Doula Logistics....

... the child care edition.

This is definitely my biggest challenge, the part I hate. Who will watch the kids?

I'm very lucky that my husband works from home so if he's in town, it's an easy question to answer.

But... sometimes he travels. For work, for church, for fun.

He's traveling twice this month. I have a potential client who could deliver while he is gone.

So, the child care hunt begins. Who will be able to pick up the kids from school if I get a call at noon? Will that person have the proper car seats? Will the kids wig out if someone they don't know very well is there to take care of them? Will that person charge a high (if fair) price to watch all 3 kids that, if the birth goes for the typical 12-18 hours, will make it unprofitable for me to attend the birth? I love my job and if love would pay mortgages and childcare providers, I wouldn't mind!

The "Emergency" C-Section

A friend found this at:

One part that made me laugh out loud is the description of a doula.... and the end!

Meet The Doula Night

Expecting in Pittsburgh?
Come to Heart and Hands Doula Service's Meet the Doula Night,
TONIGHT, Sept 14th
7 – 8 pm at the Breastfeeding Center of Pittsburgh 4070 Beechwood Blvd, Pittsburgh 15217.

I'm the hostess (yes, with the mostest) and I can vouch for the deliciousness of the light refreshments.

I'll never judge you.

That's probably the only promise I can make as a doula -- I can't promise you that your birth will go the way you want it, I can't promise you that I can protect your birthing space against hospital policies and care providers who don't respect your wishes. But I can promise you that I will back you in any decision you make.

If you decide once you're in labor that your birth plan is out the window, know what? It's not my birth, it's YOURS, and my job is to support you in your decisions.

I've been running into a lot of real negativity about how "other" doulas don't to things the right way, i.e., not the way the doula speaking does things. I've encountered what I can only describe as scorn from other doulas when they learn that I did not use a doula for any of my births. It's been actually said to me that I can't be a doula effectively if I don't use one for my own births. Mind you -- no one ever ASKED me why I did not use a doula.

If anyone happens to be interested, it has a bit to do with my feeling judged by women in my past, and frankly the last thing I need when I am in labor is to feel judged... or even just worrying about feeling judged. I don't have a lot of need for touch, and I find I can cope with labor, and other challenges, best without a lot of input or distraction. When I'm surrounded by a lot of people in labor, I feel the need to either put on a happy face, crack jokes, or just play hostess in one way or another.

This is not to say that I don't see the value in physical, emotional, and informational support in labor. Of course I do!

But I also understand and respect that everyone has her own way. I tell clients that what gets them through labor is the right way to do it. If they want me to dress like Betsy Ross and dance a jig, I'll do it. Whatever. I'm not them and it's not my job to be them. It's my job to support their choices. And if someone doesn't want a doula, then my goodness I would never pass judgment on that!

There is nothing that has happened in the past few days that has spurred me to write this, it's just been festering for a while.

Two Babies in one week!

I helped one family welcome a little baby girl in the early hours of last Sunday morning, and another family welcome their little girl late last night!

I can't describe what an honor it is for me to be able to do the work of a doula!

ACOG's new VBAC Guidelines

ACOG apparently listened to the feedback from the NIH conference. These guidelines are FAR less restrictive, and a step in the right direction!

Ob-Gyns Issue Less Restrictive VBAC Guidelines

In making plans for delivery, physicians and patients should consider a woman's chance of a successful VBAC as well as the risk of complications from a trial of labor, all viewed in the context of her future reproductive plans


restrictive VBAC policies should not be used to force women to undergo a repeat cesarean delivery against their will if, for example, a woman in labor presents for care and declines a repeat cesarean delivery at a center that does not support TOLAC.

a good feeling

i have a client due 8/6 and i have a very good feeling about this couple. they are very prepared, and yet the mom-to-be is very nonplussed about the prospect of her upcoming labor. it's not that she is thinking it'll be no big deal... so maybe nonplussed is not correct. it's more that she recognizes she'll be experiencing something she's never experienced before, and there's no real sense in tying herself in knots about something she can neither anticipate accurately nor completely control once it happens.

a real type-a-go-with-the-flow kinda gal. reminds me of someone... oh yeah, me!!! so yes, i have a good feeling about this labor and birth, in no small part because i feel like this is a very well-matched birth team, with great communication, clear and high expectations, and (this always helps) a lot of laughs!

welcome to the world baby A!

Welcome to the world, beautiful baby A. So nice to meet you, so honored to do this work.
Hospital Cuts C-section Rate, Leading to Healthier Babies

Tallahassee Memorial Hospital has decreased the number of preterm births--and thus admissions to neonatal intensive care units and infants with health problems--by cutting elective induction and C-sections over the last three years.

Isn't it nice to read about hospitals drawing the line, once and for all!? Of course... the early delivery rate at this hospital is down from a shocking 44% to a still-above-the-scandalously-high-national-average 37%. Nonetheless, I believe that the drastic reduction in the primary cesarean rate, as well as their continued practice of limiting elective inductions, will keep those numbers in decline.

First Client Since the Baby!

so, a little bit from doula-land. i have my first client since I was about 20 weeks along with my nearly 10-month old! C. will be 11 months old by the time this client is due and hopefully it'll be a terrific, straightforward birth for this wonderful mama. Of course primarily for her own well being but also for me, my husband, and the kids! fingers crossed!

New Blog

Since I have not been active as a doula for a while, this blog has started to be more and more family-y and less doula-y. I started a new blog for personal reflections!

Mom Of Three Monkeys

Please check it out!

Happy Earth Day!

Pittsburgh Cloth Diapers is having a great sale -- 15% off today!

One of the things I really appreciate about all this 'green' industry is that in the long run, it is economical for consumers as well as being good for the environment. We're for sure breaking even on the cloth diaper investment we made!

How about you? What are some things you do that give both Mother Earth AND your wallet a break?

Happy Easter!!!

I hope you are all welcoming spring in some way!

Today we went to church...
... and played in the church's garden.
Earlier this week we went to see the daffodils at Highland Park...

And in our front yard too!

Lactation Cookies

I made these for a friend who recently had her baby, and, well -- I sampled them. I sampled more than a few, and I can attest to the lactogenic properties! My supply is pretty well-established after 8 months of course -- but I definitely noticed the difference.

I got the recipe here, and the original recipe comes from Noel Trujillo. I used dark chocolate and I think they'd be great with dried blueberries or cherries added in too.

1 C butter
1 C sugar
1 C brown sugar
4 T water
2 T flaxseed meal (no substitutions)
2 Lg eggs
1 t vanilla
2 C flour
1 t baking soda
1 t salt
3 C Thick cut oats
1 C Chocolate chips
2 T Brewers Yeast (no substitutions)
Preheat oven at 375.

Mix 2 T of flaxseed meal and water, set aside 3-5 minutes.
Cream butter and sugar.
Add eggs.
Stir flaxseed mix into butter mix and add vanilla.
Beat until well blended.
Sift: dry ingredients, except oats and choc chips.
Add butter mix to dry ing.
Stir in the oats and then the choc chips.
Drop on parchment paper on baking sheet.
Bake 8-12 minutes.

So, do you like contests?

Well, do ya? I have a sweet prize lined up for a contest -- perhaps in April for Cesarean Awareness Month, perhaps in May for International Doula Month.

Stay tuned!!!

VBAC Calculator

Something Dr. Kaminski shared was this VBAC Calculator. It factors in several variables to give the odds of a vbac success. I thought it was very interesting and could be a great tool in making the decision for either a vbac or a repeat c-section!

Certified Bra Fitter

I attended Heart and Hands' 10th annual Family Centered Maternity Conference -- a nice day with lots of terrific information. I found Dr. Bob Kaminski's presentation on VBACs to be very positive and informative, but I have to say, Dawn from Mommy Gear was great -- and now thanks to her, all attendees are Certified Medela Bra Fitters! I have a pin and certificate to prove it. A fun day but I'll be frank -- it was hell on Charlie to be away from home all that time. he was NOT a happy guy for the last few hours.

Welcome Baby J!!!

I am so thrilled for my wonderful friend, J. and her husband T., who welcomed their second child yesterday. Welcome to the world little boy -- you hit the mommy jackpot. And congratulations, my dear friend!!! I am beyond happy, beyond proud, and so wishing I lived closer so I could give you all a big hug!

Stupid google ads

So I added google ads to my blog to make a few bucks while I'm still not quite ready to start doula-ing again. I see today that there is an anti-health care reform ad there with a schmuck-y picture of Rep. Pelosi, urging you to call your representative.

For what it's worth, I support health care reform and I urge you to click the heck out of that ad and spend that advertiser's money.

Just wanted to make it clear where I stand on the matter since that ad is on my blog and I don't see eye to eye with it :)

Lowering Gestional Diabetes Cut-offs

Panel Calls for Lower Gestational Diabetes Cutoffs

Lower glucose thresholds for gestational diabetes called for by an international consensus panel may double the number of women diagnosed.

True gestational diabetes is nothing to sneeze at. However, many already think that GD is over-diagnosed. I know for a fact that I'd have been diagnosed with GD with Badger if my care provider hadn't been as accepting of a range of normal.

Panel Urges New Look at Caesarean Guidelines

The New York Times reports on the recommendations of a panel at the NIH regarding VBACs and Cesarean sections:

A panel of medical experts on Wednesday recommended steps to reverse a trend that has dismayed many pregnant women: the increasing difficulty of finding doctors and hospitals that will let a woman try to give birth normally if she has had a Caesarean section in the past.
I myself tried to keep up with the tweets (twitters? twittles? I dunno.) as it was happening and I just couldn't make heads or tails of it. Trying to do just about anything that requires sustained attention is not that easy when there's potty training going on. Which Badger is doing, by Jove! He had just one accident yesterday. Progress, progress.

Lessons at Tuba City Hopsital, Run by Navajos, About Birth

An excellent article in the New York Times!

As Washington debates health care, this small hospital in a dusty desert town on an Indian reservation, showing its age and struggling to make ends meet, somehow manages to outperform richer, more prestigious institutions when it comes to keeping Caesarean rates down, which saves money and is better for many mothers and infants.

so, it snowed.

it snowed a lot. and now it's snowing again. kids off school. we're hanging in there. they better not close the schools on thursday or so help me. SO HELP ME.

i use a lot of doula-skills in my parenting. patience. compassion. creativity. strength. the ability to stay awake for insane periods of time. sense of humor.

but we haven't left the house except for a few brief trips to play in the snow (the hubbie did take the big kids out a few times -- it's too hard for me to take the three of them out solo) since 3:30pm on friday, just as the snow started. so we're on hour 101 of each other. and i'm not that good.

"Get Me Out" -- sounds like an interesting read!

This sounds like one for the library list:

Lessons from the History of Childbirth

A Q&A with Randi Hutter Epstein, MD, author of “Get Me Out: A History of Childbirth from the Garden of Eden to the Sperm Bank.’’

I find the history of childbirth so fascinating -- the similarities and differences to how we do things today!

Dads and Breastfeeding

Now here is a helpful list of ways Dads can bond with a breastfed baby:

Breastfeeding Tips for Dads

And I love that feeding a bottle of expressed breastmilk was only #4 on the list. Being a cheerleader for mom, bathing the baby, and skin-to-skin cuddles are fantastic ways to be a present father. From my own experience, my husband brought the infant Chim to and from bed for me to nurse -- and that probably saved me, frankly.

Hooray for dads!!!

Back to Sleep!

I think it's every parent's nightmare -- SIDS.

Researchers have found a new clue -- a serotonin imbalance, when coupled with external factors such as belly sleeping, can decrease a baby's ability to wake and move when oxygen supply is inadequate.

It's so chilling to think about it. I still check Chim and Badger every night before bed and Charlie, many many times per night. Of course that little stinker is waking up 5x a night so that's reassuring :)

Gisele Bundchen's home birth

She had the baby in the bathtub... on purpose!

and she didn't wear maternity clothes!

OK, the only thing I really have known about her is that she's with Tom Brady, who, as a resident of the City of Pittsburgh, I am contractually obligated to loathe from the base of my soul (read your tax forms, people, it's in there!).

But that's pretty rad. I love the normalization of pregnancy, natural birth, and mothering.

State Bill Would Ban Shackling Female Prisoners Giving Birth

State Bill Would Ban Shackling Female Prisoners Giving Birth

Legislation has been proposed to ban state prisons and county jails in Pennsylvania from shackling pregnant female prisoners to gurneys or beds in prison hospitals at the time they go into labor and give birth.

Yeah. That's big of them! There have been times during my hospital births when I have felt like a prisoner -- that gown is a big factor (and why I wore my own clothes for Charlie's birth) -- but can you IMAGINE being actually shackled? Where the hell do they think moms are going to GO? And how quickly do they think they'd be able to run?!

Cosleeping. With the Co- or the -sleeping.

Charlie is in a cosleeper. He sleeps well in the cosleeper from about 7-8pm until maybe 1am on a good night. I generally end up feeding him and falling asleep with him in bed. If I put him back in the cosleeper for the second half of the night -- well, he doesn't go to sleep. So it takes the "sleeper" out of cosleeper.

So I'm generally fine with having him in bed, cosleeping for realsies. Except for nights like last night when he was ready to greet the day at 4am. That was not OK. No co-. No -sleeping. I brought him downstairs, took the Circle of Neglect (haha, I just love Gretchen's term for the Exersaucer) into the bathroom and took a hot shower. I wasn't handling being woken up early very well and I didn't have the capacity for kind words or loving touch. A shower was just what I needed.

By 5am, I was relaxed and scrubbed clean of most of the bitterness of being up well before the sun. I had a cup of coffee in hand and I was ready to face the day. Of course Charlie wanted a nap by then. We nursed and snuggled on the sofa, and listened to my husband saw wood over the baby monitor. I dozed off myself, but not comfortably since I wasn't correctly positioned or covered (remember, it is January in Pittsburgh!), and if I'm going to share sleep space, I want to do it safely and on the sofa is NOT safely.

I think we need to put the crib together. I think it's time to at least start to ease our way into it. Charlie will hopefully be rolling over and I don't think the cosleeper is safe at that point. And I think it's possible that if I'm not there next to him, I will be able to put him back down and if he stirs, he will be able to settle himself as he does in the first half of the night.

On the other hand... it feels wrong to think about not having him with us.

Food during labor

Of course it's OK. So says Cochrane Collaboration.

In Labor? Bring on the Food!

It takes a lot of energy to give birth! I encourage my clients to eat in early labor especially. Light foods are generally advisable. The great Jan Mallak says that it's a good idea not to eat anything you don't want to see again :)

Childbirth in the age of social media

My Son Was Born on Twitter

This blog post by Lee Stranahan about the role Twitter, Facebook, and Flikr played in his wife's recent planned unassisted homebirth was very interesting! I know that during Charlie's labor we were on message boards and on Facebook -- and it actually totally saved our goose that we were because our childcare totally fell through and we were able to get the word out FAST to a lot of people that we needed help. And really, frankly, most of my best friends are not in Pittsburgh. Either they're friends I've known for years who live elsewhere, or friends who live elsewhere that I know online. It might be sad in a way but really, when is having a friend, period, not really a huge blessing?

So what are your thoughts on tweeting and facebooking, etc, during labor?

Another baby lost to Cytotec

Mother loses baby after being given 'abortion' drug to induce labor

Of course Misoprostol is not an 'abortion' drug. It's an ulcer drug. How many mothers and babies have to die before they stop administering it for labor induction? Stop being such money-hungry cowards and develop it properly for labor induction, at least. Stop being lazy and cavalier and properly monitor women if you're going to use an off-label drug to induce labor. So sad, so preventable.

Results are in!

The results of my contest are in -- and thank you all for commenting! Suffice it to say, 26 comments did not break the bank although it was I believe a record for my sad, neglected, maternity-left blog! The donation to Yele was MORE than $2.60 because really, that'd just be sad. I unfortunately couldn't specify an "in honor of" donation. came up with comment #9 as the winner -- Doula Amy! Aaaand unfortunately she left no contact information, so Doula Amy, send me your information, and I will send you some cookies! I think I know which Doula Amy it is but there is more than one.

The news coming out of Haiti is so horrific and shocking -- but underneath, and exacerbating, the dramatic misery is the steady misery of extreme poverty. As it has been said countless times in the past week, Haiti is the poorest nation in the Western Hemisphere, but extreme poverty is not isolated to Haiti. Please visit End Poverty 2015 to learn more about this ongoing issue.

Dads and Breastfeeding

I read this really great post:
Breastfeeding Lessons from the Kardashians

Now, full disclosure, I have never seen the show. But I have nursed three kids and I can tell you from my experience, I never would've succeeded breastfeeding Chim without support from my husband.

He came to the classes with me. He advocated for me in the hospital, tracking down lactation consultants. He got up with the baby at night, changed her, brought her to me, helped me feed her if I needed help, and then took her back and rocked her to sleep if she needed it. And he gave me the best gift of all -- encouragement.

He is the one who told me to commit to breastfeeding just one more week. And then, another week. And by then -- oh look, we're almost to a month. We can make it to a month, right? And by then it was smooth sailing -- she was off any supplements, back past her birth weight, by far, and sleeping a good 6-8 hours at night (seriously, we had no idea how lucky we were!!!).

Having another person -- a husband, partner, friend, mom, mother-in-law, sister -- who will be a tireless cheerleader is SO important for a first time mom breastfeeding. Someone who won't say, however well-intentioned, "It's OK, you tried, there's nothing wrong with formula." It makes all the difference to have someone there to say (especially after a cesarean birth), "You can do this. You're doing it. Your body does work."

Contest for Haiti

Taking a cue from Pioneer Woman, I am having a sort of contest. I will donate 10 cents for every comment posted to this blog post. I will donate it to Yele, Wyclef Jean's organization that helps Haiti in the short term and long term -- and if I figure it out, I will make the donation in honor of a randomly chosen winner. And that winner will also receive.... two dozen homemake chocolate chip cookies (if the winner is within the US or Canada). I don't have anything birthy to give away right now!

So leave a comment and spread the word!

Comments will be closed at 5pm on Friday.


I'll admit it -- pretty much everything I know about classical music I learned from Baby Einstein. This appalls my husband but the fact is, I don't think we ever listened to classical music growing up. My kids adore it now though -- especially the simplified Baby Mozart and Baby Beethoven stuff. If Charlie is crying, all one has to do is turn on Mozart of any variety and he will switch gears and listen to the music. I don't get it.

Smarter people than I am, do get it though.

Mozart Effect Helps Premature Babies Get Stronger

I guess it's the repeated themes? I love that something simple, pleasant, and non-invasive can help babies.

Elective cesarean sections are too risky, WHO study says

Elective cesarean sections are too risky, WHO study says

This article in Scientific American... I hope it will be one more step to a reasonable rate of occurrence for a life-saving surgery instead of the 30-35% rate that the US currently enjoys. However, since ob/gyns typically scoff at anything the WHO says, I believe this change will come from the "bottom" up -- i.e., mothers, doulas, midwives, childbirth educators, etc.

My OB said WHAT?!?

This blog is a guaranteed head-shaker. Some of the things that doctors, midwives, nurses, and yes, doulas say!!!

A new feature is positive statements posted on Thursdays -- because there are tons of great, supportive care providers!

One of my favorite recent "doozies" however, is this:
“You wouldn’t tell a pilot how to fly a plane.” -OB to a laboring woman, also a pilot, who questioned the Ob’s suggested labor management.

Ha, yeah! I'd love to say to this OB, That's RIGHT! And the BIRTHING WOMAN is the PILOT!

Cesarean Art

This is a collection of the artwork of a woman after her cesarean birth. I know that I identified with some pieces after Chim was born. I also know that not all women have such negative experiences during and after cesarean births and that it's not always unnecessary. However after mine, it was amazing to find that someone else was feeling the same way.

Some of the images are disturbing and graphic -- fair warning!

This one, entitled "postpartum," is so beautiful and haunting.
edited to add -- Badger saw this and said, "Sad mommy hurts baby." I added this not only because I wanted to show off his mad verbal skillz, but also because it gave me pause about how perceptive such a youngster is and how it's no wonder why there is such shame attached to postpartum depression -- no mom wants people to think she's wanting to hurt her baby!

Breast Cancer Screening Guidelines

So they've reverted to the previous guidelines for breast cancer screenings:
New guidelines back mammograms starting at age 40

One of the things that really bothered me was that previously they were backing off the aggressive screenings, and even recommendations of self-exams, because of false positives causing anxiety. I found this to be really condescending and contradictory.

Prenatal screenings have a HUGE false positive rate -- we received false positives for various ailments for both boys. Did those screenings cause "anxiety"? You better believe it. Would insurance pay for for the screenings and the more invasive tests? Yes it would have. But the guidelines for breast and cervical cancers that have been fiddled with recently are held to a different standard for some reason.

This line of thinking is tied, in some way, to the 30% or higher cesarean section rate -- the fact that a woman's right to make her own decisions about her bodily integrity is compromised by doctor's fear of litigation for a poor outcome in obstetrics. But frankly -- since the sun is not up and Charlie is not that great at sleeping in his own bed after his first wake up, I'm too tired to unravel it. But Charlie's cute enough that I forgive him.

Milestone Time!

Chim has lost a tooth! I understand that she is on the early side (5 years, 2 months) but I would like to assure the skeptics that she indeed had a wiggly tooth that fell out in the course of nature. In fact I have photographic evidence:

Totally stupid slideshow -- 5 Delicious Pre-Prepped Snacks For Postpartum Guests

5 Delicious Pre-Prepped Snacks For Postpartum Guests

OK -- the recipes do sound good. How about retitling the slideshow, "5 Delicious Snacks to Bring to a Postpartum Mom"?

Seriously -- a new mom should NOT be playing hostess. Anyone who crosses the threshold without food in their hands or the intention of doing a load of laundry or occupying older siblings for a few hours so mom can have some rest... not cool.

After Charlie was born -- I have to say, having my folks here was not the greatest help simply because my mom was in between gallstone attack and gall bladder removal. We spent more time taking care of them than ourselves. Not great. The friends and family who did come with a bag of bagels (yah, Julie!) or who would take the big kids out for a few hours (thx Aunt T and Uncle M!!!) were invaluable.

Postpartum depression is a real thing that some women will have to deal with regardless of the system of support they have in place but other women are rendered more susceptible by exhaustion.

Great Blog -- Birth Sense

Birth Sense -- Really interesting stories about birth both in hospital settings and at home. There are some crazy things that go on "behind the scenes" in hospitals!

Mom and Baby "Back from the dead"

It's wonderful that this story has such a happy ending. I do wonder what caused the mom to go into cardiac arrest. It's not that common for such a thing to happen during the course of a normal labor. That huge list of risks that come with an epidural includes cardiac arrest, too. I don't like to speculate, but I have to wonder what really happened here.

I know that the side effects of epidurals are extremely rare and that epidurals are not always a bad thing, and I'm glad that women can choose for themselves what to do with their bodies. I do wish however that informed consent was truly informed, instead of a list of side effects rattled off when a laboring woman is in an altered state of mind.