Journey to Becoming a Midwife

I’m on the path to becoming a midwife and consider myself still very much an apprentice. The first birth I ever attended was my nephew’s when I was 16 years old. My sister had a long, difficult birth that involved a cascade of interventions that she had not at all understood. My nephew was delivered with a shoulder dystocia that resulted in a serious birth injury from which he still suffers today. This is not when I felt the call to midwifery. Instead it left me terrified of birth. 

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A decade and a half later I attended a prenatal yoga teacher training and it was there that I learned about the physiology and importance of birth and just how different an experience it can be. For years I worked as a crisis hotline volunteer for our local sexual assault resource agency and at the time I was taking psychology courses at UVA with a view to pursuing a graduate degree in psychology. In that prenatal yoga training it became clear to me that the confluence of my interests were calling me to midwifery and that my passion for counseling would continue to blossom on this new path.  

As I was seeking the right route and program for me, I learned about a school in West Virginia and considered moving there to study. By some turn of fate and good fortune, within months of my seeking it out,  the school’s founder happened to move to Charlottesville and started a school in 2014. I was among the first cohort of students. That same year I met my doula partners in that setting, joined Bright Birthing and continued to learn from and assist at out-of-hospital births.

Much of what I’ve said so far has more to do with my journey than my reasons for why I am a rising midwife. I want to be a midwife because birth is on a continuum with sexuality and I believe that a woman’s sexual experiences are sacred and matter deeply to her sense of self and to her well-being. As a result of my own personal sexual experiences in life and my education, I have come to care strongly about sexuality, respect and consent. There is a lot of mystery in birth and a lot at stake. Women are both at their most vulnerable and most powerful during the transformational passage into new motherhood. I consider it the highest privilege and honor to learn the art of how to listen, how to respectfully inform, and how to help a woman safely navigate that mystery.



Locals we love: midwife Debbie Wong

One of my first friends in Charlottesville, a professional mentor, a remarkable craftsperson, adventurer, scientist, world traveler and exemplary midwife: Debbie Wong (of Nine Moons Midwifery) supported me in personal transformation, healing and creating my family.

If that sounds heroic it's because that's how I think of Debbie. She keeps a notable poker face when it's serving to do so, and when I ask for advice she offers it with love and no bullshit. My partner said a while ago, "I really like how Debbie can tell you things I wish I could but with her you never get defensive." For me she was the perfect care provider, holding space for my fears to surface and then sublimate.

Debbie has a tastefully appointed, sunny office that's a pleasure to visit, and she makes some client visits at home. My daughter was excited every time we saw Debbie for care during my second pregnancy and she was sweetly integrated into the team listening to the baby's heart, measuring my fundal height and massaging my belly. It felt like such a perfect circle to watch my nearly three year old help Debbie with the newborn exam after my son was born at home.

A tremendous gift Debbie offers to childbearing people in Charlottesville is meeting us where we are. She consults with other practitioners in town who may be simultaneously caring for clients; she works as a birth and postpartum doula in addition to her home birth midwifery practice. Debbie teams with wonderful assistants and collaborates seamlessly. In our case what that looked like was a planned home birth with our first, a transfer to UVA for the birth, which she attended; then, all of our care through my second pregnancy including home birth and first rate postpartum care for the baby and me. I trust Debbie deeply and will live my life in gratitude for the encouragement and authentic empowerment she instilled in my process of becoming a mother.



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.

Making the Most of Prenatal Appointments

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Oftentimes prenatal visits feel like a whirlwind. Pee in a cup. Blood pressure check. Fetal heart tones. Measure your belly. “Any questions? No? Great! See you next time.” Often after such visits, we leave the appointment feeling flustered, unheard and vaguely disoriented. I am completely certain that healthcare providers  (who worked incredibly hard to obtain their education in obstetrics and midwifery) intending to support people and couples in pregnancy and birth do not intend to leave them feeling unsure and unsettled! And yet many excellent and very caring doctors and midwives get caught up in the system. It’s not the fault of these amazing humans! The system is set up this way. They are forced to see so many patients and do so much in an incredibly limited amount of time. Because, over time, it becomes so routine for them, healthcare providers may forget that this pregnancy is certainly among the most special experiences the expectant couple may ever have.

Here’s the thing: I believe that these professionals truly want to connect with their patients. I’ve seen them in the birthing rooms. They are present. They care. They slow down and talk to their patients. So how can we ask them to bring this presence of being into their prenatal appointments? There are a few ways we can let them know how important it is to us, as their patients that they slow down and connect – and, I believe, it’s important to them as well.

It’s fine to simply say, “I’m feeling like we need to connect. Will you take a moment to talk with me?” So, that’s a great approach if you’re a person who is comfortable with that. Now, for those of us (me included!) who aren’t comfortable with being quite so direct, just ask questions. All the questions. It doesn’t actually matter if you care what the answers are. You may find, though, that once you start asking questions you do in fact care an awful lot! Less Google, more conversation with these incredibly experienced, wise, caring professionals!

The more you chat with your healthcare providers, the more comfortable you will be seeking the information through them. Sit down before each appointment and take a moment to write down a couple of open-ended questions. Your doula can help guide you in which discussions can be most helpful throughout your pregnancy. As birth support professionals, we have found that, when given an opportunity to connect, most of our wonderful local doctors and midwives really jump on it! Charlottesville is so fortunate to have so many amazing doctors and midwives and we make our choice because we believe them to be the best fit for us. Shall we give them ample opportunity to live up to our (and perhaps their own) expectations?!