It Takes a Village

Posted on by Grace Pritchard Burson

For obvious reasons, sleep is a major concern of expecting and new parents. Will the baby sleep? How will it feel to try to function on less sleep than I’ve ever gotten before? Why isn’t the baby sleeping, and how can I help the baby sleep? When will the baby start sleeping through the night?

Newborn sleep deprivation is incredibly stressful, and it doesn’t help that everyone on the internet seems to have an opinion about it. Sleep training, bed-sharing, attachment parenting, cry-it-out – the mommy/daddy/parent wars are very real. Lately (though this is entirely subjective!), I feel like I’ve been seeing a renewed spate of articles talking about how it’s normal and natural for babies only to sleep for very short stretches of time, and that parents simply have to accept that and wait it out until the baby starts sleeping for longer periods. Appreciate these precious newborn moments! The articles say. Your baby needs you in a way they never will again!

There are – in my view – three problems with this approach. I’ll name them all in this post, but I’m mostly interested in addressing the last one.

The first problem is that baby sleep consolidation is not something that necessarily just happens. Regardless of the approach that you take to teaching your baby to sleep, it is almost always something that needs to be taught, or at least facilitated. And it’s incredibly hard to teach a baby to sleep if you are nonfunctional from exhaustion yourself!

And that’s the second problem with this approach – in promoting the sleep needs of babies, it erases the sleep needs of parents, which are just as real and just as essential for the health of the whole family, including the baby! People who are sleep deprived to the point of hallucination do not make good caregivers for infants, and telling modern parents that it’s “normal and natural” to put themselves through an experience that qualifies as torture under the Geneva Convention is dubious advice at best.

Because the thing is, if we’re going to talk about what’s “normal and natural” for babies, we have to look at the bigger picture, and that is:

Humans were not designed to raise babies alone. (And “as a couple in a nuclear family with at least one person working outside the home” qualifies as “alone” for these purposes.)

I’ll say it again, louder:

HUMANS WERE NOT DESIGNED TO RAISE BABIES ALONE.

Humans are social animals, and for the overwhelming majority of our history, as hunter-gatherers, herders, and farmers, we’ve existed in networks of extended families, clans, and tribes. The separation of work life and home life, and the pattern of nuclear families living in their own dwellings, is only two or three hundred years old. Our “natural and normal” way of caring for babies is in groups, which include not just parents, but older siblings, aunts and uncles, grandparents, and just people who happen to be around.

If you’ve ever seen a group of people interacting with a really tiny baby, you know that babies get passed around. One person gets tired of holding the baby, the next person is happy to take over. This is supposed to be the way it is 24/7, not just when you happen to have people over or be out in a group. It’s my personal theory that part of the reason that people have different sleep cycles at different ages, is to facilitate the care of babies overnight. Auntie, who’s sixteen, naturally stays up until two in the morning, so she gets the first shift, handing off the baby to Mom when baby is hungry, and then going to sleep until late morning. Dad, who conked out early after a long day of hunting mammoths or herding goats, takes over between two and four, but by 4:30, Granny (or, if the generations are short, Great-Granny), who’s post-menopausal and naturally goes to bed and wakes up early, is ready to take the baby so Dad can go back to sleep until the sun is actually up. Meanwhile, Mom gets a full night of sleep except when baby is actually hungry, but is able to sleep soundly in between feedings. Baby is held by loving arms, and everyone gets enough sleep.

Holding other people’s babies is awesome.

For a couple of months when my son was a baby, my ex and I actually lived in an arrangement very like this, with a teenage aunt, a night owl grandmother, and also a grandfather who was delighted to pitch in his share. In my opinion, four or five adults is the absolute minimum that should be taking part in taking care of a baby.

(And psst, to dads in hetero relationships – if it is just you and your wife, you should be just as tired as she is. Yes, you probably have to go to work. But she has to take care of your child all day. “Sleep when the baby sleeps” is not a thing for a lot of people, in the daytime at least, and childcare is exhausting, essential, and just as skilled as whatever you’re doing for a living. Pull your weight.)

If you’re pregnant, the absolutely most important thing you can do for yourself – far more so that choosing the exact right brand of sleeper or baby carrier or breast pump – is find the people who will be, however imperfectly and partially, your village. Do you know teenagers who love baby cuddles? Or older folks who live far from their grandkids, and would be interested in becoming surrogate grandparents for yours? Or friends whose kids are a bit older and who know what it’s like? Talk to them. Find out if they can pitch in, even a couple hours at the beginning or end of the night, or during the day so you can nap. If your family and friends have more money than time to help, have them pitch in for a postpartum doula as part of the baby registry!

Living in extended families or clans is probably not going to be the default again anytime soon, but we can still take a leaf from the hunter-gatherer book and do our best, as communities, to take the load off the parents. Because we were never intended to do this alone.

What happens when it’s time to push?

Posted on by Grace Pritchard Burson

In a previous post, we explored the emotional signposts of a typical labour: what happens during the first stage, while your cervix is opening and thinning to allow the baby to descend into the birth canal. Once that process is completed, the second stage begins, and soon it will be time to push that baby out!

The first thing to know about pushing is that it doesn’t have to begin the instant dilation is complete. Many people experience a pause in the rhythm of labour between the first and second stages – which can be particularly welcome if your experience of transition was intense! This happens because once your baby’s head is able to start moving down through your cervix, it leaves some space at the top of your uterus (the “fundus”). Throughout the first stage of labour, the contractions have not only been dilating your cervix, they have been drawing the muscles of the uterus up toward the fundus, creating a thick, strong “launching pad” of muscle to push the baby down. When that downward movement begins, leaving room for the baby to stretch their legs, the uterine muscles are able to relax a bit before tightening up again to keep the baby moving downward.

If this pause happens to you, go with it! It will allow you to rest and gather your strength for the pushing phase. Your body is still doing its job, gathering itself to push your baby out smoothly and efficiently. Letting the baby “labour down” during this pause is much easier for everyone than immediately starting to push.

Once the uterus has begun to contract again as the baby moves down the birth canal, you may feel a powerful, irresistible urge to push. Many people find that the pushing phase of labour is significantly more straightforward and satisfying than the first stage. This is not everyone’s experience, however. Cynthia Gabriel, author of Natural Hospital Birth: The Best of Both Worlds, estimates that about one out of every four birthing people finds pushing harder than dilation. (I was one of them. Pushing sucked.)

Many hospitals still practice “directed pushing,” in which the person in labour is encouraged to hold their breath for a count of ten while bearing down as hard as they can, at least twice during each contraction. Most of the time, if you have a strong urge to push and each push is moving the baby down, directed pushing is not necessary. Arguably, it could even limit the baby’s oxygen supply, since you are being encouraged to hold your breath. If you feel that you are pushing well on your own and there is no concern about the baby’s condition, feel free to ask your nurses to let you push when your body tells you to.

Contrary to what you may see on TV, lying on your back in a hospital bed is not usually the best position for pushing, if you can possibly help it. After all, your baby is trying to move down, so work with gravity if you can! Many hospitals nowadays have a birthing bar that can be attached to the bed, so you can be supported in a squatting position, which will open your pelvis and allow as much room as possible for the baby’s head and body to move through. If you are giving birth at home or at a birth center, your midwives may have a birth stool that you can sit on to push.

In real life, people who are pushing out babies generally don’t look quite this calm, nor are they probably wearing pants.

I know doulas who have attended births where babies were born while their parents were standing up, squatting on the floor, any number of positions that were not “on your back in bed” but which worked for that person’s body and their baby! (Footnote: in some specific situations when your baby’s head needs to move around your pubic bone, lying on your back curled around your belly, with your elbows hooked under your knees, can be very effective – even if it seems hopelessly retro!)

On the other hand, if your baby is coming very quickly, a different set of positions may be helpful. Although it’s much preferable to getting stuck, a baby coming too fast can damage the perineum and cause temporary difficulties with the baby’s heart and lungs immediately following birth. If this happens to you, moving into a position such as side-lying or hands and knees – which reduces the effect of gravity while still allowing your pelvis to open – will help the baby to come out in a smoother and more controlled way, while your nurse or midwife supports your perineum to reduce tearing.

And what happens if the pushing phase is slow and the baby isn’t moving down much? In that case, changing positions often may be the key to getting the baby unstuck. (I pushed for three hours and in pretty much every imaginable position.) If spontaneous pushing isn’t doing the job, or the laboring person is tired or not perceiving the urge to push, this may be the time for the kind of directed pushing described above. And if it just isn’t happening, other strategies may be called for – episiotomy, use of the vacuum, or an epidural to allow swollen cervical tissue to relax – but only with your informed consent!

Regardless of whether pushing takes five minutes or five hours, whether baby comes in the squatting, side-lying or any other position, the moment when it’s over – when your baby emerges into your care team’s waiting hands and they scoop them up and drop that warm, squirming, slimy, new little person on your chest – will be a moment of intense physical relief and overwhelming emotion. Enjoy!

How a doula is like … a piece of furniture?

Posted on by Grace Pritchard Burson

One of the questions doulas hear most often from prospective clients and other people curious about our work, is “But what about the partner?”

There are plenty of blog posts that give the basics of the answer to that question. But it recently occurred to me that there’s a very simple metaphor that sums it up.

Imagine a stool with two legs. It wouldn’t be very sturdy, would it? You wouldn’t want to sit on it, and if you did, you would have to be constantly bracing yourself with your own legs to avoid falling over.

Now add a third leg, and suddenly, you have a solid, comfortable place to sit.

Each leg is essential, but there need to be three of them for the piece of furniture to be useful. A dyad – a pair of two – is inherently unstable. Add a third, and it becomes a firm and solid triad. The doula, with their experience, knowledge, and handy bag of tricks, provides this third leg.

After all, you’re having a baby because your family didn’t feel complete with just you and your partner. Our partnerships are stronger when, instead of trying to “go it alone” as a couple, we welcome the support of positive influences in our lives, whether friends, family, health professionals, clergy, or any others.

Any doula worth their fee will enhance, not hinder, the dynamic between you and your partner as you both play your essential roles at the birth. They will support you – literally, like the third leg of a stool – and help provide a solid foundation for the birth experience you hope to achieve.

I’m sure I’ll have more to say soon about the partner’s role, but this image is a good place to start!

The emotional stages of labour

Posted on by Grace Pritchard Burson

Emotional Signposts in Labour

When you’re expecting, especially for the first time, you often spend a lot of time reading books and attending classes to learn about what will happen within your body during the physical process of birth. But have you learned about what happens emotionally?

There are three stages that many people go through between the beginning of labour and the moment of birth. Not everyone experiences all three, but knowing what the stages are and their typical order will help you to understand what is happening and, hopefully, be more relaxed and empowered during your birth.

Stage 1: Excitement

The first emotional stage begins when you get the first indication that your baby is really on the way – the initial contractions, the breaking of your water, or perhaps the loss of your mucous plug. At this stage, you feel thrilled, because things are getting under way! The long-anticipated birth is imminent, and you’ll be meeting your baby soon!

It’s great, at this stage, to make sure that everything is ready, double-check that your bag is packed, and be in touch with those who may be caring for your pets or other children. But bear in mind that, especially with first babies, it may be many hours, or even days, from the first twinges until things really get going. As much as possible, as long as contractions are manageable, go about your business as usual. If you think there’s a reason you might need to go to the hospital (for example, if your water breaks before contractions begin) contact your provider. But otherwise, relax, bake something to eat after the baby is born, watch a movie, or try to get some sleep while you still can!

And some people skip this stage entirely and wake up in the middle of the night to find themselves clearly in active labour, also known as –

Stage 2: Focus

When I was a first-time mom in early labour, my midwife came over to check me and, as she was getting ready to go, said, “Call me back when the contractions are demanding your full attention.” The need for complete focus is what defines the second emotional stage. It’s no longer possible to talk, or do anything else, during contractions; getting through them is doable, but it takes work and concentration. They get longer, stronger, and closer together, and (although the precise timing depends on your history, situation, and the advice of your provider) it’s during this stage that you will call in child and pet care, contact your doula, and make the decision to go to the hospital or birth center (or call your midwife if you have planned a home birth).

The second emotional stage can last for less than an hour, or for 24 or more. If a person in labour is well prepared and well supported, they can sustain the intense focus required for this stage and manage the contractions for as long as necessary. But sooner or later, the intensity becomes overwhelming, which is when the parents and support team recognize the arrival of:

Stage 3: “I Can’t Do This”

Those who attend births have seen it over and over again, but for the labouring person and their partner, it may take them by surprise: someone who has been coping well with contractions for hours suddenly seems to lose control. There’s writhing, yelling, swearing. The labouring person goes into the corner of the bathroom and refuses to come out – or plants themself on the bed and won’t move. They flatly inform the medical staff that they’re done with this baby-having thing; they intend to leave and come back tomorrow. And they holler the trademark phrase of the third emotional stage of labor: “I can’t do this anymore!”

Far from being a sign that everything is going wrong, this kind of meltdown actually indicates that things are progressing very well. It means that the phase of labor known as “transition” is under way – that complete dilation is very close, and pushing is just around the corner

It can be extraordinarily difficult for the partner, especially, to witness the “I can’t do this” stage. This is where the support of a doula can be essential, both to alleviate the pain and panic as much as possible until dilation is complete, and to reassure the partner that, alarming as it all is, nothing is actually wrong, and that the labouring person’s emotional response is actually a sign that baby’s arrival is very close.

For most people giving birth – but not all – the pushing phase is an improvement over the intensity of transition. For more on that, stay tuned for my next blog post!

Making birth stories better

Posted on by Grace Pritchard Burson

The tagline of West Island Doula Services is “Making birth stories better.” Why did I choose that phrase?

When you tell someone you’re a doula, people will often ask you how you decided you wanted to enter the world of birth work. (That is, after you’ve explained what a doula is in the first place …) There are as many answers to this question as there are doulas: I’ve met those who took this path because they want to improve maternal and child health; because they believe strongly in every person’s right to an informed and supported birth; or simply because they love babies and everything having to do with them.

My answer to that question is “Because I love birth stories.”

As far back as I can remember, my mother told my sisters and me the stories of our births. By the time I was 11 or 12, I was reading her books about birth and babies with the same interest I brought to novels. As a young adult preparing for my own foray into parenting, I participated in online forums where parents of all ages, backgrounds and outlooks shared their experiences, including frank and detailed stories of giving birth. I learned a tremendous amount there, both about the practical details of birth and about people’s different approaches to it. It was one of the few places on the internet where everyone, from hard-core home birthers to those planning their second or third scheduled c-section, shared with honesty and listened to each other with respect.

The more of those stories I read, the more I felt drawn to participate actively in the world of birth. And now that I have become a certified doula, the idea of birth as story is all the more powerful.

When I meet with a parent or couple during the final weeks of pregnancy, they share with me their hopes and plans for how the story of their new baby’s birth will unfold, and they invite me to be part of that story. When labor begins, the story gets underway, and my presence helps to hold space for it to be told. Sometimes my support helps the couple to stick to their hoped-for script; other times, the birth story ends up being completely different from what was planned, and I am there to help them cope as the script changes.

And then, when the baby is about two weeks old, we gather for the postpartum visit, to reflect on the story. Because of the intensity of labor and birth, the parents often have a hard time recalling all the details of their story in the order they happened. As the doula, my role is to provide the informed perspective of someone who was there, to help them assemble their fragmented recollections into a coherent narrative of one of the most important experiences of their life, the birth of their child. As part of this conversation, we may process things that did not go as planned, or simply marvel at the remarkable and always unpredictable wonder that is birth.

In a real way, stories are what makes us human. And stories around birth and death, life and love, sorrow and joy, are the most powerful of all. It is always a tremendous honor to be given this important role in shaping a family’s birth story, and I look forward to many more to come!

5 reasons to hire your doula early

Posted on by Grace Pritchard Burson

5 reasons to hire your doula early

You’ll get the one you want. Finding a doula who’s a good fit for you is so important. Your baby’s birth is one of the high points of your life, and one of its most tender and vulnerable times. You want someone in the room with you whom you can trust completely. The earlier you start interviewing doulas, the more likely it is that the one you like best is available for your due date.
You never know what might happen. Of course we all hope for a straightforward, easy pregnancy – but sometimes things get complicated. If you develop gestational diabetes or preeclampsia, or your baby is born premature, a doula’s help and support could be even more invaluable than if everything goes normally.
A doula isn’t just for labour. If you’re hoping for a smooth birth, advance planning is essential. There are so many things a doula can advise you to do, that will help you to be healthy, fit and focused, and your baby to be well positioned, giving you the best shot at a straightforward delivery and a positive birth experience. And all those strategies work best if you begin well in advance!
Time is money. We all wish that money were no object when it came to our birth experience, but there’s no question that a doula is a significant investment. That investment is absolutely worth it for you, your partner and your baby, but it’s easier to absorb the hit to the budget if you commit early in your pregnancy and have 20-25 weeks to put aside the cash!
You’ll get the chance to bond. The longer you can be in touch with your doula before you go into labour, the better she’ll be able to get to know you, your partner, your individual style, and your hopes and plans for your family. And the better you’ll be able to get to know her and feel comfortable with her presence and support.

And all that said … of course, if you’re 37 weeks pregnant and decide you want or need a doula, give us a call, and we’ll be delighted to work with you!