The Importance of Childbirth Education

On my radio show, “The Perinatal Period” I had the pleasure of interviewing two childbirth educators in February about the importance of choosing quality preparation classes before the big day.

Think you can be totally prepared after watching The Business of Being Born, and reading some great books?  Don’t downplay the importance of live human interaction.  Tune in for some food for thought!

“The Perinatal Period: The Importance of Childbirth Education”

Listen to internet radio with YorubaDoula on Blog Talk Radio

African-American Women and Breastfeeding

I’ve read the standard books on breastfeeding that outline the benefits to both mother and baby. My most recent read is Black Woman’s Guide to Breastfeeding by Katherine Barber. Barber writes an amazing guide that details why it’s so important for Black women to breastfeed.

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Barber states, “African American infants are twice as likely to die before their first birthdays as white infants…have the highest rate of asthma, severe asthma, and mortality caused by asthma than any other race…have a 20 percent higher occurrence of childhood obesity than white children…[that] African American women are 2.2 times more likely to die from breast cancer…[and] are 30 percent more likely to die from ovarian cancer than white women.”

So, what do these stats have to do with breastfeeding? The numbers drastically decrease when mothers share what nature intended for their children. Before downloading this book for my Kindle on Amazon.com, I read through some of the reviews. One woman threw her two cents in by explaining that this book promotes separatism, because all moms need support when it comes to breastfeeding, not just Black women. This reviewer was quickly schooled, thankfully, by other moms who explained that African American women do, in fact, have special needs when it comes to breastfeeding.

Almost half of African American mothers choose not to breastfeed their children, and the health repercussions of such a decision usually aren’t discussed in mainstream breastfeeding books. Often, women choose against breastfeeding because they’re afraid of pain or discomfort, have been convinced that formula is just as good as mother’s milk, or a host of other reasons that attest to being unaware of both the benefits associated with breastfeeding and the risks of not doing the same.

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In addition to being a great resource that breaks down why it’s so important that Black women breastfeed themselves, this is a book that belongs on every reading list for birth workers throughout the United States. As birth workers, we must understand the challenges that Black women face when it comes to breastfeeding, and be armed with facts that help us inform mamas about the benefits of breastfeeding. If you haven’t read Black Woman’s Guide to Breastfeeding yet, what are you waiting for?

Your Child is What You Eat

In my childbirth education classes I speak with families about the importance of maintaining a balanced diet. We talk about all the goodness and gold awaiting us in vegetables and herbs, and go over the importance of understanding what we put in our bodies to stay healthy. However, where I – and many educators – fall short is in not discussing the implications on our children of how we eat.

Often, care providers will monitor a woman’s intake to make sure that she isn’t put at risk for labor and delivery. However, there may be possible risk to the lives of our children when we aren’t aware of the effects of the foods we eat. For example, most pregnant women are told to avoid salt to reduce the chances of preeclampsia or other pregnancy related illnesses. However, pregnant women who consume excess salt may predispose their unborn children to adult high blood pressure. Likewise, a woman consuming too much sugar may alter her child’s possibilities of being diagnosed diabetic.

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In the natural birth world I feel like we do a great job of helping parents understand the effects of manufactured medications used during labor on unborn babies. Parents often know THAT they should eat better, but often don’t understand why. We must do a better job of helping our families make better food choices when possible. I read an article in The Huffington Post titled, “To Eat Artificial Dyes or Not?” It would be a great follow-up to this blog to understand how dangerous something as common as an M&M can be.

Value your Doula

A few weeks ago I received an inquiry from a woman having a home birth in search of a doula. She mentioned that her midwife told her that she could find a free doula, and wanted to know, “Could that be [me].”

I was taken aback. I didn’t know now to respond. Actually, I knew how I wanted to respond, but my initial response would have been brash; I wanted to avoid that. I tweeted my frustrations with the question. I thought long and hard about what I would say to this mom who was obviously making a beautiful decision to have her baby at home with a midwife and doula.

I didn’t know what to say to this mom to convey that needing a low-cost doula is perfectly ok, but that expecting freebies is not. How could I get her to see that doulas are valuable, and must be valued, without hurting her feelings and discouraging her from searching for a doula that she could afford? Could I do any of that without my upset with her midwife’s suggestion becoming obvious? I took some time, wrote, deleted and wrote some more. What I came up with is below.

“Congrats on your upcoming birth! I’m not sure how familiar you are with what a doula does, so I hope you don’t mind my taking a bit to share a few things with you and offer advice in your quest to find a doula. 

The average doula, once hired, structures her time so she can be available to you when you need her. That may mean that she’s not going out of town to visit dear ones, she may have to call off of work (and lose money) to attend your birth, or she may even miss her child’s birthday should you go into labor on the same day. 
She has to get to you – however she can – for prenatal visits, your labor and postpartum visit(s). She takes time preparing, and possibly copying materials to share with you to help you make the most informed decisions that you can during pregnancy, labor and as you raise your child. She devotes an indeterminable amount of hours to support you and your family in a time of need to make your birth a success.   Doulas are trained professionals, and are constantly continuing their education in order to provide the best support possible. 

In answer to your question, I’m not the free doula you seek. I am a low-cost doula, and do volunteer births from time to time for families in need who understand the value of the free service they are receiving. The going rate for a doula in our city is $1200, and you can find both cheaper and more expensive. [Your midwife] was absolutely right, you can find one for free, but I do hope that you see the value in what you’re getting. You can also find low cost or free childbirth education, but it’s valuable as well. 

In reaching out to a doula, you may want to let her know that you are searching for a doula and ask her to share her availability, services and fee information with you. It can be off putting to know right up front that you are looking for freebies, and doulas who may be willing to do a volunteer birth might be turned off by your approach. I can understand if times are hard, but I hope you consider compensating your doula. If you could get $100, $200 or even $300 together over the next two-three months to help your doula serve you it would help your doula out more than you can imagine – even if you hire her for free.  Some moms have asked family and friends to give money toward a doula fee for the baby shower, or are able to barter services for compensation. 

I wish you well on your journey, and hope you find the doula for you. If you realize that you can afford a small fee ($300 or less), I would be happy to put you in contact with amazing doulas that would love to be a part of your birth team.”

I never heard back from this mom, so I have no idea how she took my reply. I think, though, that I need to make it very clear that I’m not anti-volunteer work. I live in a city where there are organizations set up to provide low-income women with free doulas; I was annoyed that her midwife suggested that she reach out to private doulas to ask for free help rather than let her know about these organizations. On the other hand, I know that women who can absolutely afford a doula would rather not pay the going rate if they don’t have to. I was annoyed with what I perceived as arrogance on this mom’s behalf.

I’ve worked for free in the past, and will work for free in the future. However, the woman that hires me pro-bono will understand the value of the service she’s getting.

Preconception Planning III: More Trying and Less Conceiving

TTC can be the most emotional time of a woman’s life, especially when trying for several cycles. The moment your uterus begins to shed its lining you feel that nature has betrayed you. For some, it feels as deeply as the loss of a child.

We’ve all memorized Taking Charge of Your Fertility, and know by heart which links to click on Mayoclinic.com. We can read basal body thermometers in the dark, and chart temperatures with our eyes closed. And when we realize that we touch our cervixes more frequently than scratching our noses, it’s clear that we’re experts in knowing what’s going on with our bodies to recognize ovulation signs.

There’s advice about the best time to take your temperature, how often you should check cervical mucus (CM), how to interpret your charts, and the best time of day to use an ovulation predictor kit (OPK). But what happens when these things aren’t coming together like the beautiful celestial chart that they’re supposed to form? Shouldn’t these methods be fool proof?

Here’s what you don’t get along with the advice: not every woman has egg white cervical mucus (EWCM), and the OPK may not detect your hormone levels clearly.

I can’t stress enough how important it is to begin charting your temperature months before you begin actively TTC, especially if your cycle isn’t very predictable (I hate to think of my cycle as irregular!). Become comfortable with analyzing your charts, and seek expert help when things don’t make sense to you. Pay attention to the moistness of your vulva the days following menstruation, and try to notice whether or not you feel any slight cramps the more moist you become (without stimulation). Before you know it, you’ll be able to feel your body releasing an egg (or two!).

Learn to differentiate between your own CM. Recognize that as your body matures your CM can change (I haven’t had EWCM since my early twenties!). Some women go from dry, to watery to creamy and never experience sticky or EWCM. Some women go from dry, to watery, to EWCM, to creamy then sticky. Some women’s bodies may do something different all together. If you’ve been paying attention to your body for months before trying, you’ll know your cycle and won’t be waiting for EWCM when watery may be your ovulation sign.

Practice peeing on different brands of OPKs. You may notice that as you approach ovulation a faint pink line appears, grows darker over the course of the next 3-4 days, but never quite matches the test line. Does that mean you’re not ovulating? It could mean a number of things, and you should speak to a specialist to help you understand what’s going on. Some women never match the test line, and the faint line is their ovulation sign. I’ve only tested positive once with an OPK, and the positive result appeared after my temperature had already spiked. Go figure!

Sometimes we end up trying so much (unsuccessfully) because we aren’t interpreting our signs accurately. Sometimes we don’t trust our bodies enough to believe what they’re telling us instead of an OPK or someone else’s assessment. There are also times when this isn’t so cut and dry, and that may be a sign of something else going on. It can be hard to stay positive when you try cycle after cycle, especially when it seems like people around us get pregnant without even trying. But staying positive is a must!

Here’s to more conceiving after so much trying.

Be Kind to Your Vagina: tampon awareness

I came across this video the other day, and thought it was something every woman should see.  Often, young girls are told not to use tampons because they, “Shouldn’t be putting things in there,” or that it’s considered by some as taking a young woman out of her virgin state.  The older I become, the more I wonder why no one seems to mention the level of toxins that are in tampons and highlighting that as a reason to abstain from tampon usage.  Please watch this video, share with your sistren, and then research menstrual alternatives.

 

Bargain With Your M.D About Fees?

One of the longest standing battles in the birthing community is over ducats.  Should we charge, and if so, how much?  Are we obligated to do volunteer births, and if so, how often?  Health insurance in the United States doesn’t cover doula services (although you may be eligible for reimbursement, find out more here) so these discussions will never go away.  One strong argument from experienced doulas draws a parallel to sexism when it comes to doulas setting fees.

Our profession has historically been and is currently largely made up of women.  We’ve been socialized to meekness, to always seek acceptance, ever offering apologies, and not wanting to rock the boat.  We give of ourselves before giving to ourselves, leaving us burned out too fast and too often.  Pregnant women are comfortable asking doulas to lower their fees (or to provide free service), or to throw in a few extras; seldom do women (or men, for that matter) ask this of men who provide services.  No one expects their mechanic to voluntarily change their oil because they’re going through a rough patch.  In fact, people would run away from a volunteer mechanic thinking, “Something’s gotta be wrong!”  Part of the paralleled sexism argument is that we don’t haggle with our care providers.  At least we didn’t.

According to Dr. Jeffrey Kullgren, we should try!  Dr. Kullgren is, “an internist and clinical scholar at the University of Pennsylvania, [and] specializes in research on the impact of consumer-driven health care.” Now that insurance companies are cutting back on what they cover (not to mention the increase of uninsured in the US), more folks are left paying for health care out of pocket.  Dr. Kullgren suggests that patients be upfront with their care providers about their financial situations, and ask for the discounted rate whenever and however they can.

Where does this leave women during the perinatal period?

Some care providers are so used to ordering tests and writing prescriptions without thinking about cost because 1) their assumption is that insurance will pay, and 2) they’re not trained to even think about the business aspect of medical care!  If you have to pay a portion (or all) of your health care out of pocket, ask your provider if each ultrasound that’s ordered is necessary; or ask to be checked with a fetascope or doppler if possible.  If your provider is prescribing prenatal pills, ask for the generic brand.  You can also ask which over-the-counter prenatal pills or herbal supplements are recommended.  If you’re facing an induction or surgical birth, find out what your insurance covers and what it doesn’t; some companies are refusing to cover elective cesarean surgery because it is so expensive.

You can also seek a midwife during pregnancy.  Midwives aren’t just for home birthing families; midwives work in hospitals and birthing centers as well.  A midwife’s fee is far less than an OB/GYN’s fee, and their care tends to be holistic more often than not.  So there you have it, ladies – grab your ovaries with gusto and don’t shy away from speaking about finances with your OB.  If you’ve come to expect volunteer or low-cost doula services, don’t let your care provider off the hook for billing you up the wazoo.

Read more from The New York Times here.