It’s World Doula Week! Who knew? I didn’t and I am a practicing doula and have been for nearly 14 years.  The idea of hiring a trained birth attendant may seem like some strange new hipster idea, but actually women have had doulas present at their births for generations. A lot of people are confused about the role of a doula and so to help with that confusion let me present:

BABY READY’s a brief history of childbirth featuring the doula!

ANCIENT GREECE – the word doula comes from the Greek work for female slave. But even slaves had a hierarchy and could advance to positions of power and influence.   The slave who rose to be the chief lady in waiting to the woman of the house had the privilege of attending her during childbirth. This stone relief from Isola Dell’ Sacra, Ostia, 1st century CE shows a woman labouring with a midwife at her feet and an attendant (a doula?) supporting her from behind.

MEDIEVAL – in medieval times fertility was greatly prized and women were encouraged to have as many babies as possible. The upper class were marrying off their girls as young as 12 as long as they had started puberty. Noble women used wet nurses rather than breast feeding their own offspring so that they could regain their fertility sooner and churn out a few more sons for the crown. Women would be attended in labour by their household staff if they had them and by their friends and neighbours.

This medieval woodcut is called Der Swangern Frawen und hebammen roszgarten, by Eucharius Rösslin, 1513. It shows a remarkably similar scene to the one above. A midwife at a labouring woman’s feet, an attendant (a doula?) supporting her from behind.  My German is non-existent, but google helpfully tells me that this translates to The Swangern Frawen and Midwife Rosengarten. Maybe another day I will try and find out a bit more about her!

REGENCY/EARLY VICTORIAN.  This lucky woman seems to have her husband supporting her while she gives birth! Even though most of the time childbirth was seen to be a woman’s only event some men did stay around to support their partners. Here the midwife and birthing mother have the support of two attendants (doulas?) It is also possible that the man pictured is an accoucher – a male midwife or forerunner to the obstetrician. It is during the Victorian era that Doctors (male) started to invade the midwives domain and in the early years they often worked together.

THE RISE OF HOSPITAL BIRTH. 

This image from the early half of the 20^th century shows nurses with babies in the hospital nursery.  Childbirth in the early 20^th century was a nasty experience. Women were shackled to the bed, drugged unconscious, verbally abused and left alone for hours. No wonder there has been a massive kickback. With the rise of feminism in the 60’s and 70’s women began taking back their childbirth rights, and the term ‘doula’ meaning a trained birth attendant was coined at this time. Doulas are hired by pregnant women and their families to support them in having the childbirth experience that they want. In some institutions this set up the doula in an adversarial position with the hospital staff, which is unfortunate as there have been many studies indicating that constant support during labour improves outcomes for both mother and child. Since Nurses are unable to provide that constant support due to cutbacks and overwork, doulas have stepped into the gap.

So there you have it: A very very brief history of doulas! If you are pregnant and live in Toronto, contact me here for more information about how having a doula can help you have the birth you deserve!

I breastfed my daughter till she was 2 1/2. I don’t mean to sound smug when I tell people she never had a bottle, it wasn’t because I didn’t offer her one. Madam preferred to go without than use an artificial nipple. At 3 1/2 months she went 6 hours without a feed rather than drink pumped milk in a bottle, milk it took me days of pumping to provide for her, I might add. But eventually she accepted a sippy cup and once she got the upper body strength to lift the thing up, we never looked back. I loved the sippy cup. I could fill it with pumped milk and she would drink it. I could throw it in my bag and it wouldn’t spill all over the place. I lugged around sippy cups full of water and weak juice and milk, both cow and my own, for years. Until one day Madam said “sippy cups are for babies, Mummy” at which point we had a problem.

Playtex, please design a sippy cup for big girls.

Madam still expects me to produce a beverage at any time, no matter where we are. And while she is a big girl, perfectly capable of using a big girl cup at table, apparently she isn’t big enough to not spill her drink all over the inside of her school bag, or my bag, or on the couch, or in her bed. Straw cups work great if you carefully put them down on the table, less so if you put them on the couch or kick them off on to the floor. Flip top cups only keep the liquid in if you remember to close them. I don’t think my kids are particularly careless, they’re just kids. But I’m tired of everything being wet. So I’m going back to the sippy cup, I don’t care how old she is.

Congratulations! You’re pregnant.  Whether you had been trying for months or this comes as a complete surprise (oops – it happened to me) there are a lot of things to get organized before the baby comes. Here’s 9 things to think about in the next few weeks and months. 

1) How well do you know your body? If you’ve ever taken the pill you know that pharmaceutical manufacturers expect you to have a 28 day cycle, but that is not true of all women. One of the first things your doctor will ask you when you go to confirm your pregnancy is “When was the first day of your last period?” They will time your pregnancy from that moment, giving you a due date of 40 weeks later. But that assumes you ovulated on day 14. But what if you didn’t? What if you ovulated on day 18, or day 21? What if you have a 32 or 35 day cycle? Those few days don’t matter a lot in the early days, but when you are 40 weeks + 3 days and are feeling pressured to have an induction, knowing that you ovulate late in your cycle may help convince your caregiver to give you a bit more time. A good book to read before you even consider getting pregnant is Taking Charge of Your Fertility by Toni Weschler.

2) Do your research. Figure out what kind of birth experience you want. If all you know about childbirth is taken from TV, you will be surprised to find out that your water will not necessarily break all over your shoes, you will not be struck by agonizing contractions out of the blue, and you will not give birth in 22 minutes, sadly. A good basic book to read is Pregnancy, Childbirth and the Newborn by Penny Simkin. In Canada read The Mother of all Pregnancy books by Ann Douglas. The more informed you are the better. Sign up for a prenatal class and learn as much as you can about what’s going to happen to you over the next few months. You wouldn’t buy a car without doing a ton of research, don’t have a baby without reading a few books about the subject.

3) Pick your caregiver wisely. Ask your friends, ask your neighbours, ask strangers pushing babies in strollers on the street. Ask about the amount of time spent waiting in the doctor’s office versus time discussing your concerns in the examination room. It’s a bit early to hire a doula but you might considering asking their opinions on caregivers as they will have seen all sorts of shit go down in the delivery room. Consider midwifery care over a traditional OB/GYN practice, as midwifes are known to spend more time with their clients and are more likely to actually be present at the birth. If midwifery is not an option in your area find out how your OB practices and ask to meet all the OB’s in the practice so you aren’t meeting them for the first time in the delivery room. Ask about C-section rates – the lower the better, though 15% is average and over 30% would be cause for concern. Ask about their views on administering erythromycin drops to your newborn – the research now shows that this has no benefit and up to date physicians should know this. Trust your instincts. If your physician is rubbing you the wrong way, then go somewhere else. A good book to read is “Expecting Better” by Emily Oster. I also like “Your Best Birth” by Ricky Lake and Abby Epstein. It includes lots of questions you should be asking before you sign on with a particular OB or Midwife.

4) If you intent to go back to work and you live in an urban centre, research childcare centres now. Some of them have wicked waiting lists. I myself called the Childcare Subsidy Office in Toronto to get Baby on the list before I informed my own mother that I was pregnant. You’d be surprised how rich you can be and still qualify for some subsidy money, so sign up as soon as you can. In Canada we are very lucky to have a full year of maternity leave, but that doesn’t mean that there’s a ton of cheap daycare available for one year olds. Daycare can be upwards of $70 a day, so budget accordingly. Which brings me to 5)

5) Get your finances in order. If you are partnered and used to living on two incomes, losing one of them will be a bit of a shock. Start saving now. It’s also a good idea to think about writing or revising your will, and getting a life insurance policy. It’s horrible to think about, but even in 2016 women still die in childbirth. Think about who you want to look after your child if the unthinkable happens and your partner is a basket case. Then try not to think about it ever again, because, hey, it’s 2016, statistically speaking your chances of making it are very, very good.

6) Exercise a little bit.

If you’re used to going to the gym you can keep going as long as you want to with some modification. If you aren’t much for exercising you might want to consider doing something pregnancy specific not just so you can get in shape for the delivery but also so you can meet other pregnant women. Who knows, you might meet a new best friend. I went to prenatal yoga classes and enjoyed them very much, but there’s all kinds of pregnancy exercise classes out there – dance, aqua fit, swimming. Do something. You’ve heard it said that labour is like running a marathon – don’t go into it without a little bit of training.

7) Eat right. Oh, I know, this is the first time in your life you don’t have to watch your weight, but seriously, now is not the time to throw all caution to the wind, either. Gestational diabetes and preeclampsia can be triggered by obesity but they can also be managed by good nutrition. Eat right now and you may not suffer needlessly later. Add another meal into your routine. Do not make that meal a dozen donuts. Myself, I consumed more breakfast sandwiches in the last few months of my second pregnancy than was probably wise, but I resisted my cravings for Coke and onion rings (most of the time) and only ate poutine once.

8) Get your home Baby Ready! Are you converting an office or a spare room into a nursery? You might want to do it now while you still feel comfortable on a step ladder. Think about where baby is going to sleep – in a crib in their own room, in a bassinet in yours, or do you plan to co-sleep? You might want to put away your breakable tchotchkes now and rethink your glass coffee table and glass fronted media centre. It’s a bit early to worry about baby proofing but anything you do now you don’t have to do later when you’re exhausted from lack of sleep and stressed out over chasing a crawling baby. Attach all bookcases and high chests of drawers to the wall so that they cannot tip over on top of a curious child. Be paranoid now so you can relax later.

9) Research baby gear. There is a ton of stuff on the market and most of it is unnecessary. The only thing you really need before the baby is born is a car seat, and that only if you give birth in hospital. Look around your home and think about where you are going to store things. Maybe your tiny condo won’t allow you to own a swing. You can’t use a jolly jumper in an open concept house with no door frames. If you live in a 4th floor walk-up you might need a carrier more than you need a stroller. Or maybe you need to move. Don’t spend a lot of money on gear, everything can be had second hand and it will all be pristine as it’s used for such a short time.

10) Didn’t I say nine things? Oh well get used to it because that 9 month pregnancy they promised you is actually closer to 10. I’m going to take you right back to #1. Get to know your new body. Sleep as much as you can. Naps are really good. Go get massages. Treat yourself like the goddess you are and try to enjoy the journey. Like any trip, if you do your research and know what to expect, you’ll have a much better time.

Enjoy this article? Comment below!

Please don’t hate me.

Wherever women with small children gather, be it playgroup or drop in centre or at the park, invariable the conversation will eventually find its way to birth stories. Mothers love to share their birth stories, and often these descend into a horror show contest – I laboured for 42 hours! My 10 lb baby ripped me open! I had an emergency C-section! I gave birth in the car! And invariably some jerk will chime in with “I had a beautiful home water birth. I laboured for only 8 hours, pushed twice, and out he popped! It hardly hurt at all, I could have ridden a bicycle the very next day! Oh, and I had no issues with breastfeeding either.”

I’m sorry. I’m that jerk.

 
When I tell people about my son, I usually jokingly say “I earned him.” He is my second born. He was born just after midnight at home in a rented birth pool. My mother acted as my doula (yes, I’m also that jerk who has that kind of relationship with her mother) my husband got into the pool with me, my daughter slept through most of my labour but woke up when she heard my cries while her brother was crowning and arrived sleepy eyed in the birth room just in time to see him being born. We had a glorious first few hours together and then all went to sleep in the family bed.

 
My daughter’s birth was not quite as easy, though all in all I don’t have much of a horror story to tell about that one either. It was a much longer labour, 17 hours or so. I pushed for a long time, in a variety of different positions, without much success. While I had planned a water birth for her also she had other ideas and I ended up birthing flat on my back. She was not in a very good position for birthing, facing entirely the wrong way and causing her mother a great deal of back pain. I had a cervical lip that just would not soften and my midwife ended up sticking her arm all the way up inside me and holding it back while I pushed the baby’s head past. This I remember as being far more painful than actually giving birth. Later I learned if that hadn’t worked my midwives had decided that they would have to transfer me to hospital, where I would most likely have ended up under the knife.

I was lucky.

As my children grew and I listened to other women’s stories, I realized just how lucky I was. But I realized something else too – luck favours the prepared.  Since I was one of the last of my friends to have children I had benefited from their experiences and knew to seek out midwifery care. I had already done my initial doula training and had attended three births already so I had seen what a hospital birth was like, and I didn’t want that for myself. I had read a million books on the subject of childbirth and was extremely well informed. And most importantly, I believe, I myself was born naturally and breastfed. My mother had told me all my life that childbirth was no big deal, and she also blamed the ‘women’s issues’ she suffered from on ‘those butchers in the hospital’ where my sister was born, who insisted on routine enemas, catheterization and episiotomy and had no idea what to do with this strange Englishwoman with her weird ideas about Lamaze breathing and no drugs. I think her story made me more than a little wary of the hospital way of birth.

 
People tell me that I am brave to have birthed my children at home, but the truth is I was more afraid of the hospital than the pain of childbirth. And I know for a fact that if I had a doctor instead of a midwife for my first pregnancy I would have had a C-section – no doctor would have done for me what my midwife did. And yet, as a doula I love attending hospital births- it is my goal to make birthing in the hospital as pleasant as possible for my clients. I hope my success stories give them confidence. I don’t believe I am special or different – I think anyone can have the birth they want if they surround themselves with people who believe and trust in the process.

Are you pregnant and in the Toronto area? Contact me here.

The first birth I attended as a doula was over 13 years ago. Rebecca, my college roommate, my best friend – the first one of us to fall in love, the first one of us to get married, was also the first one of us to get pregnant. I can’t remember whether I’d heard of a doula before that time but I had always been the go – to among my friends for sexual health information and this seemed the next logical step. I attended a DONA workshop and got hooked. Rebecca went into labour one evening in mid-April – she went out to dinner and started feeling some feelings she thought might be contractions and decided to sleep on it. Aaron her husband called me around midnight to say the game was on and that they were timing contractions but wanted to stay at home as long as possible. I took the first bus in the morning (did I mention they lived in Hamilton while I lived in Toronto?) and went straight to the hospital to find Rebecca neck deep in water in an awesome step in bathtub the likes of I haven’t seen before or since. It was leaking all over the floor but no one seemed to care and the nurses had dumped a bunch of towels on the floor to contain the worst of the mess. Rebecca was coping well at that point, already in labour land and not very chatty (not like her usual self at all.) I can’t remember specifics anymore, I remember at some point they got her out of the tub and checked her and the news was not encouraging. I remember the nurse telling Aaron off for eating a sandwich. I remember Rebecca eating skittles and drinking Snapple Iced Tea. I remember how very hot it was! At some point the decision was made that an epidural would be a good idea so she could sleep as she was very tired and at that point she had been in labour for 24 hours with no end in sight. The epidural immediately transformed her back into the chatty vivacious person she usually was but the nurse turned off the lights and suggested we all get some sleep. At this point the woman in the room next door gave birth loudly which was a little discouraging as she’d only checked in an hour or two previously and we’d been there all day. Yes yes I know birth, like yoga, is not a competitive event. Still. She had obviously invited her entire family to be there as they all soon congregated loudly in the hallway, chatting and laughing in some eastern European language that we couldn’t understand. Time passed, Rebecca slept, and the epidural worked its magic. They must have turned it down at some point as the next thing I clearly remember is Rebecca wanting to push, feeling the urge to push and no nurse came running when she pressed the call button. I stuck my head out the door and flagged one down “Uh, she feels like she wants to push, can she push?” Pushing seemed to last forever with not much progress. She pushed on her side as it was the most comfortable but the baby just didn’t seem to want to come out. The nurses called in the OB and assured us that she was the best, if anyone could get this baby out she could. They thought Rebecca could use some help and decided to go for a forceps assist. At this point things got real. Rebecca was wheeled down the hall into a brightly lit room with a ridiculous amount of people in it – I counted 17 including us. I remember holding her hand while the OB got out what looked like giant salad tongs. I remember the horrible words “I’ll just make a little cut” and then “Push – push hard!” and the doctor bracing her foot against the table and then skinny purple legs and the most beautiful cry. At this point we realized we’d left the camera in the other room and I dashed off to get it. Aaron was shaking so hard he was afraid he was going to drop the baby, so the nurse handed her to me. My first time holding a newly born baby. I can’t believe she’s a teenager now, how does that happen so fast?

Looking back I didn’t know at all what I was doing. I had attended one workshop, had no first hand experience of pregnancy and childbirth.  I am so grateful that Rebecca and Aaron allowed me to join them on their journey into parenting.