Fourth Annual Truck Touch

We had so much fun at the bubble station collaboration between Bright Birthing and Debbie Wong of Nine Moons Midwifery!  We're excited to add this bubble machine to our event tool kit - watch for it next at our Yoga Picnic on May 12 and then at the Kids & Nature Festival on June 3. 

Nearby Baby

Nearby Baby's mission is to provide quality postpartum support to families with a newborn in the Charlottesville area, regardless of their ability to pay. This service will help to insure a healthy start for baby and a smooth transition for the family.

Nearby Baby is a fiscally sponsored 501(c)3, operating under The Social Good Fund Inc., a non-profit organization.

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Check out their crowdfunding site here

This kick-off campaign is a birth announcement for Nearby Baby; letting the world know that support is there for all families in need.  By Mother's Day we hope to raise $25,000. towards our 2018 goal of $75,000. All donations are tax deductible!
Nearby Baby will offer professional, experienced care for local  families in the Charlottesville area community after birth. We will achieve this by first providing quality postpartum doula training and practical experience for women. We will then send these trained doulas to homes in their nearby communities to support mothers, much like the way a village once cared for and nurtured its newest members and their families.
Doulas help in many ways such as breast feeding support, understanding a baby's needs and development, by providing a family time needed for self care and rest, by insuring baby safety, and more. This fundraiser will make these valuable doula services finally available to all families in Charlottesville, regardless of income.  It will also make the doula training possible, empowering women to support their neighboring families with each new birth. 

Spring!

There will be no village circle this month as we gear up for our annual May Yoga Picnic (date TBD). Below is a scene from two years ago - our practice that day, led by Sara, was designed for pregnant and postpartum participants and the weather was perfect! 

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Bright Spot #5 Virginia Discovery Museum

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Perhaps the best Christmas present my family received last year was an annual membership to the Discovery Museum on the downtown mall. The colorful windows had caught my eye often and we’d peeked in one day when we’d been invited for a birthday party when my kiddo was tiny (that day the normal attendance at the museum was overwhelming to brand new parents with a wee one and we didn’t even make it to the party, but I digress).

With an annual pass, very short visits are feasible any day we’re downtown and we can explore a feature or two if we’re not up for spending a full morning - though that’s fun to do as well. It's a great place for playdates and we have sometimes seen bigger kids there on field-trips, but it's also a wonderful spot to watch my kiddo explore solo while I follow her lead. A membership at the Discovery Museum also includes discounts and freebies at a bunch of other local businesses, including a free bambino cone at Splendora’s with an adult coffee purchase.

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In February and March there are big renovations coming to the back gallery of the Discovery Museum, so it’s definitely worthwhile to get in there ASAP to appreciate the current iteration before it is (closed for a while and) improved. Regular events include a group for parents with babies, toddler time that involves attended special activities, story hour, crafts and more. Check out their website for updated event information and details about the closure of the back gallery.

 

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Downtown Pedestrian Mall near Sprint Pavilion

524 East Main Street

Charlottesville, VA 22902

434-977-1025

vadm@vadm.org

map+directions

 

What Doulas Do

 My doula, Zoe Krylova, took these gorgeous photos at my mother blessing.

My doula, Zoe Krylova, took these gorgeous photos at my mother blessing.

We remind folks through pregnancy, birthing and parenting that what they are experiencing is normal, when it is. We accompany them and hold their hands if their experience veers from normal. We are not care providers, but we do offer deep, thoughtful presence and we certainly are individuals who care.

Holly Powell Kennedy, Varney Professor of Midwifery at Yale University writes that doula-attended birth, rather than serving as a throwback to some romantic image of the past: "represents an evolution to an educated, supportive companion who knows how to support the childbearing process..." Whether trained through a certifying body or self-taught, doulas are educated.

My doula training in 2010 changed my life. At the time I was on a leave-of-absence from a Chinese Medicine masters degree program which had me feeling drained and at my physical limit. My mentor was an acupuncturist and also a doula who was pregnant with her second child: “you should enroll in the Natural Resources doula training and attend my home birth,” she invited. I did. There were a dozen students in my class, led by a home birth midwife named Abigail Reagan who is a powerhouse. I went in thinking that I would be the only non-mother but the class was evenly split between folks who had given birth and those of us who had not. We met weekly and got to know one another on a deep level. We studied birth physiology, learned about the protocols and practices of local care providers, watched birth videos and challenged our assumptions meeting after meeting. One weekend we gathered with an additional teacher for an intensive workshop in guided meditation, massage and other comfort measures. My ten week training wrapped up the month before both the first birth I was honored to attend and my wedding (the next day)!

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The summer after my training I began attending births as a low/no-fee doula. The midwife who orchestrated our training maintained and operated a list of newly trained doulas who had completed her course, written papers on six of her assigned books and worked with three families for low or no fee and received reviews from said families. She helped me find my first several clients, but I had other incredible support as well. Doulas are masters of lifting one another up and I benefited enormously from this lineage. Doulas also pay it forward.

My aunt helped found a non-profit in the Bay Area called Helping After Neonatal Death. The families I served who had lost babies at term or shortly after birth and who went on to welcome subsequent children were extraordinary teachers and some of my most cherished clients. With those families I acknowledged deeply the thinness of the veil, how tied up birth and death are, and through their loving inclusion of me in their experiences welcoming new babies I felt moved to attend the first several Spirit Babies ceremonies in the Bay Area. Spirit Babies recognized the beauty and loss inherent to miscarriage, stillbirth and abortion - honoring every experience in its holiness. I brought that ceremony with me to Charlottesville twice alongside other birthworkers. Doulas laugh and cry along with you.

A seasoned doula and wonderful yoga teacher named Britt Fohrmann took me under her wing and I was her back-up doula for several families, which afforded me the opportunity to attend prenatal appointments with her and see how she worked. I had a similar chance to learn from someone extraordinary when I began to work with Cindy Whitman-Bradley. Cindy eventually invited me to join her and Audrey Muto in a doula collective called (Re)Birthing, through which I established my enormous love and appreciation for collaboration, sharing stories and skills, processing and clarifying my art in this field. Over the years in San Francisco (after Audrey left to attend Yale Midwifery school) we in (Re)Birthing Collective were lucky to work with Elizabeth White, Cheri Solin and Melissa Berg, who was my very own acupuncturist/mentor/the first woman I saw powerfully bring a baby into the world - he will be 8 in a few months! Doulas love to learn from one another, from clients, and doulas love staying in touch with their doula-babies over the years.

The Bay Area Doula Project training I completed in 2011 was another milestone. Through that program I was certified to support folks through miscarriage and abortion and I am marvelously grateful for the connections that persist among that first BADP cohort. Many have gone on to advocacy work, to midwifery, to parenthood, and we all honor that we are experts in supporting any pregnancy through any choices and any outcomes. Doulas stay by your side no matter what.

 My postpartum doula Dianne Bearinger and birth doula Zoe Krylova

My postpartum doula Dianne Bearinger and birth doula Zoe Krylova

I moved to Charlottesville at the end of 2012 and since then have more than doubled the number of births I’ve attended. Sadly the proportion of home births has not been the same (in the Bay Area about one third of my clients had their babies outside of the hospital system) but I am moved by the variety of options birthing folks have even in this small community. There are two hospitals, two birth centers, and home birth options among providers. In Virginia I've attended two workshops related to trauma and birth, and a  course on the essentials of prenatal massage. 

During my first few years here, Charlottesville Doulas gathered on a monthly basis to compare notes, support one another in matters of business, to read and present on topics of interest to us and to share birth stories. That group is less regular these days, but I now co-coordinate EMERGE Doula Circle, which holds monthly peer review sessions as well as continued education presentations. Doulas are passionate about staying up-to-date with research and literature as well as social activism. Doulas network, organize and share knowledge to support one another and birthing people.

In their book Birth Ambassadors: Doulas and the Re-Emergence of Woman-Supported Birth in America, Christine Morton and Elayne Clift explore the history of childbirth and the social factors that have led to doula work as a profession.  They quote Judith Walzer Leavitt who said, "Ever since birth moved out of women's homes and into the hospital, birthing women, individually and collectively, have been trying to recapture some of what they lost, at the same time maintaining what they have won." Doulas know this balance well. 

For three years I was an editor with the all-volunteer staff of SQUAT Birth Journal. We held two conferences and had a large readership of birthworkers and families all over the country. The radical inclusivity that drove SQUAT is in my blood. I am thrilled in our community to have the Department of Health Improving Pregnancy Workgroup (which I attended regularly before my daughter was born) and Sisters Keeper, which is a branch of Mother Health International working to address the disgusting disparities in maternal and birth outcomes for People of Color in this region. Doulas care deeply about the future of humanity.

Giving birth changed my practice as a doula as well. I have long talked about the broad spectrum of experience around birth and how each birth drops a brand new pin in the array, but I somehow did not expect that after attending around 60 births my own daughter could completely surprise me...but of course she did. Her birth story is for another day, but I am enormously grateful for the experience of my own sheer power - as my own advocate, as a recipient of midwifery care, as a ferocious beast, as my most tender, beautiful self. To this day, 20 months after I gave birth, my attendance at other births is nuanced by the fact that I still breastfeed around the clock. I have taken breaks from supporting families to pump breast-milk. I have had to let go of seeing someone actually push out their baby because I absolutely had to call in my back-up. I am properly humbled and that is important. Doulas are realistic.

What do doulas do? We hold space. We validate and normalize. We recognize your power. We honor and share in the sacredness of your experience. By our presence we remind care providers that this is your birthing, your family, your life. We do a certain amount of physical support via position changes, basic massage and sometimes acupressure, but I see much more of my work on the energetic, informational and narrative planes.

What Doulas Don't Do (and why doing the DON'Ts made me a better doula)

 What's the T on what doulas DON'T do?

What's the T on what doulas DON'T do?

One of the most meaningful ways that I can show respect to my clients and ensure that I maintain a reputation of professionalism and safety is to adhere to a very clear SCOPE OF PRACTICE.  I love this work!  I am so excited to further my training as a midwife and continue caring for birthing people!  As a doula and future midwife, I find that it is important for me to be very clear about how I function differently in these two roles.

In preparation to write this blog post, I have realized that I find myself in very few conversations about scope of practice.  We talk about the things we DO as doulas during our interviews.  Surprisingly few people ever ask about what we DON’T DO!  It seldom comes up in discussions with other doulas.  I assume that this is because there really isn’t much to talk about.  From my perspective, the boundaries are so very clear there is not a whole lot left to explore amongst the Bright Birthing team or in professional gatherings with other doulas.  

I LOVE the Evidence Based Birth article about the evidence on doulas.  I share the article with all potential clients to provide research to back up what we already know: having a doula can make for a better birth experience!  This blog post, however, is focused on what doulas don’t do.  Knowing our limits is just as important as knowing how to use comfort measures and positioning, create a calm environment, and provide emotional support.  Perhaps we will elaborate on what doulas DO do in a future blog post?! Because what doulas DO and DON’T DO is so clear in the Evidence Based Birth article, I’m gonna use their words instead of my own to clarify the boundaries of our work -- efficiency for the win!

Here’s an excerpt from the article Evidence on: Doulas, taken from https://evidencebasedbirth.com/the-evidence-for-doulas/

What is NOT included in doula support? Doulas are not medical professionals, and the following tasks are not performed by doulas:

  • They do not perform clinical tasks such as vaginal exams or fetal heart monitoring

  • They do not give medical advice or diagnose conditions

  • They do not make decisions for the client (medical or otherwise)

  • They do not pressure the birthing person into certain choices just because that’s what they prefer

  • They do not take over the role of the partner

  • They do not catch the baby

  • *They do not change shifts (although some doulas may call in their back-up after 12-24 hours)

*YOUR TEAM DOULAS DO CHANGE SHIFT, but you don’t get a stranger, you get your caring, compassionate, skillful OTHER doula.  YAY!

Seems pretty simple and straightforward, right?!  NO cervical checks, NO monitoring heart tones, NO medical advice.  Of particular importance to me is that I do not see my role as BEING the voice of my client.  I believe it is my role to AMPLIFY the voice of my client.  I am very clear within myself, with the Bright Birthing team, and with potential clients that I am not in this work to project my own ideals about birth onto anyone else’s experience.  My job is to educate and empower.  My job is NOT to make decisions for birthing people.  

Now, I think there’s a lot to be desired in modern maternity care.  So, for the record, choosing to support my clients, empower them to make decisions, encourage them to be educated consumers, and walk with them through the maze of machines and medications in no way means I’m giving a high-five to the madness of hyper-medicalized birth and our country’s very not evidence-based approach to all things labor, birth, and child care.  But I REALLY, REALLY so very strongly believe that healthcare consumers will be the drivers of change.  And I REALLY, REALLY so very strongly believe that birthing people will drive change when they are informed, educated, empowered and having their own experiences that make it so very clear that the system IS NOT SERVING THEM.

Ok, so why am I on about this?  Well, it occurs to me how VERY important it is that birthing people understand that a doula who might be offering services such as cervical checks and fetal heart tone monitoring has stepped outside of the boundaries of doula work.  If you’re interviewing a doula who offers those services, it would be important to ask what other qualifications and experience allow the doula to perform those tasks safely.  Then, it would be necessary to clarify that those still ARE NOT things that doulas DO, so it would be important to hash out exactly in which capacity that provider intends to serve you.  See where I’m going here?  INFORMED CONSUMER-VILLE!  When birthing people, doctors, midwives, doulas, and whoever else is involved as a pregnancy support team are all on the same page about who does what, the whole system works better!  AND clients are safer!

A couple of years ago, I learned that an organization based in Richmond, ToLabor, was including vaginal exams and fetal heart tone monitoring in their doula training.  I was shocked! Alarmed!  Concerned!  How could they?!  Then, I read their website FAQs (http://www.tolabor.com/about-tolabor/faqs/) about the training and it made so much sense!  On the surface, this was so contrary to everything I understood about the doula role.  But ToLabor wasn’t teaching doulas to perform vaginal exams so they could send them out into the world of doula work to harm clients and put themselves at risk for some serious loss of credibility within their communities.  ToLabor offers student-doulas the VOLUNTARY opportunity to perform vaginal exams and listen to fetal heart tones so that they can become more comfortable with touch, better understand pelvic anatomy, and get a real sense of their clients’ vulnerability.  I actually kinda think it’s brilliant.  They also have anyone who comes through their workshops sign a scope of practice agreement and make it completely clear on their website that performing vaginal exams and checking fetal heart tones is NOT part of a doula’s work.  

I never attended a doula training workshop.  When I became pregnant with my first babe, I turned into a bit of a self-study maniac on all-things pregnancy, labor, birth, and parenting.  I read so much.  I was never without a book on one of those topics, well into my son’s first year.  Then I started midwifery school and began the process of becoming a Certified Professional Midwife.  So, I learned to be a doula by learning to be a midwife and through my own yearnings to learn about pregnancy, birth, and child care.  I’ve participated in voluntary vaginal exams.  I’ve measured fundal height.  I’ve checked fetal heart tones.  I’ve assisted with something like 75 prenatal appointments, during which I checked urine screens, checked the pregnant person’s vitals, and palpated pregnant bellies.  But learning to do these things as a midwife, did NOT ever give me the impression that they were part of my work as a doula.  

As a result of participating in voluntary vaginal exams, I understand the importance of talking to pregnant people about what is happening during pelvic exams and why the information gained might be helpful.  I understand pelvic anatomy because I have felt the ischial spines, and the ovaries, and the pubic arch with my very own short little fingers.  I’m more comfortable with touch because I’ve measured, palpated, and assessed.  Really, it is hard for me to imagine my doula practice without the deeper understandings I gained from being a midwifery student.  So, I can appreciate ToLabor’s approach.  I see the value in learning about things that are OUTSIDE of the scope, to better inform the work that is done WITHIN the scope.  And I trust the people doing the work to know the boundaries.  

If you ever have questions about the limits of the doula’s role, feel free to give us a shout!  You might also check out the DONA (very credible doula organization) statement on the doula scope of practice, which can be found at https://www.dona.org/wp-content/uploads/2017/08/COESOP-2017-FINAL-Birth.pdf.  

We’re also happy to answer questions about our training and experience any time-via email, fb messenger, or at our regular gatherings!

Response to Birth is Natural

Several days ago, I read an article in my Facebook feed-”Ten Things I Always Tell Pregnant Women” by Joanna Goddard.  For the most part, I wholeheartedly agreed with much of what was expressed.  She interviewed Erica Cohen, clearly a seasoned doula, who deeply understands the art and science of birthwork.  However, there was one thing Erica said that really stuck with me.  “All birth is natural.”  I read and reread the paragraph in which she expounded on this idea.  I thought about it for days.  I attempted to try on that concept, as if I agreed, to see how that would feel and just could not get there.  Nope.  I very strongly disagree for so many reasons.  You can imagine my surprise when I saw it pop up on the Bright Birthing Facebook page with Gwen’s comments “Love this!”.  

 Henna design by Hannah Bukowski

Henna design by Hannah Bukowski

I found myself distracted for a couple days.  I love and cherish the Bright Birthing team members and always hope to demonstrate the value I place on their perspectives.  Yesterday morning, I finally decided to send a bit of a rant to Sara, Gwen and Stephanie via email to share my conflicting views and open up a conversation amongst our team members.  One of my favorite things about working with these amazing women is that we often have differing perspectives.  We’re not always on the same page about everything.  But we care enough about each other to talk through our disagreements.  That is golden!

The group consensus was that we should share my thoughts  in a blog post.  I’ve edited a little, just to make it more of a blog and less of a rant, but content is completely intact!  Here ya go!....

Here's a link to the article for those who may or may not have read it...

https://cupofjo.com/2017/10/erica-chidi-cohen-pregnancy-advice/

Here's the excerpt I'm referring to...

Natural birth. We need to stop using the term “natural birth.” The concept of natural birth is divisive and inherently competitive. All birth is natural. It’s as simple as that. If you want to have the intense sensations of labor and you’re coping well, go for it! If you have a hard time with pain or you have bad associations from trauma, that’s totally okay. You have the inherent right to choose how you want to navigate your birth experience, and those choices should be free of judgment. You should be celebrated for moving through the process of pregnancy and birth, however it unfolds, unmedicated, medicated or cesarean. THERE IS NO UNNATURAL BIRTH. It’s not Westworld. It’s all natural.

I love the spirit of her comments.  I agree that much about birth has become divisive and competitive and find that to be a sad reality of our society.  I agree that NATURAL is an inaccurate term that may mean different things to different people.  We know with certainty that many products labelled "natural"  are full of harmful additives, for example.  When I think of NATURAL in relation to pretty much anything, I reach out to connect with the essence of the human experience spanning millions of years on this beautiful earth.  I think of the time we've spent with our bare feet in the mud;  the time we've spent huddling next to fires, made with our own energy and intelligence;  our reliance on the stars, our animal brothers and sisters, and each other.  My vision of a NATURAL human is  someone who knows how to live in harmony with the earth;  some who not only survives, but THRIVES in the natural world, with no need for modern entrapments.  Perhaps because my definition of NATURAL is already so far from the picture that is painted by corporations, the media, etc..., I am especially sensitive to this particular application of the term?

The crisis of women being disempowered and devalued by our society is something I care deeply about and hope to address throughout my life as a birth worker.  I absolutely agree that each birthing person has the right and responsibility to choose how they want to navigate the experience of giving birth.  I hope that someday every person who gives birth will be celebrated for that beautiful act of strength, grit, love, and vulnerability-regardless of method, medication, or location.  I hope that every single thing I ever say or do throughout my life and career will contribute positively, whether directly or indirectly, to the mission of creating true equity for women in all facets of life (i mean, world domination , really...but, I'll take equity I guess for now!).  

However, I think by applying the term NATURAL BIRTH to ALL birth, we undermine the importance of speaking accurately about what happens in hospitals, homes, and birth centers.  I don't see any way to possibly address the many, many problems with the modern maternity care system if we allow ourselves to placate women by generically applying the word "NATURAL" to all births.  I find it incredibly condescending to birthing people.  I don't believe that much of what happens in doctors' offices and hospitals surrounding birth (and many other "medical conditions") is anything like NATURAL.  I don't think the interactions feel natural.  I don't think the environment is natural.  And it seems like it should go without saying that being hooked up to monitors and medications, while someone looks at a screen to make decisions about your well-being is not natural.  I just can't get there.  I don't want to get there.  I think without speaking clearly about augmentations and interventions, we miss an important opportunity to truly empower women.  I don't agree that women will be more empowered if we all lie to ourselves and each other about the realities of modern maternity care.

I believe women will be empowered when they are educated healthcare consumers.  

I believe women will be empowered when they are informed decision makers.

I believe everyone will be better off when we address the unfathomable inequities and inconsistencies in maternity care.

I believe there is an enormous amount of work to be done, so that, eventually, the FACT that birthing people are being duped, dismissed, and steamrolled by the system becomes so evident that they just won't fucking tolerate that shit anymore.

I hope that I live long enough to BE the change and SEE the change when educated, informed, empowered women are DRIVERS and DETERMINERS of what maternity care looks and feels like in the this country.  

Lastly, I hope that our fears of judgement will not prevent us from having the hard conversations that will be required if we ever want to put a dent in this mess.

 

Crappy Dinner

This year in addition to village circle each month (stay tuned here or on our facebook page for dates, speakers, themes, etc) we are excited to open our homes in 2018 for irregular, occasional Crappy Dinners!

A meme that totally speaks to busy parents, Crappy Dinners may be absolutely scrumptious and indeed not super crappy at all, the point being we will not go to great measures to clean our homes, we will not be showing off or entertaining. We plan to pull out frozen meals, request attendees show up with something to share, order pizza or something similarly casual. 

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Commensality - sharing a table, eating together - is an intimate and enlivening thing to do. We laugh, make a mess, nourish ourselves on so many levels when we eat together with other beloved grown-ups and kiddos. We may discuss our day, our concerns, what we've been binge-watching on Netflix, or just touch base with one another. We are looking forward to a year of deepening connections with each other and with you - if you are interested in hosting a Crappy Dinner at your place, let us know! 

*Thanks to Sarah Struckmann and the Moms and Babies group at the Women’s Initiative for reminding us of the notion of Crappy Dinners, and this article from Mothering!