Sunday, January 31, 2010
As I was navigating NYC subways with 2 kids- one in a stroller and one in my baby carrier, I had ample time to think about this issue. If I had unlimited funds, would I really want to have one caregiver for each of my three children?
I decided that I did not. True, if every child had their own babysitter, they would never have to worry about picking their brother up from a playdate or waiting to go to the park until the baby wakes up. But that would not necessarily be a good thing. That kind of attention would also reinforce the idea, that the whole world revolves around the child and his needs. Children have a tendency to be self-involved by nature and our job as parents is to teach them to share, to think about others, to expand their horizons a bit. They need to learn to be part of a family, a classroom and, as they get older, the community at large. Having to adjust their schedules to accomodate others can be helpful in making them realize that other people have feelings and needs as well.
Of course, there has to be a balance to everything. A child who always has to bend and live her life according to her sibling's schedule may become resentful. We need to try and set aside time for each child individually to show them how important they are to us. But that doesn't have to be ALL the time.
This seemingly mundane insight gave me a little boost for the week. It made me realize how even in the small choices that I make on a day to day basis, lies the potential to teach my children something valuable.
Thursday, January 28, 2010
In February I will be taking a "Hypnobirthing for Doulas" workshop. This course is designed to help doulas work with clients who want to try the Hypnobirthing approach to pain management.
Then in May I will be taking a Lamaze Childbirth Educator training class with a cool organization called Passion for Birth. I have been thinking of teaching childbirth ed for a while now. Although I feel like I could probably teach based on all the knowledge/information on childbirth that I already have, I would feel more confident and comfortable doing a training and becoming certified. Did you know, that the credentials for a Lamaze Childbirth educator are LCCE- it stands for Lamaze Certified Childbirth Educator. Quite a mouthful :)
On the kids front, I am in the process of finding/interviewing new babysitters which is always fun- NOT. Taking Y to another doctor's appointment this afternoon. He is having minor surgery at the end of February, and being that he will be under general anesthesia already, we are considering having another procedure done at the same time. Kind of like a 2 for 1 special. Never a dull moment here.
Monday, January 25, 2010
For example, she compares the risks of VBAC to the risks of a c-section. As it turns out, a VBAC may actually have fewer risks than a casearean, but very few OBs will admit to that.
She explains why routine interventions such as Iv fluids and continuous monitoring do not necessarily lead to better outcomes.
What was interesting to me was that she quoted much information that many women don't have when making decisions about their maternity care, such as the true risks of cesarean sections. While a wonderful option when necessary, the risks are nothing to sneeze at either- both infant and mother mortality rates are higher for c-sections. There is the risk of infection and the prevalence of adhesions, as well as a higher risk of terrible complications in a following pregnancy such as placenta accreta or placenta percreta, where the placenta grows onto the uterine scar and sometimes even out of the uterus and into the bladder. Very few doctors will mention these risks when discussing a cesarean with their patients.
I am not trying to scare anyone here, but what this book really underscored to me is that knowledge truly is power. As women we have the responsibility to educate ourselves about the physiological process of childbirth. What is typical? what is cause for concern? what are our options? what are the risks involved? Even though we are not medical professionals, we need to at least be able to ask intelligent questions in order to make the best decision possible.
This reminds me of one of the first births I attended. The couple had decided to try to have a natural childbirth because they did not want the baby exposed to any drugs. In the end she was induced because she was almost 2 weeks overdue and the doctors were concerned. Once she had pitocin, it made the contractions unusually strong and she was considering an epidural. Her husband freaked out because he didn't want the baby exposed to meds. He said- maybe it's safer to just have a cesarean than to have an epidural. To which I responded "NO"- because a c-section is major abdominal surgery. Aside from that, the local anesthesia used for a cesarean is actually a (you guessed it) very strong epidural! This proves my point- do your research, understand the process, so you can make good decisions for yourself AND the baby.
Don't take my word for it- read the book. I highly recommend it.
Sunday, January 24, 2010
There are now two baristas in Starbucks who actually remember my name when I walk in. So now when I say Tall Skim Latte, they say- sure, R. Rather than finding this cute, I find this rather embarressing.
I confess that I do go in there way too often. Probably 4-5 times a week, if I am honest. The temptation of caffeine plus steamed milk that someone else prepares for you (no clean-up!) is hard to turn down, especially because I walk by there several times a day on my way to and from school, PT, OT, speech and all the other fun places we go.
I always thought I was just another anonymous crazy New Yorker who pays too much for her coffee when she can make her own for about 25 cents. But now that my anonymity is shot, so I may have to rethink this whole Starbucks thing. Or not...did I mention the foamy milk ;)
Thursday, January 21, 2010
A is the middle child but she is super protective of her older brother, always making sure he doesn't run away or get himself into trouble. This may be too much responsibility for a 3 year old (topic for another time) but it is very sweet. Whenever they meet at the playground at school, they hug and have a reunion like they haven't seen each other in months.
As for Baby M...The older 2 have this new game they love called "Tackle Meir" where they jump on top of him. He does not like this game and neither do I. But when I can convince them to do something else with him, they are great. They involve him in all their shenanigans and he is a quick learner- I wish I had a picture of Y and M on the couch today with all the cushions on the floor (another favorite game) and them trying to reach a picture on the wall and shake it. Yes, I know- incredibly safe :)
One morning this week Y and M woke up unusually early. While I was trying to get some more sleep on the couch, the two of them were playing nicely on the floor. M. was giggling and laughing so much, it almost made me want to sit up and see what they were doing. Almost. I was still too tired to really appreciate it.
So the project in the next few weeks is to motivate my older ones to move away from the tackling and suffocating w. couch cushions game to the good kind of fun where everyone is actually laughing- and breathing.
Monday, January 18, 2010
My friend and fellow doula Eden explains it so well that I am going to paraphrase her words of wisdom :)
When you hire a doula, she is on call for you for 2 weeks before your due date untill you give birth. That could be up to 4 weeks. Being on call means you live your life differently: you keep your phone on you at all times, you need to have child care coverage, you don't travel or go anywhere too far, you may drink less socially because you need to be clearheaded at all times. It also means you don't commit to other clients at that time. Different doulas have a different amount of births they feel comfortable taking on during a certain time period but there is always a limit. When you pay for a doula's services, you are effectively paying her for all the time she is making herself available to you, to the exclusion of other potential clients she could have worked with.
I'll add my own thoughts as well. In addition to the time a doula will spend with you in labor, she will typically have at least one if not two prenatal meetings with you that could be an hour or more. She is always available via phone/email if you have questions, need a referral or just want to talk. She will come to your house when you call her, even if it turns out to be a false alarm. And she will do it all over again when you really are in active labor. She will come 24/7 whether it is 2 30 am or 5 pm- weekdays, weekends and holidays. The doula will definitely call to check in with you a few days post partum and most likely visit you at your home. Even if your labor is on the shorter end, you come out ahead. You get the support you need for a large chunk of your pregnancy,not just at the time of birth. And if your doula does end up staying with you for 24 hours or more, the hourly rate is actually pretty low :)
Now does that make things a bit more palatable?
Sunday, January 17, 2010
Yesterday was a challenging day. I am a bit slow but after almost 5 years of being a parent I am starting to learn that when it is too quiet in the house it means there is big trouble brewing. While I was drinking my coffee yesterday morning and enjoying the quiet, I soon realized that I had no clue where Y was.
Bad news. So I checked the usual mischief places- the fridge, the bathroom, his room but he was not there. I checked his next favorite place, my bedroom, and found him thoroughly enjoying himself. He was redecorating the room- with my mascara. It was everywhere- on all the walls, on the sheets, on the floor, on the door. You cannot even imagine. So I did what any good civilized mother would do- I yelled. Then I felt guilty, because it' s not his fault. He doesn't understand. Even though I desperately just want him to understand why this is not okay, he just doesn't get it.
Fast forward to bedtime, 10 hours later when Y wandered off while I was reading the kids a book. Again, too quiet. Again a huge mess- this time half a bottle of grape juice all over my kitchen floor. Like I said, I'm slow. I forgot to lock the fridge.
I blew my cool and yelled. And Y was crying because he was just trying to pour grape juice into a cup and make havdalah like his Abba. I felt guilty and resentful all at once. Guilty because I know I am the adult and I need to stay calm. Resentful because my reality is such that I need to lock my fridge, hide my pens, my toiletries, my laptop AND my wallet and cannot sit for five minutes without wondering what my kid is up to.
So the lessons we learn from this is:
1) Quiet means trouble
2) I need a lot of work on my patience. Suggestions welcome.
Edited to add- although I sometimes sound exasperated on this blog, I really do love my children. Really :)
Wednesday, January 13, 2010
M is Baby nr. 3. Y was a c-section due to being breech, A. was an awesome VBAC and I was looking foward to another great experience. I had hired a wonderful doula (shoutout to Elanna Possner) and liked my doctor. This was my first time giving birth in the US so I was a bit nervous. I wanted to stay home as long as possible but I also wanted to get to the hospital in time.
I knew I would be giving birth close to my due date (Jan. 15th) because that's how it had been the previous two times. I was having lots of braxton hicks contractions in the week leading up to my due date and kept thinking- maybe this is it. Monday, Jan 12th I went to the doctor for a regular check-up. I was having stronger braxton hicks that felt different and really thought things were slowly starting to move. When he checked me though, I was not dilated. I was a bit disappointed but did not worry about it too much. That night before bed, I made sure my bags were packed just in case.
I woke up at 4 am to go to the bathroom and when I got out of bed, my water broke in a huge gush. Kind of like in the movies and you think these things don't actually happen like that but sometimes they do. I woke up my husband right away and called my doula. I knew things were going to move fast, the way they had when A was born. Elanna said she would shower and come over. I went to sit on the toilet and waited for the contractions to start. They started soon after, coming every 10 minutes. They were still manageable so I breathed through them and rocked back and forth. In between I read a book and was instructing my husband on packing last minute things.
Soon the contractions were getting stronger. We called my inlaws around 5 45 and asked them to come over as soon as they could. Elanna came around 5 30 or so. We just hung out in the bathroom because I was very comfortable sitting on the toilet. It sounds funny but it's actually a great position to labor in because they baby can move down and you can rock back and forth.
I was not sure I wanted to go to the hospital yet. I had called in and found out that my doctor was coming in around 7 so I figured I would wait till then. I preferred him to the other doctors in the practice because I knew him. The contractions were definitely coming closer together and were getting stronger. We wanted to get going but my in laws were not there yet. We called a neighbor who was leaving to work soon but she sent her nanny down. My kids were still sleeping anyway.
Around 7 10 we left. We had to stop on the way to the cab every few minutes when a contraction hit but we made it the hospital by 7 30 or so. Thankfully I got to skip triage and went right into a room. That was good because I pretty much hit transition as soon as I got to the hospital. I was so thankful that I was not in the cab anymore. I tried squatting through the contractions and breathing but things were getting intense.
In the room, they wanted to put me on the monitor for a bit so I had to be in bed. My doctor was in a meeting so he sent his midwife down to be with me. She insisted I get an IV even though my birthplan clearly stated I only wanted a heplock and my doctor had signed off on it. That was the only bummer. Meanwhile I was ready to push and it was kind of comical- me starting to push while the nurse was still trying to find a vein for some bloodwork and the IV.
I think at some point in labor, every woman hits a wall when things just get too overwhelming. I was feeling the urge to push but also very strong contractions so I just started screaming. After a few minutes, though, I got the hang of the pushing and became focused again. All this time Elanna was there holding my hand and encouraging me. She told me she could see the head already. One more push and the head was out and then he was there in full glory- a beautiful baby boy. Born on Tuesday, Jan 13th the 17th of Tevet, at 8 13 am and weighing in at 7lbs 14 oz.
I was so thankful that things had gone so smoothly and really felt exhilarated by the whole experience. I held him right away while they cut the cord and delivered the placenta. Then they cleaned us both up a bit and I was able to nurse him. We just hung out in the room and chatted while they did all the admission stuff they hadn't done before the birth because things had gone too fast. We called our families to share the news.
My doctor never made it in time. The midwife was great though. The funny part was that I had attended a birth about a month ago with her and so she remembered me. It was good that she wasn't a total stranger to me.
And now it's a year later. M is a delicious baby who is very easy going and happy. He is always smiling and rarely cries. He loves food and is very adventurous. He is cruising and almost ready to walk. I feel incredibly blessed.
If you made it all the way to the end of this post- thanks for reading :)
Tuesday, January 12, 2010
Sunday, January 10, 2010
Also a little preview of things to come- In honor of Baby M's birthday this Wednesday, I will be posting his/our birthstory. I cannot believe he is already a year old!
Saturday, January 9, 2010
We had 8 guests that night. I have to say it was a bit overwhelming to go straight from supporting a client in labor to caring for my kids and serving a big meal to guests. It strikes me as ironic that I am the primary caregiver for my children and have chosen a profession in which I am also the caregiver, although of a different nature. The contrast was heightened because that day I was coming from this intense experience and really just wanted to unwind and relax. Yet as soon as I walked in the door there were three kids who needed me, not to mention all the shabbos thing that needed to get done.
I am still learning to navigate and balance the different aspects of my life. But I would not want to give up the doula dimension. I have been at three births this past month and it feels intensely gratifying to help women in such a significant way. It is also really addictive... am already actively looking for my next client :)
Thursday, January 7, 2010
Wednesday, January 6, 2010
Some of you may be wondering what my subject line is about. No worries- I am very happily married and not dating anyone else, just meeting my potential clients. Like at the open house event I attended tonight which we sometimes call "speed dating the doulas."
Let me explain. In addition to my private doula business, I also work with a company called Birthfocus. Birthfocus is a wonderful doula agency that helps match up expectant moms with doulas. It was founded by Ilana Stein, a pioneer of the NY doula community and also the woman who led my doula training course. Birthfocus holds several open houses a month. At these open houses, clients can interview a few doulas at once and doulas can meet potential clients. It's a win win for everyone. I usually speak to a couple for about 10 minutes and then rotate so I get to meet as many people as possible.
This is a great concept and works pretty well. Sometimes, though, it can become an overwhelming experience. There is a room full of people, a lot of noise and you have to put your best foot forward over and over again. At some point all the hospitals and due dates just become jumbled together.
I find that I do much better meeting people one-on-one for a chat that's more private and more in-depth than the superficial interview. Yet I never can resist going because maybe maybe, I will connect with someone and be hired. I guess I will find out in the next few days.
Monday, January 4, 2010
Fast forward to today. Today we had another doctor's appointment and the experience was radically different. We got there a few minutes after 3 pm. We were called in by 3 15 and out the door by 3 35. It was fabulous and I was thinking- why can't all doctor's offices run this efficiently? Still waiting on an answer for that one.
Tomorrow, however, I am going back to doctor number 1, the one who I had to reschedule. I got the first afternoon appointment but am still expecting it to take about two hours. I have cleared my schedule for the whole afternoon and made sure my babysitter can stay as long as necessary to watch the other kids. I guess if I expect the worst, I may be pleasantly surprised.
On a totally different note- my kids went back to school today after a 10-day vacation. I am so so happy. I feel a little guilty being a stay at home mom who doesn't want her kids to stay home...My only defense is that the potty training was very stressful and it was just too cold to take the kids anywhere, hence a lot of boredom and frustration ensued. They were also very happy to see their friends and get out of the house for a bit. It's a win-win situation for everyone.
Saturday, January 2, 2010
Initial meeting- I usually meet with people for a free initial consultation. They can ask me lots of questions about my experiences, philosophy and just see if they like me. It's kind of like dating in the sense that a client needs to "click" with you and trust you in order to want to invite you to be with them at their birth.
Contract- Once we agree to go forward, we sign a contract that ensures that I get paid and that the client gets the services that she wants. After that point, we stay in touch via email and/or phone, if questions come up during the pregnancy or if she just wants to talk. I also give referrals for child birth ed classes, postpartum doulas and other birth-related fields.
Prenatal meeting- Around 36 weeks we have a prenatal meeting. I devote an hour or two to go over my client's birth plan in detail and make suggestions. This meeting is really to make sure that we are all on the same page and that I understand my client's needs and wishes. We discuss comfort measures during labor, pain medication and any other concerns they may have.
On call- Generally, I am on call for a client from 38 weeks till she gives birth, which could be up to 42 weeks. That is a 4 week period I am committing myself to- to be available pretty much 24/7 and drop everything else when the big moment comes.
During labor- I advise my clients to call me sooner rather than later. Even if things are just starting, and they don't need me to come just yet, I like to have the extra lead time to prepare myself.
We will be in touch over the phone until she decides she needs me there. Generally this is when contractions are 5-7 minutes apart but it is hard to set a specific time frame because things are so individual.
Either way, when I get that call to come, I try to be with my client at the latest within an hour of that phone call.
If there is time, I go to the client's house and labor with her there for as long as she feels comfortable. Otherwise we meet at the hospital/birthing center of choice.
Once I get there, I start working with my client right away- breathing, massaging or finding comfortable positions. Sometimes my client knows exactly what she wants and I just follow her lead. At other times I need to be more assertive and take the lead in order to encourage her and help her get to a better emotional place or to be more comfortable. I also try to take care of all the little things- making sure she stays hydrated, has a snack or has the music that she likes. I stay with my client until the birth, helping with transition and of course pushing.
After the birth, I stay for an hour or so to help with breastfeeding and to help the couple transition to their postpartum room.
Postpartum follow-up- I will call within a day or two of the birth to make sure everyone is doing well. If there is interest, I offer a postpartum visit to the home to discuss the birth, answer baby-care questions and give some sense of closure.
That's what I do in a nutshell. There is much more I haven't even touched on like the doula's role in relation to the father and also in relation to the doctors and nurses. But that's for another post. Stay tuned.