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…

Our Doula Toolbox

Michigan Doula and Baby
Couldn’t pick a pattern, so Ari decided on tie dye and snake-skin for visiting with this little one.
It was recently World Doula Week, and the two of us took the opportunity to do some extra reflecting on our work as Doulas and the support we provide. One prompt for a World Doula Week photo challenge was “tool you use the most.” If you know me, you know I’ve never been able to pick just one thing, whether it be ice cream flavors, favorite colors, or patterns in an outfit. So instead of posting about a tool we use the most, we thought we would (playfully) share a handful of tools that we keep in our Doula toolbox. Our Doula Toolbox is part mythical creature, part mushy feelings, but 100% true (anecdotally). It contains the following:

  1. Hands: they are great because we carry them with us wherever we go, and we use them at every birth we attend! They are also one of the more concrete tools on this list. Whether we are using them for hip-squeezing, hand-holding, bath-drawing, or cold-washcloth-prepping they are never without a job at a birth. Even when we are being “hands-off”, and maybe our hands are knitting, they have an impact on the tone of the space.
  2. Hearts: our hearts are in this work. I still cry at every birth. It’s a powerful transition to hold space for.
  3. Ears: What do you want this birth experience to be for you, for your partner, for your little ones, for your family? Listening to our clients is one of the most profound things we can do. We are there to support our clients in their birth wishes, whatever that might look like, and the only way to know is to listen.
    rebozo
    Rebozos!
  4. Minds: we like to think that we are two pretty smart cookies; thinking fast on our feet, putting thought into the resources we cultivate. Between the two of us we have a lot of experience and know-how to offer.
  5. Water: For your insides and your outside. It can provide amazing pain relief in the form of the tub or the shower. It is also important to stay hydrated throughout labor (and pregnancy) because a dehydrated uterus does wonky things.
  6. BONUS: Rebozo! Probably the most recent addition to our respective toolboxes, but already a much-loved one. This marvelous piece of fabric helps us to work smart as well as hard. It’s not only functional, but also beautiful and has a fascinating history.

What tools did you find most useful during labor(s) and birth(s)?

Mother Interview: Really Drawn Out Change of Plans

We’re going to start doing small interviews with our past clients, not necessarily about birth, but about some of the little things surrounding birth.  What was hard, what was the best advice you received, etc…  We hope that in sharing these candid little parts of pregnancy and new motherhood, we can normalize this experience for everyone.  We so often only see the most beautiful parts, or the hardest struggles, of  this major life change.  There is so much more!  All titles for the interviews are chosen by the mothers themselves.
This is MY interview!  Nothing profound, just a casual chat.  If you would like to be interviewed, please let us know, we would LOVE to hear from you.  We hope to have a new interview every month or so. Love, Katy

Katy and Ross get to know baby ZOG
Love at First Sight

Name (Age): KG (31)
City: Ypsilanti
Birth Location(s): Home Birth Transfer to University of Michigan Hospital

SRS: When did you decide to hire a doula? Was it always in your plan, or was there a moment when you decided?
KG: I actually didn’t call on a doula for support until about 36 weeks. I had people who were attending who would be great doulas, so it wasn’t until about 36 weeks that I realized I needed one of them to “take the lead” in managing all the little things that doulas do.
SRS: Who did you have on your birth team?laboring, support, labor
KG: My partner, Ross, my midwife, Beth, my mom (who has worked as a Birth Assistant), and Grace, my best friend (also a trained Doula).
SRS: What do you wish no one would have said to you while you were pregnant?
KG: Are you sure there aren’t twins in there? And all the horror birth stories. All I could think was: Why didn’t you have a doula!
SRS: What 2 things do you wish you would have been told before you were pregnant?
KG: Oh geez… 1. This is probably TMI, but, vaginal discharge! I know a woman’s body goes through all sorts of changes, but man. It wasn’t gross or anything, just like glue! Ugh. 2. I didn’t realize that pregnancy would affect my appetite so much. I didn’t have any interest in food for most of my pregnancy. I didn’t have terrible “morning sickness” but did have mild nausea the entire pregnancy.
SRS: What kept you up at night during your pregnancy?
KG: Insomnia. Which I learned was normal during my late night researching because I couldn’t sleep.
SRS: What were you not able to do while pregnant that you couldn’t wait to do again?
KG: Drink a nice strong beer!
SRS: What is the most indispensable thing that you have needed as a new mom?
KG: Baby carriers. The Moby wrap early on, and my woven wrap into toddler-hood. These are indispensable when trying to get around or get anything done with an infant. At 2 years old, Z also still loves to fall asleep being all wrapped up.
SRS: What was the hardest part about your postpartum time?
KG: Depression.  This was also great, because while depression is hard, I had never been told I was depressed.  Postpartum exacerbated my symptoms, but also helped me see I have been suffering years.
SRS: What was the biggest surprise with the immediate postpartum time?
KG: How much I actually knew about what was best for my baby. Trusting my instincts hasn’t steered me wrong yet.

So you married a doula (pt. 1)…

One of my favorite parts about being a doula is the opportunity to get to know the couples that we work with.  It’s empowering to see how they work together as a team, and it’s incredible being able to support them as the shape of their family changes. So we thought we would give folks a chance to meet our families. This week yours truly (YT) sat down with my lovely husband (LH), to ask him about his experience as the partner of a doula.
ypsilanti doula's husbandYT: All right. What is your name?
LH: My name is David Arnold.
YT: Where were you born?
LH: I was born in Park Ridge, Illinois.
YT: And, what do you do?
LH: I manage an analytical chemistry lab. I’m an analytical chemist.
YT: On a scale of 1-10 how much do you love your wife?
LH: 10! *laughing* Is that really a question?
YT: Yeah
LH: Of course it’s a 10 dear.
YT: What is a doula?
LH: A doula is a person who helps to plan a birth and provides information to mothers who are about to give birth, throughout the pregnancy, and is a support for mothers. They kind of do a lot…during the birth they are there to do whatever needs to be done; to provide comfort and coach and make sure the birth plan goes through as closely as it can anyway to how it is on paper . It’s a supporting role.

doula baby number 1
The easiest part about living with a doula is getting to hold adorable babies.
YT: What was your first thought when your partner said they wanted to become a doula?
LH: I was pretty surprised about it because before my partner wanted to become a doula she never was obviously into kids or babies or anything.
YT: What changed?
LH: She was obviously really into it.
YT: How can you tell?
LH: She has a positive attitude about it and seems to want to do all the doula stuff. She’s not like “Ugh! Dang it, I’ve got to go to work today and do this thing.” Even if it is a birth at some really inconvenient hour, which they pretty much all are, or will be, because you can’t plan for it that well, she’s still like “Alright, it’s time to do this.” And then she always talks about how great it was.
YT: What quality in your partner makes them most suited for this work?
LH: She always has wanted to help others. Even before the doula thing. Her work and all of her volunteering. She’s a much better person than I am in that respect. Plus she apparently loves little kids and babies. So the two go hand in hand.
YT: But as a doula she doesn’t really interact with babies very much.
LH: She does. It’s more about the mothers; obviously that is what they are there for.  Even though you are not super directly involved with babies a lot, you are helping that process come along. If you really like babies it makes a lot more sense you’d be into the helping of the mother to get there.
YT: What is the hardest part of living with a doula?
LH: In terms of the day-to-day life of the house, living? There is really no consequence.
YT: What about not day-to-day?
LH: If you were to rephrase the question, “what is the hardest part about being married to a doula, or having a partner that’s a doula?” Having this huge chunk of time for every client where you can’t really plan anything or do anything.  And then when the birth actually comes…you can never schedule when the baby is going to come on a day-to-day basis. It completely throws off her schedule, and my schedule. It’s hard to plan anything, basically. That’s by far the hardest part. It’s probably going to get worse as more clients come in, but we will see how it goes, you know?
backpacking ypsilanti doula
Some times we do manage to get away 🙂
YT: Yeah, the idea is to have the month off now and then…what’s the coolest thing you’ve learned living with a doula?
LH: Relating to the work?
YT: I guess.
LH: I learned a lot of really cool piano when I lived with you.
YT: Probably related to the work then. Although, I’m glad you’ve learned a lot of cool piano.
LH: That’s actually a tough question. I’ve learned a lot of interesting facts about birth and stuff. I pretty much knew absolutely nothing about it before. So that’s cool as a whole. Little snippets and facts accumulating over time.
YT: What do you worry about most having a partner whose a doula?
LH: Are we going to be able to schedule anything? We’ll see though. We’re going to try.
YT: There was one weekend there were two births in a weekend.
LH: Yeah that was really shitty. I was worried about you the whole time.
YT: Worried about me?
LH: Because it was a lot of work, and you weren’t sleeping. And you were gone the entire weekend. I know you weren’t having a great time the whole time.
YT: What other life event needs a doula?ann arbor doula and husband
LH: (Immediately) Planning a wedding. Yeah. It’s a big scary process and you don’t really know what to do. It would be useful to have someone that’s got a lot of experience. We didn’t do that, but…well you talk to other people who have gotten married, and they give you information about how this thing went for them. I can’t really think of anything else. Having a kid is a huge deal; getting married is a close number two. I don’t know…maybe trying to start your career off when you get out of school. A career counselor sort of thing I guess. All these things already exist. They aren’t called doulas obviously, but they exist for a reason. Because it’s hard and scary and you need to rely on other people’s experience.
YT: What would you tell an expectant couple?
LH: About what?
YT: I don’t know, what would be your pro tip?
LH: I’m not a reliable person to give out advice. I haven’t gone through the experience. I would say, plan stuff. Have a plan for how you’re going to take care of your baby and how you’re going to parent. Take it seriously because it is pretty serious. And uh, make sure to have sex. I hope we aren’t live on NPR or anything right now. There is supposed to be a 7 second delay for these things. Sorry, dear *chuckling*