Tuesday, March 31, 2009
Welcome!
This is just the beginning, but I am so excited. For the past 22 years I have been serving pregnant women in a variety of ways. Currently I am completing my doula certification through CBI After my certification is completed I hope to fully open my business "Positive Approach to Childbirth", this will include birthing classes, refresher classes, private classes, and doula services.
If you are looking for any of these services, or simply for some information, please leave a comment. If you’re in my area I’ll be happy to help you if I’m able. If you’re nowhere near I’ll see what tools I can find to help you locate who/what you need.
I hope to post things such as my birthing philosophy, tips from past classes I have taught, helps that I have learned along the way, and most importantly, why I think many, if not most, women would benefit from having a doula present at their birth.
For the time being let me just say welcome, and please continue to check in. Even if I don’t post, just comment and ask a question. Remember 22 years of experience: teaching, birth assisting, La Leche League Leader, ASPO/Lamaze educator, and now a CBI student.
Happy Birthing!, Kim
Gravity Is Your Friend!
But, if someone comes up and says, “Gravity was my friend,” then right off the bat I will say, “What class were you in?” Because, as we all know teachers have pet phrases and that is one of mine.
One of my all time pet peeves when I began teaching childbirth classes was that women were passive, wanting to show up and have someone birth them. But, I had a bit of a different philosophy. I figured the right way to birth was with as little interference as possible and being actively involved. This can be inferred to mean any number of things. But one of the things I always teach is to use gravity, movement and different positions to aid what’s going on.
So, here are a few tried and true birthing positions:
- sit on a toilet… you naturally relax the pelvic floor and you don’t worry as much about the “mess” of birthing
- sit backwards on the toilet… ditto for above, plus you get a bit more stretch and you can lean against the wall
- stand in the shower
- take a bath if your bag of waters is intact
- dance… anything from belly-dancing, to hula, to some slow dance or a good swing dance to some old fashioned Glenn Miller… the hip movement not only encourages baby to move, but it often takes some of the stress of that area and relieves the pain and/or pressure
- rock in a chair… again, movement and gravity
- sit on a birthing ball (exercise ball for you health gurus) - just be sure someone is in front and/or behind you to support you… after all your center of balance is a bit different
- squat… use a chair, bed, person, railing… again, a person behind you or in front of you will help with the up and down between contractions
- hands and knees… Cat backs and tail ways, again encouraging a baby to move, this time turning if they are in a “sunny-side-up” position.
- if nothing else, stand up and lean on the wall in between walking.
There are occasions where these positions would be contra-indicated: prolapsed cord, placenta-previa, pre-term labor, and a very fast labor. Always listen to your health care provider, remember, I am neither a doctor nor a midwife.
The point is, birth is not static. Each action of the baby can be helped or hindered by your movements or lack thereof. There are times to be still, and there are times to move. In early labor, and much of active labor (think 0-8 cm. dilation) you have a good number of hours in which to make gravity your friend.
Happy birthing! Kim
Writing a Birth Story
A birth story is a written record of the birth of your baby. It may include technicalities of what went on, snippets of conversation, a comment on the day/weather/time, how this birth helped the parents to grow/change/become and anything else the doula may find interesting or relevant.
While the birthing family can write their own birth story they are often so emotionally involved that it may be hard for them to recall all the details. A doula is most likely keeping notes and will be able, hopefully within a couple of weeks, to generate a birth story. At this point the birthing family may keep this story, add to it, write their own instead . I have seen birth stories written where everyone put his/her own comments in and the result was incredible.
While my last three birth stories were much delayed (sorry ladies) the writing of these taught me a lot. In the case of my more recent birth stories I am including anecdotes which show how God works through this time in each family’s life.
You know how it is, you get two or three mothers in a group and soon the birth stories come trotting out. How nice to know that you have your very own written copy to revisit and ponder.
Happy Birthing,
Kim
More on the Birth Story...
- Decide WHY the birth story is being written. For many of my clients this is a time to see God at work in their life. This is a time of testing, pain, vulnerability, faith… how does this all fit together. I include my own thoughts as well… often referring to creation, running the race, come to me all those who are heavy laden… you get the picture.
- Make this personal. Include the season, weather, time of day and what you were doing when you got the call to come, or how you felt to be asked to be the doula.
- Share anecdotes: what songs did you sing, verses did you read, books did you share, jokes you told?
- talk about the prayers and how they were answered
- talk about the pain/pressure/discomfort and how it was dealt with: scripture, positions, breathing, birthing pool, use of light, etc.
- talk about the personalities present to help flesh out the setting
- talk about how decisions were made
- contraction patterns throughout
- when does labor start? bag of waters break? baby arrive?
- what is learned about the laboring couple?
TAKE NOTES! Obviously when I write a story 6, 12 or 18 months late notes would have REALLY helped. But, even if you are writing the story the next day it helps to have notes to which you may refer. You don’t have to have pages written, simply things to jog your mind. When I first started I divided my paper into sections: The call, early labor, active labor, transition, delivery, meds, other. This helped put things in their proper time order. Again, you don’t want to be so busy writing that you miss out on being a doula… Ask the couple what they remember about the birth. Ask them if they want to help write the story. Don’t be afraid to offer the story and then to do several more drafts.
Enjoy the process. I can look back and read the stories of the couples I helped and it gives me great satisfaction and also helps me to learn how to be a better doula.
Happy Birthing!Kim
I feel like I owe you a post...
Being a doula is something I always never knew I wanted to be.
I have known FOREVER that I want to teach. I have taught in public schools, Montessori, a small Christian school, Vacation Bible School, homeschool, childbirth classes… you get the picture. But, until I had children and started teaching Lamaze I had no idea I wanted to be a doula.
The first birth I ever attended was not my own. We had a young lady living with our family during a crisis pregnancy. She was quite sweet, fairly shy and had some tough things to deal with. So, when it came time to go to her childbirth classes and her partner wouldn’t go with her she decided not to go. Part of my (volunteer) job was to help her meet goals she/we had established as she progressed through her pregnancy. So, I finally asked why she didn’t want to attend and she said she didn’t want to be the only one alone in the classes. Well, DUH! Why hadn’t I thought of that? So, I suggested I accompany her and so began this lovely journey I am on.
We attended classes, and while some helpful information was disseminated, I often called this the “How to be a good patient” class. And, these classes are what most women in our town attended. A few years later when Dear and I were blessed with our first pregnancy I regretfully signed up for these classes, but with a bit of hope that perhaps they had changed. Well, it didn’t actually matter because I gave birth on the second day of classes, so I never learned what they had to teach.
Our second pregnancy found me OBSESSED with the idea of being PREPARED and being PREPARED EARLY since Senior Son had arrived 6 weeks early and things were heading down the same path for Young Man. I found Lamaze classes in our town, taught by a sweet southern Mississippian who just loved on her pregnant mommies. I talked her into getting me into an earlier class, just in case, which was a good idea, as Young Man also made an early appearance, just not as early as Senior Son. Whew! Let me catch my breath after that run on sentence!
Our second birth, almost at home or in the car, happened very rapidly, a mere 13 minutes after arriving at the front door of the hospital. But, through all the early labor at home (2 months), transitional labor (home and car) and trying to NOT have the baby in the lobby, I found that, indeed, breathing and positioning, knowledge and support all helped me. And, voila, I was into my next phase of teaching… Lamaze classes, headed down the road to something… perhaps midwifery.
Many prayers, hours of reading, miles of travel and tests, papers and lesson plans later, I knew that while I loved teaching childbirth classes, and I really LOVED attending births I was NOT called to be a midwife, but a doula. Where I was gifted was in helping the family, not in catching the baby nor making medical decisions. And, in that manner I have supported laboring women in our town for the past 22 years, if you count that first birth that started it all. Now, all these years later I am studying to obtain my certification.
Recently someone asked why I was spending all that time getting a piece of paper. I answered, “Because once I have that little piece of paper the people in the hospital will be a bit more willing to work with me, but more importantly let me have a bit of autonomy in the room so that we can allow/help the birthing mother to truly have the birth she desires if at all possible.”
And, that’s how I got here. So, I am a bit over 1/3 of the way through my reading, I have written approximately 1/5 of my one major paper. I have been reading supplemental books to add to my knowledge and should have my first “write up” birth (one that happens during my training) in November. What I really need is another birth! Anyone up for a doula?
Seriously, part of what I will be learning is how to find clients. And, I hope part of what I learn will be how to balance client needs with my family’s needs. Other than that? Piece of cake. Okay, not quite that easy, but I hope to complete this within the year.
Happy Birthing,Kim
p.s. if you or anyone you know needs a doula, just leave a comment and I’ll be happy to help you find one.
I haven't fallen off the face of the eart...
In case you are interested, this is what I like to do when I teach a refresher course.
- stages/phases (5-10 min. max)
- positions (15-20 min.)
- breathing (15-20 min.)
- birth plans (20 min.)
- other aids: water, temperature, light, scripture, aromatherapy, rebozo [will demonstrate so you know how this works] (10-15 min.)
- questions/answers (10-15 min.)
If I have more than one couple I plan for a little bit longer. If it’s just one couple, and especially if it is a couple whom I have taught before then the class usually goes smoothly and on time.
I guess technically this isn’t part of being a doula, but it will be part of my doula services… if I don’t teach the classes they won’t know I’m out here. But, to do that I MUST complete this course of studies. And, then I hope to complete my CBE certificate via another course of studies.
Well, off to rest my feet, my eyes and my brain. Good thing I have a few more weeks till I go on call. Just that much more time to brush up on presentations and some positioning techniques.
Happy Birthing!Kim
Aromatherapy
I have been interested in aromatherapy for years for a number of reasons. Pain management for bad knees, a back that’s had some breaks, and migraines would be my top three reasons. So, to that end I purchased a book a few years back entitled “Aromatherapy for Mother & Baby,” by Allison England. (I had just started teaching Lamaze as well so figured this would be very helpful.) If any of you have helpful aromatherapy books or references please leave a comment, I would so appreciate your help!
Alas, as I am wont to do, I bought a book and put it on the shelf for a while, “a while” being about 5 years. I got it out and started to read and just got lost. It made it’s way back to the shelf and only came out again recently.
Last spring was my first go with trying aromatherapy with a laboring woman. We used a chamomile/lavender wrap that can be heated or cooled and placed wherever the muscles are stressing: head, neck, abdomen, lower back…. but, the mother I was working with found a new use. She simply kneaded it which gave her hands something to do, as well as allowing the aroma to remain soft and not overpowering.
For those interested start reading. It’s neat stuff. My favorite for myself is a peppermint/geranium oil that is rubbed on stress points with headaches: forehead, temples, neck… It is great! Plus, for me no after effect of sore stomach from aspirin or swollen ankles from the sodium in ibuprofen. I’ll write more later as we experiment with more oils/aromas.
Happy Birthing!Kim
Doula's Position Matters
Recently I attended the birth of a client whom I had worked with previously. It is an ideal situation, and one I hope to enjoy again. God has brought together a team of us that work well together and we all enjoy each other as well. What a gift.
Despite the fact of this being a repeat however, I did learn something very important. The doula’s physical position may play as important a role as the mother’s. As a matter of fact, should the doula be in the wrong position things may not go as planned. Although we knew the “right position” for this mother for delivery, I somehow managed to get myself on the opposite side of where I should have been. Eventually, through this mom moving on her own I ended up in the right position and all worked out okay. However, had she not moved things might have had a different outcome. So, here are things that I need to think about positionally:
- Does my position help the laboring couple?
- Can I change my position to be more effective?
- Can I maintain this position for long periods of time?
- If the answer to 3 is no, Is there someone who can trade off with me?
- Is there a better, more effective position to accomplish what needs to be done?
- Is my position causing a separation… physically or emotionally… between the laboring mother and her main birth partner?
These questions can all be asked and answered fairly quickly thus allowing me to be a more effective labor support person. What are things you have found that help you?
Happy Birthing!
Kim
The Doula's "Goody Bag"
For 22 years I have been attending births in this town. Some were planned attendances and others were last minute calls… either by myself as I needed births for my training, or mothers as they realized they needed more help than they thought. I have shown up in shorts from a family picnic, with nothing but a buzzer, and I have shown up with a backpack, canvas tote, food cooler, purse, hat, coat, gloves…
Eventually, through the example of a fellow (do I make that sound more feminine?) doulaI created my own list of things to bring. And, then I even went so far as to have my bag packed. SO, if you are a new doula and need help this might be a starting point for your. If you are an experienced doula then I would LOVE to have your opinion and any suggestions.
Doula Bag Contents
Scripture and Song sheets
Compact Bible
Chapstick
Aromatherapy wrap
Aromatherapy lotions: orange ginger, cucumber, ginger, eucalyptus spearmint
plastic massagers, 2
rebozo
pony holders
comb
tennis balls, 3 in a can
disposable camera
tissue pack
Tic tacs
Sour candy (relieve nausea and moisten mouth, sugar for energy boost)
Things to add:
Wooden roller (for holding [pressure points in hands] and lower back)
Aromatherapy oils:
rose (has affinity with reproductive system, assist circulation, encourages deep breathing, antidepressant) or
rose/lavender (combined with lavender effects),
ylang ylang (calming and anti-depressant for those who are fearful and anxious),
neroli (reduces fear and apprehension, helps proper breathing and concentration)
Rose spray if no oil is available (see above for rose)
Explanations for each item
1. scripture and song:
When the mother reaches the “I can’t do this anymore.” stage do the following: first, let her know that no, she can’t do this without relying on Christ as her Rock, but with Him all things are possible. Then bring out verses and songs to recite to/with her as an encouragement. Try to have others sing with you, have the father read the verses as the spiritual head of the house.
2. compact Bible:
for those who may want their own verses, or for times away from the birth when the doula needs strength and comfort.
3. chapstick:
for the mom after she has been using breathing as a tool for a while. Watch for the dry lips and offer chapstick and ice as appropriate. Keep the chapstick free of odor as the mouth and nose are so close that the proximity may allow the aroma to cause nausea towards the end of the active phase and especially in the transitional phase.
4. Aromatherapy wrap Chamomile/lavender: lavender dulls and eases pain, but intensifies contractions, also to soothe headaches
a. kneaded by hands, less aroma and good stress reliever.
b. Heated for lower back for back labor and pain as baby descends.
c. Heated for abdomen when the pains/cramps are uncomfortable.
5. lotions should be used during massage or when odors in the room are aggravating the mother
a. orange ginger: orange relieves fluid retention in ankles and legs
b. cucumber: calming
c. ginger: both calming and energizing
d. eucalyptus spearmint
e. jasmine: analgesic and anti-spasmodic, calms and engergizes, uplifts emotions
6. plastic massagers: may be used on lower back or on upper legs. May also be held by mother and used without assistance.
7. rebozo: long scarf to be used as an extension of the doula’s hands. Hold so it cradles the abdomen and use to relieve pressure. Especially good while leaning forward to relieve lower back pain. May add a heating or cooling element for comfort as well.
8. pony holders: when the laboring woman’s hair begins to bother her, offer her the use of these to hold back her hair , terrycloth holders are most effective in holding the hair back without breaking it.
9. comb: clench so tines press into crease between palm and first knuckle or across the palm so that it does not hit the valley by the thumb.
10. tennis balls: may be clenched in the hand to relieve stress or used to press against lower back for relief from back labor. The can may be wrapped in a towel while the balls are inside to provide a solid form and used to roll up and down the back.
11. disposable camera: in case the family forgets their own camera
12. tissues: at the end when all are crying… or if needed earlier.
13. Tic tacs: freshen the breath of caregivers. And, peppermint can alleviate an upset stomach… so the laboring mother may try one if she desires
I hope this list and the explanations were helpful. In the future I will be discussing which verses I use and various hymns/choruses of which I have copies. Please leave a comment…
Happy Birthing,
Kim
Welcome!
This is the new site of "~Doulas~" which was previously located at Wordpress.com. For a number of reasons I have moved back to blogger in order that I may more fully serve you and be available to your needs.
If you have any questions feel free to contact me at:
positive approach to childbirth @ gmail .com
(remember, simply remove the spaces to use the above address.)
Happy Birthing!
Kim