There was a neonatal physician on the local 5 o'clock news this week who made this statement, "Having a baby as few as four days early increases the newborn complications risk by 20%!" and the statement was made that, "Northside Hospital the nations busiest labor and delivery center with over 18,000 births per year supposedly issued a new rule that women can not schedule an elective c-section or be induced before their 39th week of pregnancy." But my experience working with moms who give birth in the Atlanta metro area- and yes even at Northside is that is not being done. Doctors seem to be able to find a medical reason for an induction even when the birth later shows the risks were not there.
Who is doing all of these inductions? What is causing this to happen? I believe it is not only the doctors who schedule inductions and cesareans for factors that include convenience as well as malpractice concerns, but it is women who are demanding it. The doctor in this interview eludes to moms getting tired during their pregnancy and wanting to have the baby born. So, do no harm should mean that the doctor advises a mom that this is risky. That not only will an induction lead to more of a chance of a surgical birth, but more risks that she will not be bringing her baby home when she is discharged.
I can tell you that I have conversations almost weekly from moms who were induced or told to have a surgical birth due to their baby being too big. Then the baby is born and is well within the normal range of size. She then goes on to have a vaginal birth with a subsequent child who is much larger than the first. What happened? Did her pelvis get larger the next pregnancy?
This is a link to the original newscast:
http://www.myfoxatlanta.com/myfox/pages/News/Detail?contentId=8311537&version=2&locale=EN-US&layoutCode=TSTY&pageId=3.5.1
The news story went on to state, "The number of Cesarean sections has skyrocketed in recent years. One out of every three babies is now delivered surgically. New research shows women may want to think twice about scheduling an early delivery."
The news reporter, Beth Glavin states that "a pregnancy is considered full term at 37 weeks." But since often a woman does not know exactly when she conceived or when she actually ovulated it is difficult to know for sure if she is 37 weeks or 36 weeks and three days for example.
One OB online states "A normal pregnancy should last 38 weeks if you count from the day of conception. However, the day of conception is not always easy to determine, especially in the ancient past. Therefore, people then have used 40 weeks from the first day of the last menstrual period, on the assumption that women have 28 day cycles and they conceive 14 days after the start of their menses.This traditional way of counting has been in use till now.
Therefore, when we say you are 10 weeks pregnant, you have actually conceived 8 weeks ago. Based on this type of calculation, a pregnancy will have the expected date of delivery at 40 completed weeks but a pregnancy that has completed 37 weeks is considered full term already.
Beth states that "the recommendation is that a woman wait until she is 39 weeks to consider having a planned cesarean." But since inductions can lead to a cesarean = then shouldn't a woman wait until 39 weeks to consider even being induced? The doctor on the news report says every week of early birth due to inductions can cause the risks to the newborn escalate. It is due to lung and brain development. "Before 39 weeks the baby is just not ready."
This is another story - more reseach showing the risks of early inductions and cesarean births:
http://www.foxnews.com/story/0,2933,477687,00.html?sPage=fnc/health/pregnancy
The study showed, "More than a third of the C-sections were performed before 39 weeks, the researchers found. Those delivered at 37 weeks were twice as likely to have health problems, including breathing troubles, infections, low blood sugar or the need for intensive care. Fifteen percent of those born at 37 weeks and 11 percent born at 38 weeks had complications, compared to 8 percent of the babies delivered at 39 weeks."
A dream of mine would be for women to trust their bodies. For babies to select their day to be born. If a mom is more high risks, sure do non stress tests and biophysicals to insure that the baby is doing great. But the stress of going "late" and having a baby "on time" needs to end. We need to embrace that nature did not make a mistake. That MD does not stand for minor deity. That we can decide if we are going to get on that induction train or not. That the induction police don't come and pick us up to drag us to have our babies. We must begin to take responsibility for our health and the health of our babies.
It begins with trusting our bodies. And it also goes to trusting our care providers. So if a care provider says an induction or cesarean is needed- ask more questions. Know the risks. Weigh their guestimations with knowledge and with what the studies show- wait if you can.
Thursday, January 29, 2009
Saturday, January 24, 2009
the secret
There is a secret in our culture,
And it's not that childbirth is painful,
It's that women are strong.
-Laurie Stavoe Harm
Why are we so scared of pain? Why do we think we can not do it? Why do we believe we have a low threshold of pain in birth? Why have we bought the lie that we are weak? Why have we allowed birth to no longer be our journey that allows us to see our strengths? Why were the women before us able to handle it? What made them so different from us? Why do we see the pain of childbirth as being bad rather than good pain? Why are we so scared to see it as a challenge before us instead of something to run from?
Women of Earth
Take Back Your Birth!
And it's not that childbirth is painful,
It's that women are strong.
-Laurie Stavoe Harm
Why are we so scared of pain? Why do we think we can not do it? Why do we believe we have a low threshold of pain in birth? Why have we bought the lie that we are weak? Why have we allowed birth to no longer be our journey that allows us to see our strengths? Why were the women before us able to handle it? What made them so different from us? Why do we see the pain of childbirth as being bad rather than good pain? Why are we so scared to see it as a challenge before us instead of something to run from?
Women of Earth
Take Back Your Birth!
Friday, January 16, 2009
Estimating Due Dates
Due Dates
How accurate is your Due Date?
How are due dates calculated?
In the 1850's, a Dr. Naegele determined the average length of human gestation was 266 days from conception, or 280 days (40 weeks) from last menstrual period. He assumed that the average woman had cycles that lasted 28 days and that she ovulated on Day 14 of her cycle. He used his data to come up with a mathematical calculation for due dates:
((1st day of your last menstrural period -LMP + 7 days) - 3 months) = Due Date. EX: ((January 1, 1996 + 7 days) - 3 months) = October 8, 1996
This is still the standard method used to calculate due date, despite the fact that it doesn't take into account: that many women are uncertain of the date of their last menstrual period and not all women ovulate on day 14. Other factors which affect term are: mother's age, ethnicity, prenatal care, prenatal nutrition, number of prior pregnancies.
Another Calculation
A more recent study (Mittendorf, 1990) indicates that term for uncomplicated pregnancies in first-time, Caucasian mothers, averages 274 days from ovulation. It averages 269 days for mothers who've given birth before. The abstract says non-Caucasian pregnancies are shorter than Caucasian, but doesn't give statistics.
*To calculate a due date: Take starting date of last menstrual period. Subtract 3 months. Add 15 days. (10 days if you're non-white, or this is not your first baby.)
What else can be done to determine fetal age?
If ultrasound is performed in the first half of pregnancy, it can indicate fetal age within a range of 7 - 10 days.
Fetal heart tones can be heard through Doppler starting at 9-12 weeks and by stethoscope at 18-20 weeks.
Some believe the baby will come five months after quickening, the first time the mother feels the baby move. This is hard to evaluate, as women can be more or less sensitive to these sensations, and may notice them at different times in their pregnancies. (First time mothers typically notice movement around 18-20 weeks. Mothers who have been pregnant before notice it as early as 16 weeks.)
Fundal height, the measurement of the uterus done throughout pregnancy, can indicate the size of the baby, which can give insight about fetal age.
When will my baby be born?
Only 4% of babies are actually born on their "due dates". 6-10% of babies are born early - prior to 37 weeks; 4-14% of pregnancies last more then 42 weeks.
If this leaves you very confused, just realize that predicting due dates is a very inexact science, and it's probably best to plan ahead of time for the baby to come anywhere between 2 weeks before and 2 weeks after your due date.
For more on due dates, read: Calculating Due Dates and the Impact of Mistaken Estimates of Gestational Age
Sources: "How long is too long?" by Penny Simkin, Childbirth Forum, Spring 1993. Abstract for "The Length of Uncomplicated Human Gestation" by Mittendorf et al
Obstetrics & Gynecology, V.75, N.6, June 1990. "When will my baby be born?" found at http://pregnancy.about.com/library/weekly/aa042197.htm "Pregnancy past your due date" by Terri Isidro-Cloudas on www.americanbaby.com
How accurate is your Due Date?
How are due dates calculated?
In the 1850's, a Dr. Naegele determined the average length of human gestation was 266 days from conception, or 280 days (40 weeks) from last menstrual period. He assumed that the average woman had cycles that lasted 28 days and that she ovulated on Day 14 of her cycle. He used his data to come up with a mathematical calculation for due dates:
((1st day of your last menstrural period -LMP + 7 days) - 3 months) = Due Date. EX: ((January 1, 1996 + 7 days) - 3 months) = October 8, 1996
This is still the standard method used to calculate due date, despite the fact that it doesn't take into account: that many women are uncertain of the date of their last menstrual period and not all women ovulate on day 14. Other factors which affect term are: mother's age, ethnicity, prenatal care, prenatal nutrition, number of prior pregnancies.
Another Calculation
A more recent study (Mittendorf, 1990) indicates that term for uncomplicated pregnancies in first-time, Caucasian mothers, averages 274 days from ovulation. It averages 269 days for mothers who've given birth before. The abstract says non-Caucasian pregnancies are shorter than Caucasian, but doesn't give statistics.
*To calculate a due date: Take starting date of last menstrual period. Subtract 3 months. Add 15 days. (10 days if you're non-white, or this is not your first baby.)
What else can be done to determine fetal age?
If ultrasound is performed in the first half of pregnancy, it can indicate fetal age within a range of 7 - 10 days.
Fetal heart tones can be heard through Doppler starting at 9-12 weeks and by stethoscope at 18-20 weeks.
Some believe the baby will come five months after quickening, the first time the mother feels the baby move. This is hard to evaluate, as women can be more or less sensitive to these sensations, and may notice them at different times in their pregnancies. (First time mothers typically notice movement around 18-20 weeks. Mothers who have been pregnant before notice it as early as 16 weeks.)
Fundal height, the measurement of the uterus done throughout pregnancy, can indicate the size of the baby, which can give insight about fetal age.
When will my baby be born?
Only 4% of babies are actually born on their "due dates". 6-10% of babies are born early - prior to 37 weeks; 4-14% of pregnancies last more then 42 weeks.
If this leaves you very confused, just realize that predicting due dates is a very inexact science, and it's probably best to plan ahead of time for the baby to come anywhere between 2 weeks before and 2 weeks after your due date.
For more on due dates, read: Calculating Due Dates and the Impact of Mistaken Estimates of Gestational Age
Sources: "How long is too long?" by Penny Simkin, Childbirth Forum, Spring 1993. Abstract for "The Length of Uncomplicated Human Gestation" by Mittendorf et al
Obstetrics & Gynecology, V.75, N.6, June 1990. "When will my baby be born?" found at http://pregnancy.about.com/library/weekly/aa042197.htm "Pregnancy past your due date" by Terri Isidro-Cloudas on www.americanbaby.com
Wednesday, January 14, 2009
Does insurance pay?
"Upon your recommendation, we submitted your fee to our health insurance (United Healthcare) and received word back from them just before the year ended. They covered the doula fee almost 100% (they wrote me a check for $7 less than the fee we paid you)!! I couldn’t believe it when I got the claim notice. I thought for sure we’d have to resubmit a few times with explanation or backup documentation, but it all went through without any of that. I was thrilled to get the notice in the mail and wanted to let you know too. We would have still contracted you as our doula even without the option of getting reimbursed by insurance, so this was just a bonus. Please feel free to relate this on to Teresa or any of your clients."
We think you should always consider filing with your insurance company. We provide a form - a superbill - for you to send in to your insurance company AFTER the birth. Don't contact them ahead of time. Wait to send it in afterward. If you have a less interventive birth, then the likelihood increases that they will consider it. If they tell you up front they will not, no matter what- they will not since it is documented that they told you so.
You can go to www.cappa.net or www.dona.org and copy their position paper documenting the effects of using a doula to substantiate the cost being a benefit to your labor and birth outcome.
Most pretax programs not only cover doula services but also many of our classes.
We think you should always consider filing with your insurance company. We provide a form - a superbill - for you to send in to your insurance company AFTER the birth. Don't contact them ahead of time. Wait to send it in afterward. If you have a less interventive birth, then the likelihood increases that they will consider it. If they tell you up front they will not, no matter what- they will not since it is documented that they told you so.
You can go to www.cappa.net or www.dona.org and copy their position paper documenting the effects of using a doula to substantiate the cost being a benefit to your labor and birth outcome.
Most pretax programs not only cover doula services but also many of our classes.
Letter from April
March 19, 2007
To Whom It May Concern:
Patient enduring reliable supportive irreplaceable sistah! That is what comes to mind when I think of Persis Bristol Dodson. I am not sure what her mothers intentions were when she gave Persis that name but that is what it means to me. P.E.R.S.I.S. was truly a God send.
At already 8 months and taking various child prep classes, I had heard of a Doula wanted one but did not know where to even begin looking for one. Persis was an interpreter for one of my classes and offered her services to me. This could not have come at a better or more needed time. Shortly after we met only once I began labor for my first baby.
We hadn’t had time to even discuss birth plans or even enter a contract and Persis was there and stayed with me the entire time. I felt so relaxed and confident that I could do it with her help constantly reassuring me that all is fine and that every inch was taking me closer to the end. Never leaving me to feel alone or misunderstood. All of my family and friends were nervous, tired and stressed at one point or another but Persis was undaunted by the task and stood as my knight. She’s so necessary that I have come to the conclusion that she is needed for all of my future children as well. To give birth without Persis almost seems unnatural!
I can’t seem to thank her enough!
April Lee Mbakop
To Whom It May Concern:
Patient enduring reliable supportive irreplaceable sistah! That is what comes to mind when I think of Persis Bristol Dodson. I am not sure what her mothers intentions were when she gave Persis that name but that is what it means to me. P.E.R.S.I.S. was truly a God send.
At already 8 months and taking various child prep classes, I had heard of a Doula wanted one but did not know where to even begin looking for one. Persis was an interpreter for one of my classes and offered her services to me. This could not have come at a better or more needed time. Shortly after we met only once I began labor for my first baby.
We hadn’t had time to even discuss birth plans or even enter a contract and Persis was there and stayed with me the entire time. I felt so relaxed and confident that I could do it with her help constantly reassuring me that all is fine and that every inch was taking me closer to the end. Never leaving me to feel alone or misunderstood. All of my family and friends were nervous, tired and stressed at one point or another but Persis was undaunted by the task and stood as my knight. She’s so necessary that I have come to the conclusion that she is needed for all of my future children as well. To give birth without Persis almost seems unnatural!
I can’t seem to thank her enough!
April Lee Mbakop
Letter from Sherri
January 28, 2005
From: Sherri Paterson
To: Prospective Client of Guina Bixler
Subject: Letter of Recommendation
Early in my pregnancy I was diagnosed with Placenta Previa. It was looking for a while that I would likely have a scheduled C-Section. So, for a long time, I did not think I would need a doula. I had meet a couple of doulas (not affiliated w/ Labor of Love) early on in my pregnancy, but by the time I found out the placenta had moved out of the way in week 32 the doula's I meet where booked up!
Luckily, I had been going to the Norcross YMCA and met Kate, a Prenatal Aquatics Instructor. As a doula student herself, she referred me to www.cappa.com. In turn, I saw a Labor of Love doula on the list (Teresa) and was then referred to Guina. Who I was told up front, was a very gentle, soothing doula.
Teresa was certainly right….. Guina has an extremely gentle and soothing, grace under pressure spirit. My husband, Troy and I felt comfortable with her from our first meeting. It was great to have found a doula and we felt good knowing that Labor of Love had several doula's in case Guina had 2 births in the same night, there would be a back-up doula available. Luckily, the night I went into labor, Guina was ready and available.
I was 4 days past my due date when I went into labor and was READY to have the baby! I started labor on Dec. 1st at 4:30 p.m. and went to the hospital at 10:30 p.m. Guina met us at the hospital shortly after midnight. She found us in the hallway walking around. She showed me how to "squat" and hold onto the rails in the halls, which helped my contractions. During my 24-hour labor Guina and my husband Troy were there. As well as hospital staff and Troy's parents periodically.
During my very looooong labor Guina helped us with breathing techniques, massages (as I had back and leg spasms), birthing ball (which rocks! I loved rotating my hips, and got in a trace-like state to get through the contractions), soft music was played, she used lavender massage lotion and oils, affirmations and mantras to get through the labor. Unfortunately for me labor was felt from 2cm and upwards it just got more and more intense! If I had not done some of the techniques Guina showed us I never would have made it to 8cm. Near the end of my labor I had pain meds and an epidural. Good thing too because to everyone's surprise, when I was at 8cm my placenta ruptured. An emergency C-Section was done.
I am happy to say Ben and I we're doing fine. I was weak after the labor, as would be expected. I think Ben was actually doing better than I was, at that point!! We stayed in the hospital for a few days and went home healthy and very happy!
Ben is now 4 mos. old and is doing great. I am recovered from my C-Section and have been back at the gym recently, which is just wonderful!
Guina came by to visit us not too long ago and brought us some pictures during labor and Ben's Birth Story. It was such a wonderful experience that I highly recommend and of course I highly recommend Guina as a doula.
Sincerely,
Sherri Paterson, a.k.a. Ben's Mom
From: Sherri Paterson
To: Prospective Client of Guina Bixler
Subject: Letter of Recommendation
Early in my pregnancy I was diagnosed with Placenta Previa. It was looking for a while that I would likely have a scheduled C-Section. So, for a long time, I did not think I would need a doula. I had meet a couple of doulas (not affiliated w/ Labor of Love) early on in my pregnancy, but by the time I found out the placenta had moved out of the way in week 32 the doula's I meet where booked up!
Luckily, I had been going to the Norcross YMCA and met Kate, a Prenatal Aquatics Instructor. As a doula student herself, she referred me to www.cappa.com. In turn, I saw a Labor of Love doula on the list (Teresa) and was then referred to Guina. Who I was told up front, was a very gentle, soothing doula.
Teresa was certainly right….. Guina has an extremely gentle and soothing, grace under pressure spirit. My husband, Troy and I felt comfortable with her from our first meeting. It was great to have found a doula and we felt good knowing that Labor of Love had several doula's in case Guina had 2 births in the same night, there would be a back-up doula available. Luckily, the night I went into labor, Guina was ready and available.
I was 4 days past my due date when I went into labor and was READY to have the baby! I started labor on Dec. 1st at 4:30 p.m. and went to the hospital at 10:30 p.m. Guina met us at the hospital shortly after midnight. She found us in the hallway walking around. She showed me how to "squat" and hold onto the rails in the halls, which helped my contractions. During my 24-hour labor Guina and my husband Troy were there. As well as hospital staff and Troy's parents periodically.
During my very looooong labor Guina helped us with breathing techniques, massages (as I had back and leg spasms), birthing ball (which rocks! I loved rotating my hips, and got in a trace-like state to get through the contractions), soft music was played, she used lavender massage lotion and oils, affirmations and mantras to get through the labor. Unfortunately for me labor was felt from 2cm and upwards it just got more and more intense! If I had not done some of the techniques Guina showed us I never would have made it to 8cm. Near the end of my labor I had pain meds and an epidural. Good thing too because to everyone's surprise, when I was at 8cm my placenta ruptured. An emergency C-Section was done.
I am happy to say Ben and I we're doing fine. I was weak after the labor, as would be expected. I think Ben was actually doing better than I was, at that point!! We stayed in the hospital for a few days and went home healthy and very happy!
Ben is now 4 mos. old and is doing great. I am recovered from my C-Section and have been back at the gym recently, which is just wonderful!
Guina came by to visit us not too long ago and brought us some pictures during labor and Ben's Birth Story. It was such a wonderful experience that I highly recommend and of course I highly recommend Guina as a doula.
Sincerely,
Sherri Paterson, a.k.a. Ben's Mom
Teresa Howard's training
How Do I Know What I Know?
by Teresa Howard
Experience is something that comes from many sources. I feel that I learn something from each birth I attend. I have personally given birth three times unmedicated. I think my experiences were good ones and I want that for others. I have breastfed all three of my children and was a La Leche League leader for many years. That too is an experience that I cherish and love helping new moms make this a good experience for them as well. Experience comes in many ways- personally having done something, training by other in techniques and being involved with someone else while they are doing it.
I began as a doula in May of 1992 when a friend asked me to come and be with her as a companion to her and her husband. I did this again for a friend in February of 1996. Later that year, in July, I was asked by a friend to be there for her at her fifth birth, my third as a companion. In 1997 I again offered to come and offer guidance to two friends in April and again in November. Then a special invitation to accompany a mom who was my second birth came in January of 1998. I offered my help to a teen friend in March of 1998 and soon after took my doula training as I was hooked at being at births!
My first professional doula birth was in May of 1998. By year end I had attended my 27th birth. The year 2000 allowed me to attend my 100th birth on Christmas Day! In February my youngest daughter gave birth to a son- I attended as her mom and she had a doula- but I feel I used my doula skills at that one for sure! In May 2003 I had the privilege of doulaing my oldest daughter at her birth - that was my 200th birth! At the end of 2008 I had completed my 400th birth as a doula. I average three births per month now and stay really busy.
In the past I have enjoyed being the state representative for CAPPA as well as a labor and postpartum doula trainer and a lactation educator trainer with them. I now stay quite busy running a company of a dozen doulas who cover most of the metro area. I really get affirmation after each birth, after each childbirth class I teach, I know what I am doing now is definitely what i am supposed to be doing. I have found my calling! So many people don't enjoy their work or don't find it fulfilling. That is certainly not my situation!
As a company we have done close to 900 labor supports as a group!
TRAINING
• DONA Labor Doula Training, Anne Tumblin, RN
• When Survivors Give Birth, Penny Simkin, PT
• Precipitous Labor, Emergency Childbirth, Debbie Pulley, CPM
• Birthing From Within, Pam England, CNM
• Joy of Labor, Northside Hospital
• Prenatal Parenting, Frederick Wirth, MD
• Lactation FastTrack
• Midwifery Workshop, Ina May Gaskin, CPM
• Psychotropic Medicine during pregnancy and lactation, Z.Stowe, MD
• Infant and Child CPR
• Another Look, Breastfeeding and HIV, Miriam Thompson
• Physiologic Closure of the Cord, Anne Frye, CPM
• Spinning Babies, Gail Tully, CPM
• Advanced Doula Training- Massage and Reflexology, Donna Johnson, CMT
• Advanced Lamaze Training- Mission Impossible, Ann Tumblin, RN
• Supporting Women through Perinatal Death, Miriam Maslin
• Escorting Women on their Inner Journey, Miriam Maslin
•1st Advanced Skills for Birth and Postpartum Professionals with Leadership from CAPPA
CONFERENCES
• LLLI conference 1980
• DONA conferences 1998, 2000
• CAPPA conferences 2000, 2001, 2002* 2004*, 2007, 2008
• Georgia LLL Conference 2001
• Summit for Safe Motherhood 2001
• Gentle Birth World Congress 2007
• International Cesarean Awareness Network 2009
*also emceed
SPEAKING ENGAGEMENTS
• Georgia LLL Conference 2001
• Joy of Labor Training, Northside Hospital 2001
• Stillwater Yoga Prenatal Workshop 2002
• Prenatal Yoga in Athens, GA 2002-2007
• Natural Mama Expo 2002, 2003
• Interviewed and Appeared on REAL MOMS, REAL STORIES, REAL SAVVY Leading the Way in Women's Health Programming on Public Television
• Panel for questions and answers Birth, the Play by Karen Brody
• International Cesarean Awareness Network:Concurrent Session 2009
by Teresa Howard
Experience is something that comes from many sources. I feel that I learn something from each birth I attend. I have personally given birth three times unmedicated. I think my experiences were good ones and I want that for others. I have breastfed all three of my children and was a La Leche League leader for many years. That too is an experience that I cherish and love helping new moms make this a good experience for them as well. Experience comes in many ways- personally having done something, training by other in techniques and being involved with someone else while they are doing it.
I began as a doula in May of 1992 when a friend asked me to come and be with her as a companion to her and her husband. I did this again for a friend in February of 1996. Later that year, in July, I was asked by a friend to be there for her at her fifth birth, my third as a companion. In 1997 I again offered to come and offer guidance to two friends in April and again in November. Then a special invitation to accompany a mom who was my second birth came in January of 1998. I offered my help to a teen friend in March of 1998 and soon after took my doula training as I was hooked at being at births!
My first professional doula birth was in May of 1998. By year end I had attended my 27th birth. The year 2000 allowed me to attend my 100th birth on Christmas Day! In February my youngest daughter gave birth to a son- I attended as her mom and she had a doula- but I feel I used my doula skills at that one for sure! In May 2003 I had the privilege of doulaing my oldest daughter at her birth - that was my 200th birth! At the end of 2008 I had completed my 400th birth as a doula. I average three births per month now and stay really busy.
In the past I have enjoyed being the state representative for CAPPA as well as a labor and postpartum doula trainer and a lactation educator trainer with them. I now stay quite busy running a company of a dozen doulas who cover most of the metro area. I really get affirmation after each birth, after each childbirth class I teach, I know what I am doing now is definitely what i am supposed to be doing. I have found my calling! So many people don't enjoy their work or don't find it fulfilling. That is certainly not my situation!
As a company we have done close to 900 labor supports as a group!
TRAINING
• DONA Labor Doula Training, Anne Tumblin, RN
• When Survivors Give Birth, Penny Simkin, PT
• Precipitous Labor, Emergency Childbirth, Debbie Pulley, CPM
• Birthing From Within, Pam England, CNM
• Joy of Labor, Northside Hospital
• Prenatal Parenting, Frederick Wirth, MD
• Lactation FastTrack
• Midwifery Workshop, Ina May Gaskin, CPM
• Psychotropic Medicine during pregnancy and lactation, Z.Stowe, MD
• Infant and Child CPR
• Another Look, Breastfeeding and HIV, Miriam Thompson
• Physiologic Closure of the Cord, Anne Frye, CPM
• Spinning Babies, Gail Tully, CPM
• Advanced Doula Training- Massage and Reflexology, Donna Johnson, CMT
• Advanced Lamaze Training- Mission Impossible, Ann Tumblin, RN
• Supporting Women through Perinatal Death, Miriam Maslin
• Escorting Women on their Inner Journey, Miriam Maslin
•1st Advanced Skills for Birth and Postpartum Professionals with Leadership from CAPPA
• Dancing For Birth Trainer Certification Workshop with Stephanie Larson
CONFERENCES
• LLLI conference 1980
• DONA conferences 1998, 2000
• CAPPA conferences 2000, 2001, 2002* 2004*, 2007, 2008
• Georgia LLL Conference 2001
• Summit for Safe Motherhood 2001
• Gentle Birth World Congress 2007
• International Cesarean Awareness Network 2009
*also emceed
SPEAKING ENGAGEMENTS
• Georgia LLL Conference 2001
• Joy of Labor Training, Northside Hospital 2001
• Stillwater Yoga Prenatal Workshop 2002
• Prenatal Yoga in Athens, GA 2002-2007
• Natural Mama Expo 2002, 2003
• Interviewed and Appeared on REAL MOMS, REAL STORIES, REAL SAVVY Leading the Way in Women's Health Programming on Public Television
• Panel for questions and answers Birth, the Play by Karen Brody
• International Cesarean Awareness Network:Concurrent Session 2009
Letter from mom of twins
Here is a letter from a mom who Teresa Howard assisted in having her first children, twins. It was an unmedicated, vaginal birth that was amazing. A few years later, she asked me to return to assist her with the labor of her third child. Again, unmedicated and wonderful! She is totally amazing!
"...When I think about those days,I feel such a close bond with you. I have often felt strange about this, but you are somehow much more than just a healthcare provider hired for just a few hours of advice and service. I had such high hopes for my births, both in terms of medical choices we were able to make but also in wanting
to experience it with joy and confidence and empowerment rather than fear and frustration and regret. And, while I praise God for three wonderful, healthy, medically uncomplicated
births, the warm positive emotions that I feel when thinking about those experiences are due largely to your care and expertise.
I think the other important role you play in my mind is that you give me permission to feel the way I do about childbirth. That it is a normal, natural and healthy process that our bodies know how to do; that it is an experience to be sought after and embraced not avoided through medication or elective surgery; that it can
be a primal, empowering moment that reveals a woman's unknown strength (perhaps most of all to the new mother herself); that the experience itself can be one of the most joyous and
cherished of a woman's life, not just the painful, unavoidable process that resulted in the joy of a child. I don't know that I need permission to embrace these feelings. It's just that they are so rare among my own circle of family and friends that it's nice to have a voice in my head that validates and agrees to them. All that to say Thanks for sharing your
kind memories of me and my children. You will always hold an important and special place in my heart."
"...When I think about those days,I feel such a close bond with you. I have often felt strange about this, but you are somehow much more than just a healthcare provider hired for just a few hours of advice and service. I had such high hopes for my births, both in terms of medical choices we were able to make but also in wanting
to experience it with joy and confidence and empowerment rather than fear and frustration and regret. And, while I praise God for three wonderful, healthy, medically uncomplicated
births, the warm positive emotions that I feel when thinking about those experiences are due largely to your care and expertise.
I think the other important role you play in my mind is that you give me permission to feel the way I do about childbirth. That it is a normal, natural and healthy process that our bodies know how to do; that it is an experience to be sought after and embraced not avoided through medication or elective surgery; that it can
be a primal, empowering moment that reveals a woman's unknown strength (perhaps most of all to the new mother herself); that the experience itself can be one of the most joyous and
cherished of a woman's life, not just the painful, unavoidable process that resulted in the joy of a child. I don't know that I need permission to embrace these feelings. It's just that they are so rare among my own circle of family and friends that it's nice to have a voice in my head that validates and agrees to them. All that to say Thanks for sharing your
kind memories of me and my children. You will always hold an important and special place in my heart."
Letter from Paige
Teresa, I cannot express my thrill and gratitude at having you as my doula! What an absolutely wonderful experience it was to give birth, but you truly made it the thrill of a lifetime.
Without you we never would have known the inner strength we had to accomplish such an amazing task. Your classes prepared us so well for what was to come and how to handle it. I believe you truly did help us to reach inside ourselves and find the power to make it through. You not only prepared me for the pain and how to endure, but you also helped Todd to know the perfect ways to support me and be present during the entire experience!
It sure is fantastic to learn what you can do if you just listen to your body and trust your instincts! Now I look at Wesley and revel in the joy that he brings us. What a tremendous way to meet God and learn about His love for us.
We couldn't have done it without you and we are truly blessed!
Paige
Without you we never would have known the inner strength we had to accomplish such an amazing task. Your classes prepared us so well for what was to come and how to handle it. I believe you truly did help us to reach inside ourselves and find the power to make it through. You not only prepared me for the pain and how to endure, but you also helped Todd to know the perfect ways to support me and be present during the entire experience!
It sure is fantastic to learn what you can do if you just listen to your body and trust your instincts! Now I look at Wesley and revel in the joy that he brings us. What a tremendous way to meet God and learn about His love for us.
We couldn't have done it without you and we are truly blessed!
Paige
Daniel's letter
Dear Labor of Love,
I wanted to take a moment and write to you regarding what I believe has been the most amazing experience of my life, the birth of my daughter Zoe. This experience was made all the more special because of an amazing woman who helped my wife and I through it. Guina Bixler is that special woman. To be completely honest, I knew nothing of doulas or birthing guides before meeting Guina, but that all changed during our first meeting.
During the months leading up to the birth of our daughter, Guina was always there for my wife. Guina would help with birthing exercises or just listening to my wife’s fears in a way that only another woman could. Zoe was breech, so that added some stress to the situation. My wife was afraid that she was going to be unable to have a true birthing experience, but again Guina was there with words of support and comfort. So with our doctor’s advice, my wife and I scheduled the Cesarean for July 29th.
In the end, little Zoe had other plans. On July 24th my wife went into labor, our first call was to Guina. She was amazing, she gave us suggestions of how to determine if these contractions were the real thing or just false labor and she also helped calm my wife and me down (Something I was having a difficult time doing).
As helpful as Guina was during the lead up, it was at the hospital where she truly shined. Her presence had a great calming effect on my wife, and it allowed me to handle the “business” end of things knowing full well that my wife’s wishes and concerns were being cared for. Without Guina, I do not think I would have been strong enough to stand up to the nurses in Labor and Delivery who only wanted to drug my wife and have her lie still on the bed. For that alone I will always be grateful for her presence.
Leading up to the C-Section, Guina supported my wife, but always made a point to check and see how I was holding up. When my wife was wheeled into the O.R., Guina spent a great deal of time explaining to me what was going to happen when we were in the room (something the doctors failed to do). During the surgery, Guina’s presence allowed me to focus on my wife, and not worry about “capturing” the moment on film. I was able to be a husband, and not a photographer or cheerleader. After the surgery, I had to leave my wife to go with Zoe; Guina again stepped in and filled a greatly needed role. She supported and comforted my wife while I was with Zoe in the transitional nursery. Because of Guina, I was able to focus all my attention on my new daughter, knowing full well that my wife was in the wonderful and caring hands of Guina. Guina always seemed to know exactly the right moment to step in and help, and when to seem completely invisible. As a husband, my experience with Guina has made me a strong supporter of doulas. I find myself time and again telling every man I know that if their wife wants a doula, that they should do it. The will never regret having a woman like Guina in their corner during this time.
Please feel free to post this message on your website, as it would be an honor for me to help more men feel comfortable with their decision to have a doula.
Sincerely,
Daniel A. Gagnon
Father to Zoe Rhiannon Gagnon
Husband to Kara Gagnon
And friend to Guina Bixler
I wanted to take a moment and write to you regarding what I believe has been the most amazing experience of my life, the birth of my daughter Zoe. This experience was made all the more special because of an amazing woman who helped my wife and I through it. Guina Bixler is that special woman. To be completely honest, I knew nothing of doulas or birthing guides before meeting Guina, but that all changed during our first meeting.
During the months leading up to the birth of our daughter, Guina was always there for my wife. Guina would help with birthing exercises or just listening to my wife’s fears in a way that only another woman could. Zoe was breech, so that added some stress to the situation. My wife was afraid that she was going to be unable to have a true birthing experience, but again Guina was there with words of support and comfort. So with our doctor’s advice, my wife and I scheduled the Cesarean for July 29th.
In the end, little Zoe had other plans. On July 24th my wife went into labor, our first call was to Guina. She was amazing, she gave us suggestions of how to determine if these contractions were the real thing or just false labor and she also helped calm my wife and me down (Something I was having a difficult time doing).
As helpful as Guina was during the lead up, it was at the hospital where she truly shined. Her presence had a great calming effect on my wife, and it allowed me to handle the “business” end of things knowing full well that my wife’s wishes and concerns were being cared for. Without Guina, I do not think I would have been strong enough to stand up to the nurses in Labor and Delivery who only wanted to drug my wife and have her lie still on the bed. For that alone I will always be grateful for her presence.
Leading up to the C-Section, Guina supported my wife, but always made a point to check and see how I was holding up. When my wife was wheeled into the O.R., Guina spent a great deal of time explaining to me what was going to happen when we were in the room (something the doctors failed to do). During the surgery, Guina’s presence allowed me to focus on my wife, and not worry about “capturing” the moment on film. I was able to be a husband, and not a photographer or cheerleader. After the surgery, I had to leave my wife to go with Zoe; Guina again stepped in and filled a greatly needed role. She supported and comforted my wife while I was with Zoe in the transitional nursery. Because of Guina, I was able to focus all my attention on my new daughter, knowing full well that my wife was in the wonderful and caring hands of Guina. Guina always seemed to know exactly the right moment to step in and help, and when to seem completely invisible. As a husband, my experience with Guina has made me a strong supporter of doulas. I find myself time and again telling every man I know that if their wife wants a doula, that they should do it. The will never regret having a woman like Guina in their corner during this time.
Please feel free to post this message on your website, as it would be an honor for me to help more men feel comfortable with their decision to have a doula.
Sincerely,
Daniel A. Gagnon
Father to Zoe Rhiannon Gagnon
Husband to Kara Gagnon
And friend to Guina Bixler
Pregnant Patient's Bill of Rights
The Pregnant Patient's Rights
Most pregnant women are not fully aware of their rights to informed consent or the obstetrician's legal obligation to obtain informed consent to treatment. More than twenty years ago, the American College of Obstetricians and Gynecologists acknowledged the pregnant patient's right of informed consent in the following excerpt from its 1974 Standards for Obstetric- Gynecologic Services (pgs. 66,67).
"It is important to note the distinction between 'consent' and 'informed consent'."
Many physicians, because they do not realize there is a difference, believe they are free from liability if the patient consents to treatment. This is not true. The physician may still be liable if the patient's consent was not informed. In addition, the usual consent obtained by a hospital does not in any way release the physician from his legal duty of obtaining an informed consent from his patient.
"Most courts consider that the patient is 'informed' if the following information is given:
· The processes contemplated by the physician as treatment, including whether the treatment is new or unusual.
· The risks and hazards of the treatment,
· The chances for recovery after treatment.
· The necessity of the treatment.
· The feasibility of alternative methods of treatment."
"One point on which courts do agree is that explanations must be given in such a way that the patient understands them. A physician cannot claim as a defense that he explained the procedure to the patient when he knew the patient did not understand. The physician has a duty to act with due care under the circumstances; this means he must be sure the patient understands what she is told."
"It should be emphasized that the following reasons are not sufficient to justify failure to inform:
1. That the patient may prefer not to be told the unpleasant possibilities regarding the treatment.
2. That full disclosure might suggest infinite dangers to a patient with an active imagination, thereby causing her to refuse treatment.
3. That the patient, on learning the risks involved, might rationally decline treatment. The right to decline is the specific fundamental right protected by the informed consent doctrine."
American parents are becoming increasingly aware that well-intentioned health professionals do not always have scientific data to support common American obstetrical practices and that many of these practices are carried out primarily because they are part of medical and hospital tradition. In the last forty years, many artificial practices have been introduced which have changed childbirth from a physiological event to a very complicated medical procedure in which all kinds of drugs are used and procedurescarried out, sometimes unnecessarily, and many of them potentially damaging for the baby and even for the mother. A growing body of research makes it alarmingly clear that every aspect of traditional American hospital care during labor and delivery must now be questioned as to its possible effect on the future well-being of both the obstetric patient and her unborn child.
Neither the approval of a drug by the U.S. Food and Drug Administration nor the fact that a drug is prescribed by a physician serves as a guarantee that a drug or medication is safe for the mother or her unborn child. In fact, the American Academy of Pediatrics' Committee on Drugs has stated that there is no drug, whether prescription or over-the-counter remedy, which has been proven safe for the unborn child.
The Pregnant Patient has the right to participate in decisions involving her well-being and that of her unborn child, unless there is a clear cut medical emergency that prevents her participation. In addition to the rights set forth in the American Hospital Association's "Patient's Bill of Rights," the Pregnant Patient, because she represents TWO patients rather than one, should be recognized as having the additional rights listed below.
1. The Pregnant Patient has the right, prior to the administration of any drug or procedure, to be informed by the health professional caring for her of any potential direct or indirect effects, risks or hazards to herself or her unborn or newborn infant which may result from the use of a drug or procedure prescribed for or administered to her during pregnancy, labor, birth or lactation.
2. The Pregnant Patient has the right, prior to the proposed therapy, to be informed, not only of the benefits, risks and hazards of the proposed therapy but also of known alternative therapy, such as available childbirth education classes which could help to prepare the Pregnant Patient physically and mentally to cope with the discomfort or stress of pregnancy and the experience of childbirth, thereby reducing or eliminating her need for drugs and obstetric intervention. She should be offered such information early in her pregnancy in order that she may make a reasoned decision.
3. The Pregnant Patient has the right, prior to the administration of any drug, to be informed by the health professional who is prescribing or administering the drug to her that any drug which she receives during pregnancy, labor and birth, no matter how or when the drug is taken or administered, may adversely affect her unborn baby, directly or indirectly, and that there is no drug or chemical which has been proven safe for the unborn child.
4. The Pregnant Patient has the right if Cesarean birth is anticipated, to be informed prior to the administration of any drug, and preferably prior to her hospitalization, that minimizing her and, in turn, her unborn baby's intake of nonessential pre-operative medicine will benefit her baby.
5. The Pregnant Patient has the right, prior to the administration of a drug or procedure, to be informed of the areas of uncertainty if there is NO properly controlled follow-up research which has established the safety of the drug or procedure with regard to its direct and/or indirect effects on the physiological, mental and neurological development of the child exposed, via the mother, to the drug or procedure during pregnancy, labor, birth or lactation-- (this would apply to virtually all drugs and the vast majority of obstetric procedures).
6. The Pregnant Patient has the right, prior to the administration of any drug, to be informed of the brand name and generic name of the drug in order that she may advise the health professional of any past adverse reaction to the drug.
7. The Pregnant Patient has the right to determine for herself, without pressure from her attendant, whether she will accept the risks inherent in the proposed therapy or refuse a drug or procedure.
8. The Pregnant Patient has the right to know the name and qualifications of the individual administering a medication or procedure to her during labor or birth.
9. The Pregnant Patient has the right to be informed, prior to the administration of any procedure, whether that procedure is being administered to her for her or her baby's benefit (medically indicated) or as an elective procedure (for convenience, teaching purposes or research).
10. The Pregnant Patient has the right to be accompanied during the stress of labor and birth by someone she cares for, and to whom she looks for emotional comfort and encouragement.
11. The Pregnant Patient has the right after appropriate medical consultation to choose a position for labor and for birth which is least stressful to her baby and to herself.
12. The Obstetric Patient has the right to have her baby cared for at her bedside if her baby is normal, and to feed her baby according to her baby's needs rather than according to the hospital regimen.
13. The Obstetric Patient has the right to be informed in writing of the name of the person who actually delivered her baby and the professional qualifications of that person. This information should also be on the birth certificate.
14. The Obstetric Patient has the right to be informed if there is any known or indicated aspect of her or her baby's care or condition which may cause her or her baby later difficulty or problems.
15. The Obstetric Patient has the right to have her and her baby's hospital medical records complete, accurate and legible and to have their records, including Nurses' Notes, retained by the hospital until the child reaches at least the age of majority, or, alternatively, to have the records offered to her before they are destroyed.
16. The Obstetric Patient, both during and after her hospital stay, has the right to have access to her complete hospital medical records, including Nursing Notes, and to receive a copy upon payment of a reasonable fee and without incurring the expense of retaining an attorney.
It is the obstetric patient and her baby, not the health professional, who must sustain any trauma or injury resulting from the use of a drug or obstetric procedure. The observation of the rights listed above will not only permit the obstetric patient to participate in the decisions involving her and her baby's health care, but will help to protect the health professional and the hospital against litigation arising from resentment or misunderstanding on the part of the mother.
@ Doris Haire
American Foundation for Maternal and Child Health
Author's note: A slightly abbreviated version of this document can be found in the "Rights of Hospital Patients" by George Annas, J.D., M.P.H
Most pregnant women are not fully aware of their rights to informed consent or the obstetrician's legal obligation to obtain informed consent to treatment. More than twenty years ago, the American College of Obstetricians and Gynecologists acknowledged the pregnant patient's right of informed consent in the following excerpt from its 1974 Standards for Obstetric- Gynecologic Services (pgs. 66,67).
"It is important to note the distinction between 'consent' and 'informed consent'."
Many physicians, because they do not realize there is a difference, believe they are free from liability if the patient consents to treatment. This is not true. The physician may still be liable if the patient's consent was not informed. In addition, the usual consent obtained by a hospital does not in any way release the physician from his legal duty of obtaining an informed consent from his patient.
"Most courts consider that the patient is 'informed' if the following information is given:
· The processes contemplated by the physician as treatment, including whether the treatment is new or unusual.
· The risks and hazards of the treatment,
· The chances for recovery after treatment.
· The necessity of the treatment.
· The feasibility of alternative methods of treatment."
"One point on which courts do agree is that explanations must be given in such a way that the patient understands them. A physician cannot claim as a defense that he explained the procedure to the patient when he knew the patient did not understand. The physician has a duty to act with due care under the circumstances; this means he must be sure the patient understands what she is told."
"It should be emphasized that the following reasons are not sufficient to justify failure to inform:
1. That the patient may prefer not to be told the unpleasant possibilities regarding the treatment.
2. That full disclosure might suggest infinite dangers to a patient with an active imagination, thereby causing her to refuse treatment.
3. That the patient, on learning the risks involved, might rationally decline treatment. The right to decline is the specific fundamental right protected by the informed consent doctrine."
American parents are becoming increasingly aware that well-intentioned health professionals do not always have scientific data to support common American obstetrical practices and that many of these practices are carried out primarily because they are part of medical and hospital tradition. In the last forty years, many artificial practices have been introduced which have changed childbirth from a physiological event to a very complicated medical procedure in which all kinds of drugs are used and procedurescarried out, sometimes unnecessarily, and many of them potentially damaging for the baby and even for the mother. A growing body of research makes it alarmingly clear that every aspect of traditional American hospital care during labor and delivery must now be questioned as to its possible effect on the future well-being of both the obstetric patient and her unborn child.
Neither the approval of a drug by the U.S. Food and Drug Administration nor the fact that a drug is prescribed by a physician serves as a guarantee that a drug or medication is safe for the mother or her unborn child. In fact, the American Academy of Pediatrics' Committee on Drugs has stated that there is no drug, whether prescription or over-the-counter remedy, which has been proven safe for the unborn child.
The Pregnant Patient has the right to participate in decisions involving her well-being and that of her unborn child, unless there is a clear cut medical emergency that prevents her participation. In addition to the rights set forth in the American Hospital Association's "Patient's Bill of Rights," the Pregnant Patient, because she represents TWO patients rather than one, should be recognized as having the additional rights listed below.
1. The Pregnant Patient has the right, prior to the administration of any drug or procedure, to be informed by the health professional caring for her of any potential direct or indirect effects, risks or hazards to herself or her unborn or newborn infant which may result from the use of a drug or procedure prescribed for or administered to her during pregnancy, labor, birth or lactation.
2. The Pregnant Patient has the right, prior to the proposed therapy, to be informed, not only of the benefits, risks and hazards of the proposed therapy but also of known alternative therapy, such as available childbirth education classes which could help to prepare the Pregnant Patient physically and mentally to cope with the discomfort or stress of pregnancy and the experience of childbirth, thereby reducing or eliminating her need for drugs and obstetric intervention. She should be offered such information early in her pregnancy in order that she may make a reasoned decision.
3. The Pregnant Patient has the right, prior to the administration of any drug, to be informed by the health professional who is prescribing or administering the drug to her that any drug which she receives during pregnancy, labor and birth, no matter how or when the drug is taken or administered, may adversely affect her unborn baby, directly or indirectly, and that there is no drug or chemical which has been proven safe for the unborn child.
4. The Pregnant Patient has the right if Cesarean birth is anticipated, to be informed prior to the administration of any drug, and preferably prior to her hospitalization, that minimizing her and, in turn, her unborn baby's intake of nonessential pre-operative medicine will benefit her baby.
5. The Pregnant Patient has the right, prior to the administration of a drug or procedure, to be informed of the areas of uncertainty if there is NO properly controlled follow-up research which has established the safety of the drug or procedure with regard to its direct and/or indirect effects on the physiological, mental and neurological development of the child exposed, via the mother, to the drug or procedure during pregnancy, labor, birth or lactation-- (this would apply to virtually all drugs and the vast majority of obstetric procedures).
6. The Pregnant Patient has the right, prior to the administration of any drug, to be informed of the brand name and generic name of the drug in order that she may advise the health professional of any past adverse reaction to the drug.
7. The Pregnant Patient has the right to determine for herself, without pressure from her attendant, whether she will accept the risks inherent in the proposed therapy or refuse a drug or procedure.
8. The Pregnant Patient has the right to know the name and qualifications of the individual administering a medication or procedure to her during labor or birth.
9. The Pregnant Patient has the right to be informed, prior to the administration of any procedure, whether that procedure is being administered to her for her or her baby's benefit (medically indicated) or as an elective procedure (for convenience, teaching purposes or research).
10. The Pregnant Patient has the right to be accompanied during the stress of labor and birth by someone she cares for, and to whom she looks for emotional comfort and encouragement.
11. The Pregnant Patient has the right after appropriate medical consultation to choose a position for labor and for birth which is least stressful to her baby and to herself.
12. The Obstetric Patient has the right to have her baby cared for at her bedside if her baby is normal, and to feed her baby according to her baby's needs rather than according to the hospital regimen.
13. The Obstetric Patient has the right to be informed in writing of the name of the person who actually delivered her baby and the professional qualifications of that person. This information should also be on the birth certificate.
14. The Obstetric Patient has the right to be informed if there is any known or indicated aspect of her or her baby's care or condition which may cause her or her baby later difficulty or problems.
15. The Obstetric Patient has the right to have her and her baby's hospital medical records complete, accurate and legible and to have their records, including Nurses' Notes, retained by the hospital until the child reaches at least the age of majority, or, alternatively, to have the records offered to her before they are destroyed.
16. The Obstetric Patient, both during and after her hospital stay, has the right to have access to her complete hospital medical records, including Nursing Notes, and to receive a copy upon payment of a reasonable fee and without incurring the expense of retaining an attorney.
It is the obstetric patient and her baby, not the health professional, who must sustain any trauma or injury resulting from the use of a drug or obstetric procedure. The observation of the rights listed above will not only permit the obstetric patient to participate in the decisions involving her and her baby's health care, but will help to protect the health professional and the hospital against litigation arising from resentment or misunderstanding on the part of the mother.
@ Doris Haire
American Foundation for Maternal and Child Health
Author's note: A slightly abbreviated version of this document can be found in the "Rights of Hospital Patients" by George Annas, J.D., M.P.H
Mary's letter
The smartest thing I ever did was hire a doula!
My husband travels extensively for his job. Although we arranged for him to be in town the week before and after our due date, our baby came three weeks early! Sure enough, he was landing in Austin, TX at midnight as I was going into labor in Atlanta, GA! Fortunately I had been in close touch with Teresa, my doula and she arrived at the hospital minutes after me. I would have been really nervous and frightened without her as my labor progressed very quickly and i was in a lot of pain. She calmed me down, helped me labor and explained to me the procedures and monitoring that were going on around me. (Don't expect the labor and delivery nurses or doctor to do this: they are too busy.) She even told me what forms I was signing between contractions. (This was despite sending in our pre-admission paperwork early.) She was more than my coach. With her amazing blend of experience, knowledge and mothering, she gave me courage and comfort and support at a scary time. Within 3 1/2 hours, our son was born. All this before my husband was even able to board the first plane back to Atlanta.
I adore my husband and he's a very capable man. And I'm typically a pretty tough cookie. But knowing what I know now, I wouldn't contemplate entering into labor without the help of a doula. We are just so grateful she was there for our family.
Mary G
Smyrna, GA
My husband travels extensively for his job. Although we arranged for him to be in town the week before and after our due date, our baby came three weeks early! Sure enough, he was landing in Austin, TX at midnight as I was going into labor in Atlanta, GA! Fortunately I had been in close touch with Teresa, my doula and she arrived at the hospital minutes after me. I would have been really nervous and frightened without her as my labor progressed very quickly and i was in a lot of pain. She calmed me down, helped me labor and explained to me the procedures and monitoring that were going on around me. (Don't expect the labor and delivery nurses or doctor to do this: they are too busy.) She even told me what forms I was signing between contractions. (This was despite sending in our pre-admission paperwork early.) She was more than my coach. With her amazing blend of experience, knowledge and mothering, she gave me courage and comfort and support at a scary time. Within 3 1/2 hours, our son was born. All this before my husband was even able to board the first plane back to Atlanta.
I adore my husband and he's a very capable man. And I'm typically a pretty tough cookie. But knowing what I know now, I wouldn't contemplate entering into labor without the help of a doula. We are just so grateful she was there for our family.
Mary G
Smyrna, GA
Letter from Donnie
To those wondering if a drive to Lawrenceville for childbirth classes is worth it:
If you have lived in Metro Atlanta for any amount of time, traffic is a big part of your life. The average commute to and from work is over one hour for lots of Atlantans. So, why would anybody in their right mind get up on a Saturday morning and drive 30 miles to childbirth classes?
My wife and I live in the East Atlanta Village area and chose to drice 30 miles or so north for childbirth classes with Teresa. We heard about A Labor of Love through some friends and decided to suck it up and make the drive for 6 straight Saturday mornings. It was highly educational for first time parents and gave us a chance to get to know our doula personally before the big day. After our child’s birth, I can honestly say that it was one of the smartest things we did during my wife’s pregnancy. Here is why:
I am a firm believer that everyone born into this world is great at something. Unfortunately, most of us never find out what that something is. Every once in a while a lucky few find their ultimate calling in life and seize the opportunity. Teresa is one of those lucky few. She was born to be a doula and childbirth educator. My wife’s 22 ½ hour labor and unmedicated vaginal birth of a 9 lb. 8 oz. baby girl went wonderfully and Teresa was a very large reason for that. Doula certifications and the experience of 295+ births are great on her resume, but what sets Teresa apart is something that really can’t be explained. You can see it in her eyes, you hear it in her voice, and you just know that you are in good hands. Not only do you get the benefit of her knowledge, she somehow empowers you to believe in yourself.
Through the A Labor of Love classes, my wife and I felt we had the tools and the confidence for what was up ahead. Sign up for her childbirth classes, hire her as your doula and drive from wherever you have to. It’s worth every minute.
P.S. Teresa didn’t pay me to write this.
P.P.S. There are some things you can do while you’re up in the ‘burbs. For example, there is a Babies R Us, so you can register. It made the drive a little more bearable.
Donnie, husband to Ila
Donnie states that it is 30 miles to his home- it actually is a little more- but mapquest says it is only a 32 minute drive- on Saturdays it is usually a less congested drive than a weekday or evening. The new childbirth location is just off of Hwy.316 which is directly off of I-85. So, don’t fear the drive to the burbs! It may be worth it to you in the end as it was for Ila and Donnie! There are a lot of things to do when you come out this way- Babies R Us is certainly one of them, as well as being a short drive to the Mall of Georgia and Discover Mill Mall. So, bite the bullet and make the drive- we will certainly try to make it a great experience!
I was invited back as their doula for their next child who came mid 2007!
If you have lived in Metro Atlanta for any amount of time, traffic is a big part of your life. The average commute to and from work is over one hour for lots of Atlantans. So, why would anybody in their right mind get up on a Saturday morning and drive 30 miles to childbirth classes?
My wife and I live in the East Atlanta Village area and chose to drice 30 miles or so north for childbirth classes with Teresa. We heard about A Labor of Love through some friends and decided to suck it up and make the drive for 6 straight Saturday mornings. It was highly educational for first time parents and gave us a chance to get to know our doula personally before the big day. After our child’s birth, I can honestly say that it was one of the smartest things we did during my wife’s pregnancy. Here is why:
I am a firm believer that everyone born into this world is great at something. Unfortunately, most of us never find out what that something is. Every once in a while a lucky few find their ultimate calling in life and seize the opportunity. Teresa is one of those lucky few. She was born to be a doula and childbirth educator. My wife’s 22 ½ hour labor and unmedicated vaginal birth of a 9 lb. 8 oz. baby girl went wonderfully and Teresa was a very large reason for that. Doula certifications and the experience of 295+ births are great on her resume, but what sets Teresa apart is something that really can’t be explained. You can see it in her eyes, you hear it in her voice, and you just know that you are in good hands. Not only do you get the benefit of her knowledge, she somehow empowers you to believe in yourself.
Through the A Labor of Love classes, my wife and I felt we had the tools and the confidence for what was up ahead. Sign up for her childbirth classes, hire her as your doula and drive from wherever you have to. It’s worth every minute.
P.S. Teresa didn’t pay me to write this.
P.P.S. There are some things you can do while you’re up in the ‘burbs. For example, there is a Babies R Us, so you can register. It made the drive a little more bearable.
Donnie, husband to Ila
Donnie states that it is 30 miles to his home- it actually is a little more- but mapquest says it is only a 32 minute drive- on Saturdays it is usually a less congested drive than a weekday or evening. The new childbirth location is just off of Hwy.316 which is directly off of I-85. So, don’t fear the drive to the burbs! It may be worth it to you in the end as it was for Ila and Donnie! There are a lot of things to do when you come out this way- Babies R Us is certainly one of them, as well as being a short drive to the Mall of Georgia and Discover Mill Mall. So, bite the bullet and make the drive- we will certainly try to make it a great experience!
I was invited back as their doula for their next child who came mid 2007!
Letter from Ron
This is a letter from a dad who actually caught his son- on Christmas Day!
This was my 100th birth!
04/03/2001
To Whom It May Concern:
I am writing in response to your husband's concerns with the partnership of a Doula. When my wife first presented the Doula to me, I was a skeptic and had the initial reaction of being relegated to a bench player during delivery. After reading the same articles as my wife, I begin to see the medical support for a Doula and started to ask questions and looking for more answers.
Teresa Howard was the answer for us, for me. My personal fear about Resa's pregnancy was two fold: 1) would I be the supportive husband she needed and 2) would I know how to make an informed decision during the stress of labor and delivery. Through constant communication with Resa and the challenging perspectives brought out by Teresa's classes, I began to understand the value of my involvement during labor and delivery.
It was refreshing to know that I could pro-actively support Resa and do things to make our labor and delivery one that both of us look back upon fondly. Teresa was always supporting both of us through constant reassurance and communication. She had the uncanny ability to sense when I needed her approving look, because I had never experienced the helplessness one feels when your wife is struggling through the contractions.
The second key support from Teresa was at the hospital. She enabled me to have confidence in my support of Resa and when I was not sure, she was someone not drawn into the emotion of the moment that I could talk to. Resa had a long labor (30 hours) and there were several times when I know that I would have gone to the hospital had Teresa not been there to guide us. Resa wanted a natural childbirth and I wanted her to have the labor and delivery she desired. But as a man, who am I to say that Resa can make through the contraction or that she needs to tough it out? Together, we worked through the challenges and Teresa provided us the guidance we needed to make the right decisions for us.
One last note, a bit selfish. Teresa's involvement allowed me to catch our son and cut the cord. Something I will never forget. That happened only because Teresa asked me if I thought about doing it during birth classes. Had she not asked me, I probably would never had considered it much less answer our Midwife's question about it with a yes. Don't miss out on that experience, it will change your life and build your bond with your spouse and child.
Please don't hesitate to ask my wife or me any questions about Teresa or our birth experience.
Regards,
Ron Mechling
This was my 100th birth!
04/03/2001
To Whom It May Concern:
I am writing in response to your husband's concerns with the partnership of a Doula. When my wife first presented the Doula to me, I was a skeptic and had the initial reaction of being relegated to a bench player during delivery. After reading the same articles as my wife, I begin to see the medical support for a Doula and started to ask questions and looking for more answers.
Teresa Howard was the answer for us, for me. My personal fear about Resa's pregnancy was two fold: 1) would I be the supportive husband she needed and 2) would I know how to make an informed decision during the stress of labor and delivery. Through constant communication with Resa and the challenging perspectives brought out by Teresa's classes, I began to understand the value of my involvement during labor and delivery.
It was refreshing to know that I could pro-actively support Resa and do things to make our labor and delivery one that both of us look back upon fondly. Teresa was always supporting both of us through constant reassurance and communication. She had the uncanny ability to sense when I needed her approving look, because I had never experienced the helplessness one feels when your wife is struggling through the contractions.
The second key support from Teresa was at the hospital. She enabled me to have confidence in my support of Resa and when I was not sure, she was someone not drawn into the emotion of the moment that I could talk to. Resa had a long labor (30 hours) and there were several times when I know that I would have gone to the hospital had Teresa not been there to guide us. Resa wanted a natural childbirth and I wanted her to have the labor and delivery she desired. But as a man, who am I to say that Resa can make through the contraction or that she needs to tough it out? Together, we worked through the challenges and Teresa provided us the guidance we needed to make the right decisions for us.
One last note, a bit selfish. Teresa's involvement allowed me to catch our son and cut the cord. Something I will never forget. That happened only because Teresa asked me if I thought about doing it during birth classes. Had she not asked me, I probably would never had considered it much less answer our Midwife's question about it with a yes. Don't miss out on that experience, it will change your life and build your bond with your spouse and child.
Please don't hesitate to ask my wife or me any questions about Teresa or our birth experience.
Regards,
Ron Mechling
Wednesday, January 7, 2009
511 - 411 - 311
If you go to the hospital childbirth classes...usually you will hear that you need to go to the hospital when your contractions are five minutes apart, lasting a full minute for at least an hour =511... If you do this you will usually be about 4-5 centimeters dilated and arriving just in time to get your epidural.
If you attend my classes... you will hear that you need to go to the hospital when your contractions are four minutes apart, lasting a full minute for at least an hour =411...If you do this you will be well established into labor and if you plan to go without medication you will not be at the hospital too early and yet not too late if you decided you wanted medication.
A midwife at my favorite practice recently told my client who desired a natural water birth... you should come to the hospital when your contractions are three minutes apart, lasting a full minute for at least an hour =311...If you do this you will be just in time to get in the tub and shortly push your baby out.
Now these are just estimates of course... it depends on what time of day you go into labor- at 4:30 pm on a weekday depending on where you live in relation to where the hospital is located (this is of course assuming you are not staying home to have your baby), you may need to go earlier... or go closer to the hospital to mingle- walk at a park, in the mall, go have soup at a nearby restaurant...etc. But one of the biggest mistakes someone makes in labor is going to the hospital too soon.
It also will be dependent on who your care provider is, whether you are GBS+ and if your water is broken.. although these variables are different depending on who your care provider is- doctors and midwives vary on their opinion of these factors all the time.
When you go too soon you set yourself up for interventions. You are usually much more comfortable in familiar settings- where you relax more and endorphins are able to kick in. When you go too soon your adrenalin kicks in and you slow your labor down. But some moms need to get to their birth location in order to nest and settle into labor.
You have to decide when to go- but keep in mind, it is rare for labors to kick in quickly without notice and to push a baby out with a sneeze... so your fear of having a baby in the car is usually unfounded and rare... but my advice to you is ...listen to your body, trust your instinctive voice, don't let fear dictate what you do...
If you attend my classes... you will hear that you need to go to the hospital when your contractions are four minutes apart, lasting a full minute for at least an hour =411...If you do this you will be well established into labor and if you plan to go without medication you will not be at the hospital too early and yet not too late if you decided you wanted medication.
A midwife at my favorite practice recently told my client who desired a natural water birth... you should come to the hospital when your contractions are three minutes apart, lasting a full minute for at least an hour =311...If you do this you will be just in time to get in the tub and shortly push your baby out.
Now these are just estimates of course... it depends on what time of day you go into labor- at 4:30 pm on a weekday depending on where you live in relation to where the hospital is located (this is of course assuming you are not staying home to have your baby), you may need to go earlier... or go closer to the hospital to mingle- walk at a park, in the mall, go have soup at a nearby restaurant...etc. But one of the biggest mistakes someone makes in labor is going to the hospital too soon.
It also will be dependent on who your care provider is, whether you are GBS+ and if your water is broken.. although these variables are different depending on who your care provider is- doctors and midwives vary on their opinion of these factors all the time.
When you go too soon you set yourself up for interventions. You are usually much more comfortable in familiar settings- where you relax more and endorphins are able to kick in. When you go too soon your adrenalin kicks in and you slow your labor down. But some moms need to get to their birth location in order to nest and settle into labor.
You have to decide when to go- but keep in mind, it is rare for labors to kick in quickly without notice and to push a baby out with a sneeze... so your fear of having a baby in the car is usually unfounded and rare... but my advice to you is ...listen to your body, trust your instinctive voice, don't let fear dictate what you do...
Tuesday, January 6, 2009
Overcoming Fear in Birth
Overcoming Fear in Birth by Bardsley and Newman
summary by Teresa Howard
Emotional fear goes to the thalamus and to the sensory cortex causing PTSD or it can take the short road to the amygdala where the immediate response is emotional- fear (the amygdala is the part of the brain that is responsible for arousal, controls autonomic responses associated with fear, emotional responses and hormonal secretions).
We need to bring our fear to a conscience level, process it and bring it down into our body out of our brain to begin to process it in a productive way.
The left side of the brain handles the cognitive, rational, explicit, verbal parts of our thinking and is very goal oriented. This is about what controls the areas of what we feel, our sight, touch, hearing, tastes, smells and temperature.
The right side of the brain controls the artistic, creative, impulsive, nonverbal parts of our thinking. It is about what we think, our beliefs, memories, culture and feelings.
IS, AM and ARE are belief words. We must balance it with knowledge, attention, evaluation and moods.
Using opposing handwriting or journaling allows us to bypass the left brain and go to the belief side of our brain. It helps us to move past the rational and create a new truth to guide us in our birth experience.
Mantras, metaphors, myths, symbols, and phrases will help us along our journey.
There is a need to make a distinction between mind and awareness. We need to plant the intention to stay in the presence and not have us to think ahead. Staying in our heads produces cortisol and stresses us- meditation balances our body and mind
Awareness is free of fear and anxiety. Our mind loves to suffer. So we need to stay out of our mind. Our awareness manages the pain and develops courage.
summary by Teresa Howard
Emotional fear goes to the thalamus and to the sensory cortex causing PTSD or it can take the short road to the amygdala where the immediate response is emotional- fear (the amygdala is the part of the brain that is responsible for arousal, controls autonomic responses associated with fear, emotional responses and hormonal secretions).
We need to bring our fear to a conscience level, process it and bring it down into our body out of our brain to begin to process it in a productive way.
The left side of the brain handles the cognitive, rational, explicit, verbal parts of our thinking and is very goal oriented. This is about what controls the areas of what we feel, our sight, touch, hearing, tastes, smells and temperature.
The right side of the brain controls the artistic, creative, impulsive, nonverbal parts of our thinking. It is about what we think, our beliefs, memories, culture and feelings.
IS, AM and ARE are belief words. We must balance it with knowledge, attention, evaluation and moods.
Using opposing handwriting or journaling allows us to bypass the left brain and go to the belief side of our brain. It helps us to move past the rational and create a new truth to guide us in our birth experience.
Mantras, metaphors, myths, symbols, and phrases will help us along our journey.
There is a need to make a distinction between mind and awareness. We need to plant the intention to stay in the presence and not have us to think ahead. Staying in our heads produces cortisol and stresses us- meditation balances our body and mind
Awareness is free of fear and anxiety. Our mind loves to suffer. So we need to stay out of our mind. Our awareness manages the pain and develops courage.
Monday, January 5, 2009
Letter from Jen
My name is Jen Hayden. I took Pam's Birthing From Within class this fall as well as the Happiest Baby on the Block class. I would've been in the December breastfeeding class too but my little son Eli decided he wanted to be born that day so we didn't make it to class! :)
I am writing because I want to say thank you. My pregnancy journey started out with me being the typical women who goes to her OB when she gets pregnant and then follows the lead of her doctor. When I was 8 weeks pregnant I became friends with a woman who gave birth to her baby at home. I couldn't believe my ears. I had never met anyone who had done that before. As our friendship developed we spent a lot of time discussing her experience and slowly I began to read books about natural child birth. After reading Ina May's book and the Thinking Woman's Guide I knew my journey was about to change course. I searched for a Midwife in my area and couldn't find one under my insurance so I somehow ended up at a midwifery practice at my local hospital. I was so disappointed in the midwives there. I had such high expectations of what a midwife would be like and they just didn't fit the mold for me. In the meantime, I knew I wanted to hire a doula. I somehow stumbled across A Labor of Love. In all honesty I have no idea how my pregnancy and my birth would have turned out if I hadn't discovered your company. I read the doula's profile and chose Alicia. We connected immediately and she referred me to her OB ( I thought she was crazy for using an OB but I trusted her) so I interviewed him and chose to switch offices. I was so worried about not using a midwife but Alicia assured me I'd be happy with him. All of my prenatal visits went smoothly, Alicia and I talked a lot over the summer, and I continued to read books. Then I enrolled in Pam's Birthing From Within class. I had no idea what to expect from class. I can't say enough about it. The classroom itself was comfortable and warm. I loved the pictures and art on the walls (I would sit and stare at the spiral with the words written on it- this is the Lawrenceville class space that Teresa uses). Pam is such a wonderful person as well as instructor. I walked away from the class feeling like I couldn't have been any more prepared. I kept thinking throughout my pregnancy that I was Superwoman and I was just trying to sew up my cape as my birth got closer and closer. There is no doubt in my mind that having Pam as my instructor and Alicia as my doula was the reason why I had such a beautiful birth experience. They gave me so much support and encouragement about having my baby. I always knew there was strength among woman but it is so much different when it comes to birth. Both of these woman have left lasting impressions on me and will always remain special in my heart. I feel like I am now part of an elite club of woman who birth their babies naturally. I want to thank you for providing woman with such wonderful doulas to choose from as well as classes. I wish there were more companies like yours all over the country so other woman could experience what I did. I tell everyone I know about A Labor of Love and what a great birth experience I had as a result of it.
If my husband and I are still living in Georgia when I get pregnant with baby #2 you can be sure we will be seeing you again! Thank you again!
Sincerely,
Jen Hayden
I am writing because I want to say thank you. My pregnancy journey started out with me being the typical women who goes to her OB when she gets pregnant and then follows the lead of her doctor. When I was 8 weeks pregnant I became friends with a woman who gave birth to her baby at home. I couldn't believe my ears. I had never met anyone who had done that before. As our friendship developed we spent a lot of time discussing her experience and slowly I began to read books about natural child birth. After reading Ina May's book and the Thinking Woman's Guide I knew my journey was about to change course. I searched for a Midwife in my area and couldn't find one under my insurance so I somehow ended up at a midwifery practice at my local hospital. I was so disappointed in the midwives there. I had such high expectations of what a midwife would be like and they just didn't fit the mold for me. In the meantime, I knew I wanted to hire a doula. I somehow stumbled across A Labor of Love. In all honesty I have no idea how my pregnancy and my birth would have turned out if I hadn't discovered your company. I read the doula's profile and chose Alicia. We connected immediately and she referred me to her OB ( I thought she was crazy for using an OB but I trusted her) so I interviewed him and chose to switch offices. I was so worried about not using a midwife but Alicia assured me I'd be happy with him. All of my prenatal visits went smoothly, Alicia and I talked a lot over the summer, and I continued to read books. Then I enrolled in Pam's Birthing From Within class. I had no idea what to expect from class. I can't say enough about it. The classroom itself was comfortable and warm. I loved the pictures and art on the walls (I would sit and stare at the spiral with the words written on it- this is the Lawrenceville class space that Teresa uses). Pam is such a wonderful person as well as instructor. I walked away from the class feeling like I couldn't have been any more prepared. I kept thinking throughout my pregnancy that I was Superwoman and I was just trying to sew up my cape as my birth got closer and closer. There is no doubt in my mind that having Pam as my instructor and Alicia as my doula was the reason why I had such a beautiful birth experience. They gave me so much support and encouragement about having my baby. I always knew there was strength among woman but it is so much different when it comes to birth. Both of these woman have left lasting impressions on me and will always remain special in my heart. I feel like I am now part of an elite club of woman who birth their babies naturally. I want to thank you for providing woman with such wonderful doulas to choose from as well as classes. I wish there were more companies like yours all over the country so other woman could experience what I did. I tell everyone I know about A Labor of Love and what a great birth experience I had as a result of it.
If my husband and I are still living in Georgia when I get pregnant with baby #2 you can be sure we will be seeing you again! Thank you again!
Sincerely,
Jen Hayden
Sunday, January 4, 2009
Gentle Birth Baby
Gentle Birth Baby by Sarah Buckley
as summarized by Teresa Howard
Gentle Birth babies are effected for a lifetime.
www.sarahjbuckley.com
Mammalian births- we are all basically the same. (I thought it humorous that she said this in her speech. It immediately made me think about Ina May Gaskin saying if you wanted to watch real birth on t.v., you should watch the Animal Planet!)
Safety, ease and pleasure = species for survival basis. So birth should be relatively safe, easy and pleasurable in order for any species to make it!
Anxiety and fright = prolonged labor
A woman needs to feel Safe, Private and Unobserved = this is what she calls the Recipe for ease of Birth
If this is the situation, then we should release the Ecstatic Hormones. This cocktail = oxytocin + beta endorphin (natural pain killer) + epinephrine (adrenalin) + non epinephrine: these release catecholamines --these rise at transition and it stimulates labor and the fetal ejection reflex + prolactin (the love hormone for moms!)
What disturbs Mother Natures plan for birth? Pitocin, epidurals, opiates and cesareans.
In 2005
21-40 percent of women were induced
50 percent tried to get labor going or their caregiver did
99 percent had pitocin after birth
Receptors in a woman's uterus will shut down if over stimulated by pitocin.
The altered state of a woman in labor is for it to be normal when "she goes out to the stars to collect the soul of the baby" (... this is what Pam England refers to as laborland.)
When an epidural is given, the pelvic floor muscles are relaxed and it numbs the lower vagina.
When mothers spent less time with their babies while in the hospital their moms felt their babies were less adaptable and more intense.
Bupivacaine, a drug used in most epidurals have a half Life 8 hours in the baby after the baby is born.
Dim lights, no numbers (dilation or time constraints), covering the clock, encourages instinctive behavior in the mom during labor.
The three things a woman in labor needs to focus on are: BREATH, making SOUND if she desires and MOVEMENT.
I heard Sarah speak at the Gentle Birth Congress in Portland a few years ago- these are my notes from that speech. She is coming to Atlanta to the ICAN conference this year. She is fabulous!
Saturday, January 3, 2009
epidural issue...
I had a client in 2008 who desired a natural birth but after several hours without any change in dilation, interventions were begun and she ended up with a cesarean birth. She was my only doula client who ended up with a primary cesarean last year. She had stayed at 8 cm for several hours and then received an epidural. The effects of the epidural dropped her blood pressure causing the baby to go into distress and her cesarean was immediate. I hate that it happened. I am not sure we could have done any more than we did. Perhaps if she had been able to relax more- given more time before getting the epidural... I don't know. But the thing that caused me the real problem with this birth was not the outcome per se.
This hospital, Emory Crawford Long, does not allow a laboring woman to have anyone stay with her if she chooses to get an epidural. NO ONE- as in not her husband or her doula or her friend or her mom... only medical staff. Why?
Let's hear from the nurses...on allnurses.com the forum had these comments:
"I have heard of a case where the husband was holding his wife during the procedure, fainted and hit his head and died!! (i believe this was a Kaiser case in california, dont know the exact details but this is the base of the story).The family then sued (GO FIGURE!) the hospital for negligence in using him as staff in supporting his wife during the procedure. As a CRNA, im very concerned about this as my new job allows the husband to hold the wife, and of course my last job did not!"
"If the laboring mom wishes to have her partner present during epidural placement, and he is able to be of comfort to her without getting in the way or compromising the sterile field, then I think that is fine. But to have him physically hold her is not safe, in my opinion."
"I think it's a shame we're unable to trust our patients anymore. We can't let dad hug mom or hold her hand because he might pass out and sue? If that's the case we better start banning dads from the delivery room altogether lest they pass out at the birth."
"They aren't doing anything to ensure proper positioning. They are there for emotional support. Even as the nurse "holding" the mom, I wasn't holding her to ensure she stayed in position. I was just supporting her. Me being there wasn't going to stop her from moving. She was the one who had to listen to us and respond when we said "Bend your back out like a cat", I couldn't make her do it. We also let dads hold moms' legs up when they were pushing. It doesn't require an RN license. "
I could not find an article regarding protocol for anesthesiologists. The articles are all membership only access articles. But several hospitals had protocols and it would state that it was up to the anesthesiologist at the time of placement as to who would be allowed to be support for the laboring mom.
So, is it they don't want to possibly have someone get in the sterile field? Hmmm then why are dads allowed in for a cesarean birth? Is it because if they make a mistake they don't want a witness? Is it because having a person there makes them nervous? Is it because they do not see any value to having a support person be with the mom? I do not do well by hearing, "it is our policy." What does that mean?
So... back to why this birth outcome made me upset. The anesthesiologist arrived and explained that it would take about 45 minutes to get the mom anesthetized with her epidural and we would not be allowed to stay during the placement. It was not my battle to fight- and the dad looked at me. I just shook my head and asked again why and was told it was policy of this particular anesthesiologist. Since we had been without a break for over 12 hours, the nurse suggested we step downstairs and get something to eat. So, we did.
We returned to the lock down unit and picked up the phone to be allowed back in after only 40 minutes. There seemed to be some hesitation on the part of the staff to allow us back in. But when they did I could see the client's room. The door was open and the cleaning staff was cleaning the room. I thought- oh no!
I asked where the mom was, although I kinda already knew. They said that after the epidural placement, there had been a reaction that caused the baby to "crash" so there had been an emergency cesarean. I asked had they thought to call the dad to alert him? They said they did not have his number and do not page overhead for such things. I was so upset. This mom had been wide awake- frightened- and alone during the surgical birth of her baby. The dad had not been included at all.
The dad was dressed in scrubs and led to the OR to meet up with his wife and baby. They were both doing good. Seems the mom's drop in blood pressure as a result of the epidural had caused the baby to have a sudden drop in blood pressure as well- therefore causing the "sudden crash."
What would I do differently? Well one thing is I tell all moms and dads that they can insist on a support person staying or ask for an anesthesiologist who does allow it to replace the one who will not. I suggest that if it is hospital protocol to write letters questioning the policy. I ask dads to stay close by- only as far as the waiting room at most. I suggest taking out a pen and writing the cell number of the dad really large on the sheet or white board for all to have access to.
The dad had been so relieved that everyone was okay that he stated he guessed that it was okay- healthy mom and healthy baby. I encouraged him to remember that it was also about her experience and he needed to acknowledge his disappointment of not being present with her during the birth as well as hear her disappointments before being dismissive of those feelings. I also encouraged him to write a letter to the administrator and anesthesiology department.
I still feel sad about this birth. Not that she had to have an epidural that caused the sudden emergency- because this mom and I both know she worked long and hard and was at the point where an epidural could have proven helpful... but because instead of birthing with her partner by her side, she experienced this alone with mostly strangers around her. This is not ever ideal.
This hospital, Emory Crawford Long, does not allow a laboring woman to have anyone stay with her if she chooses to get an epidural. NO ONE- as in not her husband or her doula or her friend or her mom... only medical staff. Why?
Let's hear from the nurses...on allnurses.com the forum had these comments:
"I have heard of a case where the husband was holding his wife during the procedure, fainted and hit his head and died!! (i believe this was a Kaiser case in california, dont know the exact details but this is the base of the story).The family then sued (GO FIGURE!) the hospital for negligence in using him as staff in supporting his wife during the procedure. As a CRNA, im very concerned about this as my new job allows the husband to hold the wife, and of course my last job did not!"
"If the laboring mom wishes to have her partner present during epidural placement, and he is able to be of comfort to her without getting in the way or compromising the sterile field, then I think that is fine. But to have him physically hold her is not safe, in my opinion."
"I think it's a shame we're unable to trust our patients anymore. We can't let dad hug mom or hold her hand because he might pass out and sue? If that's the case we better start banning dads from the delivery room altogether lest they pass out at the birth."
"They aren't doing anything to ensure proper positioning. They are there for emotional support. Even as the nurse "holding" the mom, I wasn't holding her to ensure she stayed in position. I was just supporting her. Me being there wasn't going to stop her from moving. She was the one who had to listen to us and respond when we said "Bend your back out like a cat", I couldn't make her do it. We also let dads hold moms' legs up when they were pushing. It doesn't require an RN license. "
I could not find an article regarding protocol for anesthesiologists. The articles are all membership only access articles. But several hospitals had protocols and it would state that it was up to the anesthesiologist at the time of placement as to who would be allowed to be support for the laboring mom.
So, is it they don't want to possibly have someone get in the sterile field? Hmmm then why are dads allowed in for a cesarean birth? Is it because if they make a mistake they don't want a witness? Is it because having a person there makes them nervous? Is it because they do not see any value to having a support person be with the mom? I do not do well by hearing, "it is our policy." What does that mean?
So... back to why this birth outcome made me upset. The anesthesiologist arrived and explained that it would take about 45 minutes to get the mom anesthetized with her epidural and we would not be allowed to stay during the placement. It was not my battle to fight- and the dad looked at me. I just shook my head and asked again why and was told it was policy of this particular anesthesiologist. Since we had been without a break for over 12 hours, the nurse suggested we step downstairs and get something to eat. So, we did.
We returned to the lock down unit and picked up the phone to be allowed back in after only 40 minutes. There seemed to be some hesitation on the part of the staff to allow us back in. But when they did I could see the client's room. The door was open and the cleaning staff was cleaning the room. I thought- oh no!
I asked where the mom was, although I kinda already knew. They said that after the epidural placement, there had been a reaction that caused the baby to "crash" so there had been an emergency cesarean. I asked had they thought to call the dad to alert him? They said they did not have his number and do not page overhead for such things. I was so upset. This mom had been wide awake- frightened- and alone during the surgical birth of her baby. The dad had not been included at all.
The dad was dressed in scrubs and led to the OR to meet up with his wife and baby. They were both doing good. Seems the mom's drop in blood pressure as a result of the epidural had caused the baby to have a sudden drop in blood pressure as well- therefore causing the "sudden crash."
What would I do differently? Well one thing is I tell all moms and dads that they can insist on a support person staying or ask for an anesthesiologist who does allow it to replace the one who will not. I suggest that if it is hospital protocol to write letters questioning the policy. I ask dads to stay close by- only as far as the waiting room at most. I suggest taking out a pen and writing the cell number of the dad really large on the sheet or white board for all to have access to.
The dad had been so relieved that everyone was okay that he stated he guessed that it was okay- healthy mom and healthy baby. I encouraged him to remember that it was also about her experience and he needed to acknowledge his disappointment of not being present with her during the birth as well as hear her disappointments before being dismissive of those feelings. I also encouraged him to write a letter to the administrator and anesthesiology department.
I still feel sad about this birth. Not that she had to have an epidural that caused the sudden emergency- because this mom and I both know she worked long and hard and was at the point where an epidural could have proven helpful... but because instead of birthing with her partner by her side, she experienced this alone with mostly strangers around her. This is not ever ideal.
Friday, January 2, 2009
Midwifery care
here is a great article regarding midwifery...http://www.latimes.com/news/opinion/la-oe-block24-2008dec24,0,2046506.story
Midwives deliver
America needs better birth care, and midwives can deliver it.
The highlights for those who choose to not go to the link:
*the #1 reason for admissions to the hospital is birth!
*4 million American women will birth each year!
*totally $86 billion in 2006, nearly half of which was picked up by taxpayers
*we spend more than double per capita on childbirth than other industrialized countries, yet the March of Dimes gave the country a "D" on its prematurity report card.
*the U.S. ranks 41st among industrialized nations in maternal mortality.
*American maternity wards are not following evidence-based best practices...inducting and hastening labors causing more cesarean births.
*midwifery and out of hospital births saves money and is proving to be healthier.
*but only 1% of women in the US see a midwife for their births.
"America needs better birth care, and midwives can deliver it."
Look at the stats- they speak for themselves!
My daughter Jami had a homebirth with a CPM- certified professional midwife.
My daughter Julie was denied the opportunity to have a hospital midwife since her healthcare did not allow her to go to the hospital in town that had the only midwives with her first two births. But she did leave the hospital after only 12 hours to return home. This birth she will use midwives at a different hospital and more than likely leave for home again early.
I see a midwife for my well woman care and have my annual exam done by her as well.
Midwives deliver
America needs better birth care, and midwives can deliver it.
The highlights for those who choose to not go to the link:
*the #1 reason for admissions to the hospital is birth!
*4 million American women will birth each year!
*totally $86 billion in 2006, nearly half of which was picked up by taxpayers
*we spend more than double per capita on childbirth than other industrialized countries, yet the March of Dimes gave the country a "D" on its prematurity report card.
*the U.S. ranks 41st among industrialized nations in maternal mortality.
*American maternity wards are not following evidence-based best practices...inducting and hastening labors causing more cesarean births.
*midwifery and out of hospital births saves money and is proving to be healthier.
*but only 1% of women in the US see a midwife for their births.
"America needs better birth care, and midwives can deliver it."
Look at the stats- they speak for themselves!
My daughter Jami had a homebirth with a CPM- certified professional midwife.
My daughter Julie was denied the opportunity to have a hospital midwife since her healthcare did not allow her to go to the hospital in town that had the only midwives with her first two births. But she did leave the hospital after only 12 hours to return home. This birth she will use midwives at a different hospital and more than likely leave for home again early.
I see a midwife for my well woman care and have my annual exam done by her as well.
Thursday, January 1, 2009
How to hire one of us...and then what...
We offer a Meet the Doula Tea that many folks enjoy attending. We host it every other month on the third Monday evening. We provide a video about doulas, great refreshments and a time of discussion regarding our services prior to you having an opportunity to meet the individual doulas and mingle to ask them questions. You may choose to hire a doula that evening having had time to meet her and her back ups. But...
If you are unable to attend the tea we have other ways to meet us. We provide a free interview where you can meet with how ever many doulas you desire. Some of use have an office or childbirth class space where we usually conduct interviews but we are willing to meet you elsewhere if that is needed.
And once you have talked to a few of our doulas on the phone you can usually decide if that doula is a good fit once you have met her in person. Hiring a doula is what officially retains her- that means getting the agreement and retainer received in our office.
Once you hire a doula, she usually contacts you to let you know that you have been officially added to her calendar in our office. At that point it is up to you to contact your doula with questions, concerns or just sharing how your pregnancy is going- how your appointments are going with your care provider and any thoughts you think will help her to get to know you better.
By the time you are 34 to 36 weeks pregnant, it is time to set up a prenatal meeting where you will discuss the things you learned and think may be helpful from your childbirth classes. It is also a time to define rolls more clearly and determine what your birth ideals are. Your doula needs to know what your ideal birth would look like in order to help you achieve it.
Once you think you are in labor you can call your doula to alert her. She will guide you though that time with ideas and suggestions. You will have decided at your prenatal as to whether she will be coming to your home or meeting you at the hospital- this is based on your personal needs and desires.
She will attend to your needs during your labor when she meets you once labor is well established. And there she will stay- with you- until you have had your baby and are getting settled into that special bonding time in those first hours after your birth.
It is then up to you to let her know when you want to get back together to have a debriefing of the birth and fun time to coo over your baby. Again, some doulas will come to you or meet you- and others prefer to meet in their class space in case there are items or materials accessible there they may want to share with you.
If you choose a postpartum doula you should call her once you have had your baby to let her know when you will be wanting her to start working at assisting you in this transition to parenthood. You will then set up the times and days you need.
I hope this has been helpful in understanding how we are wanting to meet your needs and have an opportunity to serve you as your doula.
If you are unable to attend the tea we have other ways to meet us. We provide a free interview where you can meet with how ever many doulas you desire. Some of use have an office or childbirth class space where we usually conduct interviews but we are willing to meet you elsewhere if that is needed.
And once you have talked to a few of our doulas on the phone you can usually decide if that doula is a good fit once you have met her in person. Hiring a doula is what officially retains her- that means getting the agreement and retainer received in our office.
Once you hire a doula, she usually contacts you to let you know that you have been officially added to her calendar in our office. At that point it is up to you to contact your doula with questions, concerns or just sharing how your pregnancy is going- how your appointments are going with your care provider and any thoughts you think will help her to get to know you better.
By the time you are 34 to 36 weeks pregnant, it is time to set up a prenatal meeting where you will discuss the things you learned and think may be helpful from your childbirth classes. It is also a time to define rolls more clearly and determine what your birth ideals are. Your doula needs to know what your ideal birth would look like in order to help you achieve it.
Once you think you are in labor you can call your doula to alert her. She will guide you though that time with ideas and suggestions. You will have decided at your prenatal as to whether she will be coming to your home or meeting you at the hospital- this is based on your personal needs and desires.
She will attend to your needs during your labor when she meets you once labor is well established. And there she will stay- with you- until you have had your baby and are getting settled into that special bonding time in those first hours after your birth.
It is then up to you to let her know when you want to get back together to have a debriefing of the birth and fun time to coo over your baby. Again, some doulas will come to you or meet you- and others prefer to meet in their class space in case there are items or materials accessible there they may want to share with you.
If you choose a postpartum doula you should call her once you have had your baby to let her know when you will be wanting her to start working at assisting you in this transition to parenthood. You will then set up the times and days you need.
I hope this has been helpful in understanding how we are wanting to meet your needs and have an opportunity to serve you as your doula.
Our Labor Doula Fees
Sometimes there is a question or confusion regarding fees that we charge at Labor of Love for our different doulas. We have over a dozen doulas in our group and have varying levels of experience, expertise and experience. Therefore, our fees vary. Our total of experience exceeds 900 births! This should allow you a better understanding of our fees. At Labor of Love we determine fees based primarily on experience. But experience alone does not make a doula a great doula. It is her heart and hands that are the most important thing to her work. Her experience enhances that, but is only one part of the recipe for a good doula. Meeting a doula and finding a great fit is the most important thing. Just as each woman has an "ideal" birth, the doula who is the "perfect" match is different as well. Within our group we offer the same services but a variety of women to meet your specific needs.'
Every one of our doulas has been through some international or national certifying organizations training to become a labor doula. Some have several certifications in several areas, and others are working on their certification currently.
We also offer an apprentice program that allows a newly trained doula to attend the childbirth series with one of the Birthing in Awareness childbirth educators. After doing so, she can then attend a birth with a more experienced doula to shadow her and assist her at a labor and birth. This allows her some hands on experience without the full responsibility to the laboring couple. We offer having an apprentice come along with your doula at no additional fee. So you get two doulas for the price of one! This is subject to if we have apprentice doulas available.
Many doulas outside of Labor of Love set their fees as to what the market will bear. At Labor of Love we try to keep our fees fair and within a reach that most couples can afford. If you are unable to afford our fees, talk to Teresa. We may be able to offer a reduced fee if there is a need or provide you with an apprentice doula for a deeply reduced fee. There are many doulas outside of Labor of Love who start their fees at our top, most experienced level. No one regulates doula fees and many doulas do not base their fees on experience level. You may find a doula elsewhere that charges $650 and is just beginning her journey as a doula. Don't assume from her fee that she is experienced. The best way to know what level of experience a doula has is to ask. If you love your doula and feel she is the perfect match for you, it is not important what her fee is if it is affordable to you.
And when looking at fees that a doula charges, it is important to know what is being offered for that fee. Other doulas may charge for "false starts" where you return home from the hospital after determining it was false labor. We do not. Sometimes other doulas charge more after a set number of hours. We do not agree with this. We feel this causes undue anxiety to the mom who may not call her doula at times she may need her, for fear she will go over that set number of hours. We do not charge for extra long labors just as we don't refund for fast ones since both are out of your control.
Parts of our services include having an extensive back up system in case of a situation where your doula is unable to attend you for a family emergency or sickness. This is extremely rare. We provide the "Meet the Doula Tea" for you to meet the possible back ups and have the ability to let us know your preference for back up. Although not guaranteed, we try to meet that request when possible. We try to provide photos and a birth story or time line for you within our services which are included in our fee. We stay for the first hour or so after the birth to help with breastfeeding at no additional fee. And we provide a free follow up meeting to get your photos and notes or story from the birth.
But we have tried to determine our fees to be reflections of levels of experience, expertise and/or certifications. As their level of experience increases or their certifications multiply, the Labor of Love doula's fees increase. If you want to know how many births a doula has supported, or what her level of expertise is, ask her directly.
Most of the Labor of Love doulas also offer a discount to repeat clients. The suggestion is to offer whatever the most previous fee was prior to the current fee to repeat clients. This is also up to the discretion of the doula. I have had several clients and their partners tell us that our fees are too low after they see what we provide. Keep in mind, just as you tip your waiter or stylist for excellent service, you can tip your doula as well! It is not necessary or expected, but always appreciated! If you have any questions regarding our fees, please don't hesitate to contact Teresa at teresa@alaboroflove.org. Thanks!
Every one of our doulas has been through some international or national certifying organizations training to become a labor doula. Some have several certifications in several areas, and others are working on their certification currently.
We also offer an apprentice program that allows a newly trained doula to attend the childbirth series with one of the Birthing in Awareness childbirth educators. After doing so, she can then attend a birth with a more experienced doula to shadow her and assist her at a labor and birth. This allows her some hands on experience without the full responsibility to the laboring couple. We offer having an apprentice come along with your doula at no additional fee. So you get two doulas for the price of one! This is subject to if we have apprentice doulas available.
Many doulas outside of Labor of Love set their fees as to what the market will bear. At Labor of Love we try to keep our fees fair and within a reach that most couples can afford. If you are unable to afford our fees, talk to Teresa. We may be able to offer a reduced fee if there is a need or provide you with an apprentice doula for a deeply reduced fee. There are many doulas outside of Labor of Love who start their fees at our top, most experienced level. No one regulates doula fees and many doulas do not base their fees on experience level. You may find a doula elsewhere that charges $650 and is just beginning her journey as a doula. Don't assume from her fee that she is experienced. The best way to know what level of experience a doula has is to ask. If you love your doula and feel she is the perfect match for you, it is not important what her fee is if it is affordable to you.
And when looking at fees that a doula charges, it is important to know what is being offered for that fee. Other doulas may charge for "false starts" where you return home from the hospital after determining it was false labor. We do not. Sometimes other doulas charge more after a set number of hours. We do not agree with this. We feel this causes undue anxiety to the mom who may not call her doula at times she may need her, for fear she will go over that set number of hours. We do not charge for extra long labors just as we don't refund for fast ones since both are out of your control.
Parts of our services include having an extensive back up system in case of a situation where your doula is unable to attend you for a family emergency or sickness. This is extremely rare. We provide the "Meet the Doula Tea" for you to meet the possible back ups and have the ability to let us know your preference for back up. Although not guaranteed, we try to meet that request when possible. We try to provide photos and a birth story or time line for you within our services which are included in our fee. We stay for the first hour or so after the birth to help with breastfeeding at no additional fee. And we provide a free follow up meeting to get your photos and notes or story from the birth.
But we have tried to determine our fees to be reflections of levels of experience, expertise and/or certifications. As their level of experience increases or their certifications multiply, the Labor of Love doula's fees increase. If you want to know how many births a doula has supported, or what her level of expertise is, ask her directly.
Most of the Labor of Love doulas also offer a discount to repeat clients. The suggestion is to offer whatever the most previous fee was prior to the current fee to repeat clients. This is also up to the discretion of the doula. I have had several clients and their partners tell us that our fees are too low after they see what we provide. Keep in mind, just as you tip your waiter or stylist for excellent service, you can tip your doula as well! It is not necessary or expected, but always appreciated! If you have any questions regarding our fees, please don't hesitate to contact Teresa at teresa@alaboroflove.org. Thanks!
Apprenticeships
Labor of Love offers apprenticeships to aspiring doulas and an extra pair of hands to our labor doulas if parents desire to include them.
If you are a new doula... who wishes to be involved in our apprentice program, please read the requirements below and contact Teresa for more information.
One of the requirements of being an apprentice is assisting Teresa,with a Birthing In Awareness Childbirth Series. This offers a new doula a new perspective in childbirth education that all the doulas of Labor of Love have shared. We feel this is an important approach to supporting women.
Although we support women in whatever choice of childbirth education they choose, since so many of our clients do take the classes we offer, it is important for an apprentice to understand this approach. We only have one apprentice per childbirth series. You may begin the apprentice program without having completed the childbirth apprenticeship if a class series is not available for you to have completed, if you have read the book Birthing From Within and have observed some of the techniques that are used within the method. But ideally we would like you to participate in this area of the apprenticeship.
The next step to apprenticeship is to have attended a certifying organizations doula training. We all are either certified with CAPPA or DONA. One of our apprentices has completed her training through ALACE. But we feel it is important if you are looking to become an doula to have completed the certifying training.These apprentice births can even act as your qualifying births toward certification. This step shows your seriousness toward becoming a doula. This investment we feel is a good one.
The final step to being an apprentice is to attend births as an assistant to one of the LOL doulas. After attending a few births and completing your training toward certification through either CAPPA, DONA, ALACE or BIRTHWORKS, you may choose to begin to do "solo" births while being a part of this apprenticeship with LOL doulas backing you up. It is up to you how many births you feel you want to attend with another doula before beginning to "solo". You are not bound by any limitations of building your own practice once you have completed you apprenticeship with Labor of Love. This apprentice program does not commit you to becoming a Labor of Love Woman of Love in any way.
New doulas who have attended the childbirth series, completed their training for certification to become labor doulas and have shadowed an experienced doula may then be invited to join the collaboration of Labor of Love Doula and Childbirth Services, Inc. This is dependent on several things- how busy our practice is, where you live and want to do births, and how you fit into our practice with matching philosophies. Or you may choose to act as a solo practicing doula during this time. There are no financial covenants or restrictions placed on you at all because you have taken the opportunity to apprentice with us. As a new doula working with Labor of Love, you may be offering your services at a reduced rate with the expertise of the experienced LOL doulas providing help and education along the way as well as back up services, if you join Labor of Love's practice. Increases in your rates for doula services will be based on experience.
As an expectant couple...you may choose to allow an apprentice to attend your birth with your doula at no additional cost. But this is totally up to you. This is totally based on availability of apprentice doulas as well. Meeting the apprentice and making a decision after that meeting is a great way to determine if you feel you would benefit in this addition to your labor team. We will not include an apprentice without your prior permission. You may choose to include an apprentice without having met her, as a way to increase the amount of help you are to receive at your birth.
Your primary doula is the doula who will be guiding you along at your birth. The role of the apprentice is to act as her helper, not her replacement. Her role is one of learning by doing but only under the guidance of the more experienced doula.
Apprentice doulas are desiring to attend births along with your LOL doula. These doulas may also be ready to begin to do births on their own as well at a reduced rate. The beginning rate for one of our newest doulas who have completed their apprenticeship and would then have Labor of Love Doulas as their back up in case of a conflict, is $450.00. These would be doulas who have completed their doula training, have apprenticed with more experienced doulas within Labor of Love and are working towards the completion of their certification.
Labor of Love is one of the only true mentoring- apprenticeship labor doula companies around. We offer our apprentices an opportunity to work along side by side with a more seasoned and experienced doula. Your primary doula is just that- the one responsible for doulaing for you. But the apprentice is an extra pair of hands to help you as well. Our apprentices have completed their doula certification training. They have attended a childbirth series with Teresa, Pam or Guina. They are there to observe and assist the primary doula.
Many times these apprentices are also using their attendance and involvement at this birth as one of their three certifying births that they must attend in order to complete their certification. But they are not there as the primary doula – they are somewhat invisible when they are not needed but highly advantageous to have in some situations. If your labor is really long, she can tag team during less needy times and allow your primary doula a break for food or rest. They can offer massage alongside of the primary doula. They can be there to hold a video camera or catch photos from a different angle. They can offer support to other family members- if you plan to have a child attend or have a partner or parent who may need some extra support.
You can occasionally meet our current apprentices at the upcoming tea. If you don’t meet the doula apprentice, you can speak to her on the phone and issue your invitation at that time. If you have her come to your birth and feel it is too much support, then she can easily be asked to leave. Her feelings are not hurt at all. She understands this is your day and you need to feel most comfortable during this time with everyone around you.
All you have to do in order to include an apprentice in on your birth is let your primary doula know. She will call the apprentice and check on her availability. If they are available, they will do their best to commit to being at your birth. Thanks for considering this option and we look forward to assisting you in your upcoming births soon! Take care and call Teresa if you have any questions regarding this fabulous program we offer- 770-923-6914.
Call of email Teresa to determine if we have any current apprentices.
The other doulas in our group can be found on our home page: www.alaboroflove.org. Labor of Love is always looking to add some new apprentices along the way.
If you are a new doula... who wishes to be involved in our apprentice program, please read the requirements below and contact Teresa for more information.
One of the requirements of being an apprentice is assisting Teresa,with a Birthing In Awareness Childbirth Series. This offers a new doula a new perspective in childbirth education that all the doulas of Labor of Love have shared. We feel this is an important approach to supporting women.
Although we support women in whatever choice of childbirth education they choose, since so many of our clients do take the classes we offer, it is important for an apprentice to understand this approach. We only have one apprentice per childbirth series. You may begin the apprentice program without having completed the childbirth apprenticeship if a class series is not available for you to have completed, if you have read the book Birthing From Within and have observed some of the techniques that are used within the method. But ideally we would like you to participate in this area of the apprenticeship.
The next step to apprenticeship is to have attended a certifying organizations doula training. We all are either certified with CAPPA or DONA. One of our apprentices has completed her training through ALACE. But we feel it is important if you are looking to become an doula to have completed the certifying training.These apprentice births can even act as your qualifying births toward certification. This step shows your seriousness toward becoming a doula. This investment we feel is a good one.
The final step to being an apprentice is to attend births as an assistant to one of the LOL doulas. After attending a few births and completing your training toward certification through either CAPPA, DONA, ALACE or BIRTHWORKS, you may choose to begin to do "solo" births while being a part of this apprenticeship with LOL doulas backing you up. It is up to you how many births you feel you want to attend with another doula before beginning to "solo". You are not bound by any limitations of building your own practice once you have completed you apprenticeship with Labor of Love. This apprentice program does not commit you to becoming a Labor of Love Woman of Love in any way.
New doulas who have attended the childbirth series, completed their training for certification to become labor doulas and have shadowed an experienced doula may then be invited to join the collaboration of Labor of Love Doula and Childbirth Services, Inc. This is dependent on several things- how busy our practice is, where you live and want to do births, and how you fit into our practice with matching philosophies. Or you may choose to act as a solo practicing doula during this time. There are no financial covenants or restrictions placed on you at all because you have taken the opportunity to apprentice with us. As a new doula working with Labor of Love, you may be offering your services at a reduced rate with the expertise of the experienced LOL doulas providing help and education along the way as well as back up services, if you join Labor of Love's practice. Increases in your rates for doula services will be based on experience.
As an expectant couple...you may choose to allow an apprentice to attend your birth with your doula at no additional cost. But this is totally up to you. This is totally based on availability of apprentice doulas as well. Meeting the apprentice and making a decision after that meeting is a great way to determine if you feel you would benefit in this addition to your labor team. We will not include an apprentice without your prior permission. You may choose to include an apprentice without having met her, as a way to increase the amount of help you are to receive at your birth.
Your primary doula is the doula who will be guiding you along at your birth. The role of the apprentice is to act as her helper, not her replacement. Her role is one of learning by doing but only under the guidance of the more experienced doula.
Apprentice doulas are desiring to attend births along with your LOL doula. These doulas may also be ready to begin to do births on their own as well at a reduced rate. The beginning rate for one of our newest doulas who have completed their apprenticeship and would then have Labor of Love Doulas as their back up in case of a conflict, is $450.00. These would be doulas who have completed their doula training, have apprenticed with more experienced doulas within Labor of Love and are working towards the completion of their certification.
Labor of Love is one of the only true mentoring- apprenticeship labor doula companies around. We offer our apprentices an opportunity to work along side by side with a more seasoned and experienced doula. Your primary doula is just that- the one responsible for doulaing for you. But the apprentice is an extra pair of hands to help you as well. Our apprentices have completed their doula certification training. They have attended a childbirth series with Teresa, Pam or Guina. They are there to observe and assist the primary doula.
Many times these apprentices are also using their attendance and involvement at this birth as one of their three certifying births that they must attend in order to complete their certification. But they are not there as the primary doula – they are somewhat invisible when they are not needed but highly advantageous to have in some situations. If your labor is really long, she can tag team during less needy times and allow your primary doula a break for food or rest. They can offer massage alongside of the primary doula. They can be there to hold a video camera or catch photos from a different angle. They can offer support to other family members- if you plan to have a child attend or have a partner or parent who may need some extra support.
You can occasionally meet our current apprentices at the upcoming tea. If you don’t meet the doula apprentice, you can speak to her on the phone and issue your invitation at that time. If you have her come to your birth and feel it is too much support, then she can easily be asked to leave. Her feelings are not hurt at all. She understands this is your day and you need to feel most comfortable during this time with everyone around you.
All you have to do in order to include an apprentice in on your birth is let your primary doula know. She will call the apprentice and check on her availability. If they are available, they will do their best to commit to being at your birth. Thanks for considering this option and we look forward to assisting you in your upcoming births soon! Take care and call Teresa if you have any questions regarding this fabulous program we offer- 770-923-6914.
Call of email Teresa to determine if we have any current apprentices.
The other doulas in our group can be found on our home page: www.alaboroflove.org. Labor of Love is always looking to add some new apprentices along the way.
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