Gentle Doula - Birth Doula in Los Angeles

Books for Siblings

2012-02-21T14:06:00.000-08:00

If you are expecting a second (or third, or fourth, or fifth...) baby, storybooks can be a great way to talk about the new one on the way. An older sibling who is well prepared will have an easier time accepting that they aren't the baby anymore.

My favorites are What Baby Needs, by William and Martha Sears,

and Hello Baby, by Jenni Overend.

Both books emphasize natural parenting - Hello Baby is about a homebirth - and breastfeeding and co-sleeping are presented well.

Another Satisfied Customer

2012-02-02T17:07:00.000-08:00

I stopped by to visit a former client and her baby a couple of weeks ago...it is so much fun to see my babies again! This one is about eight months old now and still has the longest eyelashes and a very bold personality.

Motorcycle Doula

2012-01-26T22:30:00.000-08:00

I'm not your average doula. My politics range from liberal to radical, I'm all inked up (not that unusual for Hollywood, but not the national norm), I'm a black belt martial artist, and I like to roar around town on a motorcycle. A really zippy motorcycle.

The motorcycle riding isn't just for fun. Doulas spend a lot of time driving, and in Los Angeles, that can mean a lot of time stuck in traffic. When I'm heading to a client who lives 30 miles from my house, being able to use the carpool lane can shave an hour off my drive time.

That being said, though lots of moms-to-be admire the bike and tell me they think it's cool that I ride, I have never booked a single job when I arrive on the bike. I'm not sure if it's just too much of a clash of expectations vs. reality, but there it is. I usually take my SUV to interviews now, even though it's a gas hog. Like everyone else in this economy, I need the work. My volunteer work with Pasadena's public health department is awesome and I'm totally committed to that project, but paying clients do make it possible for me to give time elsewhere.

Then again...more and more, I'm just trying to be myself. I'm not the right doula for everyone, and that's okay! If, however, you were looking for a superhero ninja biker doula, you found her.

Avoiding Pre-term Labor

2012-01-13T08:57:00.000-08:00

There are many things you can do to help ensure a full-term, healthy baby. This isn't medical advice exactly, just common sense.

1. Avoid unnecessary induction
In the absence of a good medical reason, let your baby come when they are ready! Due Dates are just estimates, and they can be wrong by as much as two weeks...so that scheduled induction at 37 weeks might result in a 35 week old baby who needs a lot of medical help.

2. Reduce job stress
Overwork, fatigue, and job-related stress leads to a higher incidence of pre-term labor than pregnant women who are not employed outside of the home. Try to work with your employers to find things you can do instead. If that isn't possible, pregnancy disability leave might be an option for your family.

3. Eat well
Not too much, not too little, lots of vegetables. Malnutrition before pregnancy and poor weight gain prior to 20 weeks are highly associated with premature labor. Take those vitamins, too.

Relax and enjoy the time before this new addition to your family!

What a Doula Is

2012-01-09T21:05:00.000-08:00

From Doulas of North America:

A Birth Doula

*Recognizes birth as a key experience the mother will remember all her life

*Understands the physiology of birth and the emotional needs of a woman in labor

*Assists the woman in preparing for and carrying out her plans for birth

*Stays with the woman throughout the labor

*Provides emotional support, physical comfort measures and an objective viewpoint, as well as helping the woman get the information she needs to make informed decision

*Facilitates communication between the laboring woman, her partner and her clinical care providers

*Perceives her role as nurturing and protecting the woman's memory of the birth experience

*Allows the woman's partner to participate at his/her comfort level

For each individual woman, needs may be different. For some, physical comfort is the top priority. For others, emotional care is most needed. Others need to feel that their partner will be able to enjoy the birth without feeling pressured to do everything.

When you are interviewing a doula, take some time to think about prior times when you have been in labor, ill, or in some other difficult situation. There is a good chance that the kind of care you needed then may be similar. Some women love to be held or touched when they are hurting; others just want companionship or to have questions answered.

Sweet Vacation

2011-12-27T15:46:00.000-08:00

Life as a doula makes it hard to schedule time off. Unless I'm working with a backup partner, I can't really take any clients in a two week window around my vacation time - which means keeping the calendar clear for 5 weeks to get one week out of town!

However, things lined up conveniently for the holidays and I got to spend a lovely week with my family in Northern California. Somehow it just doesn't feel like winter to me unless I get to spend some time up there in the trees.

Now I'm back at home, looking forward to two new babies this coming month and whatever else the new year has in store. Happy holidays everyone!

When do we go to the hospital?

2011-11-16T16:57:00.000-08:00

Your doctor or midwife will probably give you some idea, something along the lines of 4-1-1 or 5-1-1 (where your contractions are five minutes apart, one minute long, and have been that way for an hour)...but that can have a lot of variance in a normal labor. One mom I worked with went in at that time, only to be told in triage that she was 1.5 cm and should go home. Others have gone in at that time, found they were at 5cm, and were admitted.

A lot of childbirth educators feel that the numbers are only part of the story, and that the mother's emotional state is as important. If she is still feeling cheerful and energetic, can still hold a conversation through contractions, and is comfortable staying at home, then wait. Most women arrive at the hospital earlier than necessary, and are subjected to a lot of hospital routines that can disrupt and slow labor.

As labor progresses, the mother gets more serious. During contractions, she is completely focused on them, and between contractions she is preparing for the next one. She probably won't be cracking jokes or laughing at yours. Susan McCutcheon tells the story of one couple in Natural Childbirth the Bradley Way:

"Fortunately, they decided to take a picture of her all ready to walk out the door. Looking through the camera lens, the husband saw a confident smile and suddenly realized they were not as far along as they had thought.
This excellent coach very gently pointed this out. His wife took her coat off, and they worked at home for four more hours. Then they went to the hospital."

Of course, if you are far from your birthing location, this may be a luxury you don't have, and riding in a car during transition is no fun! However, for most people, staying at home, eating real food if they feel like it, and enjoying the last time together before baby comes is a good option.

Positive Storytelling

2011-11-04T18:23:00.000-07:00

If you are a pregnant woman, it might seem like every person you meet to wants to

A) Touch your belly without asking
B) Tell you a horrifying birth story
C) All of the above

Why do we do this to each other? As if there wasn't enough to worry about when becoming a parent, you have to deal with strangers (and worse, friends and family) undermining your confidence and giving you whole new categories of things to worry about.

On the other side, you may hear unrealistically positive stories, where the birth doesn't hurt at all, angels sing, and the mother ecstatically welcomes her new baby who is clean and beautiful and wouldn't have dreamed of pooping in utero. These stories can make you feel like you won't be able to live up, or that you'll be a failure if your birth isn't perfect just like that (hint: it won't...it will be perfect just like you).

The most useful stories, I think, are the ones that are somewhere in between. Real stories from women who say things like, "It was really tough, and I wasn't sure I could do it until I did, and then I was amazed at what I could do".

Some of my favorite birth stories can be found in Adventures in Natural Childbirth and Ina May's Guide to Childbirth. I also love Spiritual Midwifery, but you'll need a hefty dose of nostalgia for 60's hippie culture for that one (it works for me, but your mileage may vary). All these books are available in my lending library for clients.

Reading birth stories can help you to get a sense of what the range of sensations and feelings of birth are and ways to cope, as well as counteracting the negativity of pop culture. Enjoy, and surround yourself with strength!

Doctor Swapping

2011-11-01T12:43:00.000-07:00

As a doula, most of the women I talk to are interested in having a good birth. They may or may not want to go completely natural, but they want to feel empowered and respected throughout the process. Most are taking some kind of prepared childbirth class and do lots of reading too.

One problem is that a lot of these women decide they want a natural birth long after they have chosen a care provider, and their care provider's style and workplace may not mesh well with what they now want for their birth. Some women report feeling increasingly uneasy with their doctor or midwife, but are hesitant to do something about it. They may feel that it is too late to change, or that they won't be able to find a care provider they like on their plan, or that they have no choices at all due to managed care or Medi-Cal. Let's go through these one at a time.

1. It is too late for me to change care providers.

While many OBs prefer to take clients before 32 weeks, there is no rule against switching doctors as late in pregnancy as you need to. I have personally known women who switched at 39 weeks, but generally you will have the easiest time finding a new practice if you make the switch earlier.

2. I won't be able to find a doctor I like on my plan.

Check over your options carefully. Often, there may be doctors you overlooked because they don't practice at your first-choice hospital that are great, and living in a big city like LA, you have so many choices of birth place and providers. Sometimes the prettiest, shiniest hospitals aren't the most supportive of natural birth. I have had great experiences with clients at some of LA's smaller hospitals and teaching hospitals. Ask around and see what you can do.

3. I don't have any choices - I'm with Kaiser or Medi-Cal!

It is true that with Kaiser, you get whatever doctor is on call, but you often can choose which Kaiser location you will deliver at and whether you will be working with an OB or Midwife. Kaiser is generally very supportive of natural birth (let me put my cynical hat on) because natural birth costs less, and they don't have the luxury of passing on expensive bills to you and your insurance company.

With Medi-Cal, you just have to shop around and find a good doctor. There are great OBs and terrible ones that accept Medi-Cal. Similarly, there are hospitals that will treat you well and ones that will not be as nice. Don't stay with anyone who doesn't make you feel that you and your baby are of value. Ask your friends or ask your doula for recommendations and find someone who will respect your birth.

DONA Certification Complete!

2011-07-13T20:08:00.001-07:00

I just found out that my certification with Doulas of North America is finally complete! I get to add some fancy letters to my name, list myself on some new websites, give myself a few pats on the back, and get back to work.

Thank you to all the mothers, fathers, babies, colleagues, and friends who have invited me into their lives and helped me along this road.

Cloth Diapers

2011-06-27T15:56:00.000-07:00

I'm going to get up on an eco-soapbox (probably Dr. Bronner's peppermint soap, if you care to know) and talk dirty about diapers. Dirty diapers. You are going to use a lot of them. The average baby will go through 5000 diapers before potty-training. That's a lot of diapers.

Back when this daring doula was a wee tot, my hippie mom cloth diapered all of us. Though I still have an intense love for those big safety pins, I also remember seeing her spending a lot of time on her knees washing poop out of them...not so appealing.

Enter the diaper service. I guess I had always assumed that this was something rich people did, so I was surprised to find that here in lovely Los Angeles, you could get clean diapers magically delivered to your door for about the same price as disposables.

My favorite source is Luludew, a local company that does things as green as possible with organic cotton diapers, and will teach you how to use them. Give cloth a chance, and you just might find yourself looking to sing its praises on a soapbox of your own.

Informed Consent

2011-06-10T11:06:00.000-07:00

In a hospital birth, chances are there will be many procedures you will be asked to consent to. Papers will be handed to you to sign with a lot of fine print, but the headspace of labor is incompatible with reading fine print and untangling legal jargon. It is best to be informed about frequently used procedures before your labor begins, so that you know what you are or are not okay with. If something comes up during labor that you don't understand, ask questions! Many women are too busy dealing with contractions and labor hormones to do this, so encourage your partner to ask questions on your behalf.

Some good points to cover:

* Is this an emergency, or do we have time to talk it over?

* What are the benefits of doing this? What are the risks?

* What would happen if we waited an hour/two hours/etc?

* What would happen if we don't do it at all?

Make sure you know about the procedure in general, and what it means for you at that hospital. For example, one of my recent clients agreed to having her bag of waters broken (fairly early in labor, I hadn't even arrived yet) to speed things up. However, the nurse didn't tell her that in that hospital, policy required that all women with ruptured membranes remain in bed. For a woman desiring an active natural birth, this was incredibly frustrating. To me, this was not informed consent. She hadn't known what the implications of the procedure would be for her birth.

Things happen in birth that you won't have a lot of control over, and you often have to adapt your plans along the way...but if you feel that you are making informed decisions that you are comfortable with at each stage, your birth will be a good birth. A good doula can't offer medical advice, but we can offer informational support and make sure you have the space and time you need to make decisions you are happy with.

Your Postpartum Hospital Stay and Beyond

2011-05-18T16:35:00.000-07:00

Your postpartum stay often isn't very restful - yes, there are people to take care of you, answer your questions, and bring you food - but the hospital is loud and noisy, you are sleeping in a narrow little bed with your partner across the room, the answers you get may be confusing, and the food isn't all that great anyway.

To make your stay better, there are some things you can do. Limit your visitors: as much as they want to meet the baby, playing hostess takes a lot of energy. You know who you want to see right away; remind everyone else that you would love to see them as soon as you get home, but that you all have a lot of sleep to catch up on. Ask to see a lactation consultant as soon as possible, even if you have nursed other babies before...each baby is different, and getting off to the good start can save you a lot of wear and tear in tender places!

Your friends and family can help by making sure that everything is ready for your grand homecoming. Stock the fridge and freezer with easy foods that you can eat one-handed. Set up an extra changing station where you and the baby spend most of your daytime hours, so that you don't have to hike down the hall or up the stairs ten times a day. Invite your friends to bring over their favorite dvds to help you pass the time in your baby cave without soaking up too much daytime tv.

Above all: rest. Remember: "If you are standing, sit. If you are sitting, lie down. If you are lying down, sleep." -from Nursing Mother, Working Mother by Gail Pryor

Northridge Hospital Medical Center

2011-04-21T16:39:00.000-07:00

One of my clients is planning to deliver at Northridge Hospital Medical Center (in the San Fernando Valley of Southern California) this June, so I decided to go along on the maternity tour to check it out. I like going on these tours, and try to tour each hospital before I work there.

For my clients, I want to know what to expect before we arrive there in labor. I want to know if natural birth is supported there. I want to know how the postpartum period will be handled. I want to know whether my presence as a doula will be welcomed or mistrusted.

Northridge scored pretty high with me. They encourage women to eat light foods and drink during labor, move around, and use the shower to ease labor. The nurse leading the tour mentioned "pain relief options", but never used the word epidural. Intermittent fetal monitoring was described as the norm, rather than as an exotic request. Breastfeeding is strongly encouraged, and it seems like the hospital overall is making a big push to be more responsive to patients' desire for choices. It will be interesting to see if the labor experience corresponds to the advertising...if so, I will be recommending the hospital to all my valley friends.

Happy Birthday

2011-03-30T19:12:00.000-07:00

Proud new parents and grandparents have the most amazing glow to them. Welcome to the world, baby girl. There is a lot of love here for you.

On Waiting

2011-03-25T14:35:00.000-07:00

Whenever a client's due date approaches, I start getting ready. My phone becomes a permanent fixture, tucked into my pockets (or my bra, or the waistband of my yoga pants...you get the idea) wherever I go. There's a bag in the car packed with a change of clothes, massage tools, tea, snacks, and papers. I sleep more, because you know those babies just love to start their journeys at 2am. I warn all my friends and family that I'm on call and might have to bail on plans at a moment's notice.

And then I wait.

Babies don't usually come on their due dates. First babies are, on average, about a week late. Some mamas come to know that their babies take a little more or less time to be ready, and that's okay. As long as the mother and baby are fine, there should not be any rush.

Right now, I'm waiting. This client's OB started talking about induction the day after her due date, wanting to induce if she hadn't gone into labor at 41 weeks. This is not reasonable; the American College of Obstetricians and Gynecologists handbook on labor induction defines postterm pregnancy as 42 weeks. The rate of labor induction has doubled in the US since 1990, with 22% of births being induced. Induced labor contractions are much more intense and painful for the mother, and inducing labor before the body is ready can result in a c-section.

I'm encouraging my client to push back, and ask for the time she needs. Until then, we're all waiting together.