Wednesday, October 3, 2012

The Childless Doula

In the very beginning of my doula career (about three years ago now), it wasn't uncommon for someone to raise an eyebrow when they found out that I was a doula yet had no children of my own. And in a way, I understand where they were coming from: it is true that most doulas - at least from what I've experienced personally - came to the work after having children themselves. To some, the experience was beautiful and positive, maybe even involving a doula, and they want to help other families have the kinds of births they had.  To others, it's the opposite: they had negative experiences, felt unsupported or just plain clueless, and want to keep other women from being that way. 

I've engaged in a few conversations (some heated) on the matter of "The Childless Doula" on online forums for birth professionals. While some contributors were complimentary that there were so many young faces in their area's doula communities, others were either skeptical or outright dismissive of the idea.  I've even been passed up by potential clients because of my parental status. 

On a purely superficial level, their criticism makes sense: what can someone who has never experienced childbirth themselves really contribute to someone else's birth? But following that logic takes you to obviously irrational places, such as whether or not you'd have brain surgery by someone who's never had a tumor, or hire a family therapist who has never seen a counselor themselves. I played this defense on loop for a while, until finally I realized that if my parental status mattered that much to someone, then their preferences were legitimate and I was not the right doula for them. Some moms-to-be want motherly doulas for personal reasons that they can't really verbalize, but their preference is valid nonetheless.  Some even going so far as to want a doula that has had a similar birth experience they are anticipating (planned cesarean, VBAC, home birth, pregnancy after loss, etc).  Fortunately, our doula community here in the Triad is incredibly diverse and varied, and there's probably a doula to fit everyone's needs and desires.

But getting back to me, The Childless Doula. I came to this work for reasons becoming more common, more common in fact that I'm starting to get the raised eyebrow less and less.  Miriam Perez says it better:

"We all come to this work for different reasons. Until recently, most of the doulas I encountered were parents themselves–their childbirth experience, whether positive or negative, inspired them to serve others during pregnancy and childbirth.
Now I see a different group coming into this work. Young people without children but with a passion for health activism are finding doula work and see it as a new way to channel their desire to engage in direct service or direct action. Books and documentaries about maternal health in the U.S. have in­spired many people.
The common thread throughout all these experiences ... is unconditional and nonjudgmental support. That is the essence of doula work."

Because of this continuing trend, I get the parenthood question less and less.  People meet me, they sense my passion and energy, and they decide if I'm a good fit for them regardless of whether or not I'm also a mother. For many, the question of parenthood doesn't even enter into the equation.

The raised eyebrow reappears when people find out that I'm on the fence about having kids of my own at all.  It's not completely out of the question, but considering my divorce last year and my continued commitment to my education, I'm reluctant to even consider any intention to have a baby of my own at this time.

That doesn't change my passion for supporting women and their families through what is by far the most intense and awe-inspiring event in the world. Doulas come to the work for a variety of reasons, and as we grow we find new reasons to keep going.  I may have gotten into the work as a move to turn my feminist activism inward, but I continue to do it for reasons that I'm still trying to make sense of. To be sure, part of the work is indeed "the ultimate feminist act," but other parts transcend feminism and pretty much any other "-ism" you can name. And as any of my clients could tell you, it transcends parental status as well.




Saturday, September 8, 2012

Get Yer Freak On. Doula's Orders

The first thing people do when they find out you're a doula (other than asking what the heck that is) is tell you their birth stories.  Which I love, but they very often end with, "So then I had a c-section, and did I really need one?"  Um, I dunno.  I wasn't there, and if I was, I wouldn't exactly have the authority to say.

The second thing people do is ask about some old wives' tales surrounding birth.  The favorite of mine is always, "Is it true that having sex can bring on labor?"  And let me tell you, the answer is yes.
But why?


Oxytocin, the so-called "love hormone," is at least partly responsible for three distinct physiological events in a woman's reproductive life: orgasm, labor, and breastfeeding. As a sex-positive doula and lactation consultant , you might say that oxytocin is my homegirl.

The female orgasm was once thought of as relatively inconsequential to the reproductive process.  In fact, some fertility specialists have even suggested that orgasm "dilutes" a woman's chance of becoming pregnant.  Au contraire, says a bulk of new-ish research that essentially reaffirms what lay-health workers have been saying for years: orgasm increases your chances of conception.  See, when a woman orgasms, her body releases even more vaginal secretion than she does when simply "aroused," helping to lubricate the sperm's path to the egg.  Additionally, the oxytocin released via orgasm contracts the uterus, lowering the cervix (the "neck" of the uterus) and making the uterus more accepting of a fertilized egg (ever wonder what that tight feeling in your lower abdomen was?).

So oxytocin contracts the uterus.  Hence, it may help tip your body into labor.  But the wonder-hormone's job isn't over when the placenta is delivered.  Oxytocin is also responsible for the milk "letting down" during breastfeeding.  See, when a woman first lays eyes on her baby, she's essentially OD'ing on oxytocin, as is baby.  That's the love hormone doing its job.  Baby will hopefully find her/his way to a nipple and begin suckling.  When the nipples are stimulated, oxytocin is released from the posterior pituitary gland, contracting the tiny myoepithelial cells inside the milk ducts, forcing milk out of the breast and into baby's mouth.  That oxytocin release is still doing it's job "down there," helping mama's uterus to clamp down post-delivery, thus reducing risk of excessive postpartum bleeding.

I mention the connection to breastfeeding because oxytocin is also released with nipple stimulation.  Women who enjoy nipple stimulation during sex may enjoy it for a number of reasons, but physiologically it's because that burst of oxytocin contracts the uterus (which essentially puts interior pressure on the clitoris and, well, you get it).  In other words, if you enjoy nipple stimulation, include that in your labor-inducing sex practice.  Otherwise you can just turn on your breast pump when you're finished, and you will probably get many of the same benefits.

If a woman is having sex with a man, he may play a labor-inducing role as well.  Semen contains prostaglandins, autocrine hormones that help to soften ("ripen") the cervix.  A softer cervix makes the fertilization/implantation process more likely, but these hormones work the same when a woman is already pregnant.  The low dose of prostaglandins in semen alone aren't likely to induce labor in a woman who's not yet term (which is why care providers don't warn against sex during pregnancy unless a woman is at risk for preterm labor), but the mild softening in a term mama might just be enough to tip her into labor mode.  As an added bonus, his penis hitting against the cervix may indeed induce some mild (but not earth-shattering) uterine contractions.

Captain Obvious moment: I generally don't recommend the prostaglandin method if a mama is in a relationship where she's at risk for a sexually transmitted infection.  The last thing she needs is to be infected with an STI right before a baby comes through her vagina!  If infection is a concern, sex with a condom still contains the benefits of oxytocin and cervical pressure.  Masturbation is a safe and effective alternative for women who don't have a partner (or just simply don't want to engage in partner sex).  Again, oxytocin is stronger than prostaglandins!

So yes, good sex can in fact induce labor.  In other words, if you're trying to get labor started, just get yer freak on.  Doula's orders.
 
Lauren Guy
CD(DONA), IBCLC
 

Saturday, September 1, 2012

Welcome!

Greetings, readers!

Welcome to Spiraling Outwards, a venue where I can share birthy news and research while adding some commentary and "doula slant".

I almost didn't start a blog at all. It's tricky business for us doulas. Most of us tow the line between being non-judgmental and highly opinionated on an almost daily basis. We want to be able to present information without a whole lot of bias, giving our clients factual information to help them make decisions that are going to work for them, not us. But given the long, drawn-out rants I've been attaching to reposts on my Facebook page as of late, I decided to just go ahead and attach my business name to a blog.

I have another personal blog, and I also write for RH Reality Check and other related reproductive health news and commentary sites. However, those tend to deal with reproductive health issues that don't always have to do with childbirth and breastfeeding, though I may cross-post some of those here. I am a very political person in my "non-doula" life, and while that's just an inherent part of who I am, I try to keep things more or less apolitical in the birthing room; this goes back to my desire to be the doula for every kind of person, regardless of background, religious belief, political affiliation, etc. So don't expect things to get terribly "polarizing" here.

Comments are more than welcome, as is sharing any content in full or part (with proper credit, of course). All I ask is that people remain respectful. Comments containing hate speech or oppressive language will be promptly deleted (if you don't know the difference between non-oppressive language and just plain "political correctness", a brief primer is available here). I may also remove comments that cite bunk research... sorry, but that's just a big pet peeve. So that's about it. Welcome to Spiraling Outwards!!