About Laura:  I am a DONA certified birth doula in the greater north and west Phoenix metro area, including Scottsdale, Paradise Valley, Anthem, Glendale, Peoria, Surprise, Avondale, Litchfield Park, Tolleson, and Goodyear. I love to use my gifts and talents being able to help women have a satisfying and successful labor and birth. It's my goal to get to know a woman in such a way that I can encourage her in the way that allows her to have the very best birth experience she can. I consider it one of the best blessings to help a baby come into the world! Please email or call me at (480) 44-BABY4, for more information.

When was the first time you heard the word, “doula”? 
In 2002. I was pregnant with my 3rd baby, and going through Crisis Pregnancy Counseling training with a woman who became a friend. As we approached the end of my training, she said she was becoming a doula, and needed 3 certification births, and would I mind if she attended my labor? She was amazing! I never ended up becoming a counselor, but became a doula instead! 

How did you decide that becoming a doula was part of your journey?
After a typical hospital birth with epidural, an unmedicated hospital birth with a midwife, and then 2 birth center births, I realized there was a woman with me in some capacity in every single birth. My husband was a FANTASTIC coach, and I couldn't do it without him; at the same time, I really NEEDED a woman there (a nurse the first time, my childbirth instructor the second time, a doula the third time, and a midwife the last time). 

I decided to pursue doula work when my last child was 2. My oldest was old enough to babysit in a pinch (finding 24 hour childcare is often one of the biggest obstacles for doulas) and since they were all homeschooled and used to being home with each other, it worked. I had a supportive aunt who encouraged me and helped me with the cost of training. I also realized there were different needs in the community for different doulas. As a fairly calm, more quiet, strong-in-my-Christian-faith woman, and okay with hospital or medicated birth if the mom desired it, I would appeal to a certain type of laboring woman. I realized it's okay to celebrate our strengths and areas of expertise as doulas. :)

Are you a birth and/or a postpartum doula?
Birth doula.

How long have you been a doula?  
I have been a doula since 2008. I have been certified with DONA since 2010, and have Rebozo and TENS certifications with them as well. I have additional breastfeeding training, and I am Neonatal Resuscitation certified as part of my path to midwifery.  I have experience with hospital (planned medicated and unmedicated), birth center and homebirth. I have attended waterbirths, VBACs, teen or single moms; accompanied in cesarean section births and for expected stillbirth. 

What do you enjoy the most about being a doula?
I love being a part of the strength women and their partners’ find when being stretched beyond what they thought possible. It's a difficult journey for most, but women are amazed at when they've accomplished, and men look at the mom of their new baby with such awe at their perseverance and strength (unmedicated or otherwise)!  Helping a woman feel respected, educated, and informed is also a big part of the satisfaction I get as an attending doula.  And of course, it's always a blessing to see a new baby come into the world. 

What is your philosophy when you go to a birth space?
It's not my birth- it's hers! I am there to support her in HER choices, even if I personally wouldn't chose that path. My goal is to be an encouragement; to help mom feel empowered and confident in an uncertain journey; to make things as relaxing and calm as possible- whether through environment, thoughts/fears, communication or comfort measures; to validate her feelings.  My professional motto is "Seeking to enrich labor and birth experiences" and that can come in a variety of ways.

How do you work with and involve the Coach?
I have worked with coaches that are most comfortable sitting in a corner, and those that are catching their baby... and everything in between! My goal is to help the support person feel the most confident and comfortable they can, and to experience the labor/birth to the level of involvement they want. As a doula, I want to take the pressure off of the coach to be the source for all knowledge and physical help, because that doesn't allow them to experience the birth for themselves. I often will demonstrate how to massage gently, offer positions that he can aid in, and offer food and drink for him to provide for the laboring mom. It's also a comfort to both the coach and the mom to have me available for coach to take bathroom breaks, go on food runs, and take quick catnaps. Typically my biggest help for the coach is being a calm and experienced presence; letting him know that when things get intense, that it's all part of the process, and reassuring him that those are good signs!

What is the toughest situation you have ever dealt with?  How did you handle it?
I've had to call 911 for a mom that labored quickly and felt she was going to birth at home unexpectedly; been dismissed as a doula after a homebirth transport to the hospital; watched a family grieve with the loss of their firstborn; worked in births where the birth team was rude, loud, and demeaning. In all of these situations, I stay present for the mom and dad- a compassionate presence, and I validate their feelings and choices.  And then I go home, and cry, sleep, pray, journal, and/or talk with my mentors. I believe doulas HAVE to have those she can decompress with, otherwise there's too much pent up frustration and often, anger- towards choices made, providers, and "the system," and bitterness grows.

I develop an emotional connection with my clients, and so when they hurt, I hurt. I include a postpartum appointment in my services, and that is where we can talk about what, how, and perhaps why things happened the way they did. I validate mom (and often dad)'s feelings about a birth that went very different that planned. However, I also provide another perspective to things, which often helps them to perceive the experience differently. Lots of times, new moms overlook all the amazing things they did, or the strength they had, focusing only on where things DIDN'T go according to plan. I help her see the good choices she made, and encourage her in where things went "right."

What keeps you working as a doula?
Being there for women. I love helping laboring moms realize how strong they are, helping a couple (or mother/daughter) grow closer together through such an intimate time, and being a compassionate, experienced and non-judgemental guide in the process. Often my clients and I share similar spiritual beliefs, and they appreciate my sensitivity and ability to welcome God into their birth experience through prayer, music, and focus. I feel like my doula work is a gift and a calling - and a responsibility!- from the Lord, and that in itself keeps me going.

What does your fee cover – how many visits or hours?  Is there a different charge for a shorter labor or longer labor?
I charge $600, and it includes 2 prenatal appointments (usually 2 hours each), the entire labor and birth, 1-2 hours postpartum, and a separate postpartum visit one the family is home. I do not vary my fee depending on length of the birth; my quickest client was 10-15 minutes, and my longest was 29 hours. I don't want moms feeling pressured to "birth quicker!" because of financial considerations. 

I offer discounts to previous clients, active duty military, parents placing baby for adoption, and those in full-time Christian ministry. I have also been known to provide significant discounts -occasionally- for hardship situations, and accept barter as partial payment as the need arises. 

Do you offer any other services to your clients?
Placental encapsulation; a "birth journey" story for the baby book and/or to share electronically; all pictures, along with some that I edit. 

I am a Christian childbirth educator for an online format that I adapted from Jennifer VanderLaan's book, "The Christian Childbirth Handbook" and also teach a free one-day childbirth class for crisis pregnancy moms through New Beginnings Crisis Pregnancy/Post Abortion, 1-2 times a year. 

I am also a hobby-level photographer, and take pictures of labor and birth (with the parents' permission), for them to keep.

Just for fun, what do you do when you are not doula-ing? 
I danced professionally with a ballet company before I had kids, and still love to take a class at Ballet Arizona a couple times a year (usually when I'm dancing around my kitchen!). In the past 5 years I've taken up running and have done numerous 5Ks, 10K, and half marathons. I have completed 3 full marathons with my best time being a 4:06. I also like to hike, having done a rim-to-rim hike of the Grand Canyon, and a hike up Yosemite's Half Dome. Obviously, I love to push my body, I think because I see so much correlation in it to birth. 

My family is amazing, and made up of my 4 kids (ages 7-16) and an AMAZING husband who are so supportive and encouraging to me and my love for doula -and now student midwifery- work. Spending time with them is always a favorite, whether watching them cook with my husband, or reading books together, or watching House Hunters and the Cosby Show with them! After a year of dealing with a diagnosis of clinical depression, I am learning to heal from past hurts, and to again enjoy entertaining and spending time with friends and my church family. Other than birth, I have a passion for healthy marriages, mentoring, counseling, and non-judgmental, transparent (and often messy) Christianity. My husband is a pastor at West Greenway Bible Church in Glendale, and teaches Bible at Arizona Christian University, and combined with my work in the birth community, that keeps us hopping! 

Oh, and I can also turn ANYTHING into a birth analogy. It's a gift, really. ;)

If you would like to contact Laura to schedule a complimentary interview, you can reach her via:
Phone: 480.442.2294 (480-44-BABY-4)

Email:  [email protected]

 

When was the first time you heard the word, “doula”?
The first time I heard the word "doula" was in my Bradley Method® Childbirth Training.  I didn't pay any attention to it and wasn't convinced of the the importance.  After all... Bradley Method® teaches DADS to be the coach.  Why do we need another? I have since learned that I was wrong!  Don't get me wrong, dads are WONDERFUL coaches.  But there are times when the coach needs an assistant!

How did you decide that becoming a doula was part of your journey?
One of the great joys of teaching childbirth is classes is hearing the birth stories afterward.  I LOVE birth stories.  I started noticing frequently the need for help.  With today's hospital environment especially, there is a need for someone there who not only looks out for the emotional, physical and informational well being of the mom but someone there who's "got dad's back."  Having someone there who can continually support both partners is SO beneficial.  I had always been available via phone for my couples.  But that wasn't quite enough for some. 

Are you a birth and/or a postpartum doula?
At this time I am solely a BIRTH doula.

How long have you been a doula?
I have been working officially as a doula for four years now. I have been a certified Bradley doula for 7 years.  I did go through all the DONA training, but never submitted the paperwork.  So I am not certified as a DONA doula, but do have the training. 

What do you enjoy the most about being a doula?
I love empowering couples.  I love helping them birth their baby in the way that THEY want.  Helping mom's to discover her inner strength and ability is the best!

What is your philosophy when you go to a birth space?
My philosophy... hmm.  I have never put it into words.  When I arrive at a birth space I quietly observe and evaluate what is going on and how I can best help.  I do not blast through the door like a bull charging, but rather quietly and respectfully enter hoping to have the least impact on the moment.

How do you work with and involve the Coach?
Before the birth we clearly define their expectations of me, and I work to live up to this.  I make sure to see to the needs of the mother's birth partner, making sure he stays hydrated and fed through out the birth as well as mom.  In most cases its important for him to be the main source of physical comfort for mom.  When suggesting positions, counter pressure, and comfort measures I will talk to him and explain the benefits to him first and then we (or he) will suggest it for mom.   I will assist him in finding new comfort measures/positions as needed.  There is LOTS of communication between the birth partner and myself, both verbal and nonverbal.  I clue him in when there are things going on with birthing staff that he needs to be aware of with simple gestures and glances.

What is the toughest situation you have ever dealt with?  How did you handle it?
Its important that the birthing room be a peaceful environment, and sometimes that means NOT saying anything when the room is filled with high pressure doctors and nurses.  It’s very hard to say nothing. This is when it’s especially important to have developed the nonverbal communication cues with dad.    I have becoming very skilled at maintaining a peaceful relationship with staff even if I completely disagree with everything they have set out to have mama do. This may be consistently the hardest thing for me.

Most recently I was with a mother who labored beautifully.  She had a fantastic completely intervention free birth peaceful birth.  After the birth she was bleeding very heavily.  The bleeding continued for quite some time.  Mom was not open to accepting intervention.  The staff was getting very nervous as bleeding was extreme.  I am by nature a very anti-intervention person as well, and I understood how she was feeling.  Things were getting tense as mom stood her ground and staff was getting afraid and frustrated.  As I observed the scene the nurses had mom in the bathroom and baby was with dad.  Blood was pouring and doctor and left the room feeling helpless and angry that mom wasn't bending. This was a time when I believe that the intervention was needed to prevent further complications and long-term problems. But protecting the mom and her beliefs, needs, and desires is an important part of my job.   

How did I handle this? I quietly knelt down beside her in the bathroom and simply asked her how she was feeling and what she was thinking.  Had anyone done that yet? Nope. She was feeling bullied and unclear of what was going on.  We were able to have a conversation about what the situation was and the risk and benefits to doing nothing and all the possible interventions and their risks and benefits. THANKFULLY the nurse gave us this time to have the quiet calm conversation.  She did accept a shot of Pitocin and felt the decision was HERS.  For this mom accepting an intervention would have been very traumatic if she felt pushed or bullied, even if it truly was needed. 

I know you may be thinking "breastfeeding could have solved this."  In most cases this is true!  She did have baby at the breast for a long time.  There was a lot more blood than normal.  This truly was an unusual case. 

What keeps you working as a doula?
That is an excellent question. Sometimes at the end of long, emotionally draining birth when I haven't seen my kids (often for days), I ask myself that very same question as I drag my tired behind home feeling battered and bruised with arms so sore from doing counter pressure or from hours of continual massage that I can hardly lift them. Then I check in with the family with their new bundle of joy.  I hear how empowered they feel, how safe they felt, how happy they are and how my presence positively impacted them during this irreplaceable time in their life.  That is what keeps me going.

What does your fee cover – how many visits or hours?  Is there a different charge for a shorter labor or longer labor?
I charge a flat rate fee that covers your birth whether it lasts 3 hours or 30 hours. I do offer a $100 discount to Bradley trained couples.  With this fee you get two prenatal appointments (more if you feel its needed), continual support through email, phone calls and texts.  I go on call two week prior to the birth and stay on-call 24 hours a day until you have your baby.  I come to you when you are ready, whether at home or at your birth location.  That choice is yours.  I stay with you until you have successfully breastfed your baby for the first time.  After the birth I check in with you a few days after the birth and come and help anytime you need it during that first week.

Do you offer any other services to your clients?
I am a certified lactation educator and can assist with breastfeeding issues.

Just for fun, what do you do when you are not doula-ing?
I am a busy work-at-home mom of 5 kids. Well, kind of work at home.  I teach Bradley childbirth classes, and am a student midwife as well.  I also vacuum a gymnastic studio several hours a week to help pay for my children's tuition.  My children are homeschooled and range from preschool to 7th grade.   They are active in many clubs and activities and keep me hopping!

How to contact Zabrina:
(602) 743-9890 
[email protected] 
http://familybirthdoula.vpweb.com

I am so pleased to introduce our students and readers to Kimberly Flake in this month’s Meet The Doula feature.  Kimberly has been a doula for a few of our students, all of whom have had great experiences with her.  I wanted to feature her in April, Cesarean Awareness Month, since she, herself, is a VBAC mama, and she specializes in VBAC support.

The first time I heard the word doula was when I read about it just weeks before I sat in a class to become one.

A dear friend of mine and I walked the path together as we became doula sisters. Her road was short as she learned that she was there to heal from her cesarean births. I realized that the doula path was where I was truly meant to be. I had always considered becoming a midwife and this was my first step in the process. My first few births were amazing as I was a doula for a doula, attended the birth to a woman whose husband was not present, and my own sister-in-law. All three births were amazing natural births, where I learned, shared tears of joy and truly loved these special women as they came into their own strength of motherhood. I was incredibly privileged to share in the most intimate moments in a family's life. This was where I was meant to be without question.

I am a birth doula and monitrice.

11 wonderful years this month- April 2013.  As a doula, I apply my skill sets as a registered nurse, licensed massage therapist, and doula to support a family through their pregnancy and childbirth journey.  I specialize in VBAC support and natural childbirth.

There is a moment of complete joy as women and their partners realize their goal, give birth to their baby and experience a source of empowerment that she will carry with her for the rest of her life. This brief moment in time is without question the best thing about assisting couples through the process of pregnancy, labor and childbirth.

Keep the birth space sacred so the birthing couple can have a bonding and positive birth experience.

Pregnancy, labor and childbirth are a shared experience between the woman and her coach. I work with the couple prenatally to learn what management tools for labor will be most effective for them as a couple or team. As she begins labor I act as an example of techniques to support the woman facilitating a positive experience for the coach to be present and supportive however he or she wants to be. I encourage coaches to remain in the role of support to the woman in front of her, so she can look into her partners eyes and be strengthened emotionally and physically by their bond.

The most challenging situations have been those when a family experiences the loss of their baby. Each family is individual in how they need support, but I remain with them as their doula and sister. Helping them to cope and heal is a longer process than that of a living birth, and I spend many postpartum hours with them. I have had the honor of being asked to read a mother’s remembrance of her lost son who she knew and held for only hours outside the womb. I read her words at his memorial service and will carry her sentiments with me forever.

My love for helping couples through the process of pregnancy, labor, birth, and postpartum.

My fee is a package fee that includes the following and does not change with the length of a labor.

Placenta encapsulation for an extra fee.

Currently I spend most of my not doula-ing time studying to become a certified nurse midwife, with my family, and watching my kids sports and activities. When I do have some spare time I love to read, take photographs, skydive and swim.

Tel:  (480) 216-1837

Email:  [email protected]

I open today's post with the reminder that April is Cesarean Awareness Month. The World Health Organization and evidence-based practice only supports a cesarean rate of 15% or less.

While a cesarean birth can be life saving and necessary, and we are so grateful for the technology when our students need this intervention, we encourage you to know the difference between a variation and complication. Is Mom okay? Is Baby okay? If yes to both questions, asking for time can spare both Mom and Baby from an "unnecesarean". 

The current cesarean rate in the US is around 32-33%, so our wish at Sweet Pea Births is that by raising awareness, only the necessary cesareans are performed, and that over time we see our national cesarean rate back down to at or under 15%.

If a VBAC is not an option you want to explore, I encourage you to explore the ideas and additional readings HERE to learn more about a family-centered cesarean that may be a gentler experience for both mother and baby.  With time and planning with your care provider, these are possible and a beautiful option for families that want and/or need a repeat cesarean.

On to the topic:  Where do you begin if you want to plan for a Vaginal Birth After Cesarean?  

These notes are from an ICAN meeting presented by ICAN of Phoenix chapter leaders Stephanie Stanley and Jessica Franks on January 23, 2013, hence they get the author by-line on this one.  Thank you, ladies, for your constant support of the cesarean community in the Phoenix area.  Here are the steps that Stephanie and Jessica identified in hindsight of their VBAC journeys.

Step 1:  Find a supportive care provider
Your options for finding a supportive care provider in Arizona include an obstetrician in a hospital setting, a Certified Nurse-Midwife in a hospital setting, and Naturopathic Doctor who also holds a Certified Professional Midwife license in a home setting.  In addition, you an interview at Women’s Birth and Wellness Center in Mesa, Arizona, to see if you are a candidate for a VBAC at their birth center.  If you are in the Phoenix area, you can check the ICAN Phoenix provider list HERE to see which care providers have been supportive as per first-hand experience from VBAC mothers.

Step 2: How do I know if someone is truly supportive?
The only way to really know if a care provider is going to go along with your choice for a trial of labor that you hope is going to lead to a vaginal birth is the interview them.  Schedule an appointment with them and meet them face-to-face.  Here are some questions you can ask – you want to keep them open-ended so that you hear their spontaneous answer.

Krystyna’s note:  A comprehensive childbirth education class, like The Bradley Method®, prepares mothers over the course of the twelve week series to eat well to build a strong body and a strong baby, and we have a pregnancy exercise program that builds stamina as well as the three major muscle groups that support pregnancy and labor: Back, Belly, and Bottom.

Step 4: Mental Health
Your mental health plays a significant role in your pregnancy and birth.
A childbirth preparation course can educate you on the course of labor so that there are *less* surprises – all labors have an unknown factor and you can’t be “completely” prepared.

Krystyna’s Note: My favorite line of conversation I have heard at an ICAN meeting, and that I know share with our students in regards to birth choices is this: 
“I have taken the time to educate myself and make the right choice for our family.  Do you really think that I would make a choice to intentionally harm myself, or our child?  If we cannot come to an understanding, or at least agree to disagree, this topic is off the table and no longer up for discussion.”

Step 8: Educate Yourself
Knowing the facts about VBAC will give you more confidence in your decision, as well as prepare you to educate those who may question the safety of your decision.

LINK LIST
Family-centered Cesarean
http://blog.ican-online.org/2012/04/14/the-family-centered-cesarean/

ICAN of Phoenix Provider List
http://icanofphoenix.weebly.com/valley-resources.html    

Bradley Method Course Outline
http://www.bradleybirth.com/krystynabowman?Page=5

Disclaimer: 
The material included on this site is for informational purposes only.
It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation.  Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided.  This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.

A monitrice is a professional, medically trained, labor support person, who provides clinical monitoring within the home environment, including cervical dilation exams, auscultation of fetal heart tones, and monitoring of general well-being of mother and baby, during labor. The monitrice helps couples to assess their progress in labor, to determine the best time to leave for the hospital, where the birth is to take place.

The focus of a monitrice is to provide clinical and educational support, while the focus of a doula is to provide emotional, mental, and physical support. Our monitrice service only provides services within the home environment. She only accompanies the couple to the hospital if complications arise, whereas a doula remains with the client during their transition from home to hospital.

In the role of monitrice, the practitioner does not provide services at the actual birth. She does not "catch" the baby, or provide immediate postpartum services. A midwife provides all prenatal care, all labor and birth care, and all postpartum care.

Couples who have chosen to birth in a hospital with an obstetrician, but who wish to labor at home for an extended period of time would benefit greatly from monitrice services.  They might want to stay at home in order to avoid unnecessary hospital interventions (such as movement restrictions, food restrictions, Pitocin augmentation, breaking the water prematurely, epidural, etc.).  Although they are choosing to wait longer before "going in", they can have that feeling of "safety" with consistent, professional monitoring, 

A couple would interview the monitrice at her office and determine that the services are in line with their birth plan. They would then have two prenatal visits to get to know each other, and for the monitrice to assess baseline vitals and good health in the pregnancy.

The monitrice would be on call for the couple, starting at 36 weeks. When the couple believes labor has begun, they would contact the monitrice to give her a head's up. They may request her services at that point, to help determine if this is the "real thing" or may wait to call her over, once a labor pattern is clearly established.

Once the monitrice has arrived at the couple's home, she will assess maternal blood pressure, pulse, signs of infection, and hydration level. She will also asses fetal heart tones, and upon request from the couple, the mother's cervical dilation. The monitrice may make recommendations as to positions that would be helpful, encourage eating and drinking, and may provide herbal, homeopathic, or flower essence remedies, as appropriate, and as desired.

She will perform clinical monitoring every 30 minutes or every hour, depending on the stage of labor and the client's wishes. She performs monitoring respectfully, and can monitor the woman in any position the woman’s choosing, including in the shower, or in the labor tub. Once the couple determines that they are ready to leave for the hospital, the monitrice wishes them well and departs.

The couple will have a follow-up visit, including assessment of mother's vital signs, stitches (if applicable), a check for any signs of infection, breastfeeding support, and baby weight.  These visits occur at 1 week postpartum and 3 weeks postpartum, as most obstetricians only provide one postpartum visit at 6 weeks.

In the rare event that a complication should arise during labor, the monitrice will accompany the couple to the hospital.  Once they arrive at the hospital, the monitrice will provide a report and labor records to the staff. 

The fee is $625. This includes two prenatal visits in the office, four hours of labor monitoring, and two postpartum visits in the office. Labor monitoring above four hours falls to an hourly rate of $50.  I am happy to offer a discount of $200 to any students of The Bradley Method®; their fee for service is $425.

As an added service to our clients, our monitrice service also rents, which includes set up and take down, the Birth Pool in a Box  labor tub, for $200. 

For more information about Moxie Monitrice Services, please visit 

www.moxiemidwifery.com or call to set up a free consultation.  You can also search for "Moxie Midwifery" on Facebook and @moxiemidwifery on Twitter. 

Jennifer Hoeprich is a licensed midwife and monitrice, who provides services in Phoenix, Chandler, Mesa, Gilbert, Queen Creek, Maricopa, and Casa Grande.  She attended her first birth at age six, when her dog Cinnamon had puppies. She was the only attendant and knew then that she had found her calling. In 2001, Jennifer obtained her Bachelor's Degree, Minoring in Women's Studies. She experienced a natural birth with her son, in 2004 and began her journey into midwifery, shortly after. In 2005, she became a certified doula, and in 2008, a certified childbirth educator. She then obtained her midwifery license in 2011, and began the practice, "Moxie Midwifery." In her spare time, Jennifer enjoys being with her family, playing guitar, crocheting, and doing yoga. 

Disclaimer:

The material included on this site is for informational purposes only.

It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation.

Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided.  This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.

The information shared in a Bradley Method® class helps a couple do a Benefit-Risk analysis with each other, and their care team, "if or when" they come to a decision point in their labor.  When used wisely and at an optimal time, interventions, procedures and/or drugs can be used appropriately.  They become tools that facilitate a "Healthy Mom, Healthy Baby" outcome.  If you are not educated about or prepared for some of the risks, you may end up wishing you had known a little more.

My opinion is that for parents-to-be, birth education is a highly recommended component of birth preparation.  It does not, by any means, replace  a competent, caring medical team.  What birth education does do is prepare you to actively participate as an *educated* consumer in the pregnancy and birth of your children.

Best,
Bruss

Disclaimer: 
The material included on this site is for informational purposes only.
It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation.  Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided.  This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.

One of our Fall 2011 students had a wonderful birth experience with her unwavering support through their “marathon” birth.  I had the pleasure of meeting Dianne at the Bradley Day Family Picnic last year.  I hope you will enjoy getting to know this month’s featured doula!   

Bio: This past summer, I celebrated being married to my wonderful husband, Craig, for 30 years! We have four grown children who I loved being a mom to and now I have the amazing privilege of being a Grammie!  I am also a Birth Doula, Childbirth Educator and Lactation Educator. The miracle of birth is SO amazing to me and is a constant reminder of our Creator God.     

When was the first time you heard the word, “doula”? 

 Without knowing what a doula was, I had a support person with me through the birth of our four children. I had also attended 24 births with friends and/or family as a support person. It was the year 2000 and I was thinking of going to nursing school to become a labor and delivery nurse. Someone mentioned to me that if what I wanted was to support women through the labor and birth process, then I should become a doula.

 The decision was made to become an official doula in 2009. I had been in sales and traveled out of town often. A year earlier, our daughter had been diagnosed with brain cancer and it was at this time that I decided I no longer wanted to spend so much time on the road. It just didn't feel right to think about spending the next four years in college to become a nurse and thus began my career as a doula. Now 175 births later (as of 3/1/13) and I've never second-guessed that decision!

 I am a birth doula only. 

How long have you been a doula? 

 As mentioned above, I attended 24 births as a support person before I officially became a doula. I went through DONA training in the Seattle area and also had the privilege of working along side a wonderful mentor doula by the name of Patti Ramos. I am also a Certified Lactation Educator and received my training through Evergreen Hospital with Molly Pessl and Ginna Wall.

 I love seeing a woman transformed through her labor and birth experience; witnessing the raw strength that comes out in the midst of labor.  I tell women that they are not only giving birth to a little one, but they are being reborn themselves through this process. I also love to photograph the Dad's expression as life is coming forth from the love of his life.

What is your philosophy when you go to a birth space? 

 My goal as a doula is to help make it the best birth experience possible regardless of the circumstances. This involves educating them beforehand regarding the choices and options they have whether it's a hospital birth, birth center birth or home birth. I remind them that this is *their* birth and to take charge of it. 

 
How do you work with and involve the Coach? 

 Whether the "coach" is their partner or other family member, I emphasize the significance of their role. I draw them in close to her and show them ways to help comfort. I remind them that words are not always necessary but their presence (and maybe a hand) is. 

 
What is the toughest situation you have ever dealt with?  How did you handle it? 

 The toughest situation I have been in was an undiagnosed breech home birth. Once the midwife confirmed the baby's position, the parents made the decision to not go to the hospital. The outcome was good and everyone was fine, but getting there was tough. I supported her just the same and even remembered specific positions for birthing a breech baby. To this day, that is biggest adrenaline rush I've ever experienced and it took me a few days to recover both physically and emotionally.

What keeps you working as a doula? 

 I am very blessed in that I am on staff at Babymoon Inn birth center as the primary doula. A doula is included in their birth package and 95% of families choose to utilize the services of a doula. I also accept 2-3 private clients per month so this means I am one busy doula!

What does your fee cover – how many visits or hours?

 My fee includes the initial consultation, a birth planning meeting, 24/7 availability by phone, text or email, labor support at home and throughout until birth. I photograph labor and birth (if desired) and also include a birth story. I stay until mom is settled and baby is breastfeeding, which is usually 1 1/2 to 2 hours after birth. I charge the same whether I am with them for one hour or 41 hours! I do a 5-day postpartum visit where I give them their photos and birth story and debrief their birth. My fee also includes registration to the one-day workshop called the Birth Journey.

Do you offer any other services to your clients? 

 I require that my clients take the Birth Journey workshop. This is a one-day intensive childbirth class that emphasized the significance of the partner's role during the labor and birth process. I also prepare couples for when their birth journey is taking a different course than what was planned and give them tools that will help them through.

Just for fun, what do you do when you are not doula-ing? 

 When I am not doula-ing, I love spending time with my husband and two grandkids. We have a 6-year-old grandson and 4-year-old granddaughter that bring us tremendous joy!   

How to contact Dianne:

[email protected] 

602-881-2729 

We taught the class on writing birth plans last week.  I know my perspective has changed as we have seen other couples write plans and definitely my knowledge has expanded since the very first birth plan we wrote as consumers eight years ago.

A birth plan, or your Wish List, is the blueprint for your birth, if you will.  What do you expect to happen?  What will your birth look like from the outside?  Just like a house, you need to lay a foundation first.

The multiple-choice, check the box birth plans are a tool for the smart consumer.  Use it as a starting point.  If there is something on there that you do not know about, use it as an opportunity to educate yourself and learn something. 

 

You could have each partner complete their own multiple-choice birth plan, then use it as a starting point to compare notes and see what is a priority for each of you.  Once you have that conversation, you can start the process of preparing your own document to take with you and have a “first draft” discussion with your care provider.

 

Or you can read through a book like Henci Goer’s “Thinking Woman’s Guide for a Better Birth” that outlines many of the choices that a woman may face in today’s birth settings.  Read through her lists and and educate yourself about the many options.  What do you glean from the research she presents?

 

Read, read, and read some more to educate yourself on options.  Write everything down in a brainstorming session: what you think you want to do/have/avoid for mom and baby.  Then sift through the ideas and separate them into three lists:  Coach, Labor & Birth, Newborn Care.

 

The Coach’s list consists of things that the coach and assistant coach or doula need to be aware of:  environment, music, your preferences as far as massage, labor relaxation scripts and tools, food, drinks, snacks, etc.  What are the things that you want to have at hand during your labor?

 

The Labor & Birth list will be comprised of things like whether or not you are going to have an IV or a heparin lock, how often you are going to be monitored, will your doctor/midwife allow you a soft diet?  Basically, the kind of information your nurse will need to know if you are having a hospital birth or if you are transferred to a hospital from home or a birth center.

 

The Newborn Care list will outline your preferences for baby care – immediate or delayed cord cutting (this may also be on your birth list since it overlaps – whoever catches the baby typically takes care of the cord), what to do about vernix (rub it in or wash it off), which newborn procedures you want done and which ones you want delayed and what you are declining, along with a request for the paperwork to sign for all the things you want to say no to. 

 

Once you have separated all your ideas into the appropriate list, you are ready to start writing the plan you want to present to your care provider.  Keep in mind that you want it to be as short as possible – one of our students made a great analogy, “as if you are writing a resume”.  I love that idea!  We suggest keeping the Labor & Birth Plan on one side of a piece of paper, and printing the Newborn Care plan on the second side.  If you are really good with words and the revision process, you could probably keep it to one page by separating into the top/bottom of the sheet or into two columns on the same side.

 

We have found that care providers are receptive to the idea of calling this document your “birth wishes” or your “wish list” for your birth.  It conveys the idea that you are preparing for the best possible outcome while at the same time being open to the idea of allowing them to make the suggestions they may need to make when you are in labor.  I think at the end of the day, it conveys the sense of collaboration instead of a demand for a particular type of care.

 

Take your first draft into your care provider.  It is a good idea to make sure the appointment scheduler knows that you need extra time to review your birth wishes so that you aren’t rushing through the appointment.  Some care providers even have that talk worked into their care plan already.  Listen to what their feedback is.  If they are saying, “No” to something it is not always because they are against a natural birth.  It may be that something in their experience or their colleagues experience is driving that answer, so be prepared to ask questions and get more information.  Your final document will be a collaboration and hopefully something they are willing to sign so that your wishes are respected once you are in your birth setting.

 

The last piece of information to include as part of your final document is mother and father’s name and birthdates, and if you have them, the parents’ blood types should it become necessary for mom or baby to need blood during the hospital stay.  We never needed this information during labor, however, knowing it did come in handy when one of our children was in the PICU as a 3-month old.

 

I will close the same thought we share in class.  A great birth is not a result of the birth plan – it is your ability to be flexible that will contribute to your perception of the birth experince.  Trust in everything you have done up to this point: great exercise, good nutrition choices, educating yourself about the process, learning to trust your instincts, choosing a supportive care provider and one that trust.  Even if nothing goes according to your wish list, you will not regret taking the time to research your options and the procedures available to birthing mothers.  If and when you are faced with decisions that veer off the course you planned and prepared for, you can make those decisions with confidence because you have the tools to evaluate your choices through a “Healthy Mom, Healthy Baby” filter.

No matter what the plan looks like, or whether they follow their "blueprint" or toss it out and go with the birth their baby needs, we want all of our families to have a Healthy Mom, Healthy Baby outcome.  

 

 

 

Another group is calling for a week of recognition – this time it’s the American College of Nurse-Midwives.  October 7-13, 2012 is National Midwifery Week "...created by ACNM to celebrate and recognize our members.”  Read more about their organization HERE.

I am happy to participate in their campaign to bring the awareness of midwifery care to a larger audience.  We had an epiphany when we experienced midwifery care, and we are delighted to see many of our students making the choice to have midwifery care for their pregnancies and births.

 

As part of the awareness campaign, visitors to the website were asked to write and De-bunk a Midwifery Myth.  Here is the one I chose:

 

When we were pregnant with our first baby in 2004, we started care with my gynecologist, because, after all, wasn’t the other part of her title “ obstetrician”?  I thought I wanted a homebirth, but that wasn’t going to happen because in the U.S., as a general rule doctors do not deliver babies at home.

 

We proceeded to have baby#2 and baby#3 with the same OB/GYN group.  When it came time to deliver, we had to take the chance that the doctor on call was going to respect our wishes to have an un-managed, unmedicated, and vaginal birth.  Thankfully, we only really had to advocate for our choices once, and that was our first birth.  Thereafter, we got the reputation for being “that” couple that had big babies without pain medication.

 

Had we known then what we know now, we may have chosen to have hospital births with midwives.  Yes – they work in the hospital, too!

 

Certified Nurse-Midwives (“CNM”) are professional health care providers.  They are a mix of medical and natural,, since most of them are registered nurses, and they also have a philosophy of care that respects and works with the natural process.  They can work as a CNM after passing a national certification exam, and they must meet the requirements set by their state health agencies.  They are available to counsel women through all phases of their reproductive health, from wellness, preconception, pregnancy, family planning, annual exams and menopause.

 

In regards to pregnancy, CNMs work within a paradigm where pregnancy is healthy, birth is normal, and Mother Nature is allowed to work until there are clear signs that other decisions need to be made.  They work within an evidence-based model, which means that there is a “conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.” [1]  If and when their patient's needs goes beyond their scope of practice, they have an established relationship with an obstetrician who can come in for consultation or transfer of care.

 

For families who are not ready to make the move to a home birth, a certified nurse-midwife that works within the hospital model or at a free-standing birth center may be an option to explore.  Families that know they want more personalized and individualized care where they are treated as healthy pregnant women may think that midwives are a good choice.  Instead of a treating a pregnant woman like patient who has to prove they are healthy because they are expected to be sick and needing treatment for their “condition” of pregnancy, midwives take the time to get to know the woman, her history and a trust is established that has a different tenor than the patient/doctor relationship.

 

Now, not all obstetricians treat their patients like they are sick, and not all midwives come with sunshine and rainbows.  However, if you are sure that you want a birth with as few interventions as possible, it is a good idea to look for the care provider that is going to support your choice not just with their words; they also need to show that they believe in natural birth with their actions and their patient outcomes.

 

If you are looking for some options in the Phoenix area, here are some midwifery practices other Bradley™ students have used:

 

 

Boojum Obstetrics and Gynecology 

 

Bethany Women’s Care  

St. Joseph’s Midwives 

 

Ellen Franklin, CNM 

And new to the East Valley – we have our first student receiving care from this group in our Fall 2012 class:

 

Link List:

                                                                             

This monthly series is an introduction to doulas that serve the Phoenix area.  Read more about the benefits of doula care HERE.  Read more about how to choose a doula HERE.  

 

 

 

I took my DONA doula training in April of 2009 and attended my first births the next month, so it's been three years. I've been to 11 births as a doula, and am now DONA certified. 

 

My favorite thing about a doula is being present at births - labor and birth is such an amazing thing to be present for! 

 

 

 

A few labors come to mind where the labor was difficult for the mother. I just kept up my support and was positive and encouraging. 

 

 

 

 

Birth - the initiation ritual of motherhood - is a life-changing experience. A mother's satisfaction does matter; it's more than just having a healthy baby and mother. Being prepared and supported is key in a satisfactory birth.

Phone: 801-528-1295

Email: [email protected]