Tag: DONA

Matrescence: Coaching During a Time of Life Transition

What is Matrescence?

(pronounced ma tres ens).

The psychological birth of a mother, similar to adolescence, involving hormonal and identity shifting. According to Dr. Alexandra Sacks, matrescence and adolescence are:

  • Hormone dominant
  • Body altering
  • Irreversible
  • A rite-of-passage
  • Confidence-challenging
  • Awkward

Throughout this profound identity transition, an expectant individual undergoes an average of about 13 doctors’ appointments during pregnancy, 3 urine tests, 4-5 blood tests, 4 ultrasound tests, 2-3 vaginal exams/swabs, and 2 monitor exams. That is if they are healthy, give birth before or on their EDD, and do not need further diagnostic or screening exams. Then, they will go through the childbirth experience – an experience in which the transparent fabric of one’s routine is disturbed by pain, fear of death, and temporary loss of control as their body expel a new human being while they are under the care of medical caregivers- most of them practice from an “expert” position – an authoritative one. This abundance of encounters with medical maternal healthcare providers amplifies the neglect of expectant individuals’ emotional state and mindset during this profound transformation. Not even one behavioral assessment is routinely recommended for this individual. Instead of focusing on individuals’ well-being and mental health as they transition to parenthood and prepare for the profound transformation of childbirth, maternal caregivers and researchers tend to focus on how the baby is doing.

Not even one behavioral assessment is routinely recommended for individuals going through the identity transition of Matrescence

The acclaimed goal of the excessive prenatal testing mentioned above is to provide parents-to-be with information about their health and their babies’. It comes with no acknowledgment of the potential mental impact of undergoing so many doctor appointments, screening routines, and diagnostic exams – the potential increase in individuals’ anxiety levels. However, Descriptive statistics indicate that almost 60% of pregnant patients feel anxious mostly because of the fear of receiving bad news

Putting aside the fear triggered by these many prenatal testings and doctors’ appointments, it is hard to understand how negligent the modern maternal healthcare system is to the emotional and mental states of those who go through the transformation of pregnancy and birth. Some researchers have tried to call attention to this social failure. 

Women are Calling Attention to the Becoming of a Mother

Since the mid-70s, reachers have been calling attention to the becoming of a mother. One of them is anthropologist Dana Raphae, who coined the term Matrescence. More recently, Dr. Alexandra Sacks, a reproductive psychiatrist, has centered her work around making matrescence a well-known word as adolescence. According to Sacks, both Matrescence and Adolescence are hormone dominant, body-altering, irreversible, a rite-of-passage, confidence- challenging, and awkward. Additionally, becoming a mother changes our social status.  

Women have not only studied the transformation but also have written poetry about it.  Sophia Stid is a Californian poet who wrote a poem called “Matrescece’, describing the experience of a modern woman while becoming a mother:

Become a mother, become room, become food,
become miracle. The heart of each devours

the other’s heart. Hurry – become faster, Barely
made myself, I knew what they said meant 

my body was a door, made for someone else
to come through. Become sacrament. 

The commandments I kept, the ones
I couldn’t keep – all practice before

this one. Become sacrosanct. In birth, the pain
is not like other pain. In birth the pain is purpose-

ful and anticipatory. Anticipate. Become vanishing
act. Become numb, shaved, cut, split, crazy with pain-

become  bare beneath the wide washed
lights of medicine and angels – become everything

and so nothing, and no one, but a mother, a
miracle room, a heart in someone else’s mouth

Need a moment to catch your breath? I know that I needed to. Reading this poem shook me to the core. I have worked with expectant individuals and families for 22 years. However, this poem has allowed me to clearly see the importance of addressing our clients’ mindsets as they go through the identity transitions of pregnancy, birth, and becoming a parent.

Birth support figures who understand the nature and challenges of matrescence can become excellent birth support coaches!

I’m not suggesting that every expectant individual will engage in therapy. If we adopt Dr. Sacks’ comparison between matrescence and adolescence, we can agree that only some adolescents need therapy to successfully cope with this challenging period in their lives. Most of them are competent and functional. The missing link is coaching. Sports coaches and coaches who lead other types of school clubs become teenagers’ leaders for the transition into adulthood. It’s rarely their parents or teachers. There are so many books and movies with this theme. 

Can expectant individuals use coaching?

Yes, It’s the same as with adolescents. Birth support pros, who understand the nature and challenges of the life transition of Matrescence can become excellent coaches. Birth support coaches integrate transformational birth support coaching strategies to empower and lead throughout the transformation of pregnancy and birth. 

Coaching can help a pregnant individual to navigate throughout these transitions: to cope with the particular emotional, hormonal, physiological, and social changes that the transition entails for the unique individual, and the unique challenges that emerge for each one. Coaches can tap into expectant individuals’ mindsets and help them adopt new perspectives, which will in turn generate better mindsets. Clarity of one’s experience and vision for themselves as they go throughout the transition, higher levels of confidence, commitment to their positive and healthy transition, strong convictions about what they want and need, will all lead expectant individuals to take charge of their transformation. These states can’t be achieved by education – we don’t expect adolescents to read about the process of adulting in order to go with grace through it. We coach them! Let’s provide this complimentary and necessary care that the medical system neglect to provide, and coach expectant individuals and their family members. 

 

Facilitating Alignment of Expectant Individuals’ Visions, Beliefs, and Actions

Facilitating Alignment of Expectant Individuals’ Visions, Beliefs, and Actions

When doulas provide prenatal coaching sessions they can help clients be better prepared for the birth of their child and demonstrate a higher level of accountability for their childbirth experience. This is not done by means of education. Prenatal coaching goes beyond teaching and delivering evidence-based knowledge. Its purpose is to help couples discover hidden gaps, resistances, or inner conflicts, and work together as a team to resolve them.

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Transformational Postpartum Coaching: Promoting New Parents’ Self-Confidence and Well-Being

Just like prenatal coaching, transformational postpartum coaching shifts the focus from helping or informing to elevating new-parents’ performance level, self-confidence, and well-being.

Most of my writing has been dedicated to pregnancy and childbirth support. During the pandemic, I’ve been thinking a lot about the challenges of new parents or parents who have expanded their family recently. I want to share how transformational coaching during the parents’ postpartum period can enhance their experience.

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Becoming a Doula: A Good Career Choice or a Community Service?

Twenty years ago, when I was nearing the end of the yearlong doula training program in Jerusalem, my trainer advised us all not to quit our jobs in favor of establishing a doula practice. Regardless of the fact that we enrolled in a yearlong program with a commitment to give 100 hours in hospital shifts, Shoshannah guided us to view the doula role in terms of community service rather than a career path.

A doula for every woman is not just right; it’s a valuable asset

This perspective is reflected in the well-known saying “A doula for every woman, a motto I trust was carved with noble intentions but prioritizes the welfare and empowerment of only one woman – the birthing woman, at the cost of disempowering another woman – the doula. It should be noted that the topic of doulas’ monetary compensation, just like the other two dilemmas I addressed before it, has also caused some turbulences within the doula community. This can be read in Penny Simkins’ Real Talk from Penny Simkin, in which she responded to the disagreement with this motto as expressed by a ProDoula member.

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Is the Doula Profession at Risk?

Doulas’ Dilemma #2: The Doula Scope of Practice

This is the second blog in a series of three that I began writing in November. I am very passionate about the doula profession. That’s why I feel called to write this series before it is too late.  And by “too late” I mean that I think our profession is in danger. Being a doula trainer and at the same time an approved continuing education provider for obstetric nurses, allows me to be connected and empathetic to both sides of the conflict – doula and medical caregivers. On top of listening to nurses’ pain points in their relationships with doulas, I recently have been invited to speak at a few OBGYN and midwives’ practices and heard that they are on the verge of banning doulas

Additionally, recent events confirm what I have been fearing – the current practice of doulas’ who share evidence-based information that supports better obstetric practice (while not being medically trained and bearing no liability for their clients’ health) is going to hurt us.

  • It puts our relationships with medical caregivers at risk.
  • It will lead more cities to follow New York in attempts to license doulas.
  • It will lead our best friends – hospital-based midwives – to ban doulas or have blacklists of unwanted doulas that they don’t trust.
  • It might also make it harder for us to find paying clients because they hear more and more stories about doulas who break the trust and rapport that couples have established with their medical providers.

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Doulas’ Professional Status: Peers, Companions, Lay Women, or Birth Support Professionals?

I wanted to quit, but I discovered coaching and got excited again about being a doula.

After a decade of practicing as a doula and childbirth educator, I was about to quit. I was burnt-out. The rising rate of medical interventions led me to doubt my ability to fulfill my role and facilitate healthy and positive birth experiences. Additionally, the growing gap between doulas’ approach to childbirth and the approach held by the medical caregivers that our clients trust for their journey, triggered a lot of tension in me. These circumstances, in addition to the given hardship of the doula practice, made me reconsider my career path.

Ten years have passed since I felt under-resourced and I still enjoy practicing as a doula and training doulas. How did this happen? I discovered coaching!

In the last couple of years, I have come to learn that I am not the only one to have gone through this professional struggle. In spite of  ACOG’s recognition of doulas’  benefits and some big headlines reporting the many celebrities who hire doulas for their birth,  doulas experience a few major dilemmas that cause great hardship.

This uneasiness reflects in social media and doulas’ blog posts, and I can sense the confusion, frustration, and disputes that percolate within the doula community. Being passionate about doulas and our valuable stewardship position,  I’d like to share my  personal path that helped me resolve the three major dilemmas doulas face: 

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Resolving the Advocacy Dilemma in the Doula Practice – Webinar

The advocacy dilemma in the field of childbirth support is a tough one to crack. The dilemma lies in the tension between certain components of birth support practice, such as serving and supporting, and other components such as being a change agent in our society and a birth activist. By relying on coaching principles and strategies, I suggest that you can be sure to practice within your scope of practice and to refrain from projecting or engaging any ‘activists agenda’ in your relationships with your birth clients. Coaching is the pathway to client-centered relationships and care.

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Who is Accountable for Your Client’s Positive Birth Experience?

Is your birth client as accountable as you are for her birth process?

A couple of days ago I had a beautiful mentoring session with two local doulas; we will call them Iris and Lily.  We were going over some challenging cases they experienced recently and exploring how the Birth Coach Method’s strategies and tools help.  Pretty early in our discussion, I learned that their ‘typical birth clients’ represent some degree of polarity: Iris works only with clients who are strongly committed to an unmedicated birth.  She feels that potential clients who are “willing to try [birthing] with no epidural but leave themselves open to the option of taking it” are not a good match for her.  Lily said that her clients are hiring her in order to “Check the box” of doula services; meaning that they read the statistics showing doulas reduce cesarean rates and they are hiring her to avoid a cesarean.  

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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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