How To Latch

Below is a checklist I created to help mothers with common breastfeeding challenges.  These guidelines will be helpful for most mothers and babies. However, there can be exceptions to some of these rules, and you might need to experiment with solutions that differ from what you see here.  For example, when holding a baby in a horizontal position across the mother's chest, most babies latch better if you slide their body a bit toward the mother's center; however, a small percentage will do better if you slide them away from the center and toward the mother's side.  If breastfeeding continues to be painful, seek a lactation counselor or consultant who can assess for issues such as tongue tie or neonatal abstinence syndrome which can cause baby's jaws to clench. This checklist may be reprinted for individual use by families or healthcare providers with credit given to the author, but may not be mass-reproduced without permission.

LGBTQ Childbirth Classes and Provider Trainings

For twenty years, MAIA Midwifery & Fertility Services has been at the forefront of serving the LGBTQ community and cultivating expertise in the unique needs of the families they serve.  Books addressing childbirth for alternative families have occasionally appeared over the years, and as I mentioned in my own book, my favorite is the outstanding publication by MAIA co-founder Stephanie Brill, The New Essential Guide to Lesbian Conception, Pregnancy & Birth.  Now at the helm of MAIA is Kristin Kali, nationally-known midwife, trainer and instructor of classes for LGBTQ families and their providers.  Her one-of-a-kind childbirth classes are offered in a weekend format for the convenience of parents local to San Francisco and Los Angeles as well as families who wish to attend from out-of-state.  See below for a listing of MAIA's upcoming events.

Celebrating the Doula Training with Midwife Roots

I am thrilled to be able to say "Happy 30th Anniversary" to toLabor, the oldest national doula training program.  In 1983, Rahima Baldwin began offering birth assistant trainings through the organization Informed Homebirth/Informed Birth and Parenting.  Originally a course for midwives' assistants, the program evolved into a doula training offered throughout North America.   In 1995 the organization's name was changed to ALACE, and in 2009 it became toLabor (The Organization of Labor Assistants for Birth Options & Resources).  I was proud to serve as Assistant Director of the program for seven years, which is how I met Thérèse Hak-Kuhn.  Thérèse is the mother of six children, a doula trainer for sixteen years, an assistant midwife, and the organization's current Director.  The toLabor program is treasured by participants who resonate with the midwifery model of care.  As for myself, I knew little about birth when I began my doula career, but the more deeply involved I became with the organization, the more I discovered that its woman-centered approach to birth fit my values perfectly.  To locate an upcoming training or find a toLabor doula, visit http://tolabor.com/.  Below, Thérèse Hak-Kuhn explains the life-changing impact of the program.

Is Bed Rest Harmful?

Twenty percent of expectant mothers in the U.S. are prescribed bed rest at some point in their pregnancies.  Rachel Zimmerman, co-author of my book and journalist at National Public Radio, comments below on a recent "broad review of the medical literature that found bed rest offers no benefit for the most common conditions it's prescribed for."  My personal experience with bed rest was that it was one of the few things which seemed to (somewhat) reduce my severe nausea.  But it was a lonely experience to feel sicker than I imagined possible, and I wish my health care providers had acknowledged the toll of not being able to work.  Bed rest can mistakenly sound like a luxury.  This week Rachel launches an excellent new healthcare podcast, The Checkup, a partnership between NPR and Slate.  Her inaugural episode addresses "Three Myths of Pregnancy and Childbirth," including bed rest.  To listen to the podcast, click here.  (One of the most fascinating points in the podcast is an explanation of why the effect of gravity on the cervix is not the cause of pre-term labor.)  Additional commentary from Rachel Zimmerman on bed rest appears below.

Birth, Breath, and Death: A Doula's Memoir

Doulas have written groundbreaking books in recent decades, from The Birth Partner by Penny Simkin, to Debra Pascali-Bonaro's Orgasmic Birth, to my own The Doula Guide to Birth. However, I am not aware of many doulas who have written memoirs, a genre that I love, so I was particularly intrigued to read Amy Wright Glenn's new publication, Birth, Breath, and Death: Meditations on Motherhood, Chaplaincy, and Life as a Doula.  The book is a riveting spiritual autobiography, and an account of Glenn's work both as a doula and a hospital chaplain to the dying.  It is also the story of her complicated relationship with her mother, and becoming a mother herself.  She writes, "I am captivated by the study of life's thresholds. What is more mysterious than the great unknown existing beyond the frontiers of birth and death? Through the bodies of women, we are all born into time and space. Each one of us must also walk through that great, uncharted door of death."  I am grateful to Amy Wright Glenn for her permission to share the opening pages of her book with you below.  To purchase and read her book in its entirety, click here.

Doula Mentoring Group: PAY WHAT YOU CAN!

One of my favorite colleagues, doula backup partners and friends, Maria Dolorico, M.Ed., is launching an exciting new mentoring group for doulas of all backgrounds. Maria is a highly experienced doula, mother, mental health counselor, life coach, and group leader, with a professional focus on postpartum adjustment, as well as personal renewal for doulas and new moms. Her group will be conducted by telephone conference call, meeting 7 times, and begins on September 16, 2013.  To learn more about Maria, click here.  See below for more details about this group.

What to Read Instead of "What to Expect"

What do pregnant women really need to do to prepare for childbirth?  Award-winning investigative journalist Jennifer Margulis, Ph.D. reflects on this question in her essay below.  Margulis is the author of The Business of Baby:  What Doctors Don’t Tell You, What Corporations Try to Sell You, and How to Put Your Pregnancy, Childbirth, and Baby BEFORE Their Bottom Line.  Her book is a well-referenced expose that takes on a list of what's wrong with our perinatal healthcare system: from the risky effects of ultrasound on developing fetal tissues, to the harmful chemicals added to prenatal vitamins (and their potential contribution to morning sickness), and the profit motive underlying everything from obstetrical procedures to vaccines to long-term diapering.  Here are Jennifer Margulis's recommendations for what to read, watch, eat, do, and yes--expect--as an empowered pregnant consumer in a difficult maternity care climate.

Aunt Joanie and I were watching PBS’s Call the Midwife the other day.

“That’s not right,” I grumped at the television screen as the mom-to-be was groaning in pain during the first contraction. “She wouldn’t be in that much pain so soon.”

“Shut up,” Auntie Joanie chided. “It’s fiction, Jenny, fiction!”

Uncle Shelly, who’s 80 and a Nobel-prize winning physicist, looks forward to the episodes as much as Aunt Joanie. I applaud Call the Midwife for turning the average Joe or Joanie into a veritable birth junkie and for normalizing birth, but most accounts of childbirth on television and in the movies give the impression that it is a terrifying emergency that happens at lightning speed and is excruciatingly painful.   

Here’s the truth:

Got Courage?

I am excited to introduce you to Shauna Brandes, a new doula with an old soul.  Here she shares a simple story of courage that inspired me, and reminded me of the richness of spirit that fills the doula community.  Doulas are grassroots women who do not wait for permission to help other women reclaim their inner strength.  I see Shauna as a specialist in the transformation of fear into healing, which is a journey many of us must travel as we birth our families and all aspects of our lives.  Please visit her Web site for more fiery inspiration through her words as well as a beautiful photo gallery at www.shaunabrandes.com.  Welcome and thank you to Shauna.

You see this flaming red hair of mine?  I’m considering letting it go, for now, and returning to dark, mysterious tresses but I’m having the hardest time saying goodbye. It’s as if the blood red dye has seeped into the definition of my being.

Holistic Fertility

I am pleased to announce an online event beginning this weekend called "Fertility Secrets," created by Mary Goyer, MS, Holistic Fertility Specialist.  Listen to interviews with 20 experts on using the mind-body connection to support healthy fertility.  You may listen live on June 14-16 and 22-23, or listen to recordings of the interviews afterward.  To register for this exciting, FREE program, visit http://www.aufertility.com/event.html.  Mary Goyer describes the event below.

Top fertility experts offer their best advice for free!

~ Figure Out Your Individualized "Get-Pregnant" Plan
~ Radically Boost Your Body's Fertility Factors
~ Conceive in as few as 12 weeks

You're in the right place if you:

• Are scared that you won't ever get to be a mom...

• Have already been through a lot of painful procedures (emotionally and physically) and struggle to stay positive…

• Don’t have anyone in your world who really gets what you’re going through…

• Are facing daunting statistics… 

Doulas Working in Pairs: A New Business Model

by Ananda Lowe

The future of the doula movement -- that is, a sustainable doula movement -- will be one in which doulas work in pairs, rather than attempting to serve their clients as Superwoman by working in solo practice. 

I was first exposed to a community that successfully adopted this model when I visited the San Francisco Bay Area, where numerous doulas work in pairs and the local clientele has come to embrace this.  In other regions, I have noticed that doulas express both excitement and hesitation about working in partnerships.  Many doulas long for the support of working with a partner, while wondering anxiously if families will only accept a solo doula who promises to always be available. 

Injections, Eggs, and Attorneys: How One Lesbian Couple Conceived

For parents who are GLBT (gay/lesbian/bisexual/transgender), as well as their doulas, health care providers and allies -- which hopefully includes most everyone -- some great resources have been emerging, thanks in part to the Internet.  Dana Rudolph created the award-winning Mombian blog in 2005, and in 2006 she created Blogging for LGBT Families Day.  (Yes, there are many variations on the acronym.)  Hundreds of writers have participated, and this year writers may submit blog entries on or before June 3, which will then be collected and published on the Mombian Web site.  In particular, I would encourage you to submit your birth story for the event!  To participate, click here.  Also, for more information about the experience of GLBT parents during childbirth and how doulas can help, see pages 29-31 of my book.  Below Dana Rudolph describes the process known as "reciprocal IVF," which she and her partner of 20 years used to create their family.

Skin-to-Skin Contact: It's Not Just For Birth

More people are hearing about the benefits of skin-to-skin contact between babies and parents.  As a Certified Lactation Counselor, one of my favorite pieces of advice for new parents is to use skin-to-skin (STS) well beyond the moment of birth.  For babies, breastfeeding is a "full-body experience," and they need the sensory input of STS to let them know where they are in space, and to send a signal to their brains to begin latching correctly.  Babies also need to be able to use their hands to knead the breast, and STS helps raise levels of a mother's milk-making hormones.  If breastfeeding is not perfected after the first few days of life, by all means continue to use STS to help speed up the process!  Hope Parish and Daniela Jensen will be offering a FREE Webinar about STS, hosted by Isis Parenting, on Wednesday May 15, 2013 at 8:00 PM Eastern Time.  To register, visit https://cc.readytalk.com/r/yn3euqhwql6z.  Hope and Daniela are the creators of the NüRoo Pocket, a garment that holds baby STS for what is also known as "Kangaroo Care."  See below for more information about the Webinar, as well as the "Top 10 Myths of Kangaroo Care and STS" by Hope Parish and Daniela Jensen. 

Infant formulas loaded with corn syrup and sugar

By Selena Keegan

(NaturalNews) Top baby formula brands sold in stores contain alarmingly high levels of corn syrup and sugar. In light of rising rates of childhood obesity and diabetes, parents need to read labels carefully to protect their children's health.

Consumption of large quantities of sugar and high fructose corn syrup have been linked to behavioral disorders such as ADD as well as other issues such as anxiety, daytime drowsiness and nighttime insomnia.

Feeding your baby sugar and corn syrup also increases your child's risk for a wide spectrum of other health problems ranging from dental cavities to high triglyceride levels to nutritional deficiencies. Even the mainstream medical establishment warns of the dangers of added sugars.

Warnings issued about sugar consumption for children

The American Academy of Pediatrics has issued warnings about the health dangers of children drinking sugar-sweetened beverages such as sodas, sweetened fruit drinks and sports drinks (http://www.aap.org/).

Unfortunately, many parents do not realize that the most store-bought formulas they feed their infants and toddlers may pose the same health risks as a can of soda.

Most baby formula product lines offer options for cow's milk-based formula as well as soy milk for infants with lactose intolerance. Many formulas come in ready-to-feed, liquid concentrate and powdered forms. All the major baby formula brands offer options for all age groups from premature infants through toddlers, choices for children with special medical conditions, and organic product lines.

The top five ingredients listed for Similac Sensitive Formula for Fussiness and Gas are: Corn Syrup Solids, Sugar (Sucrose), Milk Protein Isolate, High Oleic Safflower Oil, Soy Oil.

Doulas Working in Prisons

Most of us will never have to worry about being incarcerated during our pregnancies.  Nonetheless, the voices of birthing mothers in prison are important for all of us to hear.  According to doulas Marianne Bullock and Vicki Elson of the Prison Birth Project (PBP), most mothers who are incarcerated have committed nonviolent crimes, and represent the most disadvantaged segments of our society.  Other doulas might choose to reach out to this population, and the work of PBP can serve as their guide.  When I learned about PBP, this statement struck me the most powerfully:  "Of all the women who have ever received PBP’s doula services and then been released, only one has returned to jail so far. We believe that doula care is stopping a cycle of violence and trauma to mother and baby during delivery, and helping women to have the tools to make healthier choices. Other prison birth programs report similar decreases in recidivism."  Visit the PBP Web site to learn how you can help, at theprisonbirthproject.org.  (Ways to help are as simple as writing a Mother's Day message that will be delivered to an incarcerated woman via the PBP Web site.)  Marianne Bullock and Vicki Elson tell the story of PBP below.

Dance to prevent babies from "getting stuck" during birth

A topic I would love to see discussed widely is the role of fitness in pregnancy--and its documented effects on childbirth.  These include shorter labors and a potential reduction in the need for inductions, pain medication, and cesareans, according to researchers such as Dr. James Clapp III, and reported in publications such as Fit Pregnancy magazine.  Whether women start their pregnancies already active, sedentary, slim, or plus-size, incorporating exercise has been proven beneficial.  Looking back at my own pregnancy, I believe regular salsa dancing helped my baby descend into a low, well-aligned position in my pelvis at 30 weeks, where she remained until delivery.  Recently, I have been excited to discover the work of doula and former professional dancer Stephanie Larson, founder of Dancing for Birth™, who describes the potential for dance movements involving the pelvis to improve birth outcomes (see article below).  While fitness does not always guarantee a problem-free delivery, I believe pregnant women would benefit from guidance from their healthcare providers to make these types of exercises a priority.     

How My Mother’s Death Makes Me Fear Motherhood

The loss of a mother affects a woman whether she chooses to have children of her own, chooses not to, or finds herself becoming a mother after years of believing she was not destined to do so.  Nicole Clark is a social worker and activist who writes about her personal experience with this below.  To view her full Web site, which contains a wealth of information about a broad range of reproductive health and justice issues, click here.  (Another pioneer on the topic of motherless daughters is Hope Edelman, whose books explore many issues, including the helpful role of doulas in supporting women who have experienced mother loss as they become mothers themselves.  Also, women whose mothers are not deceased, but who were absent due to other challenges, sometimes relate to these same issues.)  I am grateful to Nicole Clark for sharing her story here.

FREE Webinars: The "Natural Cesarean" and Optimal Parenting Conference

Several exciting, free online seminars are coming up in April 2013!  You can participate from any location in the world where you have access to the Internet.

On April 11 at 8 PM Eastern time, Dr. William Camann will speak about the "Natural Cesarean" for Isis Parenting (where I also teach classes on newborn care and breastfeeding).  See the previous post on my blog which describes the natural cesarean here.  Dr. Camann is an advocate for changing practices nationally, including such features as slower delivery of the baby's body during a cesarean, breastfeeding while in the Operating Room, and permitting a doula in the OR.

To register for Dr. Camann's talk, go to https://cc.readytalk.com/r/2ngcfj5zhglk.  Also visit the Isis Parenting Web page to participate in free, weekly chats with expert child sleep consultants and lactation consultants, and to access recordings of past Webinars on topics including cloth diapering, potty training, finding childcare, childproofing, and many more.

On April 8-12, en*theos presents the Optimal Parenting 101 Virtual Conference.  To register, go to
http://www.entheos.com/Optimal-Parenting-101/entheos?c=thedoulaguide.  Here is the conference schedule:

Monday, April 8
12 PT/ 3 ET - Alexandra Jaye Johnson - Optimal Parenting 101
1 PT/ 4 ET - Stephen Cowan, M.D. -  Trust Yourself
2 PT/ 5 ET - Giuditta Tornetta - Pain-Free Childbirth
3 PT/ 6 ET - Latham Thomas - Mama Glow
4 PT/ 7ET - Dan Siegel, M.D. - Parenting from the Inside Out & the Whole-Brain Child
5 PT/ 8 ET - John Mc Dougall, M.D. - Healthy Mom, Kids & Environment
6 PT/ 9 ET - Gurmukh - Bountiful, Beautiful, Blissful: Experience the Natural Power of Pregnancy & Birth
7 PT/ 10 ET - Dr. Patricia Fitzgerald - Staying Natural in a Toxic World

What I Learned From 17 Years as a Freelance Doula

by Ananda Lowe

I have never worked 9 to 5, Monday through Friday.  Financially, being self-employed is nerve-racking, yet those of us who choose to do so often feel that we would be averse to any other lifestyle.  Working from home alone in my pajamas, answering only to the families that hire me, and even being on-call, suit me. 

For most of the past ten years I have freelanced full-time, combining doula work with teaching, publishing a book, and work as a Licensed Massage Therapist.  Before that I served for seven years as Assistant Director of the doula organization ALACE (now www.tolabor.com), working 3 to 4 days per week in that role, and as a freelance doula part-time. 

As an almost entirely female profession, doulas struggle with society’s devaluing of women’s work, and our own shaky professional self-esteem.  We debate on our email listservs about how much to charge (sometimes whether to charge) and how to stave off burnout as we perform intense work for wages that are often not enough to support our own families. 

The answers to these questions are still evolving and emerging, and I would like to contribute my perspective.  To my doula sisters with your selfless hearts and drive, you can balance your passion for social change with your sanity, and your family’s need to pay the rent or mortgage.

So, here is my list of advice for the freelance soul:

A Mother's Depression: Advice for Fathers and Partners

I admire Sarah and Jean-Philippe Vine for their honesty in speaking about their experience with Sarah's postpartum depression.  Sarah is a doula who courageously told her story on her blog, in the hopes that it would help other mothers.  Her husband also chose to tell the story from his perspective, in order to help those who may be the partner of a mother suffering from postpartum mental illness.  Jean-Philippe Vine is an Animation Director whose professional work can be viewed here, and who wrote and illustrated the essay below about his family's postpartum experience.

Latina women, reclaim your birth power!

Latina mothers have a rich childbearing heritage to draw upon.  Maria Apreza is a doula and Spanish medical interpreter serving the Seattle area. She is passionate about immigrant and women’s rights. Maria also volunteers her services through Open Arms Perinatal Services, a local non-profit that provides doulas free of charge to low-income women of color.  She lives with her husband and four kids.  Originally from Mexico, she enjoys teaching women how to use the rebozo in pregnancy, birth and the postpartum period.  Click here for an excellent list of resources and information on the rebozo that she has collected.  Maria Apreza reflects upon her personal heritage and her professional experience in the inspiring essay below.