Does Birth Activism Lead Expectant Individuals to Demand Better Maternal Care?

Recently I watched the movie ‘Trial of Labor’, and listened to the stories of three women who wished for a VBAC (Vaginal Birth After Cesarean). It made doubt the approach we, birth activists, take in our efforts to improve maternal care. Especially our continuous attempts to educate and empower expectant individuals by pointing out the flaws of the medical system and its representatives.

What did birth activism look like in the 90s?

I gave birth to my oldest child in 1995. I often say that she was my muse since my first pregnancy and birth experience led me to pursue a career in the field of birth support. I was lucky to go through this journey in the 1990s, as it seems that these years offered women a wealth of information about natural childbirth: Barbara Harper first published Gentle Birth Choices in 1994, the same exact year that Michel Odent published his book – Birth Reborn. Janet Balaskas published Active Birth in 1992, and Marshal H. Klaus published Mothering the Mother in 1993. Henci Goer closed the 1990s by publishing The Thinking Woman’s Guide to a Better Birth in 1999. All of these authors were, and still, are my teachers and mentors, not to mention idols.

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Webinar: Coaching Your Client through the Dilemma of Epidural

How to Coach Your Birth Client through the Dilemma of Epidural- Before, During and After Childbirth

This one hour webinar first aired in celebration of World Doula Week, March 2015.  In light of the high percentage of birthing moms who end up using epidural in their childbirth, it is time doulas learn to conduct the epidural conversation. This conversation should take place prenatally. It is also important for every doula to know how to coach her clients through moments of doubt and crisis in order to avoid epidural during birth. However, when the mother exhausted her ability to cope with labor pain, it’s time for her doula to make a shift in her coaching strategy. Learn how to best coach and support your client’s progress after the administration of epidural, and how to facilitate acceptance and clarity about the mother’s decision to use epidural, during the postpartum visit.

Testimonial: “I absolutely LOVED your “Epidural” webinar!  Thank you, very much!  There were amazing tips I’ll want to use… Half of my clients had epidurals, and I’m afraid that I didn’t do everything for them that I could have.  After the epidurals were administered, I wasn’t much use to them, and I think my closure visits were weak.  At any rate:  THANK YOU, VERY MUCH!  In the doula spirit, Britt Hatch.

Visit our store here to purchase the webinar

Here is what you can expect to learn when joining me for this webinar:  coaching with epidural

1. Learn how to recognize and create the opening moments for a coaching conversation which will evoke a change.

2. Learn how to structure your coaching conversation, following the GROW model of coaching.

3. Study potential scenarios in which the dilemma of epidural might show up, and learn how to tap on your Client’s motivation and commitment in order to lead her through them,

4. Become familiar with the different domains of coaching for childbirth – the prenatal domain, the hands-on coaching and the domain of closure.

5. Learn how to integrate the BRAIN model of medical interventions into your prenatal coaching.

6. Don’t miss my very own coaching technique around pain, a complete refute of the horror myth of ’24 hours of pain’ by using 3rd-grade math 🙂

In addition to the information regarding epidural, you will learn the basic terminology and principles of coaching, which you can integrate in your doula practice.

‘Birth Ambassadors’ by Christine Morton – A Book Review

Recently  I have read the wonderful book  Birth Ambassadors, which I find to be the most comprehensive and eye-opening study about doulas and birth support in North America.The book is a genuine presentation of the doula role, ways of birth embassadorspractice and training system in America from a sociological point of view. As such, it is free of any judgments about the dilemmas in the field, and views them from the perspective of sociological interests, such as professional status, the emergence of occupational niche, change agents in maternal care, community service, income level and even organizational developments. This point of view allows the author to also question, or re-open for discussion, some of the most common assumptions doulas and birthing moms ascribe to, including the benefits of doula care in terms of increasing normal births, and the doula’s agenda favoring natural birth, as well as doula advocacy in labor and delivery.

   To me, the most urgent dilemma is the one regarding doulas’ professional status. It is my understanding that this is also the core dilemma, the one that originates the others. In literature and doula guides, one cannot escape the choice of words used to name and describe this role by those who are perceived as the biggest doula advocates. Morton describes doulas for her readers using a typical definition, “Doulas are birth companions…The word doula comes from the Greek and refers to a woman who personally serves another woman.”  Neither a ‘companion’ nor a ‘doula’ implies any professional position—the latter evokes servitude rather than social change agents that come from being a mentor, a teacher, a coach or a leader. Yet, doulas are trained to believe that they can and do make change. Morton’s discussion of Klaus and Kennell’s book “Mothering the Mother,” the book that still, three  decades after their emergence in America, provides doulas with the scientific data of the benefits they bring, provides additional food for thought about how doulas are described. The title “Mothering the Mother” is another poor choice of words. As we all know, mothering is considered to be a non-professional position, and although everyone agrees that it is the hardest and most valuable work of all, mothers do not get paid for all they do.

The non-professional status of doulas in North America is reflected in the current training and certification system. Morton points out that research findings regarding doula benefits were actually based on a control group comprised of inexperienced and untrained women who sat in the delivery room and took notes.  Most doula trainings in North America are between a two-four days’ workshop. In comparison, I was trained in Israel, where doula training programs last a year and are usually affiliated with an alternative medical college and/or hospital. Trainees are required to have an internship inside Labor and Delivery.  As a sociologist, Morton points out the dilemma of doulas as being committed to providing humanistic and affordable childbirth support within the community, similar to what existed in a more tribal society before women began giving birth in hospitals, and the current situation of low status, low income and low professional standards for doulas as working women.

Morton continues to point out another motivation to maintain the non-professional status of doulas, which is closely tied with the circumstances of doulas’ historical origins. As Morton observes: “Doula care emerged as a unique response to the changing social and medical context of childbirth support in the United States” and “…the fragmentation of childbirth support [that] began with biomedical experts claiming authority over pregnant women’s health and childbirth outcomes and moving birth to the hospital…it is in this period we see the emergence of the doula as a particular, specialized role in providing non-medical support to pregnant women. “ In other words, doulas emerged in the United States as a reaction to the medicalization of birth, yet they are largely practicing within the medical system, holding to a philosophy of care and birthing model that are alien and unfamiliar in the medical paradigm. It is my assumption that doulas organizations are confusing professional status with medical status. If doulas were to claim medical authority they would not be able to practice within labor and delivery. While it is important to keep doulas as non-medical care givers, it is most important to elevate and state their professional status as coaches and care givers in the field of birth. Until then doulas are left with being viewed as community service or support figures whose motivation for their work ‘comes from the heart’.

Morton goes on to explain the controversy, facing doulas in terms of how they advocate in birth. In their current status as non-professional community service workers, how can doulas be an authoritative source for evidence-based care and empower their clients to question the medical staff and the care they provide?

I can see how some doulas and doula trainers in North America might feel challenged by this book, but I believe that this challenge is an invitation to initiate a healthy change in our occupational niche. Morton contributes to the well-being of doulas and birthing moms, by opening our eyes to the reality of birth support in North America. As a birth coach trainer, I would like to encourage all doulas to abandon the term ‘doula’ and the connotations attached to it over the past decades.  I recommend that we begin a new era of re-defining doulas as birth coaches, who can acquire coaching tools and skills, and enjoy the accreditation experienced by coaches in many other fields (such as life coaching, executive coaching etc.)  The coaching model and practice standards can resolve some of the dilemmas Morton identifies as problematic for doulas and their organizations, such as the advocacy dilemma, or practicing within the territory of doula support  without wrongly step into the medical territory, as well as coaching the mother prenatally for the performance of childbirth.  To read more about the coaching model, read my  blog post on  birth coaches vs. doulas at: https://birthcoachmethod.com/imagine-giving-birth-profession-doula-profession-change/.

 

 

Birth Coach Method – A Paradigm Shift in Birth Support

What happened the first time I introduced my  coaching method

Last week I had my very first public speaking introducing the Birth Coach Method to a local audience of birth professionals at the South Bay Area California. It was a moment of truth, and I have to confess – I was crazy stressed. It is one thing working diligently on my laptop in the comfort of my home, being fully convinced that integrating coaching strategies into birth support practice is the right direction and another thing to stand and talk in front of birth professionals. An hour before the talk there was no sign to my strong convictions.

My local community is the warmest, most engaged and fun audience I could have asked for. In just a few moments,  I was able to connect to my motivation and strong found conviction, and confidently introduce Birth Coach Method philosophy using the PowerPoint presentation I made.

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