Thursday, December 3, 2015

Thank you for your support! See you later...

Dearest Loved Ones,

I have good news and bad news. 

The good news: I have accepted a very interesting position at my old, endearing hospital, now called Gouverneur Health. It was not an easy choice to make (see bad news), requiring much careful thought and deliberation. In the end, it is one of those rare opportunities in life where I would be crazy to pass it up, so I'm going for it with full force and faith.

The bad news: I have to say "See You Later" to private practice, at least for a while. Just like so many of you, I just can't do it all with two small children that need Mama around as much as possible. I hope to return to private practice again when my children are older, and do not need me so intensely and fully all the time. When that times comes, this website will be like the Wonka Factory - quiet for some time, then suddenly up and running again.

Should you need referrals: Feel free to see my "Resources" section, or check out Psychology Today and Childbirth Connection for referrals to care providers and therapists. I can't guarantee that their information is up-to-date so be sure to call them/double check yourself.

Semi-Good News: I will continue to teach on a quarterly basis Childbirth Education, Breastfeeding Basics, and Newborn Care at Melt Massage and Bodywork in Fort Greene, Brooklyn.

Thank you all very much for your consideration all these years. It has been an honor to serve you, hear your stories, and support you in your journey and growth. Every one of you that has read a post, contacted me for a phone/in-person consultation, and/or worked with me are incredible, resilient, beautiful, bright, and inspiring. 

I wish you and yours a lovely holiday season.

All the best,

Friday, August 21, 2015

9 Tips for a Healthy Pregnancy

Becoming “Mom” is no simple task. From the moment she learns that she is pregnant, any preconceived notions she had about becoming a mother begin to give way to reality. In the first nine months, this new mom changes physically, mentally, emotionally, and spiritually to create and nurture life, and arrive at her first right of passage: birthing her baby.

I love working with moms (and being a mom, myself). There is a flow of connection, wisdom, power, strength, love, and growth when moms feel free to share their experiences with one another. So, in the spirit of solidarity, I share with you 9 Tips for a Healthy Pregnancy, based on the feedback of so many fantastic mamas I know:

1. Surround yourself with a supportive birth team and community.

You will labor and birth best if you feel safe and secure. One of the ways to create a sense of security is to ensure that you have a solid, loving, and trustworthy birth team that is centered around YOU, Mama. Your birth team includes your care provider(s), birth partner, doula, and/or any other labor support people (family member(s), friend(s), etc.). Remember, finding the right team takes time.

How do you know if you have a good care provider? Simply ask yourself: “Can I ask or tell this person anything? And when I do, will this person be supportive and comforting?” If your answer is “no” or “I’m not sure,” it might be worth having a conversation that will encourage the development of your relationship.

What would this conversation look like? Here is an example:

"In childbirth education class, I learned about the risks of receiving cervical checks during my weekly prenatal appointments toward the very end of my pregnancy. The biggest risk being that it could encourage a premature rupture of my membranes (PROM), which would possibly send me down a road of medical interventions if my body didn’t go into labor on its own. So, for the first time I asked my midwife about this. I felt really nervous about bringing anything up because usually my prenatal visits consisted of her telling me how things looked and I didn’t know there was more than that. But I asked her and she was awesome about it! She was totally fine with skipping the cervical checks unless she felt there was a viable, important medical reason to do so. I felt really good about her then. And it only got better from there. No matter what I asked her, she took the time to answer me with calmness and support. I just felt more comfortable and more comfortable. By the time I was actually in labor, there wasn’t anything we hadn’t discussed prior to the birth. I felt like we were really on the same page. I never knew how much of a voice I had until I had this experience with my midwife. Totally life changing." – Mama P

If this doesn't work, or if you are uncomfortable voicing your part in the process in any way, it may be a signal that you should search for a new care provider who may be a better fit.

* For more information, check out Choices in Childbirth's "Building Your Birth Team", and Childbirth Connection's "Choosing a Caregiver."

2. Process, understand, and work on your mental and emotional junk-in-the-trunk.

There is a tendency to focus heavily on the physical processes of birth - the stages of labor, the pain, the baby at the end. Yet, I can't tell you how many times a client has been shocked by the intensity of her mental and emotional "stuff" (for lack of a better word) that surfaced during her birth experience.

"When active labor really got going, I seemed to dilate fairly quickly. Before I knew it, my care provider told me that I was at about 7cm. I thought to myself, 'Awesome, this should be over in a few hours.' But then a few hours turned into another 24 hours. No matter how great my partner and doula were, how caring and supportive my care provider was, I just wasn't opening. I was feeling stuck, and starting to feel desperate. Then, my partner told me that my mom arrived to the hospital to bring food for my husband and doula. She wasn't planning on showing up until we were in the Mother-Baby unit, which I thought would have been in a few hours. But, as labor starting moving into Day 3, she figured that they would be hungry. So weird. About 20 minutes after she arrived, I started shaking. My care provider suspected I was in transition, so she did a check. And sure enough, I was 10cm dilated! I was so elated, I was crying. I started feeling the urge to push soon after and about hour later, Baby arrived. I guess I needed my mom to be there. It felt like a relief to know she was there, that I wouldn't have to do this crazy birth thing and become a mom by myself in that moment. Not that my husband and doula weren't amazing, cause they were. Does that make sense? I think I just needed to be a little bit of a daughter in that moment. A daughter that needed her mom to get through that scary and amazing life moment." 
- Mama A

Remember this: birth is a mind-body experience. In its very essence, birth requires mom to "let go" and give in to a "good" pain - a pain that suggests positive movement and progression (not abnormality, or something wrong, as we are used to believing with regard to pain). Then, she can open and give way for Baby to be born.

So, it is critical to work on the mental and emotional facets of yourself, and take the time to reflect, verbalize, heal, and grow. How do you feel about your pregnancy so far? What hopes and concerns do you have about pregnancy, birth, or beyond? Where do those thoughts come from? How do you feel about reaching out to resources, family, or friends if you need help? The list can go on and on. 

What can help with confronting mental and emotional junk-in-the-trunk? As my dad used to say, "Better out than in." Reflect upon yourself. Identify your thoughts and accompanying feelings. Then let it out. Some possible venues:

- Share your thoughts with trusted loved ones that are great at listening and supporting you with empathy
- Process past issues and prepare for the journey of labor, birth, and beyond in individual and/or group counseling
- Make sure that those who will act as your labor and birth supports are well-attuned to your mental and emotional needs

The more you know your authentic and true self and begin to release those emotional blocks, the more you utilize your voice and advocate. Then you more easily set healthy boundaries and focus on taking care of you. And ultimately, you will be more prepared to meet your birth day (and you WILL conquer birth!). There are also pleasant side effects: as you work on the mental aspects of pregnancy and birth, the better person, mom, partner, family member, and friend you'll become. 

* For more information on mental and emotional care, read these articles by LiveScience (click here) and WebMD (click here). 

3. Kicking nausea the natural way.

Nausea is one of those immensely irritating pregnancy symptoms that leave a mama between a rock and a hard spot. Mama needs energy, so she must eat. But every time she eats, she feels like she wants to vomit, if she hasn't already. Simply. No. Good.

Most importantly, always update your care provider of any pregnancy symptoms you are experiencing. Your care provider will likely recommend trying natural, non-medicated methods to quell the nausea. The following have been favorites of my childbirth education students:

- Ginger: tea, or candy chew (though not recommended for those with high glucose issues)
- Sea bands: acupressure bands worn on the wrists, usually found at your local drug store
- Not letting your tummy go empty - eating snacks throughout the day instead of three full-sized meals
- Eating bland foods, or foods that tend to be more friendly to irritated tummies, i.e. saltines and BRAT (Banana, Rice, Apple, Toast)
- Taking it easy
- Acupuncture 

If the above methods don't work, and the nausea becomes so intense that you cannot function normally, there are medications to help. However, it is crucial to first speak with your care provider about your options, as every medication carries risks and benefits. For example, this summer American Recall Center updated on Zofran, a nausea medication initially "used to prevent nausea and vomiting that may be caused by surgery or by medicine to treat cancer," yet has been prescribed to pregnant women experiencing nausea, as well ( Zofran does not have FDA approval due to the potential harm to the developing fetus. 

*For more information on Zofran, check out American Recall Center's update here.

*For more information about natural nausea relief, check out American Pregnancy Association's article here and BabyCenter's article here. Talk with your care provider regarding any interventions before trying them out.

4. Water is one of your besties.

Ahh, water. What a special relationship we have with it. We are created in a "bag of water" (also known as the amniotic sac, or membrane), and water makes up nearly 60% of the human adult body ( We literally can't live without it. One week without water, and we're goners.

For pregnancy, water is exceptionally delicious. Staying hydrated will not only replenish the nutritive fluids that flow through your body (and Baby's), but will it increase the prevention of premature labor, as well. 

Furthermore, according to Childbirth Connection, "studies of deep tub baths have found inconsistent effects on various indicators of pain; however, many women find deep tub baths soothing and relaxing" ( Regardless of the studies' findings (which focused only on deep tubs), I honestly have yet to meet a mom that didn't find the use of water (taking a bath and/or shower) incredibly helpful for pain management during active labor. 

So, drink that water. Eat juicy, yummy foods. Remember to add water to your active labor coping skills tool kit***. And perhaps the most delicious thing of all: swimming in water while pregnant. Refreshing. Weightless. Try it. You'll love it.

5. Practice the art of listening to your body and meeting your needs.

Earlier this year, one of my students shared that she planned on working right up to her due date because she felt guilty leaving her co-workers with her responsibilities any sooner than "necessary." However, in her heart she wanted at least a few days to herself before the baby came. Every day she felt more exhausted, and started to struggle with very uncomfortable edema by the end of the day. 

The other students immediately sprang into supportive action, encouraging her to look at the facts: her body was telling her that she needed to slow down and rest, and now was the time to do so. Because when Baby came, she wouldn't be getting those "few days to herself" for a while, and she would be exhausted in a whole different way. 

"I took [my peers'] feedback to heart. I thought a lot about what I needed, what my body and mind and heart were telling me, and came up with a way to tell that to my boss and co-workers. When I got to work on Monday, I felt guilty the whole time while I told them that I was struggling and felt like I needed a few days of a break before Baby came. A couple of my colleagues seemed annoyed, but we weren't close anyway so in a way, they didn't matter so much. But my boss, friends, and co-workers - the ones that I worried about most - they told me that they felt relieved. They were worried that I was working to the bone before the real newborn exhaustion came. They told me not to worry about the workload, that everyone and everything would be fine while I was away. That made me feel good. I felt like I could let it go then." - Mama R

Tired? Rest.
Nesting? Make a list of "Things to Do" and do one task at a time, with plenty of help around.
Hungry? Eat.
Feeling frisky and want some naked cuddle time? Have fun!
Feel like saying, "No" to the 5th summer BBQ of the weekend and instead would like to stay in to veg out and watch movies tonight? Do it!

6. Daily Spa Moment(s).

Oh, how I wish that it was a federal mandate that all pregnant mamas receive weekly prenatal massage for free! Prenatal massage is incredible, and if you can make it happen, I strongly recommend working at least one into your pregnancy before Baby arrives. Lower back soreness, tired legs, aching hips, tight neck - I bet that they all could use some love. 

But, how about on a daily basis? What are you doing to relax, rejuvenate, refresh, and rest today? Many mamas answer with, "When? There's no time," or "Nothing."

Daily Spa Moment is not about adding another event into your already busy schedule. It is about utilizing multitasking opportunities to relax, even if the opportunity only lasts 5 minutes. 

Make a list of things that you like to do to relax, unwind, rejuvenate. Then find moments in your day where you can do something relaxing while doing something you usually do anyway.

Need some ideas?

- Do a mindful act every day. This means staying very present and aware with whatever you are doing. For example: 

Mama B "spends every moment of [her] 5-minute shower to breathe and try to feel every molecule of water move from [her] head to [her] feet."

- Try walking meditation. 

"I leave for work 5 minutes earlier than before now because while I walk, I focus on a phrase, like 'I can,' or an image in my mind, like leaves falling from a tree into a pool of water. I try to take my time in doing this, though it's not much in total. And usually, I end up breathing and walking to the beat of the words, or the sway of the leaves. It's a nice way to walk into the office." - Mama S

- Lunchtime getaway.

"I have come to fiercely protect my Wednesday lunch hour. During that time, I put every electronic device to silent except for music and an alarm. After I finish my lunch, I take off my shoes, put my feet up somewhere in the room, and turn on some relaxing music or nature sounds. I lie back and let my mind wander. Sometimes I snooze in all my daydreaming. If that happens, the alarm gets me up 10 minutes before the end of lunch so I can wake up, freshen up, etc. It's become one of the only moments in a week that belongs to me. I love it." 
- Mama L 
* Need some relaxing music? Try this link to meditationrelaxclub's YouTube video: "3 Hours Relaxing Music with Water Nature Sounds Meditation"

7. Invest in a birthing / exercise ball

Birthing balls (same as exercise balls) are multitaskers that offer a supportive yet airy feel, and can be used throughout pregnancy, labor, birth, and postpartum. 

Personally, I spent most of my second and third trimesters lying over a birthing ball while I watched television. Like this (probably with a similar expression and every-so-often, on the precipice of sleep):
Image from MayoClinic:
I loved feeling supported without having to do anything about it (I'm a lazy wannabe - I have every intent on being lazy, but life doesn't seem to allow it). I loved the controllable rocking and bouncy-ness that required very little effort to engage. I had a lot of lower back pain during pregnancy, especially with Baby #2, and the ball was very helpful in assuaging the stress.

For labor, sitting on the ball is a gravity-friendly supportive squat. This position encourages Baby to move down into the pelvic floor without you having to exert much energy in your legs. Plus, you can move your hips and add movement to the squat, which also encourages labor progression and pain management.

And once Baby is home with you, the birthing ball makes it very easy to hold and rock Baby. Some mamas say that it makes them feel like they are being rocked at the same time they are rocking their babies. Everybody wins!

No birthing ball? Borrow one. Buy one. Check a parenting listserv for anyone that might be happy to get rid of their old exercise ball. Or, stack pillows and cushions to a height that works for you. It won't have the same bouncy, airy feel like the ball, but may still offer some lower back relief.

* There are many sites and videos that can give you ideas on how to use your birthing ball. Here is a simple one from Mommybites to get you started: Using the Birth Ball in Labor 

8. Positive stories only, please.

Have you run into the kind of person that wants to share their story about some difficult birth they experienced or heard about? Of course, their disclosure has nothing to do with you, and has everything to do about their need to process and heal from their experience.

So, it is perfectly okay to kindly let that person know that right now may not be the best time to hear such a story, but you’d be happy to talk about it after you have birthed your baby. 

Right now, you only need to hear POSITIVE birth stories, the kind that will inspire and encourage you. 

'My siblings and I were all home births. My mother was a labor and delivery nurse for roughly 25 years. Since she had home births herself and had all the hospital experience, I thought it would be easy to count on her as labor support. But, she was convinced that I wouldn't be able to do labor without the epidural. She kept telling me about her experiences of working with so many women that chose to have epidurals, how they couldn't handle the pain, or they were too exhausted and needed a break, or whatever the circumstances were. And for some reason, she kept saying that I wouldn't be able to handle the pain. Meanwhile, I really wanted the chance to birth at the Birthing Center so her words hurt, and started to give me anxiety and doubt. After much thought, and talking it over with my partner, we decided to hire a doula, and have my mom come to the hospital after I gave birth. Of course my mom was supportive of us working with a doula. But more importantly, she really heard me when I told her it hurt my heart every time she said I wouldn't be able to handle the pain. From then on, she either didn't say anything at all, or was actually supportive. Did I believe her support? Yes and no. But it was better than hearing that I couldn't do it. And guess what? I friggin' did it without any medication." - Mama G

 9. Keep a record of this time.

My mom has always been that crazy picture-taking lady, and she saw us roll our eyes each and every time she took out the camera. But she knew that no one ever complained about her picture-taking as they poured over her albums reminiscing about all of our wonderful experiences together. She knew what she was doing, and how important it was.

Four years ago I gave birth to my first baby. Last year, I gave birth to my second. Now, I barely think of the days when there weren't two little guys in my life. Yet, every-so-often my partner and I peruse old albums, get nostalgic, and a little teary-eyed that our older boy has become so big…and only going to get bigger. It is fun to share his baby photos with him now. It boggles his mind to see the photo of his mom's belly at 9 months ("I was really in there?! But I'm a big boy now, how can that be?"), and that once upon a time he was as small as his little, baby brother ("Are you kidding me, Mom? You're kidding me").

If you have a favorite form of documenting your life, try to update it regularly. If not, see below for some ideas. Four or fourteen or forty years from now, you and your little one will surely enjoy looking at those entries, and remembering together. 

- A journal
- A hardcopy and/or social media album devoted to growing belly photos 
- A day-by-day pregnancy recording book (found online, at bookstores, or make your own)
- Post-its. When you have something you want to remember, write it down with the date on a post-it and save them all in an envelope
- An email account solely for collecting memories. Some parents told me that they are planning on giving their child the password to said email account when (s)he reaches a certain age or life milestone (i.e. 18 years old, or graduating from high school)

All the best in your pregnancy, birth, and beyond...


*** There are some studies that have shown that the use of water in early labor can slow progression. So, if early labor begins in the middle of the night, one option is to take a bath in hopes of slowing progression and encouraging sleep/rest before the arduous work of active labor kicks it. If early labor begins during the day, the recommendation is to wait on using water as a comfort measure until active labor is established. For more info, check out Talk Birth - "Does Water Slow Down Labor?"

Friday, May 1, 2015

Doula Chat with Samantha Hillstrom, CCCE, CD(DONA) - Los Angeles, CA

I am very excited to feature my dear friend and CEA sister, Samantha Hillstrom! Sam is an anchoring and loving doula, gifted childbirth educator, and attuned communicator. Los Angeles area families, if you are interested in working with Sam, check her out at Lavender Labor!

Tell us about yourself, Sam…

I am a certified cooperative childbirth educator and DONA International certified birth doula living in Los Angeles, California. In February of 2013, my company, Lavender Labor and Birth Services, was born in New York City. Inspired by the idea that women used to hold sprigs of lavender in their hands during labor to help keep them calm, I knew that through evidence-based education and continuous emotional and physical support, the fear of birth could lessen.  It is the greatest privilege of my life to be invited into someone’s birth space, whether I am actually attending their birth or we are discussing the birth process. The cliché line of, “when you do what you love, it doesn’t feel like work” is absolutely true. Any birth worker would tell you that this is a calling. Being a birth worker (midwife, doula, childbirth educator, lactation consultant) isn’t something you see at a career fair. It’s truly a profession of passion.

As a birth doula, I provide informational, emotional and physical support through the prenatal, labor and delivery and postpartum periods. As a childbirth educator, I teach group and private classes on evidence-based birth. I don’t teach a methodology for birth because every birth, like every person, is different and are entitled to know a range of options. In addition to teaching group and private childbirth education classes, I started the only LGBTQ-only childbirth education class series in New York City and now, Los Angeles. All families are deserving of evidence-based, supportive, and respectful education and not all people make a baby or a birth a baby in a heteronormative way.

What is your mission?

I believe (and I know) that birth is a normal, physiological process and every female-bodied person has the innate ability to give birth. I don’t believe that doulas “empower women”. As a doula, I aid women in empowering themselves through education and support. Ultimately, birth is unknowable and you get the birth you were meant to have. I want my clients and students to feel confident in their education and their abilities to give birth.

Not related to clients and students- my other personal mission is to show people that doulas aren’t all “hippies” or “crunchy” women who smell like patchouli, wear Birkenstocks and think you should birth naturally by a tree in the forest. Like in any profession, we are all unique people and while we likely share very similar ideas about birth, we can approach it very differently. 

Tell us about the journey that brought you to doula/childbirth education work.

My journey to birth work is unique, as I didn’t come into this field by being pregnant or giving birth. I left my career as a television producer to pursue birth work in the fall of 2012. From a very young age, I was always incredibly interested in pregnancy and found myself reading my mom’s old pregnancy books and watching movies on pregnancy. Every year on my birthday, my mom would tell me the story of my birth (I also saw it on VHS!) and it was always this really positive and empowering story. My mom portrayed birth as normal and natural and thus, I never grew up fearing the process.

As a kid, I always wanted to be a TV reporter or a baby catcher (midwife). I followed one of those paths and went to school for journalism and communications. After 7 years working at the top cable news channel and on some of the most exciting stories of the 2000s, I always found myself feeling empty, angry, and unfulfilled. Unlike my counterparts, breaking news annoyed me instead of exciting me. I started thinking, “is this it?” And what I always came back to in my mind and heart was birth work. I applied and was accepted to a rigorous childbirth education program in New York City and national doula training program. I quit my job as a producer and one week later took my first childbirth education class; two months later I attended my first birth. I never, ever looked back.

How would you describe your style as a labor support person? What can clients
expect from you?

Along those same lines, I am the type of doula who thinks, “your cervix is a bad-ass”, versus a doula who thinks, “your cervix is a beautiful flower”.  I am a “best friend/sister doula” versus an ”earth mother goddess doula”. I am down-to-earth, open-minded and contemporary. I don’t think it’s any coincidence that most of my clients have turned out to be friends because we share the same personality type and in that, there is a comfortableness between us. I am warm, compassionate, and affirming. Yet, I also make jokes, sometimes swear and have tattoos. Birth is intensely intimate for all parties and it would be impossible for me to remove my personality from my work. As a doula and educator, I want my clients and students to feel comfortable and safe being totally themselves around me. I, in turn, will be myself and thus, an authentic relationship forms. Besides, I’m going to be seeing your vagina, so we might as well get along well!

How does your personal experience influence your doula work today? 

I used to fear that because I had never given birth before, people wouldn’t trust my guidance. However, I quickly learned that just because you’ve given birth does not mean you are an expert. It means you are an expert on your birth. I did my childbirth education training through the Childbirth Education Association of Metropolitan New York (CEA/MNY). CEA/MNY is a nationally-recognized two-year program that is akin to getting an associate’s degree in childbirth education. I chose this program because I feel it is my responsibility to be as educated as possible when working with pregnant couples. Every couple I teach or birth I attend shapes my experience of birth and how I view the process.

I might not have actually given birth myself so I cannot personally relate to how a contraction feels. But you don’t need to have been through it to understand that it is really painful and that people need support and encouragement. Compassion and thoughtfulness are not things that can be taught.

Has there been anyone that has been instrumental in your journey, or in your growth as a birth worker?

Truly, every couple that has allowed me into their birth space, whether it is in the classroom or birthing room, has been instrumental in my journey and growth as a birth worker. It is such an intense honor to be there and that has never been lost on me.

On a professional level, I have made so many wonderful friends and mentors from the birth communities in New York City and Los Angeles. I have to credit the incomparable Ellen Chuse with helping me on this path. Ellen was my formal mentor through my education program. Ellen not only taught me from an academic perspective but she truly helped shape how I viewed the experience of the pregnant person. Not to mention, she treats me like a daughter with support and encouragement. She is very special to me and I feel lucky to have met her.

I also would be remiss if I didn’t mention my former doula partner, Robyn Lazara. When I was living In NYC, Robyn and I formed a successful doula practice together. She is one of my best friends, my confidantes and biggest supporters. Every doula needs a person that “doulas” them through the process and for me, that is Robyn.

What is doula-life like for you?

Doula life is...intense! When you are on-call for a client, you are attached to your phone 24/7. Every call and text makes your heart jump a little. You don’t sleep quite as well and you are constantly ending sentences with, “...if I’m not at a birth”. Being on-call is this constant state of anxiety but when you get “the call”, all of your endorphins kick in and you’re ready for action. The feeling you get leaving a birth, knowing you supported someone in this incredibly vulnerable time, is completely unmatched. 

After taking care of others, how do you take care of yourself?

After a birth, I usually take a really long shower, order some take-out and park myself in front of some guilty pleasure TV. If a birth was particularly physical, I might treat myself to one of those cheap massages. Most importantly, I turn off my ringer!

Favorite getaway that brings balance to the intensity of labor support work:

Sometimes a “getaway” just feels like putting my phone on “Do Not Disturb”.

Favorite music that gets you into the mood for birth support:

I am a music fanatic and I love when clients have labor playlists. I always listen to music while heading to a birth so I can clear my mind and think about what lies ahead. It could anything from Bon Iver to Kelly Clarkson that gets me in the headspace for a birth. 

Favorite meal/snacks that give  you energy for birth support:

If I have time, I will usually make one or two peanut butter and jelly sandwiches. Granola bars, dried fruit, and bananas are must-haves. Also, a giant water bottle! 

From what you’ve seen and experienced in birthing locations, what is one positive thing you’ve noticed and one thing that you wish would improve?

I’d say that one of the most important things that can lead to a positive experience is when the patient and care provider are on the same page with their birth views and have an open and respectful dialogue. 

There are many factors I’d like to see improved in different birth settings, specifically hospitals. Aside from the alarming rate at which evidence-based medicine is not practiced in the hospital setting, I’d like to see an understanding and respect of the woman and family’s experience of the birth process. Birth is so much more than, “healthy mom, healthy baby”, and that an acknowledgment of that could greatly improve how people feel about their birth, regardless of the outcome.

What is the longest labor you’ve attended yet? What did you and the birth team do in order to keep her energy and spirits up?

39 hours over the course of 3 days! We constantly reminded her that she was going to meet her baby at the end of this and that everything was in the range of normal.

Favorite labor/birth story to date:

I can’t possibly choose, there are too many! Here are three sweet stories…
  • During labor, mom, dad and I were walking around NYC and in the middle of it, we needed sustenance so we all stopped to eat an egg and cheese sandwich together outside.
  • I had a mom say, “this f**king hurts” over and over again during contractions and once I noticed this was working for her as a coping technique, I told her to keep doing it. She told me during our postpartum visit that encouraging her to repeat those words over and over again got her through the worst of labor.
  • A mom requested we put on a Michael Jackson playlist during her pushing stage. We sang along to the songs and tried to guess which song it would be when the baby came out. It ended up being some Michael Jackson song that was unreleased and no one had ever heard of but it was fun, nonetheless.

What are your top 10 items in your “doula bag?”

The most important item in my doula “bag” are my own hands. You’ll find that new doulas have a doula bag that is stocked like they’re taking a trip to Europe. The more births you do, the more you realize you don’t need as much. I keep toiletries for myself, an extra change of clothes, a rice sock, honey sticks, peppermint oil (for nausea), unscented massage oil, snacks and a phone charger.

If you could give one piece of advice to expecting parents, what would it be?

Do. Your. Research. One of the first parenting decisions you make is who you choose for a care provider. Understand all of your options and find a care provider who provides evidence-based, mother-friendly care. Remember that you are hiring this person and you need to feel comfortable and confident in the services they are providing. I cannot stress this enough. Also, hire a doula. 

If you could give one piece of advice to a pregnant mom, what would it be?

Trust the process and ignore most things people tell you. For some reason, people always feel it necessary to share the worst parts of their birth experience or to tell you “how you absolutely have to do it.” What they are really saying is, “validate my experience.” Your pregnancy and birth are unique to you and only you know what is right for your body and your baby. 

If you could give one piece of advice to a pregnant mom pursuing a VBAC
(Vaginal Birth After Cesarean), what would it be?

Do. Your. Research. Find providers who proudly support VBACs and have high rates of VBAC success. Avoid an induction. Hire a doula. 

Thank you for taking the time to share with us, Sam! And thank you for the amazing person you are, and incredible work that you do in support of women and families!

Wednesday, April 1, 2015

Doula Chat with Malika Aliya Hook Muhammad, LSW, M.Ed., CD - Washington D.C.

Today's Doula Chat features the ever-incredible Malika. A dear friend from social work school days, Malika now gracefully wears a number of fantastic hats - mother, wife, doula, advocate, educator, friend, spirit. She is ridiculously smart, reassuringly strong, and beautifully loving. Washington DC area families interested in working with her, check her out on Facebook: The DC Doula

Tell us about yourself, Malika…

I was trained to be a doula in 2008 by Debra Pascali-Bonoro, author of Orgasmic Birth.  After training, I worked with the Philadelphia Alliance for Labor Support (PALS), providing doula services to women in Philadelphia who could not afford them.  I served as PALS dispatch coordinator and training coordinator for two years before moving to the DC metro area, where I have worked since 2011. 

With the help of an amazing doula and my husband, I was able to get through 50 hours of active labor that resulted in the birth of a fantastic little boy.  In my spare time, I enjoy practicing yoga, studying herbalism, and learning about natural healing.

In my other career, I obtained Masters degrees in Social Work and Education from Columbia University and Baruch College in New York City.

How did you come to labor support work?

When I lived in Philadelphia, I supported a friend through the birth of her child.  This was my first live birth ever.  Afterwards, my friend told me that I should consider becoming a doula.  I had never heard of doulas, so I did some research and found that there was an organization in Philly that provided free/low cost doulas to women without resources.  My background in social work made me immediately attracted to this work.  So, I took their training and never looked back.

What is your mission?

I don’t have an official mission statement, but my driving mission is to help women protect the memory of their birth experience.  Birth is an event that impacts and imprints on women. A woman can tell you the minute-by-minute events of her labor, no matter how old she is, or what her mental state may be.     It breaks my heart when women have difficult or traumatic experiences that could have been avoided with information and support.

How would you describe your style as a labor support person? What can clients expect from you?

My training in social work has taught me to meet people wherever they are starting.  Some women need a lot of physical support during labor.  I’m there to help ease their discomforts and remind them that their bodies are capable of doing the work.   I offer comforting touch, counter pressure, acupressure, reiki, work with the rebozo, hot and cold packs, yoga and positioning advice, etc.

Some women just need a witness.  A quiet presence that’s there in case they need it. They need someone who can support them (or their partners) as they move through labor without being intrusive/overbearing.  Sometimes people just want someone who has already been on the journey as reassurance that they can make the journey as well.

And other women need someone who can shoulder the burden of labor with them.  Those are my hardest births.  I help women to carry their emotional strain in addition to their physical strain.  Many people don’t realize that birth has just as much to do with your mind as it does with your body.

Do you have kids/not have kids? How does your personal experience influence your doula work today?

Yes!  I have an amazing baby boy.  Well, I guess he’s technically a toddler now.  My labor with him was 50 hours long and took me on a journey that I never could have expected.  It was not a miserable experience, however. I had an amazing midwife, an amazing doula, my mother, and my husband as my birth team.  They helped and supported me through the entire journey and I feel 100% confident in all of the choices we made along the way.  My son’s birth taught me that even though we may plan, babies all come out in their own time, and in their own way.  I truly had to surrender to the process and trust that my body and my baby knew what they were doing.  I got out of the way, went along for the ride and had a beautiful birth.  I use this experience to remind women that challenges in labor do not have to be devastating.

Has there been anyone instrumental in your journey as a doula?

First and foremost, my husband.  Being a birth worker can be hard for a family because birth is so unpredictable.  A birth can take me away for a few hours, or it can take me away for a few days.  He steps up and keeps our family running when I need to step out of my role as wife and mother.  I think he gets just as excited as I do when I go out to a birth.

My other biggest support is my sister-friend, Muneera.  She is also a doula and a postpartum womb steam practitioner.  It is through her encouragement and support that I decided to take the leap to do birth work full-time.  She and I serve as back-up doulas to one another.  She watches my son when I have a birth, and she has a wealth of knowledge and resources about birth.  She was also my doula when I had my son. :)

What is doula life like for you?

I think of birth work as a calling.  Either it’s for you or it’s not.  Every time a family chooses to hire me and invites me to the birth of their child, I feel as if they’ve given me a gift.  As such, doula life is exciting!

On the other hand, managed healthcare in the US and our perspective of birth is sometimes very unfriendly to women.  Being a doula can be frustrating because laboring women are treated as sick patients who can’t do anything for themselves.  I witnessed a doctor walk into a labor room and say to the patient, “You’re in my house now and this is my show.  This labor is going to go the way I plan it.”  It made me so angry that that doctor was trying to steal my client’s experience from her and change the focus to being about her skill as a doctor.  I helped my client to advocate for herself so that her labor progressed the way she wanted it to, and so that her voice wasn’t lost.

After taking care of others, how do you take care of yourself?

I rest when I can. I spend time with sister-friends. I get massages with my husband. I take long showers when my baby is asleep. I meditate when my house is still. I eat good food.

What is your favorite getaway to balance the intensity of labor support?

My quiet bedroom.

Favorite music that gets you into the mood for birth support:

Salt ‘n Pepa – Push it

From what you’ve seen and experienced in birthing locations, what is one positive thing you’ve noticed and one thing that you wish would improve?

Hospitals have come a long way in terms of being mother/baby friendly, but they still have a long way to go.  May hospitals now will honor a mother’s request for delayed cord clamping, immediate skin-to-skin contact and breastfeeding or a mother’s wish to have her baby in the room with her instead of the nursery.  These are major strides in patient-centered care.  But many hospitals still need to do some work around how they treat laboring women.  Allowing women to move freely, eat and drink as they need, wear whatever they want, etc.  It doesn’t make sense that laboring women are treated as sick patients when birth is a normal, non-emergency life event.  The best births I’ve seen are when practitioners leave the mother alone to let her body do what it’s built to do.  Far too often, practitioners try to insert themselves into the process in ways that aren’t helpful.  Forcing mothers to stay in bed, connecting them to routine IVs, keeping them continuously strapped to monitors are all things that can contribute to a the length of a labor and a mother’s experience of stress and discomfort.

What is the longest labor you’ve attended yet? What did you and the birth team do in order to keep her energy and spirits up?

Three days.  I had to come and go, to check on my family, but I only did so while mom was asleep.  We kept the mood light and I worked with the midwife to help mom understand what was contributing to the length of her labor.  Mom did really well and managed the birth like a champ.

Favorite labor/birth story to date:

My very first birth as a doula.  Long before I had a child of my own, I supported a woman in labor who had no other support.  I met her the day she went into labor, introduced myself as the doula and said, “This is my first birth and I’m not really sure I know what I’m doing.”  She smiled at me and replied, “Well, this is my first birth too.  So I guess we’ll be learning together.”

What are your top 10 items in your “doula bag?”

  1. Portable Bluetooth speakers to play music in the labor room
  2. Hand fan made out of rattan to cool mamas down
  3. Homemade rice sock to use as a heat compress
  4. Rebozo
  5. Essential oils/massage oils
  6. Massage tools for mamas that need more back pressure
  7. Disposable under pads for mom to use in the car ride to the hospital/birth center
  8. "The Labor Partner" by Penny Simkin - it's a great reference book and I sometimes give it to fathers/partners who don't know what to do with themselves
  9. A change of clothes and toiletries to freshen up
  10. Snacks! Coconut water, honey sticks, trail mix
If you could give one piece of advice to a pregnant mom pursuing a VBAC (Vaginal Birth After Cesarean), what would it be?

Find a provider that supports your efforts, learn about your options, hire a doula!

You're amazing. Thank you for spending time with us, Malika!

Wednesday, March 11, 2015

Doula Chat with Leigh Kader, CD (DONA), CCCE - Brooklyn, NY

I am proud to open "Doula Chat" with one of my favorite people on the planet. Leigh Kader is a gifted doula and childbirth educator. She can make some killer curry, calm and empower you with her words, and transmit some major love and care through her excellent hugs. For more information about Leigh's services and classes, please check her out on Kin Doulas, FacebookLinkedIn, and Chi Moshi Massage Studio.

Leigh, tell us a little about yourself:

I'm a Certified Cooperative Childbirth Educator and DONA certified birth doula. This means that I work with families throughout the perinatal period; teaching expectant couples comprehensive preparation classes and supporting women and their families in labor and the immediate postpartum. I’m a member of the Childbirth Education Association of Metropolitan New York and the Doulas of North America (DONA). Raised in the southwest, I’ve called New York City home since attending Barnard College and worked for many years in fine arts before entering the birth world. I live in Brooklyn with my husband and two young children and also have the support of my mother who lives across the hall!

What is your mission?

One of my missions is to educate people about the midwifery model of care, versus the medical model of care. It’s no surprise that there is a cesarean epidemic in this country when you take into account that the vast majority of women (who are by nature having low risk pregnancies) receive maternity care from obstetricians who are trained surgeons, versus from midwives. One way to influence this statistic is to begin working with couples early in their pregnancy, when they are still making decisions about with whom and where to birth.

Tell us about your journey to doula and childbirth education work:

Before I had my own children, I knew nothing about birth. Attending a dear friend’s birth before I became pregnant the first time was transformative. Afterwards, I remember proclaiming to everyone that if people watched babies being born we would still be worshiping women as goddesses! This experience began the process of normalizing birth for me, which I’ve come to realize is key to having a positive childbirth. Over the next few years I had my own children and my passion around childbirth steadily grew. While working towards my teaching certification with CEA, a rigorous 2+ year program, I realized that I longed to support women in labor and became certified birth doula through DONA in 2014. The development of these two district roles has been an organic process, wherein I teach with real time knowledge of what’s happening on today’s NYC labor and delivery floors.

How would you describe your style as a labor support person? What can clients expect from you?

My style is down to earth and pragmatic and decidedly “un-hippy”. This is sometimes surprising to people who presume that if someone hires a doula they must have sworn off pain medication and that all doulas proselytize natural birth. This is a myth I’m continually debunking. I have no agenda other than to support a woman’s personal choices. And in terms of what clients can expect, connecting with others is profoundly important to me, both in life and as a doula. My most successful (an enjoyable) births have been the ones where clients understand and appreciate that hiring a doula is not merely transactional, but more about building a relationship.

How does your personal experience influence your doula work today?

I have two kids, going on 4 and 7 years old, and without them I would not be doing the work I do today. I learned so much about myself and gained so much confidence throughout both of my pregnancies and births. I’m truly grateful to everyone who helped me have positive birth experiences and I think of that often when I’m working with families. Being able to personally relate to my clients is key for me.

What is doula-life like for you?

It’s a constant learning process full of surprises and humbling moments. The time leading up to a client’s due date is a waiting game and a healthy reminder that we need not control everything, and the labor itself it an exercise in patience. After attending a birth I’m typically wiped out emotionally, physically and mentally but always feel as though I’ve made a positive difference in a family’s birth experience.

After taking care of others, how do you take care of yourself?

Not well enough! Haha. There seems to be quite the burn out factor for doulas, which is why I’ve partnered with a fellow doula (Marni Deutsch) with whom I trained and really like and respect. We decided to formalize how we support each other to help make this unpredictable work more sustainable. We truly feel our partnership is mutually beneficial; we have built-in emotional support and schedules that are a bit more predictable and are clients get two doulas for the price of one!

From what you’ve seen and experienced in NYC birthing locations, what is one positive thing you’ve noticed and one thing that you wish would improve?

Access to water, either a shower or a bath, is one of the most beneficial coping tools for active labor and is scarce on most labor and delivery floors in NYC. Methodist Hospital in Brooklyn and Mt. Sinai Roosevelt (previously St. Lukes) in Manhattan both have at least one wireless fetal heart monitor available, as well as bathtubs, or at least showers in most rooms. I’ve seen moms in both locations laboring in water with considerable results.

What is the longest labor you’ve attended yet? What did you and the birth team do in order to keep her energy and spirits up?

had a client who was in early labor for around 3 days before things finally picked up. Though I wasn’t physically with her most of those 3 days, we were in constant contact and it was important to keep reminding her that every labor is unique, that there was nothing wrong, and that this was just the way her body was figuring labor out. Once things intensified, and contractions became more regular, I joined her, and she labored another 15 hours, pushing through sheer exhaustion. I held her up literally with my body and figuratively with constant words of encouragement. After the birth, she mentioned after I arrived, the contractions were stronger (a good thing J) yet easier to cope with.  

Favorite labor/birth story to date: 

     It’s hard to pinpoint one labor as my favorite. There is such joy when each baby is born. Though I do feel especially buoyant when the normal labor process is respected by all who come in contact with the mother, from her family to the hospital staff.

What are your top 10 items in your “doula bag?”

Handmade rice sock, heating pad, rebozo scarf, tennis ball, hair ties, chap stick, flameless LED candles, honey sticks, change of clothes, and snacks for me!

If you could give one piece of advice to expecting parents, what would it be?

Take things one day at a time, and try to remember that before you were parents, you were lovers and partners. Be intimate at least once a day, even just a hug and remember to say “thank you!” to each other. That goes for both partners. It’s easier to cope with challenges when we feel appreciated.

If you could give one piece of advice to a pregnant mom, what would it be?

Trust your body; trust your innate abilities to give birth. Do your best to allow your body to do what it’s designed so well to do!

If you could give one piece of advice to a pregnant mom pursuing a VBAC (Vaginal Birth After Cesarean), what would it be? 

      Learn from your previous experience and surround yourself with people who are 100% on board with your wishes…and hire a doula!

Leigh, thank you for taking the time to share with us, and all the amazing work you do!