LaborEnabler™
So - when you become a doula you start joining all these online communities where people ask questions and you maybe answer them or just read the answers other people post.  Over the years I have quit answering so much and I have spent more time listening.  Recently, on my original certifying agency board a woman asked a question about back up for labor doula services.  I have seen this question before and never spoke up…. but this time it was different.  I knew I had something to share.  My response is relatively concise, but it is important to me…
 
 
This was my response:
 
“After flying solo for six years… I couldn’t take it anymore. I had a couple of back-ups and they were nice ladies, but I was always asking myself how I could make it work better. I never knew when they were going to be out of town. Plus, even though I knew them and we had a shared philosophy - I had never SEEN them be a doula.

Two years ago I started a group practice. I LOVE it! It has been the most successful thing I have ever done. We all maintain our own businesses, but we work together to provide better care for our clients. We do births together so we can say - I have seen Amanda at work and she is amazing!. We don’t have a set fee division for sharing births or laborsitting or full coverage. Each birth is unique and we decided it must be treated that way financially as well as emotionally.

All of our doulas offer different things: labor doula, postpartum, childbirth education, massage for pregnancy and postpartum, placenta services, etc. There is some overlap and frequently our clients will take childbirth education with one doula, have one labor doula, a different postpartum doula, her massage therapist. That way she gets to know several of the doulas in the group should we need to use a backup for any reason. We do not share call - so the doula you hire is almost always the doula who attends.

We now have 5 doulas in our practice, plus we have seen a huge increase in business with this model. We all work full time now and turn away business every month.

I can’t encourage you enough to find good back -up. Women with a shared sense of purpose. But, I also encourage you to build your own skills by attending births with your back-up. Working together to provide rounder, better care for your clients and their families.

I have always loved my job, but I love it even more now that I have this beautiful group of doula sisters to share it with every day!”
 
 
 
 

My sister doulas saved me. They lift me up when I am struggling. They are there when I cannot be there. I lean on them. I listen to them. They are my community within my community. My safest place as a doula is their arms.
When I see doulas struggling to make their births and find back up, I want to help them. This is the only way I know how. So I shout now - “Find YOUR sisters! WORK with them! Learn from them! Build your own community within a community!”

 
You can find out more about our doula practice by asking us!  Any of us!  ANYTHING!  We love what we have created and want to share it with other women - pregnant women, doulas, midwives, IBCLC - we don’t care.  We just want everyone to feel the love and comfort that we feel. 
 
Kathleen Wilson, Birth and Labor Doula, Placenta Specialist, Childbirth Educator and Lover of all things Birthy!
www.laborenabler.com
kathleen@laborenabler.com
 
 

So - when you become a doula you start joining all these online communities where people ask questions and you maybe answer them or just read the answers other people post.  Over the years I have quit answering so much and I have spent more time listening.  Recently, on my original certifying agency board a woman asked a question about back up for labor doula services.  I have seen this question before and never spoke up…. but this time it was different.  I knew I had something to share.  My response is relatively concise, but it is important to me…
 
 
This was my response:
 
“After flying solo for six years… I couldn’t take it anymore. I had a couple of back-ups and they were nice ladies, but I was always asking myself how I could make it work better. I never knew when they were going to be out of town. Plus, even though I knew them and we had a shared philosophy - I had never SEEN them be a doula.
Two years ago I started a group practice. I LOVE it! It has been the most successful thing I have ever done. We all maintain our own businesses, but we work together to provide better care for our clients. We do births together so we can say - I have seen Amanda at work and she is amazing!. We don’t have a set fee division for sharing births or laborsitting or full coverage. Each birth is unique and we decided it must be treated that way financially as well as emotionally.
All of our doulas offer different things: labor doula, postpartum, childbirth education, massage for pregnancy and postpartum, placenta services, etc. There is some overlap and frequently our clients will take childbirth education with one doula, have one labor doula, a different postpartum doula, her massage therapist. That way she gets to know several of the doulas in the group should we need to use a backup for any reason. We do not share call - so the doula you hire is almost always the doula who attends.
We now have 5 doulas in our practice, plus we have seen a huge increase in business with this model. We all work full time now and turn away business every month.
I can’t encourage you enough to find good back -up. Women with a shared sense of purpose. But, I also encourage you to build your own skills by attending births with your back-up. Working together to provide rounder, better care for your clients and their families.
I have always loved my job, but I love it even more now that I have this beautiful group of doula sisters to share it with every day!”
 
 
 
 
My sister doulas saved me. They lift me up when I am struggling. They are there when I cannot be there. I lean on them. I listen to them. They are my community within my community. My safest place as a doula is their arms.
When I see doulas struggling to make their births and find back up, I want to help them. This is the only way I know how. So I shout now - “Find YOUR sisters! WORK with them! Learn from them! Build your own community within a community!”
 
You can find out more about our doula practice by asking us!  Any of us!  ANYTHING!  We love what we have created and want to share it with other women - pregnant women, doulas, midwives, IBCLC - we don’t care.  We just want everyone to feel the love and comfort that we feel. 
 
Kathleen Wilson, Birth and Labor Doula, Placenta Specialist, Childbirth Educator and Lover of all things Birthy!
www.laborenabler.com
kathleen@laborenabler.com
 
 

sometimes I am dumbfounded

I am truly one of the luckiest women in the world.  I LOVE my job and I get to meet some of the most amazing people.  One such woman - Kristina Roth George - surprises me constantly! This quiet, pretty woman has burgeoning writer deep inside her that I never knew about.  You will be amazed as you read about being ‘Carried Forward’ -

Today, the dictionary project is pleased to share with you the winning entry from the first write this word contest. Here is “Carried Forward” by Kristina Roth, inspired by the word ripple!


rip·ple (ˈripəl), v.t. [RIPPLED (-id), RIPPLING], [Early Mod. Eng.; orig. of stormy, dangerous water; hence prob. < rip, v. + -le, freq. suffix], 1. to form of have little waves or undulating movements on the surface, as water or grass stirred by a breeze. 2. to flow with such waves or movements on the surface. 3. a) to make a sound like that of rippling water. b) to proceed with an effect like that of rippling water: said of sound. v.t. 1. to cause to ripple. 2. to give a wavy or undulating form or appearance to. n. 1. a small wave or undulation, as on the surface of water. 2. a movement, appearance, or formation resembling or suggesting this. 3. a sound like that of rippling water. 4. a small rapid. SYN. see wave.

Carried Forward


That summer, I attend aqua aerobics classes with a handful of elderly women, where I can float and swim with no crowds. Their soft, saggy upper arms wiggle as we raise plastic dumbbells overhead. I find childlike delight in the water. I wonder if you feel as buoyant in your amniotic fluid as I do in the pool. Sometimes I have to stop moving and stand still because the intermittent waves of morning sickness don’t combine well with the splashes and slaps of the water as we bounce up and down with our foam noodles.

My doctors are ultrasound crazy. I see you on the screen many times and imagine waves of sound moving around your body. At thirteen weeks, your tiny arms curl and uncurl on the screen, and I see that your vertebrae have unfurled down your spine with precision.

You travel to many places that summer. We circle the continent in our comings and goings, making loops back and forth between Houston and more beautiful places. Your father and I trace our history and at the same time turn outward to imagine our future, turning to places we’ve already been, and some we haven’t, wondering what travel and life will be like once you arrive.

In New Mexico, I sit on the edge of the hotel bathtub and run mountain-cold water over my dusty feet. The sand from my toes is carried down the tub drain by small ripples. I buy tiny, sweet strawberries at the Santa Fe farmer’s market. Miniscule seeds speckle their red flesh, beginning in a tight whorl at the tip of each berry and spiraling out into wider rings toward the stem. On the way to Taos, we stop at a state park. I stand and watch a small, clear stream running over its rocky bottom while your dad hikes up to a raging waterfall. He shows me a picture of it later, water pounding in a steady rage over a cliff.

In South Dakota, your dad and I walk deep into the woods behind Pactola Lake, following the course of Rapid Creek. He finds the biggest slate pieces he can lift and swings them into the moving water. They crash loudly on the stream’s surface before sinking to the bottom, the impact sending small circular waves toward the banks. I don’t know why he thinks this is so amusing. Ferns are unfurling themselves along the forest floor, tips tightly closed as they lean upward and unroll themselves toward the sun.

In Minnesota, I do the dishes when we visit my mom, your grandma. She’s only 56, but her dementia is moving quickly. Sometimes she will pick up the dishrag and dip it into and out of the soapy water, drops puddling back into the sink from the soaked rag. We visit the largest farmer’s market I’ve ever seen – stands of vegetables, fruit, flowers, and baked goods march onward in even rows.

In Oregon, we rise early, at low tide, and chase to the shore as I did fourteen years previous. The waves flatten on the wide beach. Each footstep in the shallow water makes a lovely splish-splash. I scan the beach for sand dollars, wanting to find them before the flat waves that brought them in carry them back out. Mesmerizing patterns cover the beach, ripples in the sand replicating the ripples of water that have disappeared. Rivulets begin to run into the tide pools as the morning moves toward noon.

In Pennsylvania, we baptize another godchild. She is dunked three times into the large metal font, water splashing up and beyond the lip, white towels already piled around the base. Their folds rise and fall along the floor. In less than a year, it will be your turn for this ancient immersion.

Your limbs move visibly across my stomach as you turn inside. Some women call their contractions waves. I suppose they do start slowly and then build in intensity as a wave does, and to me, they are as violent as the waves we saw pounding a rocky shore in Maine, water still pouring out of the clefts as each new wave came in. I wanted to use a tub for at least part of my labor, but medical interventions make that impossible. We watch the undulations of my contractions on the screen, another line below charting the valleys and peaks of your heartbeat. The two lines are not as synchronized as they should be. I wear a mask, oxygen flowing into my lungs, not for myself but to try to help you. They break my water, thinking it will speed labor. White towels are put out to catch the stream. A photo shows the doctor grasping you as you emerge, a circle of fluid radiating around your head.

You sleep next to me at home and little pools of milk spread out in circles on the sheets. You nurse and then rest, nurse and then rest, rhythmically swallowing. Blue-white milk streams down your chin and onto your neck.

Two weeks old, you relax visibly as the warm water I pour over your scalp trickles down your shoulders. Eighteen months later, you still want me pour water over you in the tub, protesting with a little grunt when I stop. You are mesmerized by the thin cascades of water running down your skin. You hold your hands under the hose as water sprays in a circle onto the perennials, wiggle your fingers in the dog’s water bowl. You pick up the bowl and dump it onto the floor into a huge spreading puddle if I don’t catch you in time.

Each month of your life expands my own, rings of experience and memory growing bigger with time, carrying the three of us forward just as the flattened waves in Oregon slide sand dollars out of the ocean depths and onto the level sand, into the wide open.




Kristina Roth is a native of South Dakota but now lives in Houston with her family and dogs. Her work has been published in Platte Valley Review, Blue Line, Relief, and other literary journals. Her artwork and photos have been published in several Somerset magazine titles and online at Shutter Sisters, WhipUp, and forthcoming at South Dakota Magazine online.

Notes on “Carried Forward”: I’ve been processing my son’s arrival and growth and my new identity as a mother for almost two years now. Writing has been crucial in helping me examine these topics. The word ripple seemed to magically provide a new framework within which to reflect upon my pregnancy and son’s birth. The idea of ripple gave me a fresh way to define and describe these events. Having a word limit was also very freeing and refreshing, as it made me focus on key images and events without getting sidetracked. This essay was written during naptimes and came together more quickly than my pieces usually do, probably because these events have been on my mind so much.

Just be you!  It&#8217;s the person I like the most anyway.

Just be you!  It’s the person I like the most anyway.

The scope of a Labor Enabler™ Doula

It’s because I am in the birth community that I am exposed to alot of information regarding birth support.

The scope of a doula has been a discussion I have run across alot lately and so I thought I would take a moment to talk about how I practice and what I think doulas do. 

Firstly, no two doulas are created equal.  Meaning nobody is going to give you the exact same experience as the doula you hire.  I practice with my partners, because we share a philosophy.  A shared outlook that birth, every birth, is in the hands of the family living it.  We are there to be their guides, their friends, their mentors, their support system.  We are there to help them feel safe and to build the right birth team for their birth!  Should I attend a birth on behalf of one of my partners, I try to do as they would do and be as they would be, but at the end of the day - I am uniquely me and can never be Amanda, Dorin, Jessica or Rowan.  Just as they can never be me.

DONA - the largest certifying body defines a doulas scope this way - “The DONA International certified doula does not perform clinical or medical tasks such as taking blood pressure or temperature, fetal heart tone checks, vaginal examinations, or postpartum clinical care.”

ALACE - the group I certified through defines scope of practice this way - “Labor assistants/birth doulas provide emotional support, physical support, education, collaboration, and professionalism to the birthing mother and her family. Labor assistants/birth doulas provide support in all settings: home, birth center, and hospital. The labor assistant/birth doula is not the primary caregiver.”

The biggest difference noted is DONA is very specific about not performing ‘clinical tasks’.

There are other certifying bodies out there (and you certainly welcome to quote their scope at me), but for now I will work with these two.  DONA prohibits clinical tasks.  ALACE introduces them, but does not teach them and there is no specific prohibition on doing them. 

There are also doulas out there who do not certify, but learn by experience or through a mentorship with another doula or midwife.  As long as I have been doing this, there have been doulas doing clinical assessments  - also known as monitrice or someone who monitors. 

Back to me - I walk a fine line between being a doula and a monitrice.  And I am REALLY good at it!  I carry a doppler, a blood pressure cuff, sterile gloves for exams, lube, an emergency childbirth delivery kit and an aromatherpay kit.  I have been trained to palpate, give vaginal exams and detect heart tones with both a doppler and a fetoscope.

I call myself a doula, because I don’t want to monitor you.  My belief is that a woman left alone with her instincts will usually birth better than with my interference (vaginal exams, etc.)  I certainly don’t want to get caught up where someone thinks I am practicing medicine either.  I am NOT.  I don’t hand out supplements or tell people to do anything or give exams at prenatals (or in birth).  I offer options and counsel my families to seek the guidance of the professionals they have hired to caretake their physical well-being (that’s your doctor or midwife folks).

What I do do is -

I put the monitor to mamas belly when asked and often say, “does that sound good to you?” (just so we are clear - a mom can rent or buy a doppler).  This has come in handy several times in the past for various reasons.  Parents know what their baby should sound like on a doppler.  If something is up with the heartbeat, we know to go straight to the care provider and get more monitoring. 

I don’t do vaginal exams unless under great duress (kathleen - the baby is coming out).  I just don’t think we need them.  I think we get hung up on numbers that mean so little.  I can’t tell you how many times I have heard a doc say something like: Well, you are only 2 cm.  I recommend an epidural.  It’s going to be a long night. - only to see the babys head 30 minutes later.  Or: You are almost there,  9cm - only to be stuck at 9 for four hours.  Numbers mean NOTHING, Folks! NOTHING!  In all my years I have done maybe five vaginal exams and they have all been to check and see if we could make it to the hospital or birthing center.  (most of them weren’t even real vaginal exams - just a look to be sure).  I have had several moms ask for vaginal exams and my usual response is - you don’t need me to put my hand inside of you to tell you what is going on.

I also palpate at prenatals and suggest exercises to help baby get into the optimal position for delivery.  I use my hands, a rebozo and whatever furniture happens to be around to do these things.  We are a senditary lot these days and we do a lot of reclining.  I see alot of posterior babies - this is normal!  Back in the good old days we squatted all the time, pitching our babies forward and down into a nice wide open pelvis.  If only we would do more squatting to work.  I let my clients guide me in palpation - they always know where baby is, even if they don’t know they know.  And, at the end of the day, I tell them - it’s a guess, not a guarantee and baby can change position at any time.

I do aromatherapy.  I love it! 

I know accupressure points I use for a variety of reasons.

I carry a blood pressure cuff, thermomater and emergency delivery kit.  I rarely get any of this out of my bag.  But, we are with women who are birthing folks, BIRTHING!  Wouldn’t you rather me be prepared than stand aside and let nature take it’s course. 

If there is a baby being born on the side of the road - I want to be READY!

This is how I work.  This is what runs the core of my belief system -

I should give families every advantage available to birth their babies into this world safely and by the method of their choosing (not mine).  If there is something I can do to help you and I am not doing it or am not skilled to do it, well….I feel like a bad doula.  So, I develop my skill set.  I am prepared to help in any and all circumstances.  I want you to succeed, triumph, conquer and prevail in birth!  Even when it’s hard, even when I don’t want to do it, even when you don’t want to do it.  We all have to be ready to do our part to help that baby into the world.

I make no apologies for not following this scope or that scope, but I set my own.  I demand that I learn these skills, because I think they make me a better doula.  I am proud of myself and the journey I have taken.  I don’t demand anybody work the way I do.  I believe everyone has their own path to follow and this is mine.  My journey to becoming the best doula i can possibly be. So, if you don’t practice like me, that’s okay and if I don’t practice like you, that’s okay too.  Until the government decides they are going to regulate this profession more closely (I hope that day never comes), we are free to choose how we practice.  We are free to choose the skills we learn and how we use them in birth. I know amazing doulas who don’t do any of the things that I do and I know amazing doulas who have a higher skill set than mine.  I am proud of the way I practice.  And in the end, I think that’s how we should all feel, regardless of scope.

Taken with instagram

Taken with instagram

Taken with instagram

Taken with instagram

Beach ready (Taken with instagram)

Beach ready (Taken with instagram)

Here comes the rain&#8230;.. (Taken with instagram)

Here comes the rain….. (Taken with instagram)

Lola likes Thai food!!!! (Taken with instagram)

Lola likes Thai food!!!! (Taken with instagram)

Thai food!!!! YumTumTum!!!! (Taken with instagram)

Thai food!!!! YumTumTum!!!! (Taken with instagram)