Friday, July 29, 2005

Bountiful Beautiful Blissful

It's August, so I am leaving for a month in Scotland without my pager...what an amazing concept. Being on call 24/7 can take its toll. Think of those lucky ones who are due in September. They will receive a fully rejuvenated me! And I do hope I don't come home to find my backup was busy with everyone! Fingers crossed!

While I'm away, I hope each of you takes some time to browse the shelves at Banyen Books. My favorite book of 2005 is "Bountiful, Beautiful, Blissful", by Gurmukh. Don't be scared off by thinking it may be too flakey - it's not, and incorporates many of the words and concepts that I use when working with pregnant and labouring women (I even sang "Row, row, row your boat" to myself during my second labour in 1987). When I read Gurmukh's book I feel as if she and I know each other intimately, and have been using each other's phrases for years. So, have a good read!

- Jacquie Munro, Vancouver Doula

Tuesday, July 19, 2005

Jacquie Munro - Vancouver Doula

Doula - n. a Greek word referring to an experienced woman who helps other women. The word has now come to mean a woman experienced in childbirth who provides continuous physical, emotional, and information support to the mother and her family before, during, and after childbirth.

I help you to realize that you have the abilities, wisdom and courage to give birth. Birth is something that you know on a basic level. I just help you to access that knowledge.

My care includes:
  • 2 prenatal visits for teaching and planning
  • pre/post-natal telephone consultations
  • physical and emotional support during labour and birth at your home and/or hospital
  • written birth notes
  • 1 postpartum home or hospital visit (and unlimited postpartum phone calls!)

The Research
When a doula is present, it results in:
  • a 25% reduction in the length of labour
  • a greater than 50% drop in cesarean sections
  • a 60% drop in the mother's need for epidurals
  • a 30% reduction in the mother's need for other pain medications
  • a 40% reduction in the need for oxytocin and forceps
  • a higher incidence of breastfeeding success

Some investigators theorize that stress hormones cause the labour of many mothers to slow down, making complications more likely and the labour experience more stressful. By reducing the woman's (and her partner's) fear through calm reassuring words, touch, and relaxation techniques, the doula helps to moderate these reactions, ultimately lessening the need for medical interventions and shortening the labour.

How can I help?
As your doula, I am the person who helps you to understand the rhythm of labour and birth, who comes to your house when your labour is beginning to intensify, who helps you to find comfort, and reduces your fears. I work with you and your partner, teaching you both to understand the wisdom and the logic of the body, so you can recognize and accept the changes in labour. I encourage you to move, to take showers, to get into just the right position for your baby. I can help with relaxation and massage, taking turns with your partner, so that he or she never becomes too tired. Whether the labour is straight-forward, or you encounter the unexpected, you should both feel empowered by your ability to make informed choices. The effects of a positive birth experience can immeasurably increase your self-esteem, and strengthen your relationship with your partner and baby.

To the Dads: I am your resource person during the birth. I can explain what is happening, what you can do to help, how you can effectively work with your other caregivers. One dad described me as a choreographer. You both do the dancing, I just help you to look good! Or you could see me as the best waiter you've ever had, always knowing intuitively what you want next, or when you both need privacy!

During your Pregnancy: I will meet with you both to discuss your hopes, dreams, and concerns. We will talk about your own best ways of coping with pain and fatigue and how you and your partner foresee working together, and with me. We will discuss roles, expectations, comfort measures, and the rhythm of labour. We will build on the information you received in your prenatal or yoga classes.

You can phone or email me at any time with your questions, or just to chat. I suggest that you call before or after each prenatal visit with your caregiver. Our contact will usually increase as your due date approaches. During the on-call period (two weeks prior to and after your due date), I am generally available 24 hours a day, 7 days a week. I will give you as much advance notice of times when I may be unavailable due to illness, birth conflicts or planned vacations. To cover those times, I call on other experienced doulas for back-up. You do have a choice about whether you use the back-up, or which doula you'd like.

I strongly encourage you to develop and maintain a trusting relationship with your physician or midwife. Discuss with your caregiver what you expect from her, and what you expect from me, your doula. This goes a long way toward creating a positive birth environment. I am happy to meet with your caregiver in person or over the phone at your request.

When you are in labour: I prefer that you call me as soon as you think you might be in labour. I can reassure you, answer your questions, and make suggestions over the phone. Together we will decide if I should come right away or wait for further changes. I usually need one hour to reach you. Depending on your labour, we may meet at your home or at the hospital. No matter what, we will remain in touch with your caregiver or hospital during early labour, for safety. Except for extraordinary circumstances, I (or my back-up) will remain with you throughout the labour and birth.

After the birth: I usually remain with you for one or two hours after the birth, until you are comfortable and your family is ready for quiet time together. I can also help with initial breastfeeding if you wish. I am available for phone consultations during the postpartum period to answer questions about the birth or your baby. I will visit you at home or hospital within the first 8 weeks to see how you are doing, to review the birth, and to give you the birth notes. If you think you might need help in the weeks after the birth, I can make a referral to a postpartum doula.

As a doula, I do not:
  • Perform clinical tasks such as blood pressure readings, fetal heart checks, and vaginal exams. Your physician, midwife, or nurse will provide that service.
  • Make decisions for you. However, I will help you get the information necessary to make informed decisions, and be your advocate.

Fees: My rates are available upon request. There is an initial non-refundable booking/prenatal visit fee due when you select me as your doula, plus a birth fee which is payable within two weeks of the birth.

Please Note: I will make every effort to be at your birth. If I am unable to attend your birth or provide back-up due to circumstances beyond our control (e.g. emergency cesarean, unforseen illness, etc), you will not be charged the birth fee. However, I will retain the booking/prenatal visit fee, which covers the cost of prenatal visit(s), phone calls, and handouts.

I look forward to working with you!

- Jacquie Munro

Every birth is an adventure.

No matter how many times a woman has given birth, she is setting out on a new experience.

I hope to support you during this life changing time, and help you to create a positive memory of your pregnancy, birth and postpartum experience.

Saturday, July 16, 2005

This is what it's all about

"Mi muchacha salvaje" My wild girl

Birth is something you know. Can you imagine arriving at the age of 30, and having your body throwing you an entirely new experience - something without a reference point? It’s just not that nasty.

Birthing is a lot like lovemaking...and Buddhist teachings, for that matter. It involves surrender, letting go, release, acceptance, and total trust. It also involves passion and power, which, for some, can be overwhelming. For others, it can be a process of awakening, change and growth.

Yes, birth is like lovemaking - and the majority of people would think there was a world of difference between birthing sounds and lovemaking sounds. But there isn’t - they are both an expression of intense creative power. The only problem is that I’m so used to birthing sounds that I only categorize groans and moans as birthing sounds. This can get me into trouble. Oh, dear!

So, there I was - on a walk with my husband last summer. The heat was so thick that it hummed. All doors and windows were open to the still air. Walking past a house, I heard the sounds of a moaning, panting woman, “Oh, GOD! Oh, GOD!”

“Bob...I’ve got to go help her!”

“Sweetie, no - She needs no help.” Why does he have that smile?

“No, Bob, you don't understand. She sounds like she’s about 5-6 centimetres. Maybe they’re worried they won’t get to the hospital in time!” I was so anxious, I was ready to knock on the door.

“No, dear, she’s fine - let’s keep walking.”

Then silence in the heat...



She wasn’t in labour.

Thanks to my husband for being so wonderfully understanding and accepting of my focus on birth (sigh!).

Birthing and lovemaking are psychosexual processes. Most women aren't fearful of lovemaking, though the experience can be overwhelming both physically and emotionally. There's a loss of self, a letting-go, a transformation of the perception of space and time, and the knife-edge of pleasure and pain. The sounds we make are deep and open. However, if consent is not given the experience leads to pain, anger and emotional damage. For birth to be as open as consentual lovemaking, there needs to be consent given by the woman to her body. She needs to consent and surrender to this powerful psychosexual process. She needs to trust her body.

Birthing is truly something that we are prepared for on a cellular level. But our twenty-first century brains fight for supremacy over the reptile brain within us. We try to label and time and impose a structure on this force which is all about fluidity and stillness of mind. Yes, there will be a struggle within the mind and body, but eventually there needs to be acceptance and a surrendering to the body’s knowledge and power. The length of that struggle is what determines how easily we birth.

Now, of course, this is assuming that all is well physically, and the baby hasn’t decided that today he is going to try to come feet first, or elbows above the head, or sucking both thumbs. Yes, there’s the wild card baby at play. It’s not just about the mother. We have to trust that the baby is an active player here, pressing and wiggling the head against the mother’s muscles...pushing his feet against the top of the uterus. And we must trust that the baby will wave a big red flag if there’s trouble. Trust, acceptance and surrender are involved here. The baby is wise.

So, how to prepare for this wild ride? Live in the moment, look into your love’s eyes, experience passion together, trust each other, walk on the beach together, make noise, dance, read, sleep, trust your body, laugh, let your mind be still. And know that you will come out the other side a family.

- Jacquie Munro, Vancouver Doula