Where does the evidence come from?

“All of the high level medical evidence is flawed because it only reflects what happens at institutions that are big enough to do research. I’d like to call this institutional bias or academic bias, but those titles are both taken by other concepts. For lack of a better term, let’s call it research hospital bias.” – 

loving mother adoring baby after waterbirth

While my personal anecdotal data is of course a very small sample, I find it so confusing, and sometimes frustrating when the newest research provides “evidence” against what I feel is true in my bones. For instance the recent study that says a low-risk person less likely to have a cesarean birth if medically induced at 39 weeks.  Our very own Lisa Kane Low, is quoted in this NRP article! She brings up an important point that while the risk does appear lower, the actual risk decrease is VERY low, and might not actually be in the mother’s or baby’s best interest, Especially if the mother is very fearful of a c-section, and that is informing her choices.  Thank you Lisa for your insight.
This article Midwifery Today article touches on one of my issues with all this evidence coming out. I think it’s reasonable to think “If we mess up how mammals labor, it’s safer to mess with it even more”.
 
Anyway… Thoughts?
 

Doula Katy #1

Doula Katy, pt 1

Hi y’all! My name is Katy Gladwin. This post is just a start, but I’m going to try to tell you who I am, and why I think the way I do.

Katy Gladwin sisters
Me and my sisters!

I grew up in Michigan from the age of 5 and have lived here my whole life (minus a year in Nashville, but that’s an entirely different post). I have 3 little sisters, all of whom are amazing, smart beautiful women who I love dearly. We are all close, and feel very lucky to have them in my life.

I am married to a smart, driven, project and outdoors loving engineer. It’s because of him and his support that I’ve been able to be a doula, continue my education, while also being a mostly stay-at-home/work-from-home mom. We built an awesome house in rural Ypsilanti, which just over a mile from the city center. Building a house from scratch is quite an undertaking, that I don’t recommend taking up lightly. I did not quite realize how much work and thought goes into designing, then planning, then building a home. It took a couple years in the planning phase, but once we got to building, it took shape fast and now, we live in a house that we designed ourselves, for ourselves, in the woods. Looking back, it’s pretty fantastic what we were able to accomplish.

Gladwin house in the woods

My partner and I have an almost 5 year old son who is, 98% of the time, pretty much the coolest kid ever. He is empathetic, sweet, super goofy, smarter than us both, and an introvert like me. He makes even the hardest days joyful.

I’ve been Doula Katy for 7 years!

Katy, ZOG and Ross Gladwin
My little family

Never once have a thought maybe this isn’t the right job for me. I love love love this work! When I was in college, studying and preparing myself for the MCATs, I was so looking forward to being able to help people! I was looking forward to working with people to heal themselves, to listening and learning. I was also dreading the years of hazing and indoctrination that goes along with med school. For many this is just part of the plan to become a doctor, for me, I was worried it would hurt my ability to be critical, to question the systems set in place, not to mention the staggering debt. When I learned that being a doula was even a thing, I was sold! A profession where I get to listen and learn, empower and advocate… I am in!

It was one of the best decisions I have made in my entire life. While it can be frustrating to see births go sideways in an individual basis, overall, I love this job with all my heart. I love the families I have had the honor of working with. I love the care providers I have gotten to know over the years. I love the nurses I get to work along side. While 90% of the births I have attended are in the hospital, I extra love that I have the opportunity to attend home-births as an assistant as well.  This helps me remember that birth works.

I learn something at every birth I go to. A new amazing phrase to use with laboring families, a magic trick to help a swollen cervix disappear, a new medical procedure to talk to mothers about, or a new way to advocate.  I take all of this and can share it with the families I work with.  Help them prepare and create a vision for a good birth.  I’m so grateful!

to be continued…

Giving Thanks

We, Ariana and Katy, would like to show our gratitude to all of our family, friends and community for supporting us as we work to grow this business to support our families.  Thank you to the mothers and families who have trusted us to come into the birth rooms to hold space and support.  We never take that honor lightly.  Thank you to all the clients who have become great friends!

doula selfie
Thankful doulas

We thought we would list out a few things we are each grateful for this fall.
I am grateful for my partner. I am grateful that my partner has a job that allows him flexibility on days I’m at an overnight birth when he needs to find childcare for the day.  On that note- I’m grateful that I have amazing childcare options, a must in this kind of work.
I am grateful that hospital policies seem to be following evidence lately.  The shift towards even more mother/baby friendly care is heartwarming to see.

Cuddly Kitty
Cuddly Kitty

I’m thankful for my house.  It is awesome.
I’m grateful for cozy fires, cuddly kitties, and yarn.
I’m grateful for Zachary!  Parenting a toddler can be a serious challenge, but the growth I feel as we go through everyday’s little tests is profound. His joy, curiosity, wonder, and spirit make everyday better!
I’m thankful to have found work that fulfills me. I never want to live to work, or work to live, but it’s great to have a job I love doing that fills me up.
I am thankful for my partner who totally understands that we might have to leave in the middle of Thanksgiving dinner so that I can go to a birth (or any dinner for that matter); who has been helpful and supportive as I put more time into make doula work work.

doula husbands
And for overlapping off-call time so our families can go camping together!

I am grateful for care providers who trust women, their bodies, and birth.
I am thankful for all of the families who have allowed me to serve as witness and support during their pregnancy, birth, and postpartum.
I am grateful for horrible horrible dad-joke level puns that get me laughing no matter how hard a day it’s been.
Happy Thanksgiving from our families to yours!

Creating Your Ideal Birth Plan

This is a starting point, use the method of writing your birth plan that suits you and your family.  Dreaming is encouraged! Step out of reality a little bit and use your imagination.

alexander97“The first step in writing a birth plan is to dream.  Let go of all the ‘shoulds’ and pressing realities that circumscribe your choices. Let yourself visualize the perfect, ideal birth for you.  Trust that later you can add in reality.  Right now, let loose your feelings and your imagination.  It’s OK to invoke magic in your dream birth.  Think through all the stages of labor: early, active, pushing the baby into the world, and the first hour with your new baby […]. Get specific about the details.”

Natural Hospital Birth (2011) by Cynthia Gabriel

Dream

Write this dream down, be as specific as you can.  Have your partner dream too.  Talk about your dreams and begin the dialogue of what is a reality.

Discover

Next, take a look at one of the “check-box birth plans”.  Check all the boxes!  Mark everything you want, or don’t wantcheck all the boxes while creating your birth plan as the case may be.  
Use this tool to start your research.  Ask questions, google, read.  

Find out what procedures are common in your chosen birth location, and which ones are unlikely to happen no matter the situation.  

Create

Now take these two very different ideas of a birth plan, both of which may be several pages long, and begin to reconcile the differences.  Chat with your care provider, your doula, your friend who has had a baby in the location you have chosen, or your mom or sister.  Work with someone who is familiar with local birth policies and make your final birth plan.  Ideally this plan is one page, uses positive language (“I would like…”, “I prefer…” etc, rather than “I don’t want…”, “Don’t do…”) and expresses your desires in a kind, yet firm way.  
There is no need to compromise at this point in your birth process, there will be plenty of time for that if a need arises while IN LABOR.  If you would like to avoid pitocin, don’t say “I would like to avoid pitocin, unless XYZ…” Instead say “I would like to avoid pitocin, I have other labor enhancing methods I would like to try in the event that there is a need”.
Sit with it for a few days, revisit it and make changes as you need. This is not a document you will necessarily be able to finish in a day, or even a week. Take your time. Print a few copies, put them in your birth bag. Now forget about it.

Printable PDF version of this post is here –> CreatingyourBirthPlan

I get to teach! Birth and the First Three Months

Update!  I am no longer teaching for Pregnancy Arts as Deb has retired from CBE and commenced her career as a Certified Nurse Midwife!  It’s very exciting for her, and our area is very lucky to have her in that roll.  Therefore, I will continue teaching at Ypsi-Arbor Childbirth Education, Ariana and my joint venture.  Check us out!

It’s happening!

I get to teach childbirth education! This has been a dream for awhile, and while I have taught a few private classes here and there, I haven’t found a class model that I really wanted to teach in a group setting. Well, that’s not quite true, but the style of class I wanted to teach was already being taught, and by a Man_150x390fabulous, inspirational teacher.
Deb Rhizal, of Pregnancy Arts and Mara’s World, a doula, mother, and wellness coach, has the most fantastic, evidence-based, and feel good class I have attended. So much of her class has gone directly to my clients, as I try to emulate the feelings I left her class with, and share them with new families as they ask me questions about what to expect, and how to manage labor, birth, and the postpartum time.
Recently, Deb has been super busy with all sorts of new life adventures and letting go of the 6 week course was a necessary change to her schedule. I jumped on the opportunity! I believe this class, Birth and the First Three Months is important to have in our local Childbirth Education resource list. I think that it is essential to have available to help families really prepare, to be empowered to make the right choices for them and their birth.  So, I asked if there was a way I could be entrusted with her curriculum, and continue to share it with the community.  And she said YES! 40-weeks-pregnant-term-internal-large
The reason this class is so great is that it does an amazing job of speaking to all people.  We all come to pregnancy and birth from a different place, with different stories, and different belief structures.  This class can speak to everyone, from those planning a home birth, to those who feel most comfortable in the care of an OB.  It covers labor and birth, but also the postpartum time, as families really do the hard work of adjusting to the major changes that come when you add another (tiny) person into the fold.  This class is truly about encouraging women to do their research, both by reading, and asking questions, but also by looking inside and seeing what feels best.
babyandsacinfoSo, here we are, just a month away from the start of class, and I am so excited!  I am working on perfecting my presentations, and getting some feedback as I go along.  It is going to happen, and I am so honored to get to work for Pregnancy Arts in this way.  Check out all the great information Deb has on her website about the class, and please let your friends know that there is a really great class starting up again this fall!   Registration is on the Pregnancy Arts website.  I will be teaching at Indigo Forest in Ann Arbor.
Deb also teaches this class in a condensed version, as well as a breastfeeding class.  Check those out too!