"We must and will have women leaders among us. Native women are going to raise the roof and decry the dirty house which patriarchy and racism have built on our backs. But first we must see ourselves as women: powerful, sensuous beings in need of compassion and tenderness." -Lee Maracle

Thursday, October 4, 2012

The seasons are always changing

I'm flattered that so many people have been coming to my blog, even though it has laid dormant for several months. I've never been good at blogging regularly, being so busy with all my commitments including my family, graduate school, work, EMR training, and working on my fitness. The full time blogging lifestyle just isn't for me.

I have a couple of announcements for those who have been visiting and those of you who used to read my stuff. My blog focused almost exclusively on birth work and reproductive justice. These are issues I'm still very passionate about, so read on for more information.

1. I'm not currently practicing as a birth doula. I simply cannot commit the time it takes to do this job while I am in graduate school. I also cannot partake in the "on-call" lifestyle - I don't have as much freedom to miss class for births now that I have transitioned to a more difficult program and university.

2. As such, I will not be regularly blogging or updating my Facebook page. While I feel it is important for radical and full-spectrum doulas to have their voices heard among other birth workers, at this time I must focus on my schooling. It is too easy for me to get sucked into the conversations going on, especially online - so I am doing what's best for my studies and removing myself from those situations. I will be deleting my professional Facebook page in one week. I won't be deleting my blog, but I cannot promise to be posting new information regularly after today's post.

3. I posted earlier this summer that I trained to be an Emergency Medical Responder. I successfully passed the National Registry of Emergency Medical Technicians, and am officially a nationally registered EMR! I am currently awaiting licensure from the state of Michigan. Unfortunately, or perhaps, fortunately, I did not get to catch any babies or attend a birth as an EMR student. I did, however, attend the birth of a wonderful little boy as a doula.

4. I feel a strong calling to continue my medical education. I am applying to medical school next year and hope to train to become a physician. The cat's out of the bag: I am interested in Family Medicine and Obstetrics and Gynecology. Those of you who know me well already knew this was coming - it was just a matter of time. :-) I am very excited to be taking my passion for reproductive justice to a clinical level. I am grateful for the experiences I've had working as a doula. The perspectives I've been exposed to will certainly help as I transition to yet another calling in helping women and families.

5. I have plans in store for developing and implementing a doula training workshop especially for Native American and First Nations doulas! Look for more information from me as Summer 2013 approaches. I am still VERY passionate about doula work and look forward to forging more relationships between underserved communities and professional support networks.

Thank you, everyone, for supporting my journey as a doula and reproductive rights activist. My days as a warrior for full spectrum health are NOT over - they are just beginning. My studies in public health have excited me for a future of serving families as both an educator and clinician.

Things are changing here in Michigan.

Monday, July 9, 2012

Moving and Changing My Practice

It's time to move my doula practice.

I will be moving soon to start graduate school at the University of Michigan. As a grad student in the MPH program, I will be taking 15 credits per semester or completing a full-time internship, and working on campus. I also hope to volunteer with a local First Responders group before attending Paramedic School. So that's a lot to do!

I'm lucky to be moving to an area of the state where birth work and birth culture is alive and thriving. Doulas and midwives are common - much more common than where I'm currently living. There's no doubt that I could work as a doula down there, even make money at it. Many birth workers can take on enough clients to essentially have a part-time or full-time job.

The thing is: I can't take on another part-time to full-time job when I move.

As a graduate student, my primary responsibility is, well, to be a graduate student. That's what they pay me for. I fear that I won't be able to honor the University's expectations of me if I am constantly on-call, watching the phone, missing class, etc. As an undergraduate I usually coasted through my classes and missing one or two classes a semester, for a birth, was no big deal. But I'm moving on to harder classes, more in-depth research, and even time-sensitive medical/clinical research. That requires me to give graduate school my all, 100%.

So I will not be taking on any new clients when I move.

This does not mean that I'm done with doula work. Oh no. For at least a year, I would like to partner up with another local doula (or two) to serve as a back-up doula. I've never worked as a back-up doula before, but it seems like a great way to continue to serve women and families while keeping my focus on school and family. Basically, I will be "on-deck" for births when another doula goes out of town, or has an unforeseen reason for missing a birth for which she was scheduled. Doula partnerships and group practices are becoming more mainstream. I believe this is a good standard to offer our clients - so they are confident that no matter what, they'll have a doula at their birth.

As such, I will be moving my practice down state Michigan to become a back-up doula. I look forward to having new experiences and connecting with the doulas down there. I will also be participating in a research project with a professor: looking at the work of doulas and their impacts as a "pregnancy text." So I'll still be immersed in birth culture, and I'm sure I will love every minute of it. :-) 

That being typed, I am looking for advice from more experienced doulas on what it's like to move a practice to a totally different area. How did you adjust to the new environment? How did you transition your hospital-birth skills to home-birth and birth center situations? How do you advertise yourself as a back-up doula to other doulas? How do you cope with working in hospitals that are MUCH larger and different than what you've been used to?

I've got a lot to learn; I have never worked with water births, placenta encapsulation, twin or multiple births, and many other experiences. I look forward to continuing education including a professional breastfeeding support class.


Tuesday, June 5, 2012

Doula Discourse: Labor and Birth Foods

Hi all. First, a few updates:

I attended two births since my last post! Both were valuable yet challenging experiences. I learn something new every time!

I'm happy to announce that my clients have had 100% breastfeeding success. Every client I have worked with has initiated breastfeeding during my stay with them at the hospital, or shortly after I left. Go moms!

Local hospitals in my area are making some great changes. One has implemented a birthing pool into their newly updated L&D suites! If all goes well, another pool will also be installed. Another hospital is working towards certification as a mother-baby friendly hospital, which means that their practices will encourage and support exclusive breastfeeding.

I have at least two births coming up in the next month. Both of the couples will be paying me which is the first time I've ever received a monetary payment. I'm a little nervous, I have to say. I've never charged because it is in my traditions to work for whatever a person can provide. Personally I have earned a Kitchen Aid Mixer and a lot of gratitude. I don't know what to ask for. I'm super lame and embarrassed when it comes to money. How do I decide what to charge for attending a birth?

I'm almost done with my Emergency Medical Responder training. I plan on becoming a licensed EMR in the state of MI. I start 24 hours of clinical rotations this weekend. Needless to say, I'm really hoping I can put my birth worker skills to use and attend a few births! This is an exciting opportunity for me because as an EMR I can act as a doula, but as a doula I cannot administer health care. I feel this is a great way to use all my skills and deliver one wonderful experience to my clients/patients.

Second, let's talk food:

Fact: Most women in labor need food and drink to keep them hydrated, healthy, and energized during the hard work of, well, labor. All the current evidence* supports women eating and drinking in labor as needed and desired. I've attended too many births where the moms weren't "allowed" to eat and drink because of old and outdated care practices that are not supported by evidence. At the very least, eating and drinking are discouraged by many nurses. Many women also do not wish to eat even if they are starving. Why? Because:

1. Fear. Fear of pooping, peeing, and throwing up. Women do not want to throw up in their labor. Nurses do not want to get thrown up on.

Keep in mind: Sphincter Law tells us that throwing up can actually be a good thing in labor, because it helps relax and dilate the muscles like the cervix. Nature's Law also tells us that pooping and peeing are a part of this normal, physiological process. Many women will indeed poop. Before she even realizes it the nurses or doctor will have cleaned it up and she will never even know IF no one tells her. Sometimes ignorance truly is bliss. Barf bags in the hospital (and for what it's worth, in the ambulance) are nifty little things. They're a small bag that fits right over the mouth and closes automatically when released, so literally no puke can spill from the bag. You just toss it right in the garbage when done. Ultimately the body knows what's best and will respond to and act within labor as it needs.

2. Fear. Fear of an emergency C-Section requiring general anesthesia. Some believe that women are in danger of vomiting and then choking while put under for surgery. Now, I'm no Nurse Anesthetist with an MSN, but I do keep up on current research. Current research* shows that modern technologies and the skills of NAs almost always prevent vomiting and choking during surgery.

Keep in mind: The patient has every right to her own dignity, respect, and competent care. If she wants to eat and drink in her labor, she has the right to. Period. Always. Forever.

Doulas and clients should expect that many staff still stick to a no eating and drinking policy. During the pregnancy, doulas should discuss this possibility with the clients and prepare for a situation where the client doesn't get what she wants. Practice ways of resolving the situation, which should always come from the client herself, including:

-Demanding the right to eat.
-Asking for another nurse.
-Eating anyway.

The client can prepare a defense of her concerns and preferences before the labor, so that she, her partners, and you the doula can be ready if something should come up. She can respectfully address the staff and try to resolve the dispute if she has the energy and motivation. Or she can swear at the nurse and have a tantrum like I did during my labor. Whoops. She can request another nurse who will better respect her needs. She can also ask to consult the OB. If all else fails, she can eat anyways.

The truth is, most women will not need or want an entire turkey dinner during labor. Here are some good foods that will give her energy and hope for a stronger delivery:

-Nuts, dried fruit, trail mix
-Tea of all kinds (What's her favorite? Find out before the delivery. Be a good doula and bring some with you to the hospital.)
-Yogurt with fruit, nuts, or just plain
-Soup, porridge, broth
-Fruit, raw or canned/jarred
-Granola bars
-One or two scrambled eggs
-Nut butters with fruits or crackers

These are also good foods to have on hand for birth partners and doulas!

Happy labors, and may you eat and drink in peace. If not, eat anyways.

*Some may wonder why I do not provide hyperlinks to my research sources. Well, because I am a doula and a college graduate and soon to be Public Health scholar and also just a health nerd in general, so I spend my "free time" reading texts, following too many health blogs and websites, and talking to other health professionals. There's no way I am willing to keep track of all these sources for one little blog post. And chances are, most of the birth pros out there, at least the good ones!, are keeping track of much of the same research I am and reading the same material. I simply provide my interpretation of the research in my own words, and my site should never, ever be utilized a substitution for appropriate medical consultation. Consider that your run of the mill health blog disclaimer. :-)

Tuesday, May 1, 2012

I'm Back to Blogging

Boozhoo, everyone! I have not been on this site or my Facebook page for quite a few months. For that, I apologize. I missed writing and sharing my ideas with you. I had a very difficult and busy semester. In the last week along, I have written over 40 pages for school. But the good news is: I accomplished a LOT while I was away. And I mean a lot! The future looks very exciting for me and my family.

Here's what I've been doing all this time:

-Designed, implemented, and analyzed a pilot ethnographic study of fitness and self-care routines, spent ten hours in the field doing observations, conducted/transcribed/analyzed an interview, wrote a seminar paper, aced the paper;

-Conducted a site study of a local preschool for tribal youth where language and cultural learning is integrated into the curriculum, wrote a paper for this project with a focus on language preservation and youth education, aced the paper;

-Helped create an English to Ojibwe language translator for kids using the Java programming language;

-Helped to host an AISES regional conference at my university, introduced Dr. Anton Treuer, served as Head AISES Female Dancer;

-Attended the birth of baby Oliver - this birth was amazing!;

-Worked with an international couple who are expecting their first baby this month - I worked with them on childbirth education and SOON I will be their doula as well! I learned so much about working with couples whose primary language is not English, and will be developing more inclusive resources for international students soon!;

-Attended a continuing education course for doulas about supporting families with NICU babies, with a special focus on supporting breastfeeding;

-Presented my research at the HU Dept. Colloquium;

-Publications were achieved! My writing was accepted in the following: Sunday Evening Poem (online poetry publication), Ain't I A Woman: Race, Feminism, and Social Media (anthology), Hip Mama (Zine), and Occupied Bodies: Women of Color Speak on Self-Image (anthology);

-Co-founded an organization on campus for pregnant and parenting students;

-Played the tenor saxophone at my final jazz concert at Michigan Tech;

-Was invited to be a plenary speaker at the opening session of the CPTSC conference;

-Received the Percy Julian Leadership Award for my work in promoting cultural understanding, social justice, and equality on campus and in the community;

-My daughter turned FOUR!;

-We got a german shepherd puppy!;

-GRADUATED from Michigan Technological University with a BA in Scientific and Technical Communication! I graduated with honors, achieving over a 3.7 cumulative GPA, and having taken three graduate courses in my time here. I'm very proud of this accomplishment!

-Last but certainly not least: I accepted a position as a masters student in the Masters of Public Health program at the University of Michigan, to pursue a degree in Health Behavior and Health Education! Many people do not understand how much work goes into a graduate school application, and how competitive the process really is. The position comes with NICE stipend, amazing research opportunities, and the chance to work with faculty who are leaders in the Public Health field. I am SO excited to start at a new university, especially in the top MPH program in the state.

As you can see now, I haven't had any time to manage my Facebook page or to write on the blog. But now summer is here, and I will have more time to dedicate to sharing my thoughts and research. I do pan on continuing my series of posts on maternal and infant morbidity. I also want to write about the birth I recently attended, because I learned so much about being a doula at this birth. Stay tuned for some materials from me, and thank you for excusing my absence! :-)

Monday, February 20, 2012

Doula Discourse: Morbidity Matters Part I

A lot of conversation surrounding maternity and infant care in the U.S. laments our reprehensibly high rates of maternal and infant mortality. Mortality is commonly defined as death that occurs within one year of a birth. The U.S. has astonishingly high rates of infant and maternal mortality, ranking as one of the worst and most dangerous developed nations despite our access to life saving technologies and health care. Many birth activists, moms and dads, and professionals have pointed out this fact in books, medical literature, and everyday conversation.

Preventing maternal and infant mortality is central to our work as birth professionals. The fact that maternal and infant mortality continues to dominate discussion gives hope that together we can address these issues and, literally, save lives. That being said, I am troubled that morbidity is not given as much mainstream attention as mortality, and wonder why birth professionals/activists/breeders don't make it more of critical topic.

Morbidity refers to any injuries to the body suffered in birth. Injuries suffered in delivery include natural and iatrogenic injuries - iatrogenic referring to injuries that are partially or wholly caused by medical interventions/medical staff. Common maternal natural injuries include: perineum tears, bruises, soreness, and red eyes from pushing, and hemorrhage. Common maternal iatrogenic injuries include: episiotomy, greater surgery such as C-section, hemorrhage, lacerations from tools, incontinence, and bruising. For babies, common injuries include sprains and broken bones, blood loss, oxygen loss, and lacerations from tools. I consider early cord clamping to be a great injury inflicted on infants, as research and tradition have showed that early cord clamping causes great harm. I am not sure whether or not emotional and psychological trauma officially get counted as injury, but I would argue (as would many doulas) that emotional damage is real damage and should count as an injury.

In addition to having unacceptable rates of maternal and infant mortality, the U.S. also ranks poorly in terms of maternal and infant morbidity. Injury is common in births and iatrogenic injuries in particular are alarmingly high. Why, then, aren't more people talking about morbidity and demanding prevention?

I believe that the efficiency and outcome based model of childbirth contributes to the silence surrounding morbidity. The efficiency and outcome based model asserts that as long as a whole, "healthy" and living baby comes out, then we have achieved the goal of efficient childbirth. How many times have you heard the saying, "Well at least you have the baby!" when a mom or dad explores their feelings of trauma and disappointment related to their birth experience? While these words are meant to comfort distraught parents, they attempt to erase parents' real feelings. The efficiency and outcome based model of birth also demeans the work that doulas do when we work under the philosophy that birth matters.

A tenet of doula care provides that birth and experiences are inherently important, have significant cultural , spiritual, and emotional meaning, and have lasting implications for families. Doulas serve families with this philosophy in mind, hoping that we can help make their experience meet their expectations, and by validating the real feelings of our families if and when injury occurs. Morbidity matters to doulas.

Morbidity cannot be completely eliminated from childbirth. However, it can be reduced with the help of doulas*. I will be exploring morbidity in the next few blog posts and addressing how I believe doulas can contribute to preventing injury to moms and babies. In doing so I hope to move morbidity to the front of contemporary doula discourse, thereby honoring our philosophy that birth matters, and hopefully, also preventing some injury along the way.

In the meantime, feel free to share your experiences with birth injury in the comments, or email me if you prefer. I respect your experiences and want to hear from you.

*I pretty much think doulas are amazing creatures who can save the world if given the right opportunity.  

Sunday, January 15, 2012

2011 in photographs

2011 was definitely a great year. I achieved as much as dreamed I could, worked harder than ever, and grew in all dimensions of my personal, academic, and professional life. I took risks and embraced vulnerability. I was strong and healthy. As 2012 begins the highlights of 2011 remain with me in memories and photographs. To my friends and family, and the communities and followers who have supported and challenged me, thank you.

My daughter and me, Keweenaw Bay Indian Community Midwinter Powwow, Baraga, MI

My daughter and me, Northern Michigan University Powwow, Marquette, MI
Northeastern State University, Tahlequah, OK
Bois Forte Band Traditional Powwow, My rez and homeland, Vermillion, MN
Oneida Nation Powwow, Oneida, WI
KBIC Traditional Gathering, Baraga, MI
Michigan Technological University Spirit of the Harvest Powwow, I was honored to serve as Head AISES Female Dancer, Houghton, MI
My first conference presentation, Oklahoma Workshop for Native American Languages (OWNAL), My presentation was on barriers to technological access and literacy at the KBIC, and the implications for language learning, Tahlequah, OK
I interned and volunteered at a local alternative high school, where I worked as a health educator and mentor. Here I am with my mentee and her son at graduation, Hancock, MI
I'm a sucker for turtles, so anytime I see one on the road I take it off the road and move it to a safer location.
For the first time in many years, I rode a horse. This girl is a big half-draft horse named Oreo.
I got married this summer in L'Anse, MI, in a small ceremony on the rez where my husband grew up. We were married in the Cora Anderson building, which is named after the first women elected to the Michigan Senate. Cora Anderson was Ojibwe. We spent the afternoon taking pictures on the shore of Keweenaw Bay and spent the evening having fun with friends and family.
Instead of buying each other wedding gifts, we adopted a dog named Sunflower at our local humane society.
I introduced my daughter to the love of riding at our local county fair. Here she is with Dusty the pony.
I attended the birth of Baby A.
I attended the birth of Baby L.
My husband graduated with his second bachelors degree, in Scientific and Technical Communication.
Here is one of several publications I had this year. My research and creative writing was accepted by a number of journals, including this one here, International Doula, the journal produced by DONA International.
As you can see, we were very busy in 2011. I am grateful for everything that we have been given and pursued. 2012 is already off to a great start. My husband had a paper accepted to a conference and we will be traveling to Chicago in the Spring. I have three or more clients lined up whose births I will be attending. I continue my internship at the high school until I graduate with my degree this summer. I've also had a major paper accepted into a book, making this my most significant publication to date. As I apply for graduate school I'm excited for the future.

As the new year begins, please feel free to share your perspectives with me. What are you most proud of? What did you learn in 2011? What are you most excited for in 2012?

Monday, December 19, 2011

Doula Discourse: Random musings after a second birth

I was at a very lovely birth this weekend (a planned C-section--talk about kairos!) where all sorts of things went through my head, that I feel helped me grow as a professional. This post may be a little random because, well, life doesn't always fit together in one happy chronological blog post. I hope you will follow along as I  explore some seemingly random musings.

1. I believe I was the first doula a particular nurse had ever worked with. I'm sure this nurse had at least heard of doulas, but for a C-section, I think she was surprised if not a little territorial about me being there. I'm not sure why she was so surprised to see me in the room hours after the surgery. Honestly, I was still figuring out my role as a doula for a planned section. It didn't take me long to figure it out, though. All I had to do was be there for the family. Keep them company, answer their questions, validate their feelings, get water and snacks, take pictures, help with breastfeeding, and all the other wonderful things that doulas do for any birthing family, anytime, any place. Being there after the surgery might have been even more important to the family's comfort, so mama was never left alone, without a set of hands to grab a drink of water or a friend to talk with. I understand that nursing staff are very busy, and they take care of all the laboring/birthing women PLUS the babies in the nursery. This is exactly why doulas are so important! We can be there. Always. As long as a family needs us. I'm glad I was there to show the staff how helpful and important doulas can be, especially for mamas fresh out of major surgery.

2. Doula care is not a luxury. I get the feeling that many people, including medical staff, think it is. Only some moms get a doula. Only some births deserve a doula. Doula care is something "extra." I don't agree with these sentiments. I believe that having a doula at every single birth is absolutely a right. A right to safety, comfort, and ease during a time when support is extra important. I would like to see doula care as normal, accessible, and affordable to everyone experiencing a pregnancy outcome.

3. Visiting hours are awesome! The hospital we were at enforced visiting hours with the goal of protecting the mama and baby's breastfeeding relationship. Having people walk in and out of the room is distracting and potentially harmful. Birth is special, sacred, and private. Doulas, please know the visiting hours of the centers and hospitals you are working at. It also helps a lot if the family knows the hours and communicates them ahead of time to anyone who might be around, so there are no awkward surprises.

4. Doulas should be aware of what it takes to care for a mama after a section. Talk to mamas who have had that experience, and see what they needed. Think about your own experience. Read. A lot. Talk to staff. Talk to other doulas. Do your research. Attend a C-section. I am disappointed that the doula literature out there really doesn't cover the special needs of C-section care. It's insulting, actually. All the literature focuses on labor and birth with a vaginal birth as the desired outcome. While we can prepare for work with mamas receiving medication, epidurals, and all sorts of other interventions, post-section care is rarely if ever covered. We didn't even cover this in our DONA training, which I considered to be rather excellent given the time constraints. This is unacceptable. We need to know what to do, what not to do, what language to use and avoid, in order to best serve our families. There ought to be continuing education available for doulas via training workshops, focus groups, peer workshops, and webinars.

To conclude, simply: doulas and C-sections are an important pair.

I am honored to have attended this birth. I thank the family for for letting me be a part of such an important and beautiful event.