A Crack in the System

A couple of years ago, when I was deeply into my work at my cafe, and running longer and longer distances, I told my husband at some point "Yeh, The Man won." I meant that crippling internal conflicts had brought me to a decision to abandon my volunteer doula organization; that the arrest and conviction of unregistered midwives in Canada and around the world meant that women were left with less and less choices; and that my simmering suspicions about the nature of feminism were possibly true. 

So, I took pleasure in my cafe. I ran faster and had a load of fun doing races. I made new friends. I ignored the birth world, and only answered a call if one of "my" students had a question about a birth or a pregnant client of theirs. Occasionally I would check in with midwife friends around the world, just to check in. I was happy giving it all up. I put my doula bag away and forgot about my plans to go back to Greece to attend women in the camps there.

Then that crazy virus hit and I spent two month at home, with my family (husband, two sons, nephew). I made myself a small cocoon, and I crawled into it and meditated, thought, wrote and pondered. And then women started calling me. Women who had planned to give birth at home but whose midwives were forbidden to attend. Women who planned to give birth at the hospital but their doula were forbidden to attend. I gave advice, gave comfort, affirmed choices, made suggestions. 

I met with a few women who were planning to give birth in their own homes, without a midwife in attendance. I spoke to them after their births and got the idea I would interview them for an article or a podcast episode. Then I looked at the footage and I realized - you women are amazing by the way! - that I have some beautiful, inspiring footage. And then I realized, yes well, women experience less-than-optimum births and they're also worth interviewing....

So, now I have interviewed about thirty women, I have so much beauty on my Google drive and so many words of wisdom... so I'm making a documentary to celebrate our strength, tell our stories and let the world know that our care of the birthing woman needs change and needs it NOW!

There is a crack in our maternity care "system" and women are falling in. Luckily, the Covid crisis is a chance for us all to have a little time to check in with our reality and make some changes. Fast. 

Some questions to ponder:

• Why are women expected to "reach for the top" in their professions and then called "too old" when they decide to bear children?
• Why are women expected to go to the hospital to give birth? As we now know, hospitals are where sick people go. Pregnancy is not an illness.
• Why are women threatened with the death or morbidity of their babies, while they are in labour?
• Why are there so few midwives in Canada?
• Why are doulas so expensive? Is a birth companion a luxury?
• Why do women feel ashamed for their birth experiences?

And some mantras to reflect on:

• Nature is not gentle, it is powerful and untameable.
• Heal birth, heal earth.
• Powerful women can change the world.
• Just a reminder, when a woman gives birth, she is BIRTHING A NEW HUMAN! 

So, I have my work cut out for me, and I am feeling good.

If any one of you wants to participate in any way, let me know: do you want your voice to be heard? Do you want to be involved in production? Do you have an idea you want to tell me about? 

I'm listening!

Vote for Montreal Birth Companions!

As you all know by now, if you are regular readers of my blog (speaking of which, please follow me!), Montreal Birth Companions is a volunteer-led organization that provides free doula services and resources to marginalized women in and around Montreal.

The women we serve are at risk because of youth, poverty, isolation, or refugee/immigration status, or because of all of these factors. MBC doulas work to provide non-judgmental and unconditional support to all of our pregnant women and new parents.

Montreal Birth Companions have been providing support for birthing families since 2003, with no funding. Our volunteers work from the heart; our coordinators and administrators spend unpaid hours devoted to this worthy cause. Please help us help women by voting for Birth Companions on the AVIVA FUND. You can vote every day, from individual email addresses!

HOW TO VOTE:

1) Create an account on the Aviva Community

Fund website: https://www.avivacommunityfund.org/users/registration/register

2) Go to your email inbox and click on the link that Aviva sent you.

3) Go to the Montreal Birth Companions Aviva idea:

http://www.avivacommunityfund.org/ideas/acf16929 and VOTE for Montreal Birth Companions!

4) Do this every day starting September 30th. Help us win funds to provide prenatal classes for the women we serve.

Level One Doula Class Fall 2013

Doula classes are starting again in September. This program has been a great success! The doulas that completed Level One in May, 2013 have had a very busy summer attending births as volunteers with Montreal Birth Companions (always working with a partner, as a shadow and then as a co-doula).

Level One will start again on September 9, 2013. Registration is moving along, so if you are interested please get in touch with me for a registration form. See below for a description of the course.

Level Two is scheduled to start at the end of November, 2013.

Birth Companions Doula Course

Level One Description

Fall 2013

Introduction

This course is the first of three levels of the Birth Companions doula program. It includes 24 hours of class time.

Classes will be held every Monday evening starting on September 9, 2013, for eight weeks.

When you have completed this level, you will be eligible to accompany clients from the Montreal Birth Companions volunteer doula program, under my mentorship and with a partner doula. During the shadowing process, you will proceed to Level Two, after which you will be able to work as a private practice doula.

The course will integrate theory and practice. Shadowing and mentoring may take place throughout.

The only prerequisite is enthusiasm and availability.

Materials

Bring your own experiences, a notebook, your hands and an open heart. We will utilize The Birth Conspiracy as our main reference. The book will be available on or before the first class.

Requirements

To fulfill requirements for Level One, you need to attend all of the classes, if possible. I may ask you to present or prepare assignments, but these will be done within class time. If you are interested in doing an independent project, please speak to me and I will be available for mentorship.

Cost

We are pricing this course to be accessible for as many women as possible. The cost for Level One is $400.00. I do not turn anyone away so please contact me about a financial plan.

Birth Companions Doula Course

The next Level One doula course is coming up soon - starting on April 15! This course will give you the skills you need to volunteer with Montreal Birth Companions.

Level One Doula Course

Looking forward to seeing you there!

Birth Companions Doula Course: One, Two, Three

Level One of our Birth Companions Doula Course spring 2012 session was a wonderful success! The students are already attending births, either with partners or with mentor doulas. They are now part of Montreal Birth Companions, and it has been a busy and productive summer.

Level Two will be starting on September 9, 2012, at Studio Vie. It will run for eight weeks, with three hour classes every Sunday. In Level Two, we will explore the challenges that can occur during pregnancy, birth and the postpartum period, and discover the ways a doula can facilitate healing. This level is open to anyone who has completed a doula training.


Level Three will be comprised of a select group who will travel together to Cuba, to explore in depth an aspect of maternity care and will tour the facilities at a Cuban hospital and meet the midwives.


Level One will be starting in the fall of 2012, as soon as we have full registration. We have registrants already, so please register as soon as you can. See below for registration details.

Hoping to see you all in the fall!!

Montreal Doula Training revised schedule

I have been getting lots of positive response about the course, so I have decided to give you all some more details - here below is an outline ... remembering that the best class plans are never followed to the letter!

 Birth Companions Doula Course

a knowledge-based, hands-off approach

Introduction

This course is the first of three levels of the Birth Companions doula program. It includes 24 hours of class time.

When you have completed this level, you will be eligible to accompany clients from the Montreal Birth Companions volunteer doula program, under my mentorship and with a partner doula. Once you have completed three volunteer births, you will be able to proceed to Level Two, after which you will be able to work as a private practice doula.

The course will integrate theory and practice. Shadowing and mentoring may take place throughout.

The only prerequisite is enthusiasm and availability.

Materials

Bring your own experiences, a notebook, your hands and an open heart. We will utilize The Birth Conspiracyas our main reference. The book will be available on or before the first class. The cost is $24.95.

Requirements

To fulfill requirements for Level One, you need to attend all of the classes, if possible. I may ask you to present or prepare assignments, but these will be done within class time. If you are interested in doing an independent project, please speak to me and I will be available for mentorship.

Cost

We are pricing this course to be accessible for as many women as possible. The cost for Level One is $400.00.

Please see the outline below, for the class program. This course will take place at Studio Vie, 5175C, Sherbrooke West, Montreal, H4A 1T5

Class One April 15, 2012, 10am to 1pm

Introductions

“What is a Doula?”

Class Project

Nutrition assignment

Class Two April 22, 2012, 1pm to 4pm

Bare Bones – anatomy

The birth process, cardinal movements

Class Three April 29, 2012, 1pm to 4pm

Questions and Review

The Childbearing Year

Centering Exercise

Class Four May 6, 2012, 10am to 1pm

Nutrition

Breastfeeding

Role playing

Class Five May 13, 2012, 1pm to 5pm*** note this class is a four hour class

Doula Care A to Z, the process, the doula bag

Doula Techniques – alternative ways for coping with the pain of childbirth

Role playing

Class Six May 20, 2012, 1pm to 5pm *** note this class is a four hour class

Common Interventions – Induction, Epidural, C-Section, Episiotomy, Instruments, Exams

Role playing

No class May 27

Class Seven June 3, 2012, 1pm to 5pm *** note this class is a four hour class

Presentations – Nutrition Guides

Review

Montreal Doula Training April 15, 2012

I am happy to announce that I have teamed up with Jana from Studio Vie to organize a doula course that will be starting on April 15, 2012.

The program is based on the approach that I have explored in my book, and we will be using the book as our text.

This program is comprised of three levels. Completion of the Level One course will allow the participants to volunteer as doulas for Montreal Birth Companions volunteer doula organization.

Level Two is a continuation and an exploration of themes introduced in Level One. This level will provide doulas with the necessary skills to run a private doula practice.



 Level Three courses are specialized, and they take place in all sorts of interesting places.

We will be going to Cuba together next spring, and this summer we will be exploring storytelling and healing with Lewis Mehl-Madrona, in Italy.

To be accepted into Level Three you need to have attended births as a doula or lay midwife, and you need a strong foundation in self-directed learning.

If you are interested in accompanying me on any or all of these journeys, please let me know. Our courses are filling up fast!

Ask the Doula - epidurals

I am always getting letters, phone calls, or face-to-face questions about birth, doulas, and such.

Every week, I am going to  try to answer and explore a different question that is presented to me, and, in doing so, perhaps answer some of your questions, and perhaps learn a thing or two myself.

Please send me your questions as comments, and I will select one question each week to answer.



Question Number One

"I was at a birth the other day, and the doctor said to my client that there was a recent study done that proves that an early epidural [that is, administered before 4cm] does not lead to a rise in c-sections. What is your opinion on this?"

I think more doulas and women will start to hear about this study, and I think it reflects a dangerous trend. The doctor who quotes recent research seems very with-it and up-to-date - she's done her homework. But let's have a little look at the research in questions:

The study is a systematic review of six studies that included over 15,000 women. Please click here to retrieve it. As you can see, it is a nice little study, I suppose, with one serious flaw that jumps out on first reading.
It states that the ..."review showed no increased risk of caesarean delivery or instrumental vaginal delivery for women receiving early epidural analgesia at cervical dilatation of 3 [c]m or less in comparison with late epidural analgesia." Early epidural analgesia was defined as that administered at 3 cm or less. Late epidural analgesia was not defined, so it could have been administered anywhere from 4 cm well into the pushing phase. Well, when was it? Was it at 4.5? Or was it after an hour and a half of pushing?

The danger is that, the media being the creature it is, someone could simply snip this conclusion, as I have done, and weave a generalization from it. An unsuspecting woman reads the two-sentence generalization and thinks "ahhh, well, that's a relief, I don't have to wait to take my epidural."

Let's look at the reality:
What do we see, as doulas? As I suggest in my book, IF a baby is not optimally positioned (and, by the way, this is also something that we have studied and studied, and we still can't ever really tell when and if a baby is well-positioned, except by watching her  weave successfully down the birth tunnel), and IF a woman takes an epidural early in her labor, and IF the baby's descent could have been helped by a resistant pelvic floor, then this mother and baby could end up with a surgical delivery.

So, in fact, when I see a nice easy birth and:
a mother who has always taken an epidural (and this is her sixth baby and hey! who am I to argue?)
or a mother who always maintained she would ask for pain meds
or a mother who needs meds for another, outstanding reason (sexual abuse being one - we'll get to that another week)
then I have a better feeling about outcome when she decides to take an epidural (even if I know she doesn't really need it).

But when I see a labor that is not going well, for whatever reason: for example, if a woman is having the particular kind of pain that may indicate a poor position, or a woman is undergoing an induction (more about induction coming up too) that looks like it may fail, then I worry about an early epidural, and its effects on labor.

So what can we do about it? "No, little missy, you cannot take the drugs. I as your doula know best"?
Of course not. Maybe there is not really much we can do in the moment. Maybe prenatal education is absolutely paramount. We need to sit with our clients and talk with them about what they are reading, what they understand, what they believe. We need to work with them and open up to them about our own experiences as doulas, and let them know that although a natural birth is definitely simple, it is not usually easy, and that even during labor they will probably have to make choices. And that her choices WILL affect the way her birth unfolds. If she wants a natural birth in a hospital, she will have to work for it. Part of that work will be not accepting pain medication too early in labor.
I know it goes against the review.
But I have evidence that early epidural administration DOES interfere with the normal progress of labor. That evidence comes from my own observation. No studies, no funding, no university degrees. Just women birthing.

More Storytelling - in Lunigiana

The second installation of our storytelling adventure will be in Lunigiana, a hidden corner of Italy where ancient peoples worshipped the moon and carved moon statues, or "menhir".

Lunigiana Storytelling will take place from July 28 to August 4, 2012. We are inviting anyone who is interested in stories, birth, healing, or just plain relaxing and having fun under the Tuscan moon.

Birth - The Need for Community

One thing I really enjoyed about the workshop I just led in Halifax was the feeling of community among the women there. Although the participants were mostly doulas, we also had participants from other professions who were just as happy to be there, and who enlivened the activities with their own insights. We ranged in age from just a few weeks old to quite elderly. Some of us work as private doulas, some volunteer, some have a "day job", and doula on the side. It was very refreshing to see such a mixed group of people really connecting and working for a common good - of course, that particular common good being the most women having the best birth experiences.

I had an interesting conversation with a midwife in the group who was discussing program options with an aspiring midwife who now works as a doula. The talk led to the issue of bullying and unkindness within the birth community, and unfortunately it is a real problem that does not go away if it is ignored.

Because birth is so important to us all, and because most of us who work with birth are usually very busy, there seems to be a natural progression to some bad habits. It is so important for all of us to take a good look at ourselves and our beliefs and actions every once in a while. We can see that, for example, we are holding on to a belief about birth that does not apply to every woman. Or that we are being less charitable to those less experienced, by simply criticizing instead of taking time to teach. Or perhaps we feel very strongly about a certain aspect of birth, and hold on to it too dearly.

Attending birth is all about letting go of your own ego and your agenda, and accompanying a woman as she makes her own journey to motherhood. It is also about reaching out to others who are on this path, and being able to accommodate the reality that there are many of us on the path, that we all have different opinions and histories, and that the most important thing is that we walk along together with an attitude of respect.

Not to say that we can't ever disagree. Of course we can. Nothing better than a good argument. But that argument should never, ever take place in a birthing room. It should never descend to personal insults. And if there is no accommodation in sight, no agreement to be reached, then at least we can agree to disagree and continue to work together to provide the very best care for women and their families.

Montreal Birth Companions

Right now, a lady who dearly wants to have a natural birth is in labor. She found out about Montreal Birth Companions from a little workshop she attended, and she contacted us with a request for a volunteer doula. She is single, living alone, and doesn't have the means to pay for a private doula - they can run to over $1000 here in Montreal. Of course, many people can afford them because they have private health insurance, and many doulas are now able to provide insurance receipts, which makes it a lot cheaper for the average working couple.

But MBC gets requests from women and families who cannot afford very much at all, and so our dedicated doulas donate their time and energy to accompanying these women on their childbirth journey. Sometimes we are approached by women who can afford a small stipend, but usually we are called by other agencies who have clients who need companions.

Over the years, MBC doulas have accompanied women from the four round corners of the earth: from the continent of Africa, from India and south-east Asia, China, Eastern and Western Europe, Central and South America, and of course from Canada. Our clients speak many different languages, as do the doulas. Many of our clients over the years have not spoken either of the official languages of Quebec (French and English, in case you were wondering...). Many of these women are single, many have recently arrived in Canada, some have left their other children behind.

Today's champion started early labor yesterday. She has been happy at home on her own until this morning, when her contractions started to become more intense. One MBC doula went to her place after she finished work; another is on the way when her work day is finished. They will probably be heading to the hospital soon.

Eight years ago, when our doulas first started volunteering, I was mentoring two exceptional women who were at one of their first birth experiences. This was with a lovely woman from the Indian subcontinent, who was unsure about when to go to the hospital. Although the doulas had been through a very comprehensive training (Holistic Perinatal Associates which, sadly, is no more - it was created by myself and Lesley Everest, of Motherwit fame), they couldn't figure out what exactly was going on, so they made several trips to the hospital in the middle of the night. Each time, they phoned me to ask my advice, and several other times too. So finally at around four am, they called me to say they were off to the hospital. I was lying in bed, and my feet happened to be pointing in the direction of the hospital they were going to. So I sleepily said "I'll point my toes for you.", which meant, of course, the equivalent of crossing my fingers, kissing my amulet, or praying for a good birth. The lady did go on to have a wonderful, natural birth, accompanied by her stout-hearted and exhausted doulas. Since then, "pointing your toes" has become a common saying in the Montreal doula community.

Some of our volunteers relaxing in the hospital!

So, everyone, "point your toes" for the lady in labor, wish her all the best, and let's hear a cheer for her wonderful doulas!!!

Birth Companion Doula Course

Birth Companion Doula Course

A knowledge-based, hands-off approach to accompanying woman during the birthing experience.

I am very excited to propose a new series of courses designed to assist women to attend births as companions, as friends, as knowledgeable and respectful assistants.

I will not be training or offering anything novel or out of the ordinary. We will be developing our innate skills as women - patience, kindness, strength, care - and these skills will lead to confident, non-judgmental companionship.

The courses are thirty hours and of varying schedules, and they are priced reasonably. The participants will receive lessons and interactions on theory, practice, and healing during the childbirthing year.

The first of these will take place in Montreal in mid-October 2011 and several are upcoming internationally throughout 2012.

Places will be filling up fast so if you are interested in attending please let me know as soon as possible.