Hospital Choice Matters, A California Infographic

 

While this infographic is California specific, it goes to show how an individual person, having a low-risk pregnancy with a first baby, is likely to have a very different birthing experience depending on the norms of the hospital/practice they choose. I know people are limited by location, insurance coverage, and other needs, but doing some research into the intervention rates at local hospitals can make a big difference in setting expectations. So can working with a local doula who knows what the norms of various local birth sites are!

I recently finished Jen Kamel’s class The Truth About VBAC and learned, among other things, how hard it can be for an individual provider to calculate their own rates of cesarean section. While an individual may have a low rate of intervention, those rates may double during the weekends when that particular provider is non on-call. Ideally, any consumer of OB/Midwifery care should get to know the rates of intervention between every provider in a practice they choose.

Interview with an Acupuncturist

Last week, I had the pleasure of making a little video interview with local acupuncturist, Angela Bell. She often works with folks who are trying to conceive (including with IVF and other fertility treatments), as well as during pregnancy and generally focuses her practice on women’s health. More about her practice can be found on her Facebook and website.

One thing I so adore about Angela is her desire to connect and highlight others who are birth workers in the Boston area. She holds networking events, and has continued to host a video series on her social media pages for other birth workers to highlight their work. She’s chatted with doulas, massage therapists, midwives, yoga instructors, lactation consultants and others about the work we all do with clients.

In our 30 minute interview, we cover what it means to be a “full-spectrum” doula. I talk about why I decided to become a doula, the work I do with the Boston Doula Project, how others doing this work can best support LGBTQ+ families. We also chat about placenta encapsulation, my practice in Western herbal medicine and what it means to be an advocate for folks in all of this work. If you’re interested to get to know me a little better, check out this video interview!

The Business of Being a Doula

A few folks in my life have recently asked how I feel about the divisive/controversial ProDoula articles that are circulating. Honestly, as someone who chooses not to use any social media, I probably would have missed this entirely if folks didn’t bring it to my attention. I was relatively preoccupied while attending two clients’ 37-week labors, organizing the year’s goals with the steering committee of the Boston Doula Project, and encapsulating another client’s placenta.

Generally, I think there is enough space in Boston (I can’t speak for smaller or more rural communities) for many types of doula practices and their clients. While some doulas have always argued that providing free or very low-cost services devalues doula work as a profession, others continue to provide free or very low-cost services because it is exactly what they are called to do. I absolutely believe folks need to charge a rate for their work that is sustainable to them. On-call support for labor is extremely valuable, and not just because the studies show doulas save thousands of dollars in healthcare costs. We literally prevent trauma (and hold space for trauma that exists) on a regular basis.

The ProDoula founder is right to say that plumbers don’t worry about people who can’t afford to hire plumbers, but birth is not the same as home repairs. Supporting one another in the childbearing year is something that people have always done, and are always going to do. We live in a time and place in human history where folks aren’t all having 15 babies, witnessing 10 younger siblings be born, hanging out around groups who are feeding babies at their chests, and having that community of support built in. We’re giving birth in hospitals, often in big cities far away from family. Most often, the first birth people witness is their own baby’s! We’re needing to pay people out of pocket to create a sense of that lost community support. This used to be culturally built-in, for everyone, for free.

I’m all for folks charging what they need to in order to make their work sustainable – that part’s important and isn’t typically emphasized in many doula trainings. Most doula trainings emphasize what’s normal in birth and postpartum, what’s not, how to be a compassionate and competent helper and how to plug into the extended community of resources for when you need to make referrals. These articles make it sound like ProDoula’s trainings emphasize profits, avoiding the local community (“ProDoula tells doulas to ignore local doula collectives — why fraternize with the competition?”) ostracizing new doulas, and not making referrals because your agency provides The Best And Only care.

Boston is big enough to connect low-cost doulas-in-training with clients, as well as highly-experienced, $2,000-per-birth support folks (many of whom are also homebirth midwives and have skill sets above and beyond the average doula). If a client feels most comfortable with someone who has loads of experience, they are available. If someone is looking for a student doula who is available at a low-cost, they are likewise available. Just take a look at doulamatch.net to check out the diversity of prices, skillets and experience that available doulas display.
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As of this date, I’ve attended 67 births in the Boston area (and one of my dear friends in San Diego). I feel comfortable charging $1,100 for a birth because it sustains me and allows me to spend hours every week volunteering for the Boston Doula Project, or taking on low-income clients in special circumstances as private clients. I offer the same explanation to all the folks I work with: I have set a standard full fee, but if that feels like a barrier to you accessing doula support, we can have a conversation about it and find something that works. Having regular clients who can pay my full fee allows me to spend time providing miscarriage and pregnancy loss support, as well as the occasional birth, for free.
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Marketing is an important part of running any business. Many communities of doulas operate largely from word-of-mouth referrals, but others find providers by searching online. To fill the gap in business coaching that many doula training programs lack, Bloom Business Solutions is one of many providers that focuses on professional coaching for birth doulas and placenta encapsulators. (They are based in Seattle.) Like myself, they’ve noticed that “some training organizations” (and I’m going to name them: ProDoula) use fear-based marketing and misleading information in order to discredit doulas who provide placenta encapsulation in order to make their own providers seem like the only legitimate option. I know that anybody providing placenta encapsulation services needs to be adequately educated in the risks of blood borne pathogens, universal sanitation techniques, food safety handling, and the wellbeing of their clients. I also know that many providers of placenta encapsulation, myself included, have been providing this service since before ProDoula was even launched.
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With my experience, I know there is SO MUCH demand for placenta encapsulation in the Boston area, and there is lots of space for many providers to offer services. We do not need to discredit one another in order to get clients. I am committed to giving any prospective client all of the (safe, reasonable) options available to them. To illustrate my commitment, here are some other folks who are experienced at placenta encapsulation and serve the Greater Boston area. You’d be in great hands with any one of them!
  • Kara Schamell, at Modern Mama Midwifery has tons of experience, especially in sanitation techniques and lab safety as a midwife. We back up each other’s placenta clients in the case of travel or client birth overlap.
  • Jennifer Lynn Frye, at New England Placenta Encapsulation, who has a background in nursing, and has been providing this service since 2014. She was also part of the first-ever batch of Boston Doula Project trainees.
  • Jennifer Lewis, at New Life Blessings has encapsulated over 250 placentas in MA, RI and CT.

Herbal Aid for Fertility Support

Herbal Aid for Conscious Conception. CommonWealth Center for Holistic Herbalism in Brookline, MA.

With our culture’s strong focus on birth control and avoiding pregnancy, many people are left in the dark when they actually WANT to become pregnant! With the trend toward older ages for first-time parents (especially around Boston), many are wondering how to prepare their bodies best for parenthood. Why does it seem like everybody has babies so easily while others struggle for years, considering invasive fertility treatments? What does it even feel like to ovulate?

Come learn how to lay the groundwork for healthy fertility cycles, nourish your gametes and give yourself the best chance to have a healthy baby with the help of medicinal herbs and foods. This class is taught from the perspective of a birth doula who has years of experience helping parents (of many ages) have babies around Boston, MA.

Wednesday, January 20th, 2016
7:00pm – 9:00pm
25 St. Mary’s Court, Brookline

The fee for this class is $20. RSVP at this link.

An Umbilical Tree

This past week, I was excited to host my friend Anabel, of La Loba Loca, who was in town to facilitate some skillshares at local colleges. Seriously- if you’ve got folks who are interested in sexual health, herbalism, and community-based care, bring her to your community! We met last year at CLPP and, together with others, organized a workshop in Los Angeles this summer.

We realized we were born less than two weeks apart, both cling to yarrow as we meet (and love to meet) TONS of people in our work, shared our 1970’s feminist/herbalist/queer book collections and spun wool together. I also took her to my favorite part of Boston, the Forest Hills Cemetery. We walked around the small chunk of local wilderness behind the gravesite and talked about how we best like to dry out an umbilical cord when preparing the placenta for encapsulation. She knew someone who would tincture the cord, separately, and suggests using it when a birth parent needs to be away from their child. Connection medicine.

Loba and I found this tree and stopped to check it out for a moment.

Umbilical Tree
Umbilical Tree

A Full-Spectrum Fertility Chart

A few weekends ago, I had the opportunity to teach first year apprentices at the CommonWealth Center for Holistic Herbalism while the school’s co-directors, Katja and Ryn, were out in Colorado at the American Herbalist’s Guild Symposium.

It was a really fun weekend. Kim from Blue Vervain Farm facilitated children’s health, my beloved roommate Gavin taught about men’s health from a refreshingly queer perspective, Danielle at Growing Habits helped with our cold  and flu season materia medica and I was able to teach about women’s reproductive health from my full-spectrum doula perspective.

I began with giving some background on the fertility cycle. We are born with 4 million follicles. By the time we reach puberty, we have about 40,000, ready to mature one (or two)-at-a-time to be ovulated. Progesterone warms us, many hormones constantly in flux. Nobody’s cycle is quite as picture-perfect as the one I had fun drawing as a teaching tool.

Visual aids help teach fertility awareness
Visual aids help teach fertility awareness

I am grateful for the opportunity to speak about fertility, pregnancy prevention, birth control options, miscarriage, abortion, abortion options, pregnancy in the first, second and third trimester, labor, birth, breastfeeding and postpartum considerations all in one day. (Not to mention the herbs! It is an herb school, afterall…)

It is true that while nearly one third of pregnancies end in miscarriage, it is one of the most silenced fertility experiences. It is true that while one third of women in the US will have an abortion before age 45, cultural stigma hides that “normalcy” from the mainstream. It is true that while the majority people who choose to have an abortion are already parents, our cultural dialogue around fertility states that abortion and birth are two opposites, never to be touched upon in the same sentence, never to be considered within the same lifetime.

As a doula, I have supported women who struggled to conceive for years, after having miscarriages medically managed by D&C procedures. I have supported survivors of violence, who had to terminate pregnancies that resulted from brutal attacks on their bodies. I have supported substance users choosing abortion, queer families choosing gestational parenthood, and single moms bereaving their babies, born still. My practice is full-spectrum.