I got the following email and although it's a quick reply, I thought I would share it with y'all (with Stephanie's permission), since some others might be curious too.
Hello!
I have been a stalker on your blog for a while now, and I am just now getting the courage to write you. My name is Stephanie Fritz. I am currently a senior in the Sociology program at the University of Indianapolis. Over the past two years I have become increasingly fascinated with the reproductive rights of women, and alternate services provided to women during the pregnancy process. I have become increasingly fascinated with the concept of home birth, midwifery, and doula services. I am far from becoming pregnant or even considering having a child, but I have begun considering doula training. I have looked into the different programs for Doula training out there (particularly DONA), but I wanted your opinion on where I should start to find out if this field is truly for me?
I guess my main concern is the viability of it as a career. How are you faring? Also, how did you fall into this?
Thank you!
Stephanie Fritz
Why did I bold that one sentence? I wanted to respond to this part first and foremost. The biggest piece of advice I have for Stephanie, far more important than sorting through the various programs and certifications and reading materials, is to ABSOLUTELY go for it now! The fact that you haven't given birth, in my opinion (I'm curious to hear others' opinions too), is really not much of a disadvantage at all. Doulas attend all kinds of women having all kinds of births, even if they are mostly in the hospital, realistically speaking.
I have had one birth of my own, and even if I only attended all natural home water births, they would still all be different. Mine was 13 hours in active labor. Very different than a 29 hour labor. Very different from a 5 hour labor. Yes, I know what 'a' contraction feels like . . . but that means I only know what MY contractions felt like. I have no idea what a a posterior baby and thus the dreaded "back labor" feels like from the inside. I didn't have to transfer, no resuscitation was necessary, I had an extremely long pushing phase, there are all kinds of things I didn't experience firsthand. You catch my drift: having had ONE birth isn't all that different from having NO births, in a weird sort of way.
But my main point to you, Stephanie, is that having no children at the moment is actually a huge, HUGE advantage, logistically. It might not seem like a big deal to you now, because you've never had to think about it, but trust me, having to arrange for child care in order to attend births can be a massive, stressful undertaking. There are work and class schedules to deal with, and I've so been there and know what a whopping headache that can be, but it's still more workable than a doula with kids (unless she's independently wealthy, I suppose). To illustrate that, I should remind you that I'm actually still IN training for the labor support portion of my doulahood, largely because figuring out how to attend the necessary number of births for my certification is ridiculously complicated due to child care issues.
I could kick my twentysomething self for not having started this process years and years ago, when I first became aware of the concept of a doula. DONA itself was newish, and within a year. three of my closest friends all got pregnant. I had always been fascinated by birth, and now my interest kicked into high gear. I learned along with them, reading the Searsbooks and "Natural Childbirth the Bradley Way" by Susan McCutcheon. I had plenty of dancing left to do, but definitely felt a strong pull towards birth even then, and one of the mamas-to-be was the first to suggest doula work. I considered it, and ultimately decided against it for the time.
I hate to say I regret the decision, since regret is such a waste of energy, and it's true that I did have all kinds of other experiences . . . but it really would have been a good choice. So I say if you're feeling that same kind of pull - go for it! Especially now.
Which organization? I can't say enough nice things about toLabor's workshop. I did DONA's postpartum training and have been working through CAPPA for my childbirth ed, and I think they all have their strengths, but toLabor was truly a transcendent experience. Do consider it! Reading recommendations: there are of course tons of great books out there, my favorites of which are over there on the right, but I'd prioritize the latest edition of "The Birth Partner" as well as "The Doula Book" by Ananda Lowe.
As for making a career out of it? I'll . . . have to get back to you on that. (See above re: logistics and childcare.)
Best training EVER. (Okay, it was my ONLY birth doula training so far, but I can't imagine a training being more awesome than this. This was our group, and I'm second from the right, perched on the birth ball.)
I'm fortunate to have now had the opportunity to "sample" three of the most significant doula & childbirth education organizations out there. My postpartum doula training was with the big guns, DONA International. I've been doing the distance learning program for childbirth education through CAPPA. And it's now been five days since I finished the toLabor (formerly ALACE) Birth Doula Workshop in Chicago.
I genuinely have enjoyed aspects of all three. DONA's postpartum training was thorough, enjoyable and efficient, run by wonderful veteran Susan Martenson. The CAPPA training is a little tricky to get a feel for since I'm doing the work independently, but based on the written materials included as well as the video portion of the distance learning (consisting of footage from an actual workshop), I think this is a very worthwhile program as well; quite challenging, as it should be, but well-structured. And I was lucky enough to convince The Feminist Breeder to be my study buddy as we worked through the manual and videos, Skyping once a week to talk about our progress and bounce stuff off each other. (Yo Gina, have you gotten to those essay questions yet? Ay caramba! Buzz me to vent when you do.)
But this has been the zenith of my experiences so far. First, it was the culmination of a process I began about a year ago, in fact, when I applied and was approved to sponsor this workshop in my own area; in exchange for coordinating, promoting and otherwise acting as local contact people for the training, sponsors are then able to take the workshop for free. I was thrilled and enthused, and set about doing everything I could to make this happen. Alas, after months and months, the deadline drew nigh and in this arid birth climate (more on that in a moment) we only had two - TWO - people signed up (there was a minimum of 12), and toLabor had to make the difficult decision to pull the plug. Fortunately for me, they were generous enough to invite me to attend a workshop in another area. As I have a few friends in the Chicago area and it was a reasonable drive away (well, moreso without a toddler, but such is life), I signed on with the Chicago group.
My arrival at the location of the workshop itself was like walking into an oasis from two years of wandering the desert. It was held at Mother Me, a collective space where doulas, childbirth educators and other birth professionals pool their resources to serve the needs of pregnant women - birth preparation classes, massages, prenatal yoga, and more; it all happens here. What really blew my mind? This isn't even the only place like it in the area. There were even other collectives like it IN THE SAME BUILDING. And this is just one area in Chicago proper. It's all over the place - travel a bit outside the metro area and you can also find places like Birthing Babes (which happens to be TFB's latest gig, but it's just one example).
You must understand where I'm coming from. In my area, there is ONE independent childbirth education teacher - a truly excellent teacher (I sat in on her class and had a ball), but still. One. The only other options are the hospital's own class or the 4 week series taught by a "crisis pregnancy center", where for ten dollars people can take the series and get (I am not making this up) a free car seat. What's truly amazing about that $10 plus a car seat series? They are having trouble filling their classes.
There is a small but dedicated local chapter of ICAN, comprised of fabulous women who I not only consider good friends, but care deeply about birth and do everything they can - but in this climate, where there are only a handful of active doulas and even those doulas are being challenged by some OB offices' policies, their battle is mighty indeed.
The local cesarean rate, you ask? 37.6% as of 2008.Some L&D insiders estimate that it has easily risen beyond that in the last two years. I'm sure that's just a coincidence.
So yeah. To walk into this space was a glimpse of paradise, of the way the world CAN BE. Everything being relative, I am positive that the local birth pros could tell me quite a bit about the challenges they face in their own area, and I don't mean to discount that. But seriously, Chi guys, take just a moment to appreciate the fact that your community exists and thrives to ANY degree, because it could be so much worse.
So back to the training! Where to even begin with how amazing this was?
There was plenty of material that one would consider standard and expected; a thorough breakdown of the stages of labor, a risk/benefit analysis of every standard current intervention, discussion and practice of positions and techniques used to support laboring women, and much conversation of the way to walk in the world as a doula, supporting women's choices with information yet without judgment. All well-organized, all as thorough as can be in an 18 hour training; the time constraints were my only criticism, but it's an unavoidable given in this setting.
There are some features that are unique to toLabor's training, however, features which are controversial, and I'm going to address them and share my own feelings about them.
Since its inception, toLabor has included two unique hands-on experiences in the workshop. The first is the palpation of actual pregnant bellies, provided by volunteer mothers-to-be on the second day of the workshop. We also used fetoscopes (not Dopplers) to listen for fetal heart tones. There were four women who graciously offered themselves, and we divided into four groups, each group getting to work with two of the mothers. It was amazing to really have a chance to take our time really sensing and feeling a baby in utero other than the quick, cautious feel of a friend's kicking action - typically the only experience we ever get outside our own bellies, if we're had them. We took turns locating each woman's fundus, at first gingerly and then with more confidence, then worked at identifying anatomical landmarks - not quite as formally as using strict Leopold's maneuvers, but as accurately as we could, with continuous feedback from the mother (and the occasional commentary from the baby, too) and help from our classmates.
The fetoscope was also a revelation, truly a shame that they are used less and less often. It IS much quieter than the blaring of a Doppler, true, but it is also so much clearer without the associated static (Rixa writes about this here), not to mention risk-free (exactly how much risk is associated with Doppler use is a matter of some debate, which I won't get into here). It looks like this, in case you haven't seen:
And you use it either like this:
Or like this:
Therese, our fantastic and intrepid instructor, explained that this was absolutely, positively NOT about learning to palpate pregnant abdomens in order to do so on our clients. She was crystal-clear about the limitations of our scope of practice all weekend long, on this and other matters. This was an experiential, well, experience, simple as that. She described it as learning to touch, and while I agree with this, I also saw it as an opportunity to get some practice communicating with and just plain being around pregnant women, period, getting more comfortable talking with them about their lives and bodies and babies. To an experienced birth pro, that probably sounds so basic as to defy a need for practice, but I would argue that some of us still have nerves about it, and want to make sure we're both confident and respectful.
The second experience is the one that triggers the most raised eyebrows, and understandably so. If you're a part of this birth pro community, you might have heard about it, and yes, it's true. In this workshop, under extremely careful guidance, we had the opportunity to give and receive a very brief vaginal exam. All volunteer, working as partners with one another - no one had to participate, and indeed, we did have a few women sit out (though I'm not even sure who did, as we were all just focused on what we were doing ourselves).
Let me make this clear as can be: This, like the palpation of the pregnant bellies, is a learning experience ONLY. This was not instruction on how to perform pelvic exams on our clients, EVER, and it could not have been made more clear that doing so was strictly prohibited (unless this is something that is already within one's professional scope of practice; if an RN were participating in the workshop in order to learn how to give better hands-on support - but even then, it couldn't be clearer that a vaginal exam would be done in his or her capacity as an RN, anyway, not as a doula). A pregnant pelvis would feel completely different anyway, as would a cervix that was in the process of dilating - the assessment of which is a different skill altogether.
Those participating paired up, donned sarongs and slipped off their underwear, grabbing gloves, chux pads and tissues. The women receiving first lay in a circle with their heads together, a configuration which preserved modesty completely. We had learned the sterile technique for donning gloves, and once they were in place, we sat with our dominant hand raised in a fist, awaiting a touch of lubricant from Therese. She then guided us through what was ultimately a very short exploration; not rushed, but not terribly lingering either, with lots of feedback from our recipients. We first felt for the cartilaginous tissue of the cervix itself, then upward for the pubic symphysis and on each side for the ischial spines, giving us a tactile understanding of what the pelvic outlet comprises. Finally we felt for the downward slope of the sacral curve, and we were done. (No speculums, by the way, just gloved fingers, straightforward verbal instruction, and respectful caution.) We efficiently switched off and repeated the process in opposite roles.
What was this about, for me? First and foremost, it was about context, about taking the discussion of the baby's journey out of descriptions, diagrams, vinyl models of the pelvis and even 3d animations, and just for a moment giving us live, real, conscious, flesh and blood experiences. It also (unexpectedly for me) demonstrated the subjective nature of what we're discussing. Sometimes I hear birth stories where there is a discrepancy about how dilated a mother is, or how a position was misread, and my initial reaction definitely included a bit of "What? How could they, the PROFESSIONALS, not get that right?" And it's so much clearer now. So increased understanding for the care provider's perspective was an added bonus.
A third and more nebulous purpose of this exercise has to do with our culture's vaginaphobia, as Therese aptly put it. Does participating in this solve the problem, does it instantly cure us? Probably not, but it sure goes a good way towards demystifying the area, which is certainly apropos for those of us who care enough about birth that we were in the room in the first place. Which leads into addressing the controversial-ness of this part of the workshop.
The controversy DID come up, though not at length or with any specificity. We were not given details of debates past or identities of accusing parties, but it is clear that there are those out there who disapprove of this part of the workshop. I'm willing to listen to anyone's thoughts on this, if they take issue. Everyone has a right to their opinion, and I'm certainly willing to concede that there may be a POV that I have not considered.
But if the argument is (as it does seem to have been in the past) that toLabor/ALACE, by including the palpation and the vaginal exams in their workshop, is tacitly approving of doulas performing either one as part of their professional service, I wholeheartedly, emphatically disagree. I would even go so far as to say that suggesting that the inclusion of these exercises might be interpreted as permission to do so professionally is a bit of an insult to the intelligence of the participants. Anyone making this argument is simply not listening to the explanation and detailed description of the exercises, and has certainly never taken part in the workshop, since as I stated previously, it could not have been made more clear that this was never, EVER to be done on clients. Some toLabor participants are interested in becoming midwives in the future (i.e. me), as toLabor definitely appeals to the midwifery-minded (being explicitly based in the midwives model of care) so perhaps there's some legitimate confusion out there.
Is there a chance that some doula out there could go rogue and start doing so anyway? Sure, it's possible. But that is an irresponsible act by an individual, and in no way reflects on the training organization. It's just as likely that a CAPPA doula would turn off a fetal monitor, or a DONA doula would take it upon herself to start removing IVs, or turn down the Pit, or even simply start answering for the family regarding their decisions. ALL of which are terribly irresponsible, ALL of which reflect poorly on us as a community, ALL of which are repudiated by the major organizations. None of which means that the rogue doula's training organization has approved of their individual ethical breaches.
Now, on the flip side, none of that is to say that if you haven't been through these exercises at a toLabor training, you therefore aren't a good enough doula or that an organization's training isn't adequate without them. Not at all. It's not for everyone! It's not even for everyone who attends the toLabor training itself - I mean it when I said there was no sense of judgment at all. But let's please recognize, as a larger community, that there is a place for a variety of experiences, just as there is a place for a variety of doulas, and for some, this is going to appeal greatly to their learning style and if it does (not that it has to), it will only serve to enrich their work and thus their service to women.
There, I feel better.
Suffice it to say, I can't recommend this training highly enough. I would happily do the whole weekend over again, and in fact, I just may get to in the spring, if I'm lucky enough to be selected as a sponsor when I move to my new location in Portland (from a desert to an oasis to the freaking rainforest). In closing, here's a bad camera phone shot of my own workshop, followed by some quality shots from the toLabor site itself.
Yes, right here in Erie! ERIE NEEDS DOULAS. I am both delighted and fortunate to be making this training available to women right here in town. The workshop takes place over the course of three days, from June 4-6.
ToLabor is the professional organization formerly known as ALACE, providing the same woman-centered training and certification which has exceeded national standards, bridging technical knowledge with a compassionate personal touch. So here's the scoop:
Is there a desire in you to:
• Help pregnant women and their families recognize what options there are in pregnancy, labor and birth? • Provide evidence based information for the healthiest maternity care? • Provide practical suggestions to help pregnant women relax during labor including physical and emotional support? • Help a woman find her voice in order to advocate for herself and baby? • Encourage an environment of calm within her team of care providers? • Offer follow-up support in the postpartum period?
A toLabor Professional Birth Doula provides support for the pregnant woman and her partner, continuous care throughout the labor and birth to help them fully experience their birth.
The workshop includes: an introduction to physical assessments, adding an aspect of experiential learning unavailable in other training programs; these experiential exercises serve to enrich and empower all those who attend our workshops.
Tuition includes: the entire training and certification process, the training workshop, processing your work, the exam, the certificate itself, and activates membership. Before discounts, the total cost is $425. Payment plans are available. Enroll for the workshop 30 days in advance & receive a discount of $30. Past graduates of our training who are current members, may attend a workshop again for only $200. Previous doula training discounts are also available.
Erie PA Birth Doula training June 4 - 6, 2010 Contact Anne 860-922-6439 annetegtmeier[at]yahoo.com or www.tolabor.org 804-320-0607 tolabor[at]gmail.com
So as you may know, I completed my three-day postpartum doula training through DONA a few weekends ago. This is just one step of the certification process, but it's the biggest one, and I enjoyed it thoroughly. I was worried about being away from my daughter for so long - over 12 hours every day, including the commute, but she was a total champ, and I think it was good for her and Daddy to spend so much time together. I was also pleased to see that I can still pump a good amount of milk, at 18 months, which I did in a corner of the conference room every 3 hours or so.
We learned an incredible amount in such a short span of time - it would be ludicrous to try and reproduce or even summarize it here. The underlying refrain we kept coming back to, no matter what the topic was (infant bathing, nursing, integrating older siblings, addressing postpartum depression, light housekeeping) is the phrase "maximizing self-sufficiency". Sounds a little bit corporate speak, right? A little approved-by-committee? Yep, I get that - but it's also pretty spot-on, and really helps to distinguish a huge part of how postpartum doulas are different from, say, housecleaning services or babysitters or even "mother's helpers". There IS some overlap, some grey area, with those services, and we will often be doing a bit of all those things.
Part of the difference does have to do with additional training in breastfeeding, recognizing postpartum depression, and overall postnatal recovery. Part of it is the multifunctional nature of it, since we do a little bit of everything, including some grunt work (especially at first), but there's more to it than that. It's much more about helping the family to slowly become more and more capable of doing all these things on their own, focusing on how best to support the new, confident mother. At first, the job may involve doing the laundry pretty regularly. But then, what happens when the term of employment is over, and mom never figured out how to work it into her routine, and doesn't know what settings and products are best for the cloth diapers and baby clothes, and hasn't worked out a trade-off with her partner on laundry duty? When the doula departs for good, and hasn't addressed that, she's just leaving a void where her services used to be. She just made the family dependent on her for doing their laundry, and now what?
So it's the classic adage, made maternal: if you give a mom a fish, she eats for a day. But if you teach her how to fish for herself, she eats for a lifetime. And at first, just getting her to eat for a day may be the most important thing - but the long-term needs to be kept in mind. This was a really important revelation for me.
It was also interesting/amusing/embarrassing to see just how many things I had done DEAD WRONG with my first very unofficial client that I had taken on the week right before the workshop. (I had put the word out that I was going to be seeking practice clients soon, and this mom needed help, so, I figured, why not? She knew I was pre-training, and was happy to pay the extremely reduced rate, and just needed the extra hand.) For one thing, we are never, ever to install car seats for clients, for what in hindsight are obvious liability issues. D'oh! But in the moment, that's what she needed done, so I just went ahead and did it. For another, we are never ever ever ever to drive the children anywhere. No way, no how, for even more obvious reasons. That one I could really smack myself for, but in the moment, again, she asked if I would just drive the loaded-in kiddos (four total, including the new wee bairn) around the block a few times while she got dressed before departure for an outing, and I just said, "Okay, sure!' GAH, when I think of what could have happened . . . but now I know better. There were a few other instances too, more benign than those examples but still a little off from the postpartum standard of practice. Ah well - I feel all the more professional now.
Now for the other adage - one that is considerably harder. I'm working with my first 'real' client now (still part of the certification process, but post-training), and wouldn't you know I get a HUGE challenge right out of the gate. This mom is working on breastfeeding after a reduction, and is having some serious challenges. I am having a really tough time with the limitations of our scope of practice as doulas. We do have training in the basics of breastfeeding, but anything even slightly out of the ordinary and we are to refer, refer, refer. Well, she's already seen a lactation consultant, but frankly, either this LC is terrible or mom is not quite following the directives. Whichever one it is, I am really struggling against what I suspect is some bad information, and what I know are some counterproductive practices. So I'm already frustrated with how my hands are tied as a doula when it comes to breastfeeding. So much so that I'm thinking more and more about becoming a lactation counselor (and maybe eventually an IBCLC), but that's too far in the future to help me now.
I want to encourage this mama more than anything, but I CANNOT push her. I'm not sure I should get into the specifics here due to client confidentiality issues, but suffice it to say, I am doing my best to offer as much good information as possible, and making it as easy as possible to organize their lives around the practices that will support nursing - and her supply - as much as possible. One of the hardest things is having had the extreme difficulty of my own nursing experience and NOT sharing the information that I learned from that experience with her. DONA really drilled this into our heads, too -it isn't about us.
I understand the values and the rationale behind that, and with why keeping that in mind is important, but honestly, it's just not possible to remain 100% pure about that. If we learned a trick that was really useful in diaper changing, of course we're going to teach that to our clients, so why would I not be able to offer coaching in using a Lact-Aid, for example? So yes, I've broken the rule a bit already, despite my efforts to keep personal experience minimized and focus on information from expert sources (I bring printouts of articles and other handouts to pretty much every visit).
After our third visit, I got in touch with my own brilliant guru of a lactation consultant, to bounce some things off her. She had some great specific advice, but more importantly, she recommended making the mother state aloud exactly what her goals are - because, honestly, I never actually asked her what they were, specifically. It wasn't on the DONA questionnaire that I gave her. Perhaps no one had asked her this. A rookie mistake, maybe, but when she said this, I realized that I had been approaching this as what *I* would do, according to what MY goals would be, instead of having her articulate it to me, and for herself. Big difference.
And then, she said, the path is to ask yourself each step along the way: "Are the steps I'm taking now steps that will get me closer to my goal, or further away from it?" I remember having to ask myself that every day - every feeding, even. So I asked her to state what her OWN goals were (it was in the context of reviewing a questionnaire, so it fit perfectly & didn't feel confrontational). She right away distinguished what she perceived as "Ideal" vs. "Realistic", which I thought was revealing, and we took it from there.
The BFAR book is titled "Defining Your Own Success", and it's a double-edged sword, of a concept, in my opinion. Some women post-reduction may REALLY try everything and still not be able to produce 100% for their babies. So for them, it's important to be okay with redefining success for themselves, and not feeling like a failure because they are not able to exclusively breastfeed. I absolutely get that. But the flip side of that is that some other women are going to set such low expectations and even hopes for themselves from the beginning, that, as we can see, completely undermines and possibly even sabotages their efforts and intentions from the beginning.
So if my LC's process is to be followed, as long as every day, the mother consciously takes the steps she knows she needs to take in order to move toward her goal, THAT is success. That's defining your own success with integrity. There's nothing to feel guilty about if you've taken the steps towards your own goal, whatever that might be, and it doesn't work out perfectly for reasons you cannot control. If you know the steps you need to take for your own goal, whatever that is, and are not willing to take them, well, then, that's a little different. So I want to make sure that she is as well-informed as possible, and that she herself is clear on her goals, and that she herself is clear on the steps that are to be taken, in her own mind.
So my revised plan with my client (who I really like and respect, incidentally) is to try to keep reminding her of her own goals and the steps that we identified together as the ones that are most supportive of her ideal, and continue trying to integrate those steps into her daily life. And the biggest personal challenge for me is to not take it personally when she makes different choices - and remember that (here's that second adage) I can lead her to water, but I cannot make her drink. I can help her find the best water there is, I can put it into beautiful glasses with ice cubes and fresh lemon wedges, I can create a comfortable place for her to sit and have the water . . . but I cannot force her to drink it.
I thought this day would never arrive - but here it is, only a day away! My three day DONA training workshop, part of my certification as a postpartum doula, starts TOMORROW!
I'm so stoked . . . and also a little worried, as I'll be away from Lily for over TWELVE HOURS each day. The most I've ever left her for was 6 hours, just this week (while working with my first client - I know, a little backasswards, but I gotta be me). She did okay, but 12 is a looooooong time. I'll be leaving before she wakes, which could be tough on her, and then there's naptime, which is always started with nursing. But I know her daddy will dote on her and keep her fed and hydrated. I was also reassured today, while at the aforementioned client's house (more on that later), to find that I can still pump 4 ounces of milk in about 5 minutes. *snap* So at least my supply isn't threatened.
Anyway, I'll see you next week. In the meantime, in case you haven't seen it, Navelgazing Midwife's latest post is a masterful parody of the CODE MECarticle recently put out by Medscape.
I almost titled this "Brianstorming". Sorry "Brian", whoever you might be.
Okay, I seriously need to come up with a name for my practice so I can at least get started with some flyers and business cards, perhaps set up a separate website where services and fees are explained, etc. Sooo, after some initial brainstorming, I have a few finalists.
AfterBirth (again, either great or horrifying, right?)
I'm kind of leaning towards Mamarama because it's catchy and open-ended - I could keep the same name once I add labor support into the mix in a year or two. Or . . . I could just go with Dou-la-la? And for either one of those two, maybe have a more descriptive "tagline" after the name in printed materials, like "Postpartum Pampering & Pantry Provider"? (I'm a sucker for alliteration.)
I dunno. Maybe I should just be straightforward: Anne Tegtmeier, Postpartum Doula, LLC? But, pretty darned blah.
What poem is more overused and abused than this one? It's misquoted right from the get-go, being commonly referred to not by its proper name, "The Road Not Taken", but by the partially-excerpted line used in the title above. More to the point, its very meaning has been twisted into an inspirational cliche for cheering pioneering action on, which is all well and good - it's just not what was intended by the poem at all. Before the final lines, Frost says plainly that "As for that the passing there had worn them really about the same," and then states that he will be saying that he took the road less traveled, and that that has made all the difference . . . but it's obviously not really true. Both experiences would have been equally valuable.
What in the world am I getting at? Eventually I want to comment about a few things that were recently all abuzz in the birthblogosphere, but first a little on what's been on my mind re: my own life and the whole raison d'etre of this blog.
As I mentioned, I just returned from the promised land. For me, this is Portland, Oregon. It's hard to think of a more ideally suited place for people like me to raise a family. In addition to amazing choices in education, tons of family-friendly activities and resources like OMSI, a thriving arts and music scene, fantabulous restaurants, a very green mindset, including tons of farmer's markets and an urban chickens movement, and its proximity to both mountains and ocean with rivers and abundant waterfalls in between; it's also a place where midwifery thrives and doulas are everywhere.
I got to visit Birthingway while I was there, a MEAC accredited midwifery college. I have no idea how my life gets from here to there, but this is the place I want to eventually enroll for midwifery. It's just an incredible program. I love that it's accredited, I love that you can transfer in a year of general education and come out with a Bachelor of Science in Midwifery. I love that the program revolves around a core day that remains the same day throughout your schooling (which will be so helpful when juggling child care and other jobs - I LOATHE scheduling conflicts and all the tension that results from them); this is in addition to other supplemental classes during the week. I love that on your core day, the entire class cooks and eats lunch together - this and some other attributes of the atmosphere reminds me a lot of my education at Connecticut Center for Massage Therapy (only much longer and much more rigorous, of course). I love that so many midwives in the area go to Birthingway to get their apprentices.
I've looked at some other programs, and liked some of them, but this is my first choice. The Midwives College of Utah also looks really good, but from what I understand, isn't eligible for federal aid, and thus is pretty much out the window for me. Plus, much as I love Utah, there's the greatness of Portland weighing heavily in the 'pro' column. Some have recommended doing a distance learning program, like Frontier, and while I don't doubt that many, many people can thrive on a distance program, and are great self-directed learners, I know myself pretty well by this point in my life, and I know that this just isn't for me. I honestly thrive on a classroom environment. I need to have the lecture in person, and to be able to ask questions as we go; I love the supplementation provided by class discussion; and I especially need to have the positive pressure and directness of assignments and projects. Call me a big ol' nerd, you wouldn't be the first, but there you have it.
So where does this leave me now? I won't be able to commit to this kind of a program for several years. Lily is only about 17 months old now, and still nursing at that. We're nowhere near ready to commit to this kind of intense program, much less the rigors of midwifery itself. This is where doula work comes in. It's actually great experience for future midwives - the more births (of all kinds) you see, the better! And with my massage therapy background, I think I'd be appealing to a lot of mamas - it's a nice confluence of skills there. Moost importantly, I really believe in doula work - you can hardly turn around on the internet without bumping into an article about the benefits of employing a doula. It certainly gives you the best odds of getting a natural or low-intervention birth in a hospital setting, and, let's face it, even though home birth and birth centers are becoming more common and available, the majority of American babies are still going to be born in hospitals for the foreseeable future. So, good way to make an impact, while preparing for the future.
There are quite a few reputable organizations for doula training now. The big behemoth of them all is DONA, of course. CAPPA, Birth Arts International, Childbirth International and ALACE have all gotten good reviews from various attendees. I am most drawn to ALACE (recently changed to "Tolabor", kind of oddly if you ask me), because it is specifically based on the Midwifery Model of Care, which behooves me for the future - though they are clear that they know most of their clients will be giving birth in the hospital, and prepare their trainees accordingly. Their training even includes the option of giving and receiving a pelvic exam - NOT to be performed as a doula, but as an educational experience. How incredibly cool is that? I love this and am totally down for participating.
Unfortunately, one disadvantage of theirs is the relative infrequency of their trainings, in far fewer locations than the large organizations like DONA and CAPPA. On the plus side, in seeming compensation for this, there is the possibility of becoming a sponsor for a training in your area, in which case you not only bring the training near you, but get to do it for free. I'd sound a little more excited about this, but I filled out the application for sponsorship several months ago and have yet to hear anything back. It's iffy whether my current locale is a desirable place for them, which I understand, but I still hope that I can do the birth doula training through them
But wait, you say. Being on call for births as a doula isn't so different from being on call for births as a midwife, and you just said you and Lily weren't even remotely in a position to start doing that. What gives? Well, here's where I'm going to start: I'm actually going to work as a postpartum doula first. This is something much more flexible in terms of hours and somewhat more predictable in terms of planning. Yes, it will still all depend on when the baby decides to arrive, but postpartum doulas get a bit more advance notice.
I think this will be valuable experience, seemingly backing into the whole birth spectrum from the last page of the perinatal process. I saw firsthand just how valuable postpartum care can be, not just from my midwives, but from the first in-home lactation consultant who visited me twice and checked in multiple times by phone. This was not the genius IBCLC that I later saw, and who truly got us breastfeeding after a very long struggle, but she was helpful in her own way, advised on other postpartum issues, and even helped change the sheets. More than anything, the kindness and the human contact itself (mother to mother, too) made a big difference. She was filling a bit of the role that a postpartum doula does.
Another part of the appeal as a postpartum doula is the very fact that it's largely quite humble work. Yes, breastfeeding counseling is important, and teaching women to swaddle their newborns and care for their stitches, and offering herbal support, but it's also a lot of doing dishes, scrubbing the bathtub, throwing some laundry in the wash and folding what's in the dryer, preparing food, and so on. And to me, this feels like a good place to start. It feels like paying my dues, in a way. When you consider that I'm going to be asking women to share their deepest miracle with me someday, and eventually to entrust me with acting as the safeguard for that miracle, paying dues upfront seems like exactly the right thing.
Lo and behold, through a midwife I met at last month's ICAN meeting, there is a DONA postpartum training going on just about an hour and a half from here, coming up in early October. It's even being taught by a past president of theirs, so it's sure to be a great experience. I still hope to do labor support training with ALACE, but there's no real urgency - it could even wait another year or two. I like the idea of doing the birth portion with a different organization regardless. Meanwhile, starting out, I think it will be advantageous to be connected to the larger organization, just from a logistical standpoint.
So at last, I can finally take the first concrete step on this slightly backasswards road less traveled, as I shall someday tell with a sigh, ages and ages hence - whether it's really less traveled or not. Either way, it's my road, and I'm stoked to be getting on with it.
