I do indeed doula

It's not every day that you get to sit down at your blog and write that you have just passed what is probably one of the most important weekends of your life, but that's what I'm sitting down here to do.  I spent it out of town at a doula training workshop, which is one of the major milestones toward my certification as a birth doula through DONA.  The instructor, Robin Elise Weiss, was amazing, as was the experience of sitting in a room (and laughing and crying in a room) full of women also passionately committed to the birth experience and toward helping women fulfill their potential as birthing mothers.  The more I read, the more I come to believe that a woman's body is precision-designed for birth and that with the proper support, the overwhelming majority of pregnancies can end with natural birth.  That said, I also believe in birth as an experience of empowerment for a woman, and I see my role as a doula as helping every woman have the birth that will empower her, whether that be natural or otherwise.  I hope that, if better educated on the amazing potential of their bodies, women will begin to regain confidence in their ability to give birth and will feel comfortable choosing natural birth.  Although advances in medicine have made truly miraculous things possible when interventions are necessary, I think the medicalization of birth over the last few decades has done women a great disservice in that it has caused them to doubt their ability to birth normally and naturally.  The control of maternal care by obstetricians (who are, after all, trained surgeons) has forced a reframing of birth from a normal, natural event to one where the process is seen primarily from the viewpoint of pathology, where the potential for disaster is a constant, shadowy companion.  Women have been stripped of their power and have instead become patients in a system that treats them as if they were ill and not on the brink of one of life's most awesome and transformative rites of passage.  The female body is seen as defective, not normative, and seldom able to deliver a baby without medical assistance.  I'm not asserting that these are the active thoughts of most doctors, but these beliefs do underly the culture in which medicine is taught and practiced.  It's shocking to me that most obstetricians leave medical school without ever having seen a normal birth, so how can we truly fault them for believeing that women need help delivering their babies?  And is it any wonder, then, that we have such an astronomical rate of intervention in the US and such a shameful rate of maternal and fetal mortality that can be directly attributed to those interventions?

As a doula, I hope to do my part to change the culture of birth in this country through education and through honoring the strength and potential of birthing women.  Doulas also have an important role to play as birth attendants in hospitals, where staff shortages and charting obligations keep nurses from spending a significant amount of time with labor support duties.

It's hard to believe that I am now qualified to go out and start working as a doula, but I still feel as though I need a lot more preparation before I am ready for my own clients.  I'm now looking for a mentor, with whom I hope to spend some time shadowing and getting some on-the-job training.  And of course there's one of the greatest ur-mentors of all time - Ina May Gaskin, from whom I am constantly learning.

So... a momentous beginning, the first steps taken on a road whose destination is still unknown to me.

Here are a couple great videos on doulas and what they do:

Our birth story

Seems like everyone I know who is involved in childbirth, either as a profession or just a passion, eventually gets around to airing their birth story, so it seemed right that I should tell my daughter's.  It was not only the best experience of my life, but also the experience that kindled within me the passion and drive to become a childbirth professional myself.  I've read so many birth stories that in some ways mine seems a bit lacking in drama, although it certainly didn't feel like that, and I consider myself very lucky that we didn't have drama in the form of big scares or hospital showdowns. 

I'd long thought I wanted a home birth, and I still wanted one by the time I got pregnant with the kiddo, but circumstances that put me in the technical high risk category took that off the table.  My husband and I were still committed to having as natural and non-medicalized a birth as possible despite having to deliver in a hospital setting.  I'd been unknowingly radicalized long before I really even envisioned myself as a mother when I stumbled across the incredible book Spiritual Midwifery by Ina Mae Gaskin.  The films Pregnant in America and The Business of Being Born, as well as other books by Sheila Kitzinger, Penny Simkin, and Martha Sears sealed the deal on my committment to natural childbirth.  I was actually terrified of having to give birth in a hospital, especially after we toured the "birthing center" at the hospital where we had to deliver and were told that IVs and fetal monitoring were mandatory.  I was sobbing by the end of the tour, convinced that we'd have to struggle VERY hard to get anything approaching the birth we wanted.  As my pregnancy progressed without major complications and as we deepened our relationship with our amazing Ob-Gyn, I began to hope that things might be salvageable if my pregnancy kept on being uneventful.  I did have a big scare at 28 weeks when I started having strong contractions that landed me in triage at L&D, with some question for a while as to whether or not they were going to admit me and start steroid injections in the event I went into premature labor.  I ended up being diagnosed with irritable uterus, was on semi-bed rest for a little while, and had weekly checkups and regular fetal fibronectin tests for the rest of my pregnancy.  As time went by and our confidence increased that these contractions were going to remain non-progressive, it became the "new normal" and we started to relax a bit.  With our doctor's full support, we drew up a birth plan that clearly stated our wishes and outlined our ideal scenario for our daughter's birth.  We had our doula lined up and ready.  We ferreted out tedious details of hospital procedure and policy to make sure we knew our rights.  We hashed it out and rehearsed it and picked it apart, back to front and up and down, until we felt we were prepared for anything, and then we just had to sit back and wait.

The day I went into labor, I woke about 6 am to contractions that I knew were the real deal (I'd had 12 weeks of "not the real thing" contractions to compare them to).  Part of our plan involved laboring at home for as long as possible, so we went about the business of breakfast, showering, some last minute cleaning, making phone calls, and enjoying the last hours of our life as a two-person family.  By the time I had been in labor for about 10 hours, the contractions were starting to become quite painful and, surrounded by family, friends and our doula, we hunkered down for the toughest part of the journey.  It was a chilly, rainy October evening and my house was full of people I love having tea and maple bars that I'd made the day before and drifting in and out of the bedroom where I was laboring.  It was a really wonderful, supportive environment.  I decided it was time to go to the hospital when my contractions were about 3 minutes apart; this was about 8 pm.  By about 9 pm, I'd been processed thorugh triage and was dilated to 7 cm and 100% effaced!  Show time!  Off to the L&D suite...  We'd been sweating because our Ob-Gyn was due to go out of town any day, and I shouted with relief when we found out that he was still in town and on his way.  Things were happening so fast at that point - the nurses tried to get a heplock started but couldn't due to my tiny, uncooperative veins and the fact that I was in such heavy labor, so they finally gave up, which was one of the greatest reliefs of the night.  No IV!

My parents and one of my best friends accompanied us to the hospital and were with us in the labor suite (along with our doula).  It was great to have the support, and I guess we seemed like a capable little army since the staff left us alone, for the most part, to labor in peace and relative privacy.  My water broke about 10:30 pm, and not long after that I hit a real low point - total and utter exhaustion and the fear that I wasn't going to be able to go on.  I had been kneeling on the bed for quite a while as that was the most comfortable way I'd found to ride the contractions.  The nurses were, by that time, really starting to push me to get down on the end of the bed and into the squat apparatus.  I could hear them and I knew what they wanted me to do, but I just.could.not.do.it.  I couldn't access either the strength to move my legs or the command over the periphery of my body to make it happen.  All of my senses and energy were concentrated in my belly; my reality had shrunk to just that.  Just that.  From somewhere out in space, I heard my voice saying that I couldn't, and the next time my doctor came in, he told them it was OK, we'd just roll with it (the man is awesome, awesome).

I really had to struggle to regain focus at this point.  I'd done enough reading to know that I was probably hitting the transition and that if I could just get through a little more, our daughter would be born.  Not long after I started trying to regroup and get it together, the urge to push came along, and as we had decided to do self-directed pushing, I just went with the urge and the flow.  I didn't think about it at the time, but in retrospect it was amazingly easy to do, and worrying that I would know when and how to push was one of my big anxieties prior to labor.

Although I was only dimly aware of what was going on around me, I could tell that the room was starting to turn into a hive of activity.  My doctor came in and stayed, I had a couple minutes of fetal monitoring, and the nurses were gathering and starting to roll around several tables of gear.  I had expected that once I got through transition my contractions might spread out a bit, but it didn't seem like they did, and I felt like I was still flailing around, psychologically, trying to find a place to anchor myself.  I was still feeling an overpowering fatigue, but at some point I heard my husband yell "I can see her head!" and that did it for me!  I pulled it together for a few more big pushes, felt that incredible sensation of crowning, and then at 12:05 am on October 15th (five minutes into her due date!) my daughter slipped out into my husband's hands.  The doctor pulled her forward through my legs, and there I was, gazing down into the face of my child.  She came into the world very true to her personality - hyper-aware and intense.  She didn't cry much, but seemed more interested in just checking everything out.  The doctor went about the business of giving her a quick once-over, my husband cut the cord once it had stopped pulsing, and then kiddo was placed on my chest and we did skin-to-skin and I nursed her.  There were some immediate concerns about her body temp being a bit low, so after she had been at the breast for a while, they took her and put her in a warming bed on the other side of the room.  While I nursed her, I delivered the placenta, got an intramuscular shot of Pitocin due to the fact that I had lost quite a bit of blood, and had 2 stitches placed in a small tear.  While the kiddo was in the warming bed, my mother helped me shower and get changed, and after that I crawled back into bed and did some more skin-to-skin and nursing.  Fortunately, my daughter's temp came up fairly quickly, so there was no need to discuss having to take her away, and we were moved into our room to finally get nested down and have some sleep.  Luckily, our hospital had rooming in, so my husband was able to stay with us, all three together in the room for the rest of our stay.

Our daughter, just a few minutes after birth 

In hindsight, the only aspect of the birth I was unhappy about was the time my daughter spent in the warming bed.  I wish we had been a bit more insistent that she stay skin-to-skin with some warm blankets over top of us, which I think would probably have been more effective.  All things considered, despite my fears, we really did have the "homebirth in a hospital" that we had dreamed of.  It was without doubt the most intense and most wonderful experience of my life.  In some ways, it was almost as if my daughter gave birth to me; so changed was my life afterwards, it was almost as if I was the one completely new in the world.  Nursing also came very easily for us, and I believe a big part of that was that I didn't have any drugs during labor that could have made my daughter groggy and interfered with the nursing process.  All the more reason, I think, to have a natural childbirth and one more reason I want to do the work of helping other women birth their babies without drugs, too.  So - to that end, I'm taking a birth doula workshop next month which will count towards my DONA certification.  With any luck, this time next year I will be finished with my certification and seeing clients of my own.  I don't think it's possible to overstate how excited I am about becoming a birth professional, and suddenly there are all kinds of things to think about, such as business cards, a web presence, memberships in professoinal organizations - all kinds of planning and things to start organizing in my head.  Over the last couple of weeks, it's kind of gone from 0-60 with that and it still has something of a sense of unreality about it, but it's only about 5 weeks until the training, so it's going to get a lot more real very soon!  Stay tuned.

Oddments from the corners of my brain

Outside, there's a fresh skiff of snow and tonight it's supposed to be down to 4 degress.  That's Fahrenheit.  Amazing, then, that it's already time to start thinking about starting seeds for spring planting.  And the big question around here this year is whether or not to finally get hard-hearted (meaning, primarily, me) and take out a tree or two in the backyard so that we will have enough sunlight back there for a bigger garden.  We have a yard full of silver maples, which are not particularly lovely trees, and they can be problematic.  Their wood is fairly brittle and they are prone to storm damage.  We've had three significant ice storms in the years we've lived in this house, and those have definitely taken their toll on the maples.  Even a simple thunderstorm with strong wind is enough to bring down big chunks of tree, so it's hard to keep them from looking ratty around the edges.  Also, they have very aggressive root systems and can cause problems with underground pipes, and, in our case, foundations.  We have trees planted too close to our house, too close to our power lines, and my husband (ever the practical one) has been after me since we moved in to take at least a couple of them out.  I understand the arguments in favor of removal, and they are compelling, but my in my heart I feel that trees (lovely or not) are kindred souls and taking their lives is not something I find to be particularly desirable.  Certainly not easy or to be taken lightly.  When I stand with my hands on the bark of a tree, I can feel its life force flowing.  Trees have an amazingly potent energy, and cutting them down seems a bit like doing murder.  These trees are my friends.  But I also realize that nothing lasts forever and that I am far too sentimental for a life lived within the realities of nature.  Everything dies or ends or burns or simply fades away, and the best thing we can do when confronted by these realities is not to cling, but to mark the passages with due reverence and appreciation.  The trees might be going, but in their place would be a garden, full of new-growing life to nourish our bodies and spirits.  I expecially feel that it's important to have a nice garden for the kiddo, not only to grow good food to feed her, but also to have her participate in its care, now that she's old enough to toddle around and to express an interest in "helping out" with the household whirl.  I want her to know where food comes from, what is involved in producing it, and even more, to have her know and respect the cycles of the land.  That would be a great gift those trees could give to us in exchange for their lives.  So.

Shifting gears a bit, I've been thinking more and more about education for her in a larger sense.  It will still be a little while before she's ready for any formal education, but it's never too early to start thinking about what that's going to mean for us as a family; what form its going to take.  We've already decided against any mainstream education in a public school setting (or at least identified that as the least desirable route), and are seriously thinking about homeschooling, either by ourselves or (hopefully) in some sort of cooperative.  I've been doing a lot of reading about educational philosophies, particularly Waldorf and Montessori, and I'm sure I will have a lot to say here about those as I learn more and digest more.  But immediately, it finally occurs to me what I find so troubling about mainstream education in the United States.  It was articulated particularly well in this article about Waldorf education:  "...we know that in most ways public education represents and reinforces the culture of consumerism, competition, and materialism. At a Waldorf school, our children will not be treated as future job seekers or savvy consumers or high tech warriors in the battle against foreign competition, but as evolving spiritual beings who seek lives of meaning and beauty and inspiration."  Yes, yes, yes.  I'd been having trouble articulating for myself what it was that is so troubling about public schools, aside from the deplorable amount of learning that actually goes on and the conditions under which it occurs (or doesn't).  I don't want metal detectors to be a part of my child's everyday life.  I don't.  Everything within me cries out at the wrongness of that.  But there's more to my objections, except that I hadn't realized what they really are.  It's the cultural values that mainstream education presumes: that it's best to be the smartest, the fastest, etc; that what you know matters more than who you are (and that what you are taught matters more than what you know); that the Western model of civilization is superior.  It seems that what is being transmitted are not the skills needed to think independently and imaginatively, reason critically, and to make a good path through whatever life they choose, but rather a mass-produced, one-size-fits-all blueprint for being a successful little cog.  They want to make sure that you hit the treadmill running, that you will define success and measure happiness by the standards of our race-to-the-bottom consumer economy.  The educational environment is a sort of microcosm of larger society that either explicity or implicitly endorses a lot of values that I would prefer my daughter to have limited exposure to.  I feel like public education is mortgaging the souls of our children, and that's not where we want our kiddo to be. 

The responsibility of educating a child seems awesome and at times totally overwhelming, but then again so did breastfeeding, once, and we've sailed through that with flying colors.  It's all about trusting your instincts (our "guts" are smarter than we can imagine) and going with the flow.  

And I'm committing to attend a weekend-long birth doula training workshop in March - so excited!  It's been a while now since I decided to totally change course and pursue a career as a childbirth professional (hopefully some combo of doula/lactation consultant/childbirth educator), and it's nice that my enthusiasm and the conviction that this is absolutely the right path for me are strong as ever.