"I Am a Doula"

Nicole at Bellies and Babies wrote this lovely post about what it is to be a doula. She briefly and beautifully tells the story of her role at a woman's birth, and toward the end writes:

Pregnancy and childbirth is a time when women can be motivated or de-motivated to fulfilling their roles as strong, capable and competent individuals, which then translates into their mothering roles after birth. The difference often lies in how they are treated during their pregnancy and birthing time.

Empowering women with options and support enables them to take ownership for their healthcare and their bodies, which, later, gives them the confidence to take responsibility as mothers. A doula-relationship allows for that mental and emotional wellbeing while also freeing the medical professional to focus solely on the physical wellbeing. This holistic approach to pregnancy and birth has been proven to be the safest and most satisfactory approach for all involved.

Doulas support women who are choosing unmedicated birth, medicated births, hospital, home, and birth center births. We support women with multiple gestations, medical complications, variations, and normality. We are trained in what is normal and natural and how to make situations where interventions are chosen or become necessary as productive and risk free as possible.

I thought she did an excellent job of explaining doulas' value. For many of us, our first birth in particular is filled with so many unknowns. It can be scary! A doula can be an incredibly reassuring presence. With their knowledge and experience, they can provide very helpful suggestions, information, and affirmation- to both the birthing mother and her partner.

Homebirth Photo Slideshow

Check out this gorgeous and moving photo slideshow documenting a home birth. (It is not graphic.)

The burning question is how Andrew is going to take photos like this AND be in them too.

Breech Birth in Canada

In contrast to the increasingly intervention-heavy and divided American childbirth scene, The Society of Obstetricians and Gynecologists of Canada has released new guidelines recommending vaginal birth for breech babies.

Released yesterday, the guidelines are a response to new evidence that shows many women are safely able to vaginally deliver babies who enter the birth canal with the buttocks or feet first.

With the release of the new guidelines, the SOGC will launch a nationwide training program to ensure that doctors will be adequately prepared to offer vaginal breech births.

The new approach was prompted by a reassessment of earlier trials. It now appears that there is no difference in complication rates between vaginal and cesarean section deliveries in the case of breech births.

Read the full Globe and Mail article here.

A similar article was also published in the Vancouver Sun: Canadian docs to stop automatic C-sections for breech babies

Let Nature Take Its Course

Leaders of Canada's pregnancy specialists are urging doctors not to induce labour unless there are compelling medical reasons.

The call is part of a campaign to "normalize" childbirth and efforts to reduce Canada's soaring caesarean section rate. Some studies suggest inducing labour in a first-time mother significantly increases her risk of a C-section.

Most of the birth blogs and news stories I read come from the US and many are frustrating and depressing. This was a very pleasant surprise- as was finding it in the Winnipeg Free Press!

Read the full article here: When it comes to birth, let nature take its course - Winnipeg Free Press

About Doulas

If you've ever wondered what a doula is, what she does, and whether her services are valuable.. check out this 7 minute video.

Awesome and Exhausting Four Days

Saturday morning at DebnRobnAshe's place. Micah nonchalantly drove Ashley's toy motorcycle straight into the fence. It did not cross his mind to do anything like, oh, try to steer, or take his foot off the gas.

Eva's new- previously enjoyed by Ashley- hat and sunglasses. Can't get them off of her.

Micah trying on a pair of shades.

More photos to come after I get permission from everyone...

On Thursday morning I got a call from Tara. I know her from church here and she invited me as a support person to her home birth this month. She was due on the 20th so we were crossing our fingers it would work out. She called to say her water had broken! She wasn't having regular contractions yet but I rearranged my schedule so I could be ready for her when she needed me. Around lunchtime she asked me to come be with her while her boyfriend went out to pick up her mom. So my mom dropped me off and took the kids with her to her salon appointments. I was so glad they were really good for her! I hung out with Tara until the late afternoon. Her contractions still weren't regular and I thought she needed some space. I got a chance to eat with the kids and tuck them in then I headed over there again for a couple of hours. Things kind of died off so I headed home and climbed into bed with my cell phone close at hand. Still no regular pattern so in the morning I was able to go to the park for a really fun playdate with some of my mom's friends that she had a playgroup with when I was young. Four of us daughters/daughters-in-law were able to be there with a total of eight little kids ranging from 4 months to 4.5 yo. So cool! We went to an awesome park.

Just as the playdate was ending I got the call that Tara was in active labour so Mom dropped me off and headed home with the kids. She laboured beautifully and had the birth she dreamed of in water, right in her own living room at 5pm. I was honoured and privileged to attend and support her, and it was very moving. Mom and baby are doing great! Seylah is perfect and content.

So that was VERY exciting! Also very tiring and my cold which was improving took a turn for the worse.

We had lots of fun plans for Saturday. In the morning we went to see 9-year-old Ashley's lacrosse game. I really enjoyed it! Good entertainment and so fun to see her out there. She is one of only two girls on her team and she holds her own. She is loving it. Now our kids want lacrosse sticks!

Afterward we were invited over for lunch and wow did we pack a lot of fun stuff into a short couple of hours. There was cookie making and trampoline jumping, swingset playing, treehouse playing, BBQ eating, motorcycle driving, and hand-me-down hand-me-downing. We had a blast and didn't want to leave. But we had a family BBQ we were also looking forward to in the afternoon.

Everybody made it and it was great to have a chance to see and catch up a little with everyone. I loved seeing the kids together. Eva and Micah really really enjoyed playing with seven year old Ben and nine year old Jamie.

We got home way past the kids bedtime and by then I was completely out of gas and just went to bed with them. I was thrilled to open my eyes to a clock that reported 7:08am! At least a full hour later than Micah's recent usual.

Today we went to church. This time Eva trotted right into her class and had a great time, and Micah dissolved into tears at the thought of leaving me. So I took him into church for a while where he actually did sit quietly for a while. I knew it was time to try taking him to class again when he crawled under the chairs all the way back to the sanctuary. And he went right in and was ok with me leaving. When he came out he declared, "That was fun!". Maybe next week they'll both go to their classes for the whole time and I'll get a chance to focus on church.

After church a few of us had a picnic lunch at the park. It was great to hang with my friends, see their kids, see them with my kids, and to see the kids together. It was finally really sunny and hot today, whoohoo!

When we got back, all three of us took a super long nap. I actually had to wake Eva up. I'm looking forward to getting back into bed and hopefully sleeping this cold away. Lots more visiting planned for this week!

Delayed Cord Clamping

Watch my Baby Journal blog for a post about cord clamping... in the meantime, check out this really excellent video about it:



If you're interested in knowing more and reading some research about delayed cord clamping, this is a Labor & Delivery Nurse's comprehensive blog post on the topic.

Great Videos

I really enjoyed this two part short film. Quite a few of the Moms and Dads are health care providers themselves. Their experiences and thoughts bring out interesting contrasts between the conventional medicalized birth model and natural childbirth. If you enjoy this film, search "Birth Matters Virginia" in YouTube to see a great selection of birth related videos submitted as part of a contest.

South Coast MidWifery presents a modern account of today's natural child birth. Told by 10 mothers, this short film chronicles their journeys to challenge the conventional hospital birth model to give birth in their own way.

Watch Part 1

Watch Part 2

Thoughts on Birth

“Birth is not only about making babies. Birth is about making mothers ~ strong, competent, capable mothers who trust themselves and know their inner strength.”

-Barbara Katz Rothman


My friend Melissa recently wrote a great post on Unassisted Childbirth (UC) (click here to see her followup post as well). She discussed her opinion of UC, her thoughts on the open letter Navelgazing Midwife wrote to the Australian birth activist whose baby was stillborn during her UC, and ends realizing that we in the developed world are bickering over type of attendant when there are women and babies dying for lack of a skilled attendant at all. I have been pondering the post and formulating a comment. While I was doing that, I came across something that I thought was very relevant to the discussion. I subsequently decided to write my own post in lieu of a comment on Mel's blog (sorry Mona, I know how fun it is to get comments!)

Birthing Your Baby blog pointed to an excellent Mothering.com article called Breaking Free of Mother-Guilt*. Here are some excerpts:

How, for example, do we discuss the overuse of cesarean delivery without making the one-fifth to one-quarter of us who've had one feel bad, or promote extended breastfeeding without seeming to blame women who haven't been able to do it?

I suggest that the answer lies in achieving a certain perspective. This perspective starts from the premise that each of us does the best she can—given the particulars of our knowledge base, resources, support system, and the circumstances in which we find ourselves (and which we often cannot fully control). No one should ever allow herself to feel judged inadequate for doing the best she could, or the best she knew at the time of choosing. But we must also note that because our knowledge base is one of the keys in our decision-making process, it is absolutely appropriate that every effort be made to disseminate good information as widely as possible—never to blame people for past choices or idiosyncratic situations, but to get good facts out to whoever needs and can use them.

A UC is where a woman gives birth intentionally either alone, or with family/friends, but without a trained birth attendant such as a midwife or OB. I'm not going to say that I agree or disagree with the practice of UC. Each situation is unique, and each woman does the best she can, makes the best decisions she can, given her "knowledge base, resources, support system, and circumstances". I am sure that the Australian woman felt strongly she was doing what was best (and maybe she was- no details have yet been released). Babies and mothers die sometimes during childbirth. It happens in the best hospitals. It happens in assisted home births. And it happens in unassisted births. There are also beautiful outcomes regardless of location or who is in attendance. Not that it is a crap shoot whether you and your baby will live and die. I absolutely think that some birthing environments lead to better outcomes than others (and research supports that). But sometimes even in under the best circumstances things do go wrong. Presumably each woman does her best to minimize the risks she perceives, and others may disagree based on their own perceptions, but we must be careful not to judge. I have made different decisions with regard to each of my births based on my research and experience. I can't beat myself up for decisions I made with my first and second births which I won't repeat for this third birth. I'm in a different place in my journey, knowledge, resources and circumstances.

What about the women who just haven't got the same range of choices many of us do? The women who live in communities where there is no qualified birth attendant? Or women who have access to a birth attendant but tragically no access (for a variety of reasons, including lack of funds or pure apathy on the part of the medical staff) to emergency medical care when it is required? Read a this news story about a young African woman who died recently of postpartum hemorrhage, leaving behind her newborn and four older children. She was unable to get to a medical facility for treatment. Melissa said:

There is a poverty of skilled birth attendants in the world, and here we are in our developed nations quibbling over to choose or not to choose a birth attendant. It makes me think of Marie Antoinette's "They are hungry? Let them eat cake!" We have so much we don't realize how privileged we are. Instead of buzzing around gossiping about the birth of one UCer's baby in Australia, we should be standing up and shouting for the rights of women in countries around the world whose babies and who themselves are dying by the thousands because they don't have the option to choose a skilled birth attendant.

True that we in the developed world often don't recognize and appreciate how privileged we are. True that we should be standing up and shouting for the rights of women who are denied basic medical care. But it doesn't mean that we shouldn't also continue to work locally to educate women and caregivers, and to advocate for change where evidence based protocols are not being followed. To work to improve the outcomes and experiences of mother and baby.

The more I learn about childbirth, the stronger my feelings that God has designed us women beautifully for birthing our babies. Given education, support and safe environment, I believe that the majority of women have the capacity to safely give birth vaginally, joyfully, and to come away feeling strong and empowered. It grieves me that so many women are left believing that their bodies are broken. That some have outright traumatic experiences. Unnecessarily.

Consider the "cascade of interventions" which begins with a procedure not medically indicated and which leads to a real medical emergency in the end.

Example: A woman comes to the hospital in very early labour. She is offered the drug pitocin to speed her labour- with the promise that the baby will be born very soon as a result. She is not informed of the risks of pitocin (which include ruptured uterus, postpartum hemorrhage, and fetal asphyxia. See the link to read more about pitocin. Interestingly, the article states, "...the drug never was approved by the FDA for use in augmenting labor."). The pitocin makes her contractions much stronger, and they become very painful. She is offered an epidural to relieve her pain, but again not informed of the risks of epidural anesthesia (they include fetal malpositioning, instrumental/surgical delivery, difficulty breastfeeding). The epidural slows the contractions. The pitocin is therefore increased. The contractions are much more intense and unrelenting than non-augmented contractions, and the baby doesn't tolerate them well. Fetal heart rate indicates distress. Emergency c-section ensues. Woman is grateful that the medical team 'saved' her baby. But the baby wouldn't have needed saving if labour had not been artificially augmented with the drug pitocin!! Was this woman's body broken? Did she come out feeling strong and capable?

Some may say, well at least the baby is ok, and that's all that matters. Yes, absolutely it matters, but doesn't it also matter that major abdominal surgery could have been avoided? That a normal physiological event was transformed into a medical emergency- with all the risks and harmful side effects that come along with that... unnecessarily? That mother and baby unnecessarily missed out on all of the benefits of a normal vaginal birth? Humans are incredibly adaptable and absolutely can overcome suboptimal conditions. Thank God we can; medical interventions do save the lives of babies and moms who wouldn't otherwise survive. But if we have an opportunity to provide optimal conditions for birth- the birth of the baby AND of the woman as a mother- the burning question for me is why wouldn't we do our best to seek it and to provide it??

The beliefs I stated above are based on my research, circumstances, experiences, understanding and general gut feel. Each woman has her own unique set of circumstances and worldview and I certainly can't and shouldn't force anyone to hold the same beliefs as me. But what I can do is to offer solid information that allows women to make informed decisions about their birthing experience- from the care provider to the location to the interventions accepted. Consumer demand as a result of good information will hopefully bring change where evidence-based care is not being provided. That is why I want to be a Childbirth Educator- knowledge can make such a difference to a life. My challenge is to provide that information in such a way that doesn't minimize anybody's experience or cause guilt or offend.

I realize this post is a bit on the rambly side, but since it is a blog post and not a dissertation I trust you'll forgive me. There are plenty of related topics that beg discussion, and topics included which lack depth. But I think I'll leave it at this for now.

* a related article, Regrets, is also well worth reading

Read this doula's blog entry about a pitocin induced labour she attended. The birth stories in the comments are also very interesting.

Childbirth Education Update

To complete my certification, I need to read a bunch of childbirth related books, write reviews on them, observe two attempts at natural childbirth, attend a series of four La Leche League meetings or a lactation class, attend a workshop and write an exam.

I flew through the books way back when I got them, but haven't gotten around to writing the reviews yet. I have no excuse.

When I entered the program, they were just changing over from an in-person workshop format to an online format. Since then, as far as I know, no workshops have been offered.

There are no lactation classes offered in this city, as far as I know.

My investigations showed that the La Leche League in the city was not currently meeting.

Natural births here are few and far between. Also, it's not until recently that I feel comfortable with the idea of running off and leaving the kids for an unknown period, on short notice.

So, I was feeling a little bit in limbo about my course requirements. And the two year deadline for completion is now looming (this spring).

All of the sudden things seem to be coming together! I got in contact with the only midwife working in Torreon, who also is the only person giving childbirth classes. She will be attending a waterbirth at the end of next month and is going to ask the mom if I can attend as well. I am very hopeful about that. She also told me that a La Leche group has started meeting! I attended my first meeting on Saturday and it was good! There was a mom there with a so-cute week old baby girl. There was another mom there who is still nursing her 4 year old and her 2 year old. Two very pregnant women. And a married girl who is thinking about starting a family, and wanted to find out more about breastfeeding. She brought along two unmarried friends. Finally, there was a supportive pediatrician in attendance as well.

Just earlier that morning I had been mulling over the fact that I had to somehow find at least two couples to teach my course to within one year of certification. Our expat group has shrunk considerably and I'm not sure anyone is planning a pregnancy. How would I manage that requirement? Would I have to somehow arrange to run a course during a visit home to Canada? Well, after the meeting one of the very pregnant ladies approached me and asked me anxiously when I'd be ready to give classes. She said she thought there would be a lot of demand for it, given that there is currently only one option in the area. I was blown over. I had not considered teaching in spanish. My spanish is good, but to teach in my second language? Makes me very nervous. So that was scary and encouraging all at the same time.

I definitely have to get on my reviews, but apart from that it's a bit of a waiting game now...

Free Book

Sheri Menelli has decided to give away electronic copies of her book "Journey Into Motherhood: Inspirational Stories of Natural Birth".

In the introduction she says: Whether you choose a medicated or natural birth, this book is for you. These women will empower and inspire you, offering a deeper understanding of what the female body is capable of, and where the feminine psyche turns in moments of intense emotion and vulnerability.

All of the birth stories are written by the mothers themselves. They describe a variety of birth situations, "...stories of women who were really challenged as well as those who seemed to sail right through labor...", stories of women giving birth in hospital and at home.

Learn more about why she is giving it away.


Get your own electronic copy

Thandie Newton on Pregnancy and Childbirth

I really enjoyed this quote from a recent The Sunday Times interview with Thandie Newton:

“People talk about pregnant women as if they’ve gone a bit mad,” she says. “You know, ‘She’s a bit hormonal.’ But I felt as though I’d been introduced to myself for the first time. You become totally uncompromising, wild and fierce.”

She gave birth to both her girls at home in a birth pool. “Birth is very challenging in the best way possible. Every fibre of your being is alive. It’s like you are conducting electricity; literally creating something. I’d like to give birth every year if I could, just for that experience.”

Study Shows Benefits of Professional Labour Support

A new study concluded that:

For middle-class women laboring with the support of their male partner, the continuous presence of a doula during labor significantly decreased the likelihood of cesarean delivery and reduced the need for epidural analgesia. Women and their male partners were unequivocal in their positive opinions about laboring with the support of a doula.

You can read the abstract here.

What is a doula? The Canadian Doula Association defines a labour or birth doula as "a woman trained and experienced in childbirth who provides continuous physical, emotional, and informational support to a woman during labor, birth and the immediate postpartum period."

The study results are no surprise to me. In particular with a first baby there are often so many unknowns that it can be overwhelming and scary. Fear causes tension, and tension causes pain. A doula can re-focus you, reassure you, cheer you on, suggest techniques to improve your comfort, help you to relax, advocate for you. She will take care of the practical things like getting you water or juice, keeping your gown closed, wiping your brow when you're sweaty, and covering you up when you're cold. You have a relationship with her and you won't lose her to a shift change. She is there from beginning to end. She is still there when your husband needs to step away to go to the bathroom or get a bite to eat, and you are never alone, or alone with a stranger.

Both my births were attended by a midwife who was also there from beginning to end. For Eva's birth I had a doula as well, and for Micah's birth my Mom took on the doula role. And Andrew was with me all the way through. I felt particularly well supported!!! I was not distracted from my work by worries like being left alone, feeling cold, hot, hungry, thirsty, or exposed. I felt confident and comfortable asking for help in the form of back rubs, counterpressure, someone to hold my hand, someone to help me into the shower, or to help me change position. I wasn't worried about or distracted by hospital staff I didn't know wanting to perform interventions or procedures. And if that had happened I know that my support team would have stepped in on my behalf. My only focus was my labour and my baby, and I had two beautiful births which each left me feeling on top of the world!

International Midwives Day

Today is International Midwives Day. Join me in celebrating these important women!

I had midwifery care for the births of both my children. I am so grateful for the excellent, compassionate, continuous, family-centred care we received. I loved the long, unrushed visits we had throughout my pregnancy. I felt free to discuss any and all of my concerns. My midwife answered all my questions thoroughly and thoughtfully. I was able to make informed choices about everything to do with my pregnancy and birth, including all tests and procedures. My midwife was in the room with us throughout active labour and of course during delivery. She stayed with us afterward for a time. She provided breastfeeding support. She visited us at home the next day, and every couple of days for the first weeks. And she let my daughter use her stethoscope.



It is my firm belief that midwives should be the primary caregivers for all uncomplicated pregnancies. It makes such sense for the woman and her family to take advantage of the continuous and complete care offered in the midwifery model. This model also makes economic sense. Additionally, study after study has shown that outcomes for mom and baby are better. Obstetricians have an important role to play when mom and/or baby is threatened by medical condition or trauma, and their considerable skills and expertise are absolutely needed for these cases. But the midwifery model provides the best care for a straightforward, normal pregnancy and birth.

Midwives Model of Care™

The Midwives Model of Care™ is based on the fact that pregnancy and birth are normal life events. The Midwives Model of Care includes:

- monitoring the physical, psychological and social well-being of the mother throughout the childbearing cycle
- providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support
- minimizing technological interventions and;
- identifying and referring women who require obstetrical attention

The application of this model has been proven to reduce to incidence of birth injury, trauma, and cesarean section.

The Midwives Model of Care definition above is Copyright © 1996-2001, Midwifery Task Force, All Rights Reserved.

I'm so proud and excited for good friend Jen who is well on her way to becoming a midwife. Go girl go!

Welcome Michel!

Claudia had her baby girl at 8:17 this morning! Her name is Michel. She was 3.1kg (6lbs, 13oz) and 53cms (22") long. They are doing great! She was nursing well. Claudia described her birth as "good". Whoohooo!!! The hospital was a little sketchy feeling in the reception area and hallways but had a good, relaxed feel in the ward where she was. Praise God for answering our prayers!

Claudia Update

I did call that woman who teaches natural childbirth classes. I found out some very interesting information! For instance she has actually attended some home births here in Torreon. That surprised me a little. However she is not overly inclined to continue to do so, since there are so many opposed to it. If something did go really wrong she would get whisked off to jail.

She told me she has a small team of OB/GYN, pediatricians and childbirth educators. She has only three OB/GYNs, one of whom she said is very close to retirement. They support just the kind of birth many women are able to choose in Canada or the US- the ability to move around unrestricted, without unnecessary interventions, and give birth in any position. I spoke to one of these doctors and was impressed. He was very gentle, soft spoken, kind, and without arrogance. Anyway he also offered to see Claudia for half his normal consult fee. I think that is great, but I'm not sure that means he would give her enough discount on the fees to attend her birth to make it affordable for her. From what he said, even if you find a hospital with affordable fees, it's the doctor fees that cost upwards of $1,000, which is beyond her means.

Tomorrow Claudia is going to spend the day here. She will help with the kids during Bible Study and then do some light cleaning. I asked her to babysit in the evening while I go to a presentation for the school we found for Eva, and she will just stay here rather than heading all the way home and back. I will have some time to talk to her more about the birth process. Hopefully I can support and encourage her with information! There is so much, pray for me that I choose just the right topics and can communicate well.

Birthing in Mexico

I took Claudia to a hospital today to get information about giving birth there. Her sources tell her that this particular hospital is the best of the cheap ones. We entered a dingy, rundown, dark building and spoke to a woman in an office. Claudia can choose a "Normal Birth Package" for $2,500MXN or a "Cesarean Package" for $4,500MXN (~$450CAD). We inquired about how things would go once she was admitted and my heart sunk deeper with each piece of information. I dreamed that Claudia would have a beautiful birth experience, but based on what I heard this will just be something she has to get through, like having wisdom teeth out or something. Relaxation is a key element to reducing pain in childbirth but I don't see how she can possibly relax. She will be admitted, checked for dilation, shaved, given an iv and a catheter. I suspect she will receive an enema as well, and possibly denied food and liquids. She will then be installed in a room with 3 other labouring women, and be with only strangers for the rest of her labour and delivery. After the baby is born, she will get a peek before the baby is whisked away to be suctioned, bathed, medicated, and given formula. She will not be allowed to hold or nurse her baby right after it is born!!! Several hours postpartum, if she is up to it, she may walk to the nursery to breastfeed. She must stay in the hospital for 24 hours, but not beyond unless she wants to incur additional charges.

I didn't know what to say to Claudia. I didn't want to make it worse for her by telling her all the ways it could be better. I couldn't think of any way to safely circumvent any or all these crazy protocols. I don't know if Claudia feels very strongly about any of it, enough for me to fight on her behalf. And even if she did, I couldn't be counted upon to be there fighting every step of the way, because I have to take care of my own family. What to do, what to do. My heart aches just thinking about it.

We also checked out one of the expensive hospitals. This one was much brighter and nicer. The lady at the desk we spoke with had crazy eye makeup. The hospital fees for a "Normal Birth Package" are $10,000-$12,000 MXN ($1,000-$1,200CAD). That is completely out of reach for Claudia's family.

Last year I met a woman who teaches natural childbirth classes. I am going to contact her to find out if there are other options. We'll see where we go from there.