To those giving birth, and the people who support them—you’ve got options! As a birth worker, I am often surprised by how *infrequently* people ask for advice, options, and perspectives about childbirth. If you’re reading this, you’re probably the exception. You’re likely either a birth worker or soon to be giving birth, and scouring the internet for information. Or, maybe someone just sent you this link with a little nudge and a wink.
I am a doula, and in this work, I interact mostly with people who are taking one of two approaches. The first, and by far most common, approach (in my experience) to childbirth is the “wait and see approach.” In this approach, the pregnant person doesn’t prepare much beyond a standard hospital birthing class. This approach is just about going with the flow, and it tends to end up in a birth that works best for the healthcare providers (doctor/midwife and nursing staff). The most common outcome here is an epidural, plus (usually) one or two weird things that could’ve been avoided, and a “healthy” outcome. In the end, the person giving birth is usually like, “Um, WTH just happened? Oh well. Hey! Look at my cute baby!”
The second common approach is the very specific approach. In this case, the person giving birth is very motivated for a specific outcome. They might be planning on getting an epidural as quickly as possible, or maybe they want an unmedicated birth and are actively pursuing that with classes, visualization practices, etc. Because there are so many variations to childbirth, getting one specific birth experience isn’t common, but sometimes you can get pretty close.
There are two approaches to labor: the wait and see approach and the specific plan. Which are you?
Whether or not you want to prepare, or whether or not you have a specific plan in mind for your birth, the most important, crucial, non-negotiable, key point here is that: You Have Options! And, that’s where my job as a doula comes in. Doulas are highly experienced in the childbirth setting, and using a doula improves outcomes, as they know lots of new and ancient practices that make the whole shebang a lot better. One of the most crucial roles a doula has, in my opinion, is helping you understand that, in almost every situation, you have choices. Why is this so important? Well, unfortunately, one of the most frequent complaints that women have after childbirth is that, at some point, they felt out of control, which can lead to a sense of violation.
I’ve seen women go through the childbirth experience in the most unexpected ways. I’ve seen women hoping for an unmedicated birth have a C-section, and I’ve seen women who were expecting a C-section have an unmedicated birth. What tends to make the experience more positive, in both cases, is when women feel like their voices are heard, they are presented with choices, and they move forward in their choice feeling empowered.
We live in a culture that too often fails to gain consent from women before acting upon their bodies. This is all too common in sexual assault statistics, the ways women’s bodies are governed, and, unfortunately, we see this in the childbirth setting. Most frequently this means that a hospital’s policies, or a provider’s preferences, take precedence over the person giving birth. It can mean people in childbirth have things done to their bodies that they don’t want, or before they understand what is happening or why. In fact, I am so passionate about this topic that I write about it for my job.
We live in a culture that too often fails to gain consent from women before acting upon their bodies.
The truth is that you have lots of options. Your body is giving birth, and, if you are conscious, there is every reason your care providers should explain what’s happening, what your options are, what they recommend, and help you move forward feeling like you’ve made the best decision possible for you and your unique childbirth experience.
Sheri Rysdam, PhD
Sheri Rysdam teaches college writing and yoga. Her scholarship is rhetoric, including feminist medical rhetorics. She works as a doula in the Salt Lake City area, where she focuses on supporting young women with limited financial resources. She writes at www.sherewin.com.
Lying In with Your Baby: The First Two Weeks – Fiona Judd
We’ve all seen her—the mom who has her baby and two days later is back in the grind of carpools, shopping, and even laundry. We wonder how she does it. We secretly hope it happens to us. Our culture seems to value women who can “bounce right back” after childbirth and leaves little time for rest and bonding. But is this realistic? Is it even healthy? As it turns out, many cultures throughout history have embraced a time of “lying in” for women after childbirth, and the benefits may surprise you. Lying in is the sacred time after childbirth that allows the new momma to rest, heal and bond with her new baby.
Mothers who observe a period of rest after childbirth will probably notice a faster physical recovery. Their bleeding will stop sooner, and they will experience less pain in their perineum. They will also notice a faster recovery emotionally, as sleep can help with the “baby blues” that are so common as the hormones adjust after giving birth.
For breastfeeding mothers, lying in is a great way to establish a healthy milk supply and ensure that baby is gaining weight. Babies who lie in with their mothers are healthier overall, as their little bodies can more easily regulate things like breathing and heart rate when in close proximity to their mother. Finally, mothers and babies are much more closely bonded when lying in occurs, as it makes it easier to read the baby’s cues and learn to soothe and care for her.
It’s true that lying in can be difficult in a more modern society. Life keeps going at an incredibly fast pace, even after you have a baby, and there are lots of things that can’t be put on hold. But with a little preparation and help from those closest to you, you can create your own period of lying in with your new baby that will provide lasting benefits. Here are some ways you—as a modern mother—can observe a two-week period of lying in with your newborn.
Set up Your Space
It’s much easier to rest and relax when your space is conducive to relaxation. The first few days after birth should be spent in bed with your baby—nursing, sleeping, and bonding. Have someone with you all day if possible to bring you meals and take care of immediate needs. This could be your spouse, parent, or other close family member or friend. If you have other children, make sure someone is available to care for their needs as well.
Place items next to your bed that you know you will need. This may include a good book, feeding supplies like bottles/formula or nipple cream and a nursing pillow, diapers and wipes, snacks, a water bottle, a thermos with warm tea, and anything else you may find yourself using frequently. You may want to set up a similar “resting station” in another area of the home such as a living room sofa. Make sure you are near a bathroom that is well-stocked with postpartum recovery supplies like pads, bottom spray, and a peri bottle.
Clear Your Schedule
As much as possible, clear your schedule for the first two weeks after birth. This includes things like social events, volunteering, carpool pickups, and even church. If you have daily or weekly responsibilities, ask others to fill in for you for a couple of weeks. People are usually more than willing to help out a new mother. If you have other children, ask another trusted adult—such as your partner or a neighbor—to help get them to school and extracurricular activities.
Don’t agree to attend any events the first several weeks after giving birth. It’s okay to respond with a “maybe.” Let people know that you will try to be there if you are feeling up to it, but that your healing and bonding take first priority.
Stock Your Freezer
One of the best things you can do to prepare for a “lying in” period is have a freezer stocked with meals that are easy to prepare. You can choose to make these meals from scratch and freeze them yourself, purchase frozen meals from the store, or a little of both.
Don’t be overwhelmed by the idea of making freezer meals all at once. One of the easiest ways to stock your freezer is to double your favorite recipes as you cook meals prior to the baby’s arrival and use half that night and freeze the rest. It doesn’t require much extra effort to double a recipe, and you end up with enough for another meal.
If cost is a concern, watch for sales on the frozen food items your family likes to eat, or ingredients for your favorite recipes, and stock up. Things that freeze well are soups, stews, chilis, casseroles, and slow cooker meals.
Another way to stock your freezer is to request meals from friends and family who attend your baby shower or ask what they can do to help after the baby comes. You can even request a “meal train” from friends and family. Someone close to you may be willing to arrange it, but you can also arrange it yourself by sending out a list of dates and having people sign up to provide a meal on each date.
It’s also a good idea to stock your pantry with dry goods you use often. This reduces the number of trips to the grocery store you will need to make after the baby is born. Make a list of your essentials and watch for a sale on those items so you can stock up without breaking the bank.
If your budget allows, consider hiring some extra help for the first few weeks after baby arrives. A postpartum doula is trained to work with women after giving birth. She can help with breastfeeding, errands, light housework, laundry, breastfeeding, caring for other children, and even meal preparation. Some postpartum doulas can come during the night and help care for your new baby so you can get extra sleep during that time. Postpartum doulas usually work on an hourly basis and cost anywhere from $20-$40 per hour.
You may also want to consider hiring a professional cleaning service for the first few weeks postpartum so you don’t have to worry about a messy house while you recover. Some women don’t mind a little extra clutter and disorganization, but some find that their physical and mental health are affected by the appearance of the home.
If you don’t have anyone that can come help you care for your other children, you may also want to hire a nanny or babysitter for a few hours each day so that you can have time to rest.
Enjoy Your Baby
Last of all, remember to relax and enjoy your tiny new baby! The newborn stage passes quickly—almost in the blink of an eye. Taking time to slow down and enjoy each moment will really make a difference in how you feel and your relationship with your baby. The first two weeks are critical to your baby’s development, both physical and mental. The more time you can devote to cuddling, fondling, singing, talking, and playing, the more your baby will make those important connections in the brain that lead to healthy growth.
It may seem difficult at first, but with a little extra planning and preparation, you can enjoy a two-week “lying in” period after your baby’s birth that will provide long-lasting benefits for years to come. Instead of focusing on “bouncing back” from childbirth as quickly as possible, do yourself a favor and use these tips to make your first few weeks after birth really count.
The Call to Build Villages
by Tresa Haymond (VillageWITH.com)
The day I heard about Emily Dyches’ tragic death was the moment I felt a call to do something. As I sat sobbing on the edge of my bed, I felt a powerful force connecting my heart to Emily’s heart, as if I knew her well. This was a clear cry from somewhere very real, a plea “to build villages,” to let moms and all women know that we are not alone, and there is hope.
Thankfully, we know that there are answers for those going through perinatal mood disorders like postpartum depression, perinatal anxiety, PTSD, and OCD. Truly, healing is just around the corner, especially when we find a way to unite our hearts with those who understand. The aching desire that began in my soul that day was that no mom, no woman, should feel alone. Of course, Emily wasn’t alone. However, her family sensed that she would surely have benefitted from more awareness and better access to the most helpful resources, Emily has become a symbol of the need to build a village where women can invest together in healing.
A few years ago, Hannah* told me that she had finally reached out to someone who lived nearby. She told them that she couldn’t get through the day alone with the excruciating thoughts that were racing through her mind as she sat trying to nurse a sick baby, with a demanding toddler screaming to be fed as well. Unfortunately, the answer on the other end of the line was, “Welcome to motherhood, honey!” Sadly, this answer lacked the understanding that, though feelings of desperation are common, they are not normal or healthy. Amazingly, Hannah took courage again, this time trying to explain to her doctor how the voices in her head nearly caused her to crash on the freeway. His response was, “Anyone with a smile like yours must be doing fine.” Tragically, this doctor’s response demonstrated the ignorance of knowing that it is often the mom who looks the most “put together” that we may most need to worry about. It is very possible that she is putting on the make-up, the heels, and the smile in an effort to keep from collapsing, striving to maintain the appearance of independence, while her core is drowning. Thanks to recent awareness efforts around perinatal mood disorders, Hannah would probably be taken more seriously if she were to reach out for help today. Hopefully, someone would even have the preventative insight to ask how she was really doing. This would likely help to avoid terrible suffering and even tragedy by surrounding her with love and practical support, (such as nutritious meals, visits, and breaks from her toddler and baby).
Roberta* told me that she now takes an antidepressant through her last trimester of pregnancy because of former experiences with depression during pregnancy. Her doctor had also openly explained that this put her at risk for postpartum depression during pregnancy. She felt empowered to deal with this, as it was being addressed early on, and she had spoken to me as her doula about wanting additional emotional support. Throughout her last trimester and into the postpartum weeks, we discussed articles and books on the topic together, and I regularly checked in to see how her “self-care” was coming along. Was she staying hydrated, supplementing with Omega 3s, going for walks, and getting enough sleep? And when was the last time she had been able to laugh? Deliberately, we discussed Roberta’s plan for who would be there to help following the birth and how she and her husband could have time alone together each week. A few weeks after her precious baby girl arrived, things were going quite well until the day Roberta received a devastating phone call about the tragic death of her sister. I enfolded her in my arms as she broke down and eventually went into a sort of shock or numbness that wouldn’t begin to wear off until days following the funeral. She spiraled downward into sadness and anger and found it difficult to connect with her baby and older child. Often, she felt anxious around people and frequently experienced panic attacks, especially in social situations. Roberta’s closest friends and neighbors were aware of her struggles and offered support by checking in, taking over a few household tasks, and bringing in occasional meals. On one of her darkest days, Roberta bravely picked up her phone and began dialing numbers of friends until one of us answered. I couldn’t understand what she was trying to say, but I could tell she was at a breaking point and maybe in some immediate trouble. Calmly, I told her it would be okay and that I would be right there.
When I arrived, I found Roberta sitting in despairing darkness, on her lonely bed, with her quiet baby lying next to her. Between broken sobs, Roberta confided that she was fearful for her children and herself because of the thoughts that had been torturing her mind. I wrapped my arms around her again and assured her that these feelings were common with what she was going through and that it did not mean that she was a bad mom. It only meant she needed more help. When I walked outside of Roberta’s house, I saw her neighbor coming to meet me, and we called another friend to come and stay with Roberta until her husband came home. The three of us (part of Roberta’s “village”) planned who would check on her each day of the following weeks, and Roberta agreed to make appointments with her doctor and therapist to follow up on the best treatment. The days and months were long, but Roberta incrementally and steadily recovered, primarily because she knew she had a foundation of support that she could rely on.
“Joyfully, I look back on the day she posted a video of herself making her darling baby girl laugh as one of my very happiest occasions since I became part of the village building effort.” Tresa Haymond
Jacie* found herself far from home, living in the U.S., with a new tiny baby, married to an American whose culture, language, and home in a winter climate were completely unfamiliar to her. In South America, she had been surrounded by constant love and social interaction, but now she suffocated in an isolated apartment throughout the day, not knowing any of her neighbors. Several of my friends who were aware of her situation drove to check on her from time to time and offered to help with the baby. Gradually, they began to notice signs of depression and decided to ask if I could somehow help her. I was surprised that Jacie agreed to let me visit, as I was a stranger to her. I think she viewed me as a sort of counselor and a professional who could rescue her. I kindly explained that I was “a postpartum doula” and that I could help her find resources and be there with her as she became well. As she shared experiences of pain and fear, her heart opened to someone for the first time. It became apparent that Jacie had been through several traumas since the birth of her baby. I pointed out to her that she had many of the symptoms for mood disorders listed on my papers from the Utah Maternal Mental Health Collaborative. I helped her locate a few therapists in the area that would accept her insurance. Fortunately, I was still with Jacie when her husband came home, and he was surprised that we were talking about such serious issues, as he had “no idea” that she had been struggling so severely. I gave the two of them an “assignment” to call their doctor. I also helped Jacie make a list of people she could ask for specific help and finally, I demonstrated ways to exercise with her baby boy inside through the rest of the cold winter, explaining that this benefits moms by producing some of the “happy chemicals” that our brains need to be healthy. One week later, as Jacie and I walked to my car after attending her first support group, she turned to me with a fresh light in her eyes and exclaimed, “I loved that so much! Thank you for bringing me here. I didn’t know that other moms feel the way I do. It helps so much to hear their stories.” That was another incredible moment when I witnessed the magical progress a village can bring about.
After hearing about this “village world,” Kay*, my best friend from high school, asked, “Where was this when I needed it?” My heart broke for her because I realized that I had been in my own world of going at it alone with my own babies, and I wasn’t available to be there or even see her need. Kay’s mood disorder came from getting next-to-zero sleep for about six months, and being completely at a loss of what to do with a more-than-fussy baby who rarely calmed down long enough to sleep for more than an hour at a time. Kay describes how she was raised to be “fiercely independent,” and how that became a trap for her after becoming a mother. Now that Kay is healing from this experience, she talks about how she wishes that she had known that there was such a thing as “Rent-a-Grandma” or a postpartum doula, who could give relief to sleep deprived moms. When I ask for what advice she would give to moms who are suffering emotionally, she pleads, “Believe that there is someone who wants to help you, and let them help you.” With tears in her eyes, she honestly expresses, “I would drop anything on my schedule to hold a baby for four hours so any mom can get some sleep and reset her brain.”
Today we may no longer have the village around us as we once did, but as women, sisters, and mothers, we are still villagers to the core. Therefore, building creative, consistent, and compassionate villages is our life and soul saving call. Emily Dyches and a multitude of women who relate to her story would agree: nothing could be more worthwhile!
*Names and circumstances have been changed to protect privacy. Go toVillageWITH.com to join our online peer support group, the second and fourth Thursday of each month at noon. You can also listen to podcasts of moms who share their experiences of healing from perinatal mood disorders.
I have been called to attend two births of Muslim mothers in my time as a doula. I have found their culture to be very warm and welcoming, and I loved the experience I gained from attending Muslim families. This particular Muslim birth I attended was a very special experience.
The whole family came and waited and prayed in the waiting area while the mom labored. Everyone was very happy and friendly, and at one point they started a roster with guesses of birth weight and time of birth that was almost two pages long! Most Muslim births are all-female with only the birthing woman’s mother, mother in law, sisters, and other female family members present.
While this sweet mother did not choose to have an all-female staff, most observing Muslim women prefer to only birth in a location where they can guarantee no men will be present with the exception of the father of the baby. This can also exclude male doctors and nurses, so the birthing location is methodically thought out prior to baby’s arrival. Many Muslim women also prefer to stay very modest and covered throughout the birth experience, using sheets to cover their legs while pushing and minimal exposure of their pregnant belly.
While speaking to this family before the birth, they told me that the level of dedication to their religion dictates how the mother chooses to dress during birth. This mother was planning on letting her instincts and body lead and guide her during her birth and she wasn’t going to worry about remaining any more modest than she felt would be comfortable for her.
During birth it is normal for prayers to be spoken aloud for the mother to listen to as she labors. The prayers are quiet and meditative, and although I couldn’t understand what was being said, it was so beautiful and calming to listen to. My client’s mother in law was the one praying during this birth and she was so sweet, hugging me in celebration of new life.
After this baby was born, she was brought up to her mother’s chest and my client’s mother-in-law began to ‘read on’ the baby. I felt honored to witness this private rite of passage; sometimes this can also be referred to as an Adhan. Prayers and verses from the Quran are whispered in to the baby’s right ear and then again into the baby’s left ear so that it is the first words she hears. Many of these versus are fundamental and serve as a pivot point around which the life of a Muslim rotates, so it is very symbolically significant to be done immediately after birth.
It is culturally and religiously important for Muslim women to breastfeed their babies. They believe that eating specific kinds of dates called ratb help to improve breastmilk quality. The Quran also makes many references to the benefit of breastfeeding their children for two years. After birth, the women are given Cinnamon Tea to help the uterus shrink back to size, ease cramping and discomfort, and warm the mother. It is often used during periods for similar reasons. Cinnamon Tea is made with cinnamon sticks boiled in water, and then walnuts, sugar, and butter are put in it before drinking. I was so excited when I was offered some during my postpartum visit with this mom and I still think about the amazing taste and heat of that tea. It really cleared my sinuses!
Each religion and culture has their own customs surrounding pregnancy and birth. It is not typical for Muslim women to have a baby shower, but women still can if they choose to, especially as Western culture finds its way into many aspects of day-to-day life. Often, after a Muslim child is born it is common for an aqiqah (pronounced ah-kee-kah) to be held a week or so after the baby is born to celebrate with close family and friends. Other than this celebration, the family stays in their home for up to 40 days while family and friends provide meals to them during that sacred postpartum time.
I still have so much to learn about this amazing culture and its people. Going into these births, I was very open about wanting to know how to best serve these families. I asked them to tell me as much as I needed to know so that I could support them with love and respect. I would advise anyone in a similar doula/client situation to do the same.
These families were so happy and willing to share their personal lives and culture with me, don’t be afraid to ask! If you have experience working with other cultures or specific religions, make sure that people know it! The second Muslim family contacted me for their birth because they heard that I had previously worked with other Muslims, and it was comforting to them. If you have specific experience, list that on your website so it’s welcoming for people of other cultures.
Many times, if you have multi-cultural experience it will lead to a more diverse clientele, not just more of the same culture you are advertising to. You are drawing in and welcoming all kinds of people by showing that you have a willing heart to serve those who have a different cultural background than you do.
Bonnie Baker is a birth doula, Hypnobabies instructor, placenta encapsulation specialist, bengkung belly binder, and fertility educator. She serves Salt Lake County and Davis/Weber County. Learn more about Bonnie at www.BellisimoBirth.com
Free to Breastfeed: Voices of Black Mothers
by Jeanine Valrie Logan & Anayah Sangoele-Ayoka
As doulas, part of our role is to provide general information, tips, and help with getting our clients started breastfeeding. It is important for us to take into account the societal and cultural factors that could present possible hurdles for our clients who choose to breastfeed. That is why I was so excited to read Free to Breastfeed: Voices of Black Mothers. The book (available on Kindle or paperback) is a collection of stories, essays, poems, and email conversations from a wide variety of black mothers. They all share their unique experiences and perspectives regarding their personal breastfeeding journeys, with all the ups, downs, joys and challenges that most women who breastfeed eventually feel. The book is broken up into six chapters covering topics such as the legacy of breastfeeding, myths and barriers, troubleshooting problems, stories of empowerment, and the eventual ending of the breastfeeding relationship. The book ends with a collection of useful terms and resources, as well as profiles for each of the contributors.
The authors compiled all of the stories into this book to “act as a starting point for discussions within our communities, a steadfast support in those difficult moments, and a self-empowering guide when discussing one’s breastfeeding goals with family, friends, partners, and health care providers…because breastfeeding IS the revolution.”
The Health Implications of Not Breastfeeding, and How Black Mothers are Disproportionally Affected
Statistically, African-American mothers are the least likely ethnic group to breastfeed, and if they do breastfeed it is often only for a short time. The authors point out that there is a shortage of breastfeeding support groups specifically targeted to black women, as well as a “lack of trained lactation consultants, specialists, educators and counselors in black communities.”
The Center for Disease Control and Prevention reports that black women breastfeed at a rate of 54%, compared to white women at 74% (source). Black women under the age of 45 are also at a higher risk for developing breast cancer compared to white women, (source) and the authors point out “that breastfeeding not only reduces one’s risk for developing breast cancer, but risk is also exponentially reduced the longer one breastfeeds. This information is major for black women who die from breast cancer at a rate four times greater than white women.” (source)
Black Women and Breastfeeding: A Complicated History
With the clear health benefit to breastfeeding, as well as the emotional benefits of bonding with one’s child through the breastfeeding relationship, one may wonder why more black women don’t breastfeed. There is a complex history surrounding black women and breastfeeding, and for some women this plays into their decision not to breastfeed.
A “Wet Nurse” is a woman who is hired to nurse and sometimes care for another woman’s child. Wet nurses have been used throughout history, but the author tells us that wet nurses “are very significant to Black American history. Black female slaves were readily used as wet nurses for their owners’ children, often at the sacrifice of their own children.” Because of this, some black women feel a complicated mix of feelings around breastfeeding. The author of the blog post Breastfeeding While Black: Let’s Normalize It also shares more reasons why black women may not breastfeed, including “lack of general knowledge, few hospital resources, limited peer support, lack of family/spousal support, and insufficient maternity leave.”
What Can We As Doulas Do?
As doulas, each of us has the power to help black women in our communities breastfeed if they choose to. We can reach out to offer support, education, resources and help clear up myths and misconceptions about breastfeeding. We can connect clients with resources specifically geared toward black mothers, starting with the resource list below. Also, please share this blog post on social media to help spread the word about the need for more breastfeeding education and support for black mothers.
- Motherlove podcast: featuring the authors of the book
- Black Breastfeeding Week: Annual celebration of Black mothers who breastfeed
- Black Breastfeeding Week Facebook page
- Black Women Do Breastfeed: Website featuring a blog, resources, and breastfeeding stories
- Black Mothers Breastfeeding Association: Providing resources and support to African-American breastfeeding families
- Mocha Manual: pregnancy and parenting lifestyle website and blog for African-Americans
- Black Breastfeeding 360: A comprehensive multi-media content library of resources, perspectives and voices of the Black breastfeeding experience
- African-American Breastfeeding Alliance: Empowering Black families to breastfeed their children
- Uzazi Village: Providing support groups for breastfeeding mothers
- R.O.S.E. (Reaching Our Sisters Everywhere): Programs that include breastfeeding clubs for moms
- Blacktating: Breastfeeding news and views from a mom of color
- Mocha Moms: a support group for stay at home mothers of color with information on childrearing and other family topics
- “Black Women Breastfeeding: A Multi-Generational Story”, short YouTube video
- “The African-American Breastfeeding Project”, YouTube mini-documentary
- Utah Breastfeeding Coalition: To collaboratively support, protect, promote, and celebrate breastfeeding in the State of Utah
- Utah Department of Health Breastfeeding Resources
- La Leche League of Utah
Beth Hardy, SCMT, MT-BC, PCD(DONA)
Music Therapist | Birth Doula | Postpartum Doula