The doula's first-time mama advice kit

Just about everyone who knows me knows I like to talk. Very quickly they generally find out that I am especially talkative on some of my favorite subjects of birth and breastfeeding. (I am so proud of myself last month that I went to a New Year's Eve party and only ended up talking about breastfeeding once, and very briefly at that!)

So when friends and acquaintances get pregnant, they often come to me for advice. (Sometimes I hear in their voice a kind of loving "OK, know-it-all, NOW you can tell me" tone!)

While I always try to tailor my advice to their specific questions (in part so as not to overwhelm them!) I do find myself answering similar questions and requests more than once. I've been thinking about putting together a set of the links, books, and resources I recommend to the newly pregnant woman (as opposed to the packets of info and resources I put together for my doula clients). That way I won't forget anything and will have it all conveniently in one place, so I can answer specific questions and then say "If you want more information, here's the link".

Here's a preliminary set of the info I'd give to a newly pregnant woman:

Suggested for everyone before they do anything else

The very first thing to do - before ANYTHING else - is read my post on What I Want My Friends to Know.

Next, unless said friend has put up with a lot of my rants or been following my blog for a long time (hi guys! hope you have been!), it's time to start researching options for birth.

So secondly, watch The Business of Being Born (also available on instant view from Netflix). Seriously, this is the first thing I think any pregnant woman and her family can do to help them understand the lay of the land in the U.S. right now, birth-wise.

(Reading "Pushed" by Jennifer Block is also great but not as easy as sitting down to a (very well-made) movie for a couple hours.)


Choosing a care provider and birth setting:

Often the first care provider someone goes to after finding out about the pregnancy (or to confirm pregnancy) is the person's regular GYN provider. That may be a gynecologist, an ob/gyn, a nurse practitioner, a family practice doc, a midwife, etc. If that provider offers obstetric services, the woman may begin her prenatal care with that provider, but wonder if she should investigate other options. If that provider does not offer obstetric care, she'll definitely be looking for a place to get prenatal care and deliver (since the two generally go hand in hand). So people frequently talk to me about how to go about researching and choosing a provider and birth setting.

What I say is that when looking for a care provider and birth setting, it's important that they match YOUR philosophy and what YOU want out of your birth experience... which can be hard to formulate when you're all of 5 weeks pregnant and have never thought about this before! So it's OK to establish care with someone knowing you might switch later.

In the meantime, gather your information and investigate your options carefully.


Why it's important to investigate and choose carefully

The First Birth - No Do-Overs Currently Available - just found this via Birth at Home in Arizona and love it. Make sure to read the comments as well.

You buy the hospital ticket, you go for the hospital ride by Navelgazing Midwife is an honest assessment of why it's so important to look very closely and be realistic about whether a particular birth setting will be right for you.


Information to gather and questions to ask about a care provider/setting

Their state's hospitals' c-section rates if available, from The Unnecesarean.

From Childbirth Connection:
Choosing a caregiver
Questions to ask a health care provider
Choosing a place of birth
Tips and tools for choosing a place of birth

From Birth Sense:
In Search of Dr. Right: 11 Questions to Ask and One More Question to Ask

Considering a home birth? Here are some links for thought specifically to help you interview potential homebirth midwives:

A short discussion and links about the fact that all midwives practice differently, and you will still need to find someone who has the right practice style for you.

From Navelgazing Midwife, advice on interviewing homebirth midwives: Part 1, Part 2, Part 3, Part 4, Part 5, and the finale. A commentary she wrote while posting the series is here. This is another post she wrote about interview questions, critiquing a list of suggested questions. Please read them all if you are planning to interview homebirth midwives!


My biggest piece of advice is to find experienced local doulas and talk to them about your options. They will know not just what local maternity care providers say they will do, but also what they actually do, which can help avoid the problem of the doctor or midwife who seems lovely and then becomes a totally different personality in the delivery room, or claims they practice one way and end up doing something very different. If you aren't ready to commit to hiring a doula or a specific doula, I think most doulas would be open to meeting with you for an hour or two, with the offer of compensation for their time based on the understanding that you may not hire them for the birth. (Doulas understandably feel poorly used when people act like they're going to hire them, spend a long time "interviewing" them while getting lots of advice/information/resources with no compensation, then never call again.)

If I know you personally, I'll usually get on a doula forum or two and ask for local suggestions from the doulas there - so hit me up!

Finally, go into this keeping an open mind. You may think you've found Dr. Right and then when you finish your birthing class at 32 weeks, realize that person is not the right fit for you. That's OK; there is still time to switch. Please don't fall into the trap of thinking that you can't switch after some magic number of weeks! Every doula can tell you the story of the client who switched at [34 weeks, 37 weeks, 41 weeks, in early labor, in active labor, etc.] It's only too late to switch after you've had the baby... and are regretting not switching before.

Here are the instructions for how to switch if you need them.

I'm not done talking about switching care providers, because I can hear people saying "I know I COULD switch, but it just seems too complicated/confusing/difficult/scary... I don't love this person, so I think maybe for my NEXT birth I will choose someone different/a home birth/a new hospital/etc." Do you hear yourself saying that? Stop and go back and read The First Birth - No Do-Overs Currently Available.

Now read the Unnecesarean's post of mothers who did (and didn't) make the switch.

Have you done those two things? Go and do them right now. Okay, REALLY done them now?

Then one more thing to remember: you may never have as many options as you do now - carrying scars, emotional or physical, from your first birth may impact your second in ways you may find hard to think about right now. Do not make excuses for care that does not live up to what you know you want and need! Do not put yourself and your needs off into the future - address them now in whatever ways you deserve.



Books

Along with advice about bras, probably the most frequently asked question - what to read?

Standard warning: NOT "What to Expect When You're Expecting". 'Nuff said.

My favorite suggestion lists for books: What Not to Read, from Bellies and Babies. Along with each book she thinks women should avoid, she has 3 suggestions for better books on that topic.


Childbirth classes

I can't emphasize enough not taking the hospital classes. No matter how great the teacher is or how much freedom she seems to have - she is limited by hospital policy and you cannot be sure exactly what those limitations are.

An independent childbirth class with at least 5-6 sessions is a far better choice. Research a little bit about the philosophy of instructor and the class before signing up - there are many options (e.g. Bradley, Hypnobirthing, Hypnobabies, Lamaze, etc.) This post at Bellies and Babieshas a nice overview of the most common/popular childbirth ed programs.

If you live in an isolated area and can't find local classes, some independent instructors offer DVDs of their classes, and Hypnobabies has a full home study kit.

I have heard several childbirth educators recently saying plaintively that parents are looking for a small number of sessions, or preferring weekend workshops with a lot of information packed into 1-2 long days. I agree with them that it's very challenging to get all the information you need AND (more important) absorb and process it with these kinds of classes. If that's all you can do, go for it - but really try to make the time for something with a slower, calmer pace.

If you have trouble finding affordable birthing classes, ask around for childbirth educators in training, and talk to your local health department and/or community health center - they sometimes offer low-cost options.


Bras

By far one of my most frequently asked questions. Fortunately I wrote a series on this!


Breastfeeding

I recommend, if the mom feels comfortable, going to a couple La Leche League meetings while pregnant. They are a great place to see other women breastfeeding, hearing their questions, and getting advice. And they're free!

You might also think about taking a breastfeeding class. Oftentimes local maternity stores, hospitals, private lactation consultants, etc. will offer them. I currently teach one at a local yoga/wellness studio. No matter who teaches it, you can almost always look forward to practicing latch and position with baby dolls!

Rixa at Stand and Deliver has some excellent suggestions on A Proactive Approach to Breastfeeding.

You'll see a note from me in the comments encouraging confidence. Many of my friends ask me tentatively "How often do women have problems nursing?" or "What percentage of women can't make enough milk?" These are normal concerns coming from a culture where so many women seem to struggle with latch and supply. These are real issues, many stemming from institutional and systemic factors like birthing practices and hospital policies (see more at Rixa's post). But the biggest predictor of breastfeeding success is confidence, and the perseverance to overcome whatever challenges arise.

(And again, if we know each other you know you can call me any time about any breastfeeding question! Seriously. Any time. I have a bizarre sleep schedule anyway.)

**

Phew! That's all I have for now. Readers, what would you add to this list? What are your first recommendations for a newly pregnant mom?

Feminist reading group on pregnancy, birth, and parenting

Molly at First the Egg is starting up a Goodreads-based reading group on pregnancy, birth, and parenting from a feminist perspective. Books she suggests (click through for the full list) are a nice mix including memoirs, social/cultural criticism and academic texts, and a variety of different topics.

I am really excited about this (as you can see from my overenthusiastic suggestion of new titles for the list at every opportunity) and encourage others to join! As I said in my intro post to the group, I don't get a lot of opportunities to talk about this stuff with people in my offline life right now. That's not to say I don't have access to smart people who think critically about these issues, but we tend to be talking more about "how do we get more people to enroll in our study" vs. "hey, let's have a cup of tea and talk about gendered bodies in reproductive spaces". So having an online group for that is something I'm very much looking forward to.

To go directly to the Goodreads group, join, and introduce yourself, just click here.

And the Oscar goes to...

This was a hard one! I was just about ready to do eeny-meenie-miny with my favorites, it was so hard to pick. But the winner is...Olyglotpay! For capturing that special patronizing WTEWYE tone with deft writing and a plot that's true to the spirit of this pregnancy classic - even incorporating an especially lovely quote from the original:

Our protagonist is a woman who thinks of herself as a non-conformist. She's been married for a few years, doesn't work, and is antsy staying at home. Her husband is getting kind of freaked out because she seems different than he remembers her as a new bride. She goes for long drives and returns late at night, wide-eyed and silent.

On her birthday, he surprises her at a nice dinner with his gift - the announcement that they can start trying for a baby. She acts ecstatic, although we see some signs that she's privately ambivalent.

Fast forward a few weeks and we see her starting to deal with some morning sickness. She's not happy about the pregnancy - just pissed off about the inconvenience. Unsurprisingly, the dad-to-be is alarmed that getting knocked up hasn't knocked her out of what he thinks is a long-lived funk.

In desperation he goes to the university library and browses until he stumbles on an old, ratty copy of WTEWYE. He jots down a note and leaves. Cut to him handing his wife a nicely wrapped package, containing a bright new copy of WTEWYE (you didn't think he was actually going to hand her that germy old copy, did you?!).

That night, our little mother starts reading. We see dark turn to light as she sits up overnight, reading in a rocking chair (in a muumuu). When dawn breaks, we zoom in for a close up of her face. She has found her focus. Her pregnancy will give meaning to her life! She has something to spend her time on!

The next montage shows her raiding every room in the house, throwing out all plastics, sanitizing, getting rid of all her old unhealty/evil foods, then making trip after trip to Babymart for gizmos and gadgets of all sorts. She curses herself for being over 30 but starts wearing flats and support hose. She puts away her China so that she can "keep her clumsy paws" away from it [that's a real quote!]. She buys the WTE Journal. Bravely, she peruses some pregnancy websites, but of course trusts her OB to know best.

When her husband tells her he's anxious about the birth, she comes up with her own surprise for him: a C-section, scheduled during week 38 on his birthday! As he pulls her into his arms, he sheds a single tear of happiness for how involvement in her pregnancy has changed his stagnant wife's ways. No longer does she mope around, thinking about herSELF. And the baby itself? Why, that's just the icing on the cake.

As they day draws near, she gets happier and happier, counting down. On the actual day of the birth, we see her wheeled into surgery (doors swing closed), then being wheeled back out (doors swing open) ... down the hall to the nursery, where her lovely baby lies fussing. The credits roll as she gives the baby its first bottle.

Please go and read through all the entries - there are some great zombie horror, "your baby will DIE", mass world domination, and Stepford robot plots cooked up by all the awesome participants.

Olyglotpay, please e-mail me with your address so you can get your copy of Our Bodies, Ourselves: Pregnancy and Birth!

Thanks to everyone for participating! This contest has been fun, I'll have to do another one sometime!



And for my last word (for now) on the subject of WTEWYE, I leave you with a passage from a recently published novel (that I otherwise enjoyed): "Commencement" by J. Courtney Smith. (Note: SPOILERS if you plan to read the book):


"Sally, we're having a little trouble getting the baby's shoulders out," the doctor said. "We're going to have to do a small episiotomy." ...

"No," Sally said, shaking her head. "I don't want it done."

Celia was about to speak up, about to say that these damn people needed to listen to Sally, and really, hadn't the poor girl been through enough without slicing her open?

"Babe," Jake said gently. "I know you didn't want one, but it will heal so much better than a jagged tear."

Bree's eyes nearly popped out of her head.

The doctor grinned. "I see Daddy here has been reading What to Expect When You're Expecting. He's right, I'm afraid."

"Oh okay," Sally said. "Just get this thing out of me." She put her head back, resigned.

Contest closes tonight! And 2 more questions: baby books and rockers

Don't forget that you have but a few more hours to post your WTEWYE movie plot! You too could win a fantastic prize (that is, ahem, currently at the bottom of a pile of books on my desk, but otherwise in excellent condition and hopefully inspiring me to tidy up this weekend.)

My last post didn't come up with any suggestions for a mom-oriented breastfeeding newsletter (but I'm with Dou-la-la that gosh darn it, somebody should do one! Another project for the spring?)

In the meantime, I have one more question to pose: my cousin is expecting her first baby in the spring (yay!) and asked me two questions as she prepares:

1) Is a rocker/ottoman combo worth it for the baby's room? They can get pricey but they are pretty comfy! I tend to err on the side of suggesting to people that they wait on most baby gear (expensive cribs in particular, who needs a $600 laundry hamper for a baby that ends up in the Pack & Play or in the grown-up bed every night?) But that's just my opinion; did other people find those rockers helpful for getting baby to sleep and/or nursing?

2) What are good baby books? I own the Sears & Sears Baby Book - one thing I think is great about the Sears books is that you can trust them to have good, accurate breastfeeding advice, and not to give suggestions that interfere with breastfeeding. I've also worked with families that loved this book. But besides that, I have little experience with the baby book world - other suggestions?

More book recs on what to read for pregnancy, birth, and beyond

I really enjoyed this post from Bellies and Babies on what to read and what not to read when you're expecting. (Sneak peek: definitely NOT What to Expect When You're Expecting"). She also breaks her "to-read" suggestions down into 3 categories: Citizen ("for the average Joanne), "Seeker" ("for the one who is definitely looking into her options"), and "Sold" ("she knows, she has researched, she is a proactive consumer"). Her recommendations are right on, too - for example, the Sears & Sears Pregnancy Book is a good "Citizen" read but the Birth Book is more for the "Seeker".

Ultimately my goal is to have a really great "doula library" of books that I can lend out to clients, and send out to friends, who are at any of those "levels". Her recommendations have definitely added some titles to my wish list!

Another way to build your birth(/pregnancy/breastfeeding) library

I've mentioned before that the thrift store of a college town is a great place to build my "doula shelf" of books that are useful to me and to lend out to clients and others. Last weekend I was at Barnes & Noble where they were selling "Birthing From Within" for the list price of $20. A half-hour later I found it at the thrift store for 25 cents!

Finds like that don't come along all the time, though, and lately I've become enamored of PaperBackSwap. The way it works is pretty simple: you post books you have to offer. Every time someone requests one from you, you mail it, and get a credit. When you find a book you want, you request it, and use a credit. Since every book you mail costs about $3 by media mail, each credit you use has basically cost you about $3 - not 25 cents, but not bad either.

Some books are hard to come by (I think I'm something like #171 on the wish list for "Ina May's Guide to Childbirth") but others come easy - I lent out and never got back my Sears & Sears "The Birth Book", and when I looked there was already one posted for me to request (hopefully not the one I lent out originally!) And it's a good way to get rid of books you're not going to read again! The thrift store reads I don't want to keep, I just post up there and they go to a good home.

So that's my tip for the evening. Now back to homework!