Last night, I met with a birth client and her husband at a local coffee shop to talk about our plans for me documenting the birth of their first child. As we were talking about their midwife, the hospital they plan to birth in, I started noticing mom making some unsure comments about her pregnancy and birth. As a mom of two girls under 4, I have been pregnant twice and birthed twice, and I sure know what it feels like when you are pregnant with your first, EVERY THING is a new sensation, google is an open sea of information and you kind of don't even know where to begin educating yourself about birth or what to even trust and believe. When I got pregnant with my first child, I did not know what the word "doula" meant, I also had never even heard it spoken nor seen it written anywhere. I did not know what hypnobirthing was, and I'm sure if you had said that word to me I'd look at you a little weird and assume it had something to do with hypnotizing yourself during labor, right? That's hocus pocus isn't it? (I actually used hypnobirthing for my second birth and found that I loved it!) I didn't know back then that it mattered who you chose to be your medical provider and what hospital you chose to birth in.
So as my birth client and I were talking, I put the pause button on my birth contract and said, alright, I think we need to talk. Not birth photographer to client, but mom to mom. I want to take a leap of faith and talk to you about some stuff that I wish someone took the time to talk to me about when I was pregnant with my first. Because I am so sad and so disappointed in myself for not trying harder when I was pregnant with my first to go out of my comfort zone (beyond the four friends I had in my life who had been pregnant and had their kids within the span of 2 years who I assumed were all I needed to complete my knowledge on everything pregnancy and birth)
*This blog post / story has been approved by my dear sweet mama clients.
So let me mention two short words that make a big impact on birth:
BIRTH PLAN.
Do you have one?
Did you know you should have one?
Not sure if a birth plan is for you? A good way to know is... do you have an idea of what you are expecting out of your pregnancy, as well as your labor & birth (other than a healthy mom & baby of course?)
Here is where google can actually be a big help. Go to google and type the words "birth plan" and then click on google images. You will find SO many birth plan suggestions. Browse through them and then write down in bullet points on a piece of paper things that are important to you.
just a few biggies to me:
You can go on Pinterest & Google and find great icons like these, put them together and laminate them and put them in your hospital bag. Make sure to take a picture of it with both your cell phone and your partner's cell phone (or anyone else who will be in the delivery room with you) in case you happen to forget your birth plan at home you can still show medical staff the things that are most important to you.
If you aren't sure if something on your birth plan is important or necessary, or a smart idea, be sure to look it up online. Look for links on websites that link to medical/university studies that provide real, unbiased facts.
But before all of that....
Make sure you're working together with your medical provider as a team
It is important to bring this birth plan with you to your prenatal visits during your pregnancy and go over everything with your provider. Make sure you're on the same page as far as everything you are planning for your ideal birth and that they aren't apprehensive of anything on your birth plan. If they are worried about something, be sure to discuss it in detail to understand how their concern affects you.
BACK UP DOCTORS AND MIDWIVES! This one's a biggie!!
While you are doing your prenatal visits during your pregnancy.... Be sure to find out who backs up your medical provider in the event that they are not available the day you go into labor. Even if they say they will be, emergencies do happen. Make it a point to meet every provider (midwives and obgyns) who would be backing up your provider so that if any of those people end up helping you with your delivery, you are in the room with a familiar face who you know and trust.
LET'S TALK DOULA
I mispronounced this word for months. Is it pronounced "doola" or is it "doe-a-deer" doe-la???
(It's DOOLA)
9 times out of 10 I believe every woman in labor needs and deserves to have a doula supporting her. (The 1 time I can see it possibly not being necessary? A situation such as where mom has the support and confidence of her partner and they've done this before, and can verify that they got this all on their own. Some families who prepare for birthing using birth preparation classes such as The Bradley Method where partners learn how to coach moms through labor bradleybirth.com)
I was chatting with a friend who is expecting her second child. We were talking about doulas and how she has met with several and is just trying to decide on who is the right doula for her needs.
It is definitely not a one size fits all. Every doula has a different set of skills, experiences, a different personality and characteristics that make her the right doula for one mom, but not another.
So how do you find the right doula?
I told my friend to make a list of the things that are important to her in a doula, reasons she would want a doula present at her birth.
my own doula wish list:
1. compassion, security, mama bear
She needs to be compassionate and gentle to me. She needs to be calm and soft spoken. She needs to be a patient and active listener so that she can really hear, understand and anticipate my needs during labor.
2. discretion
Birth is sacred and private.
Although doulas are not required (like medical personnel) to abide by HIPPA laws, (at least not in Florida), they should have a solid code of ethics and be extremely discrete about all their past client's pregnancies and birthing experiences.
3. sisterhood
The people who I want to surrounded myself with in my birthing space, I don't want it to end there. I want my child to know them. I want to look back and say, that person was there for me the way my family has been and is still an active part of my life. I want to remember and keep the bonds forged during the more intense and emotional days of my life.
4. dedication
I am a birth photographer, so although I am not a birth companion, to me, dedication to my job runs deep within my heart. I have two young children at home, but my family knows this is my career and they know it's not just a 9-5 job you can call out sick from. Unless there is a life threatening emergency happening with my family, I am dedicated to my birth mama when she is in labor, without any doubt. She comes first, before any of my own needs. I can put my life first any time of day, but when I am with my birth client, she is all I see and serve. And that is what I am looking for from my birth companion too.
5. support. focus. breathing.
Of course support and stellar focus and breathing assistance during birth is transparently vital.
6. advocate
Although I am not expecting my birth companion to speak on my behalf, I do expect them to help me to find courage and the voice within myself to be my own, informed advocate for my birth, especially when interventions become necessary. (When I say interventions, I am thinking of procedures like.... administering medications that help to strength contractions, checking for dilation, pain medication, etc.). But sometimes, interventions can make labor different from the experience you had envisioned. And sometimes, certain interventions may have alternatives that are just as effective and safe and may be less disturbing to a woman in labor.
In labor, you may find yourself focused and not always remember to ask what alternatives are available to a necessary intervention. Or if this invention is needed, if there is urgency, or if it can be postponed for a few hours.
If you are hoping for a birth with as few medical interventions as possible, and communicate that with your doula, she will be sure to go over any interventions that arise during labor and if they have alternatives and their pros and cons, to help you make an informed decision during your labor for the safest and closest outcome to your ideal birth plan.
Every decision during labor can affect how a woman ends up feeling about her birth.
7. curveballs
Sometimes, even if we have our ideal birth plan printed, copied, laminated, and discussed and agreed upon with our provider and hospital, things still may not go according to plan. One of my previous births mamas who had her first child this year said to me:
"have a plan but also come to terms that it's ok if your plan changes a little than what you plan. Because sometimes things don't go exactly as planned but no matter what know your labor will go exactly how it's supposed to go and that's perfect ."
So even when birth plans don't quite work out how we envision, and birth takes a turn of its own, having your birth doula prepared to remind you of basics that are easy to forget during labor such as reminding medical staff to explain any medical procedures being done or reminding you to ask staff what alternatives are available to certain non-emergent procedures, can leave a woman feeling like she had a say and some power in her birth. Because after all, this is no one else's birth but her own.
I often get birth inquiries where my clients have either chosen not to hire a doula or have not even known this is an option.
I find that lack of knowledge/awareness about what a doula is and what they can do for you during labor (and after birth) is usually the cause for why families decide not to hire one for their birth.
I am so respectful of all my families birth plans. Whether you are having a scheduled cesarean birth or are planning to birth at home, I will honor and serve you. What I find with many (not all, but many) moms is that they are simply unaware of what they are missing out on when they actively choose to not hire a doula. I have had some really incredible experiences watching compassionate and experienced doulas during women's labors and I have seen labors without doulas.
Going back to my friend who is searching for a doula for her second birth. I was really curious about what she is looking for in a doula, after interviewing several and being uncertain who to choose. Here is the list she sent me:
Ok, things I'm looking for in a doula:
-personal connection is huge. This person is going to see me through a hugely personal and emotional time (where I will likely be completely naked!) so I want that comfort level
-confidence. I want someone who I know will take charge, be proactive, and knows their skills and how to use them. In the interview I want to be told about these skills so I don't leave feeling like "she was nice but what does she offer?"
-a feeling from me that the person is intuitive. When I'm in the throes of labor and don't know what I need, I want someone to be intuitive enough to see what I might need.
-laid-back personality. I interviewed a few women who were really cheerful and bubbly, and I just couldn't imagine that being calming. And I want confidence but not bossy or overbearing.
-massage is a big bonus for me, even though I'm not sure how much I wanted to be touched during birth last time! I didn't have a doula, however, just my husband who was well meaning but clueless! I love massage in general and think it could be a wonderful tool.
-Hypnobirthing knowledge. I took the classes and would love someone who is supportive and guiding during the tough times of labor when I have a hard time staying "in the zone."
-experience. Although I know everyone starts somewhere, I feel more reassured with knowledge. Same for the person being a mom. I interviewed a few who were not yet mothers and I respect that but I feel like there is something vital you learn having actual birthed a child.
I am horrible at asking questions, so it is comforting to me when someone can talk about themselves and what they bring to the table. The confidence for that person to provide me with that information, being prepared.
After listing these things that my friend is looking for in a doula, she asked me to also include the following in this blog post:
"I went into my first birth thinking "I practice yoga, I took Hypnobirthing, my mom will be there and she had 2 unmedicated births... I can do this without a doula!" Boy was I wrong. My husband was exhausted and unsure of how to help and I didn't know what I needed. I was so overwhelmed by the emotions and sensations that Hypnobirthing went out the window. I didn't push myself to eat or drink and ended up tired and dehydrated, which stalled labor. I needed a doula, I needed a guide. I never once lost my drive for my water birth, and ultimately had a good experience, but having a doula would have made it so much better for everyone. I now tell my expecting friends "just get the doula!" And my husband always chimes in in agreement!"
Addressing the question of the mom who may possibly not need a doula
Some moms who have birthed before and may know their bodies well enough that they can identify every sensation, whether pain or otherwise, and can assure themselves, this physical intensity is normal, this timeline is normal, I feel confident, safe, I can breathe all on my own, I am of sound mind through transition and as my baby is crowning, I reach down and I catch my own baby in my own hands.
These are the moms that know they have not needed a doula before, they will not need one again, they've done it on their own before and persevere in that atmosphere.
Most moms I have met in my lifetime are not the above mentioned mom.
Most of us need some level of support. Be it physical counter pressure for 23 hours on our lower back during labor or emotional support when we are not sure if we can do this anymore. Many times, when we get to this point, we are not the same resilient energetic person we tend to be everyday. Labor can be exhausting, it can be hard work for many moms. And after hours of labor, many moms do get to the point where they need someone who will be that resilient encouraging energetic person who will get them from active labor to holding their baby on their chest.
Moms, our partners are not a 24/7 coffee shop either. They do need a break when they've been providing us with support for hours upon end. Their muscles wear down and ache, and for some very lengthy labors that started right as you were about to go to sleep last night, but now you've been up through the entire night and it's already the next day, it is totally realistic and normal to see partners dozing off. But mama doesn't stop. She continues laboring. And she needs someone there for her at all times.
One of the things I most commonly hear from family and mommy friends is:
"I'm planning to labor naturally without medication, unless I can't handle the pain then I'll probably get an epidural."
There is nothing wrong with that birth plan. But before you commit to one plan or the other, consider a birthing class that will help you realize that first part of your birth plan. The laboring naturally until plan.
Ultimately, the goal is to have a healthy and happy mom & baby. But that does not mean that your ideal birth plan does not matter. Mama gets a voice in how and where she chooses to birth her baby. I want to see women who are supported in labor and who aren't fearful. That is the reason behind this blog post. When you look back on your birth photos, or think back on your birthing day, you want to see yourself surrounded by people who are there to serve you, your partner and your baby during labor. You want to remember feeling safe and sure of yourself.
So do not go into labor alone with a mentality of "we'll wait and see what happens"
Be prepared.
Have a plan.
(and a back up plan, and an emergency plan, and be flexible!)
But most of all....
Plan to be supported on your greatest first day as mom, your beautiful birthing day.
This blog post comes at a really striking time for me. Today is the one year anniversary of my birthing day with my second child. Today my little girl turns 1! In a way, writing this blog post, despite it not being my own personal birth story, it does give me some closure and shows me how much I've grown to understand about my own birth in the last 12 months.
