Eva’s Blog

Ten Myths about Doulas

Posted by on Mar 13, 2014 in Blog | Comments Off on Ten Myths about Doulas

#1 – A doula will prevent my baby’s other parent from feeling fully involved with our baby’s birth

A doula works with the whole family. When the partner is looking tentative, the doula can say something like “Why don’t you stand here and hold her through the contraction while I rub her back?” Right away, the partner feels involved and knows what to do. In a study comparing families who had doulas with families who didn’t, it was found that partners who had a doula’s help touched the labouring mother MORE than partners who did not have a doula. And mothers who had a doula were more likely to feel satisfied with their partner’s role at the birth. For more on this – see http://www.dona.org/mothers/dads_and_doulas.php

#2 – A doula is the same as a midwife

A doula works along with the mother’s midwife or doctor to provide emotional, physical and informational support during pregnancy, labour and the post-partum period. She can help them find information, provide reassurance, help them communicate with their care-provider, hold a hand, rub a back. She adds to the experience of pregnancy, birth and breastfeeding by helping parents feel safe and supported. She is not a clinical care provider and does not have the level of training of a midwife or physician. For more about doulas see www.dona.org/mothers/index.php

#3 – A doula will boss me around and tell me what to do during labour.

A doula’s role is to help the mother feel in control and “on top of” the events of her labour. The doula spends several hours in prenatal meetings getting to know the mother and her partner, their preference and plans. The doula helps the parents implement the birth plan while helping them to accept the changes to the plan that may be needed as labour progresses. For more on how a doula can help, see http://www.dona.org/mothers/why_use_a_doula.php

#4 – Doulas are all natural childbirth types who will look down on me if I choose to use pain medication or need to have a caesarean.

The doula’s priority is for the mother to feel that she had every support she needed during labour. If those supports include an epidural or a caesarean, the doula helps the mother to feel good about her choice and to experience her baby’s birth fully, with no regrets.

#5 – Doulas only go to home births.

Most of the births attended by doulas are in the hospital. Doulas’ clients may be in the care of a family physician or a midwife. Doulas work with all sorts of families and care-providers, in the hospital as well as at home. They work where their clients need and want to be.

#6 – A doula will just be an extra stranger at the birth – I want it to be an intimate time with my partner and family.

Labour and birth in a hospital are not intimate times – nurses, lab technicians, the obstetrician, the anesthesiologist, the paediatrician, the resident will all come and go. The family doctor or midwife may be part of a call-group or have a back-up. A doula gets to know her client and the partner through several prenatal visits and promises to be there throughout labour. She is not a stranger, but a trusted and familiar face. And a doula can make the birth feel more intimate by keeping the door closed, keeping the lights dim and making sure the music is playing while the partner can concentrate on staying close to the labouring mother.

#7 – I don’t need a doula – the nurse will take care of me at the hospital.

The nurses who work on Labour and Delivery love their job and are very good at it. But they are not able to be with the labouring mother every minute. They have clinical responsibilities and must cover for colleagues who have to take breaks. The doula works with the nurse to make sure the mother and her partner always have support and reassurance.

#8 – The doula will argue with the hospital staff.

The doula’s role if to help the parents have a good memory of their baby’s birth. A good doula doesn’t argue with anyone. She reduces stress by helping parents communicate well with their caregivers and get all the information they need to make their own decisions. The doula does not speak for the parents, she helps them speak for themselves. For more on doulas see http://www.dona.org/mothers/faqs_birth.php

#9 – I don’t need a doula – I have a midwife.

Midwives provide excellent, individualized care. But they have responsibilities to other clients and their clinic. The midwife is not present during early labour – which is usually the longest part of labour. Once active labour has begun, the midwife is there, but her focus on the progress of the labour and the clinical well-being of mother and baby does not always allow her the time to provide labour support. The doula and midwife work together to provide full support to the mother and her family.

#10 – I can’t afford a doula.

Doula fees cover a wide range. Ask the doulas you interview if they will allow for a payment plan. Many are happy to do so. Ask around about newly trained doulas who will take clients on at a lower cost in order to get experience. There is a doula out there for every woman who wants one – just ask.

Talking to Babies – Part 2

Posted by on Mar 6, 2014 in Blog | Comments Off on Talking to Babies – Part 2

The best evidence there is that we should talk to babies, is that babies LOVE to be talked to. Tell a baby a story with an animated face and voice, and the baby will stare, in rapt attention – for as long as her little brain can handle it. Then she’ll turn her face away – to take a rest from the hard work of listening. A minute later, she’ll turn back toward you to see if you’ve got anymore to say.

One mother told me how her baby hated having his diaper changed. So she decided to explain to him why she had to do it and what she was doing every step of the way. She found that the baby cried much less and seemed to listen to her explanation and accept it. Now I am not suggesting that the baby thought something like this: “Hmm. Mom makes a good case for this diaper-changing business. I guess I’ll go along with her to avoid getting diaper rash which I know can get darned unpleasant!” Of course not! But I do think the baby thought something like this: “Hmm! Mom is talking about something. I wonder what it is? She seems to feel pretty strongly about it. I wish I could understand what she was saying, but I’ve got a hunch that if I keep listening, someday I’ll figure it out.” And while baby is listening and trying to understand, Mom can quickly change that diaper.

Daniel at 4 months

Daniel at 4 months

One night when my eldest son, Daniel, was seven or eight months old, he was teething and had swollen puffy gums. He was miserable – drooling and crying and rubbing his face on my shoulder. I tried to nurse him and soothe him and cuddle him and sing to him. I rubbed his gums with my finger and gave him a cold cloth to chew on. Nothing worked. Finally I got out the Tylenol and tried to give him a dose. He clenched his jaw shut and would not let me put the dropper in his mouth. He would have nothing to do with the sticky artificial-strawberry-flavoured medicine. I struggled with him briefly and then gave up. I took him out into the dark living room (leaving my husband to go back to sleep).

I walked up and down and started to talk. I talked about his teeth buds growing in his gums and how extra blood was being sent there by his body to make nice strong teeth so that he could chew crunchy nuts and yummy steak. I talked about how the extra blood caused pain for him. About the Tylenol that would take away the pain. About the nice scientist in her white coat in the lab with the bunsen burner and the test tubes who invented the Tylenol so little boys could have medicine to make their gums feel better and so they could go to sleep and let their Mommies go to sleep too. I talked to calm myself and prevent myself from feeling angry at my poor little boy who was suffering. I talked to calm him down and to let him know everything was okay. I talked to amuse myself in the dark – to see how long I could talk about something I knew nothing about!

After I had been talking for ten minutes or so, Daniel was quiet. I sat down and looked at him. “Now what do we do, little guy? I asked. He looked at me solemnly and opened his mouth – as if to say: “Giveme the medicine and stop talking, already!” My surprised laughter startled him, but he took the Tylenol, cuddled in against me and eventually fell asleep.

Babies’ capacity for empathy (the ability to feel what another person is feeling) is a subject for argument in the world of psychology. How can a baby understand how Mom feels, when he may not even be quite sure how he feels himself, may not even comprehend that Mom is a separate person? But a fetus in the womb experiences the mother’s emotions. The hormones running through the mother’s body, creating physical responses such as an elevated heart rate, blushing, crying, laughing, also get into the fetus, through the placenta. So the fetus too experiences fear, embarrassment, sadness or joy. And the newborn arrives with an experience of emotion which may help him to recognize those emotions in his mother’s voice when he meets her on the outside.

When we talk or sing to our babies, we keep ourselves calm, and in doing so, we keep our babies calm. Diaper ditties – those silly songs we make up to entertain our babies when we change them – are not only for fun. Singing helps the parents to regulate their own mood and stay calm and cheerful even when the baby is screaming the house down. I am sure that lullabies are only partly for babies. When I sang to my babies in the night, I was also entertaining myself, challenging myself to see how many of the lyrics I could remember. And when I made up songs and rhymes for my babies, it was partly to deal with the awful boredom of being the only adult in the house. Some parents will deal with the loneliness, isolation and boredom of parenting a small child by playing music or talk radio or having the television on. And I confess to having used these tools myself. But a real live, caring, alert and interested grown-up is so much more valuable to a baby than a distracted care-provider listening to the news while he makes lunch or watching TV while she breastfeeds.

One way to understand our babies is to see them as scientists collecting data on how to be a human being. Over the first few years of their life they amass an immense collection of information, not only about how to move, walk, eat, but also about how to talk, sing, dance and tell stories. Our job as parents is to input that data. We can provide some of the input through our actions, our physical presence, the gentle care we take of our precious babies. But by talking to our babies we model for them the myriad and endlessly creative ways that human beings use language to transmit information and emotion.

So to go back to the example in Part 1 of this article, what does the mother do by talking to her baby about the prickly sweater? She distracts the baby with the sound of her familiar and beloved voice. She calms herself and reminds herself that she is not torturing her child gratuitously. She acknowledges her baby’s upset while taking care of a practical need. She attracts the child’s attention and begins a habit of explaining things to him. She is developing a relationship with him. So it doesn’t matter that he doesn’t understand her words. She should talk to him anyway.

Talking to Babies – Part 1

Posted by on Feb 27, 2014 in Blog | Comments Off on Talking to Babies – Part 1

Daniel - 10 weels old - his grandfather is telling him all about being a diplomat!

Daniel – 10 weels old – his grandfather is telling him all about being a diplomat!

Written by: Eva Bild

A new mother is trying to put a horrible prickly sweater on a baby before taking him outside in the cold weather. The baby is howling and the mother is distressed. I start to explain to the baby about how cold it is outside and how the lovely sweater his grandmother knit for him will keep him warm. The mother looks puzzled: “He won’t understand that, will he?” Well, no, he probably won’t but it’s still worthwhile to talk to him about it.

When we talk to babies, we feel a little foolish. We laugh, embarrassed, when someone catches us at it. If we talk to our baby before other adults, we often do it archly, really meaning to communicate with the adults present:

Dad: Come on, baby, let’s go and change your diaper and let Mom here get herself ready to feed you as soon as we get back.
Mum: (when baby has been brought back to her for feeding) oh yes, baby, here you are nice and clean, isn’t Daddy a nice daddy to change your diaper for you?

Our culture does not encourage us to believe that babies understand or feel anything. We are told that babies aren’t smiling “they just have gas”. We are told babies aren’t sad when they cry, they are just “exercising their lungs.” Until the 1970’s surgery was commonly performed on infants without anaesthesia, because it was believed they couldn’t feel pain. Mothers have said things to me like “I think she recognizes me, but she can’t, can she?” I remember one new father holding his newborn daughter who was staring with clear fascination at her father’s face. “When will she be able to see?” asked the father. Our culture teaches so strongly that babies are incompetent that we can’t even believe the evidence before us.

I wonder if so many babies used to die in infancy that it just wasn’t worth it to get too attached to them, to see them as real humans. It was easier to stay a little aloof until we were sure they would survive. So, to protect our own feelings, we developed these beliefs about babies not really being present and aware.

And yet babies start listening to us and learning from us very early on. There is good evidence that newborns can recognize their parents’ voices and music they have heard in utero. Our babies are born ready to tune in to our voices and to start learning language. They are hard-wired to watch our faces, especially our eyes and our mouths. They are born with a sense of how to take turns. Play the “I’ll stick my tongue out – now it’s your turn “ game with a two-week-old, and you’ll find a creature who has an innate sense of how to have a conversation. As soon as you stop sticking you tongue out, she’ll take her turn. If you wait too long to take your next turn, she’ll do it again, to encourage you to keep playing with her.

More on this topic next week…

 

Every Drop of Breastmilk Possible

Posted by on Feb 20, 2014 in Blog | Comments Off on Every Drop of Breastmilk Possible

DSC_8257The extra drop baby gets when the nurse or the midwife helps Mom to latch the baby on just one more time before she goes home.

The extra drop baby gets from the extra five minutes Mom waits before putting baby back in her bassinet at 2am.

The extra drop baby gets because a woman a hundred miles away donated her milk to the milk bank.

The extra drop baby gets because Dad brings Mom a sandwich while she sits on the couch and feeds the baby.

The extra drop baby gets because the breastfeeding educator made a house call on a Sunday.

The extra drop baby gets because Grandma takes Mom out for lunch – with the baby.

The extra drop baby gets because Mom and Dad decide to delay introducing solids until 6 months.

The extra drop baby gets because Mom keeps on giving that 3am feed when the neighbours are asking “Isn’t he sleeping through the night yet?”

The extra drop baby gets because Mom spends her lunch hour at the daycare centre, nursing the baby.

The extra drop baby gets because Mom pumps while she is away at her high school reunion.

The extra drop baby gets because Mom and Dad know the breast is a great way to calm a two-year-old’s tantrum.

The extra drop baby gets when the big sister decides she’s not a baby anymore and the nummies can be just for the little brother.

Each of these drops is a priceless gift the Mother has it in her power to give and the rest of us have it in our power to support – for as long as she chooses.

How to introduce a bottle to a breastfed baby

Posted by on Feb 10, 2014 in Blog | Comments Off on How to introduce a bottle to a breastfed baby

Let me start with a disclaimer. Not all babies need to have bottles. Babies who are doing well at the breast, and whose mothers are available and happy to provide the breast whenever the baby needs it, these babies do not need bottles. Not all mothers want to or need to spend time away from their babies. And some babies are peaceful and happy between feeds and can go 2-3 hours in the cuddly arms of the other parent or a grandparent while mom goes for a swim or a walk, or sings in her choir.

But some babies and mothers need bottles. Some mothers need time away from their babies, for their physical, emotional, financial or professional health. These babies need bottles. And the mothers, having followed the best advice from breastfeeding experts which is to offer only the breast for the first six weeks, sometimes find themselves at 6, or 8 or 12 weeks, trying to get a very breast-imprinted and irritated baby to take a bottle.

When babies are very new, in the first 4-6 weeks, they will suck on almost anything. A bottle nipple, or a breast, or a finger, or a pacifier, are all relatively easy for them to learn to use. But by 6-8 weeks, babies move on to using their mouths more for exploring and gumming and chewing. So when an 8-week-old baby is presented with a bottle nipple, that behaves in no way like a breast, the baby gets frustrated. Here is this thing in her mouth, it smells like milk, she can taste a little milk leaking out, but she can’t get it to work! Often, parents are given the advice to try the bottle with the baby when she is hungry, and that makes her even more irritated. And then Dad is holding her in his arms, in a position similar to the one in which she gets the breast, and instead she gets this hard rubbery thing which doesn’t work! So the baby howls, and the Dad or Other-Mother or Grandmother or Aunt feels very rejected indeed. So much for bonding with the baby by giving her a bottle!

Very often, parents will try many, many different sorts of bottle and nipples, trying for the one which the baby will “like.”  They often ask me what nipple I recommend. My hunch is that no matter what nipples they try, no matter what the order they try them in, the baby will finally take the sixth or seventh one they try. It’s not that they have finally found the right nipple, but that the baby got some practice.

So based on my basic knowledge of how to teach skills to children, and on some ideas I have gathered from clever, patient parents who have done this recently, here is the method I suggest. These instructions are intended for the Dad or other parent  – not the breastfeeding mom. This is a skill the baby needs to learn to do with someone else. That’t the whole point of the bottle, for someone else to be able to care for the baby. So let that start now.

Equipment

  • 1 baby in a good mood – not hungry, not sleepy
  • 2 bottles with plain, “slow-flow” silicone nipples (I recommend these because they are cheap and easy to find. If you have something else, use that. The only bottle  would not recommend is the “Calma” by Medela. That nipple is great for a newborn who has to be supplemented. But for a baby after 6 weeks, it’s going to be very frustrating.)
  • In one bottle – for the baby – put just 20ml of breast milk. (If you put more in the bottle, you will be bothered when it gets wasted and you will try to force the baby to take more. This is just going to be a practice session. Don’t expect too much. When you eventually teach this child to ride a bike, you won’t expect him to ride all the way to school on the first day, will you?)
  • In the other bottle – for you – put something that you would like to drink!
  • 1 car seat or bouncy chair

Procedure

  • Put the baby in the car seat or bouncy chair.
  • Put a happy, cheerful smile on your face and arm yourself with patience.
  • Talk to the baby and explain that the two of you are going to have a drink together. Remember, babies may not understand the words you say, but they are very good at picking up your emotions.
  • Suck on your bottle a bit and make some yum-yum noises.
  • Then offer the baby’s bottle to him. Let him explore it with his mouth.
  • As soon as he seems puzzled, take it away again, and show him how you suck on yours.
  • Make it a game. Sing a little song. Be really silly and happy. This makes babies relax.
  • Try a few times back a forth, baby’s turn, your turn.
  • As soon as the baby starts to look unhappy and has had enough of the game, stop right away. You want to create good associations with the bottle.
  • Remember, babies have a short attention span and they get tired and overstimulated quickly. So a five minute session is plenty!
  • Try again tomorrow, and the next day

Try every day, at the same time, if you can, but only when the baby is in a good mood. It may take a week, or more, but eventually, the baby will figure out how to get the milk to flow from the bottle. And you will have taught your baby a skill. Now that’s a way to bond with your baby!

If you try this out, do send me an email to let me know how it works for you! And let me know if you make any amendments or variations. I will give you full credit when I pass them on!

 

Keeping the Love Alive

Posted by on Jan 9, 2014 in Blog | Comments Off on Keeping the Love Alive

I am spending the morning working on our course for new parents – Keeping the Love Alive – When Partners become Parents

It’s such a challenging topic to try to wrap up into 6 hours! Many parents see having a baby together as the ultimate expression of their love for each other. And then, once the baby is there, they find their ability to continue to express their love for each other eroded by lack of time, lack of sleep, lack of patience, lack of communication.

Most partners, as they enter into what we call “The Baby Project” believe that THEIR relationship, THEIR love, THEIR family will be different from the ones they see around them. “WE don’t let OUR baby do THAT!”

Now a certain amount of denial is helpful. We’d never move on and do new things and change our lives if we considered every little detail. But it only works for awhile. Eventually the problems have to be confronted, the mess has to be cleaned up, the relationship has to be repaired.

Almost every couple goes through a rough patch when they have small children and almost every couple has to find a way to communicated and stay close, to maintain their emotional and physical intimacy during this time.

Keeping the Love Alive focuses on communication skills, but also on roles, responsibilities and the division of tasks. We discuss aspects of good (and bad) communication, and we provide you with a recipe for “Family Talk”, as way of communicating about difficult topics. We create a safe, comfortable space and a time dedicated to you as a couple, so that the two of you can focus on each other and find each other through the mess of The Baby Projsct.

Do come and join Joss Hurtig-Mitchel (Registered Clinical Counselor) and Eva Bild, (Parent Educator) (that’s me!) to spend some time reviving your couple-life. The next course runs at Mothering Touch on Sunday February 2 and Sunday March 9 from 2:30-5:30pm. (Get a sitter and go out for dinner afterwards!) You can read more about the course and register on-line here: http://www.motheringtouch.ca/classes/partners-parents/

Happy Holidays!

Posted by on Dec 20, 2013 in Blog | Comments Off on Happy Holidays!

hannah santa smallChanukah was earlier this month – we had latkes galore! Our friends south of the border gave thanks, ate turkey and watched football. And now we head into the end of December – the busiest time – end of term, papers due, concerts, and “getting ready.” Increasingly through the month I get asked “Are you ready for Christmas yet?” It makes me crazy. I feel as though everyone is checking in on my progress – or procrastination.

When my children were small, I felt rushed all month. I wanted Christmas to be magical for them, and it meant a continuous frenzy all month. Until one year, when I was sitting in a coffee shop (we were waiting for our dentist appointment time) with the three of them – they were 10 and 8 and 6 – and I asked, what do you want us to do for Christmas? What traditions are important to you?

I discovered the food and the baking were not important. But the tree and the presents were. I discovered they really DID like to go to see the Nutcracker and the carol concerts. But mostly what they liked was sitting in the living room with a fire and reading stories and watching movies. I found out that they really liked doing all the preparation WITH us. Hannah said she liked wrapping presents for people! (MY least favourite job.) Daniel liked making fires in the fireplace and setting up the tree. Simon liked making gravy.

Most of my readers here are the parents (or the parents-to-be) of babies. And your kids will not be helping you to make gravy or wrap presents for a very long time. But you can remember that your babies are very sensitive to how you feel. If you feel tense and rushed, your baby will pick up on it. If you feel happy and contented, so will your baby. So as you get ready for this first Christmas with your baby take it easy! Do things that are fun and relaxing. Don’t let family pressure you to participate in too many big events. DON’T host Christmas dinner – it’s too much work. It might be easier to have one or two days crammed full of visiting than to have many days in a row where you have to go out. Plan for some time with just baby and your partner to create some traditions of your own, where you do some things together that you will all enjoy doing every year for may years to come.

May this dark month that takes us to the turning of the year be a happy cozy one for you and your little ones.

~Eva

Why I Am A Doula

Posted by on Aug 26, 2013 in Blog | Comments Off on Why I Am A Doula

I became a doula because I was a childbirth teacher who got curious and went to a “labour support” course thinking I would learn some useful things to teach the dads and partners in my classes.  This was way back in 1994, when I didn’t know the word “doula” and had a 5-year-old, a 3-year-old and a 1-year-old.  There was no way I was going to be a doula.  I couldn’t leave my kids.  My youngest was still nursing.

But only a week or two after the doula course (which I loved), a woman called to ask me to be her doula.  She was going to be in my prenatal class and didn’t have a partner and knew she needed support in labour.  Of course, I said yes.  It was irresistible.

After that birth, I realized how much I learned from being with the parents, how it informed my childbirth teaching and how much of a difference I could make in the parents’ experience.  I was hooked.  I took three clients that first year, and five clients the next.  And then I started taking a client a month – that was as many as my family could handle.  Nowadays, I run the Mothering Touch Centre, but I still take on five or six clients each year.  I have to.

I have to keep going to births because it helps me stay current with the hospital practices and that is important for my childbirth teaching.  It also stops me from forgetting the intensity and the unpredictability of birth.  I need to remember what hard work it is to support a woman in labour.  I need to not develop a rosy memory of how lovely it all is.  I want to be able to give the parents in my childbirth classes and the doulas in my workshops a realistic idea of what birth is like.

But mostly, I have to go to births because I love them so much.  I love the excitement and the intensity of it.  I love how doula work helps me to stay in the moment and be with the parents as they move along their journey.  I love watching the power and the strength of the chilbearing body.  I love watching the partner’s awe.  I love seeing the parents’ response to that tiny, new baby – and the baby’s response to the parents’ touch and voices.

I love being part of a team to support the birthing parent.  I love working with Moms and Dads and Parents and Partners and midwives and doctors and nurses who are all devoted to this family’s safety and well-being.  I love working with a person as they discover their childbearing power and go through this immense change that leads them to parenthood.

I am so grateful to all the families who have allowed me to join them on the journey to parenthood.  It has been such a wonderful opportunity for me to learn about birth, about people, about life.  That’s why I am a doula.

September 19th & 20th 2013 : When Survivors Give Birth

Posted by on Aug 23, 2013 in Blog | Comments Off on September 19th & 20th 2013 : When Survivors Give Birth

When Survivors Give BirthThis is a not-to-be missed opportunity to learn from renowned experts Penny Simkin PT and Phyllis Klaus MFT, LMSW, authors of the book When Survivors Give Birth.   Join other maternity care, mental health and allied providers to focus on the issues of the least understood of pregnant clients.   Advance your understanding of an all too common issue for childbearing women and families—a history of early sexual abuse and/or other trauma.   Expand your care practices for women at risk of poor physical and psychosocial childbirth outcomes.   Improve your response to women who express emotional concerns about childbearing.

Topics will include:

  • Definition of childhood sexual abuse (CSA) and other child abuse
  • Common manifestations of any type of child abuse on the childbearing woman
  • Unique manifestations of sexual abuse specifically on the childbearing woman
  • Neurological and behavioral sequelae of child abuse
  • Impact of childhood sexual abuse on conscious memory
  • Impact of childhood sexual abuse on the adult woman
  • Impact of CSA on pregnancy
  • Impact of CSA on labor and birth
  • Relationship between the woman and her caregiver

This class is presented by Doulas of VictoriaClick here to register online (PayPal or Credit Card via PayPal) or register by phone by calling Mothering Touch at (250)595-4905.