{Ottawa Doula} Reflecting on One Year

One year ago, I attended my first birth as a doula. I remember excitedly packing my bag, rushing over to my client's house, and then finding my "groove" as a support person. I remember trying to please the midwives and nurses, and trying to stay awake, despite my client's insistence that I get some rest (first lesson learned: when there is time for sleep, take it!!)

In 2011 I served over 20 clients, from all different walks of life. Some births, I have felt extremely confident, knowing I have made a positive difference. At other births, I have felt a sense of failure, both real and imagined. Not surprisingly, the failures hurt the most, and remain forefront in my mind.

There are many lessons I've learned, and some I have written about here.

What I have been reflecting the most on this past week are the struggles I have with the business side of doula work. The fact that I must have an attractive website; an interactive Facebook Page; and a number of followers on Twitter. I must be constantly "on the ball," answering emails within 24 hours, and looking/feeling my best at interviews. Despite all the stipulations in the contract I hand out to potential clients, I have, on occasion, found myself failing to meet my obligations and/or clients failing to meet their obligations. We are all human, and having something written down doesn't just "make it so."

Doula clients pay me money to serve them, and for all the benefits of paid service, it sometimes puts me in an awkward position. If my family could afford it, doula work would probably become a hobby of mine - something I might do without fees for friends, and friends of friends.

So for fellow doulas and other small business owners out there, here are some tips and tidbits I've learned along the way:

1) Surround yourself with like-minded people. Join business groups, network with fellow doulas, and find someone to mentor you. You would be surprised at how much you'll learn from others.

2) Don't get catty - small cities (like Ottawa) and niche-businesses are notorious breeding grounds for gossip and naysayers. Who cares what other people do or don't do? As long as you know your own values and try to abide by them, then the actions of others are not your concern (that said, we doulas do become concerned when someone is not representing us in the best way at our local hospitals! It kind of gives us a bad reputation)

3) The business side DOES matter. Yes, as doulas we must be emotionally supportive, creative and active listeners. But that doesn't mean we can afford to ignore the important things - answering emails on time, following up as much as possible, and being extremely clear about our limits. Transparency is best! This is my area of weakness, and one of my goals is to improve in 2012.

4) Record, record, record. It's so easy to just mosey-on along without properly documenting invoices, amounts paid/owed, and receipts. You will pay for it when tax time rolls around!

5) Have a social media plan. My friend, Lara Wellman, has some great services for folks hoping to enter the world of social media. Decide how much time you want to spend on social media, and then stick to it. Maybe you can only manage one half-hour per day - if you sit down and plan your posts/tweets for a whole month in advance, you will most likely meet you goal!

6) Try, try again. You will make mistakes - guaranteed. There will be guilt and tears. The important thing to do is pick yourself back up, and learn from the mistake. In our business, communication is key. It is miscommunication that usually leads to problems, so focus on being as clear as a bell. And practice makes perfect, of course!

To all my fellow small business owners, have a happy and fruitful 2012!

Scatterbrained {New Year's Resolutions}

While everyone else vows to eat and drink less, exercise more, and lose those last 10 lbs, I'm wondering how to resolve to be less scatterbrained. Not a very exciting resolution, I know.

I'm a big picture kind of person. Show me a room that's been redecorated, and I couldn't tell you what was there before. But, I will get a "feel" for the room and decide whether it's to my taste or not (modern, cool, funky, comfy....) I focus on overall feelings and emotions, as opposed to tiny details. The details bore me, frankly.

But this makes for tricky business when I live in a world where people demand preciseness. A big picture person has a tough time following schedules, setting deadlines and often gets caught up in procrastination.

Is it because I don't care about achieving goals and "getting things done"? No, of course not! I just forget...a lot. I forget about appointments I've made, I forget to ask my friend about something important that has happened in her life, and I always, always forget people's names. My head is in the clouds so often that I have a hard time coming down to earth. When I do, I look around in surprise, as though to say "wow, is this what things are really like?"

I've tried to mend my ways. I've posted a massive calendar on our kitchen wall, detailing every appointment, birth and activity coming up. I enter appointments and birthdays into my Blackberry so that the little reminder message will ding me. I try to get my husband to remind me to complete tasks I've started.

And I STILL seem to miss things.

I don't really have an answer to my dilemma, and sometimes wonder whether I'm just not a great fit for the modern world. If I lived in the 1800's, I think I would have been perfectly happy living a Lizzy kind of life (a.k.a Elizabeth, from Pride and Prejudice). Spending my days playing piano, going for walks, and writing in my journal. Oh, and daydreaming, of course. But I'm sure many of those women were bored to tears, and I don't really wish to live in a patriarchal society.

So with a big sigh, I pledge to try to do better in 2012; to try to find little ways to gently bring myself back to this earth - with all its appointments, rushed schedules and full inboxes. If there are any organizational gurus out there reading my blog, send me your favourite tips in the comment box below!

Happy New Year!

Merry Belated Christmas

I was supposed to do this on Christmas day, but you forgive me....right?

Happy Holidays Everyone!

Dear Santa: My Letter to the Big Guy

Dearest Santa Claus,

When I was 12, I asked you to bring me an Ouija Board....and you did. Thank you for all of those terrifying nights spent with my girlfriends, contacting the dearly departed and causing the heads to break off of our parent's cherub angel figurine.

When I was 14, I asked you to bring me Blue Rodeo's Five Days in July CD....and you did. Thank you for allowing me to hear the most beautiful song in the world - Dark Angel. To this day, whenever I am sad, I only need to listen to this song to be lifted up (listen here).

When I was 24, I asked you to help me through a difficult time...and you did. 25 came, and I conquered my fears and moved on with my life.

When I was 28, I asked you to give me strength, and help me know how to raise a child we hadn't planned for. And you did...our little girl seems so grown up this Christmas, and we're feeling like proud parents who finally know what they're doing (sort of).

This year I'm 31. Life seems somehow more hectic and more stable, all at once. So what do I want for Christmas this year?

I've realized that wishing for world peace won't make it happen. I've realized that wishing for the Canadian Government to honour our Kyoto commitments won't happen. I've realized that wishing for our healthcare system to catch up to the research is going to take some time. And I've realized that I can't save everybody - that there will always be suffering in the world.

So I'm asking for something really simple this year. It's not too hard...a little moisture in the air. A temperature below 0 degrees Celsius....and a BIG, HUGE DUMP OF SNOW. I'm talking like 50cm. Preferably before Christmas Eve day; before my family travels all this way to visit us.

That's all I want for Christmas this year Santa Claus....can you help me?

Love,
Misty

{Ottawa Doula} Can I Check My Own Cervix?

I have a habit of writing posts on issues that are somewhat counterculture...I can't help it! I love learning about things that are not mainstream, especially when it comes to women's health. So read on, but be warned....this may not appeal to you :)

If your care provider is a doctor or an OB, there is no way of knowing how dilated you might be without heading into the hospital and getting a cervical exam. If you have a midwife, they will often come to your home and do a check, which will tell you if it's time to head into the hospital or not.

I would first like to point out that dilation is not the primary indicator that labour is progressing. Penny Simkin (my doula guru) teaches that there are 6 ways to progress in labour:

1) The cervix moves forward - it faces your birth canal, instead of your bum!

2) The cervix softens and gets squishy

3) The cervix thins (effacement, in %)

4) The cervix dilates (from 1-10 cm)

4) The baby moves down the birth canal (station, from -4 to +4)

5) The baby rotates

For a lot of women, long early labours (24+ hours) are doing a number of things - the cervix is moving forward, softening and effacing. Dilation may happen during this time, but it's common for effacement to take place to a greater degree. So women arrive at the hospital, find out they're 3-4cm, and feel extremely disappointed. But if effacement is 90-100% then dilation can occur rapidly after this point. Or, if baby's head is sitting very low (say, +2 station), then the pressure may spontaneously break your waters, and you are soon pushing!

However, it's also possible that you may find yourself at 2cm, with little effacement. You then receive the disappointing news - they're sending you home.

So clients often ask me: how do you know when it's time to go to the hospital?

Personally, I like to confer with astrological charts and assess my client's aura for signs....

....kidding! But sometimes I am definitely unsure as to whether my client is dilated enough, and find myself holding my breath during the exam. There are plenty of signs, but women's bodies can sometimes mimic active labour when they are in early labour.

So during prenatal appointments, I half-jokingly inform them that some women check their own cervix at home. I'm generally met with nervous laughter (they're probably wondering whether they hired the doula who does use astrological charting and auras), but I secretly hope that one day, someone will take me up on the suggestion.

Because, let's be real....this is your body we're talking about. When you get to the hospital in labour, many different people repeatedly stick their fingers inside your vagina. Yes they wear gloves, but like condoms, there's no 100% guaranteed protection. Personally, I like the idea of using my own bacteria-ridden hands to do the job. But clearly this is a very personal choice, and who knows whether I'll actually do it myself if I'm ever in labour again!

{Before you read on, please note that this is not medical advice. It is simply some observations I have made about the cervix, in addition to my own experience!!}

For interest's sake, I thought I would provide some information on how to check your cervix....if you so wish! It might be a good idea to check your cervix once or twice during pregnany, just to get a sense of how it feels during non-labour (also, some women are dilated 1 or 2cm throughout their entire pregnancies):

• Wash your hands well with warm, soapy water. Make sure your nails are clipped - nicking yourself on the cervix would not be pleasant during labour. You also need to be sure you're not going to break your bag of waters by accident.
• In between a contraction (please don't do this during a contraction), have your partner or doula help you get into a squatting position
• Insert your middle finger into your vagina, and go all the way back until you run into the cervix.
• When you're not in labour, the cervix will feel "tough"....probably as tough or hard as your forehead feels. As things start getting softer, it will kind of feel like the tip of your nose. Once your cervix is very soft, it will feel like your lips
• When you're not in labour (and not ovulating), your cervix looks and feels like a puckered kiss. If you are 1cm dilated, you will be able to slip your finger into the cervix (through the puckered kiss!) Basically, the more fingers you can get in there, the more dilated you are. Most nurses will insert 2 fingers, and then will stretch them out to see how wide the cervix is stretched out (keep in mind though, if you're manually stretching your cervix, it's gonna hurt! This is not a good idea - just stretch them out as far as you think the cervix is stretched)
• Once your fingers are in the cervix, you will feel the bag of waters. If you press on the bag, you'll feel a hard head. If your bag has broken, you'll obviously just run into your baby's head at some point.

Given that checking dilation is an art (and takes some practice), keep in mind that you may be off by 1 or 2 centimetres. But, if you definitely feel some dilation (for example, 2 fingers are inserted and stretch out a bit), AND the cervix feels very soft and thin, you can be pretty sure that you're in active labour. Especially if you're also exhibiting other signs of "labourland."

Bottom line - if labouring at home for a long time is really important to you, consider learning how to check your cervix. You may save yourself a wasted trip to the hospital.

{Ottawa Doula} Growing

{I'm joining **Capital Mom** today by blogging about a moment from my life based on a theme she has provided. This week’s Monday Moment theme is Growing}

The orchid I was given as a present last year by one of my first doula clients seems to have stopped growing. Where once there was a magical wand of blossoms now remains a long stem, withered and dried brown at the tip.

People keep asking if it's dead.

There are subtle hints that something is still alive in there - the dark, solid green leaves haven't changed. New sprouts have poked through the mossy dirt and made their way up to greet the weak sunlight.

I'm confident that the flowers will emerge once again, greeting me in their quirky way - like the wink of an eye.

I feel at one with my orchid - I lie dormant, anticipating the deep swaths of snow to fall down like a heavy blanket; burying my energy and drive to "go, go, go." I welcome the coziness of this blanket, and the deep sleep of a cold winter's night.

Codladh samh (Sleep Well)

{Ottawa Doula} A World Without Coffee

Image Source

I was in a big rush, as usual. It was 8:50am, and I was determined to get my morning coffee at Starbucks, a 10 minute walk from the main campus of The Ottawa Hospital - despite having a meeting at 9am. Cafeteria coffee sucks, and Tim Horton's has long lineups. Plus, the walking does me good.

As I waited to use the creamer machine, a man ahead of me was dumping an enormous amount of cream into his coffee. My first reaction was judgemental ("who puts that much cream in their coffee?") and my next reaction was impatience ("would he hurry up already!")

Before I could set my coffee down on the counter, he hurried to get some napkins and clean up a spill he had made. He apologized. As we stirred our coffees simultaneously, he joked about how the Canadian government would fall if our country suddenly ran out of coffee. This made me chuckle - I could just imagine it now: rioting and looting, people shaking and crying in the streets. Caffeine withdrawal is a messy thing.

"The thing I can't understand," he said, "is why all you Canadians - with your fancy machines, and recently purchased coffee - leave your homes every morning to stand in lineups at Tim Horton's."

"Where are you from?" I asked.

"Zimbabwe" he replied.

He introduced himself as Paul from Africa. We stood and talked for a moment, and I learned that he had been a doctor in Zimbabwe, and came to Canada as a refugee 8 years ago. He's still trying to practice as a doctor here. He works at CHEO (Children's Hospital in Eastern Ontario), alongside men and women as qualified he is. But instead of picking up the tools of the trade and saving lives, his work includes menial tasks that could be done by someone with a high school diploma.

"What astonishes me the most," he said, "is the beautiful posters the Canadian government uses to attract skilled people like us to move to your country. They make it seem easy."

Eight years doesn't sound very easy.

We said our goodbyes, and I was on my way, hurrying again to get to my meeting. I was late...but you know what? I didn't even care.

Today as I sip my homemade coffee, I suddenly feel a sense of shame. We live in (supposedly) one of the greatest countries in the world, and yet Paul can't work as a doctor and up North, children are dying from a lack of proper health care.

A world without coffee? Good! Let the government fall, and replace it with people who know what they're doing.

Love Doesn't Leave You Black and Blue

National Day of Remembrance and Action on Violence Against Women is December 6th, and commemorates the 14 women killed at l'Ecole Polythechnique in Montreal in 1989. The CBC archives from that day are chilling to listen to and watch.

Not only is this a day to remember the horrible events of 1989, but it is also a day to recognize the fact that violence against women is taking place here and now, often behind closed doors and away from the media's glare. It is a day to recognize and take action; to work towards prevention and education.

I'd like to share a song with you - a song that has always touched me, and leaves me thinking about the women experiencing abuse in their relationships. This is by Lynn Miles, Ottawa's favourite singer/songwriter...

{Ottawa Doula}: In Postpartum, What's Normal?

I wish I'd never done this.

I want to turn back the clock - go back to a time when I wasn't pregnant.

I don't think I love my baby.

I secretly hope my baby dies so that I don't have to take care of them.

If I were to die, I would rather my baby died with me.

Do these thoughts sound "normal" to you? I think a lot of people reading this would say no.

A woman harbouring these secret thoughts can feel terrified - she realizes that some of them are irrational, but that others are somewhat true (eg. I don't think I love my baby). And so she buttons up, and instead of talking about thoughts that are actually normal she instead feels like an outsider in a community of happy new mommies.

We hear a lot about postpartum depression (PPD) these days. Postpartum psychosis (PPS), a rare manifestation of PPD, is sensationalized in news stories, making it seem as though this kind of situation can happen to anyone.

And so we binarize postpartum emotions into three camps: normal baby blues, PPD and PPS. Baby blues happen to most people, and are a result of massive hormonal changes in the days following birth. PPD is characterized by a continuation of the baby blues, long past the accepted "normal" (usually 2-3 weeks postpartum). And PPS is an extreme form of PPD, where a woman loses touch with reality and may actually plan (and carry out) ways of harming herself and her baby.

But when has a woman crossed the line? Or are they blurred anyway, given that nothing in our emotional lives can be put into boxes?

I'll tell you this - many women with normal baby blues are harbouring secret thoughts that have never been expressed to a single person; not even to a partner. It's taboo to talk about death and desperation in our society - even well trained counsellors can botch a session with a client who expresses the desire to kill herself, either by overreacting (oh my god, you should have told me this earlier - I may have to report you, you know) or by dismissing the client's thoughts (that's ridiculous, you can't kill yourself. You have a baby to look after. You need to snap out of this.)

We want new mothers to be happy - to be like the sweet Pamper's commercials on TV. Lots of smiles, one-on-one time and cuddles with baby, and lots of cooing and ahhhing.

The reality is, postpartum life can be messy (I stress can be, because some women have a wonderful postpartum time). Your bed is sweat stained from postpartum sweats; milk is leaking out everywhere and soaking your sheets; your eyes feel like sandpaper from lack of sleep; and your baby is not cute and cuddly, but instead screams 5 hours a day.

It's no wonder some species eat their young...

I know, I know, I'll probably get a lot of feedback from people, telling me that I shouldn't be trivializing these types of thoughts - that any feeling of harming oneself and one's baby needs to be taken seriously.

And I completely agree. I hope I don't come across as trivializing a complex problem. Certainly, it's worth a trip to a trusted doctor, or several sessions with a counsellor. Especially when thoughts and emotions carry on past the "normal" timeframe we're alloted to be sad {insert sarcasm}.

My goal is not to trivialize, but to normalize. To say to new moms, living in a society where we have almost zero support in the postpartum period, that it's ok. It's ok to feel crazy.

What's not OK is when your thoughts and emotions take over - becoming real, rational plans for action. A way out. It's not OK to still be crying daily one month postpartum. It's not OK to have zero interest in your baby after spending many weeks with your child. The good news is that there's a lot of help out there - websites and forums abound, and Ottawa has an amazing MOMS (which I believe stands for Moms Offering Moms Support) group where you can go to talk about these unspeakable things.

But what if we changed our definition of normal, so that women could say the unspeakable without judgement? So that they didn't have to join a secret society of other moms just to say what they really think?

If I could really fantasize here, a world in which women were treated like royalty after the birth of their baby would be ideal. Then maybe these "crazy" thoughts wouldn't even enter our heads...

If you're about to enter the world of parenthood, consider these helpful tips for dealing with intense emotions after birth:

1) Have only sympathetic and helpful people stay with you in the postpartum weeks; people that share your views on newborn care. An abrasive in-law, who can't understand why you're hoping to breastfeed (for example), may not be the best choice.

2) Hire a Postpartum Doula - these are doulas who are specially trained to care for women in the postpartum period. It is definitely worth every penny. For Ottawa folks, check this doula and this doula out.

3) We hear a lot about "babymoons" - staying snug at home with your baby and partner. This is great for women adjusting well to postpartum life, but when you're experiencing baby blues, sometimes a sense of normality is what you need. Go for short walks, rent your favourite DVDs, and invite friends to come over for short visits. Don't isolate yourself!

4) Ask for help - the hardest one of all. It takes a village to raise a child, and you alone are not a village. Let people know you're struggling, and ask how they might help - dropping by a homemade meal? Sending you a care package with chocolate and epsom salts? Texting you positive affirmations every day? It can be anything!