Jane and I were on the phone (again!) and we got sidetracked (again!) and started sharing stories about girls we know, the girls we were, and the time we’ve spent teaching girls.  Up comes the topic, “It’s like pulling teeth to get a girl to use the bathroom without asking permission first.” Not often the hot topic in midwifery circles—at first I thought we were talking about empowering girls to empty their bladder.  Ms. Jane, ever the former school teacher, shared stories of telling her students that if they would just use the bathroom when they need to without telling her about it, or asking her permission to do it, she would also abstain from telling them when she needed to use the bathroom.  In the perfect way that she has, she made it clear to them that this arrangement would work as long as they used it responsibly and didn’t linger, loiter, or use the time to organize against The Man. Now don’t be shocked all you folks who rely on stickers and hall passes and complicated systems whereby only one student can use the bathroom pass at a time (please watch Weeds and note the girl positively begging her teacher to be allowed to use the bathroom—pleading which was ignored and denied—and the subsequent in-situ explosion). But her system—the one where the teacher says, “I trust you to know the needs of your body and manage those needs in a responsible way,” worked.  On and on the conversation traveled until there was a flash inside my head.

It’s no wonder that birthing is so darn hard for so many American women.  We are taught to deny our most basic bodily sensations from a very early age here.  And then it is reinforced year after year and hour after long hour in some cases.  A full bladder is a wonderful thing—the sensation of pressure that results from hydration is so informative.  Not only does it tell us that we are taking care of our bodies by drinking, but it tells us that our bodies have a system used to regulate liquids, toxins, vitamins, and all of the other lovely little goodies that compose our urine.  But mostly it is great because our body yells at us to get up and move and use our very amazing and natural abilities to create change and restore comfort.

You can see where I’m going…if we spend our lives denying the signals in our bodies that positively scream at us to move or make change or simply let go the urine in our bladders…how on earth are we supposed to suddenly respond to those signals for which we have never developed receptors?  Why would we ever even know what to listen for, how to listen, or how to receive and react to the messages our body and baby send us during labor and birth?

Don’t get me wrong, it all works…eventually.  Because gravity and the force of what my son once proudly and loudly referred to as, “the MOST POWERFUL muscle in the human body!!” do tend to conspire to eject our babies from our bodies despite everything we do, and don’t do to aid in the process.  All of the extra time it takes us to just let our bodies take over is too much time in the world of modern obstetrics, and 30-40% of us here in Seattle will have our babies in the OR because of the time we are taking with labor.  It appears that the increased cesarean rate may be traceable to the rules of elementary school as much as anything else.

You draw the conclusions—and consider—the conversations you will have at the next parent-teacher conference.

And though my youngest is now a strapping man-sized child of 13, I just want to gather him in my arms and feel him close to me, to say nothing of my 18 year old who is on the other side of the world having a fabulous college experience. So why is it that when the world goes to pieces it is our arms that feel like the safest place to shelter our children?  Surely gathering everyone in a sturdily made bomb shelter outfitted with 20 or 30 years of supplies would be safer—but the gut and the heart call our children to our arms instead.

New mothers often struggle with questions of how to be “the best” kind of new mother.  We read books by the dozens, watch videos, attend classes, and subscribe to “parenting philosophies”.  We tumble from one to the next, constantly in search of the next better method to follow.  We could blame the internet or the smart phones, Amazon or the year 2013, but taking a brief tour through the history of parenting psychology shows us that we are not alone in these struggles.  Our American grandmothers struggled with all of the same issues—pamphlets and doctors and the neighbors all piped very loud messages into their ears and brains.  When I have the opportunity to talk with student and practicing midwives, it is a very rare occasion that I don’t quote Dr. Donald Winnicott (a protégé of Freud’s, who lived from 1896-1971) for one reason or another.  I love his sense of mother’s rights, of his trust in the mother as the best expert when it comes to her children, and his calming demeanor which shines through in his writing as he address mothers head-on.

Dr. Winnicott talks extensively and beautifully about what happens in the arms of a mother.  It seems like a crime to paraphrase too much, so indulge me as I quote him on this issue—a task I cannot do in real life without catching my voice and taking deep breaths.

“There is room for all kinds of mothers in this world.  And some will be good at one thing, and some will be good at another.

Or shall I say some will be bad at one thing and some bad at another?

Some are anxious holders.  It may be worth while looking even a little more closely at this business, because if you do handle your baby, well I want you to be able to know that you are doing something of importance.  This is a little part in the way in which you give a good foundation for the mental health of this new member of the community.”

He goes on to say that he could have chosen any topic at all to illustrate how wise and important mothers are, but he chose the seemingly menial task of holding babies to demonstrate his beliefs:

“You are specialists in this particular matter of care of your own children. I want to encourage you to keep and defend this specialist knowledge.  It cannot be taught.

Then you can go and learn from other specialists about more technical things  [like vaccines and vitamins]  But only if you keep what is natural in you is it safe for you to learn anything that doctors or nurses or others can teach you.”

It is in the holding of our own baby that we flourish as an expert—comfort in our arms is one of the primary needs of a newborn, and we provide that! It is in the holding of babies that we give them their sense of the world, of cause and effect, and the confidence to know that their one secure base is reliable and trustworthy.  They see themselves reflected in our regard for them.  They smell us and we smell them.  We bond deeply from this place of holding.  Our hearts are knocked together, beating in time with each other.  We breathe together in this position, and find comfort and desire to nurture here.  Our milk pulses downward towards their needy, growing, bodies. And as our eyes lock with theirs, we share intensely personal space with each other here.  As our children grow, they start to move away from our arms, but return for bonding, healing, and grounding throughout their lives.  We instinctively know to hold them—even as they become men or women, even as they have their own lives and connect with us in thousands of ways outside of our arms.  We know that we have done our best, deepest work in that small space which is the span of a couple dozen inches at the widest part.  Our children know that they gained their sense of safety and balance in those inches.  And that is why, even when they are grown, the original home-base is the one that calls us to each other with such fantastic eloquence and urgency.

It’s that word that gets me.  “Naughty.”  It is a child word.  Nursery school kids are naughty when they eat finger paint.  Third graders are naughty when they let their eyes slide over to their neighbor’s math test.  By the time we get to teenage curfew violations, taking the car without permission, and swigging Boone’s Farm, the transgressions have moved far beyond  ”naughty.”  At this point, they illicit  other descriptors, ones which carry more weight, and possibly four letters.

This mother had just achieved something gigantic.  Not only had she accomplished her vbac goal, but she did it on her own terms.  Now, I do not know this woman, but if she is like most of the vbac-ing mothers I do know, she probably did a whole lot of research, asked others for their opinions and apparently was comfortable waiting a bit longer to see if labor would start on its own.  She evaluated the risks, made her choice and stuck by it, even in the face of opposition from her care provider, a provider that she herself chose.  She did not hand over her power to another.  She not only claimed it, she used it, in a very visible and undeniable way. That child came out her vagina because she insisted on time. There can be no argument there. And that is not the mark of a naughty child.  It is the mark of a fully grown, capable human, exercising fully grown, capable reasoning.

And that is extremely threatening. Someone in power wanted her to do something.  She didn’t.

In conflicts of oppression, if the weaker person “wins,” there are repercussions. Without punishment, the weaker may try this independent thinking thing again.  It might even spread to others, and then we have a revolution.  A revolution would make a mess of the carefully constructed hospital system, destroying a top heavy power base that has worked extremely well for those in power for decades.  (Just decades, mind you.  Not centuries or millennia.  Maybe it is not as strong as it first appears?)

In this case, the repercussion came from the nurse.  What better way to put a new mother in her place, taking back that mature power she claimed, than to turn her back into a baby?  Babies do not threaten.  Babies drool and look cute and poop.  This mother used her adult prerogative of self determinism; let’s use child words to negate that, to cut it down into something easily contained and understood.  Something “naughty” rather than terrifying, something teensy-weensy rather than something momentous.

Or let’s not.  Instead, let’s celebrate adult women making  choices, making fully developed, reasonable, heart driven choices, that are neither outlandish nor insignificant.  Our world deserves that.

Boy, that is really long and ugly.  Ah, well. We’ve had a lot of fun doing promotional events; our favorite was being on Dr. Christiane Northrup’s radio show, “Flourish.”  She was a very generous hostess, and gave a lot of airtime to Vaginal Birth After Cesarean, one of our favorite topics.  We were completely nervous, but the hour flew by!  We’ve also been doing a lot of guest blog posts on some very well known sites, including parents.com.  Imagine our surprise when our article, complete with a picture of the book cover, was flashed on the Rachel Maddow show!  One of our intrepid friends was able to get a screen shot of the exact moment:    Pretty wild, eh?  We heard about it as we were coming back from a book singing in Olympia, and there was a lot of screaming and overjoy-ed-ness, I promise.  Such fun!

Jodilyn’s newest venture The Essential Birth and Family Center in South Seattle is off to a roaring success.  It has become quite the hub in the short time it has been open, hosting all kinds of groups and services for young families.  It is so needed, and we couldn’t be more pleased.  Here’s the website, so you can check out the latest offerings:   http://www.essentialbirthandfamily.com/

Jane is off to Uganda again in October, teaching the second annual Shanti Uganda Doula Training.  This year we are adding a NARM Review Retreat, for all those student midwives who are preparing to sit the exam.  It is going to be an amazing time of study and reflection, and I cannot tell you how excited I am about this.  Please feel free to pass it on to all the student midwives you know.  Wouldn’t it make a fantastic graduation gift?  More information about both trips can be found on the Shanti Uganda page, here http://shantiuganda.org/get-involved/doula-training/  and here:  http://shantiuganda.org/get-involved/volunteer/narm-review-retreat/  There is just nothing else like these two programs out there, and it would tickle me pink if you decided to join us.  I will also be staying on in Uganda for three months, catching babies, doing some more midwifery trainings, and generally just having a rocking good time.  I can’t wait!

We are also attending the Midwifery Today conference in Eugene, Oregon April 4-7, schlepping books, networking and filling up our midwifery cups.  We can’t wait to hang out with our favorite people in this community, and hopefully meet some new friends.

So that’s the update.  What have you all been up to? We’d love to hear from you!

Here’s an excerpt:

600 people reached the top of Mt. Everest in 2012. This blog got about 3,600 views in 2012. If every person who reached the top of Mt. Everest viewed this blog, it would have taken 6 years to get that many views.

Click here to see the complete report.

This Center has long been a dream of mine—to have one place where families can connect with each other and the professionals who provide the services they want, to develop a sense of community around expecting and new families, and to change outcomes and access to quality, not just routine, care, in my neighborhood. In my mind’s eye, I thought I would make some phone calls, people would agree to teach a class or sublease a treatment room for a few hours or a day each week, and mothers would flock in to receive the benefits.  The reality proved to be one of the most meaningful experiences of my life.  Over the past 5 weeks I have met with dozens of professionals and parents.  We sit in the lovely Meeting Nook aka The Nursing Nook, and settle into the comfy chairs with some tea in one hand and a pen in the other.  I wanted to understand what services we might offer, what’s missing in our neighborhood, and how we can translate all of that into something meaningful for families.  We spent hours dreaming and refining, writing curricula, and sharing stories.  That Nook has some kind of special magic to it—it is so cathartic to sit there and connect with people.  I’ve had meetings with leaders of local birth organizations, a home organizer, a professional photographer, doulas, educators, business specialists, and a surprising number of grandparents and fathers of twenty-somethings.  It turns out, this idea of creating community around families makes sense to people.  Together, we’ve managed to create a dynamic offering for mothers, babies, and the people that love them.  We have classes covering everything from how to organize your house for baby, infant massage and photography, to babysitter’s training and grandparents classes.  We offer Friends and Family CPR—a simple two hour class designed to create comfort for anyone who spends time with babies or kids, and a beautiful class called Girl Sense—a seven week program for 8-9 year old girls.  We have the classics you would expect in a Birth and Family Center—childbirth education, postpartum drop-in and support groups, lactation classes and support, doula care, nutrition counseling, acupuncture, massage, and more.

As I struggled with how to create a group of doulas who can work out of the center, I met with doula trainers and new doulas and local doulas and finally, with Jane.  I was telling her about my struggle, “I deeply want to promote the work of local doulas–how can I recommend them if I don’t really know a lot about them?” We began to hash it out, the things we learned over the years through trial and error, acquisition of information, and sheer luck.  Before long we realized how great it would be to create an extended learning opportunity for newer doulas, or those that never had formal training.  And thusly was born The Essential Doula Training Academy—a year long course designed to delve into all of the issues that doulas face using the model we have adopted in our work lives. As we filled in the curriculum for the program, the conversation became more animated and passionate; we hit on something that we care deeply about.  We are thrilled to bring this resource to the community here.

In the end, what’s in a community is the people, their ideas and hopes for building a place to gather together and grow in our knowledge and support of each other.  I am so grateful for all of the people who have given me so much time and energy, and to those who have pledged theirs’ for the coming months to help launch this business.

I hope you’ll check out the website for Essential Birth & Family Center, and share it with your friends, family, colleagues, and clients.  Come by and visit me there—we are located in the heart of Seward Park just a few blocks south of PCC.  If you have ideas for classes, workshops, groups, or services come sit in The Meeting Nook and brainstorm with me—I have a great selection of tea and can’t wait to meet you there.

The Meeting / Nursing Nook

Welcome!

In 2013, Jane will be spending three months in Uganda, teaching, training, and learning with birth professionals from around the world. If you’d like to join her for a doula training, please go to www.shantiuganda.org.  She’d love to have you!  Jodilyn is opening a community-oriented center to provide education and support for expecting and new families in South Seattle. Very exciting! And of course, “The Essential Homebirth Guide” will be released on February 12th and we will be engaged in book signings and attendance at conferences and events to promote this work.

The forward for our book was written by the renowned Christiane Northrup, M.D. She has taught women about health, wellness, and the miracle of their bodies for decades. Now, in her first children’s book, “Beautiful Girl,” she shares her wisdom with the youngest of future women. Beautiful Girl presents this simple but important message: that to be born a girl is a very special thing and carries with it magical gifts and powers that must be recognized and nurtured.

Through empowering words and illustrations, little girls will learn how their bodies are perfect just the way they are, the importance of treating themselves with gentle care, and how changes are just a part of growing up. After years of working with birthing women, and seeing our own lives and careers continue to evolve, we know that preparing girls for change is normal, healthy, and even exciting.  It is really preparing them for the work they will do their whole lives.
In talking with women about how they feel about their bodies over the years, we have seen a direct link between the way they relate to their bodies and the way they approach birth. A lifetime of messages built around fear and gate-keeping (providers not sharing decision-making and evidence based research in health care with the patient or client) can create anxiety and trepidation at the way our bodies change during pregnancy and birth. Our New Year’s wish is that all women have the expectation that pregnancy and birth will be infused with joy and awe instead of fear and inadequacy.

Imagine a girl raised to believe her body is the center of her power and the foundation for her accomplishments. The impact of that belief will affect every aspect of that girl’s life and reach into pregnancy, motherhood, and beyond.  “Beautiful Girl” can help pave the way for this possibility.

Dr. Northrup believes that reading and discussing “Beautiful Girl” with your children will help them to value the wonder and uniqueness of their bodies and have positive benefits that will last throughout their lives.
SPECIAL OFFER from Dr. Northrup and Hay House! As an added bonus, purchase or preorder a copy of Beautiful Girl here and receive FREE access to Dr. Northrup’s upcoming Live Online Event “Feeling Beautiful” taking place January 24th, 2013!  Offer good until January 23, 2013. (Valued at $97).

Guess what? You don’t get to. You don’t get to claim that your magic acupressure points, or your special way of sweeping membranes or the way you channel the Goddess does anything. Now, this isn’t meant to become a debate on the efficacy of these or any other techniques. Maybe they work, and maybe they don’t. I have my own ideas about it, something along the lines of “I don’t know…maybe if a woman is teetering on the very brink of labor then maybe maybe maybe what you do can have a little tiny effect, and topple her over the edge into the Land of Regular Contractions. But most likely they would have gone into labor anyway, as most people don’t start with the desperate until they are over their estimated due date.” Those are my thoughts, and of course, you are welcome to yours. You may truly believe with all your heart that you can throw a woman into labor. And that’s great. Believe it. Just don’t share it.

There are some studies, of course, because if you look, you can find studies on anything. But they are small, and again, you can’t disprove a negative. If you are looking at term women, trying to isolate one variable can be difficult. Term women are actually known for going into labor all by themselves, which could, well, throw off a study.

I’m sorry if this is hard on your ego, or if you have made your fortune by “naturally inducing” women. Or if you like the feeling you get when you say (off the record, of course, because you are professional, and only talk about such things with your trusted birth professional circle) “Oh, she’s really close I’ll just do–fill in the blank–and we’ll get this show on the road.” But the truth is, this isn’t your show.

Like almost everything else in birth, it’s the mother’s show. And when it’s not hers, it is her baby’s.Mostly, it is a combination, as it is hard to separate these two bodies and souls, and I for one, would never want to. The last thing we need is another “professional” trying to own this process, to give off the impression that the mother is not enough. Mothers already struggle with abdicating their pregnancies and birth, with giving over their power and their process to those they believe “know better.” Jodilyn and I see so many things, almost everyday, that serve as wedges between a mother’s strength and intuition and her baby.

Mothers receive oodles and oodles of messages that they are not enough for their baby, that their bodies and minds cannot be trusted, and that it would be best if they would just surrender to these outside forces. What happens when they go to one of these professionals, hoping to start labor, and it doesn’t work? Nothing good, I tell you. More separation from intuition, more doubt, more guilt. Who needs that? Even pitocin doesn’t work if a mother’s body is not ready. How many c-sections come about because of failed inductions? A lot. Then more questioning, more trauma.

So if you are a birth professional, I ask you to offer your gifts freely, without any expectation or ego. Give real information, and please please don’t regale your clients with stories of how your last client went into labor three hours after getting off your table. Don’t even mention labor induction, even if you really truly think you can make a difference. If a mother comes to you hoping for it, tell her that her body is absolutely the most wonderful thing on earth, and that she has done a fantastic job growing this little person inside. Tell her about the benefits of relaxation. That’s something every pregnant mother can use. Tell her that you believe in her and her baby, and the inherent wisdom of the body. Tell her that it is an honor to work with her, and that you have faith in her. In short, tell her the truth.

We always say that third babies are the wild card.  While they are housed in an experienced uterus, it is one who has been stretched out.  Third babies can get into all sorts of wonky positions, causing a longer  (and depending on the position of the baby) more intense. labor.  Early this afternoon, one of the midwives asks if I would check her, as they would like to know if I can ascertain the position of the baby, and maybe give some suggestions to help.

When I enter the birth room, Viola is lying on a plastic sheet, moaning slightly, even when she is not actively contracting.  She is having a very difficult time relaxing between contractions, and she is holding her lower back.  I note where she is lying (her left side), and that she taps out a quick staccato rhythm with her right hand when she contracts.  She is sweating, shaking, and she is deep deep into that place we call Labor Land.  She does not glance up at me as I sit silently on the bed next to her, just letting her get used to my presence. Her belly is flat in front, from just above the umbilicus to a few inches below.  Her contractions are irregular, between 3 and 6 minutes apart, although when they do come, they are very strong. I ask her softly if I can feel her belly, and she nods quickly, just once.

Now, so far, my “examination” of her has been pure  observation, and observation is the heart of doula work.  If she’s clutching her back, there’s a good chance it probably hurts even in between contractions.  Lying instinctively on her left side is not only good for getting the maximum amount of oxygen to the baby, but can also help a baby rotate and come down into the birth canal.  And a flat front belly can indicate a baby who is hanging out in the occiput posterior position, also known as “sunnyside up.”  The baby’s spine is resting against the mother’s and this bone on bone action can cause the dreaded “back labor.”  And, from the shape of her belly, I can tell that the baby has not yet dropped down into the pelvis.  This is not uncommon in women who have had prior babies, so it doesn’t really concern me.   From the length of her labor, I can theorize that this baby is probably not only sunnyside up, most likely acynclitic as well, a situation where the baby’s head gets cocked off to one side or the other. This makes it harder for the baby to descend, as the surface area of the head is increased.

All of these things can be helped along (sometimes) by positioning exercises, which, coincidently, is exactly what we are teaching today!  So convenient.  The midwives have already used some of the exercises we showed them, but here is a great chance to illustrate how to read a labor, how to put all these little clues together and make a plan to get this baby shifted.  I knew that as soon at the baby worked out how to drop into the pelvis, Viola would not have to push long.  I could tell from the size of her belly and some gentle palpation that this was not a giant baby, and if she had birthed two full term babies previously, there should be plenty of room.

At this point, I pretty much knew all there was to know, and an internal exam was just going to be a formality.  She was most likely almost through dilating, but the baby was still high in the pelvis, trying to turn its head this way and that, searching for the way that fit him or her best.  The trick was going to be to give her enough time, and keep her energy up enough to let her body and her baby do their work.  She was very very tired, although she was eating pineapple and peeing frequently.  (This last is important, as a full bladder can impede a baby’s descent.  Think about how close the bladder is to the uterus, and you can see why.  For those readers without a uterus, I’m sure you can imagine.

I grab a glove from the box, and ask her permission to examine her.  She nods once and rolls over.  Sure enough, she is 9 cm dilated, but the baby is still floating.  As hard as she has been working, she’s going to have to do a bit more.  I explain how to position her on her left side, with her leg raised high on pillows, almost lying on her baby.  In the western obstetrical world, we call this position Modified Sims.  In Viola’s world, we call it resting comfortably.  I give the midwives a few more suggestions for when Viola is able to participate more actively, including the Captain Morgan (one leg on a chair, the other on the ground, swaying gently through contractions) and hands and knees, leaning over one of the new donated birth balls.  (Thank you, Simkin Center in Seattle!!).  I smile at her, check the heart tones of the baby to ensure that he or she is liking this position, (heart tones are perfect!) and leave her with the Ugandan midwives.

This goes on all afternoon.  Periodically I would be asked to check on her, and periodically I would go in and hang out with her, offering suggestions as we went.  Eventually the midwives start an IV, just to keep her hydrated in the Ugandan heat.  We also used the rebozo with her, and put her through a million different other positions.  She was a trooper though all of it.  Eventually it was time to leave, though, and Viola was still laboring.  I was certain she would either deliver that night, or be transported for an obstructed labor.

The next morning, I was delighted to find that she had birthed during the night.  Hooray!!  And sure enough, it had only taken two pushes .  Baby just had to find the way.  As Melinda and I sat admiring the baby, and telling Viola how wonderful she was, I asked his name.  “Jane, I want you to name him,” she replied, smiling.  I was shocked and honored.  Together we decided on Patrick, after my beloved husband.  It is a gift to get close enough to someone that they want you to name their baby.  A true gift  to connect on the most basic womanly level, though birth.  I hope Patrick lives a long and happy life.  I know he has a wonderful family, and I hope I can see him next time I return to Shanti.

I don’t know what the drum shop lady thought when a herd of mzungus descended on her; its entirely possible that she had never sold so many of her wares at one time, and it is equally possible that she was just sitting down to lunch, and we were a huge interruption.  The drums, however, were beautiful, and we all picked out our favorites.  Several of our gang’s had insects inside, so they set them outside their door back at the guest house, where they remained the rest of the trip. Some people have old room service trays.  We have buggy drums.

Here’s the drum lady.  She looks considerably happier than when we first arrived.

Drums bought, we were off to lunch.  It was a buffet style on the Anglican diocese grounds.  We ate here last year, and it was remarkable in that it was basically our only bites of animal protein the whole trip.  I’m such a carnivore.  I was completely looking forward to it again for that reason.  No mattooke today for this girl!  And, in fact, there it was, sitting in the covered dishes in all its glory”  A piece of stewed chicken.  I think it was a thigh.  I’m not sure.  I didn’t care.  I was just so so happy to be eating it.  i also knocked back a bottle fo the local ginger beer (non-alcoholic).  It was delicious!

The afternoon’s training was four hours on how to educate your clients, and politics and power dynamics in the birth room.  I could talk all day on these subjects.  The education piece is always tricksy for me.  A doula’s job, on the deepest level, is to help draw out what a mama already knows.  We always say we want a mother to trust herself and trust her body.  The easiest way to facilitate this is to help her understand that she already knows the answers to the deepest questions, which in turn builds her confidence that she can participate fully in this experience without fear.  With help, a mother is often able to access that internal knowledge about the larger philosophical questions of birth and life and death, and can be taught how to express them coherently, This is awesome and magnificent, and these moments keep me going as a doula.

However, when it comes to the shallow questions, the nitty gritty details about birthing, like “WIll I poop on the table?”  or “Will Hospital X let me have my baby on my chest right away?”  I am totally fine with just telling them the answers. Many doulas (and this is not a slam.  Really.  It is a stylistic difference.) feel that it is our job to provide resources, rather than provide specific information, so they tell their clients where they can find the information, rather than just sharing the information itself.  People remember things best when they have to work for them a little bit, of course, so there is a great argument for educating that way.

Me?  I think that one of the reasons they hired us is to make their lives just a bit easier on their Birthing Day.  And if I can do that by just saying,”You might poop.  Its a great thing.  It shows you’re pushing in exactly the right place, and chances are you won’t even know you did.”  then I probably will.  It seems like an oral tradition to me, sharing the sacred knowledge (Yeah, I think poop can be sacred.  its an odd life I lead.)  with the uninitiated, helping lead and prepare them for that time when they too will undo go the trials, the rite of passage, if you will, into motherhood.  American women today often don’t have time to completely research every little question they might have, evaluating sources, and wading through a swamp of google hits.  They wanted an expert in birth, and that is why they hired a doula.  And, to bring it back around to Uganda, most of these women don’t have Internet access, so asking question of their mothers, their sisters (read “their doulas”) is how they get information in the first place.

So that means, doulas, know your stuff.  Study up, keep abreast of current information, and don’t be afraid to say that you don’t know, that you will get back to them.  The only thing worse than no information is bad information.  And keep in mind, that at the basest, most primal level, mothers know how they need to give birth.  You’re just there to fill in the blanks