Doula 2 Doula - Why I Don't Offer In-Home Consults

I've had potential clients get miffed from time to time over me not offering in-home consultations. Sometimes they've even compared my practice to other local doulas who do offer in-home consultations.

I get it, it's more convenient to the potential client, especially if they have children. It's more private, intimate, etc...

But let's talk about the other side of things.

As a human, and a female human, I would like to think the best of people. But there's no denying that we live in times where we need to be considerate of our safety. If I were to meet a complete stranger in their home without any prior knowledge except an email and possibly a phone call, I have no idea what I am walking into.

There are a number of stories in the birthing community of doulas who found themselves in scary, and even dangerous, situations because they trusted the strangers that they were going to meet. In one, the woman backed out last minute and said 'go ahead and meet with my husband at our home, I have to go to an appointment.' (this was when the doula was literally on the front step knocking on the door). In another, someone blocked her ability to leave the home when she had to leave for another appointment. In yet another, the home was abandoned and a car pulled up to block her leaving the driveway, but then her husband (who happened to be with her for that day) stepped out of their car and the other vehicle drove off.

So please know, potential client, it isn't because I think badly of you. It's because I am thinking safety for all when I say 'let's meet here'. And doula to doula - staying safe in our field isn't difficult with simple boundaries and safe business practices.

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 equally 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. Doulas should give non-biased resources and education to their clients so that they feel good and positive about their choices, whether they go 'according to plan' or not, and no matter what those choices are. As I have said time and time again, how can we hope to make mothers out of women when we treat them like children? 

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... to their clients, their clients choices, or their peers.

It would do us well to remember the difference between good and bad judgement, and bias; I hope none of us provide biased support, but I hope we all show good judgement. So let's be doulas who use wisdom, prudence, sense, logic, reason, astuteness, and perception to benefit our clients through education, resources, support, and community. 

Entitlement and Luxury

There is an old concept in the doula community that simply won't die... this concept is that, just because a woman deserves a doula, that implies that every woman is entitled to a doula.

And this simply isn't true.

Let's go back to some of my earlier posts...

Much Ado About Gratis
History of Birth Workers

Doulas/godsibs, were always servants and loved ones. Historically they were women who weren't paid for their expertise and assistance during your labor and birth, and historically they had all had birth experience themselves so that they could be considered competent help for the midwife and mama.

Fast forward to today - a doula is now a profession. A profession means that we need to get paid so that we can continue to offer this service to women and don't need to go get a 9-5. We no longer live in an age of indentured servants and a strong local community of women who have experienced normal, natural, physiological labor and birth. So we who have embraced the profession and calling of a doula have had to learn the art of doula work. See here for more information .

I receive around 4 requests a month of women looking for free or reduced cost doula services. Most of them are not because a woman truly cannot afford our services; most of the time it's because they believe that, just because every woman deserves a doula, she is entitled to a doula. That, m'dear, is simply not true.

You're not entitled to a doula any more than you are entitled to a mechanic, or a chiropractor, or a college education. You deserve all of these things, but you are not entitled to them.

Entitlement is to have a right or claim to something, either by virtue of who you are within a certain social or professional network, by law within a given society or organization, or simply being human (i.e. basic human rights).

Deserving is to do something or have or show qualities worthy of a thing deserved. To be worthy of. 

Yes, every woman is worthy of deserving a doula. And every doula is worthy of getting paid for her work.

Now there's also a new concept going around the doula community recently. This concept irks me to no end just as much as the entitlement concept does... it's that our profession is a luxury. This concept stems from the ProDoula campaign to 'elevate the profession of the doula'.

Now, while I commend their vim, and agree that we are professionals and should treat ourselves as such (see earlier posts), we cannot lose sight of what our profession is historically and in terms of the current childbirth climate.

Let's break this bad baby down, shall we?

Luxury is the state of great comfort and extravagant living. Opulence or extravagance. Lavishness.
Profession is a paid occupation, especially one that involves prolonged training and a formal qualification.
To Elevate is to raise something to a higher position. To make it more important or impressive. 

We need to be careful of our words - because our words will exclude or include, promote or reject the heart of our profession and the women we serve...

Yes, a doula is a profession. By merit, so that we can provide this service, it is a paid one, and rightly so. Times have changed and it is a necessity.

No, it was never meant to be elevated. Being a doula isn't about how important and impressive I am... It's about how important and impressive the women we serve are. 

And finally, I am damned well not a luxury item. 

Doulas are a safety measure. It's helpful to look at doulas in terms of value, rather than cost. They put in many hours with each client, doing their best to help them have the healthiest and most positive birth experience possible--keeping you out of surgery and your baby out of special care. It's hard to put a price on that kind of experience. - Improving Birth

As I pointed out in prior posts, and specifically in the history of birth partners, doulas and midwives were not only meant for those women who could afford them. A doula was never a luxury item, although the term we use for our profession is one of luxury.

Doulas and midwives, godsibs and sage femme, historically went to every woman - not only those who could afford one. We trudged through hell and high water to ensure she had a good, supportive birth because we believed in a woman's worthiness to have it - not because of what she could provide us.

I love how Doula Speak puts this:

Well...Depending on what camp you sit in, either could be true. If you narrow your opic to the individual business level you may experience confirmation bias and for your own purposes define doula support as a luxury. With this perspective it makes it easier to be more "hard nosed" about your business model and putting earning before anything philanthropic. After all luxuries should be paid for. But this falls apart when you widen the optic and look at birth outside of your own business goals. The research is clear. Continuous Labour Support is vital to achieving better outcomes for mothers and babies.

Vital. Necessary. Not a luxury. 

So what can we come away with from all of this?

FACT: every woman is not entitled to a doula
FACT: every woman deserves a doula
FACT: the role of a doula is a profession worthy of compensation
FACT: our profession is vital and necessary to achieving better outcomes for health of moms and babies

I love Cassandra Jiminez' response below:

" I think it's a deeper issue of women appreciating their intrinsic value as human beings and we deserve to be taken care of and safe. My safety & well being are worth the cost of a doula and vice versa, my work as a doula is both necessary and valuable and I deserve to be compensated for my services."

What camp do you fall into? Do you consider yourself a Jaguar or a Louis Vuitton handbag; awesome but totally unnecessary?  Do you see your business as something that should be put on a pedestal for women to fawn over because of how great your role is? Or do you feel your work is worthy of compensation, completely important, relevant, and necessary, and have a heart of servitude for the women that you are given the honor of attending?

Bathrooms or Birthrooms

It happens - mama is laboring along and someone, whether it's mom herself, her partner, her doula, or her provider, suggests she go to the bathroom for awhile. I get a little happy flutter in my belly, I love when mom labors in the bathroom... or, as many of us birth workers consider it, the birth room.

Yes bathrooms are where we relieve our bladders and our bottoms, or where we wash up... but, it's also where we have been conditioned to completely let go. We let go and urinate. We let go and pass gas and poo. We let go and sing in the shower. We let go and have a good cry when we need to be alone and find some solitude. Birthrooms, err, I mean BATHrooms, are a great place to let go.... and labor and birth is all about letting go.

The bathroom is full of great tools to use during labor and birth. It's no coincidence that women progress so well when they are in the bathroom. And here, in this post, we're going to break down all of these lovely tools, one by one.


THE TOILET, aka the magical birthing throne

The toilet is one of the most powerful labor and birthing tools in the bathroom. And no doubt the reason why: we have been conditioned to relax our pelvic floor when sitting on it! So if a mama needs to get her baby deeper in the pelvis, or  needs help relaxing and completely letting go, or getting a stronger or better labor pattern going, or simply emptying her bladder - this is the place to do it. It also allows mom to rest while allowing her physiology and natural law (gravity) work in her favor. 

"OK. So we have you on the toilet and now you’re pretty comfy. You can rest your upper body and head on the pillows. You can close your eyes and sleep (between contractions). We’ll get your partner on a stool or the birth ball behind you ready with a back massage during your rests and double hip squeeze or direct pressure during the contraction. And we’ll likely ask you to stay here 20-30 minutes. Maybe longer. Yep. Because it makes a difference. 

It’s probably clear that the toilet is a similar shape, size and height to a birth stool. So it makes sense that this is good place to hang out. But we’re here not because you are ready to push, we’re here to either get contractions longer, stronger, and closer together or baby to move down or both. And it seems to work. Here’s why: in addition to harnessing gravity, and getting you into a position that opens your pelvis while supporting you to rest, the open space in the toilet seat allows you freedom of movement to rock and sway your pelvis during your contractions. This movement makes a huge difference and can be just what is needed between lovely spells of resting to bring your baby down and progress your labor.  And let’s talk (for just a second) about how psycho-somatically, this the perfect place for your body to remember how to let your lower sphincters open. ‘Nuff said? Thought so."

- Baby Bump Services, Laboring on the Loo (an EXCELLENT article, go read the whole thing)

THE DRAIN, aka what happens in the bathroom stays in the bathroom

The drain is a great tool that is oftentimes overlooked... But let's not forget that birth oftentimes means that there is going to be a great amount of body fluids involved. And for this reason, the drain is so very helpful. 

Ok, so truth be told, some women have a really hard time going potty on the potty during labor. Sometimes, it's because there are other people around (performance anxiety), and for other women it's because sitting 'disallows' for her bladder to release, for positional reasons. In both of these cases, I'll sometimes encourage mom to stand over the bathroom drain, or in the shower/tub to urinate. Some moms find that standing, or standing and leaning, or even squatting, allows for her to completely release her bladder through swaying and swinging during contractions. 

Drains allow for that freedom and quick clean up. 

Likewise, if a mom is feeling very nauseous and has 'emesis basin retraction' (as soon as you offer her the place to vomit she swallows it back again, only to repeat with the next contraction), some women are given 'permission' if they are allowed to just 'let it go' (yeah, there are a number of you who started singing right then). 

It might not be pretty, but it gets the job done when other tools have failed; and for that, I am eternally grateful to the almighty drain!

THE SHOWER, aka the fount of oxytocin

Since we're still in the shower/tub and talking about the almighty drain, let's just stay here a moment and transition into our next tool, the shower. The shower is a helpful tool throughout all of labor. If your shower has a stationary head, the shower stream can provide excellent nipple stimulation if you place a washcloth over your breasts and aim the stream at your chest and belly. It can also provide a great distraction from back labor if it is directed at your back. 

If your shower has a removable shower head, you can focus the heat and rhythm of the shower stream to your aches. This can mean that you direct the shower stream to your lower back, your belly, or even against your perineum/inner thighs. 

Heat relaxes your muscles and melts away tension, while the invigorating rhythms of the shower get blood flowing and wake the body and mind up. Standing, or sitting on a stool or birth ball, while in the shower allows the woman to remain upright, giving gravity a chance to work in her favor throughout early and active labor. And finally, the shower itself provides enough distraction to the nerve endings that many women find showers to make contractions both stronger (because of the oxytocin produced from tactile stimulation) and easier.


THE TUB, aka the aquadural

Yes, it's been called the aquadural for good reason. The birth pool is oftentimes considered the best method of pain management during labor and birth.

Complete immersion in a tub or birthing pool is best reserved for when labor is active, unlike the shower, which can be used at nearly any time during labor. The reason for this is because the tub can sometimes space out contractions if used too early in labor - because mom isn't using gravity for progress and she relaxes a little too much for the uterus to be as effective as other positions.

That said, if the laboring mama is having a long early stage of labor, or if she is looking for a way to slow things down or stop them to get some rest during the early stage, the tub can help mom to achieve that.

"The warmth of the water on the mother's body can be very mentally and physically relaxing. The water pressure can help alleviate muscle tension and back pain. The effects of immersion in water may be summarized as the following: bathing provides buoyancy and warmth, both of which often bring immediate pain relief, relaxation, lowering of catecholamines, increases oxytocin, and more rapid active labor progress."

- The Labor Progress Handbook, by Penny Simkins and Ruth Ancheta

THE DOOR, aka the support that just won't stop

The door to the bathroom is a powerful thing. It gives mom power over whom is invited into a small and intimate space for her birthing journey. If she feels she has too many people watching her, or she feels the need to have some completely alone time, she simply invites those people she wants into her little cave of birthing energy and shuts out the rest.

So yes, the door is a tool when used how a door was actually intended to be used.

But, there are other ways that a door is tool for labor. One of these is for body work by using the door and door frame itself. If you happen to experience round ligament or hip tightness during labor, between contractions simply put your hip against the door frame and twist until the stretch releases that tension. Be sure to repeat on the other side so that you are balanced.

This stretching is great because, oftentimes, tension on one side of the pelvis/hip/thigh and not the other can be a sign that baby is coming down a little asynclitic. Stretching not only feels great, but can actually encourage baby to rotate and straighten out as it balances out the inner workings, tendons, and ligaments of the pelvis and pelvic floor.

http://eliteathletic.com/

Another exercise that can be done with the bathroom door frame is to do posterior pelvic tilts (aka, lift and tucks) against the door jamb. This exercise is perfect for posterior bubs, or any labor, in which mama is experiencing back discomfort. To do this, simply place a towel between mama's rump/lower back and the door frame. Then, at the start of a contraction, mama should press her lower back flat against the frame/towel, tucking her tailbone under, and lifting her belly to tuck it into her body.

Some women enjoy doing this as a continuous motion (tuck/tilt, release, tuck/tilt, release) whereas other women prefer to tuck/tilt and hold throughout the contraction. This can help get a baby lower in the pelvis, tuck their chin to their chest, or rotate. It can help mom by providing comfort and pain relief, along with give them a great tool that they can provide for themselves - which is a very powerful and positive thing to give mom.

And our final use for the bathroom door is to use the door itself as an addition to the rebozo. You can make a knot in the top of a rebozo, other long scarf (think baby wrap) or sheet, hang it over the top of the door, then shut the door to anchor it in place. Voila! You have an anchored laboring tool that mom can pull on, hang from, squat with, etc... This gives mom confidence and security to be able to get into many positions that she might feel a little wary of otherwise getting into.

If possible though, and unlike the picture linked, TRY to have the rebozo hanging down from the opposite direction that the door opens toward. This will ensure that someone on the outside of the door doesn't accidentally unlatch the door, loosening the anchor, and sending mama onto the floor!

IN CONCLUSION

I hope that our little trip into the bathroom has helped you see how a truly great birthroom the water closet can be! I didn't even touch on the acoustics of the tiled walls/floor and how it helps mama to open up her glottis. I didn't even get to talking about the usefulness of the sink. There are still so many more tools to be found in the bathroom that help make labor and birth a more fluid, efficient, and comfortable event.

But tell me, did you labor in the bathroom? If so, tell me your story (or link it) below!

Scapegoats and Birth Teams

Dear Nurse -

"I don't like doulas. Just in case my actions didn't make it obvious enough, let me spell it out for you - 'your presence isn't welcome. You complicate my job and my relationship with the doctor."

I'm sorry that you have been bullied by the hospital contractors enough that you feel the need to treat doulas like that. I get it, I do. A doula's presence can sometimes make your job harder, no matter how hard we try to make it easier.

A doula's presence should allow you more freedom to focus on the details of your job - like charting, other rooms where women don't have additional support, and supporting mom in the medical aspect of her care. A doula should be able to focus her attention on physically and emotionally supporting mom during her labor, changing out linens, helping mom to the bathroom, helping her into different positions, cleaning up her messes, and getting her fluids and nourishment.

Sometimes, though, our presence can complicate your position. Sometimes, when we see a medical provider attempting to coerce mom into interventions or medications for the sake of the providers comfort, schedule, or personal bias, we might have to put on our advocacy and educator hats. This can place you between that proverbial rock and hard place.

Please remember though, we aren't the bad guys. Bad policies, medical advice for the doctor's best interests, and convenience sake are the culprits for the position that you are in. A doctor who bullies mom most likely also bullies nurse when nurse doesn't follow through with their orders - even if it is mom's refusal of those orders that made it so that you cannot fulfill those orders.

But let's call a spade a spade, shall we?

The provider wants you to do xyz to mom. Mom asks educated questions about xyz, and you repeat what you have been told to repeat; that it's 'necessary and non-negotiable'. I remind mom of her rights as a consumer and patient and offer, while attempting to include you in the conversation, other possible options.  

You update doc that mom has opted for abc and will be forgoing xyz. Doctor doesn't like this answer and puts the pressure on you to 'finish the job' that he wanted you to do in the first place. You are put in a hard place. It would've been so much easier if I wasn't there so that you could do xyz. 

Whose fault is this awkwardness really? Mom's for being a proactive partner in her own healthcare? Your's for not assaulting mom to complete what mom has refused? Mine for educating her so that she can have the best chance at achieving a birthing experience that is both safe and fulfilling? Or the provider's for attempting to manipulate both you and the mother?

Your anger and frustration is misplaced. I get it, it's hard to properly place blame when the blame rests on someone who can make or break your career. But to remain silent when you're being mistreated by your superiors is simply enabling them to continue mistreating you. And displacing that blame onto my shoulders only perpetuates the cycle of mistreatment. In essence, doulas become the scapegoat for your dissatisfaction for the way you are treated by your boss.

Did you know that a doula would be happy to back you up if you were to report a provider for mistreatment? Did you know that a mom would have your back in an instant if you had hers? And did you know that, if we began to demand more ethical treatment on all levels of healthcare, and worked together instead of offering up scapegoats for sacrifice, we could really make a difference?

So make your statement earlier or a little more honest and a little less enabling... "Cole, your presence complicates things. I was taking it out on you earlier because it's difficult to stand up to this doctor. Having an educated patient with a solid support team that advocates for her options ticks this doctor off... and he takes it out on me."

Additional reading:
https://www.amsn.org/sites/default/files/documents/practice-resources/healthy-work-environment/resources/MSNJ_Murray_18_05.pdf

It's Just Going To Hurt - And I'm Sorry

eventful.com

My husband and I went to a local comedy joint, as we often do, and had the privilege of watching the act of inspirational comedian, Darryl Lenox. Darryl is a man who's personal struggles, both physical and emotional, have provided him with the substance needed to bring his audience to chuckles and tears, motivation and amusement.

At one point, while talking about his eye surgery, he begins to explain how his cataracts were extensive enough that his pain medication wasn't touching the discomfort he was feeling. 

His doctor offered to stop the surgery, or to put him out with general anesthesia. Darryl replied that he didn't want to be put under general anesthesia because, in the event the surgery went awry and he lost his sight completely, he wanted to 'watch the lights go out'.

So his doctor made a very profound statement:

"This is just gonna hurt, and I'm sorry." - Darryl Lenox, 'Blind Ambition'

How many times in our lives would that statement have been helpful? Darryl expounds upon this by giving us a bit of humor.. It would be helpful to have this advice in high school, during our wedding vows, and so many other times... 

And what about birth? There are times when I hold a woman's hands while she is piercing me with the 'look beyond the birthing room' stare. She breathes heavily on my face and gasps, "but it hurts!"... and I do, I hold her gaze and earnestly say, "this is just going to hurt, and I'm sorry." 

Sometimes labor's just uncomfortable, but sometimes it hurts. I'm always honest with my mamas, but sometimes my best tool is to give her this type of honesty.  Breath awareness, counterpressure, massage, mantras... sometimes they all fall to the wayside and we are left with the root of it. 

This is just going to hurt, and I'm sorry.

Acceptance

and Surrender

How much freer could some mamas be, could we all be, if we were given that raw honesty so that we could accept, and surrender to, it? 

Small-Minded Birth Workers

Some of you might know, or it may come as no surprise to you that don't know, that there are a number doula support groups on Facebook.

The intent of these pages are many-fold. Some are intended to help you grow your business, others are on ethics and peer review, while others are for mentoring and local/community support. Most of these are a combination of some sort.

Now, recently a doula friend of mine, who is a member of one such board, sent me a screen shot of a current conversation.

The focus of this group is outlined as such:

" We are strong business women. This group was formed because _____ saw a need in the doula industry.  ____ trainers wanted a place where doulas could discuss the business side of doula work.

This is a forum where we will be sharing marketing ideas, business strategies, answering questions and facilitating discussions. The purpose and intention of this group is to spread the  _______ message.  _______ is dedicated to helping women turn their passion into a paycheck.  _______ believes that Doulas should be paid for the services they provide and believe it is counter-productive to the industry when other Doulas provide these services for free or low cost."

Ok, duly noted that they don't promote or believe that doulas should offer their services for free or low-cost.

And duly noted that they say in their description that they are a group about the BUSINESS of doula work, But... 

But what I don't understand is how these 'professionals' can pretend that they are professional when they make disparaging remarks and ridicule others in the same profession for having differing business practices.

If we lose site of the heart of what a birth worker is, even/regardless to how it pertains to being a 'business', we cease being community changers. 

Now a side note, many of my fellow doulas and friends, both IRL and online, are a part of this group. Just because they are a part of this group does not mean that they partook in the very unprofessional behavior that you will read herein, or that they support this type of ethic. 

Another aside, I received these screen shots from someone not a part of this conversation - so none of the doulas involved sought me out - I sought them out for their side of the story.

Along the left hand column of this post, you will see a conversation that has since been deleted from the group (per an individual involved in this conversation). Also, since this conversation began, at least two of the women ganged up on have been forcefully booted from the group.

Yes, it's a closed group. Yes, it's a moderated group. And yes, they are allowed to keep whomever they want in the group. That is not the point. The point of this post is the unprofessional, unethical behavior and bullying that occurred in this thread. 

The conversation started with an innocent enough question: "do you see doing a discounted or free birth here and there as your business 'giving back to your community'? I don't."

From one individual who was a part of the conversation, there was some conversation immediately after that initial post that talked about how free and discounted services discounts the work we do as a doula. To which a doula came on and said, "It's making a difference.. it's impacting the community."

The next doula who came on replied a little more directly: "['discounting the work of a doula' poster's name], just because someone has the desire to give freely of THEIR services, THEIR skills and knowledge, THEIR time - does *not* mean that they do not value doula work as a 'profession'. 

That is just small-minded to say, I'm sorry but it is. I see is as less likely for someone who *only* does doula work to be able to do low-fee/free births than someone who offers various services/has another source of income. But those birth workers who *choose* to do that work, shouldn't be put down for it."

Snarky, derisive, rude, and condescending comments begin at that point and blossom into a conversation that is almost too painful to read. These remarks are made by both members and admins of the group, alike. Always lobbed at those who support the right of a doula to choose to give free or discounted services, regardless of their reasons for offering.


I have posted before on my feelings about people asking for low cost or free doula services, but I don't care what side of the fence you are on regarding free and low-cost doula services, the behavior of these moderators and members is completely unethical. 

Ethics: moral principles that govern a person's or group's behavior.
synonyms: moral code, morals, morality, values, rights and wrongs, principles,ideals, standards (of behavior), value system, virtues, dictates of conscience"

It is never professionally ethical to treat someone so disparagingly. Never.

One person asked what principles and basis a dissenter to the 'popular opinion' might be referring to when she said "I cannot disregard the principles and basis of what a Doula was meant for."

Let me expound on that dissenters response... As I pointed out in prior posts, and specifically in the history of birth partners, doulas and midwives were not only meant for those women who could afford them. A doula was never a luxury item, although the term we use for our profession is one of luxury.

Doulas and midwives, godsibs and sage femme, historically went to every woman - not only those who could afford one. We trudged through hell and high water to ensure she had a good, supportive birth because we believed in a woman's worthiness to have it - not because of what she could provide us.

The moderators and contributing members have completely missed the point of this calling. From their own words, it is easy to see that, to them, it is only a business. To them, the 'principles and basis' for what we do for women and why we do it has been lost.



I get wanting to be valued in the community. I get wanting to be seen as a professional in the community. I get it because I wrote about it and continue to write about it. But the militant, aggressive, close-minded, and callous version that they believe? No way, I don't get that.

Hell, midwives in this area take state insurance and, as a default, offer reduced-fee services. Doctors do as well. Chiropractors and massage therapists in this area give reduced fee services and do community services and classes for those who cannot afford it.

Restaurants give free food to the homeless and grocers give food to the food pantries. A local man I know offers car services for the price of parts only on certain Saturdays for single mamas and spouses of deployed partners.

It takes a special kind of business owner to not see the merit of giving back to their community through their services in some capacity. And one I wouldn't want to do business with.

Shame on you, moderators and others involved in this disparaging and bullying thread. Shame on you for doing the very thing that you claim to be avoiding: making the doula profession unprofessional in every regard.

I will think of you next time I spend my time sending packets of information and resources and free samples to the 18 year old who is working her ass off trying to graduate with her class at the end of the year regardless of the fact that her mom and dad have all but disowned her and her baby's daddy is nowhere to be seen.

I'll think of you when I send her the name and number of an amazing midwife in the area that does offer her time and services free of charge just so that she can get out of the care of the only provider that her state insurance will cover that is within walking distance of her home because no one will drive her to a better doctor further away.

I'll think of you when I send her to a stellar up-and-coming doula who has a heart for these situations and plans on, someday, getting her midwifery license and traveling to third-world countries to help train birth professionals in every village.


And I'll think of you when she births her baby, on her own, into her own hands, surrounded by women who cannot disregard the principles and basis of what a Doula was meant for.

- actual situation in my professional past

*edited to black out their pictures ;) after receiving numerous 'requests' (well, threats) from a number of the women involved,. Only one woman contacted me and actually asked. Most of them cited Exploitative Law. But this doesn't fall into that category as seen here. As I told them, my intent was to draw attention to unprofessional behavior in our profession, not to individuals... As is apparent through my blacking out of the offenders names (insert roll eyes).. so I obliged. 

Some said it was yellow journalism. Some said I was muckraking. Some said I was unprofessional for calling them out. But here's the thing: I didn't sensationalize or exaggerate it in the least. Hence the screen shots. It's only muckraking if I a) SOUGHT it out (which I didn't seek out this information b) it's considered 'scandalous'... to which I asked if they thought their behavior was scandalous? and c) they'd have to be famous. :/ 

And would you consider me a bully if I stood up against bullying? That's what's happening here. So there you have it. 


So...

Rather than end on that note, tell me birth workers, how are you giving back to your community. Mamas, what are you doing to give back to those in your sphere of influence. 

My Doula Suggested

If you haven't noticed, I am taking a bit of a comical relief break in my blogging.. This blog post is no exception. So, without further ado, I give you, "My Doula Suggested" (a compilation of suggestions made by doulas that I know and trust, or me).

I Be Like...

Being a birthworker is such a rewarding profession. The ups, the downs, the in-betweens - all equate to one thing = my job is an adventure.

That said, there are ups and downs. This is my unprofessional view of birthwork through a birthworkers eyes.

What I feel like I look like at consultations

What I really look like at consultations

What I look like when I nail the consultation

What I feel like when someone tries to pop a pregnant mama's 

bubble of peace

How I feel when a mama I'm working with switches out of the care of her 

unsupportive provider and into the care of one I have worked with, 

trust, and supports her choices

How I feel when a mama I'm working with says, "I really want a natural

birth" but is unwilling to do anything I recommend to prepare for it or chooses to 

birth at a hospital notorious for cesareans 

How I react when a provider asks a mom if he can strip her

membranes at 36 weeks, 'just to see what happens.' ... 

and she consents

What I look like when a new report, study, or review comes out

regarding pregnancy, birth, or parenting options 

What I feel like when a provider ignores all of those same research, studies,

reports, and reviews for their 'own policies'

How I look while getting ready to head out to a birth

When the on-call steps in the room and says they 'don't do VBACs'

even though mom is ready to push

The face I make when a mom calls me to tell me she ignored

my advice to rest while she could in early labor, instead she

went for a walk, and now she is exhausted, wants to nap, and

labor just kicked into high gear

What it feels like when nurse and I work great like a team and rock it out

with our superstar skills 

The look I give a nurse in triage when

mom is making 9-10cm noises and she says, 'let me just go

get your chart' and leaves the room

What I do when an OB, who has made their first appearance in 

the room for the whole labor, says, "better start preparing for the

possibility of a cesarean. You aren't progressing and I don't see this ending vaginally."

What I do when, 2 hours later, mom is pushing so "well" that the

same OB barely makes it in time 

What I feel like when a mom has been been 'stuck' at 7cm for a millennium

and her baby is floating high in the pelvis and there's rumors circulating
in the room about "plan C"

What I feel like when, 30 minutes after the Parrish Maneuver, fear releasing,

and Walcher's Technique, mom is crowning

My face when I hear a midwife say, "a doula isn't helpful

or necessary at a birth outside the hospital."

What I do when a provider meets me at the door to a laboring

woman's room and says, "I don't like doulas, they are irrelevant

and I have had very bad experiences with them in the past."

What I think of other doulas and midwives who are unethical
(talking trash about other birth workers) and territorial with potential clients

What I do when a mom calls me to tell me she thinks her water

broke, she thinks she's having contractions, or she thinks 

she 'did something to her back' because it's aching

What my face must look like when a provider says they 'can't let mom',

'don't do ___', or tell her she "can't ___'

How daddy and I look when nurse goes to bat for mom's choices

and mom get's the birth she wants

The look I give an OB when they transform into a

midwife before my eyes...

What I probably look like when a provider or nurse takes 

the time and opportunities to teach me something

new and 'above my pay grade' 

What dad and I look like when a mom finds her voice during

labor, becomes empowered, and stands up for what she knows 

she and baby deserve

What I know I look like when a nurse or doctor says that babies

can't be born in any position but on a woman's back

What I do when an OB says for mom to pick whatever position

feels most right for her to birth in

What I do when someone gives advice that is neither medically sound

nor evidence-based on an online forum

What I do when a nurse says, "epidurals are completely safe

and have no real risks."

What I do when a midwife, mom herself, or partner ask if I will help mom

to do nipple stimulation

What I feel like for every. single. VBAC mama

What I feel for every single mama after she birth

What I look like when I get off a 32 hour shift and stumble into my home

And why I would do it all again after just a few hours rest