How the Buzzfeed ProDoula Article Reminded Me of What We Are Doing Right in Monterey
Babies are great, but what I love about birth is how that experiece will influence who the birthing parent is, how they view themselves as the caretaker of this new little person they have made, and how they view themselves as a person with a place in this world. I want everyone to feel at the very least competent, and birth in American seems revolve around making birthing people feel inadequate, dysfunctional, dependent. My vision as a birth educator is to change that.
When I dipped my toe into our local birth community in 2012, I was ready to join the ranks of other birth warriors, fighting for the rights of birthing people in my hometown and all of Monterey County.
Well... found fighting for sure...
Fighting doesn't scare me. I'm comfortable in debate, I'm not easily offended, I believe in confrontation and flushing things out into the light.
I'm also successful. Eric's work is unpredictable and some years my income keeps us from losing our house. I've started several successful businesses. I've never left an industry because I couldn't get my service to the people who need it and make enough money to live, save, and support my tattoo habit.
So if you have read Buzzfeed's recent ProDoula article, this is a response.
If a friend hadn't sent it to me, I may have never heard about it. I don't belong to many birth pro facebook groups. There is real, life changing and saving work to be done and I don't think it happens in those groups. I don't find them productive and everyone is usually rehashing the same arguments over and over. Meanwhile, we need to change legislation, hospital policies, and radically improve outcomes and experiences and I do not have time to do that and argue with yet another doula about fees. I give zero fucks what you charge when this motherfucker over here snapped yet another cord during an aggressive 3rd stage management.
But I read it, and read some interesting responses and there's many good points that can be made, but I was reminded of the practices that had deeply damaged our community, so I thought I'd share.
So, in 2012 I stepped into a community, specifically a birth network (not affiliated with BNN), where tensions were high and collapse was possibly imminent. I kept my opinions to myself and listened to warnings about competition and scarcity and backstabbing and cutthroat doulas who worked more for the doctors than the moms and unprofessional rogue doulas who fought with care providers, and who was safe and who wasn't and if you want to make it you have to be in with so and so or don't piss off blah blah blah.
Well, I've never "made it" because I was in with someone, so while that wasn't meaningful to me, I was sad for these people doing such important work, but hobbled by all this drama. I wanted to fix it, but I also needed to fix it because my students left Meet the Doula events saying many of the doulas were clearly trying to have the last word, very competitive, palpable dislike for one another, and they didn't want that at their birth. I went to see for myself and lo and behold that's exactly what I witnessed.
Yes, this community also had childbirth educators, midwives, OBs, nurses, massage therapists... but all of the tension came from the doula community. They were the problem child and at first leadership was a permissive parent, but I later discovered they were mostly exhausted and out of options, considering letting the birth network dissolve. When I joined the Board, I pushed us forward into gaining our nonprofit status, establish by-laws, a code of ethics, a grievance policy... and advocated for saving the Meet the Doula events, even though I am not a doula.
Then I picked up the end of the string at "scared, anxious community" and followed it to just a couple aggressive and insecure doulas holding a community hostage with threats, fear mongering, and divisive marketing approaches that centered around harming the reputations of their competition (or peers) to both parents and care providers. The local "rogue doulas," a myth. I've never found any evidence of a doula here working outside their scope or interfering with care, just a lot of vague rumors that drove business in one, clear direction... which I followed. I asked questions and listened to all sides and learned from the successful doulas how they aligned themselves with the desires of the nurses and providers, at the expense of their clients as they persuaded them to comply... cornering the market on some OB and hospital referrals. As a business model, this may be a ProDoula fairy tale, but I don't think it's what parents are expecting when they hire a doula.
In the end, the policies put in place to protect members and parents worked, without my involvement. Truthfully, I hoped by offering ethical marketing alternatives we would see aggression traded for confidence and collaboration. I was a little dumbfounded that it didn't play out that way, but now our birth network is a safe place. It has doubled in size, nearly all the local doulas, educators, midwives, and many complimentary practitioners and some wonderful OBs belong. I want that to be not because they are afraid not to, or because of cult like devotion, but because we help them reach more clients and give them valuable professional development resources. The number of families we connect with professionals has multiplied many times over.
I believe in service, and donating thousands of hours to this community and seeing the culture of birth in our hospitals shift, access to midwives improve, and more people meet their babies in a supportive, respectful environment is very fulfilling, but it's not all selfless. It's worth noting that friendships are not without worth, and sure, you can't feed your family with good feels after a networking event, but it's possible to be successful, and liked. With a flourishing network, my business has grown, and I'm encouraging more people to offer high quality, comprehensive childbirth education to meet the demand. When yelp calls, I tell them I have no room for growth, my classes are full. I still have big aspirations and something new is always in the works, but I don't feel like I have to hustle so much, and I certainly haven't spent tens of thousands to get here. There is a comfortable and enjoyable rhythm to my marketing, and it's accessible to all of my colleagues who share my vision.
If you think the only options are to be cutthroat and successful, or a softhearted failure, I'm truly sorry for your narrow understanding of success. If you can't make it using ethical marketing, maybe you just aren't good at this work. I don't know Randy, she has cool hair and I'd have a beer with her like I would anyone else... but "elevating the doula profession" is not marketing the doulas whose success you will personally benefit pyramid scheme style, from while harming and excluding doulas outside of your organization. As long as that mentality continues, there will be hurt, and drama, and quality ProDoula doulas everywhere will carry that stigma.
When asked about my role in the birth community, I identify myself as a birth activist and educator. A common follow up question is whether I'm going to become a doula or a midwife.
Like I'm a caterpillar...
So I'm finding myself saying, "no I'm just an educator," and I feel myself reinforcing a birth worker hierarchy that I'm totally opposed to... a food-chain that would look something like educators as grass, then doulas, OOH (out of hospital) midwives, nurses, hospital midwives, OBs... right? And we need to be nice to whoever is above us so they don't eat us.
My experience leads me to believe many OBs feel they can do everything a nurse, OOH midwife, doula, or educator can do; that a nurse believes they can do everything a OOH midwife, doula, or educator can do, that a midwife believes they can do everything a doula or educator can do, and that a doula believes they can do everything an educator can do. Maybe you perceive this all differently, but I'd like to talk about it.
We are not nesting dolls, these are all unique professions, we aren't just leveling up.
Local physicians have told my students that they will be their doula, and my own OB told me there is nothing a midwife does that he doesn't do (long story short, not true). I've been told by midwives that they are their clients childbirth educators and doula. I've sat in rooms full of doulas, as the only non-doula, and had all these beautiful women whom I totally admire tell me they don't refer clients to childbirth educators, because they are their clients' educators.
I know parents are participating too. I sit on several panels a year and I watch parents hold the opinion of the physician higher than the doula's, when at times, the MD may have little or no expertise in the subject being discussed and the doula may have a tremendous amount. Parents have shared they have hired a doula because she is in midwifery school, which I see the logic there, but there are doulas who are in midwifery school who are much less experienced than doulas who are... "just" doulas.
This is deeply irritating not because... I'm the grass, or the littlest doll... but because I know how this negatively impacts parents, and I want us all to do better by being honest about our expertise, our roles, and referring our clients to the appropriate people to fill the other necessary roles on their team.
In addition to this, many of the roles actually prevent practitioners from truly taking on the responsibilities of the other profession, or their responsibilities interfere with their ability to take on this outside role.
Let's look at doulas and educators.
I want all my students to hire a doula. I have volunteered at least a thousand hours (pulled out a calculator, or the calculator app, to confirm) to the promotion of doulas in my community for no reason other than the fact I know a quality doula helps people have a better birth. Some of my closest friends are doulas, and I will have a doula at any of my future births.
This doesn't mean I will support the idea that a doula is a childbirth educator just because education is one way in which they support (along with emotional and physical support). I'm fresh out of several courses designed with doulas in mind, and I hope doulas are considering how their role as a support person can interfere with their ability to also be a truly comprehensive educator. Also keep in mind, if your certifying organization offers both doula and cbe certs, this topic may not come up because they want to sell you more of their product. Education is such a critical part of a birthing person's prenatal preparation. How much can you really cover in two prenatals, along with everything else you should cover as their support person? What about when the information might put you at odds with their care provider, whose referrals you may want or you will soon be working alongside in the birthing room? How does that impact your client's education from you?
I recently completed a course in communication for doulas (that was wonderful, I'd recommend it to every doula) that was teaching doulas to communicate with, and educate their clients. However, they shared recommendations that completely undermined the doula's ability to educate in a comprehensive way, though did strengthen the bond between doula and client. This bond is essential, but is it smart to achieve it at the expense of the parent's education just so one professional can fill two roles?
I appreciate and frequently think about this passage from "Three Things Your Doula Can’t Tell You" by Cristen Pascucci of Birth Monopoly:
"My own doula and I have had more than one conversation about why she didn’t warn me about my own provider—someone who I now know has a reputation for not following through on promises to patients. 'But I asked you!' I’ve said to her. 'Why didn’t you tell me?'
I completely understand why a doula needs to choose the information they share carefully. Birth is an intimate event, it's important parents feel completely at ease with their doula. Same is true with OOH midwives. If a doula share's clear opposing or favoring evidence regarding an intervention, or a controversial newborn procedure like circumcision or vaccines, then the parents may take that as the doula being biased. The doula may fear the parents will feel unsupported in their decision that might be contrary to evidence, and that parents may hear "these studies show midwifery care has better outcomes than OB care," as "You made the wrong decision by choosing an OB." I've personally watched great doulas backpedal true but uncomfortable statements to comfort their clients. I don't completely disagree with this, I understand it, it's one reason I am not a doula. I present the evidence, I share stories, techniques, answer questions candidly (yes, even "what do you think of my provider") in a friendly and I hope engaging way, but will not also soften what may be a harsh truth or say positive things regarding decisions that I know work against the parent's desired outcome... I feel this role is important, and has a place, uncompromised by other roles. My experience is that parents want someone to plainly "tell them what they're up against" at some point in their prenatal care, and there needs to be a role carved our for that to happen.
There is nothing that I respect more in the birth community than a practitioner that frequently refers clients out to other complimentary practitioners. Have pride in your area of expertise, every one of these roles is absolutely indispensable.
If you are an OB and your patient wants a doula or a midwife, you will not fill that role, you will just have a less satisfied patient, maybe not the day of the birth, but someday when they have more information or experience. What you do is important, but different.
Midwives... you know I love you... half of my students who begin with OBs switch to midwives... but when you are being a midwife, you are not also being a doula. I've had a fair number of local families share they regretted not hiring a doula for their home birth, and often times they were told they did not need one. Doulas are not there to defend families against unnecessary procedures, home or hospital. The doula is there to provide continuous support in any setting while you chart, observe, rest... or so the partner can eat, use the bathroom, have a moment to collect themselves.
Doulas... I'm so grateful for you. I am lucky that in my community, doulas have embraced the need for comprehensive education for their clients. I'm concerned about burnout rates and the expectation that a doula should do it all, doula, cbe, placentas, photography, lactation... and how much of this is because of organizations trying to sell more certifications? I want to see doulas have long fulfilling careers doing what they love.
Educators... we provide the foundation. We present all the options and the evidence so that parents can make the important decisions that only they should be making. We help clients understand how a doula can support them, why a midwife might be an appropriate choice for them, or how to find an OB that is supportive of the care they want. Don't let anyone undervalue what you do.
Please network, connect with different practitioners in an authentic way! Midwives, sit in on your local CBE classes and Meet the Doula events and see how they can be of value to your clients. Doulas, keep the ass kissing to a minimum, you do noble work, expect respect for what you do. Doctors and nurses, come out and have a drink with us once in a while, come to birth network events, and hear our perspective and we will hear yours. We all make a great team if we'd all just let it happen.
In friendship and optimism,
Happy New Year
UPDATE: I am offering doula care periodically, only for families who have received the foundation of a quality, comprehensive childbirth class.
Birth Chemistry 2015 Birth Stats
Keeping thorough stats is important to me. I want to know that my classes are helping families find care that aligns with their values and make the right decisions for their family. The curriculum I use is Birth Boot Camp, along with supplemental materials I have developed. I also provide concierge style maternity support with unlimited calls, texts, assisting with finding resources, one free private meeting should unexpected circumstances arise, and my availability for advice and support during and after the birth.
In 2015 I had the pleasure of teaching thirty-nine families. My stats are based off the thirty-five families who attended reunions and returned their birth summaries to me.
The average maternal age was 31 years old, and percentage of families expecting their first baby was 94%. Parents with a variety of pregnancy variations such as gestational diabetes, planning vaginal breech birth, twins, advanced maternal age, and vaginal birth after cesarean, were all included.
The percentage of families who started with OB care was 74%, during my class 46% of families switched to midwifery care, and 23% switched to home birth. Midwife led care has shown to improve outcomes for women and is an under utilized option in our country, so encouraging midwifery care for low risk parents should be apart of any evidence based curriculum.
Labor began spontaneously for 88% of the families, and the average length of labor was 15 hours (excluding inductions). The average of when babies were born was at 39 weeks and 2 days.
Out of the families planning a natural birth, which was everyone this year, 80% birthed without needing pain relief from an epidural, narcotics, or nitrous oxide. Of the 11% who received an epidural, half had been induced with pitocin, and the other half had labored more than 40 hours and used the epidural for sleep.
Vaginal births made up 91% of all the births. Of the 9% of births via cesarean, none were planned and all parents labored naturally before needing an emergency cesarean. Reasons for cesareans included no fetal heartbeat, maternal request after a long labor, and footling breech. When possible (ie, not under general anesthesia) family centered cesarean practices were implemented.
Sixty-six percent of families hired a birth doula, and 87% of hospital birthing families hired a doula. No families that completed the class and hired a birth doula used medications for pain relief.
There were 0 failed births. Birth is not a pass fail event. My ultimate hope for every family is that they have a satisfying experience, free of trauma or disrespect, even when unexpected circumstances arise.
So there you go! I was going to wait until I had taught 100 parents (I'm to 72), but I was curious. Here are some of my thoughts... possible rambling...
Of course, we cannot compare these numbers to the general population, (up to 95% epidural rate, 40% induction rate, 33% cesarean rate) because we don't know what percentage of the general population wanted a natural birth, then did not have one... unless someone does... then, gimme. I do know I meet many parents who share that they wanted a natural birth, but ended up not having the birth they wanted. More parents who want a natural birth should be able to have one in the US. The decision to birth naturally is not frivolous, but often times is based on a desire to minimize risk to the birthing person and baby. So far my experience has been that the barriers to a natural birth are less often the birthing person's body, but the maternity care system and how birth is managed by care providers, so we spend a lot of time addressing those barriers and parents are encouraged to make decisions that will reflect their desired outcome. Some parents will need medical interventions in labor, but that should be from medical need or maternal choice, not because of a lack of alternative options/support. I encourage families to get support not only through my class, but many other practitioners in the community. Gather the village.
In addition to thorough education (my class is 25 hours), I believe in professional, but candid support. In the era of bait-and-switch maternity care, just asking a provider how they practice is not always enough. I understand many educators also work alongside care providers as doulas, and doulas may feel restricted in what they will share, but I'm not a doula. If my student asks me in private what past students have experienced with a care provider, I will share (while respecting past students' privacy).
Parents who ask want to know, and need that information to make an informed decision for themselves.
If you want pain medications in labor, to induce labor, or a cesarean birth, this post (and my class) is not about telling people what they should do, or that natural birth is superior. I've had both natural and medicated births that were my choice and that made me feel like a capable, confident parent. Your choices are personal and unique to you. No matter what your hopes are for your birth, I believe there are benefits to taking a fully comprehensive birth class.
I'm excited about 2016. Please check out my class schedule if you are birthing in Monterey or Santa Cruz counties.
Birth Advice from Bill Murray
Planning a natural hospital birth? Bill Murray gives his advice to Birth Boot Camp students in Monterey, CA.
My husband is a huge Bill Murray fan. One of the things he does for fun is this for charity:
I am also a fan, but I'm more of a Lost In Translation fan than Ghostbusters. What's important here, is that when my students shared the following story, Eric and I LOVED it. Bill Murray, love, talking about birth... double love! And he actually gave amazing advice!
Melissa and Dan took my Salinas Spring 2015 class. At the first class they shared that they had just met Bill Murray, and seeing that Melissa was pregnant, he gave them some birth advice. Unsolicited birth advice is usually not very helpful, "Oh you will be begging for that epidural," "You are having a home birth? I would have died if I was at home," "You are pregnant? Let me share my most traumatic birth experience with you!" Rarely do women get practical, positive birth advice from a stranger.
Unless that stranger is Bill Murray.
Bill Murray's advice:
"Bring a fan because Moms in labor get hot."
"Tell everyone you are due a month after your real due date."
"Bring something to hang on the hospital wall to make it look nice."
"Bring night lights because the hospital lighting can be really bright and intense."
Seriously... Bill Murry is moonlighting as a doula. This is the solid advice of a seasoned professional! He is also the father of six boys, but I just can't believe how on it he was with these unique and genuinely helpful tips. I just have to share why.
"Bring a fan because Moms in labor get hot."
Moms DO get hot, especially in transition. Mom may go from comfortable to intense hot flashes with very little warning so being prepared for those shifts is key. I shared a friend and Birth Boot Camp grad's birth where she suddenly got very hot and her doula had to use her teeth to help her get out of her gown. Another favorite. Be prepared with ice packs, misters, fans, cold drinks and easy to remove clothing.
"Tell everyone you are due a month after your real due date."
The controversial due date. One mom in Melissa and Dan's class actually DID tell everyone she was due a month later than she was. This is brilliant. Normal gestation is 37-42 weeks, but it's not uncommon for friends and family to freak out if mom passes her due date, even though this is totally normal.
"Bring something to hang on the hospital wall to make it look nice."
During a hospital birth, make the space your own. Sights and smells from home can help mom feel safe, lessen anxiety, and stimulate hormones essential to birth. Many women have some anxiety about being in the hospital, making the room look less sterile can help mom relax. Have friends make affirmation flags at your baby shower. Create some birth art while envisioning what your ideal birth looks like. Personalizing your birth space isn't just for mom's benefit, it can communicate to hospital staff that they are entering your sacred space in a very non-confrontational way.
"Bring night lights because the hospital lightning can be really bright and intense."
Yes Bill Murray, you are once again right on! The lighting in a hospital room was designed with hospital procedures and not laboring women in mind. Hopefully during labor there are few procedures being done so turn those lights down and use night lights. Oxytocin, the hormone that causes contractions and creates a feeling of well being for laboring women, works best when mom is in a dark warm space. Humans, like animals, labor best with privacy. Nurses will usually respect a woman's desire to labor in this way, but if lights are turned on partners can turn them down again once the nurse steps out.
I so enjoyed this list. It also appears that Bill Murray also loves babies. The weekend that Bill Murray was in town some of my friends posted pictures of him posing with their babies, interactions he initiated.
Do you have a great Bill Murray or celebrity birth advice story? Please share!
I teach birth classes. I'm not a doula. I freaking LOVE doulas, and I love the doulas that support my students. So for World Doula Week I have 7 reasons why I appreciate my students' doulas, a reason for every day. Please feel free to share why you loved your doula!
Doulas back me up
It's nice to know that someone else is also giving my students information that will support them having a normal birth. When I share the benefits of upright birth or the possible drawbacks of heading to your birth place in early labor... it definitely helps to have a doula sharing the same information. We might not all teach the exact same thing, but the doulas I know all believe that birth is normal, and mom can do it... and that means something to me.
Doulas add a different perspective
Two people can share the same information and for some reason one delivery might stick with you. Maybe the way I described vocalizations just didn't click with you, but the way your doula shared the information did. Or maybe when I was talking about positions to alleviate back labor you were daydreaming about nachos. We've all been there. You are in my class for 25 hours, you wont connect with or remember everything I say, and I'm ok with that. Fortunately your doula is there to fill in those gaps.
Doulas have first hand experiences
I have not attended dozens or hundreds of births the way a doula has. What I teach is important. A doula cannot provide the level of in depth education that my students are getting in class, but it can be really nice to have a doula to share what she has experienced in your birth place or with your provider. She knows where the ice packs are kept, which nurses are going to be most supportive, and how to get you unhooked from the monitors when you need to pee.
Doulas help you decide when head to your birth place
Though we cover this topic in class, when you are in active labor, your focus will be on labor. You probably wont remember how far apart contractions should be and you might not notice that the sounds you are making are getting louder and deeper and it's time to head out. Or maybe, even though you planned to stay home to postpone hospital interventions, those first twinges are making you nervous and without someone there to tell you that you are ok and everything is normal, you may head to your birth place too soon. A doula's expertise at that time can be invaluable. A chipper "Hey, we are headed to the hospital! Yay!" post from mom on social media always makes me nervous. I appreciate knowing a doula will help you head to your birth place at a time that supports your desired birth experience.
Doulas are there when shit gets real
At some point in labor you are probably going to look up at whoever is next to you and say "I can't do this," or at least think it. I've done it at each of my 4 births. So when that moment comes for my students, I always hope that the person they are looking at says, "you did an amazing job with that contraction, you ARE doing this," and not "want me to get the anesthesiologist?" If mom is looking at her partner, he might be able to say "you are doing great" but he doesn't have the credibility that a doula has. A doula knows what "doing great" looks like and what "we might need to change things up" looks like. Moms figure this out in labor. I wont be there to remind you that you've got this, but I can breathe easy knowing your doula will.
Doulas provide real time information
In the midst of contractions and concern for your baby you might be struggling to remember the pros and cons of cytotec vs pitocin that you learned in class. Your doula is there to remind you of that information so that you can make the right decision for you... and hopefully she will also remind you about nipple stimulation and encourage you to squat through some contractions to maybe kick things up without medications.
Doulas involve the partner
Sometimes in class partners are all "I've so got this birth thing!" and then at the birth they are all "oh shit." Even the most enthusiastic partner might freeze on birthing day, and that's ok! Having a doula means she will help make your partner feel comfortable and get him involved in ways he expressed he would like to be at your prenatal appointments with her. Your nurse has not met your partner (or you) and might not know that frozen in the hospital corner was not what he envisioned for the birth, and he just needs a little encouragement.
Doulas provide gentler breastfeeding support
The breastfeeding support mothers receive in hospitals is sometimes not patient, or gentle, and is not always accurate. Moms sometimes contact me after a hospital birth overly worried about proper latches, positions, supply, schedules and ready to give up on breastfeeding altogether... and I wish that their nurse had spent more time building mom's confidence and less time covering the cross cradle hold (seriously, who cares what it's called). Just as a doula may trust normal birth more than a medical professional, she probably trusts your ability to breastfeed more also. Many of the doulas in my area have received more training in lactation support than your average nurse. So while you will be set up for breastfeeding success when you finish my class, I still hope you will have gentle, knowledgeable support right there the first time your breastfeed.
After completing 10 weeks of childbirth education together, I am confident that my students' have all the information they need to have an amazing birth. However, even as an experienced childbirth educator, I had doulas at my 3rd and 4th births, I should have had a doula at my 1st and 2nd, and I will hire a doula for my 5th. Just having information is not enough. The environment you put yourself in and the team you surround yourself with is just as important. So this is my thank you to the doulas in my community who support Monterey county women. You are the best, thank you for the sacrifices you make, and you make this anxious educator a little less anxious.
Thank you <3
the Monterey Doula doulas
One of the most important decisions you will make regarding you birth is who your provider will be and where you will have your baby. I dedicate an entire two to two and a half hour class to this decision. Many couples believe that which ever hospital is closest to their home should be where they birth. However, all hospitals are not created equal. Like any business, they provide different services, options, and amenities. If you are in Salinas, Monterey, or anywhere in between you are blessed with five hospitals to choose from within 45 minutes of you, which is more than enough time to travel to your birth place, even if you have very fast labors! Choose carefully, where ever you choose to bring your baby into this world will impact your birth immensely.
In class we are able to cover many details like induction rates, which hospitals are doula friendly, and where your decisions like to eat in labor, labor in a variety of positions, or birth in an upright position are most likely to be honored... after all... these are YOUR decisions to make, not your doctor's. If you choose a doctor or hospital that tells you upfront that these are not your decisions, I may not be able help you achieve the birth you want.
To help simplify this choice just a bit, I put together this chart. It compares Natividad Medical Center, Salinas Valley Memorial Hospital, Community Hospital of the Monterey Peninsula, Dominican Hospital, Sutter Maternity and Surgery Center, and home birth. It is available in printable PDF form here. This is something you are welcome to print and share! I hope you find it helpful.
Learn more about local hospitals and read reviews from local women:
Community Hospital of the Monterey Peninsula
Natividad Medical Center
Salinas Valley Memorial
Sutter Maternity and Surgery Center
Everett Levi's Story
This story begins with empty shot glasses on the counter, my friend passed out on my couch, and me leaning over a toilet.
Oh not the night our baby was conceived... this was the night he was born.
I'm finally sifting through the blurry montage of partial moments and memories of Everett's arrival. There are few pictures and no video to go by. There are images and sound clips pinned all out of order in my mind and new ones pop up as I sort... certainly nothing like any of our other births, but that's one reason we keep doing this... it's always an adventure!
We never planned to take this pregnancy to 40 weeks, but a GBS positive diagnosis, my first one, stayed our plan to nudge this birth along at 38 weeks. I had gestational diabetes for the fourth time and had previously birthed my babies at 41, 38, and over 42 weeks. Our sons were 10 pounds 3 ounces, 8 pounds, and 11 pounds 5 ounces. Only our second son was born naturally and without complications. I worked out almost every day of my pregnancy until the end. I didn't fear another big baby, but we were planning a home birth and I wanted to avoid any possible complication. My only fear was having to transfer after the birth.
Our estimated due date was Thursday, December 18th. I never felt "done" with this pregnancy. I loved this pregnancy, but I could feel baby dropping lower and lower... and little feet reaching higher and higher. That week I stayed calm, but booked a labor encouragement massage, acupuncture appointment, and asked my midwife, Jacqueline, to do a cervical stimulation (stretch, sweep, strip... whatever you like to call it). I went to prenatal yoga on my due date... keeping relaxed but active. On the recommendation of a doula friend, on Sunday morning I went to Ribera beach in Carmel to climb the stairs and stand by the ocean. I felt great, but I also felt like this baby needed to be born.
Anyone who drinks has probably sworn to never do it again. I've sworn off Crown Royal, Southern Comfort, Tequila (though I always go back to that one)... and castor oil. I drank castor oil to induce labor with my first. There is a video. It was disgusting and it didn't work. I swore never again, but I talked to my midwife about it anyway. She thought it was a reasonable option. I decided to take the first of three doses at 4pm... but the anticipation became too much and I poured the first shot at 2pm. I took another two ounces at 4pm, and downed the last shot (barely) at 6pm. We warned our birth team.
About an hour after each dose I would have to use the bathroom, it wasn't bad. We put the kids to bed and settled down to watch a documentary that my brother recommended, Harmontown. We went to bed around 10pm, all was quiet... guess it didn't work.
I got up to go to the bathroom again probably an hour later, maybe less. I was spotting. I called my midwife. For me, spotting usually means baby is coming. I was having contractions, but they weren't regular and they felt a lot like the prodromal labor I had been experiencing for weeks. Sometimes I was shaking and nauseated, even dry heaving into the toilet... sometimes I couldn't tell if I was even having contractions. I think she offered to come, or said she would, or I asked... I don't know. She was on her way and I tried to go back to bed.
Then the contractions were gone. I called and told Jacqueline that she probably didn't need to come, but she was on her way. I think I probably sounded like I was in labor... I think I was tired and confused sounding. I would have come too.
Eric blew up the tub and I tweeted a picture of the room at 11:45pm. I have no idea where I was or what I was doing while Eric set up the tub. I remember waves of "omg just get this tub up hurry hurry hurry" followed by periods of not even knowing if I was in labor.
Jacqueline arrived and set up. I continued to try to go back to bed but would get up again to go to the bathroom, which was happening about every hour and getting very tiresome, followed by 30 minutes or so of fairly hard contractions... but they'd fade and I'd try to sleep again for 20-30 minutes, and then the whole cycle would begin again. Basically I was laboring on the Hunger Games Mockingjay Clock Arena drunk on a mess of labor hormones.
My midwife decided to try to sleep on the couch. I would have these pretty long periods of no contractions and total clarity. No one knew if I was in labor. I was probably having the baby soon, but maybe it would be the next day, the next evening. I was tired of getting in and out of bed so I propped pillows up on the other couch and tried to sleep leaning over them.
Eric was in bed and I don't know if he was sleeping either. At some point I got him up and told him to make up the bed with the plastic and extra sheets. I labored in the doorway, holding onto the door frame when contractions hit. Sometimes I'd call Eric over to press on my back, but I wanted to let him get everything done so I didn't every time. I alternated between leaning on the kitchen island, the bedroom door frame, and the bathroom door frame. I wish we had done the bed up sooner, I missed laboring with my husband.
At one point when I went in the bathroom I decided to check my cervix, just to see if I could feel it, or baby's head. I put my leg on my bathroom counter and got about half a finger in before hitting a bulging bag of waters and I think a head. In my fog I didn't think "Oh shit, the baby's coming... maybe I should tell someone." I just... don't remember thinking anything... it didn't register. I'm sure this is information that my midwife would have found helpful.
For some reason around 4am we started really preparing for the birth... I think... I really don't know if we all thought this was it. I should have known... but I had proven to be pretty worthless in the communication department at this point. I remember telling Eric to call the birth team at 4:11am... I think contractions were just getting really close... but I wasn't totally convinced that they wouldn't stop again. Eric began calling, and also working with Jacqueline to fill the tub. No one answered except my doula, Brittany, who was soon on her way, along with the assisting midwife Caroline. We couldn't get a hold of our birth photographer, my cousin, or my sister-in-law. It was frustrating, but I also couldn't concentrate on that.
I labored on my own as Jacqueline and Eric tried to fill the tub. There wasn't enough hot water because I had asked Eric to start a load of laundry, not realizing that we were going to need to fill the tub so soon. I remained pretty unaware as they boiled pots of water on the stove. I wanted in the tub so I didn't want to take Eric away from preparing it.
At 4:49am I messaged the birth team on facebook to come. We had already called a couple times. It was so hard to try to bend or sit, just typing "come! baby is!" took everything I had. I leaned on the kitchen counter again. I had a really hard contraction that I had to moan then pretty much roar through. Roar isn't right... it was just louder than a moan. I got Eric to hold me through it. My body was starting to push some. I really wanted in the tub, but there wasn't enough water yet.
Brittany arrived and asked me what I needed. I told her I didn't know... that's all I remember..
Then I'm in the hallway holding onto the bathroom door trim. I'm telling Eric to get my bathing suit top (actually it was my friend Lindsey's) and he can't find it. It's the only teal thing in a very small drawer but he can't find it. I think Brittany and Jacqueline are both close, and I have another really hard, loud contraction. I don't know what I sounded like, I imagine I sounded like Whitney of Leaves of My Tree. At one point I thought I was screaming and then Eric said I was totally quiet and barely grunted so I'm not a good judge here... but I think I was getting pretty loud. Jacqueline says I did good, that was a hard one... something like that. I just have to get in the tub. I decide to just take off my shirt and wear my bra in.
I remember pulling off my shirt and it's like when I close my eyes to pull it over my head I never open them again. I don't remember seeing anything from the hallway to the tub. I keep trying to remember. I don't know when my underwear came off, I don't know if Eric was close, I know Jacqueline was. Every time I try to remember I go back to when I was 19 and at this party and drank Tequila Rose and held onto the kitchen wall trying to make it to another room... and I don't remember seeing anything, just feeling... and then not feeling... and then just being somewhere new like in a dream where all the transitions are cut out.
I think my hands are on the side of the birth pool. I think my eyes are closed because there's still no visual to accompany this part of the story. Another really hard contraction. No visual or audio for this part, I just know that it was hard, my body pushed so so so hard... and gave way. 5:13am. I heard my midwife say "there's the water" and all I could feel was a big hard head, and then like I was going to pass out. I said so and Eric caught me and leaned me on the seat of the couch behind me just in time for my body to bear down again.
I was along for the ride, the baby was coming now, here, just a couple feet from the pool. I put a foot up on my midwife's leg and pushed.
It hurts and it sucks. It doesn't burn... it's just this massive force trying to come out, and my body holding it back and I decide, once again, that I'll never do this again. But before I never do this again I have to get this one done. I push and the head is born. No wriggle out. Fuck. I NEVER get a wriggle out! I push again for the shoulders, maybe twice... too many times as far as I'm concerned... and the baby is here! December 22nd at 5:14am. On my chest, so warm! Freshly born babies are the best warm.
Eric grabbed the camera and is taking pictures. I think that he did get a hold of the birth photographer before the baby was born, but she didn't make it. I finally open my eyes and look at my baby. Eric and I didn't consult on who would announce the sex, but this time I looked. Another boy! This is the little person that I had spent the last 40 weeks with... little Everett. We have four boys.
My sister-in-law, who was going to take video, walks in the room and I say "So I had a baby." She missed it by a few minutes... she started taking pictures, I'm not sure if there is video from after the birth, but I know there is no video of the birth, or labor... first time we have missed it.
Leaning back on the couch (I'm not exactly laying on it) is getting uncomfortable as we wait for the placenta. It hasn't been long. I ask if I can just push it out and my midwife says sure. I push it out and Brittany holds it in a bowl (thanks Brittany). The cord is done pulsing so Eric cuts it. I didn't want to linger on this, I wanted to get up and in bed.
We settle into bed and our photographer, Kirsten, arrives and our older boys, Milo, Ashley, and Indiana wake up.
I'm having terrible after pains. They are miserable and I don't feel like I can really enjoy this time. It's so true that they get worse with every baby. I'm still so grateful to be in my own bed. The other midwife, Caroline, arrives once I'm in bed. I'm sure Jacqueline probably appreciated having help to clean up... thank you to whoever cleaned the blood and amniotic fluid out from under the couch, I saw the pictures.
It's time for the midwives to look over me and the baby. I didn't tear, once again, only a very small something to the side. Everett looks great...
Everyone seems to think Everett will be around 9 pounds. Nope, 10 pounds even and 22 inches long. I've had two heavier babies, but he is my longest.
So Everett was born after basically an hour of active labor. Every time I am tempted to complain about having such a short labor I think about how I feel when thin girls complain about being thin... and that feeling is a little murdery... Everyone wants a short labor, but honestly, I would have liked a little more. I've heard of women with short labors having a harder time... kinda being in shock because all the hormones of birth don't get to gradually build. I get that. I feel like I missed my whole birth, I've described it as my blackout birth a few times. I've struggled to know that it even happened which is so weird. But how can I complain about that? We had a home birth, not a water birth, but a totally uncomplicated birth at home with the midwife I adore, a fantastic doula that I regret not getting to labor with more, my older babies sleeping just down the hall and my unwavering husband at my side. No matter what I told myself then, I really can't wait to do it again... I can't be trusted to make good decisions when pushing out a human. It was an awesome birth.
You are so welcome here Everett Levi, thank you for the amazing story.
Henry Parker Young's Birth Story
As we wait for our own home birth story to begin, I thought I'd share with you one of my favorite recent local home birth stories of one of my couples who took my natural childbirth class. Thank you Corey and Lindsey for sharing it with me!
July 26, 2014: I woke up at about 6:30 a.m. with menstrual type cramping. I had been having this for a few days and just laying down with a heating pad usually sent it away. I got up and took a nice long, hot shower hoping to send these cramps away as well. I shaved my legs for the last leisurely time. Of course I denied this being the "real thing". I tend to be a hypochondriac, so for fear of overreacting to things I tend to underreact. Corey and I went to breakfast. I insisted on driving despite Corey's objections. I denied I was in labor even after driving there and making Corey park the car, because I couldn't parallel park through contractions. After breakfast was the farmer's market, Vitamin Shoppe and Costco. My contractions were about 7 minutes apart and 45 seconds long. I chalked it up to being too active. I checked in with my midwife Carol (told her not to cancel her plans just yet) and set home to park myself on the couch with a heating pad. Corey was supposed to record vocals for a band at noon, I wouldn't let him cancel it until about 11:15. I was still convinced that if I could only relax enough they would go away, they had slowed to about every 15 minutes for about 30 seconds after all! I started a bath, used the toilet and noticed I had lost a bit of my mucous plug (still in denial). While I was in the bathtub reporting the mucous plug to my midwife, I felt the sudden urge to pee, or rather, that I WAS peeing. I hopped onto the toilet and still wasn't certain but thought that might have been my water breaking. What came out was yellowish and cloudy, not what my urine usually looks like but not what i was expecting amniotic fluid to look like either. Ok, I was ready to admit I was in early labor! I have like 24 hours ahead of me, right?
I called Carol again and she suggested she come by to take a look at me. Ok, I agreed, but first we have another errand to run! Corey and I had been planning on baking a birthday cake and I didn't want to even buy the ingredients ahead of time, because I figured I had a long labor ahead and wanted ways to make time pass quickly. We took a leisurely trip to Nob Hill, complete with contractions in the ice cream aisle. Yes, we got concerned looks and comments. Corey assured them that yes I was in labor, but I'd suck him back up until we got home. We made one more stop on the way home to borrow a rebozo from Cori, our Birth Boot Camp instructor before returning home to find a Comcast truck in front of our house. I completely forgot about our 2:00 p.m. appointment! Business was conducted quickly and the worker left, I was prepared to watch my Breaking Bad marathon while I labor for the next 22 hours!
Corey and I started together to make Henry's birthday cake. I don't think I lasted longer than pulling out the pans. I instructed Corey to keep at it while I labored in the shower for a bit. I put Jim Gaffigan on Spotify and got in the shower. Corey kept coming in and checking on me. He asked me if he should set up the pool, of course I said "not yet" but I saw him roll it past the doorway anyhow. I asked him to call his mom and let her know this was happening.
My mother in law Kathy arrived and I remember her observing from the bathroom doorway. I was butt naked, I didn't care. We knew what we were in for. Carol arrived, watched me for a little bit and informed me that we were having a baby! Yay! Carol said she would call my other midwife, Jacqueline. I kept looking at Kathy and saying "SHE did it. She did it with Pitocin. I can do it." Corey later told me I was in transition at this point. He overheard Carol relaying to Jacqueline that I was grunting during my contractions.
I could hear Corey baking and filling up the pool in the kitchen. I heard something about a connection giving him a hard time. Later, I found out that instead of hooking up to the kitchen sink and pumping warm water into the pool, he had to fill it with the garden hose and boil pots of water to pour in to warm it up. Baking, boiling and pool filling, so far labor seems more labor intensive for him than for me! By now it was around 5 p.m. and Corey let me know the pool was ready when I was, so of course I got right out of the shower and into the pool. Jacqueline arrived by then. The water. Felt. Amazing. I spent a long time there. Sometime around now Henry's birthday cake came out of the oven and was set aside to cool. I made Corey sit on a chair right in front of me. I would go in and out of consciousness. I woke up and asked if I time travelled. I was aware that there were no less than 8 eyes on me, but no one was in my face. It was very quiet, I could hear whispering.
Then came the pushing. It wasn't an "urge". It was happening. My body was doing it, it had a mind of its own. I hung onto Corey's leg for dear life. I threw up. I had Corey drape the rebozo over his shoulders and stand up so I could pull down on it. I think somewhere about now I asked how dilated I was. I kept asking, as if laughter wasn't a clear enough response. Finally Carol (or someone) told me my cervix was long gone. Wow, that was quick! More pushing. Carol checked Henry's heart rate several times in between pushes. She gently recommended I get out of the pool and walk around. Nope, I'm in my happy spot. "Ok but maybe now you might want to walk around?" No way, Jose. "Ok but don't you have to use the toilet by now?" Someone promised me I could go back into the tub afterwards. Trickster. I realized by how they wouldn't let "getting out of the pool" drop it was probably in mine and Henry's best interest to listen to them. I found out later that Henry's heart rate had slowed a little, that the pool had slowed my labor and they were hoping some movement would get it going again.
I reluctantly waddled over to the toilet, my entourage helping me on my way. I labored on the toilet for a bit. I remember at one point wanting, TRYING, to throw everything off of the pony-wall next to it. Someone explained to me that I needed to get Henry out, I needed to push with the contractions in an effort to tear my perineum because he had been in the birth canal for a while. If I couldn't tear, I could receive an episiotomy. Carol said she could see his head and suggested I feel for myself, as it would give me a better idea as to my progress. I asked if he had hair, several times. I was assured that he did and encouraged to feel for myself. I stood up and reached down. I felt... not what it usually feels like down there. I couldn't tell where I ended and Henry began so, frustrated, I gave up on that venture. I moved to the birthing stool in front of the toilet. I pushed. Corey wanted me to wait a moment for him to adjust the rebozo during a contraction, my response was to pull harder as if I was trying to break his neck. I pushed as hard as I could. Carol massaged and tried to get my perineum to give up my baby. The words "perineum of steel" were used at one point. I called it, I couldn't keep pushing like this, I asked for an episiotomy.
Jacqueline explained to me that it wouldn't hurt, it would just feel like relief. She was right. I realize having written this far that this is the first real mention of pain in this story. The thing is, I don't recall it being painful. Sure there was pressure. Sure it was uncomfortable, but nothing like the insurmountable pain like they show in the movies. I leaned back on Corey for support as Carol (I think) performed the episiotomy. I didn't feel a thing. The next contraction, I had an urge to stand up. With Corey's hands under my armpits, I reached out for more support. I grabbed onto the pony wall with my right hand and reached up for the towel bar with my left hand. In one fell swoop both my baby and my towel bar were liberated from their restraints. My head was spinning. Carol placed something warm, wet and squirmy on my chest, it went "waah" once. I gathered my wits enough to wish Henry a very happy birthday. It was 7:58 p.m.
Henry was squinting, alert, holding his head up. I offered him my breast to nurse from and he took to it immediately. Carol asked me to cough. I half-heartedly obliged and my placenta was liberated as well. We brought our family bubble to the bed for some much deserved bonding. He was beautiful. Corey and I both just stared at him as he nursed and slept. Corey continued the skin-to-skin snuggles as Carol repaired my episiotomy. Henry proceeded to christen Corey "Daddy" with meconium. Eventually Daddy left to clean both of them up, himself and Kathy putting Henry's first cloth diaper on as I tried to. describe how to do it from across the house. We discovered our cat helped himself to a layer of Henry's birthday cake. We measured Henry, he was 6 lbs 2 oz, 19 inches long, 13 inches circumference and "100% adorable". I think we'll keep him.
When I first heard just a whisper of this birth story, I didn't know that I knew the mom. Her doula only shared that she had just attended a birth at a local hospital... in the dark. Only a little light shown from the open bathroom door and when asked if lights should be turned up the OB replied "I do my best work in the dark." Weeks passed and I didn't know who that mom was, but thought she must have an incredible birth story.
Then in late August a friend sent me a facebook message with her birth story. As I read, hanging on every word as I usually do when reading a new birth story... I realized my friend's birth was THAT incredible birth. I would have never suspected it, not because she wasn't incredible (she super is) but because she was supposed to birth in a different hospital! OMG what happened??? I'll let this mom tell you that, and how she never gave up on her birth...
The birth of our lovely Stella Alba was thoughtfully planned. I researched and found a physician who would support my decision to experience pregnancy, labor and delivery as naturally as possible. Although the hospital we planned to use, Community Hospital of the Monterey Peninsula, has a reputation locally for policies that make natural birth difficult, I felt confident we could, with the support of our provider, navigate their policies in a way that respected my wishes and kept both our baby and me safe.
A few days into my 39th week of pregnancy, our physician left town on Friday on an unexpected trip. That evening, I thought that I might have a “high tear” in my bag of waters that was causing a very small trickle of amniotic fluid. On Saturday afternoon, my water definitely broke. We stayed calm, asked a friend to get our daughter, Aria, and did what we knew to try to get labor started.
Saying goodbye to Aria was surprisingly difficult for me and caused quite a bit of distress on my part. I wasn’t quite ready to transition from a family of 3 to 4. Since labor was not moving along, we brought Aria home for dinner and put her to bed, fully expecting to go into labor during the night. The next morning, when nothing had happened, we decided it was time for some help. We contacted a local acupuncturist who generously met us at her office on a Sunday morning for a long, relaxing treatment. During it, she also gave me a massage and encouraged me to sing along with some “birth music”. I’ll confess that the singing felt silly and uncomfortable for me, but I obliged.
After the acupuncture and consulting with some local doulas, we called the hospital to request to come in to check the baby. Contractions were beginning, but were not very intense yet. Knowing that my water had been broken for almost 24 hours made me want to check on the baby, but I really did not want to be admitted. The nurse manager that I spoke with on the phone had a hard time really hearing what I was asking. She followed hospital policy by asking me to come in, but did not understand that I had choices and I was not willing to submit to her inflexible perspective.
Travis and I regrouped, and contacted a local midwife, Caroline Cusenza, who lived close by and she graciously welcomed us into her home and listened to the baby with a Doppler. The baby sounded great and she let us borrow the device for the weekend. Probably the best advice we received throughout the entire process was from her – RELAX and go eat lunch. So, we drove to a new organic restaurant in Monterey and had a relaxing lunch. We paid the bill early because contractions were getting uncomfortable.
On the way home, we decided to call our County hospital, Natividad Medical Center, to speak with the attending OB. The physician listened to our situation calmly and expressed comfort in working with me despite the fact that my water had been broken more than 24 hours. I was able to have prenatal health records faxed to them immediately, and then I settled into the idea of delivering the baby at an unknown facility with an unknown doctor.
When we arrived home, my mom had arrived from Florida to be with Aria, so we visited with her, went for walks, took a nap, and put Aria to bed again. Birthing textbook-style, I insisted on making a batch of granola. In between contractions I measured, stirred, and baked. When granola was done, labor kicked into high gear and by 9:30 p.m. we checked into the hospital with our doula. While laboring at home and in the car, I tried to visualize riding a wave. This worked for a bit, but I shared with Travis while in the car that the wave visualization was useful for reminding me to relax (come down off the wave) during contractions, but was getting challenging because the wave seemed to get impossibly high in my mind. He encouraged me to re-frame the visualization to instead be a wave coming in to shore with him, our doula, and our community there to greet me and support me each time. This slight change made a tremendous difference.
At the hospital we met our nurse and doctor. They reviewed our birth plan and declared it all “no problem”. They did a few quick tests, got a 20 minute “strip” to check the baby and my contractions and checked me (only 3-4 cm—disappointing!), then left the room and said they’d come back only when we asked.
Our doula helped us turn off the lights, turn up the heat, and cover the existing neon lights that don’t turn off. I labored some in bed on my side and sometimes standing up with Travis providing counter pressure on my hips/back during contractions. I found myself going back to the singing I’d done 12 hours before with the acupuncturist and I began quietly chanting during contractions – “open …baby …. Open … baby ….” It helped me tell my body what I needed it to do and to remind me that the work of labor was all for the baby. (During labor with Aria, I lost sight of the fact that there was a baby at the end of the hard work!)
After awhile I got into the shower and Travis stayed with me. Our doula heard my vocalizations deepen, and she gently asked if I wanted the nurse to check me. Fairly sure that I was in transition but afraid that maybe I wasn’t, I had a hard time deciding. I must’ve said yes, because the next thing I remember is being on the bed with lots of warm blankets and feeling a need to push. There wasn’t a chance to check me because I was ready to deliver.
The doctor was called and after 20 minutes of pushing in the dark, our perfect Stella Alba came into the world. She was much more vocal than Aria and screamed for quite awhile, but was healthy and lovely. Inspired by a desire to soothe her, Travis asked our doula to help sing the “welcome song”. Around 1:30 a.m. in a County hospital, the three of us sang to the perfect and brand new Stella:
We all came to welcome you, we all came to your birth
We all came to welcome you, to welcome you to earth
And I was there to love you
I was there to love you
I was there to love you
and give my body for
Your quick and easy entrance here
from heaven’s open door
Lactating or not, I love lactation cookies... really I love oatmeal cookies... but lactation has some added healthy ingredients... and chocolate. I've tried a few recipes over the years and I always come back to Progressive Parenting's Boobfood: Lactation Cookie.
Please check out Progressive Parenting for the recipe and why these cookies are amazing for lactating moms... though I think what's good for a lactating mom must be good for everyone so... have a cookie :) or six...
Natural Birth Series
Sept 28 – Nov 15
Infant Sleep for Expecting & New Parents
6:30pm - 9:00pm
Gentle Cesarean: Planning & Recovery
Toro Park, 3-6:30pm
Natural Birth Refresher
Salinas, 1– 4pm
Preconception & Early Pregnancy Class
Salinas, 1– 4pm
Sibling Prep for Parents & Kids
November 4th & 5th
Toro Park, 2:-4pm
Fall Home & Birth Center Birth Series
Nov 7 – Dec 12
Natural Birth Series
Nov 29th – Jan 17th