What confident births look like

The weekend, during the Ready for Birth: Express class, I took a couple of minutes to show a birth video that I don’t always show; it was a larger class, and it was wonderful to have so many different families. Some were giving birth in birth centers, others in hospitals, some with OBs, others with midwives. There are a billion birth videos out there, but I love this first one because it’s a wonderfully accurate depiction of birth: the mom has intense contraction waves, but is able to still laugh a little during the breaks in between. It shows her moving around and changing positions. And more importantly, it shows how gorgeous birth can be when the person giving birth is surrounded by caring providers in a calm, patient environment. On Saturday, after this video, there weren’t many dry eyes.

The birth of Cody Taylor | Waterbirth at Mountain Midwifery Birth Center in Denver, CO from crownedbirthphotography on Vimeo.

Why do I want to show you these? Because birth is usually talked about in a way that’s scary. Because birth isn’t shown realistically on TV or in the movies. Because most people never hear about the amazing empowering, positive births– only the traumatic ones.

Here’s a birth in a hospital. It is another water birth, and I’m not terribly thrilled with how long it took to get baby to the surface, but it’s cool.

Milo’s Water Birth from David Mullis on Vimeo.

Here’s a hospital breech birth–keep in mind, these care providers are taught how to deliver vaginal breech births. It is something that is possible, but ONLY when the care providers know how to handle it. There are still quite a few places where vaginal breech birth is a skill still emphasized during education and training. Unfortunately, it’s not taught in the US on anything approaching a regular basis.

Nascimento Mariana, parto natural hospitalar pélvico – 04/jul/2013 – Natural breech hospital birth from Além D’Olhar fotografia on Vimeo.

A preterm birth of a wee double rainbow baby; again, the care provider is calm, patient, and caring. Births of rainbow babies are emotionally challenging. When a family gets pregnant after a previous stillbirth or miscarriage, there’s the very reasonable fear that another loss can happen. BUT, and this is important– in these cases, it’s even more critical to have a calm, caring, supportive birth environment rather than a fearful, negative birth environment.

Double Rainbow Baby, the Birth Story of Emilia from Jennifer Mason on Vimeo.

A hospital birth in—well, not the US. I love everything about this video. Again– you see calm, patience, and encouragement.

Thomas | Parto natural hospitalar from Ana Kacurin on Vimeo.

So here’s the deal: Everyone deserves this kind of environment during birth. Full stop. It’s not about medicated, unmedicated, natural, vaginal–it’s about understanding that birth is a normal biological process. It’s about a mother who is confident in her body’s abilities. It’s about having care providers and support people present who hold the space. Birth can be positive. It’s a lot of work, it’s never easy, but it doesn’t have to suck. A triumphant experience is possible.

Veronica Jacobsen, BA, CD(DONA), CLC, CPST, LCCE, FACCE

DONA-Certified Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

Do we expect too much from dads at births?

dads birth doulas

This month is International Doula Month, and as such, I’ve been thinking about what I really wanted to say about doulas that I maybe haven’t said before. There have been a few interactions I’ve had lately that really got me thinking, although this is nothing I haven’t thought about before or even mentioned in classes.

We expect FAR too much from dads during birth.

So, here’s the deal:

Back in the day, like 130 years ago or more, when a woman went into labor, the local midwife would come into her home. The mom’s female friends and family would come to help– they would prepare her a birth space,  soothe her, help keep her fed, hydrated, and reassure her. Birth was a normal part of life, something that most woman would be familiar with long before it came time for them to give birth as well.

I’ll say this again: Birth was a normal part of life.

The role of a birth doula is to try to bring into the picture those women who were very experienced when it came to birth. Unless you’ve been around a couple of women as they give birth before, birth is a pretty weird process that no amount of videos can ever prepare you for. So while I’m not saying we should go back to the time when it was considered “improper” for men to witness births, I’m saying that the idea of a partner having to bear the responsibility of caring for emotionally and physically supporting a mom through birth is unfair to everyone– it’s unfair to the partner, it’s unfair to the mother, and it’s unfair to the baby.

We have mounting evidence of dads (there is no info out on same-sex partners) experiencing PTSD as a result of being at the birth of their babies. Even if there aren’t ANY complications, while we should try very hard to prepare partners to be active participants at birth, there’s nothing to really prepare anyone for the twists and turns of birth. Doulas can’t predict how a birth will go, but they are prepared to walk the journey with families, no matter what that ends up looking like. Doulas provide that reassurance to EVERYONE during the process, no matter what, helping reduce trauma.

Doulas aren’t emotionally attached, not do they have to bear the responsibility for the medical care being provided.

Hiring a doula isn’t a value judgment on the state of your relationship; in fact, having a doula can help provide the space and time for those critical moments during labor and birth that can bring couples closer together.

Hiring a doula will not take away from a partner’s role at birth; having a doula present will give him more confidence to be involved in a way that he’s comfortable with.

Hiring a doula means that the laboring mother will have what’s very biologically normal– the care and support of an experienced woman who will stay with her through the whole process.

Hiring a doula isn’t a luxury. Hiring a doula should not be a status symbol. Hiring a doula should not be political. Hiring a birth doula is a logical, critical, SMART choice that can help ensure that no matter what happens at a birth, everyone in the room was able to benefit from the professionalism and reassurance and care that a birth doula provides.

I believe in birth doula care SO MUCH that I have created a non-profit that, in addition to providing mental health services, provides doula care on a free and sliding-fee basis. Families who are interested in doula care through The BabyLove Alliance can come to our Information Nights. Upcoming dates are May 20th, June 24th, and July 29th at 7 PM at BabyLove. Find out more information about our unique program here.

Hire a doula. It’s important.

Veronica Jacobsen, BA, CD(DONA), CLC, CPST, LCCE, FACCE

DONA-Certified Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

Announcing The BabyLove Alliance’s Doula Program

As the Executive Director of The BabyLove Alliance, Ltd., I’m proud of many things. I’m proud of our 501(c)3 status. I’m proud of the little organization we’ve built. I don’t think building this or any non-profit is as hard as anyone likes to think it is, but it’s still an impressive little accomplishment. We’re working on creating a program that integrates prenatal education and birth doula support with mental health and medical risk counseling, and I’m working on raising money to open our very own Baby Cafe to provide breastfeeding help and support to families free of charge. Today, I want to tell you about our doula program.

First, a little background: I’ve been a doula for 9 years. I started my career in Southeast Minnesota. Things there 9 years ago were very different than they are in the Twin Cities now. First of all, there were (and still are) only a handful of doulas in the area; however, those doulas were some of the kindest, most caring doulas I’ve ever had the pleasure of working with and I miss seeing them on a regular basis. Second of all– do you know how much doulas cost? I charged $350 for the first two years I was a doula. That was a totally normal fee. By the time I started taking clients again after my son was born (7 years ago), I think I was charging $550. Third, many of the doulas that started as doulas the same time I did are no longer doulas. Why? Being a doula in a solo practice is brutal to maintain over any length of time. It’s hardly steady income, it’s almost impossible to balance with any other job, and if you have kids it requires many sets of extra hands to be willing and able at any given time to pitch in when a doula is called to a birth. It makes it exceptionally difficult for doulas who don’t have family at the ready. It also means almost any doula ends up having to be a stay at home mom.

As my doula fee for private clients crept up, I’ve become acutely aware that, in all likelihood, that fee was out of line with my own family could afford if we had to hire a doula today. Paying what amounts to a mortgage payment or a month’s rent on a doula? Whoa. Now, it would take a book to explain how doula costs got this high, but if you believe in market forces (and, yes, I actually do), then it’s easy to tell it was time for something to change.

So, if you’re keeping track, there are a couple of issues at play: It’s hard for anyone who needs to work a regular job to pay the bills to work as a doula in private practice (how 99%* of doulas in the US operate). It’s hard to be a doula in private practice unless you have a ton of flexible social and family support to help with childcare. It’s hard for families to pay for doulas out of pocket (and no–I’m not going to tell parents to go to extreme measures to pay for doula care). Over 40 studies have found that doula care improves birth outcomes for mothers, partners, and their babies. No study has ever found negatives to doula care. Having access to doula care is a critical part of providing evidence-based maternity care. That’s why The BabyLove Alliance, Ltd. is doing doula care differently than anywhere else. So, here’s what we’ve come up with:

TBLA Doulas (800x800)

The BabyLove Alliance, Ltd.’s doula care is different. The fee for doula care is determined by a family’s income level, and our doulas and providers work as a group to ensure complete collaborative care.

  • Fees range from $150-$800 based on a family’s income (more here).
  • Families are matched with 2-3 of The BabyLove Alliance, Ltd.’s doulas, whom they will work with during pregnancy, birth, and postpartum. We call this a “pod”. They work together as a team to help families throughout their pregnancies and attend births based on a rotating call schedule. This way, the doulas can balance jobs, kids, life, all while being paid a fair wage for their time spent with clients.
  • The program starts with a comprehensive intake to make sure we can do our best job of supporting our clients. If necessary, we may have them work with other professionals in our organization.
  • Our doulas are accountable to the organization and to each other. They are trustworthy, professional, and kind– a must for any birth professional you’d hire!

I really, really, really believe in this model. It’s sustainable. It’s the most fair to everyone. Yes, others are doing similar things in the US (maybe?), but I think it’s enough of a difference that doulas and families looking for doulas should take a look.

To find out more, shoot me an email at info@thebabylovealliance.org or call me at 651-200-3343.

Or, attend one of our upcoming Doula Information Nights to meet our doulas, have a chance to ask questions, and to start the process of working with our program. They are: 

  • February 26th, 7PM
  • March 25th, 7PM
  • April 22nd, 7PM

At BabyLove– 4590 Scott Trail, Suite #102, Eagan, MN 55122

Having a doula is more within your reach than you think. Being a doula is something you can actually do. Hooray!

Warmly,

Veronica

*I’m totally guessing there. 

Veronica Jacobsen, BA, CD(DONA), CLC, CPST, LCCE, FACCE

DONA-Certified Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

Is there a problem with doula care?

Last week Choices in Childbirth released a report on doula care and insurance coverage. As someone who is deeply interested in the subject (and very opinionated on the specific barriers and possible solutions), I found it very interesting and even useful. Unsurprisingly, the report also became fodder for an anti-doula option piece. On Slate, Elissa Strauss wrote the very click-baity titled piece “More Doulas Can Lower the Cost of Childbirth. There’s Just One Problem.” My mom actually ended up sending my the link, asking me if I could believe what she wrote. I read it. I yawned a little. It was nothing I hadn’t heard before, but I think it’s still a good idea to address her article point by point.

Point #1:  Doulas aren’t regulated or licensed

Yep, this is totally true, and realistically, it is creating a major issue in many ways. In fact, Strauss writes,

Anyone can call themselves a doula without any training, certification, or practice. I could declare myself a doula right now. So could you.

Some doula trainers that I totally respect and admire have pointed out the number of certifying organizations has increased exponentially in the last couple of years. Every program is a little different, some requiring more documentation than others, some having in-person trainings while others are mostly done online. Not every organization promotes certification, either. Certification can protect families by knowing that, absent any other regulations, the doula can be sanctioned by her certifying organization. I am a birth doula who was trained to be a doula in November of 2006 and have been certified through DONA International since August 2007. Currently, no doula organization is accredited, either; however, Lamaze International IS an accredited childbirth education program.

I have more opinions about this specific subject than can fit in this post, but parents can still find doulas who are held responsible in some way, shape or form. Which brings me to her next point:

Point #2: Some doulas resent certain protocols

OK, so this is a really sweeping generalization, and I’m not sure if it makes for a good argument about why doulas are in of themselves bad. However, yes, my experience in the last 9 years is that there are doulas who can push the limits of what a non-licensed professional can and should do. However, in the absence of a standardized Scope of Practice (I follow the scope and standard of practice as set forth by each certifying organization depending on which hat I’m wearing), it’s up to the hiring party to figure out what that needs to look like.

Point #3: They are biased!

This is a tricky as heck little paragraph. Strauss states,

With standardization, women, as well as insurers, could feel confident that the doula they hired would be providing them with sound advice. This means providing information that is accurate as well as unbiased. Doulas currently have a reputation as being advocates for intervention-free childbirth; for many of them, having an epidural is a sign of personal weakness and/or capitulation to the medical industry and maybe just a big, fat failure. (Note how the report mentioned above doesn’t distinguish between C-sections and epidurals in terms of their potential value to mothers.) There are some good—if often overstated—reasons to avoid epidurals, but there are also manygoodreasons to get one. It would be unfair to women to populate our labor and delivery units with doulas who insist that childbirth will not hurt too much if the mother just remains calm and breathes.

First of all, as I’ve stated before here, too often the discussion of pros and cons is labeled as being biased. As far as I know, at no point was the CiC report meant to be a comprehensive report on the use or overuse of maternity care interventions. If Strauss needs to be enlightened on evidenced based maternity practice, I’d suggest she start by looking at the groundbreaking Obstetric Care Consensus “Safe Prevention of the Primary Cesarean Delivery” released by AGOC and SMFM. Maternity care in the US needs to be be improved in all metrics, including cost.

Second, all humans are biased. All professionals are biased. However, some are better at recognizing their biases and at removing those biases from their day to day professional interactions. As a doula, I would never, ever talk a mom out of an epidural. Now, that’s different than telling a mom who has a baby’s head halfway out that the epidural might take longer than the one push needed to finish giving birth. No care providers, be they doulas, nurses, midwives, or doctors, should ever, ever, EVER disrespect or manipulate patients. Period.

Point #4: I didn’t have one

Whenever I read or hear discussions about public health policy, it’s really silly to bring any one person’s experience into the larger discussion. Really, it’s not how anything scientific ever gets done. Since Strauss didn’t have one, it’s a great reason to ignore a really well-done report, I guess. Or it’s not. Let’s go with this being a bad reason to ignore the report, ok?

Overall, the piece points out nothing that those of us who are working on doula care access don’t already know, namely that we have a lot of work to do on standardization and definitions before we can even talk about reimbursement. And on it’s face value, it’s possible that Strauss could have written a more thoughtful piece on the other issues that exist in doula care being covered health services. Instead, it comes across as a piece to justify her own rejection of doula care under the guise of commenting on the Choices in Childbirth/ Childbirth Connection report.

Interestingly enough, the use of doulas to improve a medicalized life experience have popped up in conversation about health care on the other side of the life continuum: Death. PBS’s Next Avenue brought up the topic this week. My ideal solution to gain access to doula care as a covered service recognizes that there is a need for emotional and physical support for patients in many different health care scenarios. A proper doula serves as a conduit, a guide, a translator, and a constant companion who is wholly invested in the emotional support of the patient and his or her family. Doulas fill the gaps.

My post is by no means meant to be a comprehensive discussion on the state or future of doula care. I do have very practical, actionable ideas on insurance coverage of doula services that I’d be happy to talk about with people in person. But just because a writer on the XX Blog thinks doulas are terrible, it’s no reason you should too.

Speaking of doulas, the non-profit I run, The BabyLove Alliance, Ltd, offers doula services on a sliding scale. Our very first Doula Information night is coming up on January 29th at 7pm at BabyLove at 4590 Scott Trail, Suite 102, Eagan, MN. Come meet our doulas (who aren’t pushy, btw), find out what makes our doula services more complete than anywhere else, and ask any questions you have about having a doula at the birth of your baby. Email info@thebabylovealliance.org or call Veronica at 651-200-3343 for more information. Spread the word!

Veronica Jacobsen, BA, CD(DONA), CLC, CPST, LCCE, FACCE

DONA-Certified Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

Meet our new doulas!

As you may remember, I announced the launch of Metro Doula Agency, LLC just over a year ago. Since then, my doula partner Liz and I have been taking clients as a team, and it’s been wonderful. We know our team model improves the quality of support that families receive and it makes life easier on us and our families.

The word “agency” implies there will be other doulas…and I’m excited to announce that we’ve brought on two wonderful women. They will be working as a team as well. I’ve had a chance to spend time with them and I could not be more thrilled with their gentle hearts and bright spirits. Below you’ll find pictures and introductions from Liz R. and Katelyn. They are both trained and have experience, but are working on their certifications.

We know that the agency model is something new to the area, but I’m confident families and providers will come to know that our doulas are the most professional doulas around, that they are highly knowledgeable, and that families will never be without support for their birth, no matter what. Metro Doula Agency stands behind our promise to support families, even through long labors, epidurals, or cesarean births.

With the addition of these two fine ladies, we are able to offer doula services on a sliding fee. So if you’ve been wanting to hire a doula, but have been trying to scrape together pennies to pay for one, we may be a wonderful solution to give you continuous labor and birth support. Contact us at info@metrodoulaagency.com metrodoulaagency@gmail.com and we’ll get you the excellent doula care you deserve.

Warmly,

Veronica

Minneapolis birth doula

Hi!
My name is Liz Ripka. I am 30 years old and have been a birth doula for the past year. I have always been fascinated with pregnancy, birth and the postpartum period.  After many of my friends, and family told me how wonderful I would be as a birth doula I thought I would look into it. A few weeks later I found a workshop and began my training. I have never felt so passionate about my job! I love being able to help and support women and their partners.  I focus on offering a nurturing presence, educating, supporting a woman’s choice, and making the birth of their child as special as possible to each family. I believe that laughter and love are important in the birth process. In addition to working with BabyLove as a birth doula, I am a nanny for two adorable little boys. I love serving each and every family and I feel so honored to be welcomed into their life story. I look forward to this journey!

St. Paul Birth Doula

Hello!

My name is Katelyn Hinrichs. I was born and raised in Minnesota and currently reside in the suburbs of Minneapolis with my family of four. My interest for birth came about when I gave life to my firstborn. I found myself reading anything I could get my hands on, and it was then that I realized this was my calling and there was no looking back! When I’m not spending time with my family, I love to grab some coffee and go shopping, snowboarding, and getting cozy with a book! I love to collect glass containers in hopes to give them another use down the road. My favorite subject in school was my fine arts acting classes. Being a doula means supporting my fellow sisters through this transformative time; giving them the support and means to feel empowered throughout their pregnancy, birthing experience, and beyond.

Veronica Jacobsen, BA, CD(DONA), CLC, CPST, LCCE, FACCE

DONA-Certified Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

Am I biased? You bet.

BiasedBiased

Recently, although I’ve heard it before, the charge was leveled at me that I am biased in my classes. I was called, “Pro-breastfeeding, anti-drugs.” I spoke with a few other Lamaze Certified Childbirth Educators, and it seems that this charge is something that we’ve all heard. So, I think it’s time that I out myself for all of my biases.

First of all, I teach what’s best practice, what’s evidence-based, and what’s biologically normal. Now, keep in mind that it takes, on average, 17 years from the time something is deemed best practice (ie. safest) in maternity care before it used on a regular basis. 17 years. When new practice bulletins come out from ACOG, when the American College of Nurse Midwives issue statements, when the AAP put out new guidelines, guess what? That’s what I’m teaching. If I only taught what was being done by doctors and midwives– well, I have major ethical concerns with that. In an environment of “shared responsibility,” there’s a moral imperative to give families the information that they need to know if they are getting safe and competent care.

As for the “pro-breastfeeding” charge; I’m always interested to know why someone’s motivated to make that charge. Yes, I am a Certified Lactation Counselor. So? In classes, I teach the American Academy of Pediatric’s guidelines on infant feeding and mention what the World Health Organization’s stance is on the issue. Maybe the issue is that my classes meet the standards as set forth in the Baby Friendly Hospital Initiative. Again…so? We have 6 hospitals in the Twin Cities that are certified as meeting the Baby-Friendly requirements, all of the Healtheast system, one HealthPartners hospital, HCMC, and the U of M hospital, I hardly think I hold a renegade position. If those hospitals want to maintain Baby-Friendly status, they need to make sure their childbirth education classes have the same content as mine do. With almost 90% of moms initiating breastfeeding, I’ll stand with and support them. This is not about condemning one feeding choice, it’s about helping moms reach the goals they have for themselves.

What else?

I believe that it’s important to teach an understanding of the processes that are the biological norm.

I believe in maternity care transparency.

I believe that moms need to be responsible for finding competent care. They need to learn what that looks like and how to find it.

I believe that infant car seats are usually a waste of money and, since they are more often recalled and used incorrectly, can quickly become not as safe as convertible car seats. I also hate that parents aren’t taking their babies out and more than half of kids now have flat heads by age 1.

I believe in teaching about healthy choices and safe choices.

I believe in judging a hospital and birth center by their outcomes, not their wallpaper.

Are these things really that bad? Is it wrong to make sure parents aren’t being lied to? Is it wrong to be critical of those “educators” who are giving parents unsafe information because it’s the cultural norm? Is it wrong to help parents seek out safe care? Is it bad that I advocate for the right of a mother to be listened to? I hope not.

Every day, I hear birth stories and breastfeeding stories from moms who didn’t get the education or support that they needed and either they ended up with poor outcomes or their babies did. And you know what? I’m going to stay the course, because moms, babies, and families deserve it.

-Veronica

Veronica Jacobsen, BA, CD(DONA), CLC, CPST, LCCE, FACCE

DONA-Certified Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

“I had no idea!”: Unrealistic Expectations for Pregnancy, Birth, and Baby

unrealistic expectations

There’s a common theme that I hear over and over and over: parents experience a huge disconnect between what they expect versus reality, and they find that very upsetting, irritating, and frustrating. Some of these unrealistic expectations are deeply ingrained into our popular narrative about what it means to become parents. This narrative is reinforced by fictional portrayals of pregnancy, birth, and parenting, and large commercial forces exist to profit off of these. It’s time to change that. And while there may be the rare case where these assumptions and intentions are met, those situations are not the norm. So, listed below, are seven of the most common scenarios I run across:

1) Your prenatal visits will have lots of time to answer all of your questions and are enough to teach you everything you need to know about giving birth. Prenatal visits can last anywhere from 5 to 30 minutes or more, and are entirely clinic and provider specific. In high-volume clinics, short appointments are not uncommon. Additionally, a recent study found that many moms did not fully understand what their doctors or midwives were telling them.

2) The care provider you saw during pregnancy will be there during birth. Depending on the provider’s specialty and practice structure (Individual, small group, large group), you’re most likely to be at the mercy of their call rotation schedule. With the exception of the practices that work on a rotating call basis with care providers at the hospital or birth center during an entire shift, or if they happen to have a chance to pop in earlier, you won’t see a doctor or midwife until you’re pushing–and then, who shows up may be a surprise.

3) A nurse will be there to help guide an support you through the entire birth. First of all, a nurse’s primary job is to keep tabs on the health and well-being of baby and mom throughout the labor. They are also required to document heartbeats, blood pressures, temperatures, cervical checks, etc. And while in many cases,  best practice is to have staffing ratios that allows for one nurse to be taking care of one mom in active labor, some hospitals are more likely to have much lower staffing ratios; some Twin Cities hospitals have one nurse for every 2 or 3 mom in labor.

4) An epidural is guaranteed to work (and everyone can have one). Not all women are able to have epidurals– and your doctor or midwife may not catch that ahead of time. Also, epidurals only work perfectly about 80% of the time. No matter what your goals for pain medication are, it’s good to know about other options–just in case.

5) Having a birth plan is enough communication of your preferences. Birth time is NOT battle time. While you are in labor, you don’t need to be using that time to negotiate over the things that are important to you. While nobody knows what your birth will be like, you need to go over your preferences with your doctor or midwife. They should be willing to listen to your concerns and what’s important to you. If they are dismissive or tell you what you want won’t matter, it’s time to think about finding a provider who will be flexible (as you should be, too) to wait until labor unfolds.

6) You won’t need any postpartum help. A new baby is way more overwhelming than most people expect. The baby takes a lot of care and attention, and mom will need 2-4 weeks to really recover from birth, so everything else can quickly get out of hand. Groceries need bought, food needs made, dishes need to get done, laundry needs washed, etc., etc., etc. Ask for help! If you can’t coordinate help via friends, family, coworkers, or church community, then consider hiring a postpartum doula.

7) Your baby’s doctor will help you achieve your breastfeeding goals. The reality is, very few pediatricians covered breastfeeding for more than a few hours in med school. They don’t often seek out breastfeeding education after they start practicing, either. When you take the lack of knowledge base, a common desire to be able to measure every single thing, including how much a baby is eating, and an inherent distrust in the ability of women’s bodies, it’s no wonder so many women give up breastfeeding at the direction of the pediatrician. Some providers so have a passion for breastfeeding, so choose that doctor or nurse practitioner very, very carefully.

Those were the ones I came up with. What else did I miss?

Warmly,

Veronica

 

Veronica Jacobsen, BA, CD(DONA), CLC, CPST, LCCE, FACCE

DONA-Certified Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

Is a Doula the same as a Childbirth Educator?

doula same as childbirth educator

This Thursday, I’ll be heading down to the Lamaze International/ DONA International joint annual conference. I’ve been to a Lamaze conference. I’ve been to a DONA conference. As far as I know, this is the first time they two organizations have had a joint conference. It’ll be interesting to see what happens when both groups are in the same room. You see, there is some doula/ childbirth educator crossover, but not as much as you’d think. One reason? It’s far easier to get trained and certified as a birth doula than to be trained and certified as a Lamaze Certified Childbirth Educator, mostly because there are simply more doula trainings. One thing, though, that I feel very strongly about is making sure people realize that hiring a doula is not an acceptable substitute for childbirth education, and a childbirth educator isn’t a substitute for a doula. Both are necessary, and they have very, very different roles.

A childbirth educator, and thus, a childbirth class, is important to help you understand the birth process, various interventions, and help you set realistic expectations for the first few weeks after your baby is born. You need to know these things before you go into labor– once you’re in the midst of birth and postpartum, you just won’t have enough bandwidth to absorb any of that information. And as I wrote previously about the relevancy of childbirth education in 2014, the conversations that we can have in class can not be replicated through any other means.

As a childbirth educator, my certifying organization works very hard to make sure we are staying up to date on evidence-based care. In fact, I’d argue that since we aren’t contractually required to follow a set curriculum that is rarely updated, Lamaze Certified Childbirth Educators are the most likely to have the most up to date policies and guidelines included in the class content. The policies and standards of care are ever-evolving; usually with the goal of improving outcomes for moms and babies.

As a doula, I prefer if the parents I work with have developed their birth preferences separate of my input. That way when the doctor or midwife asks them about their preferences, I know that the family has fully thought through what they want and don’t want. Education allows them to sort through all of their options, and doula support seeks to help them achieve those goals. And really, to think that 2 or 3 prenatal visits can cover as much as is covered in a birth prep class is an insult to those of us who are childbirth educators.

BUT…as a doula, I offer in-person support at the time of birth. That’s obviously not something I do for the families who take classes at BabyLove (unless they contract with me and my doula partner for doula services).  As a doula, my role is to stay there, in the moment, to offer physical and emotional support to the birthing mother and her partner. The act of being a doula is fluid, sometimes intangible, and it’s hard to articulate exactly what I do. So much of what I do comes from instinct, from my experience with other births, and largely just following mom’s lead.

As doulas have become more mainstream, the role of childbirth education has diminished. And I am frustrated that the same women who are fighting so hard to promote paid doula care are also trying to say that what they do is a replacement for childbirth education. If they want respect, they should be respectful. We would all do a lot better if we could acknowledge that it takes interdisciplinary cooperation to best care for and support new families.

Veronica Jacobsen, BA, CD(DONA), CLC, CPST, LCCE, FACCE

DONA-Certified Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

Introducing: Metro Doula Agency, LLC!

After lots of work, some web issues, and loads of care, I’m excited to announce my co-baby: Metro Doula Agency, LLC.

My long-time doula backup and doula partner Liz Fish and I started MDA to serve two needs: It can be a long search for parents to find an available doula, nevermind one that will fit their needs. Also, not all doulas have a love for running a business, and want help with marketing, paperwork, etc. Thus, Metro Doula Agency, LLC was created to help connect doulas and families throughout the Twin Cities area.  Our goal is to find a team of doulas who are professional and highly skilled who parents and providers can trust. And for parents, they will have the peace of mind that comes from knowing that our standards and expectations meet theirs.

Want to find out more? Head on over to the website and check it out!

Warmly,

Veronica

Veronica Jacobsen, BA, CD(DONA), CLC, CPST, LCCE, FACCE

DONA-Certified Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

Myths about Doulas

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To celebrate International Doula Week, I wanted to talk about some of the myths out there about hiring doulas. While many people know about doulas or may even know a doula, there are still some things that people don’t fully understand about what a doula does or does not do.

1) They can only help if you’re planning and unmedicated birth

Doulas do lower the chances a mom will have unnecessary interventions, but there’s a lot can do even when mom is planning to get an epidural or needs to schedule a cesarean.  The most important thing a doula can do in all of these situations  is to hold the space, provide support for both mom giving birth and her partner too.  And, if anything unexpected should arise, doulas are trained to help you roll with the changes and make sure all of your questions get answered by the staff.

2) They are a substitute for comprehensive childbirth education

While it is part of a doula’s job to help parents get the information they need to make informed decisions, there is simply not enough time during prenatal visits to cover the information that would be included in a 12 hour childbirth class. Additionally, it is out of a doula’s scope of practice to provider education; the doula trainings simply do not cover enough information to allow a doula to know as much as a certified childbirth educator. I’ve also heard from other doulas that it’s just hard to work with families that haven’t taken the time to learn about their options and the possibilities for what can occur.

3) Doulas tell you what to do

Doulas provide emotional and physical support for mom and partner. While doulas can make suggestions for positions or other comfort measures that may be helpful, ultimately, all decisions are the mother’s. Also, a good doula will not judge a mom on her decisions, and only really bad doulas would stop supporting a mom as a result of any decisions she makes. It’s not our birth- it’s yours.

4) They can speak to the staff on your behalf

As with #3, it’s imperative that any decisions and any discussions are between care provider and the family. Doulas can help you get more pillows, help you find your nurse, and fill up your water bottle if you need more water. If you need to talk to the staff about questions or concerns, the doula is not a part of that discussion.

5) A doula takes over for the partner

Doulas provide support for both mom AND the partner, making it a more pleasant experience for both. So that means a doula can get food for everyone, let the partner take a nap, and if things are going really well with just mom and partner, blend into the background, ready to step back in whenever needed.

6) A doula can “protect” you

Sometimes moms are really good at realizing that they place they are planning to give birth and/ or their care provider may not be the best choice, and they want to hire a doula to “protect” them against unwanted procedures. While a doula can help support families in all kinds of situations, the better choice would be to hire a doula AND find a care provider they feel safe with. And again, a doula can’t speak to the staff on your behalf.

7) Doulas are a luxury

While the cost of a doula can range from $400 to $1200 or more, the reality is, a doula is something that could potentially save you money in the long run. Parents will spend a lot of money on a lot of things that may or may not get used, such as expensive strollers, fancy decorating for the baby’s nursery, and more toys and clothes than they have space for. A doula, though, is one thing that can result in better outcomes for both mom and baby. And don’t listen to me…even Suze Orman thinks doulas are a necessity!

I am excited to say that my business partner Liz and I are are currently accepting doula clients; we work as a team to provide top-notch care and support. Find out more information about hiring us here.

Have any questions? Comments? Sound off below!

Warmly,

Veronica

 

 

Veronica Jacobsen, BA, CD(DONA), CLC, CPST, LCCE, FACCE

DONA-Certified Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.