Monday, April 29, 2013

Doula Myths...and the Reality

Oh, those urban doula myths...they just keep circulating...

Myth #1: 
I'm always fully booked. 
The reality: I usually have openings! Many clients call as soon as they're pregnant, but, it's never too early nor too late to call. Sometimes, clients birth early (or move away), making room for a last-minute client. So, please email or phone me and we can have a good chat!

Myth #2:
I work with 7-10 clients per month. 
The reality: Eek! I'm a busy doula, but not because I work with that many clients.  I actually book an average of 4 clients per month (to a maximum 50 births a year). That way, I am able to attend 98% of my client's births each year, and rarely need a back-up doula. (In fact, my last missed birth was in September 2011, when I was in Europe.)

Why the myths might have started:
Myth #1: Yes, I am often fully booked within a month or two of a due date, so please call early.
Myth #2: Yes, there are some rare months when I might attend six births. Earlier this year, one baby was born at 32 weeks, one at 38, one at 40, and another at 42 weeks - all in a 6 day period. Then two more babies came the very next week. Nature has a wry sense of humour. My "4 births a month" can be theoretical at times.

Deeper into the reality:
So, with just four booked clients a month, I often do short "tea visits" before a client books me. Then I make two prenatal visits with each family in their home...and I might squeeze in an extra visit if a client would benefit from the extra care in the final anxious weeks.  I also allow lots of time for postpartum visits, and any extra breastfeeding help that might be needed. Yes, I often have to reschedule some visits so I can attend a birth, but that's the way birth works. It's random. It's unexpected. It's also amazing.

Going slow:
Because I walk, cycle, or car2go to client visits in a small catchment area, there's a natural slow pace to each day. Today, my first prenatal visit was at 9am, but I was able to chat with another postpartum client on the phone as I walked over.  Then I walked to Matchstick to warm up before my second "repeat client" visit, while answering new client emails. Later, I talked with some postpartum clients before popping over to see another family for their first prenatal visit. All told, I had three client visits today, and connected with another 11 clients.

Yours forever:
11 client chats in a day? That's right. I always tell my clients that "I'm yours forever", so I do spend time each day connecting with former clients, answering their questions, brainstorming, and talking about breastfeeding, parenting, sleep!, growth spurts, baby-led weaning, and more sleep! It keeps me current, connected. And I hope each client comes away feeling uplifted, confident that she can trust her instincts and her baby.

Slow and Simple Parenting:
I keep current with "the boys," my twin grandsons. I'm with them on Wednesdays...and as much as I can between client visits.

So, please don't hesitate - give me a call. If I don't pick up right away, I might just be slowly riding my bike to a client visit. Or I might be bike riding to Jericho Beach with the boys. Yes, I'm a busy doula. But be assured, I'll call you as soon as I pull over!

Saturday, April 27, 2013

The Possible Effect of Yaletown Condo Living on Labour Length

Pssst. I think I have discovered a secret formula for birth. I know, I know, every labour is unique and distinct, and you just can't apply a formula to birth. But, this has worked so many times recently that it's blogworthy. Here's the secret:
  1. Take one new condo with a view of the water (False Creek, especially).
  2. Add one spacious and powerful shower.
  3. Add one first-time labouring woman whose contractions have just dipped under the 5 minute mark.
  4. Take one doula who says, "I will sit silently on the floor outside this door so you can labour undisturbed. I hope you will be able to stay in the shower for at least 45 minutes. I won't disturb you, but I will respond to you if you express a feeling or a need or ask me a question. But remember these words. Trust your body. Trust your baby. You are strong. You are spiraling your baby down, down and through. You are open, wide open."
  5. Take one partner who says, "I will make sure everything is ready for you when you need to come out of the shower. I will put towels in the dryer for you, and place the clothes you will need on our bed. I will not disturb you. I will be here when you need me. I trust you, I trust our baby, and I trust your body."
  6. Add filtered sunlight through a crack in the door.
  7. Add liquids and food within easy reach.
  8. Add the sounds of an iTunes playlist created by the woman, her partner, or loved ones.
  9. Gradually, add the apparent dissolution of time and space.
  10. Add one fast elevator and a short drive to the hospital (or the arrival of two midwives at home)...and the addition of a baby soon after with very little (okay...maybe a little) drama.
Okay...there's more to Step 10, but you get the idea.

I've just had such luck lately with condo labours, with unlimited showers, beautiful views of the water, no disturbance, a fast elevator ride, and a short drive to the hospital (if planned) with few stop lights. And, recently, one woman never made it out of the quiet dark space, and gave birth on her bathroom floor (yes, her midwife was there).

Am I just in the middle of a statistical blip that balances the challenging births, or am I onto something here?

I pulled the info from my database, and was truly surprised to discover the high percentage of women living in the tall condos around False Creek (think Yaletown, Crosstown, Fairview, Olympic Village, etc.) who have had relatively short labours requiring limited technology or assistance. Okay, I'm not just imagining things. But why are these labours going so well???

Perhaps, it's the women who live in condos in Vancouver? Okay...I'll give you that one.

Perhaps, it's the unlimited hot water.  I have had similar experiences with women who have laboured at home in tiny basement suites with flash hot water heaters. But, it's rare to have a flash heater in a single family dwelling in Vancouver.

Perhaps, it's the speedy elevators. One study linked a fast elevator ride with a reduction in cesareans (strangely, the working theory was the elevator ride to the OR somehow repositioned the baby, resulting in the cancellation of the surgery).

Perhaps, it's the ability of these women to remain undisturbed high up in a concrete condo. No one knocks unannounced if you live on the 23rd floor. There are no mail carriers tromping up your stairs. No garbage trucks barreling down the lane. No neighbours to worry about. We know that disturbance can slow down a labour (we've seen the effects of jackhammers in the hospital during renovations and a labour speeding up after the roofers go home for the day).

Perhaps, the answer is as simple as one word. Many women have said the word "spiraling" had a huge impact on their labour. "I saw myself as being calm, zen, quiet, in the middle of a storm, and the baby was spinning, spiraling down to earth. I released everything, and the baby starting pushing his way out!"  Aha! Ina May Gaskin's sphincter law in action.

Or it could be that one special song that her partner added to the playlist.

Or it could be his, "I trust you," that made all the difference.

So...I guess I have to retract my announcement of a secret formula. There are so many combinations of things that can add up to a smooth and short labour. Each labour takes as long as it needs. Each baby takes as long as it needs. Each woman takes as long as she needs. You aren't at a disadvantage if you don't live in a condo with unlimited hot water. There is a big world out there.  You can have lovely smooth labours in Dunbar and on The Drive, inside or outside, in birth pools or on dry land with slow dances and kisses and just one word. You can also have a challenging birth. That's just how it is sometimes.

I'm sorry that I took you on lighthearted ride to look at our universal need to make sense of birth.  I doubt there's a secret formula involving Vancouver condos. But, if you remove all the noise and chatter from the labour equation, you might just find one word, one concept, interwoven throughout...

That one secret word might just be...


(Although, in an alternate universe, I would dearly love to know the results of a randomized controlled trial on "The Effect of Living in Yaletown Condos on the Length of Labour in Primiparous Women".)

Wednesday, April 17, 2013

A Lesson from Nardia

With maturity there comes

that there is darkness at birth

Walk with it. Respect it. Never forget it.

But do not make your choices
out of fear
of the darkness

Trust birth