Doula Tools?

Often I am asked what I bring to a birth—what is in my doula bag.  Many new doulas are curious and looking for tips or ideas of what to pack with them that is easily transportable for comfort measures and such when they attend labouring mothers.  Suffice to say, I carry nothing tangible—no essential oils, no massage tools, no lotions, no rice socks, no birth ball—what kind of doula am I?

What I bring to births pretty much is God-given…my voice, my ears, my eyes, my heart, my brain, my hands and a very strong back.  I do carry a camera, my wallet and a change of clothes; but otherwise I have no backpack of supplies, no rolling suitcase of magic tricks—no special items of any kind.  I think that all doulas new to this field eventually give up or limit what is brought to births the longer they actually do this job.  I think I carried a bag of labour support items for the first 5 births I did, then I just found I never really used any of it!

If one reads and understands the literature of what a birth doula actually is and what she is supposed to be in the first place, they’ll realize we were never intended to have all these lotions and potions.  The 21 controlled and randomized studies done on doulas in the last 25 years focus solely on the doula's presence, not what the doula is doing.  Doulas inherently protect a labouring mother’s space; doulas BE not DO.  Many times newer doulas think they need to be helping a mother labour by assisting in ways of massage techniques, using essential oils, understanding herbal remedies, moving her into positions to promote labour progress and such.  (Most of this stuff is outside a doula's scope of practice, but it depends on her certifying organization.) While sometimes a doula will offer guidance in different types of comfort techniques or help promote movement, if it becomes necessary, a doula does not need tools to do so…she needs instinct, love and kindness.  Birth is not a production—it is a bodily function, and it needs time and patience to occur. 

Most items, if indeed necessary, used during a birth can be found either in the home or the hospital—my clientele chuckle that I am the MacGyver of all things related to labour.  Many of my clientele already have things in their homes to use (which solves the whole cross-contamination issue) and most hospitals carry what I can use; if I need something.  Honestly, homes pretty much have anything and everything and hospitals have towels for gripping, ice and water dispensers, heated blankets, hot showers, water bottles, perhaps a birth ball gathering dust in a far corner, a TENS machine hidden away on a shelf and many other items that if you think outside the box, you find you can use it! 

But really, what all my mothers and partners want from me is a calming presence, a hand to hold, sincere praise and encouragement and knowing that I believe in them and the work they are doing to bring forth new life.  They want me to hold their private space, they want me to be the tranquility in the storm, and they want me to slow the pace down if things start to veer off their intended course so they can make informed choices.  They want my instincts as a birth observer—nothing more, nothing less.

So to answer the question I am so often asked—I take myself to a birth—the essence of me and I give that to each and every labouring mother.  No tools, no tricks, no magic…

Family or Career?

I cried when I received this…I nearly broke in two when I ended up withdrawing my offer of admission.  Why can people not understand that my family comes before my career? Initially everyone was on board of having their wife and mother move to Ontario (a mere 2500 km away) for FOUR years—including a 20 month practicum, but my youngest son’s reality is simply this…at 13 he still wants and needs his mom.  I chose him over midwifery school…for now.  Although Southern Alberta is screaming for midwives...licensed, registered midwives, and we have NONE…I’m sorry.  What kind of mother or midwife would I be if I sacrificed the very things that lead me on this journey in the first place?  One day…some way…some how…I will get there.  Just not now.  And for all you "non-believers" that I actually achieved an acceptance…see below…

When you learn...teach!

Have you ever had one of those days, when you got home from a day that didn't seem to end? You collapse on the couch, your muscles screaming from overuse, your temples pounding because your brain fried itself hours before and your stomach cramping because you can't remember the last time you ate? No sooner than you park your rear to catch your breath,  you’re ambushed by an adoring feline who fights you for cushion space, one of your children suddenly awakens with the flu and christens your carpet and your loving husband took the laundry from the dryer but dumped the clothing in a wrinkled heap on the floor.  Seems lately I've been having a lot of "these" days... 

Sometimes it’s hard to know where we, as women, find our energy to multitask and survive. But despite the challenges, the gratification we receive from what we are able to accomplish makes the chaos worth the aftermath.  We work hard to “have it all” and in the process of living we sometimes forget our own health and well-being. Most of us are guilty of putting ourselves last.

For me, after a long day or night spinning on the hamster wheel called my life, I regain balance and restore my mental energy by turning to a woman I have always loved and admired. Maya Angelou revives my tired spirit. She is my beloved guru whose powerful words lift me up and make me believe in myself again. She is a creative genius, gifted in story telling, using a melody of verse that can quiet the stormiest of souls.

She enters my sensory world and fills my empty cup with knowledge and meaning. I ingest her works with gratitude, literary metaphors and poetic symbols. Words enter my mind and touch my heart, painting pictures of a new world filled with possibility. She taught me that we all have an opportunity to contribute and make a difference, if we are willing to give of our time, while wishing on a shooting star that we’ll be able to leave a brighter world to our children.

She is a creative power, a grand giver and if you open your mind,  she will gently explain life’s truths and mysteries. When you close the pages of her words, you will believe that no mountain is too high to climb; failure and quitting is never an option; wishes do come true, even if you’re not Cinderella; love yourself; love others; rise up every day and do your best -- magic can be found if you look for it….

45 Best Maya Angelou Quotes

1. If we lose love and self respect for each other, this is how we finally die.

2. Love recognizes no barriers. It jumps hurdles, leaps fences, penetrates walls to arrive at it destination full of hope. 

3. If you have only one smile in you, give it to the people you love. Don’t be surly at home, then go out in the street and start grinning ‘Good morning’ at total strangers.

4. If you find it in your heart to care for somebody else, you will have succeeded.

5. Love is like a virus. It can happen to anybody at any time. 

6. The honorary duty of a human being is to love. 

7. Courage is the most important of all the virtues, because without courage you can’t practice any other virtue consistently. You can practice any virtue erratically, but nothing consistently without courage. 

8. I love to see a young girl go out and grab the world by the lapels. Life’s a bitch. You’ve got to go out and kick ass. 

9. My great hope is to laugh as much as I cry; to get my work done and try to love somebody and have the courage to accept the love in return. 

10. One isn’t necessarily born with courage, but one is born with potential.  Because without courage, we cannot practice any other virtue with consistency. We can’t be kind, true, merciful, generous, or honest. 

11. The ache for home lives in all of us, the safe place where we can go as we are and not be questioned. 

12. The idea is to write it so that people hear it and it slides through the brain and goes straight to the heart.

13. Life is not measured by the number of breaths we take, but by the moments that take our breath away.

14. I can be changed by what happens to me. But I refuse to be reduced by it. 

15. I’ve learned that every day you should reach out and touch someone. People love a warm hug, or just a friendly pat on the back. 

16. Success is liking yourself, liking what you do, and liking how you do it. 

17. My mission in life is not merely to survive, but to thrive; and to do so with some passion, some compassion, some humor, and some style.

18. You can only become truly accomplished at something you love. Don’t make money your goal. Instead pursue the things you love doing and then do them so well that people can’t take their eyes off of you. All the other tangible rewards will come as a result. 

19. When you get, give.  When you learn, teach. 

20. I’ve learned that no matter what happens, or how bad it seems today, life does go on, and it will be better tomorrow.

21. Be a rainbow in someone else’s cloud. 

22. We delight in the beauty of the butterfly, but rarely admit the changes it has gone through to achieve that beauty. 

23. You alone are enough. You have nothing to prove to anybody.

24. Bitterness is like cancer. It eats upon the host. But anger is like fire. It burns it all clean.
 
25. The desire to reach for the stars is ambitious. The desire to reach hearts is wise.

26. Hate, it has caused a lot of problems in the world, but has not solved one yet.

27. You may shoot me with your words, you may cut me with your eyes, you may kill me with your hatefulness, but still, like air, I’ll rise!

28. I’ve learned that regardless of your relationship with your parents, you’ll miss them when they’re gone from your life. 

29. Nothing can dim the light which shines from within.

30. I sustain myself with the love of family.
 
31. I’ve learned that whenever I decide something with an open heart, I usually make the right decision.

32. A woman in harmony with her spirit is like a river flowing. She goes where she will without pretense and arrives at her destination prepared to be herself and only herself.

33. The ship of my life may or may not be sailing on calm and amiable seas. The challenging days of my existence may or may not be bright and promising. Stormy or sunny days, glorious or lonely nights, I maintain an attitude of gratitude. If I insist on being pessimistic, there is always tomorrow. Today I am blessed.

34. The problem I have with haters is that they see my glory, but they don’t know my story… 

35. A woman who is convinced that she deserves to accept only the best, challenges herself to give the best. Then she is living phenomenally.

36. The sisters and brothers that you meet give you the materials which your character uses to build itself. It is said that some people are born great, others achieve it, some have it thrust upon them. In truth, the ways in which your character is built have to do with all three of those. Those around you, those you choose, and those who choose you.

37. Living well is an art that can be developed: a love of life and ability to take great pleasure from small offerings and assurance that the world owes you nothing and that every gift is exactly that, a gift.

38. Never make someone a priority when all you are to them is an option.

39. You may not control all the events that happen to you, but you can decide not to be reduced by them.

40. We spend precious hours fearing the inevitable. It would be wise to use that time adoring our families, cherishing our friends and living our lives. 

41. When we give cheerfully and accept gratefully, everyone is blessed. 

42. This is my life. It is my one time to be me. I want to experience every good thing. 

43. I have found that among its other benefits, giving liberates the soul of the giver. 

44. We all should know that diversity makes for a rich tapestry, and we must understand that all the threads of the tapestry are equal in value no matter what their color.

45. You rose into my life like a promised sunrise, brightening my days with the light in your eyes. I’ve never been so strong. Now I’m where I belong. 

Why I am a Doula

I wanted to become a doula to be an advocate for women and their families, to remind them of the power of the female body, a mother’s inner wisdom and intuition and to support them in whatever choices they make that are right for them.  I want to be a resource to help women locate quality, accurate information as it pertains to what they wish to be more informed on.   While I cannot lead them in their decisions, be their voice, nor do the work of labour for them, I can treat women with soft words, an open heart and gentle hands to help expand and soften the path to motherhood.  I want women and their families to understand that birth is a sacred event – physically, emotionally, mentally and spiritually – so it should not be treated at as a means to an end.  Since birth is a journey, one that will test everything a woman thinks or knows about herself, I want women to know they are the best advocates for themselves.  As a doula I strive to be a guide to the mysteries that unfold; supporting mother, baby and their families in a loving and relaxed environment.

My personal experiences have guided me toward the doula I am today.  My first birth I was young and uneducated about pregnancy, labour, birth, breastfeeding.  I trusted the “system” to take care of me; after all, that’s what a doctor and a hospital did, wasn’t it?  Fear and pain were something to be medically managed with pain relieving drugs.  Who in their right mind would attempt childbirth without them?  My physician knew best about the changes my body was going through, he knew best about how the process of labour worked, and he knew best on how to safely deliver my child into the world.  During this birth I was so out of control. I screamed, cursed and tried to escape the fear of pain.  Nurses didn’t have the time to stand beside me to calm me so instead offered medications.  Narcotics didn’t help as they only made me woozy and nauseous.  My husband was clueless and as terrified about the whole process as I so he had no tools to try to help me.  The doctor tried to “speed up” the labour after 27 hours of being stuck at 3 cm and ruptured my membranes leading to a prolapsed cord and a stat cesarean section.  My recovery was a nightmare. Breastfeeding was difficult, my milk was delayed from the cesarean section and no one offered to help me work around my incision.  After a week, I was exclusively bottle feeding.  I was consumed by anger, frustration and rage.  I felt used, abused and discarded by a system I believed to better than what it was.  I was left bitter and resentful about the whole experience of birth.  I vowed I would never have another baby.

 When I found out I was pregnant with my second child and overcame my initial terror, I wanted things to be very different.  I spent hours trying to educate myself through books, articles, magazines, and sought out other’s advice. I journeyed and explored my rights as a patient and as a woman in her childbearing year. I gathered information on midwifery care and the benefits of doula attended birth.  I took prenatal yoga classes to blend my body, mind and spirit in preparation for birth.  I discussed my fears about pregnancy, labour, birth and breastfeeding with a counselor trying to move past my trauma and anger.  I wanted to avoid a repeat cesarean desperately so I armed myself with knowledge about VBAC and it’s benefits and risks. Through this inner growth I learned about birth plans and the benefits of breastfeeding.    Hearing the wonderful stories about doulas empowered me to find one for my birth, when at this time they were new and almost unheard of.  My doula became my lifeline. I was determined to have my body and baby work as one.  This time when labour started I became connected – I wasn’t just a vessel, I was a woman and I was strong.  I ended up being induced with pitocin at 38 weeks because of uncontrollable obstetric cholestasis (my ALT enzyme in my liver was 400% above normal - that was with medication). My labor was hard and fast but I DID it and pushed my baby into the hands of a medical student – I pushed so fast my physician was still in transit.  My husband and I were relaxed and confident in my body, our baby and our choices.  By following my birth plan and having an acceptance for the unexpected my birth felt flawless.  My doula was so helpful through all my transitions, she never judged nor lead me to my decisions but provided compelling information.  Even to this day, almost 15 years later, I have never forgotten how exhilarated I felt during that birth and after.  I owned it and I did it – on my own terms this time.  I wanted to share this new found joy of birth with other women and to help them on their paths to a enlightened childbirth experience.

These are only two of my personal and very different experiences with birth, which have led me to the path of being a doula.  I have been told I have a gift; a divine feminine energy to serve other women.  My passion as a doula is educating woman about their choices.  I strive to be an advocate for women, babies and their families; reminding women of their inner voice and birthing power.   I provide emotional and physical support during pregnancy, labour, birth, postpartum and breastfeeding.  I disseminate positive energy, confidence and love to all mothers.  I am educated about the political issues surrounding labour, birth and breastfeeding. I have had the honor and privilege to attend over nine hundred births.  This is my life’s work, for me it is a calling, and a career, and I am proud to call myself a doula. 

Essay on Informed Decision Making

Since the health-care maternity system is a consumer-orientated operation concerned with attracting mothers and keeping them healthy and satisfied, you would think that more effort would go into helping these women make informed decisions about their care.  However, those who serve the medical system are not always vigilant in supporting the needs and wishes of their patients and institute policies that could potentially conflict with these choices.  Informed-decision making creates a partnership, or shared-care, with regards to the relationship between patient and healthcare provider. As mothers learn about childbirth, they can begin to understand their options and develop necessary skills.  This approach builds confidence and self-esteem and promotes growth to both the individual and as a mother.  The process of each mother’s education is a joint venture in which the mother helps determine what she needs to know and how much information she will need to truly be informed.

An informed mother is an advocate for health consumerism.  When weighing the risks involved in medications or medical interventions, caregivers may at times interject subjectivity in to the decisions and patients need to understand this to truly make informed choices.  This is perhaps based on tradition or accepted practice, but this subjectivity can be a cause for disagreement concerning the best of course of treatment for a given situation.  The fear of malpractice claims is a great motivator in such subjective approaches.  Therefore;  informed decision-making and informed consent benefits both parties.  By gaining as much information as possible, gathering evidence-based facts, weighing the pros, cons, risks and benefits about a recommended treatment and exploring other alternatives and possible outcomes, the mother is able to offer knowledgeable and responsible input.  Mothers then can be more actively involved in making decisions and in guiding the course of their treatment for themselves and their babies.  This also enables healthcare providers to broaden their perspectives based on consumer input.

Informed decision-making means the patient consents or declines treatment based on sufficient information and education.  Since education is the key, patients must take the initiative to self-education and discovery of what choices are right for them based on a variety of situations.  The majority of medical situations allow adequate time for the mother to seek answers and to ask questions, but she needs to know which questions to ask and what answers to seek.  A mother has the right to: understand what she is giving consent to; to understand the benefits and risks of any particular medication or intervention and how if will affect her, the baby and her labour; if there are any alternative methods that can be tried; to know if this procedure is medically indicated, why it’s being suggested, if it is elective, new or experimental; to have her questions answered completely and courteously; to seek another medical opinion and to accept or refuse treatment based on the best evidence-based practice.  Informed decision-making is not a prerequisite for quality healthcare.  However, it does increase the chances for positive outcomes for the mother who has accepted the responsibility for becoming knowledgeable and actively involved in the management of her pregnancy, birth and postpartum care.

Until recently, many mothers had felt they had few choices about their experiences, with hospital and physician policies dictating the course their care.  Real change happens when an awareness and attitude shift occurs, either among healthcare providers or with their patients.  This is where support services can play an enormous role in educating and advocating for information in the choices available to women and how to help them succeed in creating a positive environment of communication with their care providers.  One of the primary roles of support is to encourage mothers to be active participants in the care they receive and to take responsibility for their actions.  Sometimes this shift in mentality encourages a change in care provider or paves the way for an understanding with a present one.  My primary goal in providing support services would be to educate and locate resources about evidence-based practices in birth for my client through reading material, conversations, classes, online resources and prenatal meetings.

However, it is important to determine how informed a woman is in her choices, if at all, before bombarding her with information and resources.  Some mothers may be unaccustomed to questioning a statement or suggestion made by their healthcare provider.  A mother not accustomed to being actively involved in her care may need more guidance in how to effectively approach her care provider to ensure a positive interaction and a healthy working relationship.  Presenting facts to a mother will help her discover options that best suit her needs and goals and begin the learning process on how to make informed decisions.  By helping a mother develop her awareness of her rights and responsibilities, she’ll gain confidence in herself, the process of birth and her maternal instincts.   For the mother that is already well versed in dealing with her healthcare provider through informed decision-making, my support services would  be more to help her clarify her wants and needs.  By facilitating her empowerment through my words and actions, I can encourage her to further growth and continued belief in her abilities.

Since every birth is unique, so will be my approach to each and every woman I support.  Every woman has an array of experiences and resources that make her needs different from another.  Respect will be given to each woman’s background, cultural diversity and personality.  This personalized approach with every mother – one that assesses her needs, capitalizes on her strengths and praises her accomplishments – will lead to a mother’s satisfaction in both her communication with her care provider and in her birth experience.  By facilitating this growth through words and actions, my belief is that a mother will trust her instincts in birth, ask questions and seek the best care for herself and her baby through informed decision-making.

To summarize, informed decision-making is the responsibility of both the mother and the healthcare provider to develop a relationship based on communication and trust.  The more exposure a mother has to asking questions, seeking educational opportunities through written and online resources and receives the support she needs to find her voice, the more positive the experience will be regardless of interventions or method of birth.  And sometimes, the attitude towards out-dated practices, policies and procedures are changed, due to the educated and informed patient for the benefit of others.

Miss Understood

I’m an introvert and I like it...


I am tired of being misunderstood.  I’m tired of other people thinking I’m intimidating, arrogant and anti-social. I’m tired of people thinking if I just tried a bit harder I’d really love social gatherings and engaging in hours of directionless conversation.  I'm tired of being tired...


Simply put introverts are drained by socialization...it takes a lot out of me when I do it.  The world in which we live seems to reward and praise the extrovert, even if it borders on what I, an introvert, would consider manic!  And people think I’M crazy!


Honestly, large social gatherings aren’t particularly fun for me, albeit with friends, family or strangers. I am not missing out on anything. I don’t miss it because I don’t want it. This is how introverts feel about social situations. If I wanted to hang out with a dozen people at once, engage in mindless chit-chat for hours, believe me I would.  Even my husband’s family, which is extremely large, doesn’t get me, and I’ve been involved with them for 20 years! 


This is not to say I am not social. It’s just that I take socialization in little pieces and prefer to be more situationally sensitive. I excel at one-to-one interaction.  Any client of mine will tell you that.  Give me a laboring woman and…HELLO…I come alive!  I prefer solo activities which engage my mind. This doesn’t mean I never hang out or participate in large groups; it’s just that unlike an extrovert, I don’t need to. And that’s an important distinction.


So don’t be confused or misunderstand my behavior. I have a very vast, rich and full life. I have a wonderful family.  I’m into birth, babies, families, running a doula business and interacting with wonderful, thoughtful people. I do go out to great restaurants, see fabulous concerts and shows, and enjoy hanging out with my family and a few close friends.  I read.  I think.  I spend hours listening; it’s amazing what you hear on the wind and what floats back when you keep your mouth shut.  Sometimes the things I hear about myself hurt…devastatingly so.


So I’ve put together a list for dealing with me. These are general tendencies and patterns. I don’t care if you follow them; I just want you to understand them and therefore; me...


1. Don’t put me on the spot and expect me to perform.


This one is mainly for other adults. I can be somewhat awkward in social situations, so don’t misinterpret my behavior as a deficiency in hearing, sight or language processing.  I’m not an idiot and I’m not being a bitch. When you ask a question there may be a delay in my response and I could talk in a soft monotone, avoiding eye contact. When I’m comfortable with my surroundings I’m extremely verbal and my tone is very expressive.  I have a photographic memory but I need quiet to activate it.


2. Don’t throw me into complex social situations and expect anything but silence and withdrawal. At least at first.


To an introvert this is a no brainer. To an extroverted world an introvert‘s natural response to social stress can be misinterpreted as aloofness or arrogance. It is neither. I simply feel uncomfortable and overwhelmed. I eventually warm up, let me.


3. I need time to get used to you. Don’t take it personally if I don’t immediately engage you because you said hi.


Introverts need time to warm up to someone. Once they let you in, they can be quite talkative and physically demonstrative. Until then though, don’t expect much. I am not being rude and it has nothing to do with how I feel about you personally.  Be patient.  I’ll eventually talk your ear off.


4. I recharge my batteries by being alone. Don’t take offense if I leave and go off by myself for a while.


I have been known to disappear at family functions, conferences or even workshops during sessions, lunch, coffee breaks or when I feel overwhelmed.  I am not being anti-social.  I process information internally. I need to look inward to find my center and make sense of new information or an unfamiliar situation. An extrovert looks externally to accomplish the same thing. It’s really not a big deal...I always come back!


Introverts are like layers in an onion. You just have to be patient. Some onions are just harder to peel than others.  And I have many, many layers.  You'd be surprised at what you find when you start to shed them...