birth, doula, Healing, Honesty, Intention

Yesterday, on the day of the Winter Solstice, I attended what will (probably) be my last birth of 2018. On the darkest day of the year, baby made their entrance into the world right at sunrise. On the darkest day of the year, this baby brought the light. The poetry of that moment prompted me to reflect on other births I have witnessed that also brought light to dark spaces, and the qualities that these births shared.


For lack of more suitable language, these are the births that, “went well.” What do I mean by that?


I mean that these births had the best possible outcome – and no, the best possible outcome is not just “healthy baby, healthy [parent.]” I also don’t mean (necessarily) that their were no deviations from their “birth plans.”


When I say that a birth went well, or had the best possible outcome, I mean that the parent(s) walked away from the experience with a deeper trust and understanding of their own power and intuition. They didn’t feel betrayed or shamed by their bodies, or care providers.


The light that these births brought to the dark reality of the overwhelmingly broken perinatal care system is twofold – first, the birthing person deeply and truly believed in their capacity to give birth; and second, they were able to cultivate a safe space for their labor experience.


The belief in ones capacity to give birth is something that can be grown over time. It is normal to have some doubts, especially for first time parents or parents who are carrying trauma from past births. It is crucial to find a way to alchemize that doubt into deep belief. The process by which that is done looks different for everyone but follows a similar pattern – unlearn what you think you know, in order to make space to remember your inherent wisdom. That is the way folks find their way to a deep belief in and trust of birth.


In order to build a safe container for their birth experience, individuals who had the best possible birth outcomes prepared mentally, emotionally, and physically for birth. They unpacked their own narratives surrounding birth and their bodies, and when they were in partnerships, invited their partner to do the same. There was a willingness to dive into the uncomfortable that was a central theme of the weeks, months, or sometimes even years leading up to birth. Finally, they considered and understood the importance of choosing a care provider and labor team who supported their goals, and whom they trusted.


It was nothing other than that well established sense of safety and trust that ultimately allowed them to stay focused throughout labor – to stay on what I fondly refer to as, “planet labor,” a mystical brain space that exists outside of analytic thought, emotion, and even bodily sensation and connection.


Let’s not misunderstand, of the births I witnessed where these elements were present – safety, believe, and trust – there was still intensity. The experience still shook the birthing person to their core. They may still live pieces of those memories over and over again until they process and heal from the pain and intensity of it all. There may still be trauma that they carry. There may still be injury. There may still be disappointments.


But, by doing the work to ready themselves for the transformative experience of giving birth, they will have set the scaffolding needed to build themselves back up after birth. They will walk away from their birth experience stronger and more aware. They may still carry doubts, but they will be practiced in the process of unlearning and remembering their inherent wisdom. They will understand that the only way out is through, and they will heal in their own time and in their own way.


To my clients, thank you for showing up for yourselves in this way, and allowing me to stand alongside you and witness your power. You are the light and love that makes this deep, dark, sometimes fear-laden work worth returning to over and over again.

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BestSelf, doula, Healing, Honesty, Intention, Loving Kindness, Practice

Masculine Brith Ritual – A Podcast About Creating Life Outside The Lines


Masculine Birth Ritual is a podcast created by Grover Wehman-Brown, a writer, Baba to two  kids, and a transmasculine butch who has carried a child. The podcast came out of a desire to connect queer and transgender people to roadmaps for survival in pregnancy, birthing, and parenting, and create space for more representation of transmasculine and gender-non-conforming people in those spaces. 


I absolutely adore this podcast and the stories that are being shared through it. The discovery of this podcast came at an extremely critical moment for me, both personally and professionally. So I thought I would give a little bit of background and then return to the podcast itself and share pieces of it that have been most meaningful for me.


If you would like to learn more about Masculine Birth Ritual and listen, click here!

& consider becoming a Patreon to support the production and longevity of this amazing work! 


Acknowledging and Affirming: My Own Gender Identity, Expression, and Social Transition as a Birth Professional


This past spring, I was in one of those places where it feels like everything is pulling apart just so that you can piece it back together in a new way. After leaving an unhealthy living situation to the call of, “go home, Jenna,” I moved back into to my parents’ house for a temporary hiatus (5 months) from a sliver of the responsibilities that I could give up (rent, groceries, utility bills), and I acknowledge the fact that I was able to do so is an immense privilege. I was exploring sobriety after – justly – questioning my relationship with alcohol. I was expanding my work as a doula – rebranding, establishing an LLC, hiring an accountant, adding new service offerings, working in a business coaching program, taking multiple courses related to my professional development… 


Still, all of those shifts were nothing compared to one piece of myself that, while it had always been there, had recently begun to swell up, throb, and demand action – my gender identity. “Now is not the time,” I tried to convince myself. 


Fast-forward through a whole mess of internal work. 


Many of you know what came next, or you can probably guess. I ultimately decided that I couldn’t step fully into the deeply personal work of a doula without being authentically myself; I had to be transparent in order to be trustworthy, even if it meant being misunderstood by many, and all the loss that comes along with that misunderstanding. I began the social transition to out as a trans non-binary person in both my personal and professional lives. 


It always seems like massive shifts happen all at once, rather than one at a time. Like nearly all transitions, the ones I was experiencing at this time in my life were painful, but worth it. 


The only one of these changes that I ever catch myself doubting is my choice to be out publicly. I could look to blame others for this lack of confidence, but I won’t. The onus is on me for the way that I internalize the cultural narrative of the gender binary, and as a result fight with my own transphobia on a daily basis. I am responsible for the way I allow being misgendered and misunderstood to invalidate my sense of self, and the way that I question my value as a non-binary birthworker. This is an every day battle for me, and until recently, I failed to fully realize that this struggle makes me even more valuable as a doula, not less. 


It was one moment recently – one small moment – that was so meaningful in affirming both my identity and my identity as it relates to my profession. Scrolling through Instagram one day, I noticed my friend Ray of Refuge Midwifery had posted about a new podcast. Enter, Masculine Birth Ritual. 


My experience as a non-binary doula, and also as a non-binary hopeful future parent, is defined in part by a sense of isolation, despite knowledge that there are other people out there like me. So when I come across any connecting force for birth-y genderqueer folks – a podcast, an article, a facebook group – I find myself instantly uplifted. 


As I began to listen to the podcast, I immediately felt parallels between the stories shared and my own experiences. Though each of the individuals interviewed have vastly different backgrounds and stories than one another, and myself, the connections I felt were extremely validating. Rather than diving deeply into analysis of those connections (because I’m not even sure I could articulate them clearly), I will instead share a few excepts from the transcripts of two interviews below, and then a very short list of affirmations I have been working with.


From Rabbi Elliot Kukla, a trans Rabbi & non-binary Papa, who cares spiritually for folks who are dying, as they process their grief. 


Listen to Episode 5 here.


I actually came out as trans the same year I was ordained as a Rabbi in 2006. So they were very connected for me. I didn’t plan to come out really that year it was a really difficult time to come out in the same moment as being ordained. But it really was you know discovering that I couldn’t step into this role of being a Rabbi without a coming out process.

We have a stereotype that elders are going to be the least open to a trans population and very sick people are you know the least open to something new. And I really discovered just the opposite that you know elders and people who are very sick and people who are dying and in moments of transformation. Are often you know going through a similar process that I went through when I came out of you know… cracking open and are often at their most open and most vulnerable. And that being served by someone who clearly is liminal in some way and is fairly marginal in some way can be a profound form of connection. In fifteen years now of being a chaplain of doing this kind of work I can count on one hand really at the times that someone’s really struggling with my gender. And those times have been spiritually powerful often. You know there’s been a couple of times I’ve had to just not serve someone but most of the times it’s been spiritually meaningful when someone struggled with my gender.

…meaning that we are able to use that struggle in something that is relevant for their spiritual care and that’s what I’m for for that usually you know we’re able to not get stuck in that but but figure out what it is that is what is being touched on in them. And maybe it’s something about their own gender or something about their own transition in that moment or feeling outside or feeling in-between things
or feeling like the world is changing really fast.


From Mac Brydum, a social worker, doula and transman who is trying to conceive.


Listen to Episode 3 here.


I’ve found over the years through trial and error that that’s really where I shine and that’s where I’m happiest professionally, is being with people as they’re going through major life transitions and having a baby is one of the biggest life transitions anyone can go through. And I also just have a real love and passion and a real wonder, actually, about pregnancy and birth and parenting. And I think that stage of life for so many people is confusing and overwhelming. You hear a million different opinions and
sorting through all of that and figuring out what you actually want to do can be really really complicated.

So in the last few years I’ve found that being a doula is the perfect fit for me because it’s this fusion of, you know, I think of it as a form of social work because I am supporting people through a major life change. And I also think of it as a spiritual practice in a lot of ways as well because when somebody is becoming, you know, they are taking on a new identity…

…and as a trans person I can understand a shift in identity. While I’m not a parent myself yet, I hope to be soon, and so one thing that I’m really big on is just holding space for that shift in identity for the parent. 


Affirmations…


My trans non-binary identity makes me stronger as a full-spectrum doula supporting people through birth, postpartum, pregnancy loss, and abortion because…


  • I understand personal loss.
  • I am practiced in transformation.
  • I know what it feels like to question myself.
  • I understand that grief is inherent in transition.
  • I know what it is like to feel misunderstood or invisible.
  • I live in the space between who I was before and who I am becoming.
  • I am familiar with the feeling of being lonely, even when I am not alone.
  • I relate to the experience of existing outside of the “norm” in a space where “norms” are an illusion.
  • I know that while others may relate to my experience or try to define it on my behalf, my experience is mine alone.
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doula, Healing, Honesty, postpartum, Practice
In my previous post, Through a Trauma Lens: The Need for Doulas, I did something that I have too often been guilty of in the past – I only addressed pregnancy and birth, while neglecting postpartum (and conception, contraception, abortion, etc.). Over the past several months, my practice and study has been focused on integrating more postpartum support for those I serve. Now, I feel as a birth doula that I have failed my clients if I have not adequately prompted them to evaluate their potential needs in the weeks and months after their baby is born. It is still the case that far too few people consider, value, and hire a doula for their birth – even of those for whom the cost of these services is well within an accessible range. However, it breaks my heart when a person or family does see the value in a birth doula, but not in a postpartum doula. Birth is a blip – a significant blip, but still just a blip in your journey. The way that you are supported (or not) in the postpartum period will impact your physical, emotional, mental, and sexual healing and wellbeing for the rest of your life. Having adequate support during the fourth trimester and beyond can help prevent your birth story and your early parenting story from becoming traumatic memories for you, your partner, your family, and your baby. In addition to providing extra hands to help you care for your baby and household, a postpartum doula (or someone filling a similar role) will help you process as you go along, and make sure that you have the space, energy, and capacity to explore the emotions and thought-patterns that are integral to your healing. So often I see new parents who have been conditioned to believe that they are martyrs. The results of putting your needs so far below the needs of your new baby are devastating. Your family cannot afford to bottle up the difficult feelings that can, and will, arise in early parenthood. One cause of this perceived martyrdom is the slew of unrealistic expectations that you may have of your baby in their first few months of life. You may expect that your baby will eat on a schedule, poop on a schedule, and perhaps most outrageously, sleep for several consecutive hours on a schedule. Then when this doesn’t happen – because it won’t – you put a huge amount of pressure on yourself and your partner to care for this tiny being 24/7 on virtually no sleep. Why? I am sick of hearing, “this is just parenthood.” Perhaps this pain is a rite of passage, but when the pain becomes traumatic, it has gone too far. Often times, the lack of help sought during postpartum has to do with the intimacy of this time. Between the physical healing of the birthing parent, breastfeeding (when applicable), and the sheer loss of all social niceties under the weight of exhaustion, many families have a very short list of people whom they feel comfortable welcoming into their postpartum space. Rightfully so. I am all for setting boundaries and limiting your energetic expenditures through social exposure, but at what cost to your support system? Is that list of welcome guests so short that the only people on it aren’t available to really be there and help? Other times, I see pride as a limiting factor in receiving postpartum support. More often than not, it is a partner, not the birthing person/primary caregiver who adopts the attitude of, “we don’t need anyone else, we can do this on our own.” Sometimes in these cases, weeks later, when both parents are depleted, there is still a stubborn allegiance to this mindset that serves no one. To this person I ask, what if instead of taking pride in independence, you could take pride in your ability to receive help gracefully? Finally, the financial strain of having a new baby may limit the extent to which families are able to hire help in the months following birth. My advice to anyone who is now pregnant or trying to conceive is to budget for postpartum help now. If you end up reading this after the birth of your baby, consider sitting down and reevaluating the idea of hiring help – I can all but guarantee that your sleep and your sanity are wearing a much higher price tag these days. I can appreciate that for some people, hired help will simply not be a financial possibility. If this is your reality, consider expanding the list of folks you choose to ask for help, and really think about how those friends and family members can be most helpful in the limited time they may be able to come over and provide support. Do the dishes need to be done? When was the last time you showered? Could they hold the baby for a couple of hours while you nap? To return to trauma… all of the categories I addressed in my first post could be applied here. Rather than lay them all out in detail I would like to just remind the reader… Remember that people used to parent in larger family groups. Previously in human history, in a household with a new baby there was never someone more than an arms-length away from the infant. More likely than not, at almost all times that baby was being held. Very young babies do not sleep deeply for long stretches when left to lie alone – this is an evolutionary defense, not a behavioral problem. A calm, confident caregiver holding an infant has massive positive impacts on their development. And finally, you cannot fill from an empty cup. Do you have more questions about postpartum doulas or how you can best support yourself during the fourth trimester? Email me! loveoverfearwellness@gmail.com
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BestSelf, Honesty, Intention, Practice
Mis-gendering has been a running shtick for centuries. From Shakespeare to Netflix and everywhere in between, you can find comic relief in the form of gender bending and misunderstanding. Imagine a shot in a film where we only see the back of someone’s head. Our protagonist walks up behind the person and says, “excuse me, sir,” only for the person to turn around infuriated because they are clearly a “ma’am.” Cue nervous laughter from the audience. Misunderstanding, tension, comic relief. What is funny to me about this shtick (though, not laugh out loud funny) is that we never know a person’s gender by simply looking at them. This situation could be avoided by using gender neutral language. And if you’re thinking, “but Jenna, it’s just a stupid comedic set-up,” my response is two-fold:
  1. Comedy writers, you can do better than that.
  2.  That was just a relatable example of something that happens all the time every day, even when people don’t pick up on the misunderstanding or the tension.
If people, in general, can relate to how uncomfortable it is for a “ma’am,” to be called, “sir,” then why do we have such trouble dropping gender-assumptive language? Yes, the gender binary is deeply ingrained, but that doesn’t mean that we can’t put forth the effort to make a change. In fact, I believe we can’t afford not to put in the effort to make gender neutral language common practice. The thing is, when we see someone in passing and casually gender them – whether in our own head or out loud – by using a gender-assumptive pronoun, designation, or colloquialism we are doing more than just “harmlessly” assuming… we are also assigning identity markers to that person. While a person can otherwise choose particular markers as a form of self-identification, in this context identity markers are perceived attributes assigned to a person in order to contextualize their status and role in society. Examples of identity markers are race, ethnicity, language, gender, age, religion, socioeconomic class, education, marital status, etc. So often people use these markers to describe another person to a friend, family member, or colleague… and much of the time at least some of the information shared is assumed based on perceived identity markers. We say, “She/he/they grew up in ____ neighborhood,” or, “she/he/they are married to a man who _____,” or, “she/he/they are 62 and go to church every Sunday.” We should think critically about what others read into when we use these markers (and also why we might be more likely to use an identity marker to describe someone than their personality or passions). Identity markers are loaded – especially when they are assigned or presumed – because of their cultural significance. Gender is a tricky marker, because it is invisible. It should never be assumed. 
If you are new to learning about gender, here is a quick Gender 101: Gender is not defined by a individual’s genitals, sexuality, body type, hairstyle, body/facial hair, clothing, pitch of voice, lifestyle, beliefs, childbearing history, presence/absence of menstruation, etc. Gender is defined by the individual, based on how they relate to their lived experience. This means you cannot see/hear gender. Sex is what is between your legs, and gender is what is between your ears. Also, as a prerequisite for Gender 102: understand that gender is a spectrum, not a binary – there are more genders than just masculine and feminine. The language as it relates to biology and identity can get quite personal and subjective, so we will save that for another day. 
To assume someone’s gender, especially if assuming their gender within the binary (i.e. masculine or feminine), is to box them into a whole set of preconceived cultural ideas about how they “should” be and behave. It also strips a person of the freedom to self-identify, which can be extremely disempowering. This happens all day, all the time. It is a habit I have been trying to break myself of, and encourage those closest to me to examine as well. Maybe you’re wondering how to start breaking the habit of automatically gendering others. Maybe you’re still not clear what I mean, or how this even shows up in every day life. Here are some practical ways to start realizing the importance of gender-neutral language, and put it into practice.
  1. When you meet someone new, wait until you know a their gender before using gender-assuming or gender-affirming pronouns (she/her/hers; he/him/his; they/them/their; ze/zir; etc.), designations (sir, ma’am, father, mother, parent, etc.), and colloquialisms (dude, lady, man, mama, etc.).
    1. How will you know the person’s gender, if not by sight? Wait for… the person to blatantly self-identify, “Hi, I’m Jenna, I prefer they/their pronouns.”
    2. Or… ask what pronouns they use. Make it a practice to introduce yourself by following your name with your pronouns, and then ask the same of the other person.
    3. Feels too new, uncomfortable, or unsafe? …wait to pick up on a gender-related identity marker, whether you hear them refer to themselves, or another person marks them (just be mindful that the other person could be mis-gendering your new friend).
  2. It doesn’t matter what your new friend looks or sounds like. It doesn’t matter where you met them. Gender isn’t visible. Unless they are wearing their pronouns on a name tag, refer to step 1. Safe spaces are improved upon by informed allies.
  3. When identifying someone in a narrative avoid assigning a gender. Maybe you just saw someone juggling while riding a unicycle down Main Street and you really want to tell your friend! Rather than, “I just saw a man juggling while riding a unicycle down Main Street.” Try, “I just saw a person juggling while riding a unicycle down Main Street.”
    1. Want to add more details to your story? Use gender neutral pronouns! “He had a tie-dye vest on.” –> “They had a tie-dye vest on.”
    2. The person on the unicycle ends up in line at the same coffee shop as you and you start chatting (but haven’t identified your genders yet) and someone else in line asks how you met? Don’t panic. It’s easy, “I saw them just now riding down Main Street and we started chatting.”
  4. Replace your gender-assumptive habits with new ones! Maybe you always say, “Hey ladies,” when you start out a team meeting at work and everyone in the room appears to be feminine because it helps you feel more immediately connected to the group.  Remember that you may be assuming someone’s gender. Find something else that connects you all – it can still be casual and fun – “Hey team,” or, “Hey party people!”
    1. You can be your authentic self without tip-toeing around!
    2. You just have to compassionately consider that everyone is having their own unique human experience, and deserves the right to own their gender identity. I all-but-guarantee you, if you sit with it, it will start to feel less important to always use that gender-exclusive language you’ve grown so attached to.
  5. If you own or operate a business that asks for personal information, including gender, revise your forms to be inclusive. If you’re not sure how, it’s always a safe bet to just write “Gender: ______________ Pronouns:_____________,” and then just let folks fill it in as they’d like.
  6. If you are a cisgender ally still struggling to understand why it is important to erase gender-assumptive language habits from your daily life… think of how you feel when someone incorrectly calls you, “sir,” or “ma’am,” (if it’s ever happened to you before)… and now imagine that happening every single day. That’s what it can feel like as a transgender, nonbinary, or gender non-conforming person.
  7. If you are a cisgender ally desperately trying to integrate gender-neutral language and habits into your daily life, and it feels really hard… Keep doing your best! We all make mistakes. Seriously. We all mess this up. Correct yourself in the moment when you can, “I saw this man – uh – person juggling while riding a unicycle down Main Street,” or “he – uh – they live downtown.” Gracefully pick yourself up if you make a mistake, and keep on trying!
    1. Don’t remind the transgender, nonbinary, or gender non-conforming folks in your life how hard it is to avoid misgendering them, though. Don’t express that them being themselves is a burden on you.
    2. You got this!
Making gender-neutral language a common practice is a great way to show love, compassion, and respect for everyone around you, so that those living in fear of being misunderstood or unseen are reminded that their is a place for them in your circle. 
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birth, Healing, Honesty
Help me bring These Are My Hours to Philadelphia in June 2019, with a special Q&A with Emily Graham! Donate to help cover the costs of theater rental deposit – If you donate $20 now, you will get two tickets to the event once it is booked! If you are a birth professional or business owner and interested in advertising at the event, please email loveoverfearwellness@gmail.com for information.  Donate herehttps://www.gofundme.com/these-are-my-hours-screening-qampa  
  I seem to be talking a lot about birth media these days. Between Facebook and Instagram recently allowing uncensored images of birth to be shared, my own personal reactions to misinformed and dangerous depictions of birth in mainstream media, and the Indie Birth conference earlier this month, it is fair to say that the topic of birth media has dominated my conversations for much of the month of May. At the Indie Birth conference we had the privilege of screening an absolutely magnificent film, These Are My Hours, and the opportunity to do a Q&A with the folks behind the film. Now, I could say a lot about this film, but just in case you don’t make it to the end of this post I will just be sure to say WATCH THIS FILM! (Click here rent on Vimeo & use the code BIRTHISRAD for 30% off In a day and age where we are hard-pressed to find any realistic depictions of birth in mainstream media, These Are My Hours, offers a truly cinematic, real, raw, and downright beautiful glimpse of childbirth. This hour-long production had me laughing hysterically at moments, bawling my eyes out at others, and sometimes, both at once – and it is completely unscripted. One of my favorite things about this film from the backend is that, while it is directed and co-written by a man – Scott Kirschenbaum – the narrative is driven by the woman laboring in the film, Emily Graham, who is also the co-writer and narrator. You can’t even find Scott’s name on the film’s website (click here to explore), you have to go to IMDB or watch the film to find him credited. What a gorgeous real-life example of the divine masculine graciously supporting the divine feminine! In order to produce the film, Emily’s home was prepared in advance with cameras and equipment so that she could get used to having these foreign objects in her intimate birthing space. The crew was called when she went into labor, and showed up to do their jobs as quietly as possible. For most of the film, Emily is alone in the frame. Her partner is nearby but not on top of her, her midwife is in the next room, and her mother is across the room peacefully knitting on the couch. Emily prefers to have the consistent presence of her birthkeepers, but not to be interrupted by them at all during labor, unless she specifically asks for support. Her preferences are perfectly reflected in the final cut of the film, and because of this, I truly believe that These Are My Hours has the power to cure the disbelief of anyone who questions uninterrupted physiological labor. While an uninterrupted physiological birth experience may not be what every birthing person prefers for themselves, it is the right choice for many people – and it is sorely underrepresented in media, and completely ignored in mainstream media. The underrepresentation of this kind of birth not only means that most people do not realize that it is within the realm of possibility for them, but it also leads to the misunderstanding, alienation, and even persecution of those who do know that this is what they want, and who choose it for themselves. My wish is that every single person who may ever give birth, or provide support to another person in labor, watches These Are My Hours. My wish is that this film is shown in med. school, doula trainings, sex ed., and childbirth classes around the world. My wish is that this film is remembered for the role it played in the birth revolution and the reclaiming of birth. I lovingly thank Emily, Scott, Jason, and Carey for this piece of living art.
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birth, Honesty
Trigger warning: Birth, hospital, doctors, mortality  In the midst of a week that has been celebrated in the birth community for the reversal of censorship of real birth images on social media, there has also been a piece of problematic fictional birth media circulating online. When I first saw SNL’s sketch from May 12th, 2018, “On the Day You Were Born,” which stars Amy Schumer as a mother and as a woman in labor, I was annoyed by it, but willing to let it go as a joke. Of course it is important to laugh about the things that can be most challenging in life, and for a lot of people their experience of childbirth tops that list. Then yesterday, I saw the video being shared via BuzzFeed, with the title “This SNL Sketch About Childbirth is Hilariously Real,” and that tipped me over the edge. Okay fine, so I read the comments (never read the comments) and really that’s what tipped me over the edge. (Haven’t seen the video yet? Watch it here). While there are moments in this sketch that are redeeming, and even some realistic depictions of postpartum and parenthood, the portrayal of Amy Schumer’s character in labor is deeply upsetting… We see a woman screaming bloody murder –  in absolute terror – while laboring in a hospital setting. Her husband is equally as terrified. There is a curtain up over her legs – disconnecting her from her own experience – and the medical staff in the room are only paying attention to what’s going on between her legs under the curtain. No attention is paid to how she is feeling… which, again, seems to be completely terrified. Everyone in the room is yelling, and in total hysterics. Another doctor comes in and Amy yells at her asking where she’s been, seemingly pleading the doctor to save her. I’ll pause there, because I think you get the picture. How often do we see birth depicted this way in the media? Pretty often. We are used to it. So it shouldn’t be a big deal, right? Wrong!
“This SNL Sketch about Childbirth is Hilariously Real,” says BuzzFeed. “Real?!” I yell, as I shake my fist skyward, “this is not the way it has to be!”
Let me back up and say that I have no problem with the fact that this sketch takes place in a hospital. People should give birth where they feel most comfortable, and for most people that will be under medical supervision, in case something goes wrong. Just remember – birth is not a medical event, and though you will likely have medical options to consider during labor, birth works uninterrupted most of the time. It is true that over the course of history maternal and infant mortality rates have gone down overall. This likely has to do more with the availability of healthcare and resources throughout a person’s lifespan than it does the presence of medical personnel during labor and birth (i.e. Rickets and Polio used to be big risk factors when giving birth – and they no longer are – even basic nutrition and access to healthy foods makes an enormous difference in prenatal care). It is also true that since the 1980’s those maternal mortality rates have been rising in the US (due to unnecessary, unsafe, and overused medical intervention). As a doula who attends births for a living, all of the births I have attended thus far in my career have taken place in a medical setting. That being said, none of them have looked anything like that SNL sketch. Most people should give birth in a hospital, because that is where they feel safe! But, they should not give birth in a state of terror! Terror can and should be avoided during childbirth. Now, to return to the SNL sketch, it’s not problematic to me because I lack a sense of humor. I understand that it’s intentionally dramatized. It is problematic because for so many people this is their reality, which is made evident by the popularity of this – now viral – video. Because we are fortunate enough to be living in 2018, when many of the pre-existing medical conditions that could negatively impact perinatal and newborn health have been treated throughout our lifetimes, and we are overall healthier than folks were even 100 years ago… birth works most of the time, and there is no need for it to be so entirely over-medicalized. The standard in obstetric care is to strip away the authority and autonomy of the pregnant/birthing person, and assign all power to the doctor in the room. This is not only inappropriate, but also dangerous. It can leave a person feeling like they have no control over what is happening to their own body. It can lead to terror. In midwifery care, this standard is often different, and the individual who is receiving care is treated as the expert in their own body and experience. (If you’re interested in hearing more about this, check out this episode of 1A from NPR on maternal mortality rates in the US). The over-medicalization of pregnancy and birth often leads to way more stress and fear than it does peace of mind. Especially when the care model is set up so that most people (receiving care from an OB) spend only five minutes, give or take, with their doctor in a prenatal appointment, and 0% of that time is spent actually discussing their feelings towards pregnancy and birth, or heaven forbid, their fears.
The standard of care needs to change. The depiction of childbirth in mainstream media needs to change.
How can we expect people to go into labor without an overwhelming sense of fear when there is no one addressing their concerns, or preparing them honestly for what could happen once they’re in the labor setting of their choice, whether that’s a hospital, birth center, or at home? That is, unless they have the resources to seek independent childbirth education, and/or hire a doula. How can we expect people to go into labor unafraid when all that we see in the mainstream media are overdramatized and over-medicalized depictions of childbirth? The more we expose ourselves to positive birth images and stories, the less “hilariously real” this SNL sketch will seem… more like horrifyingly misunderstood and unsupportive. Maybe I’m doing SNL an injustice, though. Perhaps this piece was intended to be a glaring satire that is critical of the massive shortcomings of the current obstetric model, but that is certainly not how it was received by the general public. Indie Birth does a lot of work involving the importance of birth media. As part of their work as not only midwives, but also activists, they provide images and stories that help to bring others into the birth space. In part, this is done because it is something that has been increasingly lost in our culture as birth became taboo. In the past, you may have been present at several births before your own first pregnancy and first experience giving birth. As Margo Nelson recently said on an episode of the Indie Birth podcast, “there’s a way to [share birth media] that is for the highest good.” (Check out that podcast episode here). So BuzzFeed, why not write an article about the #IGUncensorbirth petition, or talk to Indie Birth about the work they did behind the scenes to make the importance of real birth media understood (by a team of people who had no vested interest in birth rights and were not parents themselves)? Let’s redirect the attention to positive birth stories! Let’s build a generation of well-informed, unafraid, powerful birthing persons! Want to see real birth media? (Click here for my list of Instagram accounts to follow). Don’t believe me that you can give birth in a hospital, but that it doesn’t have to be like that? Check out this photo of Emily @mamasaurusssrex, cool as a cucumber, catching her own baby in a hospital setting: Still think I’m overreacting? (Check out this article about the abuse of women in labor, which is just the tip of the iceberg). Birth in love! Not Fear!
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birth, Healing, Honesty, Intention, Miscellaneous
Photography by Kayla Gonzales of @austinbirthphotos Recently, a petition that gained momentum through the hashtag #IGallowuncensoredbirth on Instagram won, causing Facebook and Instagram to change their policies surrounding images of birth posted on social media. (Read more about this change by clicking here).  While I believe it is vital that we are exposed to many different images of birth in order to breakdown taboos, expose ourselves to the many normal variations in childbirth, and begin to reprogram the way we think about birth… the visibility of childbirth should be approached in a mindful way in order to keep birth sacred. I chose the following five Instagram accounts because they photograph/post/share with the permission of those pictured, and because they include a variety of different experiences. This is a great place to start for any one who wants to integrate images of birth into their everyday experience on social media. Happy scrolling! @empoweredbirthproject @indiebirth @the_angela_gallo @blackwomenbirthing @austinbirthphotos
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birth, doula, Healing, Honesty, Intention, Loving Kindness, Practice
Trigger warning: trauma, doctors, hospital, birth, sex It is very important to me to approach all of the work that I do from a trauma-informed perspective. Whether it is asking for consent before touching a student in yoga class, offering self-regulation skills to those I work with, or preparing clients for potential triggers*, I do my best to incorporate my on-going learning in the field of trauma into my professional practices. Recently, I began taking trauma classes for professionals through Lakeside Global Institute (formerly IFP), and have been layering in what I am learning with my preexisting trauma-informed approaches. One of the biggest impacts these classes have had on me so far is the ability to speak to why I do things differently than other professionals like me.  Why remind yoga students over and over that everything I offer in class is optional? Why ask about family relationships on my doula client intake forms, or wait until the third and final prenatal meeting to practice hands-on skills with my birth clients? It has also given me the language and understanding to better explain why trauma should be considered when understanding that doulas are a necessity, not a luxury. The scope of this post will be specific to birth doulas. I feel obligated to insert the following disclaimer: I have now put myself in an interesting place, because I am saying that there is a need for birth doulas, and that they are a necessity… but I also deeply believe that the cultural narrative surrounding birth is flawed because it necessitates the help and presence of professionals and paraprofessionals during childbirth. I believe that instinct alone CAN be enough to guide someone through labor, but because birth has become medicalized and pathologize-d, and because most folks feel safest under the observation of a medical professional during childbirth, I am making the assumption that the majority of those who might read this would plan to give birth in a hospital, birth center, or under the care of a midwife at a home birth. Do I think that you need a doula order to have a positive birth experience? In the deepest sense, no, but in the cultural sense yes. That being said, through a trauma lens… what makes doulas a necessity?
Evidence Supports the Use of A Birth Doula Did you know that there have been 25 randomized, controlled trials that studied the effects of continuous labor support, including doulas? The 2017 Cochrane Review compiled the results of these studies. Overall, those who received labor support had a decrease in unwanted medical intervention (including a 39% decrease in the chance of unplanned c-section), and overall less anxiety AND less pain. Any measurable differences between those assigned labor support or those who went without, were more significant when the assigned support was a trained doula. When considering trauma, the most relevant piece of data from this review is the significant decrease in a person’s feeling of dissatisfaction with their childbirth experience… a 31% decrease in those who were supported by a doula. Now, the word “dissatisfaction,” leaves a lot open to interpretation. Let me put it this way… childbirth is demanding physically, emotionally, mentally, energetically, financially, relationally… the list goes on. This isn’t a shrug your shoulders kind of dissatisfaction, as you mutter, “Eh, we’ll get it right next time. Easy come, easy go.” This isn’t a time to be polite about the small intrusions or discomforts. Trauma is sensory. It is stored in our bodies in a way that can feel mysterious because it exists beneath conscious thought. You had better believe that someone touching you in an unwanted way (especially invasively or internally), talking to you in a way that distracts (especially in an inappropriate tone or using thoughtless language), smelling strongly near you, or being in your sensory space in any way that is overwhelming, will be much more intense when you are in labor, and the impacts may be longer-lasting. Now, add in that labor is always unpredictable. Whether you are having your first child, or your fifth, you have no idea what this experience will bring. New sensations and signs of labor, new timelines, and new thought patterns can throw us into an alarmed or fearful state. When we lose the ability to think clearly due to fear, everything starts to feel like a potential danger. In a medicalized labor setting the sensory overload and feeling of fear could be amplified. To give an oversimplified example, if you are being monitored, there might be the constant sound of your baby’s heart rate, and periodic beeping from the monitor when it is out of paper, or the band slips off of your belly and it can’t get a read. The loud beeping continues until someone is comes in to stop it, and while they’re in your room they likely also touch you and ask you questions. Double or triple that pattern of alarming sound, medical disruption, and the anxiety it might cause if you are receiving IV fluids or medication. With each disruptive trigger, you might drop into a lower brain state. You forget the tools you prepared to help you through labor – your breath, your affirmations, your movements – and minutes start to feel like hours. A doula can help you self-regulate. No matter your labor setting, the level of medical intervention you choose, or the unpredicted twists and turns of labor, your doula will remind you of your coping mechanisms. A doula can also help you improve the sensory setting. Whether its turning down the lights, or coaching your partner when and how to best communicate with you, or asking the nurse to please wait until this contraction is over before they try to place that IV. The little things that a trained doula knows to look for and prepare for make a big difference when it comes to how the memory of your labor experience will be stored and processed.
Benefits the Development of Your Child Did you know that your baby begins storing emotional memories in the 3rd trimester of pregnancy? And, emotional memories are the longest lasting memories? And, the younger a person, the greater an impact that trauma has? The way that you feel in the final weeks of pregnancy can have lasting impacts on the development of your child. When the brain is sent signals of stress or fear, development is focused in the brain stem and midbrain. Survival becomes the goal. We want our children to thrive, not simply survive! Often, stress in the 3rd trimester is related to preparation for labor. Perhaps you’re beginning to question your abilities or your level of preparedness. A doula will not only spend time in prenatal meetings helping you to prepare in the way that is best for you, but they can also answer any lingering questions. Many birth doulas are also childbirth educators, so they are a wealth of information to supplement any classes you may have taken, or books/blogs you are reading. Having a professional who will answer your texts, calls and emails, and who will validate your ability to birth and to parent makes a huge difference in your stress level in the final weeks of pregnancy. The increased positivity will help your baby store memories that are positive, too. When the brain learns love, rather than fear while still in utero, it sends a very powerful message – grow, develop, be unafraid, there is a lovely world waiting to meet you.
Helps Mitigate the Impact of Transgenerational Trauma Did you know that trauma can be passed down? We might be okay with our children having our green eyes, or creative mind, but we probably want to prevent them from feeling the hurt that we have felt in our own lives. If you have a traumatic labor, then your baby has a traumatic birth. It is that simple. If you do not adequately process your traumatic experience in childbirth, it will perpetuate. Both you and your baby can avoid unnecessary trauma, and heal from unavoidable trauma with the help of a trauma-informed doula. As a trauma-informed doula, often this means that I refer clients to professionals with higher levels of training and capacity than myself. We don’t know what we don’t know. Someone who can help you identify what is traumatic, and seek out the appropriate path towards healing is invaluable.
Long Term Financial Benefits Did you know that from a systems perspective, it is more socially and fiscally sustainable to identify, prevent and heal trauma, than it is to ignore it and find quick fixes for trauma symptoms? Okay, that was a mouthful. I want to avoid getting into unrelated politics here, so let me just say this… There is a cultural tendency to ignore trauma. Sometimes,  this is because we don’t recognize it for what it is, so how could we possibly identify it? Instead, we see and treat the symptoms of trauma. We see a new parent struggling with postpartum depression, and a doctor who prescribes drugs instead of nutritional balance in order to address hormones and mood. We see a new parent return to work after minimal parental leave, and get penalized for shirking their professional responsibilities as they adjust to a major life change. We see someone who has given birth unready to return to their pre-baby sex life, and a partner, friend, or family member say, “well your doctor cleared you for sex, didn’t they?” Consider, too, the way that any trauma in a growing child might be misunderstood and improperly treated over time. Where is the financial element in these social trends? There are layers and layers to this, so to oversimplify… drugs cost money, an inefficient workforce costs money, families in turmoil or separation cost money. Trauma impacts all of us, whether directly or indirectly. It takes a toll on our families and our societies if it continues on ignored. If we can properly prevent and heal individuals from their traumas, everyone benefits.
Remember that disclaimer I started with? I just want to remind you that you CAN do this! You can give birth, and you can parent! You are also capable of doing this without the input of an outside professional. But, we all like to feel heard, seen, and supported. Feeling heard, seen, and supported should not be a best case scenario, it should be a reality that you demand. A doula can help you create that reality, regardless of your intentions or preferences for labor. If for no other reason, consider a birth doula as a necessity – not a luxury – through the lens of trauma. As always, choose Love Over Fear. *This post does not include explicit discussion of how past traumas might be triggered in pregnancy, childbirth, and postpartum.  
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birth, doula, Honesty, Practice
#WorldDoulaWeek was March 22nd-28th this year, and I asked for questions from friends on social media about doulas, and answered one in a post each day. To close the week, I decided to compile them all in a blog post for your convenience! Bear with me, I wrote these as Instagram captions. Enjoy! Question: “If giving birth in a hospital, does a doula communicate with the medical staff if you have specific wishes for your labor/birth?” Answer: Yes… but not exactly. While many people hire a doula, in part, to serve as their advocate, your doula CANNOT speak on your behalf. However, your doula CAN help you get clear on your labor/birth preferences, and coach you on communicating clearly with your care provider leading up to the birth of your baby. In the hospital, your doula will be by your side to ensure that *informed consent* is upheld. That is, you not only have the space to consent to any care provided, but you also have the time to ask questions and fully understand it in detail before consenting. A tactic that I often use in my practice, to avoid speaking for my client, is to jump in after a care provider offers a medical service and ask them, “hey, your doctor wants to _______, do you have any questions about the benefits/risks/alternatives? Do you want more information about this option before you consent to it? Do you want more time to decide?” It’s magical what a doula can do in a hospital setting to relieve the pressure, provide more space and time to make decisions, and facilitate positive communication with care providers. As Angela Gallo has said, many care providers have a unnecessary tendency towards “rushing and obsessive active management,” on the L&D floor. A doula can help you mitigate that tendency. Question: “Why might I want/need a birth doula if my partner will be there during my labor?”  Answer: Your partner and your doula work together – a doula does not replace your partner. As Penny Simkin says in her book The Birth Partner, “Childbirth is intense, demanding, unpredictable, and painful, and it can last for anywhere from a few hours to 24 or more.” Your medical care providers will not be present for the entire duration of your labor, they will be in and out of the room. Having a doula in the room with you, who has gone through this process many times, can help put you at ease. In order to have a positive labor experience, you need to feel safe and supported. A doula can help you maintain that environment, even if your partner has to rest or step away. Your doula can guide you in applying any comfort measures you have learned or practiced, especially in moments of overwhelm. Your doula and your partner can work together to meet your needs and make you more comfortable. Your doula can step up if your partner is exhausted or overwhelmed – remember, they have to take care of a newborn AND you after your baby is born, and they need to be rested too. Even the best, most attentive, most actively engaged partner can be complimented by the support of a doula. Research shows that the birth outcomes of births attended by Doulas were overall more positive/satisfying, and that there were lower rates of c-section, and unplanned interventions I always say, a triangle is the strongest shape… you wouldn’t sit on a stool with only 2 legs… three’s company… ha! Question: “Can you enlist the help of a doula before you are pregnant to guide you/assist you during the conception process?”  Answer: Yes! There are many Doulas who are happy to provide this type of support and guidance. Whether this looks like a short email correspondence or phone call where the doula suggests resources, or if it is a more formal and ongoing service relationship depends on your needs and the capacity of the doula. There are practicing fertility Doulas out there, and many Doulas have the basic understanding and willingness to provide these services. You may also have a preexisting relationship with, or know of a doula in your area that you would like to support you – ask them if they are willing and able to do so! That individual could become an integral part of your family building experience – from conception, to pregnancy, to labor, birth, and postpartum – it is great to have a strong relationship with a doula that carries through and helps to integrate these phases of your life. So many people feel isolated and/or stressed as they navigate their own fertility. Having a non-medical professional who can support you through the conception process can be useful in ways that are different from the conversations you might have with friends and family during this time. Doulas are often practitioners of other wellness modalities that you may benefit from during this phase. AND they tend to be connected to many professional, informational, and community resources in your area that you may not know about. Question: “What services do Doulas provide?”  Answer: Doulas provide informational, emotional, and physical support. Okay… so what does that look like? It is different for every individual. What makes a good doula good, is they are able to hold space for your unique needs, and adapt their services to support you in the ways that serve you best. Let’s focus on Birth Doulas in this post. A Birth doula provides informational, emotional, and physical support – what that might look like is… meeting with you pre/during pregnancy to help you to research your options and educate yourself so that you can form preferences and make choices about your care… answering your phone calls/emails/texts when you need to talk something through… serving as your advocate and coaching you to be your own best advocate… ensuring that you have the best, safest, most powerful experience you can have… building a toolbox to use in labor to minimize discomfort, maximize progression, maximize the health and happiness of you and your family, and minimize the strain in the 4th trimester and postpartum periods 🛠 What might be in that toolbox? Words of affirmation, soothing touch, movement/postures, counter-pressure, meditation/visualization, aromatherapy, music, communication plans, ice packs, heating pads, a shower/tub, a snack, a warm pair of socks, a photo or video… you name it, if you want or need it. The services that Doulas provide make sure that YOU are in charge of your own care and your own experience. Everyone’s reproductive choices are different, and a doula can help you determine and then actualize what works best for you. Above all other services, a doula holds space. Question: “What training do Doulas have?//What does it mean to hold space?” Answer: This is an important two-fer! The training that Doulas receive can vary, because there is not a single training/certifying body for Doulas. Some training programs have been around for decades, others are very new. There are also some individuals that may have stumbled into this work by helping loved ones, and may not immediately or ever identify as Doulas. Some practicing Doulas who went through training may choose to certify, and some may not. The information in this field is always changing and expanding, and staying up to date on the latest research and practices is vital. There are thousands of continued education learning opportunities for Doulas, and thousands of hours that might be spent reading and studying individually. With all of that variation in training, it can be difficult to determine what you should look for when hiring a doula. One thing that cannot be effectively taught in any training, though, is the ability to hold space. I use this phrase lot so I just want to clarify what I mean. This is a skill that is learned overtime through experience. From @indiebirth “What does holding space mean? Is it as hippie dippy as it sounds? Sitting quietly with someone, providing them emotional support, and getting them food/drinks is a real skill that not everyone is good at. Knowing when to give space and when to be close is an art. Knowing when someone might need a joke, a back rub, and kind word is an art.” Knowing when to just sit and bear witness is an art. How many of us have experienced a person in the room with us who wasn’t actually present? How many of us have experienced a conversation when the other person isn’t listening at all? No matter how much training a doula has, no matter how knowledgeable they are about childbirth, pelvic dynamics, fetal positioning, etc… this is – in my opinion – the most important skill a doula needs. Question: “How do I choose the doula that’s right for me?” Answer: There are many factors to consider when hiring a doula. Talk to more than one doula, most will offer a free consultation which you can use as you interview a few. You can find area Doulas online, but it’s often better to ask friends for referrals. Remember, once upon a time a person’s doula would likely have been a community member with whom they had a preexisting connection – if you already know a doula, make sure they’re on your list. Remember too, that if you have a partner, it is important for them to get along with your doula as well – if possible, make sure they are present or on the phone during your initial consults. As you interview doulas… ask about their training, continued study, and experience. Ask about the guiding principles of their practice. Ask why they became a doula. Tell them your concerns and notice how they respond. As they answer your questions and you begin to get to know them, notice how the conversation feels. Is there a connection? Do they leave space for you to speak? Do they make you feel heard? Are they communicating in a way that is clear and easy for you to understand? Finally, make sure that their services, availability, and price aligns with your needs. For birth Doulas, how many prenatal meetings do they offer, and how many postpartum – what is the total cost of their services? For postpartum Doulas, fertility doulas, abortion Doulas and more, do they charge hourly and/or have a minimum number of hours? Are there additional services that they offer? Do they have availability to meet with/serve you at the times you need? Question: “What should you do if you can’t afford a doula?”  Answer: Be honest and talk about it with the doula you’d like to hire! Most of us got into this work because we want to help. I mean, yes, we want to pay our bills too, but service is the driving force. The cost of Doulas can vary a lot based on experience, services, and even the geographic area in which you live. The big commonality within this variation is we all believe that everyone deserves and has the right to these services. That being said, many Doulas offer sliding scale pricing, based on annual income. Some Doulas even build into their fee a little extra compensation from those who can afford it, so that they can serve others at a much lower rate, or even pro bono. You might not know if your doula offers these pricing modifications unless you ask! Ask your Doula of choice if they’re open to bartering for services! Check to see if there is a doula Co-op in your area! ( @phillydoulacoop is a great organization in philadelphia helping to make Doulas more accessible)💰 Everyone deserves to feel supported. Everyone deserves a doula. Don’t let cost stop you.
You can always contact me with additional questions at loveoverfearwellness@gmail.com
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