CPR Certified, Stayin’ Alive!

Yet another notch on my postpartum doula belt! This weekend I attended the American Heart Association Heartsaver CPR course, hosted by the lovely Mary Stelter of Ocean Birth. She was nice enough to host it in her own home, which was comfortable and cozy. I loved that the class was a healthy mix of doulas, and soon-to-be parents. Everyone was warm, and friendly, and for a Saturday evening class quite alive! No pun intended.

We jumped right into the class with Mary asking, “if any of us have performed CPR, or have seen it being performed?”. I thought long and hard, and the only story that stuck in my mind, was a story I heard in a doula workshop. An evening postpartum doula was folding the baby’s laundry while baby slept, she looked over to check on baby’s breathing, and it had stopped. She knew immediately what to do, and how to do it. The baby survived, because she was a) awake and alert on the job, and b) was trained in CPR. I will never forget that story, and despite needing the course for DONA certification, I would have done it regardless!

The class was really focused on hands-on learning, of adult, child, and infant CPR on electric dummies. We learned how to properly administer chest compressions, breaths, and use an AED. As an extra bonus, we also learned about the “heimlich maneuver“, which is now called “abdominal thrusts”. We all laughed about walking up to a choking stranger and asking, “can I perform an abdominal thrust on you?”. Not sure how well that would go…I think I’ll stick to the “heimlich”.

The course was very comprehensive, and I loved Mary’s use of the Bee Gees “Stayin’ Alive“, to help keep a beat while doing chest compressions. Definitely lightened the mood, as we were learning about something so serious! Mary’s best advice, was that when a person requires CPR they are by medical definition dead. They have stopped breathing, and anything you can do to help keep the blood flowing, will help NOT harm them. I guess there is a common misconception that performing CPR will do more harm than good, but in reality you are buying precious moments for the victims life. I believe being trained in CPR is vital, especially for those with children. I encourage you to look into courses, and get certified!

It feels great to check one more thing off my certification list, and every step is one more personal accomplishment. Stay tuned for more in December, when I write about my Breastfeeding workshop. I look forward to eventually adding Certified Lactation Educator or CLE to my education, which will run concurrently with my Postpartum Doula certification. It’s all so exciting!

My LEEP of Faith

This past Wednesday I had my two-week-long awaited LEEP procedure. Going into the procedure I thought I knew all there was to know, in terms of what to expect. Most women shared their experiences on forums, stating that it was not as painful as the colposcopy, and that they resumed work after the procedure. Let me tell you, that was NOT my personal experience. For the sake of being honest, I want to warn you that my story may be slightly graphic at times.

The week before the procedure I was filled with anxiety, and anticipation. I knew I wanted someone to go with me, but my first thought wasn’t to invite my husband. The weekend before the procedure he offered to go with me, and with slight hesitation I agreed to it. In my mind, inviting him was an inconvenience for him, and a discomfort for me. When all was said and done, I wouldn’t have wanted anyone else by my side. We got up early on Wednesday so I could get my Starbucks venti iced coffee (don’t judge!). Traffic was a breeze, aside from a minor construction detour, and we found parking right away. This being my OBGYN’s second office, and not the one I typically go to, it was a million-miles away from the quaintness of his Beverly Hills office. I walked into the waiting room, that was filled with other patients. By my observations, I would assume many of them are on the same government-assisted Fampact that I am on. We waited an hour, and in this “clinic” setting I wasn’t terribly surprised. When I was finally called in, I waited in an ultrasound room, to be taken to where the LEEP procedure would be performed. The room was clean, though I noticed the vintage baby blue exam room bed with stirrups, has seen it’s fair share. I spotted a dead cockroach under the sink, and tried to hide my….disgust. I know it must seem like I’m visiting a back-alley clinic of some sort, but to be honest most clinics are like this very one. I know, because I have been uninsured for several years now. They are underfunded women’s health clinics, that are run down from years of service. Yet their existence is crucial, no matter how they may look, or even smell. This place was the Ritz compared to others I’ve seen!

I was called into the LEEP room, and proceeded with the usual “from the waist down”. The nurse, and doctor both came into the room. The doctor reiterated that “we are going to do the LEEP procedure, because you have no children yet, and having them after this shouldn’t be a problem”. I assume he was referring to what I had told him about wanting a family, and having a procedure that would not affect that. Seeing as there are more drastic options when CIN II/III is involved. The nurse knows my sister as well, and asked questions about my new nephew. If it wasn’t for that light conversation, I might have really started to panic. I was told I would be getting a shot of local anesthetic to my cervix, and I would feel a pinch. It was more like a stinging sensation, and a painful one at that! I felt my heart start to race, and I became light-headed. I calmed myself by looking at the posters around the room. Posters of vaginas, and cervixes, and diagrams of pregnant bellies. Then I heard him turn on the machine, that would then cauterise the abnormal tissue. It was a strange sensation to feel the heat, but not feel the pain. Then, OUCH. He grazed the outside, the part that most certainly did not get anesthetized. Can we say, “curling iron burn”? Ladies, you know what I mean. He apologized, and carried on. Then he asked for the scissors. GULP, scissors? He proceeded to cut off the remaining tissue, and put it into a specimen cup. I must have looked curious, because he told the nurse she could show me. In my mind it looked like my whole cervix had been just removed, and put into a cup. In actuality, it was just the very end of my cervix, that contained the abnormal cells. Just like that the procedure was finished, and I was told we would wait for the biopsy results to confirm clear margins. Once the doctor and nurse left the room so I could get dressed, I was grateful to not feel any residual pain. As I was setting up the follow-up appointment, they asked if I needed anything for pain. Like a champ, I said, “no, I feel fine”. BIG mistake.

We got into the car, and it was as though I could feel the local anesthetic wearing off. I started to feel a throbbing sensation, very different from menstrual cramps. The pain and lack of breakfast, brought on pretty bad nausea. The whole car ride home I could not find a comfortable position to sit in, and every bump on the road was my enemy. With my husband nervously watching me in pain, he was able to get me a prescription for pain medicine. I just wanted to be home! I have NEVER ran quicker to my front door, got into the house, and filled up my hot water bottle. Laying on the couch, my husband finagled his way into being able to pick up my prescription without my physical presence. Which would’ve been my undoing! The pain medicine made me very drowsy, yet I could not fall asleep, so I spent my day watching hours of Call the Midwife on Netflix (Thank you Netflix!). The whole day I just kept thinking, “Out patient procedure they said?”, “Go back to work afterwards they said?”. Yeah right.

Needless to say, I survived. The cramps have come back to visit today, even though I felt pretty good yesterday. I’m glad to be sitting down at work, it forces me to relax. Doctors orders requires abstaining, and a follow-up in four weeks. I am hoping that the biopsy results will come in two weeks, and that the margins are clear of any more abnormal cells. I will go in for another pap smear in six months, and every six months until my pap smears are clear. I truly believe it was divine intervention that we found this when we did, and I have faith that the LEEP procedure will have been successful. I know now that I must take better care of myself, and that has included (amongst other things) adding Vitamin B12, Vitamin C, Vitamin D w/ Calcium, Vitamin E and Folic acid to my daily intake. However, there is one thing…I won’t give up the Starbucks venti iced coffee, just yet.

UPDATE 11.21.13

Went into the doctor today, with a suspected infection. There was a mild bacterial infection, as well as a bladder infection. Treating both with antibiotics, as we speak! I also received my results from the LEEP procedure. They confirm a CIN III diagnosis, with HPV cytopathic effect, and endocervical glandular involvement. However, THE MARGINS ARE CLEAR! That means, I will go in for a pap smear in 6 months. With the LEEP procedure, I still have a 10%-15% possibility of recurrence of CIN II/CIN III within 2 years. With that being said, I am praying for continued healing, and I am promising to be vigilant. Today my OBGYN asked me how my sister and her baby were doing, then he went on to ask me, “when is it your turn?”. I just laughed, and asked him jokingly, “I don’t know! you tell me?”. I take that as a good sign 🙂

Stage 0 C-word

Where do I begin? I have stage 0 cervical cancer, also known as carcinoma in situ, also known as cervical intraepithelial neoplasia II, and cervical intraepithelial neoplasia III, also known as precancer. Last week started out not like any other, with my not-so-annual pap smear, with my last one four years previous. For the last year, what I truly believe is none other than Him, I felt the urgency to get up the courage to go. My last pap smear was in 2009, for what I felt was a good enough reason. A. I was terrified, and B. I was terrified of something being wrong. My first and last pap smear was most likely no different from any other. I had a very nice male doctor, a female nurse was present the whole time, and yet it was traumatic for me. Given my personal history, this may not come as a surprise, and I had not come to terms with it until now.

When I walked into Planned Parenthood last week, I felt a weight lifted off my shoulders that I was finally facing one of my biggest fears. When I saw that it was a female doctor, I could almost feel the extra pep in my step! Phew. The usual “opening ceremony” happened, the “main event”, and then the doctor gave me great news. “Everything looks great, normal”. Phew. The usual “We’ll call you in 2-3 weeks, and if you don’t hear from us, everything is fine”.

I went through the rest of my week without a second thought, I truly felt like I had dodged a major bullet. Saturday morning rolled around, and as we debated about where we would go for breakfast, I let a call go to voice mail. I never listen to voice mail. REPEAT. Never. “Hello, this is so-and-so from Planned Parenthood, please call me back at blah-blah so we can discuss your results”. I must have listened to the message a million times to just catch the phone number, and to get over the initial shock. I got the bright idea to dial the 1800-number with the only part of the number I could understand; the extension. It rang, and she picked up. She said that my results were abnormal, and that I would need to come in for a colposcopy and biopsy. However, the earliest appointment available would be November 14th, but beggars can’t be choosers. Oh the plight of the uninsured. I think at some point I stopped listening, or had tunnel vision, or selective hearing. I didn’t even think to ask questions, and then I cried a little. How could I be so stupid? Why did I avoid it for so long? I’m only 26!

After sounding the alarms to my family, they unanimously agreed I could not wait the two weeks for the procedure. It was decided, I would see another OBGYN on Tuesday for the procedure, and a second opinion. If you know me, then you know the detective in me would not be satisfied until I understood everything I could about the results. Then it occurred to me, “Well what exactly did my results say?”. I called Planned Parenthood, and asked for the specifics, stupid me. I decided to do it on my lunch break, with ready access to Google. She said, “You have HSIL, High grade squamous intraepithelial lesion.” My search became frantic, with the name alone causing panic. However, I was still missing an important part of the diagnosis. It wasn’t until I picked up the hard copy of my results, that I discovered that CIN II and CIN III were present. Knowing what I knew from my extensive Google research, I knew that meant moderate to severe cervical dysplasia. When I told the nurse that I would be taking my results to another doctor, she let out a sigh of relief, and commended me for going much sooner than my Planned Parenthood appointment; very telling.

After tons of reassuring comments, anecdotes, and the like I went into my appointment with less fear, and more determination. Tuesday morning, also known as today, I was able to get the colposcopy and biopsy. Without insurance, the procedure would run up to $1,000, however my Fampact covered it. I also know that upon viewing my Planned Parenthood results, the doctor must have known the severity of my situation, and praise God performed the procedure. He calmly explained the procedure, and what CIN II and CIN III meant. I didn’t want to tell him that I had practically taken a weekend crash-course, and I knew all there was to know, as far as the internet is concerned. The procedure was relatively quick, and as painful as a pap smear, if not slightly more. When all was said and done, he reassured me that “It looks like it is just CIN III, and nothing more”. I struggled with the fact that he included the word “just”, I also struggled with the fact that he confirmed that I have the most severe grade of precancerous cells. “This is the step below cancer”, he said. We decided that the Loop Electrosurgical Excision Procedure LEEP  would follow the biopsy results, and it would be scheduled for November 13th. To think, I would have 3 screening/treatment procedures, before the two weeks I would have had to wait to get in at Planned Parenthood!

After leaving the doctor, I received calls and texts of congratulations. “Congratulations, you don’t have cancer”. Yes it is true, I do not have cancer, I have precancer. That if left untreated, could have become cancer. An abnormal pap smear, turned into stage 0 cancer, which turned into a LEEP procedure. It is highly effective, and one of the least invasive treatments, with a 80-95% success rate. This procedure is safe by most accounts, however does carry some risks of pregnancy complications. Stories of preterm delivery, narrowing of cervix, and reoccurring CIN II and CIN III. However, alternative studies have shown the necessity of the treatment of CIN, for those that want to become pregnant. Even with the possibilities looming, I have decided to push on forward. The reality is, I will not walk foolishly into the dark fearing, I will choose to walk in the light believing. The reality is, I will sit and worry for 10-14 more days until the biopsy results are in, and I will feverishly Google my results over and over again, until I accept that I already know all there is to know. That He will see me through this, and that I am not alone.

Trust in the LORD with all your heart and lean not on your own understanding; in all your ways acknowledge him, and he will make your paths straight. Proverbs 3:5-6

Friends, family, please be vigilant. We only have one beautiful cervix, that is capable of truly wonderful things, be kind to it.

UPDATE: 11.5.13

Spoke with the doctor this morning, and the biopsy results confirm, CIN II/III. We will move forward with the LEEP procedure. Very promising!

To Wear, or Not to Wear?

As I start the process of building my postpartum doula kit, I have been doing research on various baby-wearing wraps, slings, and carriers. As I have learned, baby-wearing can be a source of comfort for a new baby, and sense of freedom for the parents that wear them. With so many on the market, it can be quite difficult to distinguish the one that is best for you! Along with the various options, I also started researching the safety of baby-wearing itself. In recent years, some have been recalled, by the Consumer Product Safety Commission. The one in question, was the Infantino “bag sling”, that sold in stores such as Target, and Walmart. It has since been declared unsafe, and new safety measures have been put in place. As with ALL baby items, we must be vigilant, and cautious when using them. Here are a few tips from Babywearing International that will make your baby-wearing experience safe, and enjoyable:

1. Make sure baby can breathe. NO CHIN, TO CHEST. NO LABORED BREATHING. CHIN UP, FACE VISIBLE.
   
2. Make sure baby is positioned correctly. NOT TOO LOW, BACK STRAIGHT & SUPPORTED. 
3. Make sure baby’s face is not covered with fabric. NOSE & MOUTH FREE, AND UNCOVERED.
4. Make sure carrier is appropriate for baby’s age and weight.
5. Never jog, run, or jump with baby.
6. When bending over, bend with knees, rather than lean over.
7. Never use while driving in the car.
8. FINALLY, FREQUENTLY CHECK ON BABY!

Babywearing International is also a great resource for the benefits of baby-wearing, as established through research (references included). A few benefits include:

1. Healthy Babies – Baby becomes attuned to breathing, heart beat, and movement. This stimulation helps baby regulate own physical response.
2. Confident Parents – We become finely attuned to their movements, gestures, and facial expressions. This interaction promotes understanding of important cues, and deepens the bond with baby.
3. Loving Caregivers – Promotes bonding with fathers, grandparents, adoptive parents, babysitters, and other family members.
4. Comfort & Convenience – Promotes independence, and easy navigation without frequent interruptions from an anxious or distressed infant.

If baby-wearing is something you would consider, or have done personally I invite you to share your comments, questions, or concerns! Thanks for reading 🙂

Welcome to Holland

In my DONA workshop, we covered a topic that is so real for many women in our society. The feeling of grief or loss, when things do not go as planned. It could be a birthplan gone awry, a failed relationship, a financial hardship, an undetected disability, or even in the most severe case a loss of life. I learned that I had to be prepared for any of these circumstances, and be trained to nurture these families. In our workshop literature, this profound short story was included. It completely encompasses what I would imagine to be, the emotions that come with acceptance, and healing from what we cannot change. Please read, and enjoy.

WELCOME TO HOLLAND

by
Emily Perl Kingsley.

      c1987 by Emily Perl Kingsley. All rights reserved

I am often asked to describe the experience of raising a child with a disability – to try to help people who have not shared that unique experience to understand it, to imagine how it would feel. It’s like this……

When you’re going to have a baby, it’s like planning a fabulous vacation trip – to Italy. You buy a bunch of guide books and make your wonderful plans. The Coliseum. The Michelangelo David. The gondolas in Venice. You may learn some handy phrases in Italian. It’s all very exciting.

After months of eager anticipation, the day finally arrives. You pack your bags and off you go. Several hours later, the plane lands. The stewardess comes in and says, “Welcome to Holland.”

“Holland?!?” you say. “What do you mean Holland?? I signed up for Italy! I’m supposed to be in Italy. All my life I’ve dreamed of going to Italy.”

But there’s been a change in the flight plan. They’ve landed in Holland and there you must stay.

The important thing is that they haven’t taken you to a horrible, disgusting, filthy place, full of pestilence, famine and disease. It’s just a different place.

So you must go out and buy new guide books. And you must learn a whole new language. And you will meet a whole new group of people you would never have met.

It’s just a different place. It’s slower-paced than Italy, less flashy than Italy. But after you’ve been there for a while and you catch your breath, you look around…. and you begin to notice that Holland has windmills….and Holland has tulips. Holland even has Rembrandts.

But everyone you know is busy coming and going from Italy… and they’re all bragging about what a wonderful time they had there. And for the rest of your life, you will say “Yes, that’s where I was supposed to go. That’s what I had planned.”

And the pain of that will never, ever, ever, ever go away… because the loss of that dream is a very very significant loss.

But… if you spend your life mourning the fact that you didn’t get to Italy, you may never be free to enjoy the very special, the very lovely things … about Holland.

Value of Postpartum Support

This weekend was magical for me as a postpartum doula in-training. I attended the workshop of the inspirational, and very special Kathrin Auger. With her expertise, and patience, she taught us the role of the postpartum doula. I truly believe our group of ten women, from all walks of life, were transformed into something we never saw in ourselves. She gave us confidence, and armed us with knowledge. I believe I speak for all, when I say we are forever grateful, and blessed by her presence.

As a part of my DONA certification, I had to write a very short 500-word position paper, and it very easily could’ve been more. Especially with the weekend I just experienced! Please enjoy, and I hope it answers any questions you may have about the role of a postpartum doula.

Value of Postpartum Support

By: Tiffany Dicke

What is the role of a postpartum doula, and how is she important during the postpartum period? A postpartum doula cares for the mother and family during the fourth trimester, up to three months after childbirth. We are there to nurture, educate, assess, and refer if necessary. We assist with breastfeeding support, and adjusting others in the household to the new baby. We may also help with light housework, errands, and meal preparation. More importantly, we are there to be an active listener, and an extra pair of hands. All of this is to be done in a nonmedical, nonjudgmental, and evidence-based approach.

In the days and weeks following the birth of a child, that support can be transformative. Listening to concerns, and answering questions, contributes to their transformation. By validating their choices, and experiences, we are able to completely nurture them.  When they feel nurtured, they in turn can nurture themselves, and their baby. We must also be aware of our influence, and position of power, as not to abuse it. These parents need support that shows we value, and respect them in this vulnerable moment.

The main goal should be to educate the new family with a wealth of information that assists them in making informed decisions. Through role modeling we are able to educate them, without taking on the role of childcare or baby nurse. It gives the parents confidence, and fosters a smooth adjustment into their new roles as parents. While educating them, we are able to reassure them, and give them the tools necessary to be successful upon our departure. This creates a well-rounded family environment, and leaves a long-lasting impression.

While supporting the family, the postpartum doula is also there to assess the family’s transformation, to tailor her services to the needs of the family. By setting clear boundaries and expectations, we can make sure the family is getting the most out of our knowledge. As a postpartum doula, me must also be aware of our limitations, and have an ample resource and referral list available. That will help our clients achieve maximum healing, and health in their postpartum period.

Now more than ever, humans are craving constant contact with one another, yet remaining increasingly isolated. The focus on the family has become more difficult, as financial needs are being met, at the cost of emotional needs. In our fast-paced world, the role of the postpartum doula is becoming more relevant. We allow the family to slow down, and truly relish in their new baby, and the postpartum period. Is there a time in this baby’s life, that bonding will be more necessary? The short answer is no. We must believe that those few short days, weeks, and months will forever have an impact. We will set the tone for these new mothers and fathers, ensuring that they feel prepared to face challenges, and giving them tools to find solutions. Our presence is invaluable, and therefore we as postpartum doulas are invaluable to society.

Navigating Maternity Leave in California!

Maternity leave is still a very delicate topic of discussion, for many women in America. After all, maternity leave could be a determining factor in whether or not a woman chooses to have children now, or ever. Especially if she has spent years developing her career, and staking her claim in such a competitive job market.

As a postpartum doula, I felt it was to my benefit to know the logistics of maternity leave in California, so that I could better understand some external factors that may contribute to her postpartum period. Also, to provide her with knowledge that could enable her to take the time off that is owed to her, and her baby.

According to United States Department of Labor, The Family and Medical Leave Act (FMLA) will provide the following for those after the birth of a child for purposes of bonding, for placement of a child in the employee’s family for adoption or foster care, for the serious health condition of the employee’s child, parent, or spouse, and for the employee’s own serious health condition. Affords the following benefits (For those that qualify):

• 12 weeks of unpaid leave a year.
• Group health benefits to be maintained during the leave.
• Same or an equivalent job at the end of their FMLA leave.

To be an FMLA eligible employee:

• Works for a covered employer (see below).
• Has worked for the employer for at least 12 months.
• Has at least 1,250 hours of service for the employer during the 12 month period immediately preceding the leave.
• Works at a location where the employer has at least 50 employees within 75 miles.

To be an FMLA eligible covered employer:

• Employer in the private sector who engages in commerce, or in any industry or activity affecting commerce.
• 50 or more employees each working day during at least 20 calendar weeks in the current or preceding calendar year.
• All public agencies (state and local governments) and local education agencies (schools, whether public or private). These employers do not need to meet the “50 employee” test.

Running concurrently with the FMLA, is the California Family Rights Act (CFRA) will provide the following for those after the birth of a child for purposes of bonding, or for placement of a child in the employee’s family for adoption or foster care. Affords the following benefits (For those that qualify):

• 12 weeks of unpaid leave a year (It does not need to be taken in one continuous period of time).
• Group health benefits to be maintained during the leave.
• Entitled to accrual of seniority and to participate in employee benefit plans, including life, short-term or long-term disability or accident insurance, pension and retirement plans, and supplemental unemployment benefit plans.

To be a CFRA eligible employee:

• Full-time or part-time employee working in California.
• Has worked for the employer for at least 12 months.
• Has at least 1,250 hours of service for the employer during the 12 month period immediately preceding the leave.
• Works at a location where the employer has at least 50 employees within 75 miles.

In California specifically, Pregnancy Disability Leave runs concurrently with FMLA/CFRA (if you qualify for FMLA/CFRA), and is supported through the Fair Employment and Housing Act provides the following for workers who suffer a loss of wages when they are unable to work due to pregnancy, or childbirth:

• Paid leave 4 weeks before the expected delivery date and up to 6 weeks after the actual delivery (8 weeks for c-section). Up to 4 months total.
• Weekly benefit amount is approximately 55% of earnings up to the maximum weekly benefit amount.

To be a PDL eligible employee:

• Works for a FEHA covered employer (see below)
• Does not have to work full-time to be covered.

To be a FEHA eligible covered employer:

• Having five or more employees.

Running concurrently with FMLA, CFRA (If you qualify for BOTH), and additionally with PDL, the Paid Family Leave (PFL) will provide the following for those that must take time off to care for a seriously ill child, spouse, parent, or registered domestic partner, or to bond with a new child.

• Paid leave of 6 weeks.
• Weekly benefit amount is approximately 55% of his or her earnings up to the maximum weekly benefit amount.

To be a PFL eligible covered employee:

• Employees covered by State Disability Insurance (SDI) are also covered by Paid Family Leave insurance.
• If a Voluntary Plan Insurer provides your company’s disability insurance coverage (in lieu of SDI), then it must also provide Paid Family Leave insurance coverage.

When all is said and done, you could potentially have 12 weeks total (up to 4 months) of job-protected maternity leave if you are covered under FMLA, PDL, CFRA, AND PFL. However if you are only covered under PDL and PFL, you could potentially have 12 weeks total (up to 4 months) of non job-protected maternity leave. Both will be PAID leave for 4 months, with 55% of your earnings!

I have tried my best to state the facts, and I highly recommend more research based on your personal circumstances. What could 4-6 months of maternity leave do for you, and the bond with your baby? How (if at all) will 4-6 months of maternity leave affect your career? What amount of time feels right for you personally? These are all things to consider before and during pregnancy, to ensure that you’re fully prepared, and head confidently into your postpartum period.

For more information, visit and of the links above, or the following:

State of California Homepage

Employment Development Department

Obamacare? More like Mamacare.

Obamacare is one of the hottest debates out there right now, so I thought to myself, “Why not jump into the pot, while the water is still boiling?”. After all, a one-thousand plus page document should leave much to discussion, even the amount of pages is up for debate! With that said, lets keep this blog post short and to the point.

How will the Affordable Care Act (aka Obamacare) affect Prenatal, Labor & Delivery, and Postpartum Care in America? If you would have asked me a week ago, I would not have had the slightest answer for you. However, with a little digging I was able to find some answers. According to the National Women’s Law Center, March of Dimes estimates an “uncomplicated” pregnancy can cost as much as $10,000 out of pocket. Additionally, the NWLC reports that only 13% of private health insurance plans offer maternity coverage for women. Some even require the purchase of a separate “maternity rider”, with a one-year waiting period, that could cost as much as out of pocket for prenatal, labor & delivery, and postpartum care combined. Nothing like six weeks of adjusting to your new bundle of joy, and a large hospital bill waiting at home in your mailbox!

By 2014, this will all change, and private insurance plans will be required to cover maternity care. Under Obamacare women can no longer be denied coverage for preexisting conditions such as, ceserean section, breast cancer, domestic violence, and sexual assault. Furthermore, women can no longer be charged more for insurance, simply because of their gender. According to the White House ACA document, a 22-year- old woman could be charged 150% the premium that a 22-year-old man paid.

If fully implemented by 2014, prenatal visits will be included in the List of Free Preventative Services. That will cover things such as free prenatal vitamins, screening for anemia, and even breast feeding supplies at no additional cost. With the average pregnancy, you can expect 10-15 hospital visits prenatally, so as you can imagine the copays add up.

As a postpartum doula in-training, I was particularly interested in how Obamacare would affect postpartum care for new mothers in America. Included in the ACA Essential Health Benefits, is postpartum care that covers an extended hospital stay, regular check-ups, and counseling about newborn care, and breastfeeding. In section 2951 of the ACA, funds evidence-based home visiting to families in “at-risk” communities. That helps to reduce child abuse rates, early identification of developmental delays, and supports family self-sufficiency and school readiness. Also, according to section 2952 of the ACA, funding will be increased to encourage the National Institute of Health to conduct multi-year studies into the cause and effect of postpartum depression. Women would also benefit from accessible screening, awareness, and treatment for PPD. Another interesting inclusion, is section 4207 of the ACA,  that requires a company of 50 or more employees to provide a private lactation area, with a reasonable break time for milk expression. However I will be quick to add that companies are not required to pay for these said breaks.

In a country that seems to have ignored the benefits of accessible maternity care, Obamacare is the welcomed change that women have been looking for. Or so we think. Or so the internet tells us. In all my research I not only found the glimmers of hope, but the strong adversity to change. Many are skeptical of what can be accomplished when big brother steps in to dictate the who, what, when, where and how of health care. Many will argue that tough times are ahead, and if implemented will severely cripple our economy. I personally would rather not sit too far on either side of the fence, for fear of making this post too opinionated. I also understand that I have only touched the surface, and do not claim to know the depths of information the Affordable Care Act contains. Or rather, does not contain. I hope to have shed a very small light, on a very big topic, that is near and dear to my heart. Safe, affordable, and accessible maternity care for all mothers in America.

Look for another post later this week, that will touch on the topic of Maternity Leave in America, specifically in my home state of California!

Back to the (Doula) Books, and First Time Lactation Class!

It was the end of May, and my life was finally getting back to normal, after our early May wedding. By the time we returned from our whirlwind honeymoon in Bali, I already had a new job lined up, and started that same week. It began to sink in that I was now a personal assistant to a super awesome guy, but that I had found myself in an “office job”. However, if you know me well then you know I have an affinity for organization, planning, and office supplies. One night I was complaining about feeling like I was yet again, a hamster on a wheel. Then my husband said to me, “well are you still doing that doula thing?”. Who could’ve known that simple question, would pose such a challenge for me, and give me the kick in the pants that I needed. I got defensive of course, and explained how overwhelmed I was after a year of wedding planning, and then traveling….AND then starting a new job. Once I spoke out loud what was truly holding me back, I was almost instantly set free.

Needless to stay, the next day I reserved a spot in a Birth and Beyond lactation class, purchased my DONA postpartum doula certification packet, and signed up for Kathrin Auger’s postpartum doula workshop. In one day I managed to drain my account of nearly $600 (which had dire consequences at the grocery store later that day!). In that exact moment I thanked God that I was given this opportunity to have a steady income, while pursuing my ultimate career path.

My head was spinning! I was finally doing it. I cracked open my Mothering the New Mother book, and I’m not lying when I say that my chosen bookmark was a 20% off coupon from CVS (it expired April 19th!). I had fallen behind, and the stress of marrying the love of my life had taken over. Though might I add, the love of my life was the one that reinvigorated me to do what I love.

Mothering the New Mother is an excellent ice breaker, and is on the required reading list for certification. The book is written to help women better understand the postpartum period, and the necessity for nurturing in that said period. One of my favorite chapters is one that covers a span of several different countries, and has excerpts written by a mother from each country. There is such an insight to each culture, and it really makes you wish we had the same postpartum outlook for new mothers in this country. For example, in Colombia a mother writes that pregnancy and births are not treated as an illness, rather a sign of health and beauty. Preparation for birth comes from eating lots of soups, and drinking liquids. Once the baby is born they immediately place the baby to the breast, to help the placenta descend. Then for fourty days the mother is tended to, so that her only focus is staying rested, and breastfeeding her baby. She does not shower head to toe in that “resting period”, rather she is sponge bathed by her caretakers. They brush through the oils in her hair, and massage her body with special oils and herbs. She has constant visitors, and gifts of food, and the main focus is always her. They believe that through nurturing her, she can in turn nurture her baby. What a beautiful and refreshing way to look at a new mother, respecting her for the warrior she truly is. Lifting her spirit, and feeding her soul. With that she is able to heal not only physically, but emotionally. This sentiment is the common denominator amongst these mothers, and from country to country. Except for the United States.

In our great country, women have been sold a lie that we can do it all. Birth a baby, go home the same day, do the housework, and return to work the following day. Barely surviving the first crucial weeks of no rest, and loss of bonding time with this new little human. After the “It’s a Boy/Girl” balloons lose helium, and the flowers die in their vases, the visitors become few and far between. Most of the time they visit just to see the baby, and you are lucky if they genuinely ask how you are feeling. When the loneliness sets in, and the possible frustration with breastfeeding commences, all of the sudden your baby becomes inconsolable. Sounds like a crisis meltdown in the making, and I have heard and read about it often enough. In that time, it is absolutely crucial that a new mother (and father even), have someone there that is genuinely caring for THEM. Everything from loading the dishwasher, to doing the laundry, tidying up the house, and making sure mama is well fed and hydrated. It also important to make sure the mother is breastfeeding successfully, and referring her to a lactation consultant if she is not.

Which brings me to my next development! I attended my first class in nearly 8-years post highschool, and it was with Cheryl Baker, CCE, CD, CLE, of Birth and Beyond in Santa Monica. The three hour class was geared towards parents, and I was the only student in attendance. However, I felt extremely honored to sit in and listen to the questions and concerns those new mothers had about breastfeeding. Cheryl was able to answer each question, as well as shoot down any myths in relation to breastfeeding. It is amazing how much a woman’s outlook on breastfeeding, is greatly affected by those around her. For example, if she was told that no one in her family could produce milk, she might assume it is genetic and that she will not be able to provide for her baby. Without a support system, and a lactation consultant to show her how to breastfeed, she may never try. Cheryl reinforced the importance of breastfeeding, not only for the antibodies it gives to the baby. When mothers nurse their babies, oxytocin is released, and promotes essential bonding. Breastfeeding works on supply and demand, when a mother nurses often, she produces milk more often. In order to ensure that a proper deep latch is in place, the baby should be positioned comfortably. With the babies lips flared and covering the aereola, tongue down and forward, and the nipple angled upwards in the mouth. There should be no flattening or rippling of the breast tissue, and the nipple should not be sliding in and out. The nursing rythym should sound like several sucks, swallow, breath, and then relax. However without a good latch, a baby is not successfully nursing, therefore not contributing to the milk flow. At that point, many mothers begin to assume their supply is low, and start supplementing with formula bottles. The key is really to stay in contact with your postpartum doula, and lactation consultant so that when issues arise, you feel comfortable seeking their help. When you have an advocate that supports your decision, and guides you to what you want to achieve, you will be successful. There are many ways to ensure a special breastfeeding experience, that is memorable for all the right reasons. A proper latch is just the beginning! I also learned that pillows such as the Brest Friend are actually meant to physically support the mother while nursing, and can be a huge help. Silly me, I actually thought the Boppy pillow was for nursing mothers! According to Cheryl, it was actually developed as a pillow to prop up babies, and to be used as a sleep pillow for mothers. I have heard from multiple sources that it didn’t work for them, I wondered why, and now I know! A good bra is also very important in terms of physical support, and comfortable accessibility. Medela makes seamless nursing bras, and they are much more affordable than our Victoria Secret Bombshells. To broach on the topic of accessibility, sometimes privacy is also an issue. Bebe au Lait with their clever name, promise to provide discretion while nursing, without forgoing their fashionable prints. In this modern day we have been given so many tools to make breastfeeding as successful, and comfortable as possible. However, never forget the importance of having a mentor that can give you informed and nonjudgemental advice, allowing you to feed your baby in whatever way works best for you.

Out of breath with excitement! Look forward to posting again 🙂

Here we go again…It’s Doula time!

Two short years ago, I found myself desperately clawing my way into the production world. I had visions of wardrobe fittings, and paychecks dancing in my head. Not for one second did I stop to think about the 18-hour days, arm loads of clothes, and thousands of miles on my car (see The Punishing Hours of a TV Crew). Not to mention the shallow, and exhausting connections I was striving to make. I survived on Venti iced coffees, and very little sleep. In my mind, I was living the dream! Working with the likes of Annie Leibovitz, Will Ferrell, Will.i.Am, and Britney Spears. The list goes on! I was given such wonderful opportunities to continue, and push through the set-backs, and unemployment checks. However, my heart changed. I saw the revolving door my life had become, and I wanted out. (And as we all know, getting out of a revolving door ain’t easy!). I was stuck in a career that was simply put, unfulfilling.

Around the same time I started showing interest in wardrobe, I completely wandered off topic, and watched The Business of Being Born. I was hooked instantly, and began my secret love affair with all things “birth”. In my 24-year-old mind, I honestly chalked it up to hormones, and my internal clock sounding the alarm. After watching any and all birthing documentaries on Netflix, I turned to the internet. My hunger for information became insatiable, and I hid it for fear I would sound like a baby-crazed fool! With some careful research, I came across “doula”. A doula by definition, is a non-medical person who assists a woman before, during, or after childbirth, as well as her partner and/or family by providing information, physical assistance, and emotional support. As I did more research, I realized that there are many forms of a doula, and one can truly specialize in the form that suits them best. I was very interested in becoming a birth doula in the beginning, wrapped up in the idea that I would be there to assist in such a magical moment. The moment a new life is born into this world. Not to say one is more important than the other, but I began to see the demand for postpartum doula’s. If I heard one more woman say, “I read so many pregnancy books, I wish I had read more postpartum books, so that I REALLY knew what to expect”.  Our society has put such a huge emphasis on the prenatal phase, and almost disregards the postpartum phase. Cue the barrage of books, baby gadgets, and birthing classes. Preparation is definitely key, mind and body. I truly believe, with physical preparation, and less medical intervention, all things are possible. However, not every birth goes according to plan, because we no longer have control over our bodies once we get to the hospital, and find ourselves making uninformed decisions. Some women will say, “I went in with a birthplan, because the books told me to, but I didn’t even come close to getting what I wanted”. Without an advocate, and a knowledgeable support system, they are at a loss. We no longer focus on the mother, and her desires. Her need to feel safe and secure, and okay with whatever way her baby is born into this world. It can be truly traumatic one way or another, and they are often times unprepared for the postpartum period as a result. One of my favorite mommy-blogs is TheStir, where I have gained so much insight to the world of new mothers, as well as veteran moms. One thing I read most often, is no one can prepare you for the lack of sleep, the amount of crying (from either you or baby, or both), and the complete stronghold this new little baby has on your life. I guess those books don’t get published, because that info is enough to scare straight any prospective mother! It became such a constant anecdote, that an epiphany was slowly forming in the back of my brain. I needed to become a postpartum doula.

I wanted to become the help that these new mothers so desperately need, not to mention new fathers! How could we as a society overlook such an important role to these new families? It seems so simple, yet it is so uncommon. My heart skips a beat, and I become more emotional, when I realize that I have found my calling. It takes me back to when I was a child, and my mother who was 23-years-old was preparing for her third daughter. I don’t recall much, other than she was completely enamored and bonded with this little human. However somewhere in that process, I remember feeling left out, and discarded. As the oldest, I knew that my mother loved me, but that this was just the natural progression of having more siblings. When she became pregnant with her fourth daughter, something was different this time. I remember them hoping for a boy, and all the while their marriage was falling apart. By the time she arrived, I vaguely remember how hard it was for my mom. It seemed different with this one, even to my 9-year-old self. I mean she was my age (26-years-old), and having her 4th child! She became increasingly agitated with us, and her temper flared up at any given moment. I remember one occasion, where she waited till our dad left to work, and she just lost it. I don’t remember why she did, but the cause did not warrant the effect. She then became more distant, less involved, and more withdrawn into herself. As an adult, and a postpartum doula in training, I would venture to say she was suffering from PPD. I can’t say that she was definitively, and I will be careful not to diagnose something I know very little about. Aside from speculation, I think my mother would have greatly benefited from having a postpartum doula. Whether it was to keep up on the laundry, do the dishes in the sink, or take us kids to the park while she rested. I’ve spent most of my life worrying that I would suffer the same fate, that I too would become irrational, and enraged after having a baby, or multiple. It still is one of my biggest fears, and I have decided I will not just cross that bridge when I come to it, but I will face it before I start the journey.

I hope that with this new calling, I will be able to assist women in their postpartum journeys, and educate them on the importance of having that support system that they deserve. In this modern world, mothers face the challenges of  adaptation to motherhood, and maintaining a successful career. I hope to make that transition smooth, not just for the back-to-work mothers, but the stay-at-home mothers as well. All women, no matter what they’re decisions may be, deserve a caring, trustworthy, and knowledgeable source of comfort. I believe that cultivates a society of women that are confident, productive, and strong mothers. With helping hands, open ears, and a kind heart, we can all be doula’s for one another. Let’s share in the joy of being women, and also share in the overwhelming transition into motherhood. All while being a support system for each other, and creating a diverse community of mothers and doula’s from all walks of life.