Saturday, December 29, 2007

Birth Stories

So I recently read about the following workshop. Normally the idea of such a thing might make me roll my eyes, but today, it sounds good.

Expectant parents and babies aren’t the only ones who have powerful
experiences in the birth place. As doulas we are deeply affected by
the things we witness. Occasionally, it is time to examine our
experiences and seek resolution. Often what we really need is a safe
place, the opportunity to tell our story in a structured way and have
it be heard, really heard. We will use art exploration, facilitated
dialog and powerful ritual to promote self-awareness, stimulate
healing and celebrate ourselves as amazing women who lovingly and
bravely hold the space for others during a time of great power and
vulnerability. For more information about this workshop and other
Birth Story Workshops especially for home birth midwives and also for
women who have given birth:

I was never one for "art exploration," though truthfully, I can't say I have any experience. I have had a number of clients use the "birthing from within" philosophy which uses art as one of it's tools, but really, it all sounds a little hokey to me. I think the reason I like Lamaze is that I am much more pragmatic than hippy by nature. In any case, right now I think I could use some doula therapy.

Being a doula is a very emotionally taxing job. One of the reasons I do it is because I know the birth story matters. I know that how you experience your birth can frame much of your life and how you see yourself as a woman. Ask anyone who has had an unwanted cesarean and she will tell you how the event effected her concept of her own womanhood. The problem, at least for me lately, is that a number of the births I have attended are shaping how I see myself. I have been to at least two births this year where I felt helpless, unable to support the family in the way that they wanted, in one case, and in the way they needed, in the other one. One of them truly hurt me on the inside, deep in my core, and I am sure I have not began to process the events and my reactions to them.

Ask any doula and she will tell you how difficult a really long labor can be for her. We are not blessed with the hormones and endorphins that keep mom and dad going, but yet we have to be present in the face of exhaustion and fear. People count on us to be strong and steady. Sometimes it is easier than others.

I have doula-d stillbirths, failed VBACS, long labors ending in surgery, abusive relationships and a host of other wonderful and trying situations. But none so sad for me as when I worked so hard and left feeling unappreciated.

Tuesday, December 18, 2007

Birth at St. V's

I am still too tired and confused to have totally processed the very, very long birth I just attended, but I do have to give props to Dr. Sally Wentross and the many nurses at St. Vincents who handled an extremely difficult situation with grace and generosity. Often doulas are hesitant to work there as is can be a hostile environment but this was not the case today.

Friday, December 14, 2007

New "Section" For Men

December 14, 2007
For Immediate Release


Portland, OR- In a truly groundbreaking turn of events, the AMA has developed a procedure to save all the men of the world! No more discomfort, unnecessary pain....have a fecalectomy!

This exciting new medical development will rescue men from thousands of years of suffering. A simple incision in the intestine will make the concept of the "bowel movement" obsolete. No need to move anything! No more pushing! Your doctor can suction in out for you.

Long gone are the days of wondering "will today be the day?" "Will I be at work and have to go? What if I am in the middle of an important meeting? Do I have childcare?" Now you can schedule all of your pooping in advance! And best of all, you don't have to feel anything; after all, there is no glory in natural excretion. A simple epidural and it is all taken care of for you.

Risks include death, post-traumatic stress disorder, infection at the sight, greater need for re-hospitalization, blood loss and long hospital stays. Also, due to malpractice rates, you will be forbidden to sit on the toilet ever again without constant monitoring, and in some cases, never at all.

A Perfect Ten

I may not be perfect but these are the things that are perfect to me.

Hot, strong coffee in the early morning hours while my children are still snoring away.

The smell of Mrs. Meyers Lavender hand soap (or any other of her lavender products.)

The feeling of crossing the finish line, no matter how long it took.

My husband nicknaming me "almost," him being totally right, and both of us being able to laugh at me. I'll finish something I start soon, I swear...

My daughter Violet, who at 4 1/2 has the most amazing memory and is clearly one of the smartest people I know. You cannot fool this one. She has ruined my ability to sneak clothing purchases past my husband, as every time I wear something new she'll say, " That's a nice new sweater, mommy. When did you get it?"

My daughter Edie, almost 3 and still goofy and sweet as ever. Before she turned 2 she made up her own dance entitled "Wiggle Your Body as Fast as You Can. And Turn. And Turn."

The truffle pizza at Apizza Scholls. I ate it once many months ago and can still conger up the taste and smell. Yum. Let's go. Now. Yes, I know it's 5am.

A brand new baby with a perfect latch. One of natures true wondrous miracles. Form, function, beauty, love, all rolled into one.

Climbing into my big, comfy bed after a long exhausting birth, knowing I did good and happy to be home.

Knowing, deep, deep knowing that you love and are loved in the most perfect way possible.

Thursday, December 13, 2007

I Know Where I Am...But Where Am I Going?

So you know you are doing a good thing when an old client calls you and asks to meet up for a few minutes just to give you a hug.

This woman didn't have the greatest birth imaginable in terms of outcome. However, she was well supported by her OB, her husband and me, her doula, and I know that made all the difference for her. I talk about this all the time with expectant mamas. It's not only what happens but how it happens. If you are an active participant, if your voice is heard, if you really, truly understand informed consent, then I guarantee you will walk away feeling proud.

I have been toiling/toying for the last few months with the idea of going back to school, yet again. And yes, I realize I am in many, many thousands of dollars in debt from by undergrad and my almost-finished-but-not-quite MA in English Literature. Please do not rub it in. Sallie Mae and my mother do a fine enough job, thank you. I have been looking into Berkley, among other places, for the Masters in Public Health (MPH) program with a focus on Maternal-child health. The main obstacle is: will there be a job on the other side? I want to be able to work to create change that will positively impact the state of childbirth in America. The people with money are on the other side of the coin. So unless I want to fund raise and create my own foundation, I am not sure if it is worth it. I have been really wanting to get involved on more of an activist level, but I am not really sure what the next step is. I see myself as having the capacity to be a public voice for childbirthing rights. I am just not sure how to get there.

In the meantime, I will just continue on, supporting women and families and promoting normal birth wherever and whenever I can.

Friday, November 30, 2007

Life and Death

After a busy November ushering babies into the world, I bid farewell to a family member. My uncle, Jack Wieder, died unexpectedly on Sunday after a life that was too short, too hard and too lonely. He was 54.

The world was not against my uncle but he thought it was. In the end, what you believe to be true is your truth.

He is survived my his mother, Celia, his sisters Leona and Sandy and brother-in law Michael, and his wife of three years, Kathy. If the depth of her grief was a measure of her love for Jack, he was very well loved indeed. He was preceded in death by his father, Soloman Wieder in 2005, whom he lived for but could never live up to.

Jack was troubled but bright, always wanting to do good by his family and the world. I learned alot about him at his funeral. I am sorry it didn't happen when I could tell him how much I respected him.

Sunday, November 18, 2007

Why isn't sheepskin waterproof?

I mean really, do sheep stain if gotten wet?

Wednesday, November 14, 2007

Reasons to Have a Home Birth

1. No unnecessary fetal monitoring that leads to unnecessary pitocin that leads to unnecessary instruments pulling your baby from your body.

2. You will never be coerced into having a speculum exam to prove your water actually broke, even though fluid has been pouring out of your body for 6 hours.

3. You will not contract a staph infection at home, nor will you be told your baby has meningitis by mistake because of a "contaminated draw."

4. Your doctor or midwife won't be able to convince you that they need to manually stretch out your vagina because home birth midwives know they don't need to.

5. You will feel safer and you will be right.

6. You will not be woken up every two hours for various ridiculous reasons.

7. You will be able to eat and drink in labor.

8. You will be treated as if you are walking through a rite of passage, not as if you have a potentially life threatening disease.

9. No one will ever say to you "aren't you ready for that epidural yet?"

You should not need to have a home birth to have your rights as a laboring women upheld. But sometimes, you do.

Sunday, November 11, 2007

Two for the road

After a 5 month lapse (I cannot believe that it really was that long) I attended 2 births in 48 hours. One was amazing, the other frustrating though ultimately positive, both keen reminders of why I do what I do.

I am way too tired to say another word.

Wednesday, November 7, 2007

What I don't know

It's been really hard for me to write because it's been a really hard time for me professionally. I used to think of myself as really impartial, a doula who could happily support any woman's birth choices regardless of whether that is what I would choose. I am finding that harder and harder to do. In my years of doing this work I have maintained an 85% hire rate; most of the families I met with hired me. Lately it's been more like 50%. I don't think it's because there are so many great doulas to choose from, though that is definitely true. I think I am having a harder and harder time presenting myself as neutral. I don't think it doesn't really matter what happens in your birth as long as everyone is healthy. I know that many other things matter. I know that an empowering birth is an opportunity of a lifetime, an experience that gives a woman confidence for all of her future undertakings. I don't think that when a woman in labor enters the hospital her chances of having a normal birth are good. I know that 35% of the time the baby will be surgically removed, and if that doesn't happen, she will likely have a host of plugs and cords and devices attached to her that even if she still manages to eke out a "natural" birth, she will never really know what a normal birth is.

More and more as I try to envision what my place is in this life, I think I have to be an advocate for normal birth. I am not sure where that starts. I used to think it started with my doula clients, but now I am not so sure.

Tuesday, August 14, 2007

"I'll take Potpurri for $200, Alex."

A few unrelated thoughts.

Taking the advice of a good doula friend, when I got my tattoo I totally "doulad" myself through the whole thing. It was very Penny Simkin-esque. I was awash in rhythm, ritual and to whatever extent I could, rocking. It was very interesting, actually. I was tapping my foot the whole time to the beat of my breath, in two three four, out two three four. I was a big foot tapper in my births as well. When I do prenatals with my clients we always talk about reactions to stress and coping mechanisms. I guess however you are in life is how you are in birth. Or vise versa.

I need a life doula for tomorrow. I have a root canal. Childbirth, no problem. Dental work, whole different ball game.

I have met with some really amazing women lately. I always feel so honored when I get hired, so grateful to be able to share in this amazing time in a family's life.

Listen to WFUV online, Fordam U's really cool radio station.

Wednesday, August 8, 2007

Welcome Back, Crazy Person

The problem with taking the summer off from work is that it's really hard to get back into the swing of things. Just last night I booked two appointments at the same time because I have fallen back into my old traps of deep, debilitating disorganization. For me to stay on top of my universe I have to force myself to write everything down (not on random bank receipts and gum wrappers) so I can keep it all together. It's not natural to me, but it's necessary for survival.

Earlier today I was tagged, which I don't really understand but apparently it's blogger speak for "you must do this."

Here goes.

The Rules:

1. We have to post these rules before we give you the facts.

2. Players start with eight random facts/habits about themselves.

3. People who are tagged write their own blog post about their eight things and include these rules.

4. At the end of your blog, you need to choose eight people to get tagged and list their names. Don’t forget to leave them a comment telling them they’re tagged and that they should read your blog.

Here are some things.

1. I never step on the grates on the sidewalk. Total unexplainable phobia.

2. If given the opportunity (and a dark closet) I will crush Chips Ahoy cookies atop a bowl of Cheerios and soy milk.

3. I always eat some form of chocolate at a birth. Sometimes three forms.

4. Our second daughter was almost named Beasley and I am VERY GLAD SHE WASN'T.

5. My name is spelled Randi on my birth certificate. I added the "e" on the end in 7th grade. That's odd, isn't it? Aside from my family, there are probably only 3 people in my life who knew that before now.

6. As soon as I found out I was pregnant with my second, I went to see the midwife I had with my first. During the visit she told me she was no longer catching babies. I was so crushed; I cried on and off for days. As it turns out, it was the best thing that ever happened to me. I was carrying so much baggage from my first labor around with me that I believe I would not have had a successful home birth if the cast of characters was the same the second time around.

7. When I was in high school I had a friend down the street who lived with her grandmother. We used to smoke cigarettes out her bedroom window. One time we dropped one, but her grandmother was downstairs so we didn't think we could go get it. We attached a wad of chewing gum to a shoe, tied many shoelaces together and successfully hoisted it up to safety.

8. Aside from my youngest sister, I have the worst sense of direction on earth.

KW, KR, EV, JH...consider yourself tagged.

Friday, June 29, 2007

My Doula, My friend?

Oh my god, I have been so out of all birth loops. When I get stressed, I get crazy. But when I turn it off, i am really off. I scheduled the latter half of June and the first half of July off so I could go on vacation (what a concept!) and visit with my brother and his family when they roll into town.

It's nice to have time off to think about the last year, the births I've seen, how I might do things differently in the future. I don't know how many women and men I interviewed with exactly this year, but I know I only did not get hired twice. Both times it was the exact same situation: immediate connection between mom and me. Similar personality, sense of humor, approach to life. Feeling that we were meant to be friends.

Women do not want to hire their best friend to be their doula. The want someone to fill the space of the person they are not, to calm them when they need calming and to rev them up when the energy feels like it is dwindling. Why would they hire someone just like themselves? It makes me think that if I sense that happening in an interview in the future, i will need to navigate the conversation to a more warm, professional place. At least I will be aware of it, I suppose.

In a move in stark opposition to natural birth and all it encompasses, I will be in Las Vegas next week, sinning up a storm:)

Saturday, June 9, 2007

The Sherpa

I know a lot about a lot of things, but mountain climbing is not one of them. So when a client and her husband revealed to me that they were secretly refering to me as "the sherpa," I had no idea that it was a really great compliment! Of course, he was not saying it to be nice, he just couldn't remember the word doula:)

I can only assume (read:hope) I am not the only one who thought a sherpa was a fleece-lined coat or blanket. Then I realize it's a mountain guide, and I think, how freaking perfect! I always compare labor to running the marathon, because I have done that so I understand the challenge, both physical and mental. But I have never climbed the Himalayas, thank God, so I really didn't make the immediate connection. If you have never climbed a mountain, it'd be a great idea to have a guide to lead you through the process. Heck, it'd probably be a necessity. The sherpas help you pace yourself, drink enough water, keep you focused, remind you to keep your body in the right positions and keep your mind positive.

That is exactly what we as doulas do. We can't do the work of labor for you, but we can help make it easier and more positive. Doulas guide women (and their partners) through a challenging yet ultimately rewarding time. The best compliment I can get is not that someone feels they couldn't have done it without me, but that they wouldn't have wanted to.

Thursday, June 7, 2007

The Blahs and the Aahs

I haven't written anything lately because I haven't known what to say. As much as I love what I do, overall I have been feeling pretty jaded lately. I was on the phone with my mother the other day ranting about the state of birth in our country, how it is nearly impossible to have a normal birth with all the routine interventions, but mostly in the culture of fear and weakness surrounding childbirth in the United States. When I realized I was ranting like a lunatic and that instead of listening to me she was thinking about what to make for dinner, it occurred to me that I am in desperate need of a vacation.

I define myself largely by what I do, and if I don't feel good about that, I don't feel good about me.

My clients rely on me to be a positive force. My job is to protect their birth space from all negative energy, to make them feel like they are doing the best job they can with the tools they were given and the hand they were dealt. It's hard to do that when you are feeling shitty. Luckily I scheduled myself off for the month of June so I can get a little time to reassess.

By the way, in the midst of all this funk, I saw something really beautiful last week. This mom had an ordeal of a labor that ended in surgery. She had been awake forever and was feeling pretty poor overall. But when they put that baby in her arms, it was a miracle in the making. Everything else faded away and what was left was two new people, in love at first sight, being perfect together. In all the births I have seen, this was the most immediate, instinctual, natural mothering. Her birth may not have been perfect but her connection with her baby definitely was. Welcome to your world, D.

Tuesday, May 29, 2007

A Sea of C's

For the 4th time in 3+ years, one of my clients ended up in the operating room.

I have supported clients before where I felt like they got steamrolled into a cesarean. Earlier this year I watched as a doctor (with all of his students watching) told a woman (primip, after 1 hour of pushing) that she could push some more if she wanted to, but she was going to end up in surgery so they might as well cut their losses. It was going to be a really big baby, after all.

It was 7lbs, 9 oz.

This was not like that.
This mom was an awesome laborer. She was totally able to get into the zone, that one that is so hard to describe but we all know it when we see it. She tuned out the world, tuned into her body and her baby. But in the end, her baby was in a bad position and she did not want to move. When the time came to call it quits, everyone in the room (and there were alot of us) felt good about the decision, including mom.

I cannot say enough about her midwife, Kathleen and her group, Pacific Midwifery. They are the only midwifery group completely staffed by CNMs in the area that do hospital births. And after what was no doubt an enormous amount of work, Legacy Salmon Creek is now the only facility in SW Washington doing water birth.

This, my friends, needs to be the wave of the future. Respectful, passionate, informed childbirth that takes place wherever you are comfortable. Although I believe strongly in home birth, I also feel women should be able to birth their babies in a hospital without fear. And although this birth ended in cesarean section, countless others in Kathleen's care have had normal, natural births without routine intervention. All women deserve that.

In 1965 4.5% of births were via c-section. In 2005 30.2% were. We cannot allow this trend to continue. The World Health Organization recommends a rate no higher than 15%. To find out what's being done and what you can do, visit

On a personal note, my wonderful doula who tended to my every need at the birth of my second daughter, is moving back east. Her compassion, support, humor and sisterhood will be missed by many, including myself. Everyone should be lucky enough to have a doula like her.

Thursday, May 24, 2007

Hold Please...

The hardest part of a doula's life is not the work. It's the waiting for the work. Not waiting to get clients (though that used to be a concern) but waiting for the clients to have their babies. When I am on call, which is probably about 75% of the year, I am constantly thinking about Plan B. Who will pick Violet up from school, do we have a spare car seat in the car, did I take a shower, who will watch the kids if my husband is at a game and cannot be reached, can I have a glass of wine get the picture. When I am on call I plan the morning out before I go to sleep and then do it all over again in the morning when I wake up still in my bed, birth bag still in the closet.

It's very stressful.

Right now I have one client who is a week past her due date, and one due tomorrow. Tomorrow is Violet's last day of preschool, tomorrow night a wedding, Saturday a bartending shift and Sunday a barbecue? How many of these things will I miss?

Here is a perfect example: My phone just rang. Client A called, due tomorrow. Her water just broke, the midwives told her to go to sleep and wait for some contractions (I love midwives!). But...Client B called earlier, already plenty dilated, 41+ weeks, went to have an acupressure massage tonight. What happens if they both go? I have my back-up on standby, but after many months of getting to know these woman and their partners, I would feel AWFUL if I had to miss either of their births. I know it happens, but I really didn't want it to happen to me.

See what I mean? It's very stressful.

Monday, May 21, 2007

To Dream The Impossible Dream

Last night I dreamt I cursed out an anesthesiologist.

In my dream he was saying he didn't understand why any woman would want to deliver vaginally when it is sooooo much easier to have a surgical birth. I could not restrain myself, and I asked him if he ever tried to recover from abdominal surgery and breastfeed a baby. He replied with "And another thing, why would anyone breastfeed anyway. We have formula, why not use it?"

This was only a dream.

For starters, I would never have an altercation in a hospital, especially in front of a client. It's always important to maintain the birth space for a laboring mama. She needs her support people to protect her from any stress, to make her feel like the universe is aligned and that wherever she is birthing her baby is the perfect place to be. There is no room for egos in a birthing room.
In addition, one of my colleagues and I are always talking about building bridges. Even though doulas are beginning to become more and more mainstream, there are still misconceptions about us floating around the obstetrical world. Every time I interact with medical professionals I consider it an opportunity to represent not just myself, but every doula everywhere. OB's are busy people. They may not remember me personally, but I hope they will remember that respectful doula who acted with sincerity and compassion without being combative.

I am more peacenik than weathermen.

Now of course the sad reality is that there are many people floating around out there that don't see the value in the things I value most. All but one of the Portland-area hospitals sends moms home with free* formula samples. There are many doctors out there that are doing elective cesarean section, even if it goes against WHO and many other guidelines. But every time we are our there in the world, nursing our babies, talking about normal birth, we make one step forward.
We need not dream, we need do.

*Free, meaning without monetary cost, not without consequence.

Friday, May 18, 2007

Childbirth and the Magic Pebble

What is it about east-coasters that make us find one another wherever we are?

Two weeks ago I took this childbirth educator workshop up at OHSU in Portland. One of the trainers is originally from New Jersey, which is really Brooklyn only with more malls and trees. Wouldn't you know it, we hit it off right away. I ended up missing a day of the training because I was at a birth, so this trainer graciously offered to give me a private class to fill me in on all that I missed.

What I walked away from the meeting with is this: I should probably teach in a hospital.

I always envisioned myself teaching out of my house, and truthfully, I probably will. But that's not where my greatest impact can or will be. Most of the people who would take my out-of-hospital class will probably have out-of-hospital births, which means that many of the things about intervention and so on will most likely not apply. The majority of women in the united states are having their babies in hospitals. They deserve a great education by great teachers who are passionate about birth. Educators who believe in their hearts and bodies that birth is normal. Educators that know that women were designed to birth their babies and that they innately possess the knowledge and power to do so.

Do I wish that more babies in the US were delivered by midwives? Absolutely.
Do I think home birth is a safe, wonderful option and should be more widely accepted by the medical community? You betcha.

But like with any other social change, the scales tip one pebble at a time. If I can impact one woman by equipping her with the tools she needs to have a safe, powerful, ecstatic birth, no matter where it will take place, it's a good day.

Thursday, May 17, 2007

What happens if people realize I'm not perfect?

A few weeks ago I sent an email to an old client I had been trying to get in touch with. She had a really amazing birth- one of those that make doulas feel like they really make a difference. The mom and her husband were both overjoyed and extraordinarily grateful, and I went home with a smile on my face.

Four days later my father-in-law died of cancer.

Him and I were particularly close, and his passing fell on me like a ton of bricks. He was living with our family for the last part of his life, so everywhere I turned was a reminder of his life and death. I was in no shape to counsel anyone, least of all someone in the most exciting time of their life.

When I talked to the dad a couple of days after the birth, he mentioned that mom was having some nipple pain with breastfeeding. Since I was not up to a visit, I asked a Lactation Consultant friend to do a postpartum home visit for me so this family did not get deserted in this sacred time. She did, and they were thankful for the support.

A few weeks later I finally called this family. I left a few messages, sent a few emails. Mom had her own familial illness in California to contend with, so after a number of tries with little response, I let it go, assuming that was what they wanted.

When I heard back from this mom recently, she told be she felt dissapointed by my level of care after the birth of their baby. That I had not been there in the way they imagined.
I was totally shocked, extremely upset, and realistically, a little ego shattered. That's the first time anyone ever gave me that feedback, and it especially stung since I genuinely like this couple and thought we had a great experience together.

After much time spent mulling this over, I realize that how I feel or what I think I did or did not do does not matter at all. Who is right is immaterial. A new mom felt abandoned, one that was in my care, and regardless of what happened, I have to respect that feeling. Not because it's right, just because she feels it. New moms need support, love, attention and protection. As labor doulas we need to make sure that after the birth, even if it is not in our scope of practice, that these moms are getting the care they need. As hard as it sometimes is, people hire us to put ourselves aside and be fully present in our clients' lives. She needed me, and although she didn't tell me verbally, had I been there physically I probably would've known.