Thursday, August 25, 2011

The Childless Doula still worth hiring.

After all, women hire male obstetricians every day!  And I've definitely heard of childless midwives.

A doula who has never given birth herself, such as myself, may still be a great support person. The truth is, even if I had given birth, my birth experience is going to be nothing like your birth experience. A woman with a traumatic birth, or a cesarean birth, has her experience, thoughts and worries that she is bringing, but it may be a far cry from their doula client's birth experience. Precisely because I have never experienced a birth of my own I have no baggage to leave behind. This way, I go in with an open mind.

Another bonus to hiring a doula who doesn't have kids is that her schedule is more flexible; there is no need to find childcare at the last second!

It's also important to note that a doula without children may not be that way by choice. In her post, What Not To Ask Your Doula, Yoruba Doula notes:
A childless doula may not have children because she simply doesn’t want any. The doula you’re interviewing may not be able to conceive. The lovely woman sitting across from you at the coffee house as you feel out her qualifications may be overcoming the heartache of a miscarriage. She may be a single woman who wants children, but can’t afford artificial insemination or IVF. The woman who scores high in every area on your checklist except for whether or not she has children may have given birth to a baby that didn’t survive. 

As my DONA trainer put it, "have you ever known someone who couldn't have children who would have made a great mother?"

You don't have to have been a mom to be a motherly supportive presence during birth. And you don't have to have given birth to know what a normal birth looks like, what the usual processes with a birth are, what positions would help you find comfort or change the baby's position, and so on. Many childless midwives and doulas still have a passion for birth and babies, a natural empathy, and a great pool of knowledge to draw from!

Photo from an article on Young Doulas

However, if it is personally important to you that your doula have experienced childbirth, breastfeeding and motherhood herself, then that is your priority. Yoruba Doula writes:
Does this mean you should stop caring about whether or not your doula has children? Absolutely not! Your desires are yours, and you deserve to have your needs met by all means. Do continue to ask ask, “Do you have children?,” as you interview. Please do not ask, “So, why don’t you have kids?” It may seem like a harmless question, but it’s one that could have devastating effects on a doula who planned to have a lovely afternoon chatting with you.
Opinions vary on whether or not to hire a doula who has never given birth, but it is a personal decision to make for every pregnant woman.

For many doulas, it is not an issue to be asked. I am not always asked, but I have been. I simply say I am waiting for the right time in my life to have kids. My training, testimonials, knowledge and experience speak for themselves (obviously I've been hired before despite my childlessness), and if the couple are comfortable with me, they hire me.

The most important thing is that you click well with your doula!

Tuesday, August 23, 2011

Preconception Health Interviews

Dr. Michael Lu, associate professor of obstetrics & gynecology and public health at UCLA,was interviewed over several parts on Science and Sensibility: Preconception and Women’s Healthcare: An Interview with Dr. Michael Lu 

I've included some great segments of the posts below. If you are a maternal and child health scholar, I encourage you to read the posts in-depth!

Part One: Preconception Care
Allen Rosenfield probably 30 years ago asked the question, “Where is the ‘M’ in MCH?” Where’s the “mother” in maternal and child health programs–because much of MCH has focused on children’s health and much less on maternal health.  I think the question we’re asking today is where’s the ‘W’ in MCH—where’s the woman in maternal and children’s health?  If we really want to improve maternal and child health in this country, we really have to start by improving women’s health.
I think it’s pretty much in alignment with what you’re saying; it’s not just about childbirth.  If the natural childbirth movement is all about natural childbirth, it doesn’t have the kind of impact that it could have. The focus should really be on promoting women’s health over their life course continuum and how we would be a better society for doing that.
Part Two: Working Smarter - Prenatal Care 2.0
All of the things we’ve been learning about the fetal origins of health –the importance of nutrition, mental health, environmental exposures in developmental and fetal programming, how much of that counseling do you think is actually going on in OB’s office?  And remember most of these OB’s didn’t sign up to be a health educator, to be a nutritional counselor, to be a teratogen information specialist, to do all the things that we know are important in terms of really promoting maternal and infant health.
The public health response over the last couple of decades has been if the OB’s aren’t doing all those things, then let’s create these “wrap-around services”– some kind of the enhanced prenatal care model: I call it the prenatal care 2.0 system.

Part Three: Prenatal Preparedness and Childbirth Educators

Given the current constraints I think childbirth educators could try to really expand the content of their education into, not only the immediate postpartum, but also the inter-conception.  And if you think about it, for women that are going to have more babies, the postpartum care is really preconception [care] for the next.  I think it would be a good first step.  I think most health educators actually do a pretty good job in terms of talking about breast feeding.  I don’t think they do as good a job talking about family planning, at least I think its variable.  I don’t think they talk very much about postpartum weight retention, nutrition, physical activities.  So we know that both gestational weight gain as well as postpartum weight retention are main drivers of the obesity epidemic that’s going on in this country.  What are childbirth educators doing about that. 
We’re talking about baby-friendly hospitals.  What would a father-friendly hospital look like?  What would father-friendly prenatal care look like?   I think dads are changing.  There are a lot of dads that really want to be involved but aren’t very well supported to get involved.  What’s the role of the childbirth educator in terms of involving dads?  There are things both during childbirth as well as after the baby’s born in which dads can play a very important role.  But I think like most obstetricians, most childbirth education really doesn’t focus that much on dad’s role in all of this.

Part Four: Sacred Trust
It’s a system flaw.  It’s not just about asking the individual OB to work harder, but it’s asking the system to work smarter.  So this is where the teamwork approach actually comes into play.  I think doulas are much better trained in terms of providing support during labor than obstetricians are.  Most of us didn’t sign up to stay by the bed side.  We signed up for obstetrics.  You know that obstetrics is actually a surgical specialty? OBs are trained to screen for disease, to treat complications, etc.  They’re not really trained to provide nurture and support.

Part Five: Racial Gaps, Future Research
What’s the impact of the Medicaid Reform going to be on infant mortality and on the racial gap of infant and maternal mortality?  There’s very little discussion about that.  I’m all for Health Care Reform, but it’s really just health insurance reform.   Instead, let’s think through what are the components of care that really optimize women’s health, and make sure there is equal access to those components for African American women.

Sunday, August 21, 2011

Weekend Movie: Consequences of a Near Term Birth

RISK: Consequences of a Near Term Birth

Risk is a very human twenty minute educational film that helps patients and their providers experience potential outcomes of elective late preterm delivery through the stories of two moms.

Thursday, August 18, 2011

Randoms: Things to Share

Well, nothing as awesome as the news in my last post, but hopefully these randoms are still interesting!

I went to an art museum this past week, and of course I had to take a photo when I saw artwork that included women breastfeeding! I should have written down the names of the works of art, because I can't remember them now. I know at least the first is of the Christian "Charity."

In other news, my favorite section in my Time magazine is the Health&Science briefing. This past week there were several interesting briefs of note:

  • A noninvasive test of Mom's blood - which contains fetal DNA - can determine a baby's sex at as early as 7 weeks gestation. It performs more accurately after 20 weeks. The blood test could also help doctors identify babies at risk for sex-linked disorders like hemophilia and obviate the need for invasive procedures like amniocentesis. (Actually, Annie at PhDinParenting has an interesting post about it - check it out!)
  • 45% of female scientists say they had fewer kids than desired because of their careers. For male scientists it was 25%. 
  • Data show that soy supplements don't ease menopause - In this article they are referring to a study that finds that taking soy supplements, a popular alternative to hormone therapy, doesn't help relieve the symptoms of menopause or protect against bone loss (when compared to a placebo in a double blind).

A few others things I've been reading lately...

Kristen at Birthing Beautiful Ideas wrote a lovely blog post called Why I Love Being a Doula which sums up my feelings as well - Its not about the babies for me so much as its about helping the mothers!

A fascinating post called Doula Discourse: Ondaadiziike: Birth and the need for doulas in Native American communities

The Midwife at Birth Sense wrote a post about just how far off an estimated due date can be - quite chilling!

Some Robbie Davis-Floyd action on Mother's Advocate blog: Cultural Definitions of Motherhood

Donna at Banned from Baby Showers on why a fast labor may not be such a great thing.

Also, I got into a discussion with a friend this past week about whether Tangled was more feminist than other Disney "princess" movies (for more on what lessons the princesses teach, check out this link for some images, or this one for some commentary). I then found this article on the NOW blog called With Tangled, Disney Gets Closer to Embracing Feminism. Thoughts on how Disney did with Tangled?

Classes start next week - Hopefully I can keep up with blogging!

Sunday, August 14, 2011

Officially Certified!

Dear Readers,

It has been almost 2 years since I decided to look into becoming a birth doula, registered for a training workshop, and started my doula journey. And now, after the completion of 9 births, I am finally a DONA Certified Doula!

Despite the great debate over whether it is necessary or worthwhile to certify and disagreements about the merits of various certifying organizations, I am glad to be a certified birth doula. I am glad to have made it this far, coming from zero background in healthcare or motherhood. My interest in culture and women's rights combined with a desire to learn and improve the health and lives of women has brought me to my passion and I am grateful for all the training I have received along the way. And there is much more to learn!

I feel like myself and this blog have reached a great milestone, and I thank you for following along on my journey :) Whether you are a doula, doula-curious, a mother, a scholar, or everything wrapped into one, I hope reading my blog has been worthwhile, and that we can continue on together as I continue my lifelong learning.

Emily, Anthro Doula

Thursday, August 11, 2011

Tuesday, August 9, 2011

Recent Doula Happenings

Whew! The summer is almost winding down for me, as my summer classes have ended and my fall classes start in a couple weeks. In grad school news, I have completed all my tedious required public health courses (hooray!) and can really get into the meat of my MCH degree. In Anth, I will be taking a biocultural medical anthropology course again this semester and I am thrilled!

In my doula world, I have had an eventful summer and a lot of "doula firsts" (the learning never stops!):

I was a doula for a friend, which was much more emotionally challenging than I ever could have imagined. I was a doula at the same hospital twice (the first time that has happened to me, believe it or not), with two very different experiences. I had my first extremely negative doctor-doula experience. I had a really excellent doctor-nurse-doula experience and a beautiful natural birth! I had my very first doula client cesarean section. I was paid full price for my doula services for the very first time. I went to a prenatal visit to the obstetrician office with a doula client for the first time. I had to return to a hospital within 8 hours of a birth to help with breastfeeding because a client still hadn't seen a lactation consultant. I was called to do back-up for another doula for the very first time. I labored at home with a VBAC mom for the very first time. I was at a hypnobirth and saw a mama walking and talking through 3.5 min apart contractions! I learned that sometimes what I would fear most is not what my client would fear most. I prepared a vegan postpartum meal for the first time.

Every woman, every labor, every birth are so different and I learn something from every one. Sometimes I mess up and I lay in bed at night dwelling on what I could have done differently. Sometimes people say really wonderful things that just stick with me and make me feel great about what I do!

I also finally heard back from DONA about my doula certification packet, which I sent in over two months ago. The reviewer finally received it, contacted me to let me know, and has already called me to discuss it. Turns out DONA is ridiculously nit-picky about their paperwork! If its required for them to be this way (and not just my luck of the draw), than I definitely do not what to be on the certifying committee! My reviewer is very nice, but she is asking me to go through my charts and make sure I write or check "no" as well as "yes," not just leave some blank, "so I know I didn't just forget to check something," and then scan and send her a new copy. Also, make sure you have every form of contact possible for everyone on your resources list, fellow certifying doulas, because I am being made to return to my list and find all such information.

I'm not worried that I will be certified (she said all my references has great things to say about me and all my essays are in order), I'm just made to wait to correct silly bits of paperwork. Sigh. They truly do a very thorough job, though - she was almost giving me an oral quiz about information I had written in my essays, i.e. "what can you do in the future so that your client feels differently?" or "why do you think she felt this way about that?" etc. Another thing I noticed when she was having some trouble pronouncing my client's last names was that all my certifying birth clients were from different ethnic backgrounds! Awesome!

Two more great things happened this summer - 1. I became involved with a breastfeeding task force in my county. It is a collaborative of public health workers, health workers, lactation consultants, researchers, and so forth who are working together to increase breastfeeding rates in our county, especially among low-income and minority groups. 2. I have also become involved with a local public health organization that received a grant from the March of Dimes focusing on their "Elimination of Non-medically Indicated (Elective) Deliveries Before 39 Weeks Gestational Age" in order to prevent premature births. I'm working on program planning and program evaluation. I'm excited to be involved!

I have a client currently, and will be on-call during the beginning of the semester, but was thinking of just being a back-up doula for most of my fall semester (which has become exceptionally busy). Unfortunately, I have been receiving inquiries for doula services! I know I should turn them down but its just so tempting... Do any of you have experience or advice about being a doula while taking a full load of graduate school courses and working? Advice would be greatly appreciated! :)


Saturday, August 6, 2011

International Breastfeeding Symbol

International Breastfeeding Symbol

Due to the fact that a bottle icon was used to signify baby-feeding locations in public places, Mothering magazine ran a contest in 2006 for a new symbol for breastfeeding that could be used to represent nursing mothers everywhere. This was the winning symbol - designed by a stay-at-home dad and graphic artist. These days, it can be seen all over the web and is quickly growing in popularity and use. It also has its own blog: 

Wear the symbol, spread the word!

Happy World Breastfeeding Week!

Friday, August 5, 2011

The World Breastfeeding Week posts continue...

hilarious and random photo I found

When my blog was new, I posted a lot about the things I was learning and seeing and hearing about breastfeeding as a new birth junkie. Unfortunately, at the time I only had about 5 followers of my blog!

So, I thought I'd do a link-up of some older posts on some great information, just in case any of my new followers are interested in any of these topics. Enjoy!

The benefits of Kangaroo Care for all babies

The only reasons a mother should stop breastfeeding

What makes a hospital Baby Friendly?

The truth about Extended Breastfeeding, aka breastfeeding into toddlerhood

Is there a Natural Age of Weaning?

Improving health by understanding culture and behavior - Colostrum as "dirty milk" in India

A History Lesson: Breastfeeding and WWII

How does breastfeeding while pregnant work?

Babies can latch on themselves! Watch the incredible Breast Crawl

Would you eat Breast Milk Cheese?

Happy World Breastfeeding Week 2011!

Thursday, August 4, 2011

Links - World Breastfeeding Week style

In case you didn't hear the great news, The U.S. Department of Health and Human Services adopted the recent recommendation of the Institute of Medicine, to require insurers to provide breastfeeding support  and pump rentals, free of co-pays and other cost-sharing!
For information about the newly adopted Guidelines for Women’s Preventive Services, click over to read more at Birthing Beautiful Ideas.

The CDC recently released the 2011 Breastfeeding Report CardReuters reports:

Less than 4 percent of the country's hospitals fully support breastfeeding, said a report issued by the Centers for Disease Control and Prevention.
In nearly 80 percent of hospitals, healthy babies who are being breastfed are given formula even when there is no medical need for it, making it more difficult to continue breastfeeding at home, the report says.
Only a third of hospitals have "rooming in" policies that allow babies to stay in the hospital room with their mothers 24 hours a day, which can increase breastfeeding opportunities.
Nearly 75 percent of hospitals do not provide adequate support for mothers once they leave, including follow-up visits and phone calls, the report said.

via Public Health Doula
Great tips for doulas from a doula/IBCLC!

On Saturday, August 6 at 10:30 am local time, for one minute, women nation wide will be breastfeedingFind a local BIG LATCH ON event near you! 

The World Alliance for Breastfeeding Action is has created a video to show you how have a Breastfeeding-themed flash mob using the song they developed for this year's World Breastfeeding Week:

Wednesday, August 3, 2011

Talking About Breastfeeding Videos - WBW 2011

Happy World Breastfeeding Week 2011!

Join the Conversation on Breastfeeding - World Breastfeeding Week
by WomensHealth.Gov

Reflections of Breastfeeding - When families were asked if they could go back to before to right before they decided to breastfeed, what would they tell themselves...

Monday, August 1, 2011

World Breastfeeding Week 2011

Happy World Breastfeeding Week 2011!

This year's theme focuses on engaging and mobilizing youth intergenerational work with the catchy slogan of: "Talk to me! Breastfeeding - a 3D Experience." 

The theme deals with communication at various levels and between various sectors.

The World Alliance for Breastfeeding Action (WABA) writes:

Why 3D?

When we look at breastfeeding support, we tend to see it in two-dimensions: time (from pre-pregnancy to weaning) and place (the home, community, health care system, etc). But neither has much impact without a THIRD dimension - communication! 

Communication is an essential part of protecting, promoting and supporting breastfeeding. We live in a world where individuals and global communities connect across small and great distances at an instant's notice. New lines of communication are being created every day, and we have the ability to use these information channels to broaden our horizons and spread breastfeeding information beyond our immediate time and place to activate important dialogue. 

This third dimension includes cross-generation, cross-sector, cross-gender, and cross-culture communication and encourages the sharing of knowledge and experience, thus enabling wider outreach.

The winners of the WABA 2011 photo contest are up, and there are some beautiful photos, including my favorites:

Check the website for WBW celebrations near you, like local events for The Big Latch On or Latch on America!

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