<![CDATA[Christy the Doula - Blog]]>Wed, 22 May 2024 22:33:56 -0700Weebly<![CDATA[Unsolicited Advice: Regarding Sleep (as it relates to labor)]]>Tue, 16 Jul 2013 16:45:42 GMThttp://www.christythedoula.com/blog/unsolicited-advice-regarding-sleep-as-it-relates-to-laborI have pretty standard advice for clients when they call me to tell me that they think labor has begun. Stay hydrated. Go to sleep. If you can't sleep, consider a bath or shower. Call me if anything changes.

But of course, it's hard to sleep! Labor has begun! They are excited, and rightly so. In the face of that excitement, it's hard convey how important it is that they try to go to sleep without seeming like a bit of a wet blanket. We don't know what is going to happen yet. This could be the start of a fast and wild ride, or it could be a slow, exhausting and frustrating couple of days, or anywhere in between. 

Because we don't know much about your labor before it has begun, let us learn from the experiences of people who have prolonged pre labor. For some, their bodies can have long stretches of deep contractions that confuse them, toy with their emotions, and ultimately deprive them of a great deal of sleep. This can last for hours, days, and sometimes... it lasts weeks. And, while each little stretch of contractions is happening, you don't always know which category you fit into. This is why it is important that you make all reasonable effort to be well rested in the early stages of labor. Yes, labor is a mystery... but one can apply a little strategy as you embark.

Your body will likely kick out the contractions in a much more robust way if it feels like it's energy tank is full. You want to avoid reaching the point where your body is rationing energy carefully; labor really benefits from full energy investment. That said, the good news is, that your system can handle quite a lot of strain during labor. And for many, surpassing what you thought were your own limitations can be very confidence inspiring--life-changing even. Getting enough rest is giving yourself a serious leg up and won't detract from the transformative possibilities present in birth. In fact, this leg up will probably help you be more available for those more emotionally transformative components.  Still, if you end up in labor when you are already feeling pretty darn tired, trust that it can be done anyway. You have reserves you have probably never tapped into. The human body is incredible. 

But! If you are still in a place where you can make choices about your preparations for birth, heed my very simple advice:

Being sleep deprived is not an ideal way to start labor. When waiting on a baby, keep your sleep bank full and prioritize sleep as a part of your care plan whenever possible.

That's it! It sounds luxurious, but cultivating a healthy appreciation for the healing power of sleep is a great step towards having a great transition from pregnancy to parenthood. A certain amount of disrupted sleep and discomfort can be normal in pregnancy, but if you are having trouble sleeping in pregnancy, make sure to talk to someone about it. Though it's a common challenge for pregnant people and new parents, there are tools are tricks that might help. Let people support you in this time.

Once labor has actually arrived or seems imminent, keep in mind that you probably won't get much sleep at a hospital. (Reasons vary by case, but heres a quick list of possible contributing factors: the beds aren't comfortable, it's a unfamiliar environment, if you aren't already in labor, they will be watching to see if you go into labor, or will be trying to augment or induce labor, they will be taking your blood pressure and temperature, adjusting your monitors, tending to beeping machines, administering medication when necessary, etc.) These near constant distractions don't just happen in Labor and Delivery; this happens all over hospitals. It's a problem that was recently highlighted in an article in the Atlantic, entitled "Sleep Deprivation in hospitals is a Real Problem". In the article, the author recounts his experience getting almost no sleep while in the hospital recovering from having a small kidney tumor removed.

As I have already suggested, some of these interruptions are necessary. But many are not. And the consequence of too many sleep interruptions is that patients do not heal as quickly as they would otherwise, thereby not only reducing their quality of life but also driving up medical costs.

-Peter Ubel, Author of 'Sleep Deprivation in hospitals is a Real Problem', in the Atlantic
I hope this doesn't sound like I am calling out people who work in hospitals. I recognize, as the author of the article quoted above does, that this is a systemic problem and has little to do with individual providers of care. Most of the things that they do to people who are trying to sleep in the hospital are important. But, a lot of these disruptions are not as important as rest. And some of the disruptions could be combined into one disruption. I don't presume to know how to find the balance in every case, but I know that too often sleep is not being prioritized appropriately. I have learned to educate my clients on this problem so that they can defend their need for sleep as a part of their care plan.

Professionals who help pregnant people prepare for birth need to talk more about sleep. Fatigue is a very common compounding factor that makes labor more challenging and causes people to deviate from their birth plan. By the time that real and true fatigue comes fully into the picture during a long labor, we are pretty low on options. That's why we have to front load the sleep; a nap in early labor can be a game-changer for the whole labor! When the nurse on the phone, or your doula, or your doc or midwife tell you to take a nap... for goodness sake, take the advice!!! It's not a stalling technique. It really is the best thing you can do.

Here are a few times when you should be particularly mindful about the amount of sleep you are getting:

  • Inductions- Get good rest before an induction. I mean, really good rest; not just a few hours. Strongly consider delaying your induction if despite a good effort, you did not sleep well prior to your scheduled induction. Remember, it's still your body and your birth. Sure, you told your doc they could induce you at 5am... but at 5am, you realize that you haven't slept. Change the plan and take another nap. A lot of hospitals like to induce in the late evening or even at midnight. I understand the logic of this to an extent; cervical ripeners can take 12 or more hours to have their desired effect. But, if I knew I was going to have a baby the following day, I'd be hitting the hay at 7:30... I don't want to be getting admitted to a hospital at the time I am trying to go to bed. Plan for the process of getting admitted and induced to take a minimum of 90 minutes, depending on how busy the unit is and factor that into your sleep plan. I can't tell you the right time to be induced for your specific needs, but stop and think about the big picture when making an induction plan. Plan for good sleep. 
  • Your water broke and your provider wants to induce you within 24 hours if you haven't gone into labor on your own. Perhaps you are motivated to avoid this course of action, so you want to get accupuncture, climb stairs at Mt. Tabor, walk and walk and walk, have sex or whatever else. Great! Do all that stuff too, but make sure you save time for a solid nap! 
  • You have been having contractions for weeks. It is wearing you down physically and emotionally. You now dread going into more active labor because even a walk around the block has you feeling exhausted and emotional. Find someone who will rub your feet, get cozy and... you guessed it... Take A Nap! In fact, take LOTS of naps.

Look, I know how hard it is to sleep when you are very pregnant. I hear about sleep issues all the time, and I want you to know that there is help! Talk to your providers and hear their ideas. Some doctors will offer you medication, if that is your style. Some midwives and NDs will have magical tinctures to promote sleep, if that is your style. But here are some easy-to-come-by sleep remedies that just might do the trick. 

Exercise: Your exercise routine does not have to feature running or swimming laps to benefit your sleep. A nice walk counts. So does prenatal yoga. Exercise works so well because it changes your brain state, thus distracting you from the various thoughts that keep sleep so far away. So, take it seriously and make exercise a part of your routine throughout your pregnancy. It will help your endurance for the main event, and it will surely help you sleep better.

Diet: You already know what I am going to say about this, and you are probably already doing a bang-up job. Still, you can probably find a way to step up your game. Pregnancy is hard work! Feed the process! Eat strong! Sleep better!

Sleep hygiene: Pregnancy is a great time to learn how to improve your sleep. Try to become aware of your particular sleep issue and take steps to address it. Spend time winding down. Adopt a meditation practice. Avoid all screens around bed time. Whatever works. 

Magnesium: The benefits of Magnesium have value throughout our lives, but in pregnancy, the benefits are pronounced. I have heard the recommendation to increase Magnesium intake for almost every complaint in pregnancy, from morning sickness and heartburn to headaches, muscle soreness and endless contractions that seem to lead nowhere. And sleeplessness. You can buy a Magnesium powder that you dissolve in water and drink, or you can buy Magnesium oil and apply it to your skin.
Just the other day, I made Magnesium lotion using this recipe.

I am worried that you might have breezed right over the link I imbedded above, so here it is again. I think anyone who is planning on giving birth should hear this episode of Radiolab. I realize I have labored this sleep business plenty and I trust that if you are still reading this you are taking me quite seriously... so let's take a glimpse at the other side of the coin. Starting your labor with a full sleep bank *might* not be your fate. Even if you end up starting your labor with a very empty sleep tank, channel the runner in the first story in the link. You can accomplish incredible things. Believe in yourself.

Readers! Weigh in with your stories! Do you have a favorite sleep remedy? Were you able to nap in early labor? Was fatigue a significant factor in your birth?

]]><![CDATA[World Doula Week- March 22nd-28th, 2013]]>Sun, 24 Mar 2013 18:45:05 GMThttp://www.christythedoula.com/blog/world-doula-week-march-22nd-28th-2013World Doula Week is here and every year, I kinda freak out a week or so before it starts. It feels like I am supposed to be doing something extra to support the goal of the week, which is to: "empower doulas all over the world to improve the physiological, social, emotional, and psychological health of women, newborns and families in birth and in the postpartum period." While I am totally on board for this goal, I gotta say, this is what I bust my butt doing every day along with all the other people who have chosen birth work as their career. I sit in the quandry of just how to do this better DAILY. 

The number one problem that I have as a doula is that most people don't know about or totally understand our work. And, it is hard for me to address this problem without it coming off as a sales-pitch. I can't walk up to a pregnant lady on the street and hand her my card. (Some people do this... but... I just can't. I certainly don't think it is a winning marketing strategy.) Even if I did hand my card out freely and sing from the hills at parties and  about how awesome doulas are, I don't think I'd be convincing anyone of anything. I am a doula; of course I think what we do is important. No one is surprised. 

So, what is supposed to happen this week? I have an idea I'd like to try out... I think it is time for our clients to take the baton for a lap. We need more people talking about doulas to their families, friends and co-workers. It carries so much more weight when someone who is not a doula strongly recommends working with one.

In that spirit, I would like to testify about my own experience working with a doula. 

My doula, Julie, was a totally essential part of my birth experience. It took a long time for my first daughter to be born, and so members of the team needed naps, meals and other forms of self-care. But, I was honestly surprised that I needed someone to hold my hand during each and every contraction. Even though I had attended so many births, I still needed my doula to keep me from becoming scared as the hours and days passed. I needed companionship, reassurance, someone to make me laugh, someone to remind me why I was working so hard. It was wonderful to have my partner with me for the birth of our daughter, but he was not able to be all that I needed while still taking care of himself and being fully present for the birth of our child. Having Julie along for the ride made it possible for us to both do what we needed to do to get through those long days. In the end, I don't remember how hard it was... I remember how joyful and supported I felt. I suspect that I could have done it without Julie, but I don't even want to think about what that would have been like. Julie held the doubt and fear back so that there was room for joy.

You see, even a doula needs a doula. 

While I keep trying to figure out how to solve our awareness problem, we could really use some help-- and not just from my own clients who already do a stellar job keeping my practice thriving with referrals. We need as many of our past clients as possible to turn towards the people in your own life and tell your own story so that people can start to understand what it means to have a doula. The change in awareness needs to happen on a cultural level. The first time a person hears about a doula should not be when they are pregnant. Our stories about doulas should not just be passed from pregnant person to pregnant person, in whispers. Tell your grandma! Tell your dentist! 

Help us bust all the myths out there about us and reach our true potential.  All kinds of people work with doulas! Doulas love to work in hospitals! There is a doula for everyone! Doulas can support any kind of birth experience! Doulas can support any kind of pregnancy experience! Everyone deserves a doula!!!

Please consider doing one or all of the following:
*talking to your pregnant friends about your experience working with a doula;
*sharing this blog post with your friends;
*talking about doulas with non-pregnant people when you see an opportunity;
*posting on facebook about what your doula did for you;
*posting a testimonial about your doula on doulamatch or some other referral page;
* and, sure, you can give your doula another high-five.

No matter what tack you take, doing these things doula community face our number one hurdle head on. Open up and tell someone in your own voice what having a doula meant to you. If you need to warm up, go ahead and start by leaving a comment here about your experience. I'd love to hear about it!

]]><![CDATA[an invitation to birth workers]]>Sun, 17 Feb 2013 16:26:17 GMThttp://www.christythedoula.com/blog/an-invitation-to-birth-workersA few days ago, I read this article about social determinants of health for the perinatal period, written by Jill Wodnick, M.A., LCCE. The article is pretty interesting and makes a lot of connections between how these conditions produce longterm disadvantage for the children born into them. There is a moment in the article that sent me into a bit of a tailspin. Here is the quote:

"For too many doulas, they will be able to offer words of comfort and use a rebozo, but may never have had the training to learn about perinatal disparities and social determinants on health. We know about the high cesarean birth rate, but what about perinatal disparities which impact breastfeeding rates as well as birth outcomes."

This quote sets the writer up for her recommendation that doula trainings begin to more seriously cover information about the social and economic factors that lead to poor birth outcomes and low rates of breastfeeding. I am always excited to see this kind of information getting more attention, but the generalization that we don't know this is a generalization that doesn't sit well. There are quite a lot of doulas who come to this work not out of an interest in birth and breastfeeding, but out of an interest in being independent community health workers who can use anti-oppression approaches to support individuals and make the kind of ripples that precipitate change. And, for people who come to the work without this foundation, simply knowing about racism, classism, sexism, heterosexism and all the other garbage that people are forced to live through and just how much it sucks does not give doulas access or agency or skills to do anything about it!
 
I posted this on Facebook in response to Squat Birth Journal's request for input from doulas about the article:
I got a little triggered by the tone of this article. I agree with the author that doulas can be uniquely positioned to go where the need is, and I think that having trainings that share more about where the most significant need exists would be great. Still, I found her tone a little condescending given that most doulas that I know and work with got involved in the work specifically to address inequities in the healthcare system. I recognize that my peers do no necessarily represent the whole... but there are a whole lot of us out there who are working in the trenches on these issues and i think doulas are actually a lot more aware of these issues than we are given credit for in this piece and in general. Still, in order to work appropriately with people experiencing systematic oppression, a whole separate training would be helpful. As a profession, we have lots of experts out there who could take on the need for such training (and some of them have already started to, such as The Birth Attendants: Prison Doula Project and The Prison Birth Project) and I am excited to see more and more birthworkers creating there own access points to working on some of the Reproductive Justice issues that affect our clients. I'd love to more journalism about the inspiring work being done by our peers, so that newer doulas and underexposed doulas can learn about this important work. A lot of us know where we need to go to be most effective on health disparities, but struggle to get recognized as the high-impact community health-care workers that we could be... I imagine that the remedy to this is actually more programs that train people from communities most affected by the social determinants discussed in this article. I believe in the doula model of care enough to know that dropping a green doula into this complicated matrix can do some good... but an envisioning a strategy that would make real change is going to require us all to dig a little deeper.
I needed much more dialogue on this subject than I got on Facebook, so I am posting my comment here as well. I spend a lot of time thinking about 'doulas as change agents' and where the appropriate place to put my energy might be. 

I am very fortunate to have an very inspiring and brilliant friend living with me and family right now, named Phoenix. The best part of this arrangement is that I often have a thinking buddy around; a high-quality thinking buddy at that! So, when I didn't immediately get the discussion I was hungry for on Facebook, I just walked into my kitchen and unloaded a bunch of my thoughts and feelings on my roomie. As usual, this discussion gave me the insight I was lacking. Ultimately, we ended up talking about the value of all doula's being exposed to social determinants of health as the author suggests in her article, but acknowledged that this alone wouldn't produce more Radical Doulas. 

A Radical Doula is made through the melding of the doula framework and an anti-oppression perspective. If i'd had a pen in hand, this is the part where I would quote Phoenix's well-stated conclusion. In the absence of a pitch-perfect quote I am gonna have to improvise, (sorry Phoenix!) Basically, Phoenix concluded that there are quite a lot of people who come through doula training at least vaguely aware of what this article calls 'social determinants of health' and see the value of working as doulas to improve the outcomes and experiences of people whose lives are being influenced by these factors. A person can easily be exposed to data about health disparities in a standard doula training, and that is a call to action that I consider a great first step. However, a person cannot simply be exposed to the anti-oppression framework in order to be a powerful ally and change-agent. The anti-oppression framework is a perspective that becomes a part of how you move through the world regardless of what you are doing. Being a good ally means being willing to invest in changing yourself, not just 'helping' someone else. In addition to needing access to information (as the article advocates) and anti-oppression training (as I thought,) Phoenix compassionately suggests that people who have Radical Doula work in their hearts simply need to be invited.

I've been working on challenging myself to show up as a leader in my profession.  Currently that is looking like facilitating conversations about Full Spectrum work among doulas and other birth professionals through my work with Calyx Doulas and becoming a mentor to newer doulas.  My talk with Phoenix made me realize that another thing I can do right now, is to invite my fellow doulas to the work. Whether you are new to doula work, have a thriving private practice or just dabble in the work from time to time, there is a way for you to do anti-oppression work as a doula. There are more ways to do doula work than have been invented, but I sincerely invite you to join me and the many, many other doulas who recognize systematic oppression in learning and creating our place in the Reproductive Justice movement.

Be in touch in the comments or by e-mail if you need support as you envision and find your place in the work. Just know that you are invited, and as soon as you take the first step, you are a part of something very important.
"The right to have a child, the right to not have a child, and the right to raise a child in a safe, healthy environment." - Loretta Ross, (defining Reproductive Justice in just a few words.)
]]><![CDATA[It happens every day...]]>Mon, 11 Feb 2013 22:06:40 GMThttp://www.christythedoula.com/blog/it-happens-every-daySomething happened. Other things were already happening that were making today stand out; I am giving a workshop tonight with some peers that I work with through Calyx doulas, a collective of Full Spectrum Doulas, so I was giving considerable thought to the intersections that create the Reproductive Justice Framework before IT happened. Because really, some like it is happening all the time.

The stories of Reproductive Health and Justice are the stories of people's lives. Complex. Emotional. Rooted in our other truths. 

(trigger warning for those with infant loss in their background)
Here it is: A friend of my sisters' who was 8 months pregnant died a few days ago. While I did not know her, my sister called me immediately to help her understand how something like this could happen. Her friend had chosen this pregnancy carefully, (her mother has shared that this was a named baby; a very longed-for baby,) and couldn't wait to put all of her self into raising her child. She learned just a few weeks before her death that her baby had some brain development issues and that the severity of the issues would not be known until the baby was born. The next thing my sister heard was that she had lost the baby. A few days later, she learned that her friend had died on the operating table.

This morning I heard from my sister again. This time, she was directing me to an article on a pro-life news source highlighting her death as a botched 3rd trimester abortion, condemning the doctor who provided this surgical intervention and lifting this up as a reason to ban the procedure. Details of her story were shared in depth, including her name, and the perceived events that led up to her death.

I do not grant this irresponsible new source the authority to define this person's experience. I do not grant them the authority to claim her death as evidence for the dangerous and one-dimensional viewpoint. I wish only to mention her story as a means to reclaim the complicated meaning of a tragic loss. 

We really do not know what happened to my sister's friend. But, I am sure that I inherently trust her. In the end, I believe whatever story she would have wanted me to believe because it is the only one that is true. I know she very deeply wanted to be a mother. I know her baby was very sick. I now know that her life was in danger. I do NOT know where she experienced moments of 'choice' and where she experienced terrifying moments of 'medically necessity'. I am confident that she loved her baby and that she loved her life. I am worried that we could have done more to protect her life. But, I will never fault the doctor who tried to save her life and I will never question her motives in any moments where she had options. 

What this story highlights for me, today, the day I will talk to a group of birth doulas about abortion, is the inherent complexity in abortion and who owns the stories. Someone took this horrible story of maternal and infant loss and turned it into a battlefield. We can't let this happen anymore. For the sake of her family, for the sake of people who will come after her who are carrying pregnancies that put their lives in danger, and for the sake of people who need to voluntarily terminate pregnancies for non-medical reasons. 

The story is all that remains, when all is said is done. This story makes me deeply sad. And the way the story is being retold makes me sick. The story I believe that this young mother would tell makes me yearn for a better, safer world for all pregnant people... but I can not stand idly by while she is demonized and misunderstood. She has lost her voice and I still have mine. Every time that a person has an experience of pregnancy, they are labeled. Assumptions are made, and almost always some choice she made gets judged by someone else. 

Today is the day, I declare out loud, on my blog (associated with my business) that I am a doula who understands how complicated pregnancy experiences can be. I support every decision that brings forth our truths and I grieve each time that our experiences get labeled in ways that misrepresent our intelligence and complexity, and take away our power. 

This is the part of being a doula that doesn't get talked about enough, and tonight I am going to talk about it with tears in my eyes. I need every client, and every pregnant person I meet to know that I trust them. I believe them. And, most importantly, their life and their story matters.




]]><![CDATA[Birth Stories: Share the Magic]]>Mon, 04 Feb 2013 22:27:43 GMThttp://www.christythedoula.com/blog/birth-stories-share-the-magicI have had an idea for an exciting project that has been kicking around in my brain and heart for several years. If you know me in the physical world, you have probably even heard me talk about it. (Too much??) Today, I had a delightful postpartum visit with a client and our conversation came around to the power that resides within birth stories, and once again this project sparked. 

What project, you ask? 

A little backstory first. About a year ago, I found myself in a sauna with a bunch of friends and acquaintances, most of whom were parents-- several of whom were birthworkers. I find myself in this sauna as often as I can get myself invited, but on this particular day, a friend of the sauna's owner who I did not know arrived a little late and after being introduced and welcomed, announced her new and desired pregnancy. What happened next was pure magic. Friends, mothers, and birth workers celebrated her news, answered her questions and filled her up with pregnancy and birth wisdom. She walked away feeling confident, and excited to face this next challenge of her life fearlessly.

A few of the people in the sauna that night felt the power of what had happened, (including the newly pregnant person herself.) Everyone who shared that night had a different story to tell; we did not promise her an easy passage. But, we all stood on the other side of birth triumphant and full of meaningful communiques from our own journey. We have asked ourselves again and again how we can make the magic happen again. For every person who is planning a birth. Could it be a book? Could it be a video? Could it happen under less intimate circumstances? Could it even happen if we planned it?

I have finally decided to SLOWLY try to find out if the magic of this night in the sauna can be captured and shared. I have lots of helpers in this work and I am open to lots more help.

In phase one, I will begin to seek out a group who are willing to share their birth stories. If you have already written yours, you are ahead of the game! If you have not, please get in touch and let me and my team will support you in creating a version of your birth story that will bring forth the wisdom that your unique birth offers. I am confident enough in the wisdom of birth to know that  every birth has a lesson to offer. Do you feel called to share your story? Get in touch and let's make some magic.
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