Tuesday, May 15, 2012

My experiences with a birth doula...

Recently, I was asked to provide a reference for the birth doula I used for both Mia and Gabe. Partly for my own benefit (I love to write and chronicle events), and partly for my brain's benefit so I could reduce my experiences down into an actual reference letter, I spit out the story of how I met my doula (most likely will be released as a sitcom, sometime...never).  You can read all about it...here (editor's note, because it spans about 3 year's time, 'tis a tad lengthy):

Just a little biographical history first...
In early winter 2008, I went with my friend in nursing school to a special screening of “The Business of Being Born” at USF.  I went with her out of simple curiosity. I wasn’t pregnant nor was I expecting to be anytime soon, and I was not particularly opinionated about it. However, while watching the film, I began to realize how amazing and powerful giving birth could be, if surrounded by the right people and in the right environment. Then and there, I decided that whenever it might be my time to bring life into the world, I would do what I could to have it be as peaceful and empowering as I saw it could be.
After the screening, there was a panel discussion with OBs, nurses, midwives and doulas. I remember listening to one of the doula groups there and thinking, “If I ever got pregnant, I think I’d want her to be my doula.”  It was a woman with a mild Southern accent and fierce blue eyes.  i just preserved these thoughts until the time came...

Little did I know, about 8 months later I’d be finding out I was pregnant and expecting our first child.  After switching from a regular OB/GYN office to a local birth center, I began educating myself even more on how to best succeed at natural childbirth, particularly as a first-timer.  I saw handouts in the lobby at the birth center about doulas, so one day at an appointment, I asked the midwife whom she recommended, and she referred me to Touched by an Angel. It was her immediate response and so I called the number on the brochure, got in touch with Stefany (the “other” Stefany who owned TBA at the time), and within days, she and Stephanie were at my door, ready to meet me and my husband, go over any questions we had, and share with us their practice, plans and procedures.

As soon as I opened the door to the two Stephanies, I realized these were the exact women I had observed only a year earlier at the screening of the Business of Being Born. It could not have been more providential, I thought!  And the Stephanie with the Southern accent was the doula I was going to be using, after my husband and I confirmed we did want to work with them. Thus, our working relationship began.

My experience with Stephanie was and has been tremendous. I relied on her for the rest of my pregnancy in answering lots of questions I had, preparing myself for childbirth, and utilizing her knowledge of natural medicine to combat some of the late-term pregnancy issues I encountered: high blood pressure, leg cramps, dizziness, etc.  She assisted myself and my husband greatly one night as I thought I was preeclamptic. She stayed calm and directed us to go straight to the hospital, where we were checked out, and thankfully determined to not be preeclamptic.  She was with us each step of the way and seemingly always available via text or a phone call.  I still doubted myself quite a bit in the beginning as a first time mom; I questioned my ability to be able to birth naturally, but Stephanie never questioned it.  It was like she knew I’d be able to do it, but she also knew and gently reminded me that should things change, it was all within the realm of “we can handle this, and that will be okay.” There was never any shame or insistence that to deviate from our preferred plan meant failing.  It was a great balance between having a calm, confident assurance while also staying flexible to the ever-changing needs during pregnancy, labor & delivery.
When it came to the real labor day, Stephanie was a real asset to both me and my husband.  Once we realized things were actually happening, she came over to our house and observed me for a while, much of the time interacting with my husband to get a sense of how I’d been doing and what he had seen -- this was a big help for him as well as he had obviously never attended a birth. She helped us determine when it was time to get to the birth center and followed us there. While there, she remained a calm, gentle but assertive presence, ever determined to help me get my labor in the right direction. We spent hours walking, squatting, hovering over a toilet, in the bathtub (the last two, of course, I did by myself!), working together, with my husband as well, to get my baby ready for her debut.  She watched my physical cues and also knew when I needed to eat, drink, or take a breather.  

When it was finally time to push, both my husband and I were a little overwhelmed at the realization our baby girl was about to enter the world.  Because we were at the birth center, she was able to provide us with different tinctures and natural remedies to help us handle all the emotions that can accompany labor. She gave me Skull Cap, and him Rescue Remedy (I believe) to help him handle the emotional stress so that he could help me get through the pushing.
Within minutes, our baby girl was born, and she was there to help us with latching and all the components that follow after a delivery.  Her job was not over yet.  Far from it.

There were some unique things about our birth that required extra attention--things you can never predict. Our baby was born at a very low birth weight--unfortunately too low for the birth center to allow us to go straight home with our baby. She had to be seen by a doctor that very night, so we had no choice but to take her to the hospital.  She and the midwife helped us work with a hospital to figure out where to take her, and she kept in touch with us throughout the night as we were there at the hospital.  Since she was so small, she made recommendations as to what to do to help her eat and feed, and she came over the next day to help me with latching.  It took a few days but eventually, everything was ruled out for our baby girl and we were able to take her home and start our new lives as parents.  

Technically, you are given as much emotional and physical support as you need from your doula, during your pregnancy, delivery, and the first 6 weeks after.  
I found her support to be much more lasting than that.  

Again, unexpectedly, two weeks after our child was born, I found my leg to be in a lot of pain.  I had also been dealing with back-to-back rounds of mastitis. I really was pretty miserable and feeling pretty guilty over my postpartum situation. A low birth weight baby, breastfeeding problems on top of infections, and now my leg hurt so bad I couldn’t walk very well. I desperately wanted things to get figured out and be okay. I told Stephanie what I was experiencing and she encouraged me to get checked out soon by the midwives. Based on what my chiropractor had said there was suspicion I had a blood clot, but I didn’t really understand what it all meant at the time.  The midwives surmised this as well, and within hours, I had an ultrasound on my leg, which confirmed a deep vein thrombosis.  This was utterly surprising as my only “risk factor” was the fact that I had been pregnant. I did not meet other typical characteristics of those who had blood clots. However, Stephanie has special experience in this area, because she herself has a blood disorder (APS) and she knew all the precautions I needed to take. After that experience, which I sought medical treatment for, I consulted with Stephanie on all the things I should take to build my immune system and naturally thin out my blood. She was a warehouse of knowledge I wouldn’t have had access to if it weren’t for the fact that she had been my doula.
Because of her, I feel like I was able to turn my health around I began to rely more and more on her for treatments to even everyday issues like stomachaches, baby fevers, and diet consultation.  It was truly a lifesaver.  

Without a doubt I knew if we got pregnant again, I’d be calling Stephanie.  And so we did.

Our second time around, we knew we would be in the hospital because of my history with a blood clot.  I was even more jazzed about using Stephanie because I knew she had an arsenal of experience in hospital settings and had even more knowledge now because of her nursing training.  She had also completed a course in Kangaroo Kare, which helps mom and baby bond immediately after birth, thus improving breastfeeding success rates.  This was highly important to me as I really struggled with this the first time around.  

Throughout my pregnancy, I regularly texted with Stephanie about my dr’s appointments, the various doctors I’d met with, my medication regime, any ongoing issues I was experiencing, like nausea, heartburn or the like, and she was always available to chat with me or give me suggestions. We’d really built a good relationship by this point in time.  
We met with her again to discuss our birth plan, go over our remaining questions (and since we were having a hospital birth, we still had a lot!) and talk about how we anticipated the “birthday” to go.  

Before we knew it, it was go-time. I had kept Stephanie in the loop, so she knew that there was a possibility I could deliver early, and sure enough, I did.  
As I started my labor, I let her know what was happening, and just like she had done before, she came over to observe me and it didn’t take long for her to know that it was time to make our way to the hospital. She rubbed a special labor oil on my belly before we left and then followed us in her car and was ready to meet us at TGH.
Her familiarity with the hospital and its staff made a big difference as she was able to advise us on what to do and how to handle things, and their familiarity with her allayed any fears I had about bringing a doula to the hospital.

Things went just as smoothly as they had before, even with my inexperience with the hospital birthing system.  The great thing about Stephanie is she keeps her cool and remains calm no matter what. Once we were past triage, Stephanie helped me figure out how to get back into what I call the “labor zone.”  She suggested getting into the labor tub in our hospital bathroom, dimmed the lights and even provided soothing birthing music, which eased my transition back into focusing on labor. For the next few hours, she and my husband just provided emotional and some physical support as I moved around in the tub, sat on the toilet, and waited for the doctor to check me again.  Although I don’t remember this, she told me later she reapplied labor oil to my belly again during the middle of my labor.

While your body sort of takes control in labor, it is nice to have someone there as a guide or source of knowledge for comfort and reassurance.  When the doctor came in later, he checked me and said my bag of waters was still intact and I was 8cm dilated, but fully effaced.  He gave me two options: break my bag of waters and labor would probably speed up right away, or let it break on its own, and wade through labor possibly a couple hours longer.  I asked him for a minute to consult with Stephanie and my husband, and discussed the pros & cons with her.  Having her there for a reality check and a quick discussion (is this risky? is this okay?) helped me confidently make the decision to have my waters broken.

Within minutes, I was ready to push. And minutes after that, my baby was born! It was an incredible experience and I was so delighted to have succeeded again in a natural delivery with minimal intervention.  She helped me and my husband get ready for and excited about delivering again, she was a positive force in the labor and delivery room as we worked through distractions and needed energy and focus during the pushing, and she guarded me and my new baby “like a hawk,” to ensure that bonding and breastfeeding was able to happen smoothly after delivery.
I held my baby for at least an hour after he was born, and delayed the newborn bath and assessment. I wanted to get to know him as much as possible and improve our chances at breastfeeding success as much as possible, and Stephanie’s assistance with that made a strong impact.  Latching on is a little difficult for my babies at first, but it eventually happened and I’m thankful to report he is a great breastfeeder at 6 months. 

Once again, I was thankful for her presence and assistance.  She checked in on us at home days later to see how everything was going, and this time they were going even better than they were with our first baby.
I still rely on her for various tips, homeopathic remedies, and natural healthcare consultation (all via text)! I love that we have formed a relationship that now spans over 3 years and has helped me grow as a mother.  If you’re looking for someone that knows the ins and outs of the medical system, hospitals, has attended numerous births of all kinds (home, birth center, hospital, cesareans), and is a reliable, dependable, punctual and extremely knowledgeable resource, then I wholeheartedly recommend Stephanie as your doula!

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