“If you can find one in your area, doulas are sympathetic and knowledgeable labor companions who typically provide some form of prenatal preparation and stay at your side once labor begins until your baby is born.  The doula’s job is to make you as comfortable as possible and to reassure your partner as well.

The evidence in favor of doulas comes from more than eleven carefully designed studies: Quite simply, hiring one cuts in half the odds of your having an unnecessary cesarean.  It also halves the odds of your having a forceps or vacuum-extractor delivery.  That’s not all!  Having a doula also shortens labor by greatly reducing stress, pain, and anxiety.  In the typical U.S. birthing unit, the doula you bring with you may be the only person whose sole responsibility it is to make you more comfortable and to help you labor as effectively as possible.

If your baby’s father plans to be with you throughout the labor, you may wonder if it makes sense for you to hire a doula.  The answer is yes.  Fathers often have significant fears and anxieties surrounding birth-giving.  The calming influence the doula can have on expectant fathers is often as significant as her effect on the laboring woman.”

—Ina May Gaskin, Ina May’s Guide to Childbirth

“When a child is born, the entire Universe has to shift and make room. Another entity capable of free will, and therefore capable of becoming God, has been born. In that way, every child’s birth is exactly like the birth of a world teacher. Every child born is a living Buddha. Some of them only get to be a living Buddha for a moment, because nobody believes it. Nobody knows it, and they get treated like they’re dumb. Babies are not dumb. Just because they don’t speak English doesn’t mean they are dumb. A newborn infant is just as intelligent as you are. When you’re relating with her, you should consider that you are relating with a very intelligent being who just doesn’t speak your language yet. And you shouldn’t do anything gross to her before she learns to speak to you.”

—Ina May Gaskin, Spiritual Midwifery

In my other life as a poet, I discovered the book Home/Birth: A Poemic by Rachel Zucker and Arielle Greenberg. I am a fan of Zucker’s work, and I knew she was also a doula, as she writes frequently about pregnancy, birth and working as a doula in her book Museum of Accidents. I cannot stress how incredible this book is! It functions as part poetry, part memoir, part conversation between two friends, part commonplace book of birthy thoughts, and it is beautiful!

So often birth is described as gross or painful or “over the top” or just plain scary, and sure, it might be all of those things at times, but too rarely is it described in terms of its magic. I am fortunate to live in a state where, more ofthen than not, the sacred moment of birth is venerated and valued. Utahns love birth and I love working in Utah.

If you are interested in birth, I recommend this book!

I am now accepting clients again and I have openings from now to whenever! Feel free to get in touch with me any time! I’m happy to meet with you to see if we are a good match, and answer any questions by phone, email or in person.

In honor of Father’s Day, I wanted to re-post a great article on why dads should demand a doula (via Doula Ambitions). Every single time I meet with a couple during a prenatal interview, the dads seem a little unsure and tentative with me and then, once I explain how I can help them help their wives, they visibly relax. If someone I loved was giving birth, I wouldn’t be able to remember everything I’d learned, I’d be too excited for myself and worried about the mom. A doula is an excellent gift for both mom and dad.

Dads and Doulas
5 Reasons Dads Should Demand a Doula
HK Weiss

When my wife told me that she wanted a doula, I was hurt. I truly thought with our first baby that I’d be able to be the end all be all for my wife. She showed me the research. She let me meet some of the doulas. I still wasn’t convinced that it would be the right choice for us. I subscribed to the “If you weren’t at the conception, you shouldn’t be at the birth rule.” My wife wound up vetoing me. Here are the reasons I’m glad that she did:

1. A doula can spell you.
I really thought I’d be able to stay awake for a big event like childbirth. Who didn’t pull an all nighter in college? Bathroom breaks? Ha! I mean, if I could ride my bike for hours, drinking lots of water and not needing a bathroom break, surely I could wait a few hours while my wife was in labor, right? Wrong.

Thirty hours into my wife’s first labor and I was toast. I’d been up walking with her for what seemed like days as labor began. We’d come to the hospital and there wasn’t any sleeping for me. I was physically tired and mentally shot. The doula really helped me out. With my wife’s blessing, that 30 minute nap I caught helped me to refocus and be back on my game for the big event. And we won’t even talk about how much fun my wife made of me for my small bladder. Needless to say, having the knowledge that my wife had someone else with her while I scarfed down food, went to the bathroom and grabbed a few winks kept me sane.

2. A doula remembers what she learned in childbirth class.
I paid attention in childbirth class. I’d hear enough horror stories to realize that there was a huge, comprehensive final exam for this course – childbirth. But when push came to shove, no pun intended, the knowledge went out of my brain. Those early hours of labor I couldn’t remember if we were supposed to eat or sleep, which positions were good or not so good. Thankfully, when the doula arrived, she saved my skin and made me look like the good guy. My wife never really realized that it wasn’t my idea that she try certain positions, but that I’d been privately coached by our doula.

3. A doula knows the questions to ask.
When we arrived at the hospital, everyone was bombarding us. Questions were flying from all directions. I was busy trying to help soothe my wife, who was not happy with the bumpy car ride to the hospital. Our doula stepped in and gave them all the information that they needed. Magically doors opened and we were offered a prime birthing room.
Our doula also was very helpful in getting information. A nurse or a tech would come in and ask us if we wanted something, like a procedure or a medication. I had no clue. (See above where I forgot my childbirth class information!) Our doula would very calmly ask questions of them and of us until we had enough information to make the decision that matched what we wanted. It was never pushy or mean, just questions. She even reminded us that we could take some time alone to make a decision. That turned out to be a real blessing.

4. A doula speaks the language of labor.
Our doula was an amazing translator. I’d ask a simple question like, “How’s the baby?” And the nurse would respond with something like, “The EFM indicates that there are no decels during periods of stimulation.” I’d give her my biggest smile and nod, like I knew what she was saying. Once she left the room, I’d ask our doula, who would carefully explain each part of what had been said. She also helped us decipher what AROM was as well as second stage.

5. A doula keeps you calm.
Hard. Labor was so hard. And that’s just how it felt to me. Thankfully, when the going got tough and my wife was in hard labor, it was difficult for me to keep anything in my brain. I forgot everything from childbirth class and all I could think of was “Surely this isn’t normal!” Our doula would smile at me from across my wife on the birth ball and as if she had read my mind, would mouth the words “This is normal.” Her calm smile helped me focus again on loving on my wife and keeping her calm. She showed me how and where to touch, she modeled how to behave quietly and efficiently and she made me the star in my wife’s eyes.

When I first heard about doulas, I thought of them as birth interlopers. Now I don’t know how anyone could manage to give birth without one. Our doula really helped bring me together with my wife as she gave birth. My wife remembers my constant support and never failing love or knowledge. She remembers the doula as a nice person who did some stuff in the background. We won’t give birth without a doula.

There are many reasons to avoid vaginal exams during labor, or at least keep them to a minimum: discomfort and the risk of infection, since anything that goes in is pushing germs up into your body, especially dangerous after the bag of waters breaks. I am re-posting tips from a doula in Israel:

Happily, there are a number of external cues that can help you and birth partners get clued in to how much labor is advancing. Some are more subtle than others, but if you are ignoring the clock and keeping focused on staying in tune with your body, you will see them. Listen, embrace, wait.  Enjoy the way it responds! It is amazing what it can do, this body that God gave you.

1. Sound. The way you talk changes from stage to stage in labor. With the first contractions, you can speak during them if you try, or if something surprises you, or if someone says something you strongly disagree with. You may be getting into breathing and moving and ignoring people – but if you really want to you can raise your head and speak in a normal voice. When the contraction disappears you can chat and laugh at people’s jokes and move about getting preparations done. During established labor, There is very little you can do to speak during a contraction. You feel like resting in between, you are not bothered what people are doing around you. As you near transition and birth, you seem to go to ‘another’ level of awareness – it’s almost like a spiritual hideaway. You may share this with someone else, staring into their eyes with each surge, or you may close them and go into yourself. In between surges you stay in this place. It is imperative for birth assistants and partners to stay quiet and support the sanctity of this space: there are no more jokes, and should be as little small talk as possible. Suddenly, the sounds start to change involuntarily: you may have been vocalizing before (moaning, talking and expressing your discomfort, singing, etc) or you may have been silent. Listen – there are deep gutteral sounds along with everything you have heard before, just slipping in there. You are about to start pushing.

2. Smell. There is a smell to birth, that hits towards the end of dilation, during intense labor, just before birth. It is a cross between mown hay and semen and dampness. It has a fresh, yet enclosed quality, and is pervasive. The Navelgazing Midwife has also observed this scent and writes about it here.

3. Irrationality. I love this clue – it often is a sign of transition. It always makes me smile, and I always warn women about this phenomenon so that when we hit it during labor I can remind them that what they’ve just said is irrational, and that I told her this would happen, and here it is! Relax, it means we’re nearing the end. Sometimes a mother will say she wants to go home, she is done now she’ll come back and do this later, she wants to put on her trousers and coat and go out the door. A mother who wants a natural birth and has been coping brilliantly will suddenly say she was crazy and needs pain killers right now, or that she didn’t want another baby anyways, who said they wanted a baby? Some will just curl up and say they’re going to sleep now. If she does this, that’s okay. The contractions may die down, get farther apart, and maybe she (and the baby) will get a few minutes of sleep. This slowed down transition sometimes freaks out doctors or hospital midwives and pitocin is offered – try to see if you can put them off for half an hour. Send every one out, lie on your left side propped up by pillows and have a little nap before pushing; it is such a wonderful gift.

4. Feel. Here come some of the more fun tools that you might not have heard of before! Think about the shape of the uterus. Before labor, the muscle of the uterus is thick evenly around all sides, above, below, behind. As the cervix starts thinning and dilating, all that muscle has to go somewhere – it bunches up at that top. The top of the uterus thickens dramatically the more the cervix opens. During a contraction, at the beginning of labor, check how many fingers you can fit between the fundus (top of your bump) and the bra line – you will be able to fit 5 fingers. As the top of the fundus rises higher during labor, you will fit fewer and fewer fingers. When you can fit 3 fingers, I usually tell mothers they can think about going into hospital as they will find they are around 5cm dilated. At 1 finger, you are fully dilated. (Awesome, huh!)

5. Look. There is something called the ‘bottom line’, which is shadow that extends from the anus up towards the back along the crease of the buttocks. It begins as 1cm and lengthens to 10cm, and it’s length correlates with cervical dilation. Why not look down there before inviting a stranger to put their fingers up inside you? It makes sense to me.

6. Gooey Stuff. Also known as bloody show; there is usually one at around 2-3 cm dilation, and it can happen during the beginning of labor or a few days before hand. Sometimes it’s hard to know what is or isn’t a show, since during the days before labor the amount of vaginal mucus increases in preparation and this can be confusing. A show is up to a couple of tablespoons in quantity, so quite a lot. It can be clear, but is usually streaked with pink, brown, or bright blood. If there is more than a couple of tablespoons of blood then you do need to go straight into hospital to make sure the placenta is not detaching, but if there is just a bit and then it stops, then it is just show. There is a SECOND show at around 8cm dilation. This second show means that birth is near.

7. Opening of the Back. This is just at the spot where your birth partner has been doing lower back massage, at the area above the tailbone. It is a little smaller than palm sized, rather triangular-shaped area that bulges out during pushing. At this point you’ve waited too long to go into hospital, and you need to refer to my last post, 4 rules of what to do when delivering a baby!

8. Check yourself. Okay, so technically this one is an internal check, but it done by YOU. You don’t have to announce the results or write them down: it is not an exam. To me it’s obvious that as the owner of your body, you have more of a right than anyone else to feel comfortable with it and understand how it works. It is best to get to know what your own cervix feels like from early on in your pregnancy, if not before, and then to keep a regular check on what feels normal. If you do this through out your pregnancy you will keep your flexibility into the 9th month. This is also an excellent time to remind you to not neglect perineal massage since you’re already down there! Check out the website My Beautiful Cervix to see photos and descriptions of what a cervix should feel like. At 1 cm you can fit the tip of one finger inside. Use a ruler to practice discerning how many centimeters dilation feels like, measuring with your pointer and middle finger. NOTE: Always, always, always wash your hands thoroughly beforehand, up to the elbows, for 4 minutes at least. Do not assess your own dilation after your waters have gone.

For more labor tips and information about external assessment of dilation, I recommend finding a copy of Anada Lowe’s book, The Doula Guide to Birth, Secrets Every Pregnant Woman Should Know.  This is one book packed with practical and useful information!

A great short film by Birth Matters Virginia about why women choose to hire doulas.

Today I finally had the opportunity to see the movie Babies in the theater. I am on call, so I had my phone on vibrate in my pocket, and when it rang (it was my own mom!), I was convinced it would be one of my pregnant mamas needing me! Wouldn’t that be a funny coincidence?

I really enjoyed the film, which simply shows the lives of four babies in four different parts of the world, with no narration, no translation, so commentary. It was beautiful to see how other people rear their children and it was also a treat to spend an hour and nineteen minutes just staring at adorable babies!

There was even an adorable child with his mom in the row in front of us. The official website has a great interview with all of the babies’ parents too. I definitely recommend the movie if you’re interested in ethnography or just like babies!

I saw this on Bloody Show. It is such a great video of a midwife. I love the first image of the woman breathing too fast and bouncing too fast on the birth ball, and the midwife comes and calms her. That’s what doulas do, too.

Great video on couples who choose to hire a midwife, debunking common myths about hiring a midwife being more dangerous than an OB.