Vancouver or Bust!

One of my recent clients is a doula from Fort McMurray. She drove all the way to Vancouver to have her baby. I was honoured that she asked me to support her and her partner (and sister) through her labour. With her permission, I'd like to share a part of her email that she sent me after she had driven all the way home with the new baby (only a few days after the birth!)

"I really wanted to email you and say thank you once again for a terrific job and your incredible support. I drove to Vancouver with hopes for an amazing birth, and I couldn't have imagined it being any better, even though it was longer than I anticipated! I wrote down my birth story as you suggested, and literally just finished reading your notes. Like you said, it's so funny what a different perception you have when in labor. I love the quotes you wrote down, and I honestly thought you had arrived at my sister's place at 4am, not 4:45! You make the birth sound like it happened a heck of a lot faster than what I remember it feeling to be. What an incredible experience! Thank you for making it be so.

I can't remember if I explained this to you or not but bear with me if I already have. There are three things that you did which were crucial to my needing encouragement to carry forward. The first was the 2:30am phone call I made to you where I said I was considering going to the hospital to walk or have my waters broken and you said, "No, you're not. Go to sleep and let your baby and your body do what they need to do." I had read a birth story before driving out to BC, and this women spoke of a laboring tradition in Africa where a laboring Mom is guided to a log by village women who have not yet had children. This woman crosses the log by herself with no help and is welcomed on the other side by all the women who have children. At my sister's apartment I ventured out onto the log and at 2:30am I got stuck there. Your voice at 2:30am showed me the way across that log on my own again and you greeted me on the other side. It was amazing.

Secondly, was your word of "Safe". In my own time, mostly during a warm shower at home, I would envision myself in labor and I found myself singing a mantra of "It's okay, I'm safe here." I never explained this to you beforehand and you using that word during my contractions at the hospital renders me speechless at how effective it was in guiding me. My husband asked later if this was a word that you and I had chosen together and I said, "Not at all. She just knew."

Lastly, when it came time to get onto the bed and my contractions were extremely intense, you held onto my thighs firmly, almost as counterpressure, and it was incredible how more in control I felt during my contractions when you did this. It is definitely a tool I will carry forward when I begin doula work again. I know the hip squeeze is a welcomed favorite among my clients, but just that security of the firm hold you placed on my upper thighs was incredible. Truly.

So, thank you again so much for all that you have both helped with and taught me about. My gratitude for the opportunity to work with you goes beyond words, and should I choose to have a fourth baby in Vancouver, I sure hope I can work with you again."

...And I thank HER for letting me be a witness to her power on that day!

- Jacquie Munro, Vancouver Doula

Le Premier Cri

Don't you love Paris? There, in the Opera Metro station is an ad for an amazing birth movie. Would you ever see that here? A birth movie in full theatrical release?

However you can view Le Premier Cri, find it, view it (I googled and found the complete movie in a free download...search hard!) Yes, it's in French, but please forget all the French that you know, and listen to the birth sounds, the music, not the words of the narrators.

The cinematography is breathtaking, the births are achingly beautiful. I found myself laughing out loud in joy at the woman in Mexico being carried to her car in a blanket and transported to the seashore just after giving birth. I wanted to be the woman moving beautifully through the South American jungle to the river - stripes on her belly. There is truth in this movie.

Find this movie - the search will be worth it...

(Note: I've been getting emails from people who can't find the movie...ask a teen...honestly...they'll have it for you before the end of the day...as long as it's legal in your area.)

Peasant Feet

I usually get at least one or two phone calls a day from clients upset about the pregnancy comments and “war stories” that other women feel the need to share.

“I don’t want to hear it any more!” said a woman to me this morning.

Another client said she was literally trapped by a cousin at a family gathering...wedged in at the back of a table, locked in between a great-aunt and the story-telling cousin. “The baby’s head was SO BIG that they had to...(insert whatever horror story ending you like here).”

These comments, so freely given, can stick with you, and really hurt. Or they can turn what was a carefree pregnancy into a time of anxiety.

“Wow, you’re big!” or “Boy, you look small for your dates!” or “Make sure you get an epidural in the parking lot!” or “I’m just going to book a cesarean next time! You should, too!”

The endless combinations of horror stories and thoughtless comments are awe inspiring.

In our phone calls, I usually remind my client that it’s perfectly acceptable to say you’d rather not hear the stories...or just stick your fingers in your ears and go “LA LA LA LA!”
Protect yourself from these stories - using whatever means available!

Now, I’m not pregnant, but I was given a taste of how my clients feel just the other day. I was feeling pretty good. It was the long weekend, I’d been to a lovely birth overnight, I’d slept well, and knew that no babies would arrive on that day. As a treat I thought - I’ll look for some new sandals (I’m usually a no-nonsense “get in and get out” kind of shopper). I sat down with an array of pretty sandals to try on.

“What size?” asked the clerk. “Ten,” I answered.

She came back with a pile of boxes...then looked down at my feet. “Oh!” she exclaimed, “I should have had a look at your feet first! You have PEASANT FEET! Just like me! You won’t like those...you need something much, much wider.”

Then she proceeded to go to the back, returning with a clunky (ugly!) pair of servicable fish-net runners. Ugh! “Those are better for you.”

*sigh*

So, okay, people. Here’s a plea. Keep your comments to yourself. We’re happy to live in our own little worlds, with our own (perhaps misguided) ideas about our own bodies, our babies, our lives...whether we’re pregnant or not. We don’t need to hear your war stories, your “birth as rape” or “birth as prison” stories...or even how teenagers are going to ruin our lives. A positive outlook really doesn’t hurt anyone. I choose to think positively!

Personally, I like the fingers in the ears, “LA LA LA LA” approach. Now, I’m just going to shove my peasant feet into some nice flip flops...or, better yet, go barefoot to visit my next client.

- Jacquie Munro, Vancouver Doula

An Undisturbed Birth

I've been talking a lot about "an undisturbed birth" lately.

The language that we use in labour is so potent. I'm uncomfortable with many descriptive terms surrounding birth, such as "I'd like a normal birth"...or "She had a natural birth" ...or "We did a pure birth." It sounds like all others are abnormal or unnatural or impure. Birth just should be.

So, it came to me, recently, when I realized that so many of my clients have what I describe as "she just went into labour and then had the baby" births...they had all been undisturbed in labour. My role is to keep her private space protected and undisturbed, to help her feel free to move undisturbed, to be the guardian of her cave. She remains hidden, unobserved, in a safe space.

Even if I'm with her, I cast my eyes down in respect, until I am addressed. Often, I am just a hand, or a whisper, or even a silent presence beyond the curtain. Her partner sits still, a great gift, close by.

The photo shows it all. She is safe, alone in the shower. Her partner, and I, and her midwife, watch the rippling reflections on the floor, listen to the rhythmic pulsing of the shower, become transported, lost in time.

Our job is to help her remain undisturbed.

But...Oh, no! Here's the night nurse, who I usually adore. But she walks in at 7pm, saying loudly..."Och, it's HOT in here!" We all put our fingers to our lips...hope the woman dancing in the water doesn't hear... Later, the woman says her body tensed up at that moment, and she thought, "Oh, no, she's loud and Scottish!" and it took a while for her to get back into her undisturbed rhythm (and she later came to love the accent).

An undisturbed birth is a challenge to achieve, but its effects are immeasurable.

- Jacquie Munro, Vancouver Doula

Do you need a doula? (or...I am your Sherpa)

I was debriefing with a second-time client yesterday. She wanted to tell me how important it was that I was by her side at her second birth. “This time, lots of people said I didn’t need a doula - that you’re not a midwife...that the doctors and nurses would be there to help me. But I knew that you’d be there just for me - and I trust you. I knew you were there in my corner - always.”

Her husband thanked me for being there again - for helping to create such a positive experience. He put it all down to what he calls “the Jacquie magic”...the fact that everyone in the hospital treated them differently because they were with me.

It’s sad, but true. The hospital staff do treat patients differently depending on their caregivers. They’re human - they have their favourite doctors, nurses, and doulas. I really would love a world where everyone walking through hospital doors was treated equally. But, right now, it doesn’t happen...so if I can do anything to make my clients feel more autonomous, more respected...then I will. Petty “wars” can be waged between overworked and under-respected staff, and I do everything in my power to prevent my clients from being a witness to negative behaviour. Preventative magic helps.

It all starts prenatally. We cover every possible scenario in our talks over the phone, in person, via email. We discuss the woman’s hopes and fears, interspersed with stories of her life. We talk about how the couple works together, what their strengths and weaknesses are, how they face challenges separately and as a couple...even how they’d react if they were bumped from an important overseas flight. We discuss family dynamics, setting boundaries, postpartum planning. The prenatal preparation isn’t about following a prescribed path - its about finding how each woman’s life experience has uniquely prepared her for this particular birth. Whether she needs to do soprano vocal exercises in labour, or relive that amazing underwater night dive in Fiji, conquer the West Coast Trail’s ladders once again, or run the Paris marathon with each breath during labour - we will uncover her own history that will carry her through to birth. My job is to protect her from outside disturbance without her ever noticing (it’s kind of like trying to be the best server possible).

Luckily, since most clients are referred to me by their caregiver (and others), I know that there is a web of security and trust between us all. I may have known a woman’s midwife for 15 years (from the wonderful “community midwife” days)...or have been the family doctor’s own doula...or have known the doctor-on-call with the extremely dry wit (who my client has never even heard of) for 20 years. I know their style, their particular sense of humour, how they react when they’re tired, how they react when they’re sad, and most especially, how we can all work in concert to provide the very best care for my client. We often know each other well enough that very few words need to be spoken. This helps the woman to stay in her birth trance, without interference or complication.

At home in labour, after the client has spoken to the caregiver, I can offer additional information. The other night, in between contractions, I only had time to say...”Hi! Second baby, just vomited, some bloody show, some pressure, we’re coming in. Oh, and she’s GBS positive but doesn’t want antibiotics.” “Fine,” said the doctor, because he knew he could trust me that this baby was coming fast. I called the hospital and spoke with the assessment room nurse, who said - “Hi, Jacquie. We’re short four nurses because they called in “sick” on the long weekend, so no Cedar (the fancy rooms with windows) tonight. But we have a room for her.” When we reached the hospital, the nurse and I exchanged glances as soon as we walked through the door. “Hey Jac...pushy?” The couple didn’t really have to say anything - they could stay in “the zone”. We went straight into a birthing room - no stopping in the assessment room. She stayed standing by the bed. No “please lie down, put this gown on, etc. etc.” Her wishes were honoured without debate (the nurse and I had had the GBS-decision discussion a few weeks ago, so there was no need to belabour the fact on this night).

At the hospital, I know NEVER to show up at the end of a shift, when tempers are frayed - you will either be left to wait for the next shift, or be caught in the vortex of emotions borne out of 12 hard hours. If the vibe is weird in the assessment room (like it was a couple of weeks ago), I know the nurses well enough to whisper, “What’s up?”, and be trusted enough to be told the truth - that everyone’s on edge because an obstetrician wrote an incident report after a woman was sent to Cedar without allegedly fulfilling the criteria (long story). A war is brewing. We negotiate, and figure out a way (enlist the dad’s aid) to have my client go upstairs to Cedar without it causing a problem for the nurses in assessment (diplomacy in action). We’ve been through enough that we’ve built up a trusting relationship, and are able to work together collaboratively, seamlessly, so that my client doesn’t even suspect that we averted a petty war on the hospital floor.

I’ve worked with clients giving birth at home and in the hospital for over twenty years. I’ve quietly built bridges with midwives, physicians, and hospital staff. I’ve worked to earn the trust of each nurse and each unit clerk (these women have their finger on the pulse of the place). The amazing thing is, each new client reaps the rewards of the cumulative history of all these births, and all of the experience gained from those who have gone before her.

I’ve learned to chatter less and listen more, to teach by example, to foster trust in each woman and her baby, to soak up every lesson, to read voraciously, and to constantly tend the bridge of trust and diplomacy with all caregivers. Because I am autonomous, and not affiliated with any group or hospital (no affiliation = no baggage), I can focus on each individual client’s needs and wishes without prejudice.

I’d love there to be a day when I could trust that each and every woman in labour could be autonomous and free to give birth undisturbed, that her history would be one of complete trust in the body, that no doulas would be needed. But, that’s not possible in today’s society, within the current health care system. Each woman still has her labour, her own history, AND the system to negotiate.

Each woman in labour still needs a navigator (one midwife recently said that I have to add "Even with a midwife!"), or as I laughingly say at times, “Just think of me as your Sherpa,” as I carry the bags up the stairs. Each woman climbs her own mountain, while I quietly deal with the bureaucracy, the logistics, climbing up the stairs behind her, all the while chanting like Barack Obama...”yes you can, yes you can...”

- Jacquie Munro, Vancouver Doula

63 new mums

Since last Mother’s Day, I’ve witnessed 63 women transformed into mothers. Pretty cool, eh?

So, to all the wee ones - give your mum a big wet kiss tomorrow!!!

(Sorry mums. It will probably be somewhere between 5am and 6am...but, babies never did have a great sense of timing...)

Okay...so here’s an excuse to buy new bedding

When a single friend calls to say that she’s had “quite the night!” it can mean many things. But, when a client calls me post-baby...well, it means something completely different.

So, a client called to tell me that they’d had “quite the night!” She said that they had kept the night-time as low-key as possible. “Just like you said, Jacquie...lights out...no eye contact with the baby (Ed. note: If she sees you looking at her, then it’s party time!)...making sleep sounds during feedings...not waking a sleeping baby, diaper changing before the feed if needed, etc. etc.”

“Things were going quite well. Then, at 4am, I felt like one breast must have leaked all over the baby during the feed. In the dark, I used my hand and a cloth to wipe it up, then curled up with her and fell asleep.”

“Just after 6am, we all woke up, the sunshine streaming through the thin curtains, illuminating the bedroom scene...of poopy chaos!!!”

“My husband said if the room had been filmed in black and white, it could have passed as a scene of carnage!” she laughed, as she was telling me the story over the phone. “There was baby poop EVERYWHERE! It was smeared all over my face, my nightie, his hair, the baby’s hair...just everywhere! In our sleep, we’d rubbed it all over the sheets. too. I’d taken off her diaper, but not put another one on!!”

“We could have cried. But, we just sat there in bed, laughing. Because we remembered that you’d told us a similar story of another couple doing this...and using it as a good excuse to buy fancy sheets. So, we threw everything into the garbage (Editors note: I know, I know... this isn’t an eco-friendly story) and got into a bath together - all three of us. It was quite wonderful.”

Love it!

Phone calls to a doula

To all pregnant clients...here’s a “head’s up”. Some time after the baby’s born...you will make this phone call. The wording and timing may vary, but the questions will be essentially the same.

“I’ve got this pile of books here. One says to get the baby on a schedule, another says to feed on demand. But what does “demand” mean? What if the baby comes off after 10 minutes. Is that a feed? When do I change the baby? Before, after, or in the middle of a feed? Am I wrong to want to grab my baby away from visitors? You know, they’ve come all this way, and brought presents, but I just want to hide...”

We’ll probably spend up to an hour on this particular phone call. We’ll laugh together...we might cry together...then you’ll hang up the phone floating on air. Why? Because you will have been reminded of your infinite strength, your inner wisdom, and your ability to trust your body and your baby.

My role during the postpartum period is to help you tap into the same basic instinct that took you so beautifully through labour. Let’s assume, like most of my clients, you birthed without any disturbance, and everything was straight-forward. So, there shouldn’t be any major challenges to overcome (i.e. no latch problems caused by narcotics or aggressive suctioning, etc.) So, I will just have to remind you of your power that you drew on in labour, and remind you to continue trusting your body.

And, with the baby on the outside, you will trust her to teach you wisely and gently. You will be still and calm and hold her close always, in order to hear what she needs to teach you.

Just know that you will find it pretty freaky when she give you a withering look at midnight, as you’re changing her. It’s a look that will seem to say, “Oh, no, you really don’t know what you’re doing.” But then the look will be gone, and she will roll with whatever you’re doing, or cry and tell you a few stories. But she won’t hold a grudge. She’ll be amazingly forgiving.

And you’ll soon discover that changing her before a feed will save a lot of clean up time...because if you jostle her and change her AFTER a feed, she might easily throw up all over you and her new jammies. Then, she’ll be wide awake...and need another feeding...and the doorbell will ring...(don’t answer!)

And you’ll soon discover that zips and buttons and snaps can make you feel TOTALLY incompetent, so you’ll just buy those bag nighties with the envelope neck. Pull up the nightie, change the diaper, pull the nightie down. All done!

And you’ll also discover that a newborn baby is kind of like a 15 year old boy. “Hey, mum, I’m just going out to grab a bite.” “But, you just ate an hour ago!” “Yeah, great dinner, mum. Thanks! But I need a pizza.” No, you didn’t do a bad job as a mum. He’s just growing like a weed! Same deal with a newborn. Cluster feeds, marathon feeds, feeding every hour....whatever happens, it’s normal. Trust the baby to know what she needs - she won’t overdo it. And miraculously, she’ll morph into a more predictable creature at some point after 6 weeks.

Thinking about dinner...I like to think of the breasts like...Side A is dinner...Side B is dessert. Sometimes you want dinner without dessert. Sometimes you want a break before you eat dessert. Sometimes you go straight from dinner to two helpings of chocolate mousse. Whatever happens, it’s normal. You know, just like those nights when you have dinner (great dinner, right?) then have dessert...then want popcorn at the movies...oh, and some nibs, and a big drink. Then the next day you might just want salad. Do you analyze it to death? Do you need to read a book to see if you’re normal? No, it is what it is.

And that’s what life is like with a new baby. If you just roll with it and trust your body and your baby to figure each other out, it will work out fine. If you need a few pep talk phone calls along the way...then you’ll be just like every other mum.

“So, oh...before you go...I have to remind you to...
...lock the door to visitors who just want to hold the baby (and not vacuum)...
...turn all the clocks around, especially at night...
...sing out loud...
...and be easy on yourself...”

- Jacquie Munro Vancouver Doula

i carry your heart with me

If I had a newborn now, I would search for poetry to read aloud during each feeding, to calm us both and feed our souls.
- Jacquie Munro







i carry your heart with me(i carry it in
my heart)i am never without it(anywhere
i go you go,my dear; and whatever is done
by only me is your doing,my darling)

i fear
no fate(for you are my fate,my sweet)i want
no world(for beautiful you are my world,my true)
and it's you are whatever a moon has always meant
and whatever a sun will always sing is you

here is the deepest secret nobody knows
(here is the root of the root and the bud of the bud
and the sky of the sky of a tree called life;which grows
higher than the soul can hope or mind can hide)
and this is the wonder that's keeping the stars apart

i carry your heart(i carry it in my heart)

- ee cummings

Snapshots of Love

A woman sings old remembered songs in a shower. The sound of her laughter echoes in the room and blends with the sound of the water.

“Hands!” A woman opens the shower door during a contraction, reaches out and holds onto her husband’s...and my...hands. When the contraction ends, the door closes and her eyes close.

Only a few hours away from birth, a woman takes time between contractions to place tin foil on the sofas and chairs; her power remains.

“I like it here” says a woman as her head burrows into the corner of the car’s backseat.

“Hips!” “Water back!” A woman moves autonomously in labour. She calls to us to take our places during each contraction...at the hips, at the back, and at her hand.

“Happy?” The lips turn into a smile, her eyes crinkle, the water runs over her body.

“Shhhhh” Her eyes gleam as she looks at her newborn, rooting for the breast.

All these snapshots are of women under the influence of the “love hormones” - oxytocin, endorphins and prolactin. As a doula, I continually witness the softness, the power, and the amazing transformational effects of these hormones, which are released when women are undisturbed.

So, with these snapshots of birth "as I witness it" in my head, I watched The Business of Being Born online last night. The enormity of the loss of normal birth, the rising infant mortality rate, and the rise in planned cesareans in the U.S. struck me like never before. Michel Odent’s warning about what we could potentially lose made me dream about births all night.

Are we, as a civilization, beginning to lose what makes us human?

I spent today speaking with clients, and googling more of what Dr. Odent has said on the subject. In the Scientification of Love, Dr. Michel Odent explores this question, looking at love “from a scientific angle, yet with great respect for the beautiful orchestration of normal physiology as it works to its best capacity when it is undisturbed. Love, we learn, is a strategy for human survival.”

As critical as our need is to protect the environment, I think our need to protect the integrity of normal birth may even be more fundamental.

6 babies in 2 weeks...

Each of these 6 births has an essence that will remain with me always...

Azure's birth - Shower and more shower. Clary sage really works. Then a "hands off" birth. This wee baby slides out like toothpaste from a tube. Incredible. Mum reaches down to bring her daughter to her breast.

Nora's birth - Kisses on mum's forehead by her love. After a gentle labour, spent mostly in the water...this babe crawls to the breast just like in the WHO video, to the shock of the nurse, and smiles of the mother.

Sean's birth - Intuitive partner by her side, she makes each difficult decision with grace and patience. A challenging birth, but one where the baby's needs were honoured, and the body trusted to tell its own story.

Sasha's birth - A gentle spirit. A flashbulb memory from half way through...she's dancing in a dress from Bali...just beautiful...working to spiral her baby down...down... Her husband smiling, laughing.

Luke's birth - Women's hands anchoring her feet, she leans on the dresser, partner stroking her back...and ohhhh's her way through another contraction. Birth works.

Jessica's birth - Powerful, furious body power! Rocking back and forth, one foot in front of the other - she lives in a whirlwind of creative energy...with the cat reaching out a paw in a gesture of sympathy. The baby curls like a cat on her breast.

The Contraction Question

“I don’t think I’m in labour yet. I feel it really low down, all in front. It’s not hurting ALL OVER.” said the doctor on the phone.

“ALL OVER?” I asked, sounding like a parrot.

“Yeah.”

“Um...if all is well, it shouldn’t.” I was just a little bit confounded. Here I was, talking on the phone with a physician who’s been attending births for years. She’s amazing with her patients, so intuitive. Now, in labour for the first time, she was just as confused as everyone else in labour.

“Um...” I decided to go over the "what do contractions feel like?" question. “Primarily, it should stay down very low, near the pubic bone, like menstrual cramps, getting gradually longer and stronger over time. It can give you that drag-your-bum-down feeling. You may feel a sensation of heat wash over you, just like you’ve opened a pizza oven. You may feel shivery on and off. You might feel nauseous. You might have it radiate to your lower back. Everyone experiences a variation on the theme. But, you definitely shouldn't have that “grab your tummy and crumple up in agony because it hurts all over pain” as seen on TV. That’s just drama for TV. Real labour is something that you already know on so many levels. And it’s not linear. It doesn’t just get exponentially worse like on TV. It ebbs and flows.”

“Yes, I remember you telling me that. But I didn’t believe you or all the other women. So,” she asked, “when we palpate the contractions of a woman in labour by feeling the top of her uterus, she doesn’t feel any excruiciating pain up there?

“Not in a normal labour. It’s only when there’s something wrong and the body needs to get the message across BIG TIME that you can feel pain in weird places. If everything's fine, you should just feel the contractions way down low...”

“So...uh...what I’ve been feeling all day might just be labour?”

“Probably. The start of labour is something that you will only figure out retrospectively. But, I can hear in your voice that you’re having contractions about every four minutes. You keep fading out. How about if I come over, and we can figure it out together...”

Well, to make a long story short, I went over to find that she WAS in active labour. Her lovely son was born only a few hours later.

Now, I don’t tell this story to poke fun at the doctor, but to show that, no matter who we are, we all have various ideas about how contractions may feel. We've been bombarded by descriptions all our lives. But these descriptions tell us more about the person who is doing the describing than about contractions themselves. Our perceptions are unique. So, whether we’re a family doctor with years of training and experience, or have read every book there is on pregnancy, or have listened closely to all our friends describe their experiences...our personal experience of contractions will be unique.

No matter what, even if this is your first labour, the contractions will be something that you recognize. They may not be what you expected, but they will be something that you "know" on a gut level. Hey, you're not going to get to age 30-something and then have the body throw you a complete curve ball, are you? Trust your body to let you know what it needs. As a doula, my role is to help you navigate your particular labour, no matter who you are, and what kind of labour you are "given". I try to help you shut down your 21st century brain, and accept the logic of the reptile brain.

And, wonderfully, that’s exactly what this doctor had done in her own labour...

I think one of the reasons she had such a smooth labour was because she didn’t NAME it “labour” until her body forced her to acknowledge it. She didn’t watch the clock. She didn’t waste emotional energy on waiting for labour to speed up, or to perform in any particular way. She just let it go, basically ignoring it, just like you would try to ignore cramps during a particularly nasty period. Who cares that she'd done all this because she was expecting something FAR worse than the reality.

I’m actually in awe of her way of getting through labour.

Maybe we should all try it.

Change

Change. Is it always good?

In the next month or so, obstetricians at BC Women's will be changing their provision of care at the hospital. Rather than having three call-groups providing an in-hospital rotating OB consulting service (24 hour call, with each physician or midwife being able to choose one of the three available OBs, if a consultation is warranted, depending on the case at hand), there will be two obstetricians on hand (one primary and one secondary) at all times, each working 12-hour shifts, drawn from the combined pool of 20+ obstetricians that used to make up the three smaller OB groups at BC Women's Hospital.

When I heard about the change, I asked if caregivers would have a choice of obstetrician if they required a consult during labour. "No," said the head nurse, with a quizzical look. So, you'll just get who is available, not who might be the best "fit" (clinically and emotionally) for the client on that day. Even if an OB has been consulted during the pregnancy, if a family practitioner or midwife needs OB assistance in labour, they will be not be able to choose between the 2 OB's in hospital, but will only be able to consult the one who is designated for consultations. And remember, there will be one less OB in the hospital at any time. Hmmm...

I know that other hospitals have been using this one-OB-fits-all approach for years (e.g. St. Pauls - but they have a small pool of OBs, and a low-tech high-touch philosophy that seems to work well from the patient's perspective, and their nurses are given quite a lot of autonomy). At first glance, this change at BC Women's might appear to signal a departure from patient-centred care. But, apparently, improving patient safety was the primary motivating factor. So, it may be a good thing in the long run - the 12-hour shifts might result in more energetic OBs providing more focused patient care. But, the shorter work day (and the inability to chose the OB) could result a loss in continuity of care for the labouring woman. Could the positive working relationship between a family physician and a small OB call group be lost in this reorganization, causing further internal conflict? Who knows.

Will notice of this change be given to each woman prior to her decision regarding her primary caregiver for pregnancy, so she can make an informed decision about prenatal care? Now, this is a tricky question. Pre-conception information regarding "the caregiver decision" is already lacking in B.C., with many women making their decisions based on non-B.C. books or the internet. For example, many newly pregnant women don't know that B.C. midwives are covered by BC Medical (practicing in both home and hospital), or that the BC Women's "Birth Docs" are there for women whose family doctors don't provide obstetric care, or that, in B.C. (unlike the U.S.), obstetricians are not intended to be the primary caregivers of "low risk" women, but are consulted after a referral by a family doctor or midwife, if the pregnancy becomes "high risk".

As a doula, part of my role is to inform clients about their choices, their rights and responsibilities, and to help them to retain their autonomy. I'm also there to quietly remind them that birth is a normal life process. I do my best to provide my client with comprehensive information in a balanced and thoughtful manner, working in concert with their caregivers (many of whom I've known for 20 years). I certainly don't have all the answers to the questions that I've posed in this post, but a general wariness of change (I'm a Taurus, through and through) made me sit down to write this. Despite my feeling of unease, I'm going to have to sit on the fence with this one, and wait to see how it all works out.

To the obstetricians, it might look good on paper. But we'll just have to see how it works in reality....for the labouring women.

(Update June 11/08: The new system has been in effect for a while, and, while the obstetricians are well-rested and seem to have a new lease on life, I have witnessed some dangerous gaps in continuity of care when an OB is the primary caregiver of my client.)

(Update March 2009: Obstetricians are still voicing their concern about the 12-hour shift. Yes, they are well-rested and able to perform better in the OR, but some women have fallen through the cracks due to a lack of continuity of care. Some women may have three of four different OBs looking after them in labour, each with a different approach. No solution so far...)

Persian New Year and "Fire Bum"

Last night was a perfect example of a final prep visit...with a bonus. When I walked into their living room I noticed some special items on top of a shelf, obviously placed with care. I could see potted hyacinths, coloured eggs, wheat sprouts, and more. The shining couple explained that it was Persian New Year, and that the altar held seven items that each symbolizes some aspect of rebirth and rejuvenation. I was honoured to be a guest in their home on this special day. It seemed fitting that we were talking about welcoming a new life into their home at the new year. Then, the cat jumped up and tried to eat the sprouts (to the cat it looked just like catnip, I guess...) So, ancient ritual and custom met the quirky reality of the animal world. That's kind of like how labour works...

On this second prenatal visit, always done in a client's home, I see the couple in their comfort zone. I also look for labour inspiration by seeing what's on their bookcase or what holds a place of honour in their home. After tea and a chat, we get active, and do a "birth rehearsal" through the rooms. Stick a glass to the wall and listen to my voice as we roam the house: "Oh! You can totally polish your hardwood floors with lavender wax in the last month - on hands and knees! That might help to keep things loose and, you never know, help to keep the baby in a good position. Oh, and that toilet is positioned perfectly so you can sit backwards on it in labour..." etc. etc... No, I'm not manic, just excited to show people how their body can move them through their own space in labour. It's quite fun for the couple, to see their home from this new perspective.

So, fast forward to later that evening. Here's the scene - I was demonstrating the "shaking the apples" move to them. "You don't just shake the hips, you rub fast, just like you're trying to make fire. You can feel the heat from the friction..." The dad took over and did it perfectly (I say perfectly, because she made little sounds of happiness.) "I'll call it Fire Bum," he says, smiling, and writes it down in a notebook. We all laugh! "Fire Bum!" A new name for this move is born.

We move through the apartment, with her trying out different positions (in this visit, we discover that she can lean on the kitchen counter AND slide her bum against the cool fridge at the same time - what a bonus in labour!)

I demonstrate the different power balance that happens when someone's standing above her, moving to her level, or kneeling at her feet. "Which feels better?" I ask. "Wow...what a difference...when you kneel at my feet it feels so good." She feels the power that will flow into her in labour as her partner holds her, their heads close together.

"But, watch the thumb wiggle," I laugh. I demonstrate and she shudders uncomfortably. "That's no good," she laughs. There is so much meaning in that thumb wiggle... So many times in labours around the world, there's a sweet man who places his hand on the labouring woman's leg (good so far), holds it there, pauses, then...starts to wiggle that thumb (yikes!!!) There's so much good intent in that wiggle - "I love you, I want you to be okay, it will be all right..." - but it just comes across to the woman (just on this one day) as fingernails on a blackboard. It sends the pain signals shimmering, expanding through her body. Yowzaa! A still firm hand, instead, acts like an anchor, sending powerful messages of safety and warmth through her body.

After two hours, all of their questions about the upcoming birth are covered, as well as trust, movement, honouring the body, non-verbal communication, back circles, mesmerizing back strokes (complete with waterfall images), rhythm and ritual (plus logistics - "Yes, you can really call me at any time, day or night!") They are ready.

So, I leave them at the door, a loving couple at the beginning of the New Year, so close to the birth of "a family".

The Baby is Breastfeeding - Not the Mother

Hot off the press! In the March 2008 issue of Birth, check out the article "The Baby is Breastfeeding - Not the Mother" by Dr. Lennart Righard. The ending sums it up:

"In natural birth the woman is moving around in upright positions trying to find the most comfortable position and turning to herself to find her own inner strength. Such a woman is not so easy to control! She follows her own impulses and intuitions and her own body’s signals. She relies on nature. The same is valid for breastfeeding. The mother does not know how much her baby is eating, she has to rely on nature. This is the secret of success in the triad of reproduction (coitus, giving birth, and feeding from the breast): rely on nature, relax and let go, and you will be amply rewarded."

Then, take some time to view the WHO/UNICEF Breast Crawl video. Perhaps we all need reminding that instincts work! - Jacquie Munro, Vancouver Doula

Renee takes it to the community!

Renee Hefti-Graham, lactation consultant extraordinaire, offers wonderfully information Breastfeeding Classes and Consulting in Vancouver.

I encourage all my pregnant clients to book a private or group breastfeeding class with Renee. She also offers an additional in-home breastfeeding consultation and phone follow-up service, if needed. Renee's comprehensive service provides incredible continuity of care, a vital ingredient in breastfeeding success.

Please call Renee at 604.733.6359. - Jacquie Munro, Vancouver Doula

("Maternite" by Paul Gauguin)

That's it! Time's up!

Love this sign! What a laugh!

But it does make me think about the very real anxiety that surrounds birth...and time.

When I initially ask clients what they wish for, the most common answer is, "A fast birth."

However, after we've been working together for a number of months, most clients realize that each labour takes as long as it needs - no more, no less. Each woman's task in labour is to accept its flow, allowing it to unfold as it should. Time and space start to recede, endorphins increase, tension starts to release, and then labour works well.

To put a time limit on any labour harms its natural rhythm. Birth is a psychosexual process. And, just like lovemaking, it withers when it is pressured by time.

Ultimately, once you understand the nature of birth and its relationship with time, you settle into a pace that fits you and your baby on this particular day. It may be fast. It may be slow. But, it should never be rushed or ruled by the clock.

So, don't be pressured by that sign...

- Jacquie Munro, Vancouver Doula

Body Surfing Mama

Well, we had an amazing and regenerating time on Maui. There are so many memories that will be treasured. But there's one that seems to sum up the incredible spell and power of Maui...

The other day, we were sitting on the sand at Po'olenalena Beach in Wailea, taking a break from snorkeling and boogie boarding. I looked up and saw a pregnant woman (she looked about 6 or 7 months...must have been having the "last fling" holiday) boldly heading into the surf with her husband, just glowing.

She lined up with the other couples trying out body surfing...waiting for that "just perfect" swell. She went for it on a big wave...and got totally tumbled in the surf. She came up for air, laughing and laughing, then bounded back into the water to wait for the next wave.

It was glorious to see her, tummy shining, fearless.

I sent her a wish that, on the day of labour, she draws on that fearlessness, and leaps into the waves just like she did at Po'olenalena Beach.

So...now the phone can ring again...

Maui Bound

All doulas need a break...so I'm off for two weeks to Maui. If you email me looking for a doula, and don't hear from me until mid-March...don't panic!

Just to let you know, I do have openings for due dates in April and beyond.

So, while I'm away, please spend some time reading through my blog. Don't forget the archives. Then give me a call or send me an email after March 10th, and we can chat!

- Jacquie

Madonna

This evocative Madonna collage will always remind me of the couple (both artists) who recently gave it to me as a gift after their daughter's birth. A treasure. It hangs in my room, and will also remind me of all the births I have attended - the layering of experience, the significance of cherished objects, the importance of history, the value of memories, the power of nature.

I see an old family portrait, a pomegranate, the impermanent dandelions, the water lily, the doll I had as a child, that special bike, that beautiful floor fragment, a cupola with light streaming through to the ground. We each see those things in the collage that hold meaning for us.

Labour is like this. Fragments, layers, images - all confusing, deeply challenging, yet breathtakingly beautiful. Our births are not "the pain." Our births are not physical. Ultimately, they are not of the body, they are of the mind. They are personal, they are dependent upon perception, they are ours. We birth as we live.

Birth is not "paint by numbers." Each birth is like a collage - totally different for each woman, each birth.

Five births since Christmas - each teaching us all new lessons to draw upon. I will look at the collage and name a part for each woman.

- With love and thanks to Tanis and David
www.silentalbum.com

Äpfel schütteln

"Komm, wir wollen Apfel schütteln,
Äpfel schütteln;
alle Kinder helfen rütteln.
Ria, ria, ria, rums."

This German children's song would be perfect to sing while shaking a woman's hips with your hands in labour. One of the many indigenous practices used for centuries to loosen the pelvic muscles and ease a baby's journey through the pelvis, "shaking the apples" works really well with first time mums in early labour, as well as multips as they approach birth.

I heard the term "Äpfel schütteln" used by an older German midwife about 15 years ago. We were in the attic of an old Kitsilano house, trying to fix the malposition of a baby late in labour. My client had hit a plateau at 8 cm, and, after a good half hour of vigourous hip shaking by the midwife, the woman said, "Did you hear that thunk?!" Then the labour took off, we all dashed to the hospital, and the baby was born.

I "shake the apples" to help second-time mums release muscles and allow the baby to be born. Sometimes, it just takes a two-minute shake, then she says, "It's coming!" Most times, she's sure the shaking knocked at least half an hour off the labour time.

Think of the speed that a paint can shakes in the machine at the hardware store...or the speed of a woman's hips during a Tahitian dance...

And it feels so good!

Walking the Labyrinth

"You are a gift to me beloved
trust my body
trust my baby
breathe..."


Last night, friends and family painted the labyrinth in the living room of a woman in early labour, hoping that she would have a chance to walk the labyrinth as the labour progressed. But her labour skyrocketed and her baby was born sweetly before the paint had time to fully dry!

But I think she had been metaphorically "walking the labyrinth" for a long time and was fully ready. There were no blocks. She trusted her body, trusted her baby, and held firm and fast to her husband, whose hands held the baby's head as it slid out into the flickering light of a candle.

With a labyrinth there is only one choice to be made. The choice is to enter or not. With the smooth and quick birth of this beautiful boy, the choice was made. What a joyful entry to the world.

Breastfeeding Tips for Dads

As part of their Breastfeeding Counsellor's course, Sarah Munro and Ann Marcoux created a podcast of breastfeeding tips and tricks for men. They interviewed three local dads and let them do the talking. So, click and listen to Breastfeeding Tips for Dads.

And...

Geared to all dads, whether they're at home or not, Man in the Moon dad and baby groups in Vancouver offer support and fun with books for dads and their babies on evenings and weekends. Offered at most Vancouver libraries, these groups start their next session mid-January 2008. Check your local library for details.

Meet Carly

As a doula, I am invited into the homes of so many wonderful and creative people. This past year's client list has included an amazing collection of writers, artists, counsellors, dancers, environmental crusaders, yoga instructors, entrepreneurs (and lots of lawyers.)

I love watching my clients' postpartum transformations, as they find ways to reconcile mothering with their "pre-baby" careers. Many former clients become consultants or start new businesses, and others strike out in entirely new directions. I support and applaud their efforts to find balance in their lives.

One such former client is Carly Fleming. She has recently branched out on a career path that I believe will fill a gap in perinatal services in Vancouver. I encourage you to call her if you feel in need of expert counselling assistance during the childbearing year - and beyond.

Carly provides pre-conception, prenatal, and postpartum counselling to women and men who need some additional support as they travel through their childbearing journey. Her services are aimed at individuals who are having difficulties coping or adjusting to pregnancy and parenthood or who are experiencing emotions that are preventing them from moving forward in a productive and fulfilled way.

She offers clients the choice of having her come to their home to conduct the counselling session or meeting with them in a private counselling office (locations are Kits and downtown).

Keep her contact info handy:
Carly Fleming, M.Ed., RCC
Prenatal and Postpartum Counselling
604-808-9587
carly.fleming@gmail.com
www.carlyfleming.ca

Crossing the Portal, the Old School Way

I stood still in Pottery Barn the other week, in front of a phone that looked just like the lovely heavy black phone that we had when I was little. You know, the one with the rotary dial that, when you needed to dial 9-1-1, took such a long time for that 9 to rotate. No wonder they didn't stick with the British emergency code of 9-9-9. The emergency would have been over before the dialing was done.

So, still standing there, lost in space and time, I started to think about my low-tech childhood in the '60s and '70s, how I skipped to Kerrisdale elementary school in my skirt and walked through old door marked "Girls", and how my parents decided that it was totally unnecessary to have all the new high-tech things that were in the stores - how we shared a party line, had no answering machine, no voicemail, no calculators, no computers, no videos or DVDs, no recording devices, dishwasher or washer/dryer. We just had one little black and white TV with rabbit ears, a clothes line, and a hand cranked mangle to make life easier. (I laughed when I heard the editor of Canadian House and Home say just last week that her laundry room would not be complete without her most luxurious appliance - the mangle. Well, this one's electric, and it presses sheets, but hey...) It was truly an "Old School" childhood, and time was our ally.

So, I really noticed those multi-coloured cut-out letters stuck on the window at BC Women's Hospital the other day - "I DO IT OLD SCHOOL - ASK ME HOW". I kept thinking about those words as I helped a client through an almost 48-hour unmedicated, uncomplicated birth. After 31 hours at home, we went to the hospital to birth "old school" style. The tools at hand were our hands and eyes and ears and wisdom (other than my client and her husband, "We" also included nurse "Wendy" aka Michelle, and the Family Practice Group 2 docs Ron and Sheena, who all have the guts to go "old school"). Time, on this day, was our ally, for we needed a lot of it to accomplish the goal. The high-tech equipment didn't seem to know how to behave with us. The blood pressure cuff kept pumping itself up even when no one was there, and that brand-fangled-new monitor didn't work as well as the doptone, so it was turned off.

So, things were kept as simple as possible. On and on...dancing in the shower, rockin' an rollin' on the ball, just one contraction at a time, one breath at a time, listening to lovely music. To get rid of a puffy cervix at 9cm, we used the Trendelenburg position on the bed (no epidural necessary) and lots of encouragement. We used hip squeezes, hip shakes, swirling and spiralling hips, visualization, trance-inducing techniques, foot rubs, endorphin sleep and dreams, squatting, kneeling, walking, tears, hands, eyes, and love....liberally. And this amazing labouring woman drew on the strength of all her life, with the aid of a few sherpas, and did what all women have the power to do, climb the highest mountain ever - birthed her baby with arms outstretched to touch his body.

And when that baby came, it was pure joy. No exhaustion, just sparkling laughter and smiles and "I'm as high as a kite!" (love those endorphins) and an eager, wide-awake little boy who came out with his meaty fist stretched to the sky. Ahaa! The culprit - just one little hand had slowed things down. We knew it! But, with time, this little man and his mum had worked it out.

When the pediatrician came later to say "Hi", she actually bowed down before the woman, saying "I am not worthy." And the doctors agreed that, if any drugs had been used, it probably would have been a cesarean. And the nurses outside were in awe, knowing that there's an initiative in the hospital to reduce the intervention and cesarean rates by encouraging low tech/high touch birthing, and wishing that they could have seen how it was done.

I am in awe of the couple at the centre of the whirlwind, this vortex of birth. I thank them for trusting in birth, for trusting in the body, for trusting their baby, for trusting me to calm their spirit and their wild eyes, when I'd say, "It's fine, it's normal, you are safe, you can do it," or "She's safe, she has the strength to do this."

On this day, I think all three crossed the portal, the old school way.

- Jacquie Munro, Vancouver Doula

October 2, 1940

Maurice was born
during the Battle of Britain
mum
gave birth to him in a basement
nurses helping
having walked to work
after going to the pictures

now
bombs
falling on the engineering works around the hospital

the babies were put in boxes
pushed into the cabinets in the wall
of the morgue

the new mothers sat together
in their nighties on the floor
incendiary bombs falling

dad took us
to the bottom of the road
‘that’s where your mother is’
as we watched the flames
all red
rise in the dark sky
across Manchester

the next day
we walked
to see the new baby
walked the road
five miles past the burning
past the rubble
past the children running in pyjamas
alone

say welcome to the new baby
in the hospital
standing
white
all by itself
in the city

I think that’s why Maurice has always been
nervous

This is just one of the many family stories of birth that I have collected over the years. My own mum told this story about her brother's birth during one of the heaviest bombing raids on Manchester during the Battle of Britain. As a child, I loved hearing this story because it told me that the people in our family are strong, resilient.

I used to love hearing that my grandfather kept his family together - wouldn't let the children be evacuated. "If we go, we all go together." I like to think that our family is stronger as a result - that my own children are stronger because of this.

But it also told me that we are profoundly impacted by the stories of our births - that we believe certain personality traits are borne out of our experience of that day. Is Maurice nervous because he was born in a bombing raid? Or is he nervous because it has been an expectation of the story that has been told over and over again? What are your family stories of birth? What stories will you be telling your daughters and sons? Are they stories of resilience and empowerment? Are they stories of loss or victimization?

I hope that we carefully frame the stories that we tell, so the listeners will find strength in our words. We need to especially watch the particular words that we use when we talk to our daughters about birth, remembering that these epic stories will weave themselves into her thoughts as she is giving birth. I know that I saw visions of the bombs falling around the hospital as I gave birth to my own children. It didn't make me fearful, it made me strong. "Gran did it...I can do it... Gran did it...I can do it..."

- Jacquie Munro, Vancouver Doula

From the desk of Jacquie's daughter...

Two years ago I decided to make a drastic lifestyle change. I had spent the past six years depending on a common prescription drug. I began taking it daily at 16, not realizing the global impact it would have on my health. There were months where I felt numb, as though my hormones were sealed off. It made me feel disconnected from my body, my rhythms, and normal emotions. Every girl I knew in university depended on the same drug. Fifty years ago, we would have been revolutionary feminists, taking control of our bodies and reproductive choices. But I felt like my body was out of control – a sensory-deprivation chamber.

The pill is an odd thing. It comes in packaging of different shapes and sizes, but mine were in round packets with pills in three colours. Popping one out each night at 10 pm felt like a grotesque simulation of a Christmas ritual – opening the door to an advent calendar and eating the chocolate within. The only complaint I ever heard from other girls was how annoying it was having to remember to take the pill every day. Some spoke of how they wanted to switch to the patch or take a shot, or even have their periods disappear completely.

While dating in university, I remembered my mum telling me as a kid that the pill can inhibit and alter one’s normal sex hormones, suppressing sexual interest and responses. I wondered if my pheromone responses were messed up and if I’d ever been attracted to the right guys.

Then, I had a moment of reckoning. After Christmas, two years ago, finished with both the advent calendar and my packet of pills, I asked my doctor if there were any reliable alternatives for contraception that wouldn’t impact my hormones. When I she told me about copper IUD’s, my first thoughts were of medieval torture gadgets and pelvic inflammatory disorder. My doctor assured me that this wasn’t the 70’s anymore, all the women in her office used them, and she had used IUD’s herself for over 20 years.

“So, what’s the catch?” I asked.

“There is none.”

This seemed ridiculous. I felt completely betrayed. None of my previous doctors had mentioned IUD’s before – why weren’t they throwing these things at women like party favours?

“They’re just not a hot consumer item because prescription drug companies don’t make any money off of them compared to the pill.”

Then I looked at the statistics: Less than 1.5% of Canadian women aged 15-45 use IUD’s. The failure rate is very low - between 0.09 and 0.25 % - even less than the pill. It's slim, tiny, and undetectable. I paid only $90 for mine, which I think was partially covered by my extended medical plan, and it stays in for 5 years. There are no hormone imbalances, no alarms going off every night at 10 pm, no increased risks of cancer, etc., although it's best not to use an IUD unless in a monogamous relationship - it makes it riskier to catch STD's. Most care providers don't have up-to-date information on IUD's or know how to insert them - another reason why they are so uncommon. There isn't just a huge consumer influence on the public to use the pill, care providers are pushed in that direction as well.

Yes, it in hurt like hell for a minute when the doctor put it in – but that was it, one minute – and yes, I had strong period cramps for a few months. But knowing that I was drug-free, I was myself, and that my body was normal again, was amazing. Plus, I was sticking it to the pharmaceutical companies! My period is like clockwork and when we one day decide to get pregnant, out it comes at the doctor’s office and we can start trying right away.

It's sad to realize that I never really knew myself, my body, during those 6 years. But now I know that when I explode into tears, or want to curl up in a nest, it's just because I'll have my period in two days, and not because of the side effects of the pill. I feel like I'll be more in tune with the changes of pregnancy, when I'm there one day. - Sarah Munro

(photo: "Flying IUD" sculpture, University of California, Santa Cruz)

(Note from Jacquie: I asked Sarah to write a post on IUDs because, in all my years as a doula, I can only remember one client who had used an IUD prior to a first baby. Most women aren't told the real story about IUDs - that they are a safe choice for many women to consider, that they can be fitted prior to childbearing, that they can be used safely while breastfeeding, that the copper IUDs keep your body clean of BCP hormones...that they are about living autonomously. Check out more info online, including contraindications.)

"Meet your new brother..."

I just melted when I saw this photo of a client with her two sons. It brings back memories of her youngest son's birth, at home, in the heat of a summer night, the fan blowing hot air around the room, the cool sound of the water in the tub, the midwife fanning herself, the speed with which this little one came... I believe the birth was everything that they could have hoped for. Complete joy.

But, what this photo also brings to mind are the many phone calls and emails I receive from clients who have just had their second baby...whose births were so beautiful, but are now reeling from how busy life has become, how challenging it is to manage two children, how guilty they feel at giving less than 100% to their firstborn child, how it tears at their hearts when their firstborn just wants grandma or daddy, "NOT mummy!"

They ask me if they're the only one who is feeling torn between the love for their firstborn, and the awe that they have for their new baby. They are missing their partners, who invariably have to go to work. They are wondering how they can cope when grandma leaves. They can't remember what seemed so engaging about newborns. This new baby doesn't seem as entertaining as his older sister, who, at age four, is dramatic and articulate (certainly VERY articulate about "how life would be much better without that baby") and fun...and so very confused about this new life.

These clients ask when life will return "to normal." It won't. A "new normal" will gradually emerge. Grafting a new limb onto a strong and vigorous tree takes time. It will happen, but slowly, and definitely with some challenges. And at some later date, after the postpartum fog has cleared, clients call me and say: "Before, we were a couple with a child...now, we are a family."

Just know this...when you're in the fog of postpartum and you see another mum out on a walk, laughing while carrying her two babies - you're just looking at a moment of her day. What you don't see are her tears when the door closes behind her, or her midnight fears, or that she got home from that walk and called me, and said, "I was carrying both girls in slings because Lola wouldn't sleep and Addie wanted to pretend she was a baby, and I just wanted to cry. Then, I saw a woman, pushing a sleeping baby in a stroller, with an older child holding on, and wished I was her. I laughed at how I must look to her - how she would admire my chutzpah at carrying the girls. She wasn't seeing the truth of it."

The transition from one child to two is different for every family. It depends on the age difference, the childrens' temperaments, family dynamics, and so many other things. Draw strength from other new mums with two babes during this time, and don't forget to call me. I'll connect you with someone close by who's sharing a similar journey.

- Jacquie Munro, Vancouver Doula

Tandem "Sling Girls"

My clients are so creative! Here's a recent comment from a wonderful two-time client:

"I loved reading your most recent blog entry. I haven't used a stroller in months (actually a couple of times, but just to carry the shopping bags, so that doesn't count) and use slings instead. Hannah even naps in it when we are out. Happier baby, happier mummy. I think every new mother should be given a sling (or some other carrier) when she gives birth!"

The Pact...or how to keep your family environmental footprint small

Most clients know that I like to do without too much “stuff”...evidenced by our gradual downsizing, leading to our ultimate purchase of a small loft in Vancouver. Our internal and external spaces are now filled with what we do, not what we have.

This shift wasn’t just driven by our need to find a personal solution to the environmental challenge on our planet. It is the continuation of a parenting plan that was born on the tidal flats of Point Roberts in 1982 - before our first was born, and long before the words “environmental footprint” or “sustainability” were commonplace.

My husband and I walked in the howling wind, hoods pulled up around our faces, wearing our matching blue Goretex jackets. We faced each other, put our hoods together, and looked like a full-sized Rorschach test. There, we made a pact that the people in our immediate family had to come first - before things, before jobs. We’d make what we could, keep things simple, and remember that we were our children’s first teachers. We would teach them by example. In the 1980’s, an era full of big ideas, splashy consumerism, wide shoulder pads and the dawn of huge “toys” (both for kids and adults), this was a step away from the norm.

It was a challenge to go against the flow, to avoid the hoops that society expected us to jump through... but, we did it. I think (I hope) our kids are better off as a result. (They are, most certainly, better recyclers than we were!)

Today, I like to think that it’s getting just a little bit easier to follow the path towards sustainability. Sure, there are people who will try to get you to fall for their product placement, to “buy, buy, buy” what they say you must in order to be a good consumer. But, there are an increasing number of people convinced that more is not better, bigger is not better, and that the environment must be our overriding concern.

So, here’s a list of some “stuff” that will help you on your path towards a more sustainable family life:

Your Body is Free

1. Your Lap - Not only warm, it makes a great portable changing table, a non-slip holder for the baby in the family bath, and a bounce-machine for a fussy baby. No batteries needed.
2. Your Chest - Provides a self-regulating temperature sleep space, complete with built-in tic-toc white noise for the baby who won’t sleep easily.
3. Your Arms - with a little help from all the “new age but old as time” baby wearing gear, your baby can view the world from an adult perspective. Buy local and check out Cheeky Monkey for a wide range. Remember, in time, most parents discover that strollers are for the groceries and that the kids just want to be carried.
4. Your Legs - Leave the car at home, then walk or ride bikes everywhere. With Car2Go and the Modo in Vancouver, you can even do without having a car of your own. Think of keeping your environmental footprint small - live, work and play in a small geographic area. Buy an e-bike, a bike carrier or baby trailer on Craigslist (if you're lucky!). Vancouver’s bike routes are fantastic.
5. Your Brain - Fill up with your maximum weekly allowed books for all the family at the library. Challenge your mind, think outside the box by going to a new shelf each week. Share these ideas with your newborn. Remember that in the first 18 months, the baby’s brain is still in a remarkable growth period. Feed the brain!
6. Your Voice - Singing, talking, whispering, reading aloud from the newpaper... Whatever you do, just TALK! This is a priceless gift that you can give your children. Studies have shown that talking to infants enriches their brain development, their ability to learn, and their power in using language.
7. Your Breasts - When the placenta goes, the breasts picks up the slack, and are fully capable of sustaining the wee one for years. The benefits are immeasurable!

Some Good Stuff (not all free, but at least worth it!)

1. gDiapers - These flushable diapers were the first Consumer Packaged Good to earn Cradle to Cradle certification by the sustainability gurus at MBDC. Available over the internet and, finally, at Whole Foods in Canada (yes, you have to use too much gas to drive to their Park Royal store.)
2. Hook-on Chair - Remember that kids don’t know that they’re kids - they see themselves as a full and equal member of the family. So, let them share the table with you (at home, at friends houses, at a campsite, or in a restaurant) and you’ll never need a high chair. These can cost as little as $20. And while you’re at it, consider baby-led weaning.
3. The Corner Cupboard - Remember loving that corner cupboard with the lazy-Susan filled with Tupperware when you were a kid? I lived in the skinny cupboard between the oven and the fridge. Boy, was it cozy and warm! The kitchen, if made safe and kid-friendly, can be the best exploration zone, from Tupperware becoming shakers and building blocks, to cornstarch and water becoming fun ooze. I taught my son to write by moving his hand through flour on a tray. Being a tactile learner, he caught on faster than if we’d used a paper and pencil. Remember, the possibilities are only limited by your imagination.
4. Handmade Puppets - what a way to explore role-playing at an early age! When a younger sibling arrives, the first born can safely share feelings with a monkey puppet. Buy B.C. if possible...check out places like Natural Pod.
5. The Outdoors - Cheaper than anything in Vancouver - the ocean, the forest, the parks, the beach. There’s nothing better on a Fall weekend than leaf-pile jumping at Jericho. And, if you have a boy...remember the "let boys run for 4 hours a day" rule!

The Jars (or how to get through real life smoothly)

1. The To-Do Jar - introducing The Jar Concept! Since you should only do “one thing” a day with wee ones, burn your lists and write down any tasks on slips of paper and place them in a jar. Stick your hand in the Job Jar each morning and see what you (or your partner) can do. You have the right to decide if you don’t want to do this task! Just stick in your hand, and draw out another task! You can even make postpartum visitors draw out a task whenever they visit (mums don’t need to do anything for, oh, say, 6 weeks after giving birth - let everyone else do the work.) Lists will become a thing of the past, and you’ll be free to go through life more naturally - without time constraints or artificial deadlines. Your kids will thank you!
2. The Fun Jar - This one is great - a jar filled with fun family ideas and activities. For example, when the Georgia Straight comes out each week, you can check the family section for fun and free activities, cut out each one, then draw them out at will! You can expand this to include a magical mystery tour to Iona Island to watch the planes landing, a hike or bike ride in Pacific Spirit Park, tobogganing at Cypress...unlimited fun! Make sure one activity per week is saved for the entire mum’s group.

Back to the Beach
When my husband and I made our pact on the beach 25 years ago, it would have been seen as just a bit flakey. Now it’s seen as just another part of the West Coast family-focused environmental revolution.

For twenty years, clients have called me long after their babies are in school, just to check in with me, another mum (now grandma) who’s “gone before”. We sometimes talk for over an hour. Just like I did during their labours, I try to teach by example. They, in turn, teach me more. They tell me that they’ve discovered that babies and children just want love, how the body is free, how almost-free “stuff” is somehow a greater gift to give our children than expensive “stuff”. They tell me that once you get the hang of it, thinking outside the box becomes easier.

And I tell them that the challenge is to keep it up as your children’s worlds grow - as they meet new people, as they enter school. By then, you might be thinking about home schooling, co-op child care, working from home, flexible work schedules, community gardening... Just do what you can. The path is challenging, but worth it.

- Jacquie Munro, Vancouver Doula