The policies are ever changing at the moment but this is a current snap shot of doula status at Twin Cities area hospitals. We will do our best to update as new information becomes available.
Official Press Release: November 16, 2020
Dear Twin Cities Hospital System Representatives,
First, we want to thank you for your efforts to continue to allow doulas a presence in your hospital system. While we understand the complexity and severity of our rising COVID-19 numbers in the State of Minnesota we believe that doulas are an essential part of the birth team and that families should be entitled to a doula of their choosing. Recently several hospital systems announced their doula restrictions saying that laboring people are only allowed one visitor or labor support person. This is in direct conflict with their rights. Furthermore, we have been made aware of a hospital system (Allina) that has decided to make the ‘doula restriction’ further restrict people’s access to a doula of their choosing by requiring that doulas register with the hospital AND be certified.
It would be historically appropriate for a medical system to enforce certification for medical personnel who are present in their hospital, however doulas, by definition, are NOT medical providers of any kind and are not employed by or managed by the hospital. We are paraprofessionals and are regulated not by certification but by the families who wish to hire us as their support. There is common misinformation and misunderstanding around what a Professional Doula is and how they are trained and certified. We believe that Professional Doula is the most appropriate description fordoulas who should be welcomed by hospitals to support laboring families.
We define Professional Doulas as labor support people who have attended doula training and work as birth support astheir profession. This may mean they have a website, a business name, are part of a doula organization and/or get paid to attend births. A hospital restricting their patient’s access to professional birth support to ONLY certified doulas are enacting a policy that is inequitable, harmful, and illegal. The path to doula certification and maintaining certification is full of financial and logistical barriers that restricts BIPOC doulas and marginalized individuals from obtaining and holding
The certifying agencies that Allina is using as their list of ‘allowed’ organizations is dated and not exhaustive while also limited to only organizations that offer in person training historically, which at this time is not viable. This list is only used by the Minnesota Dept of Health for reimbursement to doulas who provide services to Medicaid patients and is a fraction of the total number of active working doulas in the Twin Cities. The list of certifying organizations also excludes the majority of BIPOC run and owned doula training organizations. Research shows that the support of a culturally congruent doula has significant impact on improving outcomes in maternal and infant mortality and morbidity especially for Black birthing people. Often doulas from marginalized groups are trained by organizations that are not in the provided “acceptable doula certification list.” Thus, this policy would negatively impact the very Black and Brown bodies research shows are at risk for racial disparities and much poorer outcomes in pregnancy and birth.
Although we are unsure how regulating certifying vs professional doulas is solving the issue of COVID-19 exposure, it is the stance of the Twin Cities Professional Doulas that if hospitals are trying to regulate birth support that they can simply state that all patients in labor and delivery can have one personal labor support plus a Professional Doula. If they are interested in vetting whether someone is a Professional Doula, they can ask to see proof of training. This would also have the added benefit of reducing extra work for hospital staff and remain racially and socio-economically equitable.
Finally, at a time where we are experiencing a historically large amount of unemployed people it is especially harmful to further restrict people’s ability to make an income in their profession. The majority of a Professional Doula’s clients are hospital birthing people, therefore when Allina and other hospitals restrict families’ access to Professional Doulas, they are also restricting people’s ability to make a livable income for themselves and their families.
We are open and available to be part of the policy wording and problem solving. Our goal is and always will be in promoting optimal outcomes for laboring people and their babies, which is undeniable with the support of a Professional Doula.
Twin Cities Professional Doula Community
I so often get asked “So, like, what do you do, you know, while you wait for a birth?” Good question, my friend. And one I asked myself multiple times in the early days of my doulaing. In fact, I remember texting my doula after I had become a doula and was on-call and waiting for my client to request me. My text said something like “Oh my goodness, how do you not drive yourself crazy waiting for a call to a birth?!” And I was serious. Here I was, a new doula, anxiously waiting the we’re-ready-for-you call and I couldn’t sit still. I paced, I ate, I channel surfed the 7 channels we had, I obsessively checked my phone, I ate some more, I checked my phone again, nothing. As it should be. Babies come when they are ready. My doula responded with a light-hearted giggle I’m sure, and said “You do you. But do things that are easy to leave. Garden, read, write, coffee/lunch with friends, clean, nap.” All things I love to do anyway, what was my problem?
No problem, just an eagerness and a readiness to be satisfied. I quickly learned that what I do while I wait for a birth is I Do Me. Just as I tell all my clients, “You do you, Boo. Baby will come when baby is ready.” Funny, once I figured out how to follow my own advice, I became much more comfortable with the continuous waiting period of labor.
Labor can have very much a feel of “Hurry up. Wait. Hurry up. Wait.” You get everything set at work to be off for a set amount of time and then you wait. You get the baby’s space all set up and ready and then you wait. You text all the family members “No baby yet. We’ll let you know.” and then everyone waits. You go into labor and then are told to sleep. And by that I mean, you wait. You get to the place of birth and oh wait for it, you wait again. Babies come when babies are ready.
And no one understands that better than a doula. It’s all we do. And we absolutely love it. However, don’t be fooled, we do have lives. It’s not like we sit all serene-like with a never-ending cup of coffee and the best book ever written on a dock by the clearest lake, just calmly waiting. (But doesn’t that sound fantastic?) We have families and other jobs and responsibilities, all that adulting stuff they tell you about in school. But man, when that call comes, when that client who is at so-many-weeks-and-a-few-days who has been ready for that plus some, calls and says “We could really use your support.” it’s like some mysterious force lit a fire inside and to keep that fire alive, we NEED to get to that family.
The life of a doula is a life lived all on it’s own. Until it’s not. And for a small amount of time in this big expansive universe, it is a life that is lived just for that birth and that birth alone.
by Hallie Rogers, PCD(DONA), CLC
Most of us have heard many “birth stories”: narratives parents weave to commemorate the arrival of a new baby. Typically beginning with early labor, birth stories are the emotional and factual account of how a new little human was birthed, and can be an important part of a woman processing her own agency, role, and part in that story. My husband and I have had three beautiful births, each different than the others. While we treasure our memories of those life-changing nights and days, in my experience, it’s my postpartum stories that have truly influenced my life and had a greater impact on my family. This is my first time sharing my postpartum story–my own weaving together of my three postpartum experiences. Why? Because I want to model my belief that a woman’s postpartum story is just as important and valuable as her birth story.
Our first child (G) came almost four weeks early. We were not prepared, emotionally or literally. We have a photo of our tiny G sleeping in her car seat just after we arrived home that first time, the room around her total chaos with opened boxes, papers, and gift wrap everywhere. As my husband took that photo, we both expressed to each other how we felt completely incompetent and at a loss for what to do now. How could they send us home with this tiny person? We couldn’t possibly know what we were doing. Those first two weeks were intense, with serious physical healing necessary for me that greatly limited my mobility. Breastfeeding was challenging right from the beginning, and I remember sitting in the bathtub one afternoon crying to my mom on the phone, telling her I’d been asking myself, “What did we get ourselves into?” It was clear that in those first few weeks, I was experiencing what’s called “the baby blues,” which is a normal reaction to the overwhelming hormonal and circumstantial adjustments women have to make following the birth of a baby. I struggled initially the first few weeks, but things got easier. G was born in May, and since my husband was a teacher, starting about 4 weeks after G’s birth, he was able to be home with us all summer long. Life with baby quickly got so, so much better, and we had a wonderful summer learning how to parent together. I had the luxury of unconditional, encouraging support every day. To make it even more incredible, that support came from the man I loved the most in the whole world, and I got to learn from him and watch him settle into parenthood alongside me.
Fast forward 16 months later to our second child (M), who also came a bit early. Born in September, it was not ideal timing for a family with two parents working in education, but she decided to debut on a gorgeous crisp fall day. Right away, M was a force to be reckoned with. Breastfeeding was much easier this time (she nursed like a champ!), but as the weeks went on, we could tell something wasn’t working for her. After researching on our own and talking with her doctor and some friends from La Leche League, we discovered M was intolerant of the cow proteins in my diet. I went dairy free for the next five months so that I could continue to breastfeed M, and while I didn’t mind doing it for her, it was not easy.
My postpartum time after M’s birth coincided with my decision to leave work and stay home with our children for a while, my husband’s return to a demanding job and classes in a post-graduate program at a university, and the chilling and darkening of the seasons in our northern climate. In those early weeks, I remember being unable to sleep while the rest of the house was sleeping. In retrospect, I was experiencing relatively significant postpartum anxiety, followed later–in the winter months–by depression. While there certainly were times of joy in those first 6-8 months after M was born, there were definitely moments I wish I hadn’t had to have, particularly with two little ones looking on and feeling the effects of a sad mom. I remember sitting on the living room floor in January with the toddler playing with the baby as I just wept, for no particular reason and with no particular remedy. I felt a deep sadness, emptiness, and loneliness, and I didn’t know how to get myself out of it. I felt guilty for not loving every minute of being home with our kids, I felt ashamed of my sadness, and yet–because it was different than the depression I had had as a college student–I couldn’t see the forest for the trees and did not recognize what I was dealing with in those moments. I made excuses for why I felt sad, and failed to reach out for the help I needed. Eventually, days got longer, baby M got older, and things got easier. That summer was a good one.
Unfortunately, however, my postpartum mental health issues reared their ugly heads again as M and I weaned that fall. As my body shifted from its lactating to non-lactating state, my hormones contributed to the return of anxiety, resulting in panic attacks during the day, night after night of insomnia, general worry over things I typically don’t worry about, and even heart palpitations. A few months later, I was able to feel “normal” again, and I thought my depression and anxiety were done and gone.
After many months and much thought and discussion, my husband and I decided to have another child. We were absolutely in love with the beautiful daughters we had been blessed with, and were excited to welcome another little person into our family. By the end of the first trimester with baby #3 (L), though, I could tell there was already some anxiety mounting inside me with each passing week. I decided to try to “head it off at the pass” by talking to a counselor who specializes in perinatal mood disorders and works mostly with mothers. This was helpful, and I began to see some improvement through therapy with her, as well as the use of a prescription light box I sat in front of every morning at 5:30.
That January, however, I began to slip into what would become the deepest, scariest depression I’ve ever experienced. While I was never suicidal, it was definitely the darkest time of my life in terms of mental health. I began to see a counselor again, and with her guidance and that of my doctor, I was able to see that medication was necessary. For weeks and months I had tried every non-pharmaceutical thing I knew of to try to treat my perinatal depression and anxiety, and it had simply reached a point when those methods weren’t enough. I also began to work on a postpartum plan. I knew that for me, the postpartum time was likely to be a challenge again. So, I decided to have my placenta encapsulated this time around, to see if it would alleviate some of my symptoms and allow me to gradually “come down” from the hormone high point of birth, as well as replenish and sustain my own levels of iron a bit more easily. We also decided to hire a postpartum doula. I didn’t know postpartum doulas existed when we had our first two babies, but between baby #2 and baby #3, I had not only learned about them, but had become certified and began working as one myself. I knew the vast benefits of having trained, nonjudgmental support after baby arrives, so we arranged for our postpartum doula to come be with me and our children while my husband was working and other family was not available to help. I also asked friends and family members to help us by bringing us a meal after L arrived, and so many people generously responded. It was incredible to feel so loved and supported by so many people, and their food nourished our bodies and our souls.
My medication, my counselor, and my placenta were all helpful to me after L was born, but I truly believe that it was the support of other people that was the key factor to this postpartum time being worlds different than the last, and worlds different than even a few weeks prior to birth, when my depression in pregnancy was so serious. I honestly remember crying tears of joy and relief in those first weeks after birth, and I remember telling my husband, “This is what it’s supposed to be like. I am so, so happy. This is what postpartum should be.” They say the third time’s the charm, and for me, it seemed to be. I was able to come out of a darkness and into the light of a new phase of motherhood, eased into it with the support of our doula and many dear friends and family members who loved us into a new peace as a family of five.
Hallie Rogers is a certified postpartum doula and a certified lactation counselor, and seeks to provide a wonderful, supported postpartum experience to the families whom she serves. She lives in St. Paul with her husband and three young children. You can find out more about her doula and lactation services, read other blog posts, and contact her at www.betterbeginningsmn.com.
by Jess Helle-Morrissey, MA, MSW, LGSW, LCCE, CLEC
Doulas serve a multi-faceted role in a birthing family’s life: supporter, encourager, normalizer, educator, guide. We rub backs, we squeeze hands, we stroke hair, we breathe, we hold space. We press cool cloths to a birthing woman’s head as she brings her baby (or babies) forth from the warm, wet womb to the bright spinning world.
One role that is often overlooked, but is perhaps most sacred to my own doula heart, is that of witness. As doulas, we witness over and over again that unique and unparalleled moment in a woman’s life when she becomes a mother. Whether it’s a first birth, or a seventh, a mother is born each time she births a baby.
When a woman has a transformative birth experience (and really, what birth isn’t transformative?), she deserves to be fully seen. And that role is often uniquely the doula’s. Partners are witnessing, but they are most often deservedly caught up in their own personal experience of the moment. Midwives, doctors, and nurses are present, but they have medical tasks to attend to. Doulas are able to attend wholeheartedly to that moment.
We witness the joy of birth. We witness mamas finding their true selves for the first time in their lives as they birth their babies. We see the look on a mama’s face when her baby is five minutes old as she tells us, “Everyone said I couldn’t do it, but I knew I could.” We witness the hilarity of birth – I’ll never forget one mama who turned to me after birthing her twins and exclaimed, “That was f*cking AWESOME!” We get to see the way a partner looks at the birthing woman in complete awe as she makes her way through contraction after contraction. We get to see him or her wipe a tear away as this new little person makes that first yawling cry.
We witness the disappointments, too. And when things don’t go as planned, we can remind her that she is strong because we have seen it with our own two eyes, and we have felt it in our own doula souls. And we remember in a way that she might not.
So as witnesses to those moments, we begin to help her reframe: Last summer, one of my doula mamas had a surgical birth after a long and difficult labor. In a case like this, it is easy to go to a place of dwelling in what went wrong. I go to my postpartum visit. We talk about all that happened, and I validate the disappointment. I sit with the pain. But I also tell her, because I need her to hear, “I have never seen anyone work so hard for so long. I have never seen anyone fight so hard for what she wanted. You. Are. Amazing.” And she begins to feel it is true because I have seen it and I know it to be true. She knows I was there. She knows I saw her fully. And as I write this, I remember her fierce birthing spirit as if her baby was born yesterday, and I feel the hair on the back of my neck stand up a bit. Because I will never forget her strength, and the gift she gave me by allowing me in.
Above all, it is that sheer strength of birthing women – no matter how they give birth – that we doulas are witness to. The strength to carry on when it feels like all the reserves have been depleted. The strength to make a choice to go a different direction than we’d dreamed. The strength to joyfully claim a place in the history and lineage of birthing women.
And the repercussions of that witnessing can last a lifetime. I spent a good part of my own life feeling like I was not a very strong person. When I gave birth to my twin boys, I found strength I never even dared to imagine I had in me. Today, more than two years later, each time I see one of my two wonderful doulas, I still stand a little taller and feel that swell in my heart – “SHE has seen my strength! She knows the amazing things I am capable of!” A bit dramatic? Perhaps. But life-changingly, soul-stirringly profound for this mama? Most definitely.
So when you invite a doula into your life for some portion of the nine months of your pregnancy (and a couple months after), know that the benefits don’t end there. We not only witness, but we also remember. I tell my mamas, “If you ever need to be reminded of how incredible you are, call me and I will tell you as many times as you need to hear it to believe it.” So on behalf of all doulas, thank you to birthing families everywhere who invite us to witness your incredible journey. Thank you for giving us the best job in the world.
Jess Helle-Morrissey is a birth and postpartum doula, a Lamaze-Certified Childbirth Educator, a Lactation Educator Counselor, and a clinical social worker in private psychotherapy practice. She teaches classes for families planning VBAC and for families expecting twins and more at Blooma, and lives in St. Paul, MN with her husband and her identical twin boys, born in January 2011.
by Samantha Chadwick
So this week is World Doula Week. And I am just a few days away from celebrating the birthday of the first baby whose birth I attended as a doula. I am so grateful to have been invited by families this year to support them on their adventures.
And OH how far I have come! I remember nervously peeking around the corner of the wall in my house to try and watch the birth videos on my yoga DVD while I was pregnant. Now, I cry and laugh and breathe and moan alongside laboring women sometimes for hours (or days) on end and I really enjoy it. It’s strikes me as sort of an odd thing to love doing, but I do! This week my toddler has been asking to “see a baby get born” so I finally downloaded The Business of Being Born and showed her some. She loved it.
I know firsthand that pregnancy and birth can be simultaneously amazing and very difficult. As a doula I help families find resources, prepare for labor, and help work to ensure they have a positive birth experience. I see my role as supporting the birthing mother (and her partner or other companions), playing the role desired by that particular family. A lot of times that means providing information and resources during pregnancy and preparing for birth, being a good listener and helping the mother/couple discern their own wishes for the birth, and then providing emotional support and physical comfort during and immediately following labor and birth. I can assist the family in getting information that the mother and partner want in order to make choices.
Sometimes I’m in a hands-on, very active and physical support role or occasionally more hands-off, background role depending on what is needed. I take pictures and write down key moments and refill water bottles and hand out Tic Tacs and chapstick. I give the partner a thumbs up or confident head nod and swap in when they need a rest from squeezing their partner’s hips. I tell it like it is. This is probably the hardest thing you are every going to do, and it’s a amazing thing you are doing for and with your baby.
I see myself as working to create a positive, encouraging, and supportive environment for the mother and her family to birth a baby, recognizing that this is an experience she will probably vividly remember for the rest of her life, and it matters how she is treated, supported and believed in.
I believe that birth works – that women’s bodies are meant to carry and birth their babies safely, and in many cases nature works best when a laboring woman is comfortable, feels safe and loved, and is allowed to follow the wisdom of her own body without much interference. As a doula I can help facilitate this kind of environment and preparedness for what to expect and how to cope. That said, birth is unpredictable and different for every mother and baby. Just as important for me as doula is to support the mother/family no matter what comes up, to affirm the choices she makes, to listen to her and help her process what happens, and to help her remember how amazing and strong she was during her birthing time.
“There is a secret in our culture, and it is not that childbirth is painful. It’s that women are strong.” –Lisa Stavoe Harm
I am in on the secret. It’s true.
I don’t work a typical 9-5 shift
I am on call 24/7
It is not uncommon to spend a day away from my own family
I get to witness your special moments and see you become a family
When you are happy, I am happy
When you are sad, I feel sadness too
I live for that next surge and the next phase of labor
I live to see the moment when you meet your precious child
I put all my energy, time, tears, and joys into your special day
I am overjoyed to be a part of your birth story, no matter what path it takes
I love to learn and see what changes the birth world will bring us
I love the passion I feel when I am working and connecting with new families
I do all of this, because I am your doula
Danielle Cincoski is a certified birth and hypnobirthing doula. She also does placenta encapsulation. When she is not “doulaing”, she is Mum to 2 crazy and cute toddler boys Charles (3), and Graham (1).She lives in Forest Lake with her Husband Joe who is a veterinarian. And yes, they have 4 animals.
by Karen Schultz, CD(DONA)
In pre-natal meetings or in the early hours of labor I learn a surprising amount about my clients, and they about me. Inevitably, our conversations turn to family, the birthing stories of our mothers, and the dreams for our own babies.
There is always a thoughtful pause in the conversation when they ask, “Do you have children?” I smile and always offer the same response: “No…not yet.”
It is often the case that a woman comes to work as a doula after experiencing her own labors and realizing what a benefit that extra support was or could have been. She either didn’t have a doula and wished she had, or did have a doula and was inspired to follow in her doula’s footsteps. But for some of us, the call to doula comes without our own transformative birth journeys.
I am the only daughter in a family of six. My mother birthed naturally in hospitals and breastfed all of us for two years apiece, an oddity at a time when breastfeeding, for any length of time, was frowned upon. My mom’s influence was subtle over the course of my childhood, but by her example I slowly came to the conclusion that 1) birth is sacrificial, sacred, and beautiful, and 2) women are strong enough to labor well, to breastfeed well, and to nurture well.
I had always been interested in childbirth (I think most women intuitively are) but I hesitated in considering it my life’s calling. What could I, a woman who had never experienced labor, offer a women in the throes of childbirth?
I considered nursing school for a time, but I didn’t want to be bogged down in charting and paperwork when my real love was building up the bonds within families and communities. Science was also a passion of mine, and eventually I did teach high school anatomy & physiology, along with biology and a host of other subjects. Inevitably, when the time came for classroom lessons about fertility, fetal development, and childbirth, my female students would moan about the anticipatedpain of birth, while my male students would acknowledge the fear they had of simply supporting their future wives during their labors.
I thought, “Is this how our young people should face one of the most transformative experiences of their lives?” Surely not! It just didn’t seem right that our society was priming them to believe in the weakness of the female body, rather than in its strength!
It wasn’t until I left teaching and returned home to Minnesota that the doors to birth work began to open. With a bit of nervousness but firm resolution, I attended my first birth on New Year’s Eve of 2012. It was remarkable! In every birth I attended since then, I’ve been struck by how comfortable I’ve felt in the birthing room, how confident I was in the mother’s ability to birth well, and how touched I was by the love between parents. I also became more practically aware of the advantages of my singlehood: I didn’t (yet) have to juggle the responsibilities that come with motherhood–no worries about getting a sitter for a long labor or finding a back-up doula when a little one catches a fever! My responsibilities, in large part, are to myself only.
I also realized that being a doula who hasn’t birthed carried another benefit: I am not burdened by my own “birth baggage”. I don’t have, for instance, the memory of an epidural followed by regret of that choice, or a c-section that I felt could have been avoided. I can pretty safely say that I don’t have any expectations of how labor “should” go because I can’t judge based on my personal experience. I know that every labor is different because every mother is different and every baby is different.
Of course, I hope it goes without saying that I know dozens of “doula-mothers” who successfully leave their own birthing experiences at the door of the birthing room and only retrieve wisdom from them if it is of benefit to the mother and her particular need. I also know with certainty that there are doulas who, having not personally experienced the intensity of labor, might struggle to have compassion for a laboring woman in great need. There are strengths and weaknesses of both states in life.
So what is it, then, that makes for a stellar doula? Is it simply a matter of knowing what labor feels like? That seems far too simplistic; having a baby isn’t just about getting through contractions or learning how to push. It’s about realizing the gift of our femininity, discovering a deeper bond with our partner, and trusting in the strength of our created bodies. It’s about relying on those whom we love and trust for a firm and steady hand and the unfailing reassurance that we can do it.
For many expectant parents, I think it’s quite natural to ask the question, “Will my doula know what to do if she hasn’t had her own children?” But I would urge these parents to instead think of the qualities necessary for an exceptional doula: Compassion. Understanding. Presence. Wisdom. Joy. Having birthed or not having birthed, it is these qualities that are most important.
Karen Schultz, CD(DONA), is happily settled in the Twin Cities after a hiatus in Washington, D.C. where most recently she taught science to high schoolers. Read more about her at http://filiabirth.com.
by Erin Stertz-Follett, CLD, LCCE, HBCE
My journey into birth began 10 years ago after the birth of my first nephew, Micah. I wouldn’t fully embrace birth as my calling until many years later, after the birth of my own two girls and the ‘birth’ of the passion inside me to bring services of meaning to pregnant women and their families.
I will never forget that moment. After an induction that lasted more than 24 hours, and “arrest of descent” of the baby during pushing, my sister was told that she would need a cesarean section. I watched as her face turned from determination, to disappointment, to resignation, and to sorrow. As my mom and I left the room while they began the surgical prep, I said to Mom, “That’s not what we wanted.” With tears trickling down her cheeks, she shook her head, “No.” The grief for what Sarah so badly wanted – a vaginal birth with minimal interventions – was palpable.
A few years later, as I was pregnant with my first child and wanting to learn as much as I could to avoid my own surgical birth, Sarah invited me to an ICAN (International Cesarean Awareness Network) meeting. At that time, the group was small and had just begun reforming here in the Twin Cities. I happened to attend on a night when a wise midwife named Gail Tully was on hand to provide information and practice in ‘optimal fetal positioning’ for birth. I didn’t know anything about birth halls or Rebozos, or the side-lying release. I just knew that it felt so good (and kind of funny!) as I was used as the ‘pregnant model’ for Rebozo belly sifting.
Two babies later, both of which included my sister’s attendance and support, I began the true path to birth work as a Lamaze Certified Childbirth Educator, doula, and HypnoBirthing Certified Educator. Again, my journey was largely inspired not only by Sarah’s first birth, but also by her successful HBAC (home birth after cesarean) her second time around.
To offer full disclosure, I dreaded as a doula the first time I would need to step into the surgical suite and witness a mama experience a cesarean birth. In some small way, I was traumatized by my sister’s experience. Now with several under my belt, I can say that my perspective has changed. Yes, it is still difficult. But, with my doula hat on, I enter the experience with an open heart and an open mind, with nothing but how I can best support that mama in that moment as my focus. It is at that time that we turn our trust over to the trained surgeon whose job now is to safely bring the baby forth from the mother’s womb. I offer a grounding hand on the forehead, an explanation of what to expect and what is happening, sounds and smells that calm the mother, words of reassurance to the partner, and pictures if mama desires.
I have seen mothers who view their surgical births in many different ways: From full-on acceptance (even requesting one at the end of a long, stalled labor); to complete devastation (offering my doula hands to wipe away tears); to somewhere in the middle (perhaps with resignation and a resolve to process the experience later). I have seen cesareans that are completely medically necessary, and those that fall in a grey area.
Look, the cesarean rate in this country (32.8%) is too high. There’s no way around that. We can do better. For women, for babies, and for their families. It may feel daunting to tackle this subject on a grander scale and I know many of us birth workers often feel at a loss. But here is what we can do:
- Approach the subject with mamas (clients, patients, friends, family) with gentleness, understanding, an open heart; and, when needed, the statistics.
- Remember and value the fact that not all mamas view their cesarean as traumatic or unnecessary. Don’t assume that all mamas do and meet them where they are, especially as they plan a subsequent birth.
- Educate. Educate. Educate. Knowledge truly is power. Whether it is ways to more optimally position baby for birth, or methods for deep relaxation, or just knowing all options and all places of referral. Education is key. The ability to ask questions and have them honestly answered is tantamount.
- Refer to birth providers who offer options for mamas in pregnancy and labor; and who understand normal, physiologic birth… Those whose rates of cesarean birth are on the lower end (including out-of-hospital options if the mother desires).
- Refer mamas who have experienced cesarean birth, especially those that view their births as traumatic, to resources such as ICAN and Homebirth Cesarean groups.
- When a surgical birth becomes truly medically necessary either before the birth or during the laboring process, we can offer support and guidance for having a more family-centered experience.
- Put our time, our money, and our voices behind organizations that support mamas in having births with low interventions.
And finally, as doulas and as friends or family, we can hold hands. Wipe tears. Validate fears. Lift them up. Walk down to the lowest lows with them. Remind every mama how strong they are… that they brought their baby into the world; that they can do it again with love.
Erin Stertz-Follett owns Flutterby Birth Services, located in Burnsville, MN. In addition to doula services, she offers HypnoBirthing, Lamaze, and Breastfeeding classes as well as other workshops and events. She is the mother to two lovely and lively little girls.
Editor’s Note: This post first appeared on the Flutterby Birth blog. Photos credited to Stephanie Ryan Photography. All birth stories used with the permission of the mothers.