Condescension and Dismissal in Pregnancy and Birth

Being a doula and someone who cares about the emotional, informational, and physical support a birthing person receives, so many of the Lexington, KY, moms’ group Facebook posts about pregnancy and birth light me up! Like right now, I’ve got that temples-about-to-burst feeling from reading through a post about how to manage discomfort in labor without an epidural. A couple commenters wrote that their providers reminded them that they wouldn’t receive a medal for unmedicated labor and that they should do what’s “easiest” and not try to be a superhero. The condescension in those remarks is repulsive.

The overused comment about a medal for forgoing pain medication does not even make sense and is demeaning to all birthing people. One choice doesn’t get some sort of reward that the other does not. Both are valid and can be the best option for any individual or situation.

Anyone who dismisses your preferences or belittles you for the decisions you make is not providing respectful care. In labor, as in every other moment of your life, it is your body. When you are pregnant or laboring, you don’t suddenly lose control over making informed decisions about yourself and your baby. 

A respectful provider should listen to and answer your questions. Yes, they know more about pregnancy and birth than you do. They study and train and practice their work for years. They can understand your medical history and determine your and your baby’s health. But what they are not is YOU. You are a unique human being with experience, values, and thoughts that they may not ask about or may not understand (or that you choose, for one reason or another, not to share). Expecting this level of care is not unreasonable and there are midwives, OBs, and family practice doctors in our area who provide it.

If your provider is demeaning or doesn’t take time to answer your questions, that’s likely the type of care you’ll receive during your labor and birth. And if a friend, family member, or stranger is going to make judgments about you based on your choice to receive pain medication, they’re probably not the ones to go to for advice or pregnancy support. I have seen firsthand how much the birth experience affects the emotional well-being of the birthing person and their family immediately postpartum and months/years afterwards. Please take time to create a birth team that will meet your needs and provide respectful, evidence based care. You are absolutely worth it.

The Ideal Doula Client

As more doulas start practicing in the Lexington, KY, area, it makes my doula heart warm to know that there are going to be more ideal doula + client pairings. In a previous blog post, I talked about finding the right doula, so in this post I want to share what my ideal client looks like. First, here are some of the things that I do not take into consideration when deciding if I want to work with someone. It is incredibly important to me to serve all people, regardless of their race, color, national or ethnic origin, age, religion, disability, sex, sexual orientation, or gender identity and expression. You’re a pregnant human being who wants to explore birth doula services? Let’s talk.

Some people assume that I prefer to work with home birth clients using a midwife. Not true. As long as you’re comfortable in the environment, I am equally content to work at a home or hospital birth, with a midwife, OB, or family practice doctor. Another common misconception is that I’m only helpful as a birth doula if someone wants a “natural” or unmedicated birth. If your preference is to get an epidural (stat!) or you know that you’re going to have a Cesarean birth, I’m as helpful and supportive as I would be to someone wanting to labor and birth without pain medication.

I have had successful doula + client relationships with such a variety of people that I’ve learned to be really open to the type of person or couple that I will work with. One factor that does seem to help my relationship with a client is their relationship with the care provider. A client having trust in their provider typically results in a better birth experience for everyone involved. And as in most relationships, personality compatibility is important, too. I want to know that we’re going to feel comfortable sharing your intimate space and time together.

Are you my ideal client? Am I the right Lexington, KY, doula for you? Read my client testimonials and contact me to set up an in-person conversation so we can find out!

In birth, ignorance isn't bliss

The exact path your birth will take is unpredictable. With so many variables in the process, it can feel overwhelming to attempt preparation for all of the possible twists and turns you’ll encounter during pregnancy, birth, and postpartum. While it may seem like the best (only?) option is to go in without expectations and follow the lead of your care providers, I want to encourage you to take the reins on your body and your birth experience. You absolutely cannot control every aspect of your birth, but you can educate and prepare yourself for the experience.

When meeting a potential client, I always ask what your plans are for childbirth education. I want to know what you’re going to know about labor and birth. I provide informational support during pregnancy and birth, but that does not replace childbirth education. And not all childbirth education courses are created equally. If you haven’t already booked classes, I’m happy to provide referrals to instructors/courses that will meet your needs.

One of the advantages to preparing yourself for childbirth is that you’re more likely to have an empowering experience when you feel confident about your decisions. You’re in a totally different state of mind during labor, and having to learn about an intervention for the first time when you’re laboring can be distracting and unnerving. It’s hard to really take in the information that’s being shared (or ask for it if it’s not being shared) when you’re laboring. If you’re prepared for what may come, you’ll be clearer on what’s best for you in the moment and in the long run. And all of that education and preparation will hopefully lead to a more positive birth experience and a stronger start into parenthood.

Why wouldn't you hire a doula?

What is holding you back from hiring a doula? I’d claim bias in saying that everyone in Central Kentucky should hire a birth doula, but given the improved outcomes for mom and baby from having continuous labor support, I feel confident in saying that choosing to hire a doula is an evidence based way to better your chances for a positive birth experience. So in all seriousness, I’m asking, why wouldn’t you hire a doula?

One reason I sometimes hear is that a doula is not in the budget. I’d like to tackle that in a few ways. The first would be to suggest that you make changes to your new baby budget to allow it. Is there something on your registry that you might be able to find used from an online mom’s group? I see popular, pricey baby gadgets like DockATots and mamaRoos posted in the Lexington, KY, Buy, Sell, Trade groups pretty often. Sometimes they’re barely used or brand new because not all newborns are hip to the fact that these sleep aids work for other babies. Or perhaps you can add birth doula services to your registry, or ask a few close friends to gift you a birth doula as their shower gift. I know that a lot of wedding registries now include money for experiences/honeymoons instead of the traditional kitchenware, so it’d be a concept familiar to a lot of people.

A second idea would be to contact me to see if we could come up with a payment plan or some other arrangement that would allow a birth doula to work for your family’s budget. There are also circumstances in which I am willing to work at a lower rate for families that cannot afford my services. And if I’m not able to meet your needs, I will gladly refer you to new or training doulas who may be able to offer lower rates than mine.

The third angle I’d like to tackle the money concern from is one of explaining the value of a doula. I think that some people don’t want to pay $300-1000 for a doula because they don’t know the value of birth doula services. If you haven’t already, you should check out the Evidence Based Birth article on doula support. Here’s part of their summary: “Evidence shows that continuous support can significantly decrease the risk of Cesareans, NICU admissions, Pitocin, and medications for pain relief. Labor support also increases satisfaction and the chance of a spontaneous vaginal birth. Although continuous support can also be offered by birth partners, midwives, nurses, or even some physicians, research has shown that with some outcomes, doulas have a stronger effect than other types of support persons. As such, doulas should be viewed by both parents and providers as a valuable, evidence-based member of the birth care team.”

What else might be holding you back from hiring a doula? I offer free in-person consultations if you’re interested in learning more about my services. During this time, I’d be eager to hear what other questions or concerns you (and/or your partner) have about hiring a birth doula. I want families in Lexington, KY, and the surrounding Central Kentucky region to hire doulas! Come at me with your “if, ands, and buts” and let me show you why you should choose About Birth for your Kentucky hospital or home birth.

Closing out 2017

2017 is a year that I am unlikely to forget because of the very personal accomplishment of launching About Birth and serving my first birth doula families. Since March of this year, when I completed my DONA birth doula training with Chama Woydak of Homegrown Babies in Asheville, NC, I have been able to serve eight families at their births. The first four were shadowing Christina Libby of Commonwealth Doula Services and the final four were solo. All of my clients this year were first time moms with their labors ranging from a lightning fast four hours to about 40 hours. Two of the births were at the families' homes and the other two were at Lexington, KY, hospitals. Each family that I worked with was unique in personality, beliefs, background, and birth preferences, but I was able meet their individual needs by listening and learning at our prenatal meetings, and all four families wrote incredible reviews of my services. I feel very fortunate that they gave me the opportunity to serve them and show that I am excellent at this work. It was truly an awesome year!

So what's ahead for 2018? I have completed all of the my DONA certification work and will be submitting the paperwork on January 2. I understand that the review process can take awhile, but I expect to receive my certification by springtime. I just started a doula mentorship with BirdSong Brooklyn and have already learned a lot about how I can enhance my work as a doula (and wife, mother, and friend). I also recently became a professional member of Evidence Based Birth and will continue my training with them this year. 2018 will also be my first time serving a VBAC family and a second time mom.

Can I add your family to my work for 2018? It's been a wonderful first year as a birth doula so far, and I'd love to have you join me as we journey through the new year. Here's to beautiful, empowered birthing in 2018! Cheers (with a non-alcholic beverage of your choice)!