? Which one should you take? Do you need a few classes? Should you give birth in the hospital, birth center, or at home? How you plan to manage the sensations of labor determines where you give birth. You can't get an epidural at home!

I work with clients who have a variety of goals and needs for their births. Just how no two people are alike, no two births are alike. That is the beauty and wonder of birth. Most clients who seek my services desire to have a natural childbirth. While there are different definitions of what constitutes "natural," most people who approach me want two things:

1. To avoid a Cesarean
2. To avoid pain meds

Many of my clients use pain meds in labor, so I want to share some thoughts about this.

Sometimes a person might NEED pain meds in labor. Some examples might include:

1. Needing a surgical birth
2. An inability to cope with the sensations of labor despite trying a multitude of comfort measures
3. A persistent cervical lip and a cervix that starts to swell despite doing all the tricks in the book
4. Exhaustion (i.e. hasn't slept days and labor has been taking a really long time)
5. Client says so

Let me say a note about #5.

I am a professional believer in you, you are capable-er, you are a badass-er, the bomb dot com-er, you are strong enough-er, I know you can do this-er, these doubts are part of the process-er, you've got this-er, let's try something else-er. I am an encourager and confidence instiller. I am a believer in your strength despite what others in the room, yes, even sometimes YOU, think. When they doubt, when even YOU begin to doubt, I believe. I never stop believing.

But I have a confession to make. It is very difficult for me to turn that off. I will encourage. I will suggest other things. But I will never say that I think you need pain meds. I will never suggest it. You probably asked me not to mention pain meds anyway. You hired me to be the one person to never ask you, "Are you suuuuure you don't want an epidural?" And I truly believe deep down to the core of my being that you don't need one.

That is, until you tell me you do.

Here's my promise to you, amazing clients. I will never ever ever stand between you and receiving pain meds if that is what you want. I might have a few tricks up my sleeve to help you get back in your groove if you hit a wall, but if you say you're done, I believe you. I support you. And I do NOT judge you. Please know that. And I am not disappointed in you. I am not disappointed in myself either. I would not put that burden on you. I understand that your choices are not a reflection of me or my skill as a doula. They're your very own unique and wonderful choices. They belong to you.

Sometimes a person might WANT pain meds in labor. Here are a few examples:

1. Natural birth is not appealing. Like, at all.
2. Goals change
3. More painful than expected
4. Sleep deprivation
5. Client says so

I don't know about you, but it is hard for me to say that I want something. I feel selfish, and I struggle about my wants and needs. I have a feeling many others might understand. But let me say this.

Wanting pain meds in labor is a good enough reason to have them. 

It is ok to have them even if you don't need them. It really is ok. Just like you don't have to justify or explain your reasons for wanting a natural birth to anyone, you do not need to justify your reasons for wanting pain meds to me or anyone else. I trust you to know what is best for you. I want you to have a satisfying birth experience, however that looks for you.

I've been around long enough to see that instincts are a wonderful thing. Even if those instincts say, "I need to go to the hospital now even though it is still really early and we planned to labor at home as long as possible" or "I think I should be induced even though we were planning a home birth" or "I think I would like an epidural even though I appear to be coping well and took all the birth classes and read all the books and hired a doula."

So if you decide in labor that you need or even want pain meds as part of your experience, I promise to support you. I promise to remain by your side. I promise not to judge. I promise not to question your choice. I promise to continue providing the same unwavering and compassionate support as always.

Monday, July 17, 2017

Natural Birth as a Spiritual Experience

I've been pondering the reasons people choose to give birth naturally. There are as many different reasons as there are people making the decisions. Some of the most common reasons people give me are: healthier for the baby, healthier for the birthing person, desire to avoid a Cesarean birth, dislike of epidurals, desire to experience birth as a rite of passage, desire to be an active participant of birth, desire to birth in awareness, and a desire to give birth how God intended. 

I'd like to focus on this last point during this post. Many of my clients are of the Christian faith. I, too, am a Christian. I don't market myself as a Christian doula, but I do live in Texas. Odds are, I will work with many clients who believe in God in some form or another. Being in one of the most diverse areas of Houston has allowed me to work with people of different backgrounds. I have enjoyed all of the families I have worked with and what they have taught me about themselves, birth, and life. I am happy to support all people, not just Christians.

I belong to the Church of Jesus Christ of Latter-day Saints. Sometimes we are referred to as Mormons. Even though our church is known for its extensive missionary program, I do not advertise my religion during the course of my birth work. I am happy to talk about it if I am asked, but I won't otherwise.

I am sharing this information because it has been on my mind lately, and I felt it was time. Reading Donna's post and Marissa's post gave me the push I needed. Heh. Push. Get it? Birth joke?

Originally, I decided to pursue a natural birth because I was scared of the epidural. The thought of getting a huge needle stuck in my back terrified me. Many people tried to reassure me that the pain would be enough that I wouldn't care. I asked my friends all the time what giving birth was like and especially about the epidural. I was still under the impression that getting an epidural was required. I didn't know you were allowed to make your own choices in the hospital. I didn't know that birth centers or home births existed. I thought one day I would have to have my babies in the hospital and that I was required to have an epidural. I was terrified.

One day my husband mentioned that he didn't want me to have an epidural because he was afraid I would be the 1 in a million that would be paralyzed from it. By then, I had come to an acceptance of it and said, "When you are the one giving birth to the baby, then you get to decide." Funny how it still hadn't occurred to me that I had options! Not even after saying that.

Fast forward a few months, and I found out that I was pregnant with our first child. As luck would have it, I was working with a woman who happened to be a doula. She recommended great midwives. I took her childbirth class. I became enamored with the birth process. Preparing to give birth became a spiritual experience for me. I prayed a lot. I read positive birth stories. I had a great birth.

I left that first birth feeling closer to my Heavenly Father than I ever had before. I felt incredibly thankful that the birth had gone so well. I learned at one of my many trainings that people enter a deeper state of awareness called delta when they are giving birth. This state is also known as "courting the divine." Entering the depths of Labor Land has been three of the most profoundly spiritual experiences I have ever had. I have called upon Heavenly assistance while preparing for each and every birth.

After my second birth, I was able to review the book The Gift of Giving Life. I wished I'd had the opportunity to read it before the birth, but it made for a special journey during my postpartum period. That book is geared toward LDS women, and I was delighted to finally find a book that combined birth with my faith.

I have also enjoyed reading another book geared toward LDS women entitled The Sacred Gift of Childbirth. Reading this book was part of my journey of becoming a Sacred Gifts Doula.

I had such a quick birth with my third baby that he was born before the midwife arrived. I was terrified and began making my peace with God. I thought my baby and I were going to perish right there in my shower when my baby was between worlds. Heavenly Father sent an angel in the form of my doula at the exact moment I uttered my prayer, "Help me!" She placed her hand on my back and said, "I'm here." My fear of death immediately disappeared, and I focused on the work of giving birth to my baby.

I was full of gratitude to my doula, my husband, and to my Heavenly Father. I still think of my doula as my angel who saved my life.

I have never experienced giving birth in any other way than without pain medication. After my first natural birth and that incredible birth high, I was hooked. I couldn't imagine giving birth any other way unless it became medically necessary. I know that the way someone gives birth is a deeply personal choice, and it can be a profoundly spiritual experience no matter the mode of delivery. For me, however, my three natural births have given me the deepest spiritual experiences of my life.

Wednesday, July 5, 2017

How to have an AMAZING induction

For one reason or another, you are scheduled for an induction of labor. You've weighed the risks and benefits of having an induction, and you have decided that this is the best decision for your family. Even though you know this is the right choice, you may be feeling pretty apprehensive. After all, you've been on the Internet. You've read all of those articles about how horrible Pitocin is, and your friends have volunteered their own induction horror stories. You may be wondering if you have ruined your chances at having an amazing birth. I'd like to offer some encouraging words and say, "No!" You can have an induction AND have an amazing birth.

Below are a few ideas on how to have an amazing induction.

1. Comfort measures

You learned about all kinds of comfort measures during your childbirth class. Put them to good use! You already know that contractions with Pitocin are usually stronger, longer, and closer together. It will help to change positions frequently in order to help baby find a great position and also to keep your mind focused on other things besides contractions. Use the tools available to you. Try the birth ball. Try various positions. Try getting into the shower or tub if you are at a birth location where this option is available.

2. Touch

Touch increases your own naturally occurring oxytocin, which is the hormone that causes contractions. Pitocin is the synthetic version of oxytocin. Back rubs, snuggles with your partner, and any kind of touch that makes you feel loved and safe is going to increase your naturally occurring oxytocin. Having more of your own oxytocin flowing may mean less Pitocin is needed in order to create the strong contractions necessary to bring a baby.

3. Environment

Dim lighting, calming music, comforting scents, and positive people can all create an environment condusive to having an amazing birth. Some people compare the birthing environment needed to generate the most oxytocin-friendly atmosphere to a date night. Think about your favorite and most intimate date night. What was the environment like? Trying to recreate that environment helps bring feelings of safety and well-being, which helps the oxytocin to flow.

4. Rest

I am a huge proponent of resting as much as possible during labor, especially early labor. I also like the idea of restful work. You can still do all of the positions you learned about during your childbirth class, but try doing them in the most restful position possible. For example, placing a peanut ball between your knees while taking a nap in the bed can help you get rest AND open the pelvis to give your baby room to move down. If labor has been taking an especially long time, you can discuss with your care provider the possibility of turning the Pitocin off during the night to shower, eat, and rest. That little break may be just what your body needs in order to be ready to start again in the morning.

5. Options

The goal of an induction of labor is to mimic a spontaneous labor as much as possible. There are many ways to achieve this. Discuss with your care provider the various options available in order to achieve the goal you both desire. For example, you may have the option of increasing Pitocin in slower intervals to create a more gentle experience. There are many methods for inducing labor, and they vary between care providers. Communicate with your care provider to decide together on a plan of action that can help you have the best experience possible.

6. Pain meds

As with every birth, the decision to use pain meds is a personal choice. Just because you are planning an induction does not mean that now you HAVE to use pain medication. Plenty of people have given birth without pain medication even though their labors were induced. However, there are times that pain meds can mean the difference between a vaginal delivery or a Cesarean delivery. They can also mean the difference between a positive experience and a traumatic experience. Remember that pain meds are a tool in your toolbox just like the suggestions already mentioned.

8. Support

Surrounding yourself with adequate support can help you have an amazing induction. Choose people who believe in you and your goals. Support can come in the form of your carefully-chosen care provider who wants you to have the birth you desire, an experienced doula, family, and/or friends. Surround yourself with people who help you to feel encouraged, confident, and safe. Your birth team needs to include people who believe that you will rock an induction!

7. Positive thinking

I truly believe in the power of positive thinking during labor. Try to have a list of affirmations handy for those times where your resolve begins to waver. Surround yourself with positive people who can remind you that you are amazing and strong and have what it takes to do this. Having an induction might take longer and be harder than a spontaneous labor, but you can do it anyway. You've got this!

These are a few suggestions I have for having an amazing induction. If you have any to add, please let me know in the comments.

Tuesday, June 27, 2017

Moving Doula

I'll just go ahead and say it. Moving is the worst! The purging, the packing, the hauling, the driving, the unpacking and asking yourself, "What IS this? Where did I get this? Why did I pack this? What am I supposed to do with this???????" It stinks. It all just stinks.

Last summer, my family moved from Sugar Land to West Houston. We were excited to get to know our new area, but the preparation to finally get here was pretty stressful. We really could have used the support of a Moving Doula.

My husband has what I like to call a "Tetris Brain." He is great at packing things and making things fit the best way possible. I'll look at something and say, "This won't work." But he takes it and makes art. He had a plan for how we were going to pack certain parts of our house on certain days. Almost immediately, we started to get behind schedule. (Surprise, surprise.) He started to get concerned that we wouldn't be done packing in time. I felt confident that we would. I was being a good doula and reassuring the both of us that we would be done in time. I kept a positive attitude.

At first.

Then it started. The snipping. The griping. The huffing and puffing. The short tempers and the frustration.There is something about sitting in the middle of a room full of boxes, your belongings tossed into an unrecognizable heap, that makes you just want to claw your own eyeballs out.

Oh. Just me?

Well, that's how I was feeling. I didn't have the strength or energy to encourage myself, much less, my husband, anymore. We were almost done, we had made so much progress, but it was looking like we were never going to finish.

Suddenly, my husband said, "I wish someone would come over just to keep us company and encourage us. They wouldn't have to pack or anything. We can do that. We just need some company."

I asked, "You mean like a doula?"

Yeah. Like a doula. Doulas are great about giving encouragement and just being there. They know when to help or when to step back. If anyone would have tried to help us pack, it would have disrupted the flow. But we sure could have benefited from someone who didn't mind just being there. Someone to tell goofy jokes. Someone to commiserate. Someone to bring fresh energy to the room. Someone to remind us that, "You've got this!" Cuz we did. We really did. We just needed someone to remind us.

Wednesday, April 19, 2017

Doulas and Birth Outcomes

When I first became a doula six years ago, I thought my job was to help improve birth outcomes. 

Everything I read about doulas boasted the same stats:

  • 50% reduction in cesarean rate
  • 25% shorter labor
  • 60% reduction in epidural requests
  • 30% reduction in pain medication use
  • 40% reduction in forceps delivery
  • 40% reduction in oxytocin (pitocin) use
These stats come from the book Mothering the Mother by Marshall Klaus, John Kennell, & Phyllis Klaus and were listed on most of the material about doulas I could get my hands on at the time. 

As a new doula, I thought my job was to help people have natural births. 

After all, one of the first bits of advice people receive after proclaiming they want a natural childbirth is, "Hire a doula!"  People were coming to me because they wanted natural births, and, by golly, I wanted to help them have natural births!

Early on, I started to notice something. Not everyone who said they wanted to have a natural childbirth during our interview ended up wanting one once they were in labor. At first, I took this as a personal failure. I thought, maybe if I were a better doula, maybe if I had more experience, maybe if I had said that one thing or tried that one position, they would have had their natural birth. I started to learn that wanting a natural birth is not always enough, and that sometimes, birth does not go how we hope or plan despite our best efforts to do "everything right."

Then I took my Birth Boot Camp DOULA training and learned something that would forever change the way I thought about what it means to be a doula.

I learned during my training that doulas are not responsible for birth outcomes.

I breathed out a huge sigh of relief - one that I had been holding in for years. Something clicked for me. I realized that I was actually doing a good job as a supportive doula even though my clients were having all kinds of births, not just natural births. I am ashamed to admit that I couldn't understand why they were so happy when I often didn't help them achieve the natural births they said they wanted.

They seemed to understand something that I didn't.

So what are doulas for if they don't help improve birth outcomes?

Support. Unconditional, non-judgmental support.

Doulas help you remember your options when others are telling you what decisions they think you should make.

Doulas help you gather as much information as you want or need when others give unsolicited advice. Or not enough advice.

Doulas stand by your side no matter what you decide when others tell you they would "never do that."

Doulas understand the art of holding space when others want to take up space.

Doulas know who the awesome and supportive care providers are. 

Doulas have a unique point of view because they often attend births in hospitals, birth centers, and homes.

Doulas encourage your partner to participate to their own level of comfort when everyone else forgets they exist. Or expects them to do everything.

Doulas won't mind if you burp, yell, make tons of noise, make no noise, forget to say "excuse me," or "thank you."

Doulas are the ones who give you a foot massage or a scalp rub or offer kind words as you prepare for your Cesarean birth.

Doulas are the ones who offer a cool breeze or take a quick picture or offer an encouraging word as you push your baby into the world.

Doulas know when to be quiet, when to talk, when to touch, when to step back, when to suggest, when to listen, when to offer....

Doulas remind you how amazing you are when others may forget this is a once in a lifetime experience for you.

Doulas ask, "How would YOU like to do this? What would work for YOU?"

Doulas instill confidence when others instill fear.

Doulas remind you that you CAN when others say you CAN'T.

Doulas are a great addition to your birth team, but can't guarantee any certain birth outcome. Doulas are there for informational, physical, emotional, and relational support. While doulas can't determine birth outcomes, they can and do help make the birth experience more satisfying and enjoyable. In short, they help make your birth experience better.