Judgmental Doulas

Recently I've been noticing a theme in the doula community. The majority of doula websites state they provide "unbiased and judgment-free" doula support. Now that sounds marvelous, and I've never batted an eyelash at it.. until a recent discussion got me thinking... 

I would love a doula who's unbiased, but I sure hope my doula has judgment. 

I'm going to start by saying that I bet 99.9% of the doulas who have this on their website agree with everything in this post, and never meant anything by their statement. But let's break it down (because we all know I love definitions and semantics). 

There are different types of judgement. There's good judgement and bad judgement. Positive judgement and negative judgement. 

Positive Judgement
"the ability to make considered decisions or come to sensible conclusions. synonyms: discernment, acumen, shrewdness, astuteness, sense, common sense, perception, perspicacity, percipience, acuity, discrimination, reckoning, wisdom, wit, judiciousness, prudence, canniness, sharpness, sharp-wittedness, powers of reasoning, reason, logic;"
Negative Judgement
"having or displaying an excessively critical point of view. "I don't like to sound judgmental, but it was a big mistake" synonyms: critical, censorious, condemnatory, disapproving, disparaging,"
Here's a little secret: No doula is non-judgmental. And I'd hope you'd want a judgmental doula too. 

I'd hope you'd want a doula who makes choices for our own business practices that show discernment, wisdom, prudence, and sense. I'd hope you'd want a doula who makes choices in the way that we serve the women we've been entrusted to attend that show discernment, wisdom, prudence, and sense. 
I would hope you wouldn't want a doula who was a Wesley - (think Princess Bride), one who simply said yes to everything, because then you'd miss out on the educational portion of doula work - the options and choices and personal experiences and head space of doula work. 

And then, on the other side of the coin, I would hope (for all doulas) that none of us would be judgmental in the fact we make choices for our own business practices or ways we serve women that are excessively critical, condemning, disapproving, disparaging, or censorious.

So let's be doulas who use wisdom, prudence, sense, logic, reason, astuteness, and perception! 


Aromatherapy and Herbal Remedies - Book Review

Herbal treatments and aromatherapy are valuable, time-proven, natural approaches to a healthy and more comfortable pregnancy and birth as well as a successful breastfeeding experience. Herbalist, instructor, and midwife Demetria Clark explains everything a woman needs to know about using herbs and essential oils during this important time of life.
Demetria Clark has written a beautiful and educational resource; Aromatherapy and Herbal Remedies is both insightful and useful. When I first began reading it, I had the bias that it would be something of a resource for myself, as a birth worker, but difficult to encourage my clients to read. I was wrong.

I have already recommended this book to three clients and will continue to do so as the wealth of information and read-friendliness of Aromatherapy and Herbal Remedies is sure to make this a regular on bookshelves across America. Her book is broken down into aromatherapy for pregnancy, labor and birth, and breastfeeding, and remedies for pregnancy, labor and birth, and postpartum/breastfeeding. She also includes an introduction to herbs, aromatherapy, and information on how to grow, harvest, and prepare your own ingredients.

She has a concise list of herbs and essential oils, as well as their uses and contraindications. Additionally, she provides a substantial section on recipes for everything from teas to poultices, and diffusing blends to massage oils/salves. I'm excited to refer to this book time and time again and have no doubt it will become a staple on many birth workers book shelves.


The Empowering Epidural

Empowerment - making one stronger and more confident, especially in controlling their life and claiming their rights.
wikipedia picture
Let's get one thing straight from the start - noone can empower another person when it comes to the humanistic experience of empowerment. Empowerment is, by definition, one finding ones own strength. So, I cannot empower you... but, you making a choice that feels good and resonates within you can be empowering to you. It is your power of making that choice that feels good. 

I am a huge advocate of low intervention, no pain medication birth. In healthy and low risk birth, less intervention (medications, tools, equipment, etc..) means less inherent risk. But just because I believe in that truth does not mean that it is going to be true for every birthing journey. Not every birthing journey stays healthy and low risk, not every birthing journey couldn't benefit from weighing the pros and cons of an intervention and erring on the side of the intervention. So, that is where we start. 

The Empowering Epidural

I always start with the nitty gritty. Epidurals, like all interventions, should be used as tools to achieve a desired outcome.  In prenatal appointments, I provide women with a sheet that details the risks involved with getting an epidural. In childbirth classes, we role play getting an epidural and all that comes with it. Each time, I tell women 'this is not to scare you, this is to give you information about a procedure that you might decide you want, or your birthing journey might require you to get'. 

So let's talk about that some, shall we? 

B*E*S*T Doula Service has an epidural agreement very like my own that I give to clients. You can see it here. I love that they outline what will be required if you choose an epidural vs what might happen with the epidural. This is very important information to share with clients because it takes the 'I didn't know' and the 'if I'd only known' out of the experience. I cover with them: 
  • It will require continuous fetal monitoring
  • It will require at least one IV bag of fluids to be given prior to getting the epidural
  • It will require a blood pressure cuff to read your BP every 15-30 minutes (depending on the hospital's protocols)
  • It will require that a pulse oximeter to be placed on your finger for at least 30 minutes during administration
  • It will require that your partner and doula leave the room for administration (in nearly all area hospitals)
  • It will require a urinary catheter to be administered (depending on the hospital, some leave it in, others empty your bladder and then remove it. It may increase your risk of UTI or bladder infection, require antibiotics, or cause trauma to the urethra).
  • It will restrict your mobility during labor. Depending on other possible risk, you will be limited to the bed, and perhaps your back. 
  • It will provide a level of numbness... some women it fully numbs them to the point they cannot move their bodies from the ribcage and down without assistance, some women can feel quite a bit of discomfort even after the epidural and move without assistance).
  • It will deprive both baby and you of your natural production of endorphins, which allow for both of you to cope with pain (both during labor and you, postpartum).
That way, if their organic experience requires, or they request, an epidural, they know this information and nothing surprises them about it. We also talk about the possible risks, so that they can fully accept them, weighing the pros and cons in the moment having already read and understood the possible risks, and make an empowered choice free of the fear of unknowns. 

Another thing I always suggest is watching one. Why? Well, for the same reason we encourage women to watch birth: it takes the mystery out of the experience. 

When might a woman choose an epidural? 
  • For pain management - some women simply want to have that control over their experience. Although the control over pain requires they relinquish control over their bodies and their functions, many women accept this and feel this is  best suited for their needs. 
  • For emotional and mental clarity - some women who have had sexual trauma or birth trauma in their past prefer to labor and birth with an epidural. We talk through their desires, including the fact that it might be triggering based on it taking away mobility and possibly requiring mom to feel 'tied down' and on her back. If she feels confident about the choice, we usually try to move the equipment and tubes/wires all onto one side of the bed so that she can feel less restrained. 
  • For rest - a number of women cope marvelously well with labor and only even consider an epidural to rest... this is usually the case when she is going on days without sleep. 
  • For a reset - this would be the case when moms labor pattern becomes 'dysfunctional' from maternal exhaustion (cntx space or stop, sometimes with ROM, but stay intense, usually after long early labors, and dilation stalls along with it). In certain situations mom and her provider might feel an epidural combined with pitocin will be the best thing to get her a vaginal birth.
  • As a tool for vaginal birth - if the woman is unable to relax her legs and pelvic floor to allow for dilation to occur, or if she is beginning to run a fever and, although contractions are strong and dilation is occurring, she needs baby to be born sooner than later and opts for a more aggressive augmentation, she might choose an epidural as a tool to help her achieve a vaginal birth. 
In all of these situations a woman can feel empowered that she chose an epidural that fit her needs for her birthing time when she is fully educated and understands the possible outcomes, and the desired results. 

The one situation where I find women routinely don't feel good about their choice? 
  • For fear - fear of the future (how much longer will this take? I don't think I can do this much longer), of the pain (how much more painful is this going to get, I can't take too much more painful), fear of an intervention (I heard pitocin is horrible, if we add that, I can't do it... I can't stand those cervical checks, one more and I want an epidural), or of the experience (if it feels like this now, how will it feel later? My friend told me pushing felt this way and that's scary to me). 
In these cases, we try to get to the root of these fears and dispel them. I remind them that any choice made in fear is not a good choice, even if you would make the same choice without fear. So we attempt work through that fear to see if they still feel the same about the intervention afterward. 

Have you had an empowering epidural? Did you experience an un-empowering epidural? Do you know what might have made the experience better or helped you make a different choice? 


Local Breastfeeding Mishap - Pearls From Sand

We've all heard the stories in our own areas:

"I was nursing my baby when our server came up and asked me to cover up. When I told her I was fine, but thanks for the concern, she picked up my napkin and tried to drape it over my babies face"...

"I was nursing in Target on one of the benches near the dressing rooms. The sales associate asked me to go into the dressing room to nurse. I told her I was fine where I was and my 2 and 4 year old's wouldn't do well in such a small space. She kept insisting and then even left to get a manager to try to get me to move. You could tell she was uncomfortable with my nursing my 2 month old"...

"I was breastfeeding my 4 week old when a nearby patron glared at me, wrinkled their nose in disgust, and told me I should have more class than that. She went on the complain to her friend that I was being slutty and wanted attention. I tried to ignore them but it hurt. Then, to add insult to injury, the manager came up and asked me to please, 'at least' cover up for the comfort of everyone else in the restaurant."

But here's a story of another sort... this morning I saw a story circulating in my feed of a local Houston woman who says she was asked to leave when nursing her baby at a local restaurant. So she moved her nursing into the bathroom.. but the server supposedly followed her in and asked her to leave. So she left to her car. Supposedly. But we don't have necessary information, and rumors abound...

Rumors are swirling that it didn't happen at all.. or that she was trying to nurse in the 21+ club area... or that she was unhappy with her meal... regardless though....

Why do I say supposedly?

  • Because the original person it involves is MIA. No one knows who it is.
  • The screen shot circulating is "my friend" or "an acquaintance of mine" and then the story"... no actual story from the horse's mouth
  • Other breastfeeding mamas have come forward and said they have never had a problem nursing there
  • The owners themselves, the woman used to be a breast milk donator for the Texas Children's Hospital Milk Bank
  • Employees and security footage supposedly tells another story, and the owners are willing to share it and set the record straight... 

But the biggest reason I don't necessarily believe this really was a situation that even happened? Or at least not the way it was portrayed on social media?

The owners of El Patio ("club no minors") have set up an event to set the record straight, reestablish how family friendly they are, promote breastfeeding education and awareness, show how breastfeeding friendly they are, and give back to their community all in one fell swoop.

From the event's details:
Join us along with pro-breastfeeding community in Houston to help bring awarenes to the importance of breastfeeding and its importance in early childhood.
Breastfeeding is an important start to a child's life. There is a lot of misinformation around breastfeeding and its importance, as well as the support for Mom's to meet their goals. It's hard work!

Many moms don't breastfeed because of their fear or embarrassment of nursing in public, even though they have a legal right to do so. Mothers are frequently shamed when they breastfeed in public.

When word of an incident gets shared, fellow moms and caregivers band together to stand up for them. Mothers are a fierce group! Rarely, stories get twisted and confused, and aren't accurate.

El Patio, recently experienced one of these incidents where our 50 year reputation as a family restaurant was challenged. We are taking the opportunity to give back and help create awareness to this issue. 
Join us for a "Feed In" from 11-3pm on Sunday, December 13th. El Patio will donate 20% of all sales during this time to Mothers' Milk Bank at Austin to support their Houston outreach and efforts.
Please bring your families and friends to help support all mothers in Houston!
To read more information or to attend the event, see here.

I'll update this post as I hear more information, but in the meantime, I have to say, I love this businesses response! They could have simply refuted it and showed their evidence. They could have just made a public apology. They could have just made a public statement... but they are giving back to their community, taking this opportunity to educate their community, and give to a very worthy organization.

So bravo El Patio! I hope to see you on Sunday!


So I've gotten some disgruntle-mail, people calling me a victim-blamer and a non-supporter of breastfeeding. This is the furthest from the truth... I have been to many nurse-ins, help women breastfeed and extended breastfeed, etc... the problem is that this isn't the norm.. I've never seen a woman not willing to stand by her word that she was attacked for breastfeeding and shamed. I've never seen a case where everyone else is so fired up from a second-hand account. This is classic 'telephone' (you know, the game we played when we were kids).

I believe that one of these is the case:

  • there is no woman, someone just wanted to start something
  • there IS a woman, but she hasn't come forward because she made it up or the issue wasn't breastfeeding and she was just finding something to complain about (i.e. trying to take a baby into the 21+ section and upset she couldnt)
  • there IS a woman, but since making that first accusation, she found out she was wrong and it was a misunderstanding
  • there IS a woman and she hasn't come forward yet because she's getting her legal ducks in a row

All that said, even if there IS a woman and this DID really happen, since when is someone guilty until proven innocent? Until I hear it 'from the horses mouth' it's just a second hand story and you cannot refute that.


So, the restaurant has surveillance footage and testimony from the waitstaff that night. There WAS a woman who had an infant who tried to access the 21+ area, but there wasn't an 'issue'... that same woman was also harassed by someone who was not employed by the restaurant (a patron) for nursing. That person did follow her in the restroom and did come across authoritative. The woman has recanted her story, saying that she thought the patron was a member of the waitstaff. She never intended for the information to get on social media and the friend who's screenshots were shared all over social media never wanted or intended for her information to be shared outside of their private parenting group..

I feel badly for the mom that a PATRON had such an air of authority that she felt shamed from doing something that SHE HAD the authority to do. I feel badly that she UNINTENTIONALLY set off a firestorm. I'm sad that the business was hurt by this story and that there was such a wildfire siege on their business from angry (mislead but understandable) breastfeeding mamas. I am SO HAPPY that they are all choosing to do right - the mother has rescinded her story, the friend has made an apology in the private group, and the business has decided to make the best of and do the most that they can for this incidence. Beauty from ashes, pearls from sand.. I am in love with humanity right now; now if only the people who have made yelp and FB reviews would rescind them.... 


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