Radio Interview on Birth Trends and Midwives

ChicagoDoula’s own Rachel Dolan Wikersham (who in addition to being a doula is also a Ceritifed Professradiowavesional Midwife or CPM) joined local Certified Nurse Midwife, Hillary Keiser today on WBEZ’s Morning Shift with Tony Sarabia. In addition to addressing concerns of several callers, they explained the difference between types of midwives, discussed the opposition of MDs in Illinois to licensing CPMs, and went further into details about homebirth and requests some parents are making in birthing such as delayed cord clamping. Listen to the full interview here:

Birth Day Appreciations

I came home late tonight to a quiet house after spending the last 26+ hours providing labor support. Partner and kids are already tucked in bed for the night – so my birthday has passed by here for my family without me. And I am kind of sad about that. We will have to make it up later.

But instead!… Instead, I got to spend it doing something I love! Something that is truly an honor. And I was rewarded by witnessing the birth of a completely posterior (and asynclitic!) baby. For those of you who don’t speak “Obstetric”, that can be a very tough birth and frequently results in a cesarean rather than vaginal delivery. Anyway – it was simply a miracle. I do love my job.

And now I am enjoying one of my favorite meals after a long day (and night) of doula work: Thai food (Panang noodles that were waiting for me in the fridge) and a dirty gin martini.

But the especially cool thing is that along with it, I got to read through so many birthday wishes from such a fantastic group of people. I got a little weepy (either the sleep deprivation or the gin or both) and thought I’d write a bit just to say: “Thank You!!” I am so glad I get to stay connected with each and every one of you.

I feel very blessed this January 23rd.

…And in case you want to know more about preventing posterior positioning – or ways to try turning a baby who’s already there. Check out spinningbabies.com!

Why a Doula is Better Than Your Best Friend

When we are pregnant, most women “know” on some more or less abstract level that this will eventually end with a birth. Chances are good that around 30 weeks or so, the thought that you will actually have to go through this birth yourself and that you will have to open and push this baby out of your body becomes clear in a much less abstract way. This is when many expectant parents begin to more seriously prepare and gather their resources and support people around them, including making a plan for how they would like birth to go, who will be there and what their roles will be.

In my first pregnancy, this part of my preparation included taking a Birthing From Within class, chatting with my midwives about when they would be there and asking my best friend if she would come as well. I never considered hiring a doula because, in addition to my partner and my best friend, I had not one or two, but three midwives. I figured I’d be set for support. I learned through first hand experience why, even with five loving, supportive people in the room, that a doula to offer continuous labor support might have been a good idea.

A doula is someone who is knowledgeable about normal birth and familiar with possible medical interventions in a way that most family and friends are not. She gets to know you and your desires before birth so that she can better help you when you are in the thick of it. In labor she can be a buffer or bridge depending on the need. She can translate from “obstetric” language to everyday language in the event that parents misinterpret doctors, nurses or midwives.

On the day of your baby’s birth your doula is someone who will remain with you continuously and whose role is unique. She is someone who will not be having a baby that day (or grandchild, niece or nephew). She won’t be watching a loved one in pain and isn’t likely to be overwhelmed by the resulting combination of high running emotions and exhaustion common for laboring parents. She is someone who will be on-call for you, get to know you, who will accompany you through the whole process and who will not be attending dozens of other births that week or that month.

Even if your midwife or doctor can be on call for you, your doula will be there to attend to your emotional and spiritual well being in a way that your midwife or doctor simply will not.

The beauty of continuous labor support from a doula is that it can look however a laboring mother needs it to look. For one woman this might mean a constant companion there to hold her hand and speak words of encouragement and reassurance through each contraction, then wipe the sweat from her brow, and stroke her hair in between… and for another it might mean a trusted presence knitting in the next room, holding the space, listening and keeping watch, at the ready if needed, but out of sight and earshot in order for this woman to have the privacy she needs to birth in her own body. Both are forms of continuous support. For many mothers, the support they instinctively want and need shifts through the course of labor depending on where they are and what else is happening around them and, ultimately, may include a combination of a little bit of both of these ends of the spectrum.

For yet another woman, the term continuous labor support could mean having a person there solely for the purpose of backing up her husband or partner – offering reassurance, water, and suggestions to her partner as he or she stays physically and emotionally in contact with the mother. Sometimes a team approach works best and a partner can remain in front of a laboring mother maintaining eye contact, while a doula provides massage and counter pressure on her back or hips from behind her. It’s the mother’s facial expressions, body language or directly spoken requests that tell her doula what support she needs in any given moment.

On the day your baby is born, your doula will most likely be the one and only person in the room in that in between space who can understand what is happening from multiple perspectives. She will work to get to know you to get a sense of who you are emotionally and spiritually as well as what fears and hopes you have for your labor, birth and postpartum period.

A doula is also familiar with terms of midwifery and obstetrics. She knows her way around a labor and delivery room and can be trusted to explain medical terms or proposed procedures. Yet she isn’t a part of the medical staff and influenced by the powerful force of a hospital’s or particular practice’s work routines and day-to-day rhythms and expectations for birth. Most importantly, she is someone who is comfortable with and knows birth and knows the value and benefits of the unique kind of continuous labor support she offers.

Midwives and doctors must focus on fetal and maternal health and safety and may not be able or inclined to consistently attend to a mother’s emotional needs – especially if she wants more support early on before “active labor” has begun.

Friends who offer loving support but are unfamiliar with or at all wary of birth, can miss how important it is that support begin early in labor and be continuous. They can also be unprepared to help parents make difficult decisions along the way – during active labor and pushing as well as in the immediate postpartum period.

And partners who remain present throughout with no one else to back them up can get exhausted or emotionally overwhelmed.

Each of these possibilities were in fact realities in my first labor and birth. It seemed fitting then, that at my second birth, in addition to loving family and friends, I had not one, but two doulas (and just one midwife). My doulas offered me what I now understand was the invaluable benefit of continuous labor support.