It’s taken time to get to know myself, or at least come to terms with it, and now squarely in my mid-thirties I’m pretty happy with who I have become so far and that includes being an introvert. I think all introverts go through the experience of realizing that they actually are one and not just weird (by the worlds standards at least because weirdness is something to be embraced as well. It’s just deeper individuality, really). But as I’ve walked the path of career choices in my life, each time I’ve come to a fork in that path the turn that I inevitably choose is the one that has progressively gotten more solitary to the point of working as a solo practice doula. And it’s the perfect job for this introvert.
So what is an introvert? On Dictionary.com an introvert is described as:
1. a shy person.
2. Psychology. a person characterized by concern primarily with his or her own thoughts and feelings (opposed to extrovert).
This is a typical yet inaccurate description (the dictionary thinks it's sooo smart). Introverts are rarely shy and even more rarely “characterized by concern primarily with his or her own thoughts and feelings”. That does not describe an introvert. That describes a selfish jerk. In actuality we are not shy, we are quiet observers. Being an introvert is about how you interact with the world and when it comes to our feelings, we just know how we feel because we have actually spent the time thinking about it. We think before we speak. Have you ever been in a conversation with a person who wasn’t really listening to a word you were saying and they were just waiting for their opportunity to talk about themselves? Introverts care deeply about the feelings of others because we know that ours are important to us just as yours should be important to you. Introverts are often thought of as having the inability to be successful as well, but the world has had a bounty of successful introverts, J.K. Rowling, Bill Gates, Abraham Lincoln, Albert Einstein, Rosa Parks, Eleanor Roosevelt, just to name a few. Some traits of introverts are enjoying time alone, considering only deep relationships as friends, feeling drained after outside activities even if they were fun. We are often good listeners, appear very calm and self-contained, think first then speak or act.
I’m not just an introvert according to Myers-Briggs typology test, which was developed from the work of psychiatrist Carl Jung, I’m an INFP which stands for Introversion, iNtuition, Feeling, Perception. INFPs are apparently somewhat rare, accounting for only about 4% of the population. Delving deeper into INFP-ness, we are driven by a strong sense of right and wrong and a desire to exercise creativity, even if only behind the scenes. Also known as, “We don’t really like to be in charge of other people and enjoy working for ourselves”. There are also some quite successful people who have been assumed to be an INFP personality. William Shakespeare, Frank Lloyd Wright, Kurt Cobain, Virginia Wolfe, Vincent Van Gogh, John Lennon, Jim Henson. You can look at those people and very easily see from their work that they spent a lot of time observing and trying to understand life and the people in it.
So how does any of this translate into being good at birth doula work (for me at least)? Most of the behaviors that fit an introvert’s personality are really very helpful with closely working with someone in an intense situation where especially, it may be difficult for them to communicate their needs. According to psychotherapist and author Marti Olsen Laney, author of The Introvert Advantage: How to Thrive in an Extrovert World, some introvert strengths are:
◾work well with others, especially in one-to-one relationships
◾strong ability to concentrate
◾creative, out-of-the-box thinking
◾analytical skills that integrate complexity
◾studious and smart
While attending someone at their birth it very often is just them, their partner, and I for periods of time. We spend hours with usually just the three of us preparing beforehand and I love working close and one-on-one. Flexibility is important, you never know how a birth is going to go and you can’t get it in your mind that it can only go one way, and out-of-the-box thinking is part of that too. Independence is necessary when you work for yourself, but I think all doulas have an independent streak in them. Only 1%-5% of people use doulas at their births, so it’s not the most common profession. A strong ability to concentrate when things get crazy is really important. If things get crazy a doulas responsibility remains you, their client. Self-reflection is upmost. Nobody is perfect but do you learn from your mistakes or decide to change the way you do something when it isn’t working? How does that saying go? Insanity is doing the same thing over and over and expecting different results. I’m not sure if I’ve ever been described as studious but when I find a subject that I love, I read, read, read everything I can get my hands on. I try to absorb what other people that I trust have to say and think about it.
But overall an introvert is an observer. I often get a sense of people before they even speak. Maybe it sounds like hippy nonsense to some people, but the energy you but out into the world is easy to feel. People in labor often retreat into themselves and watching for those nonverbal cues is often the most important part of my job (and a bonus, I’m super ok if you don’t feel like talking, which a lot of times in labor you don’t or can’t). Are they uncomfortable in that position, do they need lip balm, water, sugar? Is what their partner is doing helpful, are they saying the right things that would encourage them in that moment? These can be such diminutive changes and can be easy to miss. Does someone’s partner look like they are going to pass out, or need something to drink? What energy am I feeling from the doctor when they enter the room? Or the nurse or anesthesiologist?
I use all of this to work to help you have the birth space you wished for and hopefully, help you to transition easily if changes need to be made. Self-deprecating sense of humor comes at no extra charge. <3
Eventually, one of the things that you will be faced with or asked about during your pregnancy is “Who are you going to have in the delivery room with you?” Dun. Dunnn. DUUUUNNNN!!!! This is actually a subject you need to think carefully about as it can effect a lot about your labor and birth and it’s a time in your life that you can’t take back.
The first thing I say to people when planning this part of their birth is that birth is not a spectator sport. Birth in an intimate act that functions best in quiet environments where we can focus inward and really let ourselves go. Think of a mama kitty. When they are getting ready to have a litter of kittens they sneak away to the closet where that sweater fell off of the hanger or where your kid left a bath towel laying. Or maybe your bottom drawer where all of your nice snuggly winter socks are. They may be happy to see you, their human (who the own and control), but for the most part they find a nice quiet, dark, safe, warm place to have their babies.
You may be nude for a big portion of your labor. Many women are worried about the big “P’ word during pushing (Yes, I’m talking about poop), and I always swear that the most productive laboring sounds are the ones that sound just like you are having an awesome roll in the hay. Will you feel comfortable doing all of that with your Mother in Law in the room, or your sister, grandmother, or friend? You might be thinking, “Yeah, but they have had babies. They probably know about all of that”. Doesn’t matter. Do you care? If so that’s what matters. If you interpret everything your mother says as judgement, don’t invite her. Does everything your sister says dive you nuts, tell her “Noooo!” If your friend came to your last birth and sat and chewed food with her mouth open and then smelled like garlic afterward, tell her “Heeeell no”. Your birth, your choice.
Another thing to remember is that you may already have a large amount of people coming and going from your room to begin with. Some of these people may be:
“But I have a great relationship with my mother!” Awesome. And if you think that her presence will positively benefit your labor and birth, you go for it. I’ve attended births where that was just the case. Even as an adult, your mom is still your mom. She’s seen you sick, barfing, pooping, crying, screaming, bleeding. And if she will support your choices, even if they are not ones that she would have made for her own births, moms can really be a great and nurturing energy for you. But if you are worried that something you might say in the heat of a contraction when you don’t want to be asked anything will result in hurt feelings and resentment, maybe it’s not the best idea. You can always say, “Mom, I love you but I don’t think this would be the best thing for our relationship.” And hopefully she will respect this. Remember that you are doing what is best for you and your baby. You are still HER baby and there is a good chance that she will want to do what is best for you as well.
Now the touchy subject. Mother in Laws. This is a difficult one. I think that most of the time this doesn’t work, especially if you were pressured either by her (or her child) to have her there. If you know, I repeat, KNOW that this will be a disaster don’t even let it gain traction. Don’t deflect and say, “Well, let me think about it.” Say no right away. And better yet, this should be your partner’s responsibility. I know with my husband and I, I handle my family and he handles his. I know that this isn’t the case for everyone, if you are really close to your MIL it can work. I’ve seen that happen, but I’ve also see a MIL sit on a couch for 12 hours while browsing the internet on her phone and sighing the entire time. So the main take away is, just choose wisely. You know what’s best deep down in your gut. Follow that.
“Ok, so I invited someone and I don’t want them there any longer. Now, what?” I think that this can happen two ways. First, you decide this before the birth. This is the better of situations, although it still may feel uncomfortable telling someone that you’ve changed your mind, it’s best to get it over with beforehand. Do it sooner rather than later. The more time there is for hurt feelings to heal and be forgotten the better. Second, you decide this during labor. There are a few ways to handle this.
“What if I don’t like my nurse?” Fortunately this doesn’t happen too often. I have really for the most part seen L&D nurses be supportive and they will work so hard to help you have they birth you are hoping for. But if it does happen and you have a Negative Nancy in your midst for some reason, you can ask to speak to the Charge Nurse or Nurse Manager. I’ve even been at births where they have come and introduced themselves and told my client to ask for them if they have any issues that they could help with. There will either be a really swift attitude change or a new nurse for you.
“I think I’m just going to have my family/friends stay out in the waiting room.” This can be ok sometimes. But there is such a thing as performance anxiety from afar. How will you feel if you end up having a longer labor that you planned for (and you can’t plan for it anyway) and they are sitting out there for 12 hours or more? Will you be worried that they are tired of waiting or that they have eaten or are uncomfortable? Anything that takes you out of your birthing space in your brain can disrupt your labor. You can remind you family and friends that you will update them when you have the chance and that you want to keep you labor as free of distractions as possible and that it’s unlikely you will forget to tell them that you had the baby.
And this goes for cesarean births as well, you may actually want to tell family that you will need quite sometime postpartum. You'll be numb from the chest down and as that wears off you could feel some side effects from it. After my cesarean I was so sick to my stomach and loopy. My nurse and husband were putting cold cloths on the back of my neck and forehead for what seemed like forever. It was the only thing that helped me. It takes some time to get your footing afterward and even if you feel as well as can be expected after a major surgery, nursing and repositioning yourself with an incision can be uncomfortable as you try to find the most tolerable position to do so. You may be exhausted, especially if you labored for a while and then the decision was made to have a cesarean. People in your space may not be what you need. Rest and bonding is what is important.
The thing to remember is that this is your labor and birth. Your baby. You don’t get this chance back and other people who want to attend your birth may have already had their chance and you don’t owe them the opportunity to be there. That’s why so many people love the support of a professional doula. While I may have a connection to my clients I don’t have an attachment in the same way that a family member or lifelong friend might and I think that is an important distinction. And while I have doula-ed for both family members and friends I think that they still appreciate that I can bring my professionalism to their birth. While I obviously care for my clients and their wellbeing I’m not there to get a “high” from their birth and you will never hear me describe myself as a “birth junkie”. Those things would make it about me and it’s not. It’s about you, your new family structure and your needs for your birth and postpartum health. I have no need to feel important. You need to feel like you are safe, supported and cared for. You have no future obligations to me, you don’t have to see me at family dinners or birthday parties. And while I love getting pictures and little updates from my clients, it’s freeing to feel like you don’t have to do those things if you don’t want to.
In the end, decide what is best for you. Putting you and your baby first is always a good choice. People will either get the big picture or you’ll know who you can count on and who you can’t. The good thing is that babies tend to bring out the best in people.
In the few years I have been working as a doula I have found that the use of language is so important and there are a few words I avoid like the plague. But there is one that makes me cringe like no other and it’s used a lot in regards to birth, (Insert drumroll here…) Empowerment.
It took me some time to decide why the use of this word bothered me so let’s look at the word as defined on dictionary.reference.com:
verb (used with object)
1. to give power or authority to; authorize, especially by legal or official means:
I empowered my agent to make the deal for me. The local ordinance empowers the board of health to close unsanitary restaurants.
2. to enable or permit:
Wealth empowered him to live a comfortable life.
To GIVE power or authority? How can I or anyone else give you your own power? Nor can anyone give it to me. I can support you but I can’t give you anything you already have. Your power is not about me, and for me to say I empower you actually takes it away. Now I know that other birth workers will say “But we help women!”, "We make a difference!" and “This day can transform them!” Yes we do and yes it can but we are not responsible for that transformation. Birth itself can do that. People can transform themselves and how they think about it and still have wonderful, empowering births every day and do it without a doula present.
Don't get me wrong, I LOVE my job. Love it! It's awesome and amazing and I'm witness to beautiful things I never in a million years thought I would be and I'll do it until my fingers bleed and my knees wear out. But you. Are. Already. Strong. End of story. That hasn’t happened in just the few months that a client may have known me.
You've got this. You really do! Don't let that nagging voice deep down inside tell you otherwise.
“I don’t think a doula can help me, I’m having a cesarean.” is the second most frequent statement I hear next to “What the heck is a doula?”. But guess what? A doula can help you a bunch. The cesarean rate in the United States is just under 33%, which means 1 out of 3 birthing persons will have major surgery on their birthing day. Sometimes this will be an emergency but you may know ahead of time that you will be having a cesarean. A doula is trained to support people on their birthing day, weather that comes via cesarean birth or vaginal birth.
How can a doula help me with my cesarean birth?
No matter what way you give birth you’ll need support from people. A doula will always help you prepare and no matter your choice, you’ll still have questions and it is always advisable to have a birth plan. When I talk to my clients about writing a birth plan I tell them that the process of writing one is more an exercise in you knowing your options than anything else. The term “Family Centered Cesarean” is now being widely used to describe an experience where you are an active participant in the decisions made on that day. Your doula can help you decide how you want it to go. Immediate skin to skin and breast feeding, delayed cord clamping, your partner cutting the cord and announcing the sex of the baby are all available now. Many times your doula may be able to accompany you during the surgery. If for some reason baby needs to go to the nursery, your partner can go with and your doula will be able to stay or join you so you will not be alone for the rest of the surgery. Baby is born usually only a short time after the surgery begins and the closing tends to be the longest part. If you partner leaves to go with baby you could be alone for the majority of the surgery. If you become panicked during any part of it your doula can help you to do calming breathing exercises, hold your hand, massage your scalp, and reassure that you are safe. If you are not able to do skin to skin during this time period your partner may be able to do so and you doula can assist you with these comfort measures.
Postpartum, you may feel some side effects from the epidural or spinal anesthesia and your doula can help you deal with that. Bringing you cool drinks and cloths for your head. Helping you find a comfortable position for breastfeeding will make it go much easier too (2 words. Football hold!). Your partner can also go get something to eat or go sit and have a cup of coffee without worrying about leaving you.
If your cesarean was unplanned you may have labored for quite a while before making the decision to have surgery. All of the above applies to you as well not to mention that afterward you and your partner may be exhausted and they may feel like they cannot take a needed nap because of their worry for you. With a doula in attendance you are both being taken care of, we work as a team to make sure it is a positive experience for everyone involved. You, your baby, and your partner. After you leave the hospital and go home, we make sure you feel that you are healing well. We can suggest resources if breastfeeding complications arrive, and we’re there to talk if you feel that your emotional wellbeing needs attention.
We are you and your family’s cheerleader. Before, during, and after your birth. No matter how you decide your baby’s arrival will be.
If you have babies, are having babies, or are thinking of having babies you may have heard the word. DOULA. Pronounced ‘doo-la’, it is a Greek word meaning “woman who serves”. But in more recent times it refers to a person who provides emotional and physical support to a birthing person and their partner before during and after their birth. As doulas we strive to provide you with balanced information during all of these times so you can make your own choices.
Many families consider a doula as a must have for their birth, especially if they are choosing to give birth in a hospital and hoping to avoid interventions and possibly a cesarean birth. On the flip side, women choosing a cesarean birth love the support a doula can give them as well. The physical and emotional effects of a cesarean birth are quite different than a vaginal birth and a doula can help you plan for them and guide you through choices to make your cesarean birth a beautiful day. If you are deciding on an induction, it can be an intense experience. Many times contractions during an induction are reported to be much harder to deal with. Some women describe them as “sharper” or “more intense”. A doula will help you to stay focused and to remember what you learned in birth class, (we will also help your partner remember what they learned in birth class).
Speaking of partners, they usually love doulas too! It is so scary to see someone you love in pain. Usually you just want to make it all go away but sometimes, the way we go about “helping” doesn’t always do that. Think of birth as a language and your doula as the interpreter. We speak birth. Some jibber jabber just came out of the doctor’s mouth before they swept out of the room? We got you. In fact, we’ll probably already be telling you what they meant as you are turning to us with that look of “Say, what!?!” on your face. That growl your birthing partner just sent in your direction? It probably means “Don’t touch me now!” Its ok, I heard it and I’ll remind you when it is a good time to touch them. But a doula also looks out for YOU. There are things you’re going to have to do. Bathroom. Food. Coffee. Possibly nap. You have to take care of yourself so you can be there for your partner. You can do all of those things without having to feel guilty or worry that your partner has been left alone. Partners usually feel that they can support their loved one better with a doula present.
A doula has great intuition and a calm presence. We many times know what you need before you even ask for it. Or if you don’t know how to as for it because, well, the whole you’re in labor thing, we usually know anyway. Even a newer doula with only a handful of births under her belt will have seen enough variation in births that they will stay calm and collected in almost every situation. We’ve got your back, (Literally AND figuratively. Counterpressure is totally our thing.) And after the birth we are still there. Hours after we are still there helping you to get settled in with baby. Days after, making sure that wicked hormone drop hasn’t knocked you off of your feet. Weeks after, coming to see you to make sure you are settling in at home and that there is no other help YOU need. Making sure breastfeeding is still going well or reminding you that it's ok that you choose formula. Listening to you brag about how great your baby is (because they are) and to remind you that “You’ve got this!”
Here is a great article on the evidence for doulas -
As a doula I've found that one of my strengths is that of calm reassurance while also being able to break the tension at any given moment if need be. I started making a list of the more strange things that came out of my mouth during a birth and often afterward I drive home chuckling and thinking, "Oh, that's got to go on the list!" Here we go:
"Believe me, I am more than happy to massage your butt cheeks if you think it will help you to relax."
"No, I won't remember what your poop looked like and if I did, I'd never tell."
"Yes, I saw inside of your vagina. I saw how awesome it was! I mean, there was a person coming out of it!",
"Your butthole looks fine to me, I wouldn't lie about that!"
"You had sex last night? Great! Was it "good" for both of you? Awesome! Make sure to nap and call me if you go into labor."
"I'm going to take a little break. Maybe think about some nipple stimulation while I'm out. Let's think of a special knock for the door for when I come back. Do you know the theme to Star Wars?"
"No, you don't have abnormally large nipples. Your nipples are fantastic."
"Sure, I'll wait to go brush my teeth if you like the smell of my peanut butter breath."
"Yes, a little bit of vomit got on my shoe. I don't care if it stains, now I'll always think of you when I wear them."
I've said all of these to moms in labor, but there are just a few short reassuring things I continue to find myself saying to partners.
"Yes, your baby's head/testicles/vulva/poop is supposed to look like that."
What helped you break the tension while you were in labor?
You’ve probably heard it before, in groups with friends or family, or at your baby shower, *(amused chuckling)*, “Yeah, I had a birth plan and then nothing went like I wanted so don’t bother, you’ll just be disappointed anyway.” This is where my eyes want to roll so hard that I can see my brain. First of all, it’s condescending. Secondly, no. Just no. The idea that we should have no hopes for the birth of our children puts such a knot in my stomach. This attitude also lends itself to the idea that you’re not a grown adult that can be flexible and roll with some changes if they come your way. We also don’t know what this Debbie Downer had in her birth plan. Was it a 5 page long list of demands written in an argumentative manner that was tossed aside the second the on call doctor took one glance at it? We don’t know, but what we do know is that this person is clearly someone in pain and possibly traumatized from a birth experience that they didn’t feel in control of. How can you help yourself to feel in control of the situations you may encounter during the day of your child’s birth? By knowing what your choices are to begin with.
It’s been shown over and over that when a woman feels like she shares in the decision making process throughout her labor and birth, she has more positive feelings toward, and feels an increased sense of satisfaction with her birth experience. Here’s an abstract of a systematic review that was published by the American Journal of Obstetrics and Gynecology. The findings indicated that “Four factors—personal expectations, the amount of support from caregivers, the quality of the caregiver-patient relationship, and involvement in decision making—appear to be so important that they override the influences of age, socioeconomic status, ethnicity, childbirth preparation, the physical birth environment, pain, immobility, medical interventions, and continuity of care, when women evaluate their childbirth experiences.” A study in England had similar findings, the abstract said “…results did not support popular stereotypes: high expectations were not found to be bad for women, although low expectations often were. Information and feeling in control were consistently associated with positive psychological outcomes.” So yes, it’s important to feel satisfied with your experience, no matter how many people tell you “All that matters is a healthy baby.” Sorry, but you are instrumental to the health of your baby and family. If you are not healthy physically or emotionally, everyone suffers.
Writing a simple yet concise, 1 page (back and front) birth plan, in friendly yet flexible language not only helps you to decide what your first choices are for any given situation, it also helps you to decide what your second and third choices may be. Perhaps our Debbie Downer was possibly traumatized by a hoped for vaginal birth turned cesarean birth? Well this situation can happen and you need to think about what your wishes would be. A truly complete birth plan contains either a section or separate plan to be given if a cesarean becomes necessary. Then you’ve educated yourself on what the procedure entails and communicated what your choices are. You’ll have a better idea of what to expect and ultimately feel more in control of the situation. Now, in a true emergency a cesarean may come in a flurry with very little time to think but hopefully, if you’ve chosen to hire a doula we can help you work through any feelings you may have afterward or fill in any blanks from when time moved so fast. Your local ICAN group is also an amazing resource for this.
Another reason a birth plan can be important is that depending on the specifics of your providers practice, you may go to the hospital in labor and have never met the doctor attending you. Maybe it’s that doctor that you only saw for a prenatal once and they were in and out in 15 minutes. And it’s even more likely that you have never met the nurse charged with your care. Then there is the possibility of a shift change, the nurses that have just spent hours getting to know you and what works for you, they have helped you to communicate that to the provider on call, will go home and now you need to get acquainted with an entirely new shift of nurses and possibly a new doctor. So it’s also about communication. No one can be expected to remember the specifics of every patient’s birth plan and wishes and it's best to not expect anyone to guess. Writing a one puts that responsibility in your lap. This is also a great place to mention how awesome having a doula is at this point. We won’t speak for you but we can help facilitate the conversation between you and your new caregivers so everyone can continue to work as a team.
Adjustments to “the plan” may end up being necessary but the writing of a birth plan is more about the process of learning your options than anything else. And because you know what your preference would be in the event a change needs to happen, you still feel informed and in charge when that conversation comes up. You have empowered yourself, no one else can do that for you.
Photo courtesy of patrisyu/freedigitalphotos.net
As this new year was rolling closer, my thoughts were constantly turning toward something that had sat in my gut since I started doula work over a year ago. I hated my business name. There, I said it. When I picked it, I gave it a lot of thought. The only thing was that those thoughts were blank, blaaaank I tell you. I couldn't think of a single thing original, or different, or that spoke of "me". My dear husband gave me panicked blinks as I eagerly had "conversations" with him about it. My name is always spelled and pronounced wrong, so those were out the window and as you can imagine there are a ton of cliché names in birth work, all very pretty, but often repeated. So I picked one, and slowly I began to resent it. Lotus Blossom Birth Doula Services. It was too long and I'm just not that "feminine". There's a zillion and one "Lotus this" and "Blossom that" names out there. Then in a business group I'm in another lovely doula and her partner shared their new business and website and it was 95% the same name as mine. "That's it! I will fix this!" I promised myself. I tried to live with it to see if I would feel different in time and then one of my mentors said something to me, (and she always says what needs to be said, right when you need it like she's reading your mind or something.) "You're going to regret picking that name." Crap. There it was. I already did! I felt so un-authentic and I resolved to figure something else out. A new year was coming, perfect timing.
As I thought back to the births I had been at over the past year or so I tried to find something they had in common. Was there a thread between them in someway that I hadn't realized, a feeling, a thought I had that stitched them together in a way? There was. A little snippet of a poem, a sonnet by Keats actually, that would pop into my mind. On my way to or from a birth in the middle of the cool night, if the stars are out I try to always take a deep breath and look up at the sky and put myself in perspective with the brilliance I have just seen or are about to see, because nothing compares with seeing that new little being take his or her first breath or looking up to the stars and remembering my tiny place in the clockworks of this universe. I take that deep breath and think, "Bright star, would I were steadfast as thou art--Not in lone slumber, hung aloft the night.". Now Keats is speaking of his lover, but of her strength and steadfastness and how he was in awe of it and her love for him. But I'm always in awe of the strength of that mother, of that baby. I look at them together and think it, "Bright Star...". I feel small in a good way in their presence, just like when I look up at the night sky. So there it was, Bright Star. I'm glad to have finally found it.
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