2021 Reviewed

31 births

29 hospital births, 2 home births

24 vaginal, 7 Cesarean

1 VBAC (vaginal birth after Cesarean)

14 unmedicated, 17 epidurals

9 inductions

20 with midwives, 11 with OBs

Smallest baby: 4 lbs, 6 ozs

Biggest baby: 9 lbs, 1 ozs

Shortest labor support time: 2.5 hrs

Longest labor support time: 35 hrs

Average labor support time: 9 hrs

Longest gestation: 41 weeks 5 days

First birth: 17

Second birth: 12 (4 were repeat clients)

Third birth: 1

Fourth birth: 1

Location of births: Baptist Health Lexington 6, Clark Regional 1, Ephraim McDowell Regional Medical Center 2, Frankfort Regional Medical Center 2, Home 2, UK 18

Individual provider who caught the most of my clients’ babies: Hayden Meza, UK Midwife Clinic (5 babies)

Practice whose providers caught the most of my clients’ babies: UK Midwife Clinic (17 babies)

Professional development: Body Ready Method

My house is quiet and still as I write this- my children are at school, my husband is at a job site, my dogs are asleep on a rug. Outside my window, it is also still (and bare and cold). It feels like such a heavy contrast with the way I would describe this year in birth work. I’ve had more clients than the previous four years due in large part to situations related to the pandemic. So many of my clients’ labors and births were unique and unpredictable. Because of that, I’ve grown quite a bit in this work. The never-ending learning as a doula continues to challenge and amaze me.

Three of my clients had preterm births, meeting their babies at just over 35, 33, and 32 weeks of pregnancy. One had IUGR (intrauterine growth restriction) and severe preeclampsia that required induction of labor and the other two went into preterm labor. Two of the three had Cesarean births and all of the babies spent weeks in the NICU.

Due to the pandemic, I supported two clients virtually. One was at Baptist Health Lexington which was not welcoming doulas at the time and the other was COVID positive (on her last day of isolation- so close!). I was also unable to attend two of my clients’ births at Baptist Health Lexington because they had C-sections and the current policy does not allow doula support in the OR, in recovery, or on postpartum. I was able to support some of my clients in the OR at both UK (unplanned Cesareans) and Ephraim McDowell Regional Medical Center (planned Cesarean). I also had to call a backup doula for the first time this year because I was at another birth down the hall. I walked in shortly after their baby was born; they had wonderful care from my backup and I’m so grateful she was there for them.

While my clients’ induction rate was lower this year than the past two years at 29% (9 of 31), some of them happened suddenly/urgently, which I think made them take center stage in my brain. Six were medically indicated (e.g. preeclampsia, IUGR) and three were elective or unclear on the medical indication.

I’ll end with some interesting situations and highlights of the year:

• Supported a client during the worst ice storm of the year. We drove around downed tree limbs on the way to the hospital.

• A home birth client had a vaginal birth after having a Cesarean with her triplets about 2.5 years prior.

• Two of my clients were in labor at the same time in rooms right next to each other. With permission, I was able to leave one client to support the other’s precipitous labor, then go back to the first client.

• Two of my clients are best friends and they gave birth less than two weeks apart.

• Attended my first birth at Clark Regional in Winchester.

• Supported two 40 year old clients, one having her first baby and the other her second. They both had spontaneous vaginal births.

Reflecting on the year, the theme that comes to mind is team building and collaboration. One obvious advantage of attending more births is that I met and worked with more nurses and providers. I’ve said it many times, but learning nurses’ and care providers’ styles and approaches to different types of situations and developing collaborative relationships with them is so valuable to folks who choose me as their doula. I have now seen 40 providers catch/deliver babies! I feel like I have a pretty good understanding of what to expect from different practices, individual providers, and hospital staff.

I was also fortunate this year to team with Bundle Birth Nurses and cover tuition for five L&D nurses in their Physiologic Birth Training. Nurses from Baptist Health Lexington, Ephraim McDowell Fort Logan, Frankfort Regional, and UK claimed the spots. I know that the pandemic has been extremely taxing on nurses and this small gesture was a way to show how appreciative I am that they’ve continued to show up the way they have for my clients.

Birth work has not been easy this year. 2021 was harder than 2020, in my opinion. We’ve seen loss, illness, hospital staffing concerns and changes (compensate these L&D nurses and hospital midwives fairly, please, NOW!), and almost everyone I’ve known has felt burnout at some point this year. I’ve witnessed so much community support, though, which has provided some solace. I hope that this spirit of community care and collaboration continues and grows in the new year.

Why I Dropped the Phrase "All Births For All People"

Up until recently, I believed that I was willing and capable of supporting all births for all people. However, a client and I recently ended our relationship and it made me realize that boundaries that I have set in place for the overall health and happiness of myself and my family mean that I cannot support any and every person or birth setting. Oftentimes, I can sense whether a client is a good fit before we even meet (enter a dash of expert level internet research). Other times, it takes the consultation to know whether I want to work with them. During most of the pandemic, I’ve chosen to be a little loose with my boundaries and occasionally ignored my intuition about folks. It hasn’t worked for me or for some clients, so I’m making a change.

One thing that I think a lot of folks, including myself, do not always consider when entering a relationship with a doula is that it is just that, a relationship. Yes, the client pays me to provide a service, but I cannot do that well if boundaries are not well established (on both ends) and one another’s humanity is not respected. While ours is one relationship, we have others that we must attend to with equal or more love and time.

On my end, a couple examples come to mind. I have two children who are the most important people in my life. If they need me, I’m going to be there for them, which is one reason I have backup doulas available. I also value my relationship with self which is why I find that my “built of straw” pandemic boundaries were a terrible idea. Having attended 80-something births is enough to know that I cannot support you without fear or a protective response with any provider or in any birth setting that you choose. And while most people that I work with are different than me and make different choices than I’d make (back to my focus on one another’s humanity), there are some folks that I cannot enter into a business+personal relationship with.

So, I want to apologize to people I’ve unintentionally, but undoubtedly, misled with the phrase “all births for all people.” I also apologize to myself for not seeing how that led to crossed boundaries and near burnout. I’m looking forward to being a better doula for you. Not for everyone, but for you and for me.

Attracting doula clients that are unlike me

I’m not the doula for everyone, but I am the doula for a lot of you. I was looking back at birth data for my clients and thought, “I wonder how many of these people have ever or will ever cross paths? How many of these people would I have ever met or supported had it not been for doula work?” Not many was the answer to both, but especially the second question. I am not a social butterfly, so that’s a factor for sure, but also the majority of my clients have been so much different than me.

The reason that I attract such a varied population is because I know that your birth experience is not about me and everything that I do is in accordance to this belief. This is not to say that I have no beliefs, preferences, or personality of my own. I seek to be myself always.

Thank you to all of my previous (and future doula clients) who’ve shared pieces of themselves with me and trusted me with their stories and care. Our relationships have been examples of health and growth, where we both give and both take and both end up better because of them.

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)!