What Doulas Do

My doula, Zoe Krylova, took these gorgeous photos at my mother blessing.

My doula, Zoe Krylova, took these gorgeous photos at my mother blessing.

We remind folks through pregnancy, birthing and parenting that what they are experiencing is normal, when it is. We accompany them and hold their hands if their experience veers from normal. We are not care providers, but we do offer deep, thoughtful presence and we certainly are individuals who care.

Holly Powell Kennedy, Varney Professor of Midwifery at Yale University writes that doula-attended birth, rather than serving as a throwback to some romantic image of the past: "represents an evolution to an educated, supportive companion who knows how to support the childbearing process..." Whether trained through a certifying body or self-taught, doulas are educated.

My doula training in 2010 changed my life. At the time I was on a leave-of-absence from a Chinese Medicine masters degree program which had me feeling drained and at my physical limit. My mentor was an acupuncturist and also a doula who was pregnant with her second child: “you should enroll in the Natural Resources doula training and attend my home birth,” she invited. I did. There were a dozen students in my class, led by a home birth midwife named Abigail Reagan who is a powerhouse. I went in thinking that I would be the only non-mother but the class was evenly split between folks who had given birth and those of us who had not. We met weekly and got to know one another on a deep level. We studied birth physiology, learned about the protocols and practices of local care providers, watched birth videos and challenged our assumptions meeting after meeting. One weekend we gathered with an additional teacher for an intensive workshop in guided meditation, massage and other comfort measures. My ten week training wrapped up the month before both the first birth I was honored to attend and my wedding (the next day)!

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The summer after my training I began attending births as a low/no-fee doula. The midwife who orchestrated our training maintained and operated a list of newly trained doulas who had completed her course, written papers on six of her assigned books and worked with three families for low or no fee and received reviews from said families. She helped me find my first several clients, but I had other incredible support as well. Doulas are masters of lifting one another up and I benefited enormously from this lineage. Doulas also pay it forward.

My aunt helped found a non-profit in the Bay Area called Helping After Neonatal Death. The families I served who had lost babies at term or shortly after birth and who went on to welcome subsequent children were extraordinary teachers and some of my most cherished clients. With those families I acknowledged deeply the thinness of the veil, how tied up birth and death are, and through their loving inclusion of me in their experiences welcoming new babies I felt moved to attend the first several Spirit Babies ceremonies in the Bay Area. Spirit Babies recognized the beauty and loss inherent to miscarriage, stillbirth and abortion - honoring every experience in its holiness. I brought that ceremony with me to Charlottesville twice alongside other birthworkers. Doulas laugh and cry along with you.

A seasoned doula and wonderful yoga teacher named Britt Fohrmann took me under her wing and I was her back-up doula for several families, which afforded me the opportunity to attend prenatal appointments with her and see how she worked. I had a similar chance to learn from someone extraordinary when I began to work with Cindy Whitman-Bradley. Cindy eventually invited me to join her and Audrey Muto in a doula collective called (Re)Birthing, through which I established my enormous love and appreciation for collaboration, sharing stories and skills, processing and clarifying my art in this field. Over the years in San Francisco (after Audrey left to attend Yale Midwifery school) we in (Re)Birthing Collective were lucky to work with Elizabeth White, Cheri Solin and Melissa Berg, who was my very own acupuncturist/mentor/the first woman I saw powerfully bring a baby into the world - he will be 8 in a few months! Doulas love to learn from one another, from clients, and doulas love staying in touch with their doula-babies over the years.

The Bay Area Doula Project training I completed in 2011 was another milestone. Through that program I was certified to support folks through miscarriage and abortion and I am marvelously grateful for the connections that persist among that first BADP cohort. Many have gone on to advocacy work, to midwifery, to parenthood, and we all honor that we are experts in supporting any pregnancy through any choices and any outcomes. Doulas stay by your side no matter what.

My postpartum doula Dianne Bearinger and birth doula Zoe Krylova

My postpartum doula Dianne Bearinger and birth doula Zoe Krylova

I moved to Charlottesville at the end of 2012 and since then have more than doubled the number of births I’ve attended. Sadly the proportion of home births has not been the same (in the Bay Area about one third of my clients had their babies outside of the hospital system) but I am moved by the variety of options birthing folks have even in this small community. There are two hospitals, two birth centers, and home birth options among providers. In Virginia I've attended two workshops related to trauma and birth, and a  course on the essentials of prenatal massage. 

During my first few years here, Charlottesville Doulas gathered on a monthly basis to compare notes, support one another in matters of business, to read and present on topics of interest to us and to share birth stories. That group is less regular these days, but I now co-coordinate EMERGE Doula Circle, which holds monthly peer review sessions as well as continued education presentations. Doulas are passionate about staying up-to-date with research and literature as well as social activism. Doulas network, organize and share knowledge to support one another and birthing people.

In their book Birth Ambassadors: Doulas and the Re-Emergence of Woman-Supported Birth in America, Christine Morton and Elayne Clift explore the history of childbirth and the social factors that have led to doula work as a profession.  They quote Judith Walzer Leavitt who said, "Ever since birth moved out of women's homes and into the hospital, birthing women, individually and collectively, have been trying to recapture some of what they lost, at the same time maintaining what they have won." Doulas know this balance well. 

For three years I was an editor with the all-volunteer staff of SQUAT Birth Journal. We held two conferences and had a large readership of birthworkers and families all over the country. The radical inclusivity that drove SQUAT is in my blood. I am thrilled in our community to have the Department of Health Improving Pregnancy Workgroup (which I attended regularly before my daughter was born) and Sisters Keeper, which is a branch of Mother Health International working to address the disgusting disparities in maternal and birth outcomes for People of Color in this region. Doulas care deeply about the future of humanity.

Giving birth changed my practice as a doula as well. I have long talked about the broad spectrum of experience around birth and how each birth drops a brand new pin in the array, but I somehow did not expect that after attending around 60 births my own daughter could completely surprise me...but of course she did. Her birth story is for another day, but I am enormously grateful for the experience of my own sheer power - as my own advocate, as a recipient of midwifery care, as a ferocious beast, as my most tender, beautiful self. To this day, 20 months after I gave birth, my attendance at other births is nuanced by the fact that I still breastfeed around the clock. I have taken breaks from supporting families to pump breast-milk. I have had to let go of seeing someone actually push out their baby because I absolutely had to call in my back-up. I am properly humbled and that is important. Doulas are realistic.

What do doulas do? We hold space. We validate and normalize. We recognize your power. We honor and share in the sacredness of your experience. By our presence we remind care providers that this is your birthing, your family, your life. We do a certain amount of physical support via position changes, basic massage and sometimes acupressure, but I see much more of my work on the energetic, informational and narrative planes.

Celebrating with cookies

As a vocation we all have the privilege of marking major events in the lives of our clients and we have seen one another through major celebrations as well. This week our website (and the business, technically) reached its 5 year anniversary. Tonight was the third year we've had a holiday party all together as a team of 4 doulas and we invited our community to join us for dinner and cookie decorating - it was super adorable. 

Thanks to all of our clients, our families, our children and our community who have made so many beautiful memories with us in 2017. We're moving into the new year with a stronger commitment to one another, to our own and each other's families, and to supporting the birthing (and parenting!) people of Charlottesville. Stay tuned for more greatness in 2018!

Indoors at Ix: Bright Spot(s) #2

The Ix Art Park is basically my favorite place in Charlottesville. The fundraising for the art park coincided with my first year here and I remember looking at the plans and feeling so grateful that a community space like that could arise in this small town. Over the past five years I have only fallen deeper in love with the murals, sculptures, events and businesses that have blossomed there. My kiddo adores the free ranging she can do in the outdoor portion of Ix and our family made it to nearly all of the Free Fall concert series Saturday evenings this year, but this post is really about three excellent indoor spots to enjoy Ix during the cold months ahead.

Brazos Tacos recently celebrated the first anniversary of the changing table in one of their Either/Or bathrooms, deserving of kudos on several fronts. Other than the changing table, there’s a stack of kids’ books for borrowing, and wee toddler-sized table with chairs in primary colors. Their guac and creamy black beans were some of my daughter’s first solid foods and it just so happens - since we used to live within walking distance - that Brazos was the first place I nursed in public. Their kids’ menu is sweet, simple and to the point, but there are also endless delicious possibilities for adults including margaritas. Coming from California, “queso,” was not part of my Mexican food experience before this setting, but I can hardly go there without ordering it now, I love it that much. I’ve come around on Tex Mex. Pro tip: order ahead via their website or by calling the Taco Phone to avoid the lunch rush line!

Sweethaus is a bit controversial as its sugary goodness may not be everyone’s idea of a healthy snack, but they always have gluten-free options and I swear I order carrot cake there just because there’s a vegetable. For many months I got away with going there to play and have a coffee without even purchasing a cupcake, but my wee one is now in love with them and I can hardly blame her. A mini cupcake for around $1 and a decaf Americano for mama is totally worth it for their adorable play area, whether your kiddo is crawling or running around. We don’t have stairs in our apartment and Matilde enjoys practicing climbing up and down to the cute lofted sitting area, where I’ve also attended a lovely gathering of mamas who all peered down on our kiddos happily playing below. Head’s up: a dozen or two mixed mini cupcakes will impress folks at any gathering.

Three Notch’d is a recent addition to the Ix space and the build-out is remarkable. The night we were there for dinner there were several parties including balloons and lots of revelry - while the noise level was above my comfort zone, my kiddo had so much fun playing in their kids’ area where there were crayons, books, toys galore and lots of playmates. The children’s menu hummus platter served us as an appetizer (since Matilde was mainly into playing rather than eating) and they could stand to have smaller spoons if they’re going to serve apple sauce to toddlers, but we would happily go back...if friends invited us!

Thank You, Laura Salvatierra!

Laura Salvatierra, RN, BSN, CCE

Laura Salvatierra, RN, BSN, CCE

I often reflect on and gush to others about how much I love our sweet little town.  C’ville is a great place to become a parent and to raise children.  As a doula, one thing I have learned about Charlottesville is that there are supportive, caring opportunities for prenatal care, labor & delivery, and postpartum support.  There are doctors, midwives, hospitals, and birth centers.  Yoga classes, meetups, facebook groups, childbirth education, and community gatherings.  Wonderful options abound!  However, I believe that for more parents-to-be to feel that they are having wonderful birth experiences, these many providers and services need to be working together and communicating amongst themselves about how to better serve birthing people!  

This is exactly why I am so very thankful for Laura Salvatierra, Team Coordinator of Maternity Education at Sentara Martha Jefferson Hospital.  She gets it!  Recently, she created a Labor Support Collaborative to: “encourage all areas of birth support to come together with the common goal of supporting women who choose to have hospital births in the absolute best ways possible”.  YES, Laura!  That’s exactly what we want too!  

So on Monday evening, we gathered with Laura, local doulas, and MJH hospital staff to connect with each other with the purpose of better serving the birthing folks of C’ville.  My favorite thing about this gathering was the clear intention to work together to make hospital birth better!  Birth workers of all sorts from all corners were welcome, INCLUDING other hospitals.  We reviewed some of the hospital’s new policies, which I found to be super helpful.  Then, Laura and other nurses from L&D answered some questions from the group.  The tone was so supportive and uplifting.  It truly felt like we were all there working toward that common goal of making birth experiences better.  

A huge and heartfelt THANK YOU to Laura!  I deeply appreciate you taking initiative and providing space for these conversations to take place.  It is so exciting to know that we will continue to work together in support of beautiful births!