Monday, January 30, 2012

How college prepared me for being a doula

Sometimes - often as I'm heading to or from a birth - I'll think about the skills I draw on as a doula, and how I wasn't expecting college to have prepared me so well in certain ways for the life of a doula. I think it often enough that I decided I should do a post about it. So from least to most important, here's how what I learned in college applies to doula work:

4) Epidemiology and other courses that taught me how to read and interpret scientific literature
My master's in public health certainly built on and added to these skills, but I got a very solid foundation in college. Nearly all of my courses emphasized critically reading and analyzing primary literature. I have really enjoyed sharing the benefits of this with my doula clients - helping them understand the evidence for and against various interventions in birth or other concerns they may have.

3) Medical anthropology
Without question one of the most generally life-changing courses I've ever taken, and very applicable to doula work. So much of what we do as doulas involves negotiating the boundaries between very different cultures of birth, and understanding (and sometimes critiquing) those cultures AND our own. The most important thing I learned in my med anthro class was that "Culture is to people as water is to can't see your own culture because you're in it". It's difficult to mentally step back and try to see your own culture, but it's as important for a doula to understand her own personal mindset and cultural values as it is for her to learn more about those of her clients, the hospital staff, etc.

2) Spanish
I have a whole separate post on Spanish coming, but to summarize I will say that when I was an AmeriCorps doula this was vital. In fact, the Spanish skills of the doulas on my team got us called into a lot more births than we might have been otherwise. The nurses were NOT supposed to call us as interpreters, but they knew that having us around helped make the Spanish-speaking only patients feel more comfortable...and it did make the nurses' jobs easier. And there is a cultural preference on the part of many Hispanic women for unmedicated birth - all the harder to accomplish through language barriers - so very often a doula was especially appropriate. I haven't been to a Spanish-speaking birth in a while, but I'm pretty sure it would all come flooding back to me: "La cervix es la boca de matriz. Tiene que abrir de zero a 10 centimetros..."

And the number one thing I learned in college...

1) All-nighters
No lie. (All you doulas know I'm not lying.) I remember the first time I tried to pull an all-nighter in college I physically could not do it. I had to quit around 3-4 am and go to bed. A few more practice nights and I was able to push that out to 5 am...then to 7 am...and then I could enable my natural procrastination with nonstop marathons to finish those final papers the night before the deadline. I learned to accept the physical effects of sleep deprivation (for me, nausea) and find remedies (protein!) And I learned to carefully assess the correct way to manage getting back on schedule (short nap in the afternoon? or just stay up and then go to bed early?) I also learned to do this all without the use of caffeine (I know, I know - I was the only freakish college student not chugging coffee.)

All of this proved invaluable when I started attending labors that could last for 24+ hours and/or begin just as I was about to go to bed. And when I became a doula I discovered that giving counterpressure at 4:30 am is a actually easier than constructing supporting arguments for a thesis. And that while turning in those 20-25 pages is certainly a satisfying feeling, it doesn't really compare to the adrenaline rush of attending a birth. So while I still use my skills from those days, doula all-nighters compare very favorably to college all-nighters!

I guess the moral of all this is that if you're in college and an aspiring doula, take epi, med anthro, Spanish, and don't write any of your papers for those classes until the last minute! (Note: staying up all night partying is not equivalent preparation, but feel free to do some of that too.)

Sunday, January 29, 2012

The fantasy doula league

Fantasy football is ending. Sad? You won't be after listening to this podcast which envisions...a fantasy doula league!

These dads are obviously quite familiar with the doula trade and are fantasy doula league experts. They really pick up on the crucial skills and stats of doula practice. And, then of course, there's the placenta-kiwi foam.

Fantasy Doula Report - Comedy from Jon Cragle on Vimeo.

"With Rebozo moves like this, she will not be available long!"

Tuesday, January 17, 2012

More on the UW midwifery program

Seattle columnist advises you never to get between a midwife and a birthing baby:

Last month, the faculty there recommended eliminating the UW's 19-year-old midwife training program.

That isn't surprising on its own. Just about everything is on the chopping block these days.

It was their reasoning. It has angered midwives all over the region. Not to mention thousands of moms.

The nurse-midwife program was judged not to meet a "societal need." In fact, maternal and newborn health were not even on the list of societal needs drawn up by a UW committee looking to cull programs.

Surprisingly, this isn't directly about money. The students in the program pay more in fees than it costs to educate them. Plus midwives are a force that drives down birth-related health costs. ...

The UW hooked me up with Carol Landis, a professor in the nursing school who helped draft the recommendation. She said it was not an "arbitrary devaluing of midwives." Driven by state budget cuts, the School of Nursing is reducing the number of areas in which it is teaching- and training-focused (regrettably to her), she said. The emphasis is on high-level research, the kind that brings in grant money.

And Shari, a midwifery student at UW, commented with the following clarification to my last post:

I would like to clarify and issue with this proposal to cut our program. It is not because of the budget per se, as the Midwifery program is funded entirely from student funds. We are one of the only programs operating in the black. This is politcal decision that must be reversed! Please stand with us and sign the petition! Research dollars do not trump the health and welfare of women and children

The petition already has almost 2500 signatures - with a goal of 10,000!

Thursday, January 12, 2012

Sign to save the UW midwifery program

The nurse-midwifery program at the University of Washington is currently slated to be cut. I am shocked that in this day and age universities would be cutting, instead of expanding, nurse-midwifery programs. With our entire health system increasingly depending on mid-level providers, and with the excellent outcomes of nurse-midwives in caring for low-risk women, it seems like a bizarre decision. According the the ACNM website, this is one of only two midwifery education programs in Washington state.

If you would like to support the program you can sign a petition urging the University and the state government to reconsider their decision (you don't need to be a local).

Thursday, January 5, 2012

"Doula" in the New York Times crossword puzzle!

My family has always been big crossword puzzle fans - the New York Times crossword in particular. My grandmother, at eighty-seven, still completes the Sunday crossword every week. We're also, of course, Will Shortz (the crossword editor) fans in general; now that I'm working nights, I'm bummed that I miss out on listening to Weekend Edition on Sundays for his puzzles.

So imagine how excited I was to hear that "doula" was in this week's Monday puzzle: "58A: One providing nonmedical support for a woman in labor". Funny to read through the comments on a crossword blog about it - real mix of people who were very familiar with the term, and those who had never heard it before. But now they have!!

Tuesday, January 3, 2012

A few links to start the New Year

Happy New Year! Here is a total mishmash (not even sorted! only sort of related!) of interesting links for your enjoyment. It feels good to start clearing out my starred list in Google Reader, at least!

Many perspectives on why to have a doula for your homebirth (and a few on why you might not have one).

Doulas serving the expat community (as well as locals) in South Korea

The Well-Rounded Mama posts a list of obesity and birth/breastfeeding research on her Christmas wish list. Any public health peeps out there want to get on it?

The amazing Cathy Genna has a page on tongue tie including pictures and posterior tongue ties.

One mother's struggle with getting her daughter's tongue tie (and lip tie) properly diagnosed and treated - she ended up traveling to Dr. Kotlow to get treatment. "My prayer is that it will not always be this difficult for tongue-tied babies and their mothers. It should not require so much time and so many resources to simply feed your baby."

Interesting and varied responses
to the updated UK guidelines on c-section availability.

Knit your own baby-wearing coat extender!

A post on cultural issues and breastfeeding, specifically on diet. My preferred way to deal with this (right now) so as not to contradict any breastfeeding cultural traditions: when people ask me if there are foods they should eat/not eat, I say "Every culture seems to have their own foods that they say are good or bad!" and then I name some examples. Hispanic mothers are often surprised to hear that Americans think broccoli is bad, for instance. I say "If there are foods that your culture thinks are good or bad, then go ahead and do what is recommended. Unless you hate the food! Then you don't have to eat it."