Saturday, December 31, 2005

Doula Self-Assessment 2005

The other day I was fussing to my spouse about having to return a phone call to a prospective client. I was not available to work with her and did not feel like being the "nice doula" I try to be when I return such calls. I did not want to make sure she had other doulas to contact and offer some recommendations if she needed them.

Spouse pointed out how far I'd come from four years ago when I was dropping not-so-subtle hints to every pregnant friend and co-worker that I'd just completed doula training and was willing to volunteer my services in return for the experience of attending births. It was another year after that before I got my first call from a stranger asking me to be her doula. I was so nervous when I talked to her that I think I scared her off. She called me a week later to say she'd hired someone else. I was crestfallen. I thought it would be another year before a similar opportunity would come my way.

Part of what that caller no doubt sensed was my lack of confidence. On the one hand, I had no doubt I could help her during labor. On the other, I felt like a poseur calling myself a doula when all I had as credentials were my own birth experiences and my DONA birth-doula training certificate.

Some 20 births later I won't pretend to be a veteran of the birth scene. Indeed, I continue to experience firsts. This year I witnessed my first Cesarean delivery and had my first client with prodromal labor (and another Cesearean delivery). I had my first client with breast feeding problems that stumped a lactation consultant and two doctors. I had my first humbling experience getting sent home from the hospital with a client who wasn't "enough" in labor to be admitted.

Yet now I am quite comfortable in my role as a doula. I no longer worry when there are parts of labor where I'm sitting doing nothing. I have learned there is a time for that. Likewise, I take little offense at doctors who ignore my presence. They usually come around to being quite collegial before the whole thing is through and regardless, so long as they are treating my client with respect, I am content to blend into the hospital wallpaper.

There are many things I still long to experience as a doula, planned home birth high among them. I also have yet to work with my first teen mother, my first VBAC mother, my first mother of twins, my first version, my first vaginal breech delivery. There are other things I fear my first of: my first infant death or birth injury. My first bad client relationship. My first prolaped cord. If you practice long enough, you will see a bit of everything. So these things are eventualities if I continue this work.

Much of the novelty of doula work has worn off, even though I have yet to see all that it encompasses. Still, there comes at time during every birth I am a part of where I stop and realize with some surprise that I am doing what I aspired to do four years ago. I am helping women through birth and am there as in invited guest, accepted as a professional with skills to offer. That really is more than I ever thought possible.

Wednesday, December 21, 2005

I'm a doula in the second best city for having babies

According to a list released by, Ann Arbor, Michigan ranks only behind Overland Park, Kansas as the city with the healthiest pregnancies. If you're curious what the other 98 listed cities are, the full list appears here.

Interestingly, they don't define what a "healthy pregnancy" is. And looking at the variables they used -- age of mother during pregnancy, for example, or maternal body mass index -- the results may just reflect reproductive demographics rather than localized innovations or care models that affect pregnancy outcomes.

A community cannot control the average age of its mothers, nor whether they have diabetes or are overweight. It can, however, cultivate other features that support healthy mothers and babies. Not suprisingly, my list of such features would include non-hospital-based childbirth education courses, access to fitness programs like pregnancy yoga, availability of and access to doulas, physical and psychological postpartum support options.

Fortunately, Ann Arbor ranks high in many of these areas also. So I can't say I argue with our high ranking. But given the room for improvement I see even in this community, it is disheartening that we've given permission to rest on our laurels rather than pursue perfection.

Tuesday, December 20, 2005

Some call him Scrooge, some call him Grinch

In my family, we call him "Daddy."

Yes, it's true. My beloved spouse is not a fan of the holiday season. He puts on a good show but underneath he's seething. The perfect illustration:

Last night I was thinking aloud, excitedly, about the game plan for Christmas Eve. What we'd eat, when we'd eat it, how I'd decorate the table. I noticed Spouse reach in his shirt pocket, pull out a little slip of paper, look at it, nod, then put it back.

I paused mid-sentence and said, "What was that?"

"Nothing," he replied.

After a few vollies he showed me what he had consulted. It was a table he'd drawn up. On the left were stressors, on the right were constructive ways to deal with them. For example, across from "Job search" it said, "finish application to X University; think about interview questions sent by Y University; otherwise, try not to think about it."

Item 3 on his list of stressors? "Christmas." What to do about it? "Same as job search. Try not to think about it."

A right jolly old elf is he.

Monday, December 19, 2005

This just in: Doula Down

Well, not down in the sense of mortally wounded in the line of duty. More like down from a family sledding trip gone awry.

Please keep our doula sister T$ in your thoughts as she heals a doubly broken ankle and fractured tibia. With six days remaining until Christmas.

I'm sure she'll post all the gory details as soon as she's home from the hospital and able to sit at her computer again.

Such the Sucker for Birth Stories

I especially like the ones where someone delivers a healthy baby at home, assisted only by family, because the baby came quicker than anticipated. I should collect all these stories on one place to share with doula clients who worry "What if my labor goes really fast?"

Thursday, December 15, 2005

Coming soon to a college town near you

Posting has been very hard to do lately. No sooner did I recover from my flu, then my spouse got it. So I was in charge of the two kids round the clock. Then I had a three-day conference in Chicago (without internet access). Now I'm back in the usual routine, but digging out from six days out of the office.

Needless to say I have not had time to keep up with, let alone reflect on, the world of pregnancy and childbirth. I can only hope to do that soon.

In the interim, let me share my major disappointment of the fall, something I have been in denial about and unwilling to drag into my blog world. I can't really ignore it much longer. We -- my spouse, sons and I -- are quite likely to be relocating in the next year.

Spouse is finishing a Ph.D. He would like to use this degree to teach and write, which means a job as a professor somewhere is the best option. The only problem with this, a problem I had not considered until I had a spouse nearing the end of his Ph.D program, is that you have no control over which universities have openings in a given year.

So no matter that Spouse was willing to commute two hours by car to put him within reach of six universities near us. None of them had openings in his field. Who, you might wonder, did have openings this year? In the geographic regions I was willing to consider moving to?

U of Colorado
U of Wisconsin
York University
Harvard U
Tufts U
Cornell U
George Washington U
Virginia Tech at Alexandria
U of Michigan

Yesterday we got our first "ding." From...U of M. They notified Spouse that they are not going to consider his application in the pool because he's an internal candidate. We were warned of this, multiple times, from the search committee chair no less. There is a taboo, something incestuous, about hiring one's own alumni.

Still and all, we have been hoping desperately that the one scenario that would allow us to stay in the city that' been home for 13 years would somehow work out. Now it hasn't and I'm pretty disappointed.

I still can't bring myself to think about leaving my birth community, finding another doula partner as great as the one I have now, working with another non-profit as inspiring as the Center, having to cultivate new clients. Not to mention transition kids to a new school, leave behind the book group I enjoy so much, move away from my parents who have been such a help as I balance personal interests and the need for child care. Ack. Too much to consider now.

I know the glass can be "half full." But I think I have a few stages of grief to navagate first.

Thursday, December 08, 2005

Back in the Saddle (but not the Stirrups)

I'm rejoining you individuals with the intestinal fortitude and general strength to operate a computer. For the past 3 days I have been recouperating from a particularly nasty bout of food poisoning or stomach virus. 'Nuff said, right?

It was a good reminder of my motivation for wanting my spouse to get sterilized: the prospect of ever having to deal with hyperemesis again.

Right now I'm triaging some 500 work-related e-mails and catching up on my fundraising work for the Center so blogging may be a bit sporadic.

But I'm BACK. Back in the saddle again.