Category Archives: Doula

Focal Points for Birth

I had a beautiful focal point during my first birth.  It was a gorgeous piece of moss that my husband glued to a flat rock.  I let my eyes grow blurry and lazy as I stared at that moss.  Norah’s middle name is Moss.  I still have it sitting on a shelf in my bedroom though the moss has turned yellow.

For my second birth, I used plants and affirmation.  At my amazing blessingway, guests brought plants to surround me during my birthing time.

I see many focal points used during births.  I remember a woman who used a picture of herself sailing a boat.  That experience reminded her that she could do anything.  I’ve seen parents display their baby’s first outfit or an ultrasound photo.  Or, a couple who cut out a circle with the word, “Peace” and taped it over the clock in the hospital room.  Brady covered a wall in her home with individual affirmations.  Focal points can be fantastic reminders and affirmations during your birthing time.

But my favorite focal point ever was from Katy.  She traced a circle exactly 10 cm and used it in her affirmation.  See it here taped to her hospital bed.  It says, “Go ahead and let gO, Katy.  He’s almost here.”

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Did you use a focal point during your birthing time?

Greenville Memorial and Family-Centered Cesarean

I guess Greenville Memorial didn’t want me to only blog about Greer. They one-upped Greer’s family-centered cesarean.

History: When I first started doula work, sometimes I was permitted in the operating room at Greenville Memorial with my client. It was still hit or miss. However in recent years, the “rule” is only one support person for cesarean births. Until now.

Much to my surprise, at my last Greenville Memorial birth, JoAnn the trailblazing midwife, told me I was going back. I threw on some (cloth!) scrubs and Louise, a favorite nurse of mine, insisted I go with my client as she was being wheeled back.

That was the one-up.

Whenever I’ve been allowed back, I’ve first waited with dad until mom was prepped. This time, I stayed with mom the entire time. I was able to wipe a few tears while she waited, hold her while she received her spinal anesthesia, and talk with her as the surgery began. After the surgery, when dad left for a little while with their baby, I stayed until she was wheeled into recovery.

True continuous care.

Even better? JoAnn says the policy has now changed to allow two support people into the operating room.

I’m not saying I’m responsible for that. I’m just saying I’m glad I didn’t trip and face plant on mom’s uterus or something. Ruin it for everybody, you know? 🙂

Now, look at this adorable poppet enjoying skin-to-skin time with daddy in the operating room. Don’t worry, she got lots of immediate skin-to-skin time with mama first. Mom voluntarily permitted dad a turn.

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It looks like family-centered cesarean birth will be standard care now at Greenville Memorial.

Now, let’s keep that cesarean rate on the decline!

Another Family-Centered Cesarean Birth

This post contains pictures of cesarean birth. 

I am more and more impressed with Greer Memorial’s cesarean practices.  If I had to plan a cesarean, that’s the place I’d give birth.

There are four OBs who attend cesarean births at Greer so the policy and practice is fairly cohesive.  None of the “well, if you get dr. so and so, then expect x, y, z.”

I was honored to attend a repeat client’s planned cesarean.  I use the term “planned” loosely since her darling boy decided to come early.  Just to keep us on our toes!  Come to think of it…her last “planned cesarean” also had me rushing to the hospital.  Her babies don’t like to be told what to do, I suppose.

Here is her birth in pictures.  I only took 150 snapshots so it was easy to narrow it down to a few.  Hehe.

Top reason I prefer Greer?  Doulas can enter the sacred operating room.  And I dig the nurse’s scrubs instead of the paper ones.  In this picture, I’m waiting with dad.  The mom goes back first and there is about a 30 minute wait while she receives her spinal anesthesia and her stats are monitored.  Dad was nervous even though it wasn’t his first rodeo so we talked about our kids while we waited.

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Now we’re in the operating room.  Notice mom’s arms are not strapped down.

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Dr. Danielle Harris is the OB.  She is lovely; relaxed and accessible.   I remember my first birth with her four years ago.  I suggested something wildly uncommon and she responded with a “hey, let’s try it!”

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The sweet baby grabs an arm and says, “Wait!  I want delayed cord clamping!”  No, actually, Dr. Harris delays cord clamping because it’s not a big deal to delay cord clamping.

(which is interesting because I’ve heard all sorts of reasons from other OBs as to why they can’t delay cord clamping during a cesarean)

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So, who’s this guy?  He’s the pediatrician on call.  Typically, the pediatrician or neonatologist examines the baby in the warmer immediately after birth.  When he walks in, Dr. Harris tells him, “Mom would like immediate skin-to-skin with her baby.”  And he says, “Fine by me.”

(again, I’ve heard all sorts of interesting reasons why this can’t happen:  a nurse will have to rotate out in order to hand baby to mom or it’s too darn cold in the operating room).

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Now you’ll see how fantastic it is that mom’s arms are free.

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Beautiful.  Mom will never forget this moment.  And perhaps, just as important, significant aspects of bonding, breastfeeding, heartrate and thermal regulations are happening in this moment.

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A little while later, that laid back pediatrician asks if he can just take a quick listen to baby’s heartbeat.  He does so without disturbing mom or baby and then steps back once more.

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Twenty minutes after the birth, as they prepare to transfer mom to her room, Dad gets in on the skin-to-skin.

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Focus on the calm, alert baby.  Do not focus on the bloody gauze behind him.

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Then mom is transferred to her hospital bed via a clever inflatable people-mover blown up with a shop vac.  Fascinating stuff, hospital ingenuity.  Side-note, many nurses wrap hep-locks in Glad press ‘n seal wrap so they won’t get it wet in the shower.  Necessity is the mother of invention.  

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The hospital bed returns to mom’s original room where she will stay until she goes home.  There are no recovery or postpartum rooms at Greer.  There is no nursery either.

Mom gets down to the first order of business.

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I don’t attend many cesarean births.  I’m honored when I am invited to a planned cesarean as part of the team.  Many thanks to this sweet family for sharing their positive birth experience with the community.

Another family-centered cesarean birth is featured here.

Doulas as pacers

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Truth?  Sometimes I’m baffled by my work as a doula.  I’m confused by the mystery that my presence makes an impact.  Especially when I don’t *do* anything.

Take Julia’s birth.  I left Julia’s birth feeling like her three year old did more than I did.  I mean, really.  What did I possibly offer to that family?  And then later, Julia’s husband says I was worth every penny.

It made no sense.

Or Melissa’s birth.  I fanned her.  With a manilla folder.  That’s about all I did.  And then later, she says she couldn’t have done it without me.

It made no sense.

I read about the early studies on doula support.  In those double-blind randomized controlled trials, the laboring women had no idea that the extra woman in the room was a doula.  They’d never met before.  Yet, their birth outcomes were significantly better than the births that did not get the “extra person.”

It made no sense.

Nearly 8 years into this gig, I think I’m maybe beginning to understand how doulas work.

We’re pacers.

I’m reading an incredible book titled The Worst Is Over:  What to Say When Every Moment Counts.  I bought the book thinking it would help with my kids.  Norah has an anxious tummy and Cedar is ever catapulting from high places.  I never imagined how it might relate to my birth work.  But, of course, women in childbirth are in an altered state of consciousness just like people who experience trauma.  Childbirth is NOT trauma and not always even painful but the brain does go into an altered state.  Women in childbirth are often dreamy, time becomes hazy, thoughts may be confusing, suggestions plant deeply.  I already knew how important language is for birthing women but this book took it up 10 notches.  And it taught me about pacers.

So what’s a pacer?

You know how you modify your body language, voice, words to become more in sync with others?  It’s a normal part of communication.  Or sometimes a strong personality can change the entire mood of the room when that person is having a bad day.  The author describes pacing as “our natural human tendency to tune in to others nearby by matching our words and our behaviors to theirs.”

The author talks about the importance of pacers when people are afraid, hurting, in shock, etc.  Pacing builds confidence, healing, comfort, rapport, and cooperation.

supportHow does this work in childbirth?

Nancy is deep in the birth zone.  She is in an altered state of consciousness.  She is barefoot in the hospital shower–a state that would disturb her any other time.  Usually a very modest woman, Nancy is naked.  Her husband, in swim trunks, supports her physically in the shower.  What am I doing?  I’m leaning against the wall, offering a sip of water from time to time.  I don’t say a word.  But here is the non-verbal pacing that is happening:  Nancy locks eyes with me as she welcomes each surge.  My eyes are confident, grounded, and full of love.  She knows I’ve done this before.  My eyes tell her everything is normal.  What else?  My posture is relaxed.  I’m not carrying tension or shedding adrenaline.  As we lock eyes, I take a deep cleansing breath and release it slowly.  She mimics me.  I smile.

IMG_2632Sarah sits on her birthing ball leaning on her king-sized bed.  Her husband rubs her back.  Bon Iver plays in the background and the rain is falling outside.  There is nothing for me to do so I sit in the corner and knit.  Sometimes, Sarah looks over at me and I smile.  My calm, slow knitting reassures her that all is progressing perfectly and there is no rush.

Heather’s labor is showing signs that baby is not in an optimal position.  I show her a technique to lunge during her waves.  Her husband stands behind her providing extra support.  I stand in front of her and lunge with her.  We are exactly in sync as we lunge and lunge and lunge some more.

What makes doulas uniquely suited for pacing?

The doula’s focus is entirely on the mom.  Midwives are amazing pacers but they sometimes have other important tasks that may come first or interrupt:  monitoring baby, checking mom’s blood pressure, etc.  Particularly in those rare cases of emergency, it is vital to have a pacer who can remain focused on mom.

Dads, close friends, family members are not always the best pacers.  Why?  They’re emotionally caught up with the experience.  They should be!  I remember catching a glimpse of my mother’s concerned face at my first birth.  It did not reassure me.  Sometimes dad isn’t sure if what his wife is feeling is normal and his face can mirror it.  And the birthing mom’s spidey senses can smell fear and uncertainty.

Giving name to this intuitive process has helped to deepen my understanding of what seems so mysterious–how the presence of a doula-who-does-nothing can be enriching and often crucial to the birth.

New Classes and Doula Availability

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Have you liked me on Facebook yet??  What are you waiting for?  Click here and then click “like” to  follow my business there.  My work is entirely dependent on social media and word of mouth.  Help a doula out.

I have another parents-to-be series for Natural Baby coming up in June.  Click here to sign up or to share with some expectant couples you know.  Six Monday nights to explore parenting and learning to listen to your instincts.  Class 1:  Learning to understand and soothe your baby.  Class 2:  Breastfeeding.  Class 3:  The first six weeks postpartum.  Class 4:  How babies (and parents) sleep.  Class 5:  Saving money and creating a mindful gift registry.  Class 6:  The first year of parenting.  If you can’t take an entire series, pick and choose the classes you want for 25.00/couple/class.

Registration is open for July/August Hypnobabies classes meeting Tuesdays beginning July 23rd in Greenville.  Email me for information (j_byers @ bellsouth.net).

I only have a few more doula spaces left this year.  I have space for 1 client in late June or July, 1 client in October, and 2 clients in November.

Thank you for helping me serve families!

Babylegs in the doula bag?

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When my girls were wee babes, I thought Babylegs were just for little legs.  They looked so adorable.  And sometimes the legwarmers were the only thing I could get Norah to wear.

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We also used them as arm-warmers and in costumes.

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I thought I was pretty clever when I packed them to cover Cedar’s airplane seatbelt so she wouldn’t escape and cause mayhem.

Babylegs are pretty versatile.  But why do I pack them in my doula bag?

For hospital births, most women are forced encouraged to get a hep-lock.  The hep-lock provides IV access in case of emergency.  I haven’t met a natural birther yet who loved her hep-lock.  In fact, at many births, the birthing woman complains more about the hep-lock than anything else.

It’s usually placed in a spot that is uncomfortable during the poses a natural birthing woman chooses.  It might be in the bend of the wrist.  Sometimes it snags on things as the mom moves.  And it is very visible to the mom.

I’ve known more than one birthing woman to rip out her hep-lock and throw it across the room in a blaze of glory.

Babylegs are perfect for sliding over the hep-lock and keeping it out of sight/out of mind.  It keeps it from snagging on things.

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Has anyone else found creative uses for their Babylegs?

April is a happening month

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Just a sampling of some local events:

April 6:  Movie Day at the Hughes Main Library.  Watch “Born in the USA” and learn about birth choice in SC.  I’ll represent the doula perspective on the Q&A panel after the event.  10.00 donation suggested.

April 8:  The Spartanburg Babywearing Group meets at Labors of Love.  11am

April 10:  Greenville Cloth Diaper Group has a monthly meeting at the Taylors branch library.  10am.

April 11:  EarthFest at Greenville Tech’s Barton Campus.  I’ll be there working a table for Upstate BirthNetwork.  Stop by and say hello between 10am-2pm!

April 11:  Prenatal Yoga at I Love Natural Baby.  5pm

April 12:  Parent and Toddler Yoga at I Love Natural Baby.  10am

April 12:  Parent and Baby Yoga at I Love Natural Baby.  10:45am.

April 13:  Come hear the sexy-voiced Michel Odent, MD speak about birth.  Sponsored by the Bellies to Babies Foundation and the SC Birth Coalition.  Info here.

April 13:  Cloth Diaper 101.  A free class to introduce you to cloth diapers!

April 15:  La Leche League of Greenville meets at I Love Natural Baby.  7pm.  Other meetings throughout the upstate.  Check http://www.llli.org to find the meeting closest to you!

April 20:  Thrive:  A Conscious Health Experience in Clemson.  Looks like such a fun day full of exhibits, kids yoga, and special speakers.  10am-4pm.

April 20:  The Great Cloth Diaper Change is happening at I Love Natural Baby.  Come break the record with your baby!

April 23:  Meet the Midwives event at Greenville Midwifery Care.  6-8pm.  Registration is online through our home page on website or you can email to GMCmidwife@ghs.org.

April 27:  Blessingways:  A Gathering of New and Expectant Families.  April is Cesarean Awareness Month.  Join the discussion.  2pm.

April 28:  The Fair Exchange.  This is the third year that I’ve organized this amazing event to raise $$ for a cause.  This year, we’re raising money for the SC Birth Coalition as they lobby to protect birth choices in SC.  Stop by and shop gently used baby clothes, cloth diapers, babywearing products, etc and buy some raffle tickets for fantastic prizes.

This month, I’m teaching three Hypnobabies series and will attend two births, two postpartums, three prenatals, and meet with a few new couples for the first time.

I thought this was a part time job?  I love it so.

Extraordinary Nurses

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Many families worry about which nurse they will get during their birth.  The nurse is a wildcard.  We can pick our midwife or doctor.  We can pick our doula, our birth photographer, our childbirth educator.  We can pick our hospital.  We don’t get a choice in our nurse(s).

I’m so happy that nearly all the nurses I’ve worked with in the last few years have been amazing.  Occasionally, one nurse really stands out and shapes the birth in extraordinary ways.  Like Beth two years ago.

This time, I’m bragging on Mona.  I adore Mona at Greer Hospital.  She’s been a rockstar for many of my clients.  Mona played a big role in this birth.   And she caught the baby before Dr. Polo Shirt could arrive at this birth.

So I knew I could relax when I saw Mona walk into the birthing room.

monaWhat made her support so extraordinary at this birth?

  • She kept interactions with the mama at an absolute minimum.  Mama stayed in the tub and the door to the bathroom remained closed 99% of the time.
  • She used a handheld doppler for quick listens to the baby’s heartrate while mom was in the tub.  She also used a handheld monitor while mom was pushing.  My client didn’t have anything strapped around her belly.
  • She ran interference when the doctor preferred that the mom get out of the tub sooner rather than later.
  • She stalled when another nurse prompted that the mom needed a hep-lock.  The mama never did get that hep-lock.
  • She applied hot compresses on mom’s perineum when baby was crowning.
  • She patiently and quietly guided this first-time mom and then called the doctor in a few minutes before the baby was born.
  • After the birth, she didn’t fuss with the baby or try to talk to the mother.  She stepped back.  After an hour, she still didn’t fuss with the baby or suggest taking her.  In fact, when I left, mama was breastfeeding her baby and blissfully devouring her own lunch tray.

I love this nurse.  She is a strong and quiet presence.  If you give birth at Greer Memorial and Mona walks into the room, relax.  You’re in very good hands.

(Also, I hope she doesn’t kill me for blogging about her!)

Goodbye 2012

I like stats.

Firsts in 2012:

  • First dad to leave me in the dust on the drive to the hospital.  You know who you are, J.S.
  • First missed births.  I missed one due to dengue fever and one because I was away for the weekend (she birthed early).  I’m ever indebted to Angie and Laura for doula-ing in my place.
  • First time supporting back-to-back births.
  • First hospital waterbirth.
  • First time driving 1000 miles for a birth (which I missed, so that’s three missed births this year.  Painful.).

I am excited to see what 2013 has in store for me!  My doula availability is booking quickly and my first Hypnobabies class is filled to maximum capacity.  And how could it not be an amazing year with this adorable pumpkin as the first baby I snuggled in the new year?  He also peed on me three times.  I’m sure it is a sign of good things to come.

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I have only one resolution.  I will not miss any births.

Blooper #12 and #13

I added two new bloopers.

12)  At a homebirth, the mom was deep in her hypnosis.  I was pressing a warm rice sock on her lower back.  I looked down to see rice spilling all over the carpet.  It seems my stitches were less than precise.  I had to use two ponytail holders to twist up the split seam.  Thankfully, I remembered to remove the ponytail holders with their metal attachments before microwaving the sock.  Otherwise, this blooper would be more serious.  If I’m going to continue sewing my own rice socks, perhaps I should add a sewing kit to my doula bag.

13)  In my Hypnobabies class, we were discussing perineal counter-pressure.  At the end of the class, I reminded them of the birth rehearsal we would be doing the next week.  I mentioned we would practice positions, techniques, and counter-pressure.  Never noticing their uncomfortable faces, I continued on until a doula who was auditing my class (and had taken Hypnobabies for her own birth) interrupted, “What Julie means is we’ll practice counter-pressure on your lower BACK; not your perineum.”  There was a collective, “Whew!”  Right.  Different counter-pressure altogether.

At some point, I need to wonder if it is a savvy business move to admit to these blunders.