A Whole Life Event

"Birth Matters: A Whole Life Event" is coming up! On March 27th from 11-3, at The House Cafe in DeKalb, I am taking part in a birthing/holistic living open house! Greg (my husband) and I, along with another singer/songwriter, will be providing music throughout the day, and I'll be sharing a table with two other doulas. It should be a great day of communing with like-minded friends and professionals!

Stop by to meet me and other doulas, childbirth educators (including the Bradley Method!), yoga and pilates instructors, massage therapists, accupuncturists, photographers, breastfeeding specialists, members of our local ICAN (International Cesarean Awareness Network) chapter, and more! I'll be giving away a gift certificate toward my doula services, and there will be other great prizes, too!

So come on out to The House (corner of Rte. 38 & 3rd St.) and enjoy good company, good food, and good music. :)

Lucas, Your Mama is Amazing

Posted with permission.

This is me holding Lucas Isaac the day after his incredible birth. Chrissy labored like a pro for eleven-and-a-half sometimes peaceful, sometimes very crazy hours on February 24th, two weeks before her due date! Her labor contractions began at 5:30 a.m. and she called me around nine to let me know she was in labor. She sounded amazing--I could totally tell by her tone of voice that she was handling everything very well. She had a little bleeding so she decided to call the doctor's office and they told her to come in. So she did... and she was already several centimeters dilated!!! Dr. Atkins was really shocked by how well she was handling her labor at this stage!

After Chrissy called me to tell me the good news, I met them at the hospital at around 11:30. We got settled into the room and met our awesome nurse, Tara, who would stay with us for the remainder of the day. The next few hours were relatively uneventful, as Chrissy was doing a beautiful job relaxing through each contraction. At one point, Tara said to Chrissy, "we should bring a video camera in here and record you--this is how it should be done!"

At around 2:00, Chrissy was checked and she had reached 6-7 cm in dilation. I suggested a shower, because the contractions were getting more intense and water works wonders for bringing comfort to laboring moms. So she spent about a half-hour under the warm water as she entered the transition phase of labor, which is by far the hardest part. After the shower, she settled back into the bed for some serious hard work. We discovered that moaning with each out-breath helped her to deal with the pain, so Seth and I moaned with her as we stroked her body in rhythm. Chrissy became very serious and focused as the difficulty level was increasing rapidly with each contraction. She decided to go to the bathroom, and afterwards labored standing up with Seth, leaning on him for support. I cannot describe how difficult this part of her labor was. There were tears and moans and cries out to God for help. And he was surely there with us, helping Chrissy through the most physically and emotionally strenuous moments of her life.

She had reached 10 cm by 4:00 and she was ready to be done. "I'm so tired of this!" she said. "I just want it to be over!" By 4:30 she was able to start pushing, and she did an incredible job. During her first few pushing contractions, Dr. Atkins could literally see progress with each push! After she got used to the new and crazy sensations that come with this phase of labor, Chrissy got herself into a beautiful rhythm--pushing, pushing, pushing, and resting in-between. We could see his hair! He was so close! But the doctor couldn't get a good reading on the baby's heart-rate, and there were a few moments of concern... she ended up cutting a small episiotomy because this baby needed to come out. And sure enough, his cord was wrapped around his little neck, which is what was causing the drop in his heart-rate. Dr. Atkins quickly cut the cord, and Chrissy pushed her baby OUT!!! All was well and Chrissy was SO relieved that her labor was over and her baby was in her arms!

What an absolutely amazing day. I feel so blessed to have had the privilege of helping Seth and Chrissy welcome their firstborn into the world. They did an incredible job, working together through the difficult but joyful experience of labor. Seth was such a strong support to his wife, and Chrissy was so strong through it all. We have been blessed.

The Big Essay

Down to the wire, I'm getting all my papers and documents in order to send in to DONA after my final birth, which is coming SOON!!! I co-hosted a shower for Chrissy this past Saturday, which was so fun and made me realize how soon her baby is coming!! We'll have our final prenatal meeting within the next week or so, and then we wait... I CAN'T WAIT!!! I'm so excited that my final certification birth will be for one of my best friends--I know she's going to do great!

So I started and finished my big essay today, which will be handed in with a plethora of other documents. Here is it:

The Purpose and Value of Labor Support

A. The benefits of labor support to the mother and her family

For the laboring mother, the advantages of having a doula are great. The mother feels more comfortable with her labor knowing that a kind and knowledgeable woman is constantly by her side. She is able to relax more freely and let go of fear, which decreases pain and speeds up labor. Statistics also show that having a doula present can decrease complications, such as the need for oxytocin and cesarean section.1 In one study, having a doula present showed an 11% decrease in the use of oxytocin and a 10% decrease in cesarean sections.2 Doulas can also greatly benefit the mother’s partner. Though he may love his partner dearly and want to support her as best he can, he has never been through anything like this and may not know what to say or do to help her best. When the couple chooses to have a doula, “the pressure on the father is decreased and he can participate at his own comfort level.”3 And astonishingly, having a doula even has benefits for the baby. In one study, 51% of babies whose mothers had a doula were breastfeeding at 4-6 weeks, as opposed to only 29% of babies whose mothers did not have a doula.4 Furthermore, significantly fewer mothers suffered from post-partum depression, and more reported a positive birth experience in the weeks following their baby’s birth.4 It is very clear that doulas are extremely helpful for not only mothers, but also for their partners and their babies.

B. The purpose behind providing labor support

The birth of her baby is arguably one of the most memorable and life-altering days of each woman’s life. Throughout history, women in labor have without question been supported by other women throughout the journey of childbirth.5 Sadly, the normalcy of this natural and beautiful support system has disappeared from the highly sterile and cold environments of American hospitals. The doula recognizes the need for women to be supported emotionally and physically during labor, and her goal is to provide this support to any woman who desires it. She also understands the need for families to experience intimate connection on the day of their baby’s birth, and her services empower them to have that connection.6

C. The doula’s responsibilities

The doula’s primary responsibility is for her client. She must do everything in her power to ensure that her client has all the support possible, and everything she needs for the most satisfying birth, according to that mom’s expressed desires. As a professional, she also has certain responsibilities she must abide by. She must possess a strong work ethic and sense of commitment to each client. For instance, she should return calls promptly, be committed to sticking to pre-arranged meeting times, and make every effort to assist the mother during the prenatal weeks, labor, and the first few weeks following the baby’s birth. She should have a respectful and courteous attitude toward her colleagues and her clients, and should respect each client’s privacy. She must also remain up-to-date with new developments in her field by continuing education, actively networking with others, and being involved in related organizations. Her fees must be fair, and she should strive to offer discounted or volunteer services when possible.7

D. The doula’s role

The role of a doula is very special and unique because of the intimate nature of the birth process. She offers a minimum of one prenatal meeting, though usually more, to get to know her clients, establish rapport, educate them on the birthing process, and to learn what she would like her birth to be like. During labor, she is with the mother at all times (except for short bathroom or food breaks), providing any support the parents need. This could be giving a massage, counter-pressure, hot/cold compresses, or instructing the partner on how to do these things. She provides reassurance that her body knows what to do, and encourages the mother to trust in the process. She could help with visualization or relaxation techniques that have been discussed at a prenatal meeting, or facilitate the spontaneous coping methods the mother may begin. The doula does not perform any medical tasks, but may guide the mother to ask questions or speak up to her care providers. She provides “support, information, and mediation or negotiation.”8

1. Table 1 in DONA’s Position Paper
2. Klaus ’86, Table 1, in DONA’s Position Paper
3. DONA’s Position Paper, page 2
4. Hofmeyr ’91 & Wolman ’93, Table 1, in DONA’s Position Paper
5. DONA’s Position Paper, page 1
6. DONA’s Position Paper, page 1
7. DONA’s Code of Ethics
8. DONA’s Standards of Practice

I Love Birth.

My doula certification is coming along--I have one more birth to attend, a couple of papers to write, and a few hundred pages left to read. I have learned so much, and am realizing I have so much left to learn.

But mainly, I'm realizing more and more, that I love birth.

I love that everything about it is unpredictable--so different from everything else we can control in our day-to-day lives. If a mom is well prepared for labor, she will know that ultimately, she must surrender to the power of her surges. She must have complete trust in her body and its ability to birth her baby, and let go of any fear. It's scary at first, to relinquish control, but in the end, it is so empowering.

I love how the intensity of it brings out the reality of who we are. There is no hiding. No pretending. As labor progresses and becomes more intense, the modesty of the laboring woman becomes less and less of an issue, along with any walls she has built up around her personality. The underlying message through the groans, the breathing, and the depending on those around her is, "This is who I am!" This is the most vulnerable she will ever be.

I love that, in the best births, it's about community and togetherness--people gathering around the laboring mom as she works through the most intensely beautiful experience of her life. People imparting to her strength and courage, and helping her to draw those qualities up out of the core of who she is.

This is beauty. This is community. This is what we were made for.

And I love it.

My First Birth: A 36-Hour-Long Lesson

Posted with permission.

"I will never give birth without a doula."
~Jennifer, after the birth.

Jennifer's water broke at 3am this past Thursday. 35 intense hours later, her son, Andrew, was born. Here is what I learned.

1. Doulas are crucial for not only unmedicated births, but also--maybe even more so--for births where interventions are used.

Jen and Keenon had been preparing for a natural labor and delivery, and Jen had been reading and practicing Hypnobirthing, which uses relaxation, visualization, and meditation to cope with the pain of labor. Many hours after the broken bag of waters, though, her contractions were just too weak and far apart to be helpful. But the doctor was very patient, and waited until 6:45 pm to start augmentation with pitocin. It took an hour or so for contractions to really get started up, but when they did they were pretty painful, continuing to get stronger and closer as time passed. Jen did an amazing job of staying focused and breathing through each contraction, and Keenon was such a strong support to her. I suggested different positions and tried to create a relaxing environment for them to labor in. When things really started getting intense, she settled in the bed for some concentrated focus and relaxing. I was reading a meditation script to her, which helped get her focused, and after that she came up with her own ritual (a sign that she was really coping well). She started repeating in her head, "in love, out pain" with each breath, as I stood by her side and repeated that mantra out loud. After about eight hours of laboring with pitocin, the nurse checked her and she was still only 1cm dilated. This was awful, disheartening news. The good news was that her cervix was 100% effaced, or thinned out, which is what we had been accomplishing for the past eight hours. This was probably a low-point in the labor--Jen was so discouraged, and in her discouragement expressed that she just wanted to get a c-section and be done. Keenon was also in a state of disbelief, and very concerned for his wife. I knew, though, that they were speaking out of pure emotion, and in the end would most likely regret it if that was what happened. The nurse (who had been rather prickly up until this point) really came through, and with me, encouraged an epidural, some rest, and to go from there. Which brings me to point number two...

2. Epidurals can be very, very helpful.

Under normal conditions, I believe that women have an innate strength to get them through labor, if they are well-educated, prepared, and have a strong support system around them. This was not a normal circumstance, though, and the options were either an epidural and some rest, or a c-section. Thankfully, they decided an epidural would be the best way to go, and this was given at 3:30 a.m.

3. It is impossible to sleep in the waiting room, no matter how tired you are.

Heather (Jen's best friend, who was also a part of the support team) and I left the room so Jen and Keenon could get some much-needed sleep. We begged the nurse for some hospital blankets and headed out to the waiting room. After 2 hours of twisting and turning from floor to chair to small-hard-couch-thingy, we headed back to the room to see how things were progressing.

4. When working as a doula, I hold up just fine on zero sleep.

I walked back in the room, bright-eyed and feeling like a million bucks (well, almost). The nurse came to check Jen at 6am, and she had progressed to four centimeters! The baby was also moving down. This was awesome news! We still had quite a ways to go, but we were making progress. Friday morning was less intense than the night before, but still required constant vigilance and attending to Jen. I felt totally awake and sustained by the prayers of friends who were praying for me and for Jen and Keenon. What a blessing.

5. The "24-hour rule" can be bent if both mom and baby are doing well.

Typically, after the bag of waters breaks, the clock starts ticking--doctors say they will have the baby out 24 hours later one way or another because of the risk of infection. But as we were well past the 24-hour mark and there was no talk of c-section, I was hopeful that her baby could still be born vaginally. (After the birth, I asked a nurse why they let her go so long without operating, and she said it was because the baby's heart rate was strong and Jen was doing really well. It would have been nice to know this was a possibility!)

6. Emotions are ten times stronger when running on no sleep and adrenaline.

We didn't know this at the time, but around 11:00 the doctor had told the nurse to get the papers ready for a c-section and to bring them in for Jen to sign, but to check her one last time just in case. So she came in, checked her, and said, "I don't feel any cervix!" I couldn't contain myself--I was so happy I started crying. They asked, "Is that good?" I said, "Yes, this is so good! We made it! You can start pushing!!" It was a beautiful moment. Our awesome new nurse started rushing around to get the room ready for a baby!

7. Women can be strong. So, so strong.

Before she was checked, Jen started feeling the contractions getting stronger. She started having a urge to poop, and I was suspicious that we were nearing the end (having felt that same sensation not too long ago myself). She started having to really focus on her breathing during each contraction, and soon, it seemed like she didn't have the epidural at all. She also started getting pretty emotional, and losing her focus (which we later discerned was a sign that she was in the transition stage of labor--between 7 and 10 cm). Thankfully, her friend Heather knew just how to calm her down and talk her through it. Then I informed her that the pushing stage was going to get very intense again, and that she was going to have to draw from all her inner strength. The room was ready, the spotlights turned on. Heather and I each grabbed a leg while Keenon stood by her head, and the nurse coached her on how to push. She was in so much pain, and could feel everything, but she was so strong for her baby. For two hours, I counted to 10 for each push, which was 3 or 4 times per contraction. She was exhausted, but so focused, and took advantage of every second between contractions to rest. After almost a day-and-a-half of no sleep and barely any food, I was blown away by her strength. She pushed Andrew out into the world at two o'clock pm.

8. The minutes after birth are the most beautiful, spiritual, and love-filled moments ever.

Their new baby was placed on Jennifer's chest. There were tears, kisses, and so much love between their new family. I was crying and taking pictures, doctors and nurses were bustling around attending to Jen and the baby as she held him. But they were in the zone. Nothing could distract them from the miracle of what was happening. I am so blessed and thankful to have been a part of this incredible journey.

The Doula: A Hindrance to Family Bonding?

“Not only was it nice having someone familiar with the processes…in the thick of labor, I knew my wife felt so supported by Kim. It made all the difference, and I'm going to insist Kim be there for our next child.” ~Seth, on having a doula at his son's birth

I had a couple recently who expressed interest in having a doula, but were concerned that having another person there might take away from the intimacy of the experience. She said that they had been together for a long time, and had a very close relationship, and that was the one thing that made them a little bit hesitant about the whole doula thing.

I really do think that theirs is a totally valid and legitimate concern. Giving birth to your baby is one of the most memorable things you will ever do, and it's something that you will remember for the rest of your life! Having a doula there, or anyone else besides your partner, is truly a big decision that requires a lot of thought.

While in the end, it is totally up to you to decide, I thought I’d blog a little about my thoughts on the topic.

If you are giving birth in a hospital, there will likely be many professionals buzzing about you. Some you choose, like your doctor (who is usually only with you for a fraction of the time you are in labor), and others you don’t, like your nurses. A doula is a professional, just like a nurse or doctor, who will be there for your birth. The differences are that you choose who your doula will be, and that her sole purpose is to make sure you are okay. She doesn’t work for the hospital—she works for you.

As a doula, I encourage laboring moms to stay at home in early labor, where they can relax in a familiar environment and work with their partner to get into the rhythm of labor together. I ask that each mom calls me when she thinks she is in labor, so I can stark making arrangements for my family and be there when she needs me, but I will not come until the mom feels like labor is getting more intense and could use some extra support and encouragement. So if the mom is having a “textbook” labor, there will be plenty of time at home with just her and her partner.

When I do join the couple, at home or at the hospital, if they seem to be coping well and getting through the contractions just fine, I will gladly step back and let the dad continue supporting the laboring mom as he has been doing. I feel very strongly about not intruding on the bond that exists between the couple, and I strive to maintain a calm, peaceful, and reassuring presence throughout the labor and birth. Part of this is remaining calm and peaceful myself, and a big part of it is encouraging others in the room to respect the bond between the couple, and the intensity of the mother’s experience. I do this by speaking in a soft voice and encouraging the nurses to do the same, and asking the nurses to wait until the mom is not contracting to ask her questions or perform procedures when possible. This actually frees up the dad to give more of his attention to his lover, because he doesn’t have to worry about creating and sustaining that calm atmosphere, especially at a hospital birth.

If you are hoping for a natural, drug-free birth* in a hospital, I believe the role of a doula is vital. Sadly, most medical staff at the hospital are not very familiar with unmedicated birth, and don’t realize the importance of uninterrupted quiet and peacefulness so that the mother can maintain her focus to get through the contractions. When I was in active labor, I remember several times nurses bursting into the room, talking casually and loudly with one another and to me. It was a struggle to remain focused, to say the least. As I said earlier, Greg did a great job interacting with them—encouraging them to lower their voices and not to talk to me during contractions, but that did take his time and focus off of me. As a doula, one of my goals is to free up the dad to be available for the mom as much as possible.

Obviously, when labor is getting very intense and comfort measures or relaxation are not working as well as they did earlier, I will be available to offer new suggestions. I have been well-trained on a number of different positions and coping techniques. I can apply pressure in certain areas of the back that would feel especially good if she is having back labor, and I can show the dad how to do these techniques as well. It can actually be very exhausting to give constant pressure or massage if the mom needs it, so I can take turns with the dad, or we can work together to provide double the pressure.

There are countless benefits of having a doula, and I understand that a potential drawback could be having a "third wheel" along for the ride. I definitely respect couples who would prefer to work through the process of labor and birth alone. At the same time, though, I feel that I offer a level of service that would not detract from the most memorable day of their lives, but would enhance it.

*I also offer support for women who desire medication in labor. I will discuss this more in a later post.

My Services Include...

• 2-3 pre-natal meetings 
• Accompanyment to one pre-natal doctor or midwife visit, if desired
• 24/7 support by phone or e-mail throughout your pregnancy
• My constant presence, encouragement, and assistance during labor from the time I arrive until mom and baby have bonded
• Photographs of any part of the process, before and/or after your baby’s birth, if desired (I have a bachelor's degree in fine art, and have taken several photography courses)
• One check-up visit following the birth of your baby

Optional*

• Stepping stone made with high-fire ceramic stoneware, with your baby's hands and/or footprints, name, and birthdate

*includes a small fee to cover the cost of supplies

Contact Info:

gregandkim2004@msn.com

815.766.2356

Please get in touch with me to set up an initial meeting! I would be happy to meet with you and talk about your desires for labor and birth.
Above photo by Chrissy Deming Photography