West Michigan VBAC Access Update

Source: 2015 Geocoded Michigan Birth Certificate Registry.
Division for Vital Records & Health Statistics, Michigan Department of Health & Human Services

A year ago, I wrote a blog about how hospital bans against vaginal birth after cesarean (VBAC) limit options for Muskegon families. I used birth data from the Michigan Department of Health and Human Services to compare percentages of people with low-risk pregnancies who have a cesarean after a prior cesarean in Muskegon and surrounding counties. Not surprisingly, VBACs are more common where hospitals support them.

The data available that I used was from 2008 to 2014. Since then, 2015 data has been released. I wanted to update this information to see if there were any changes, explore what might be impacting this change and predict how this situation might change in coming years based on current developments in healthcare policy and services.

Statewide, there has been improvement. In 2015, a total of 2,006 people had VBACs, compared to 1,882 in 2014, an increase of 124. When we look at West Michigan counties, however, only Muskegon County and District Health Department #10, which includes Oceana, Newaygo and eight other counties, saw an increase. Kent county births included 40 fewer VBACs and Ottawa county had 3 fewer than the year before.

There are a few issues with this data and that make it difficult to draw conclusions from. First, the two-to-three-year lag time from when the year ends until the data becomes available makes it less useful. We can reflect on what may have happened two years ago to impact these changes, but it is less relevant than being able to access real-time data. Secondly, the online database only provides this particular piece of information by county. In a large county, like Kent, it would be interesting to see how being in an urban, suburban or rural area or proximity to a specific hospital may impact access.

When applying this information to our doula practice, we see clients make a lot of different choices when it comes to choosing a provider and location for their planned VBAC. While some Muskegon area families are happy to travel to Spectrum Health Butterworth in Grand Rapids to deliver, others prefer the intimacy of the small practice at Gerber Memorial Women’s Health, also under Spectrum, in Fremont. Still others have decided to stay in Muskegon and show up in labor at Mercy Health Hackley, while home birth after cesarean (HBAC) is a clear choice for others.

Things may change in 2018. Dr. Tami Michele, who has practiced at Spectrum Health Gerber Memorial for many years, is switching over to Spectrum Health Medical Group Ob/Gyn, with locations on 68th St. and on Mid Towne in Grand Rapids. Some say the move is to help increase the access to VBACs at Butterworth, which serves more patients. Dr. Michele is former doula, whose advocacy for those who wish to plan a VBAC has earned her a national reputation. What is less known at this time is how her moving from a small, rural hospital to a large metropolitan one will impact access to VBACs for those outside of Grand Rapids. Some will surely follow her, while others may feel that they lost a resource.

Another recent change on the national landscape was the publication of the American Congress of Obstetricians and Gynecologists updated guidelines on VBAC, which appeared in the November issue of Obstetrics and Gynecology. According to Mark Turrentine, MD, chair of ACOG’s Committee on Practice Bulletins-Obstetrics, the guidelines are meant to ensure delivery at the safest facility, “However, this absolutely should not result in women having limited access to VBAC.”

According to Jen Kamel, founder of VBACFacts.com, the guidelines are an improvement over those released in 2010. She quotes the new guidelines, “Available data confirm that TOLAC [trial of labor after cesarean] may be safely attempted in both university and community hospitals and in facilities with or without residency programs.” She interprets this to mean that if a hospital can handle deliveries, they should offer VBAC, because an emergency cesarean may be required in any birth, even a low-risk one.

How local staff changes and changes in the ACOG guidelines will impact local access remains to be seen. Will more people be able to access VBACs at Butterworth, or will support at Gerber decline? Will the 2017 ACOG guidelines result in a reversal of bans at Mercy Health Hackley, North Ottawa Community Hospital and Spectrum Health Gerber Memorial, or will the liability concerns prevail? Time will tell, but we won’t be able to see the data until 2020!

In the meantime, we will continue to support families in all their choices, whether they choose a repeat cesarean, a VBAC at a hospital or birth center of their choice, or at home.

Crying During Pregnancy and Labor: Breaking Through Barriers with Tears

Crying pregnancy labor

Person crying

I’ve wanted to write about this for years. The profound effect crying has on people has always fascinated me. How can something that must seemingly come from a place of hurt lead to what can only be described as relief?

Now, for some people, crying comes easily. Maybe they are just instinctively good cryers or were fortunate to have the support from others to cry; I’m sure there are many reasons. But for others, like me, crying doesn’t come so easily. For pregnant women, this makes breaking through barriers during their pregnancies and labors more challenging.

Crying has always been hard for me, even though I know I need to do it. I know how much better I feel, how much less cloudy my mind is. But I also know it takes a willingness to be vulnerable, something I seldom allow myself to do. I need privacy and safety, as many others likely do. Often, those two elements don’t come together and so the need to cry builds. At some point, there’s no moving past what’s causing the hurt and the only way out is to be honest and let the tears flow.

Possible Hang-Ups About Crying

I know what my hang-ups are when it comes to crying. As someone who was bullied all through school, I did my best to hide my tears because I didn’t want to be seen as weak or give them the satisfaction of seeing me hurt. Like many other kids, I also remember being disciplined or scolded at times for crying too much. It’s about safety for me; I’ll cry when I need to, but never in front of anyone…not if I can help it. I also fear that I’m “too much” when I do get emotional, and that’s embarassing to me. So finding the nearest bathroom, bedroom, or private place is a must if the tears are going to fall.

And doesn’t anyone else think crying hurts? I hate how I feel when I’m doing it. I also hate how sometimes, it’s like an earthquake with aftershocks that pop up out of nowhere in the hours after the initial round of tears. Despite how much I hate it, though, I can never deny how necessary it is. It’s freedom, it’s relief.

So, for women who are pregnant, what are some hang-ups they might have about crying prior to and during labor? Here are a few possibilities:

  • Fear of judgement
  • Fear of appearing weak
  • Fear of being vulnerable in front of others
  • A belief that crying is a sign of weakness
  • A belief that she’ll be “too much” for others to handle
  • Fear of being seen as overly emotional
  • Embarassment

The reasons for these hang-ups no doubt vary from woman to woman, based on her individual life experience. Some of these impactful experiences might include:

  • Abuse
  • Abandonment
  • Upbringing (cultural, religious, etc.)
  • Lack of privacy
  • Lack of support
  • Suggestion from others not to cry

The Benefits of Crying

 Believe it or not, even if it doesn’t always come easy, crying is good for you. The list of benefits include:

  • reducing emotional stress
  • ridding the body of toxins
  • improving mental clarity
  • moving past barriers
  • releasing tension

There is science behind the benefits of crying. One study found a difference in the make-up of reflex tears and emotional tears. While the reflex tears consisted primarily of water (approximately 98%), emotional tears included more chemicals. What I really thought was interesting is that one of the hormones found in emotional tears was prolactin, which is also associated with a mother’s let down reflex.

You can Google it all you want; the benefits of crying are real.

But what if you’re like me? What if crying doesn’t come so easily?

Practice is the Key

If you struggle to let those tears flow, consider the growing trend in Japan. I saw an article online that struck me a couple of years ago: Japanese men getting together to watch sad movies so they could learn how to cry. In a society where it’s considered a virtue to keep emotions in check, this trend is helping to “normalize” crying. Not to mention how much better the participants feel after a good cry!

Life is already stressful enough. Add to it the changing hormones, anxiety, and fears common in pregnancy. It’s very common for women to “get stuck” or plateau during pregnancy and childbirth. What isn’t so easy is giving in and letting it go with a good cry.

Any number of things can give a pregant woman reason to cry. From financial strain, physical changes, discomfort, to anxiety and fears surrounding birth and past trauma, it’s completely understandable to feel the need to cry. Pregnancy tends to be a time in the lives of many women where such issues emerge to be dealt with.

For a woman nearing the end of her pregnancy, it’s the perfect time to let the tears flow when she feels the need. Not only will it help her feel better, it’s great practice for labor. One of my favorite birth-related books, Natural Hospital Birth by Cynthia Gabriel, points out just how significant crying during pregnancy, and especially during labor, is. I was trying to come up with a good analogy to describe the way holding back from crying affects moving beyond barriers for pregnant and laboring women. All I could come up with was having to pee.

We all have to do it. We all know that if we hold it in too long, it’s all we can think about. There’s nothing else taking up residence in our minds when the need to pee has reached its nagging peak. Same goes for needing to cry. At some point, the dam will break.

I also think that Ina May Gaskin used a similar analogy that also applies here. She pointed out how most people have a hard time peeing in front of others. This, too, applies to crying. Having an audience, especially one that you aren’t sure supports you, is a real hinderance. Call it what you will (I think of it as a sort of stage fright), crying openly in front of others isn’t always easy.

As with just about everything else in life, practice is the key. Pregnancy is the perfect time to get in touch with your emotions and address any mental roadblocks you may be facing. Crying helps with this. A few ideas to help you with getting those tears to flow are:

  • Find time to be alone
  • Find safe people to talk to (your partner, a trusted friend, family member, counselor, or doula are excellent options)
  • Journal about your feelings
  • Watch a movie that makes you cry
  • Listen to music that helps you cry
  • Be honest with yourself about your feelings
  • Give yourself permission to cry

As challenging as it may be, even one good cry during pregnancy can help to straighten out jumbled thoughts and emotions. It also helps to set the stage for the transition to childbirth. If crying during pregnancy helped to move past emotional barriers, remember that it can do the same during labor. Physically and mentally demanding, childbirth is no time to hold back from crying, especially in the instance of a plateau or intense transition. Tips for crying during labor include:

  • Requesting privacy if there are too many people in the room
  • Letting your care provider know ahead of time you plan on crying as an aid to help labor progress
  • Making sure you have good support (your partner, doula, friend, or relative)
  • Shutting out negative comments or advice from others (a support person can help with this)
  • Practicing during pregnancy
  • Trusting that crying is purposeful
  • Reminding yourself of other times crying has helped you to feel better (a support person can remind you of this as well)

Facing Obstacles

There will always be obstacles to crying, though. Many people, even medical care providers (they’re people with feelings, too), are made uncomfortable by crying. It’s possible that they or others (your partner, friends, family, etc.) might tell you not to cry. They may or may not give you a list of reasons why you shouldn’t cry or tell you what to do instead. Odds are, they are simply just uncomfortable with it. Generally speaking, I don’t believe most people like to see others hurt. It’s also without question a learned response. I know I’ve heard it and hate to admit I’ve said it… “Don’t cry”. While no ill is likely intended by telling someone not to cry, it takes away from the validity of a person’s emotions.

But crying isn’t about weakness or defeat. So in spite of your own hang-ups, or what others might think or say about it, it’s important to remind yourself that crying is an essential release that leads to renewed strength.

It’s kind of like the difference between transition in labor and the pushing stage: considered the most intense part of labor for many women, transition is often the time women are pushed to the limits of what they think they can take. Those viewing on will inherently want to help. If a woman is encouraged and supported through this stage, pushing often yields a more focused and less distressed woman. With the pain and intensity of transition over, women can catch their breath and get ready for the purposeful work of pushing their babies out.

If, instead of receiving encouragement and support during transition, a woman is told not to cry or is offered other options, she may miss out on the relief and satisfaction that waits on the other side of safely expressing her emotions through tears. Anxiety, fear, and other pent up emotions that are not let out cause more physical pain, as well. This is often the point where women face decisions that will affect how their babies are born. This is a very tender period for the mother. Practice in supporting a woman in this delicate phase is essential. Not only does it reduce her risk of interventions, it increases her odds of reflecting positively on the birth experience.

Just like transition, crying is temporary. It’s simply a part of the process.

Seeking out the support of a doula is an excellent idea if you fall into the category of women who struggle to cry as a way of dealing with pent up emotions or who lack needed support. Trained to listen non-judgmentally, provide encouragement and a feeling of safety, doulas know the difference that positive support makes possible.

For information about resources in the area or to inquire about our services, please contact us.

Doulas and Homebirth: Knights in Shining Armor

“Although this moment is bittersweet, it’s one of my favorite photos and I’m glad it was captured. Just before I was taken into surgery, after 24 hours of hard labor at home. My #doula, Faith, never left my side.”
— Ottawa County client, after a homebirth transfer to hospital
“[Faith] provided me with many resources, and I also really appreciated the teas she made me. Her evidence based approach was very unbiased and nonjudgmental. I felt like I could be honest about my needs with her…  She really proved herself when the birthday came. She was my knight in shining armor! She made me feel so confident and comforted through my labor. Her knowledge of a birthing woman’s body and need for support was obvious. I credit my smooth labor and delivery to her…”
— Norton Shores mom, of her homebirth with Birth Quest

 

 

When I tell people that I’m a birth doula, the most common response I get is, “Oh, so you help women having their babies at home?”.  To which I reply, “Yes, doulas support women at homebirths, but all of the women I’ve supported have given birth in hospitals”.

Because the word doula is not a part of everyday vocabulary for most people, I think many confuse a doula with a midwife.  This is usually the second thing I have to explain to people about my job.  I don’t catch the babies; I hold space for mom and support her through the process.

The next question usually revolves around why doulas attend more hospital births than homebirths.  Several factors impact a woman’s decision on whether or not to hire a doula.  For the woman choosing to give birth at home, the biggest factor is likely financial.  Homebirths are generally paid for out-of-pocket, as are doulas.  Since doulas don’t provide the clinical support a pregnant woman needs and they don’t catch babies, women who desire a homebirth are often faced with the decision to choose between hiring a midwife or a doula.  In this scenario, the midwife is usually chosen because of the necessity of her services.

But what if having a doula AND a midwife were an option?

It’s true that your midwife will spend more time with you while you labor and provide a different model of care during pregnancy and delivery.  It’s also true that she will likely have assistants who can attend to some of your needs.  However, with their focus primarily on the clinical aspects of care, there are other elements left unaccounted for.

Generally, a doula will meet with you in your home at least a couple of times before you have your baby.  She’ll be familiar with you and your surroundings.  It’s during these meetings that doula and mom become acquainted and comfortable with one another.  If there are pets, the doula will get to know them.  If there are other children or family members, the doula will get to know them, too.  This process is vital in developing a safe relationship as the mother will depend on the doula to cover the non-clinical elements that are a part of the birth process.  It’s during these visits that mom can share her hopes and her fears.  While she’s probably also done this with her midwife, the doula provides more time for mom to process and plan.  The more informational and emotional support a woman receives during her pregnancy, the better.

And in the event of a hospital transfer?

Your doula will be with you.  Your midwife probably will be, too, but if your doula is the one you’ve been leaning on emotionally during your pregnancy and labor, her presence is vital.  Odds are, she was with you earlier in your labor than your midwife was, as well.  That’s the beauty of a doula:  no shift changes and present with you from the beginning to the end.  Another benefit is that a doula is likely to be very familiar with the hospital environment and maybe even some of the staff, so she can help to explain what is going on and bridge the gaps between a homebirth and a hospital birth.

Regardless of the outcome, whether you had your baby at home or had to transfer to the hospital, your doula will be there postpartum for you to process the experience.  Your midwife will, too, but depending on how the birth went compared to how you had envisioned it, your doula provides added space and opportunity to share things that you might not wish to share with your midwife.  I know for me, I’m no good at confrontation and had I been upset with my midwife or disappointed, there’s no way I could have told her that (fortunately, that wasn’t the case for me!).  A doula is trained to listen to your grievances and your joys.  Validating your feelings and helping you to pick through the pieces and put them together, a doula can offer perspective, encouragement, and reassurance.

Birth is one of the most unpredictable events in nature.  No matter how much you know about it, curveballs often appear in the form of all the little things that surface in the midst of the limbo of labor that no one had planned on.

I think back to my last pregnancy, when I had finally planned the homebirth I’d always wanted.  It honestly was an amazing experience to labor at home and push my baby out the way I wanted with a supportive group of women (midwives, assistants, my mom and mother-in-law) and my husband.  All of it was golden.  I was even doing “doula talk” in my head, like focusing on the words soft and open.  You see, I’d had my birth doula training through DONA only a few short months before the birth.  So at the very least,  I was able to focus and feel pretty in control during the more intense moments of labor.  Super proud of myself for that!

However, the entire day leading up to my precious little one’s arrival, my anxiety and the negative self-talk going on in my head was relentless.  Fourth baby, longest labor.  Why?  Was I not moving around enough?  How long was it going to take?  Why were the contractions that woke me in the wee hours of the morning that were 4 minutes apart and very uncomfortable spacing out to 15 minutes and not as painful?  And there went my thoughts for the better part of an entire day.  It’s the one part of my labor I look back on and wish I’d had a better attitude about.  As helpful and supportive as my husband was physically for me that last time around (so grateful for the counter pressure and back rubs!), I needed someone to help ease my mind.  I needed someone to remind me that every labor is different and that what I was experiencing was normal.  I’d fed my fear of waking in labor and things moving quickly, as they had in the past (with my third baby, I went from 5cm to holding my baby in under a couple of hours after painfully relentless contractions).  Instead, I spent the better part of the 24 hours that I was in labor anxious, discouraged, and feeling guilty for having sent my kids away first thing in the morning because I was sure “this is it!”.  I wasn’t mentally prepared for a long labor.  I’d never had one.

Don’t get me wrong; my birth team was incredible!  I’d depend on them again in a heartbeat for their care and support during pregnancy and birth.  Looking back, though, I know I needed more in those long hours before my little guy finally made his arrival.

Doulas meet so many needs that are maybe overlooked or not considered.

I know when my son was born, my house was a mess.  Pretty sure there were dishes and laundry that needed to be done.  I didn’t feel like cooking and no one brought food while I was in labor.  It was a long, lonely day.  I struggled to find distractions.  There were so many things during that entire day of early labor that a doula could have helped me and my husband with.  We were both so tired.

When I was in active labor and pushing, I soaked up every encouraging word and touch my birth team provided me.  They were tender, attentive, and confident.  In hindsight, I realize I had needed that all day to better cope with my apprehension about the imminent arrival of my baby.  I needed someone to hold that space for me and remind me that everything would be okay.  I needed someone to tend to the things my husband and I couldn’t get to while I tried to rest.

My other children were born in the hospital, where food and laundry weren’t an issue.  While the hospital environment is not my personal favorite for giving birth, those two things ended up being huge oversights for me with my homebirth.  I don’t have sisters or super close girlfriends that I would have felt comfortable having with me while I labored; and I wanted my mom and mother-in-law present for the birth, not running around my house cleaning and cooking.  While having my son at home was truly a dream, waking up the next day to the reality of…well, real life, wasn’t.  Looking back, I hadn’t planned for how to handle those seemingly tiny details.  Who knew that while I did the hard work of bringing life into the world that my house wouldn’t clean itself or cook a meal for me!  Or take care of my other children when they returned home the very next day (totally needed a postpartum doula, too).

My business partner and Birth Quest founder, Faith, also had her last baby at home.  Her labor, which was the complete opposite of mine, was quick and intense.  Despite her doula training, she found herself in need of one and speaking the words women the world over often  say when it’s become too much…I can’t do this! Make it stop!”

I needed a doula; but even if I’d wanted one, I couldn’t have afforded one anyway.

 At least, that’s what I thought.  I know better now.  I could have asked family to help with the expense or sought a doula out that would take my finances into consideration and work with me to make it affordable. Our vision is to increase access to doulas for every person who wants one, so please contact us if you have a financial hardship, especially if that is due to the unreimbursed expense of an out-of-hospital birth. Everyone deserves a doula!

As one Birth Quest client of her having a doula for her homebirth said, “My parents paid for my doula as a gift for our Homebirth. If they hadn’t, cost might had been an issue but I definitely would choose to hire a doula again. Their knowledge and support are so priceless if you can find one you love!”

My story and Faith’s are just two of many stories.  Doulas do so many things.  If any one part of your labor and birth could be considered customizable, it’s who you choose as your doula.  With you from the moment you feel like you need her, she’s the one you’ll have expressed your desires to about labor and birth.  Whether you need someone behind the scenes – doing your dishes, folding laundry, or getting a meal ready – or someone to be a part of the action – holding your hand, taking pictures, or showing your partner where to apply counterpressure – your doula is the one person attuned to your wants and needs.  And if at any time you want what your doulas doing to change, just say the words…that’s what she’s there for.

What does a doula do at a homebirth anyway?

At a homebirth, a doula is going to do everything she’d do for you in a hospital, except that she is in your space where there are more personal elements that might need tending to.  Because the list could go on and on, here are a few examples:

  • Ideally, she arrives earlier in your labor to provide support (informational, emotional, physical, etc.)
  • Support for your partner (in the form of breaks, encouragement, direction on how to apply pain management techniques, etc.)
  • Support for others present during your labor and birth (friends, relatives, children, etc.)
  • Light household chores (dishes, laundry, etc.)
  • Meal preparation
  • Tending to the needs of pets
  • Taking pictures
  • Crowd control (making sure mom has the space and privacy she desires)
  • Immediate postpartum support
  • Assistance with breastfeeding
  • Preparing a place to rest postpartum
  • Meeting needs specific to the individual
  • Hold space for the woman in labor
  • Create/maintain a peaceful and calm environment

Who could use a doula at a homebirth?

There’s no denying that as a doula, I feel the benefits are universal and for all women.  With that being said, specific reasons a doula is perfect for a homebirth include:

  • Women whose family/friends are not near enough to provide support
  • Women without a partner or whose partner might not be available for support
  • Women with anxiety or other health issues that might impact their confidence in their ability to give birth
  • Women who want to be prepared in the event of a hospital transfer
  • Women who know they need a lot of support
  • Women who don’t want to worry about meals or cleaning during labor and after birth
  • Women who know their partners will need additional support
  • Women who want support but aren’t comfortable with family/friends present
  • Women who have specific wants and needs
  • Women who have other children that will be present that need support
  • Women who want someone to promote and maintain a calm, peaceful environment
  • Women who want a safe person to hold space for them

Since doulas aren’t as commonly present at homebirths as they are for hospital births, we did a little investigating into why.

 Thanks to the women who took part in our Facebook poll (@birthquestservices) to find out why they, women who’d had homebirths, didn’t have a doula.  Not surprisingly, the leading reason was cost.  A close second were women who felt they already had enough support while the third reason was a desire for privacy.

However, because women were allowed to choose more than one option, some chose both cost and sufficient support as their primary reasons for not hiring a doula.  This leaves us to wonder…which was the biggest factor?

Why I didn't hire a doula for my homebirth

Answers to a 2017 Muskegon-area Facebook post asking, “If you had a homebirth and didn’t hire a doula, why not?”

 

 

— Blog written by Beth Singleton, DONA-trained Birth Quest birth doula and photographer,

 who had her fourth child at home in Muskegon

Introducing: Beth Singleton, Birth Doula

As a doula, two of the most important people in my life are my sitter and my back-up doula! Through the Lakeshore Doula Network, I have been fortunate to have had several area doulas willing to support my clients in the rare event that back-up is needed.

One time, I had two clients due the same week. Beth Singleton was my back-up doula. When they both went into labor at the same time, she was there for me. I cannot tell you what a relief it was to know my client was in good hands!

Beth and I have met to talk about working together since then. After making lists of our strengths and weaknesses, we identified ways that we are similar as well as ways we can mentor and support each other as we continue to develop our businesses. We recently signed a formal agreement outlining our commitment to provide back-up for each other.

Let me introduce to you, Beth Singelton, Birth Doula!

Beth Doula blog pic

Hello! My name is Beth Singleton. I have lived in Muskegon my entire life and graduated from Reeths Puffer High School in 2000. I am the proud mother of 4 awesome kids and have been married to my husband for almost 14 years. I have given birth in both a hospital setting and at home. In 2014 while pregnant with my 4th child, I completed my DONA training and am currently working towards my certification. Aside from my life as a wife, mother, and birth doula, I have spent many years working as a floral designer and I LOVE writing poetry (I have self published two poetry collections so far!). Free time with my family is best spent in nature, preferably by the river or in the woods, with my camera in hand. I am also a huge fan of watching the sun rise.

I have always had a passion for pregnancy and birth and am very grateful to the women in my life that have allowed me to be present during the birth of their children. What I’ve witnessed while watching other women labor and experienced during my own is that having support is vital to a positive birth experience yet, it is something so many women do not have. Giving birth is one of the most challenging and life changing experiences a woman can go through and how she experiences it can have a lasting effect on how she feels about herself, her baby, and the bonding experience. I know the importance of achieving the desired labor and birth and it is my hope to provide women with the information and support needed to do this. There is no crystal ball that can predict how labor will go. That is why I think it is so important for a woman to have support.

During pregnancy, I believe it is pertinent for women to educate themselves and build a good support team. It is also the perfect time for a woman to learn about self care and begin implementing this into her daily life if not already doing so. As your doula, I will be there for you during your pregnancy to answer questions, provide moral support, go over the importance of self care, help you with a birth plan if you’d like one and go over what you ideally think you will need from me. When you are in labor, it is my goal to be there for you and do all that I can to make sure you feel in control and empowered, providing you with the support you need to be a better advocate for yourself. Whether it is simply my presence that is needed, encouraging words, a shoulder to cry on, or hands on support like massage, I will be there for you. In the instance that complications do arise, I will remain with you and support you through those challenges as well. I believe all women have an inherent sense within them that guides them instinctively through labor and childbirth. My hope is that in all I do, I am able to hold that space for you, allowing you as an individual to experience labor and birth in whatever way you so desire. After birth I will visit with you, talk about the birth, talk about how you are feeling, and I can provide some help with breastfeeding if you need it.

I view birth as something sacred and a laboring woman as someone to be respected and held in the highest regard. There is a transformation that takes place whether a woman is having her first baby or her fifteenth and I consider my being allowed to bear witness and provide support during that transformation an honor. I also believe that a doula’s support is meant to complement and enhance the care that is already being provided by those who are giving clinical support and by loved ones who are also present to help. In birth (as in most of life), there are no do-overs. That is why I feel it is imperative that a woman who will be giving birth is surrounded by people who understand and are sensitive to the significance of the moment.

“Any amount of liquid gold is better than none :)”: Results of my Breastfeeding Survey

As a doula, I hear many stories of the difficulties some women experience with breastfeeding. Although I have lots of training in the basics, my role is to help facilitate early initiation of breastfeeding through skin-to-skin contact immediately after birth. In the postpartum period, I can provide referrals to lactation specialists, but my main form of support is informational and emotional.

What if I could provide education prenatally that would help women prevent the most common challenges? If not properly identified and corrected, many breastfeeding issues can get out of hand in a short amount of time, before some women are even able to identify who to seek help from!

This gave me the idea of a survey.   What better way to improve my understanding of the experiences of local women than to ask them? The response was overwhelming: in 48 hours, I had over 80 responses!

Before I share the results, I have to clarify that this is not the same as research. Most of the respondents found the survey through My Breast Friends, a Muskegon-area Facebook group started by Mercy Health to provide a social media extension of their twice weekly support groups.  For this reason, they are not representative of the general population, but it’s a great group to ask if you want to know what works!

For example, the WIC (Women, Infants and Children) program collects data on breastfeeding for program enrollees. While not all breastfeeding women are enrolled in WIC, the program provides some data to compare our group to. As of Spring 2015, 81% of infants in the program were breastfeeding at 1 week, dropping to 12.8% at 6 months and 1.29% at 11+ months. In contrast, among the women who responded to my survey who had stopped breastfeeding, 20% had done so at more than a year! Even so, 23.5% of the women did not reach their breastfeeding goal, indicating that improvement is still possible.

What was most interesting to me was what and who women found helpful. With few exceptions, when women do seek support, they find it! At the top of the list were:

  • Hospital Breastfeeding Support Group: In Muskegon we are so lucky to have a support group that meets twice weekly at the Mercy Health Hackley Campus on the second floor, 2210A. Mondays 5 – 7 PM and Thursdays 11 AM – 1 PM.
  • Husband/Partner/Father of the Baby: 80.25% of respondents found their partner to be very or somewhat helpful. Let’s hear it for dads! (Want to learn how to best help your breastfeeding partner? Click here!)
  • The Internet/Social Media: Since the survey solicited responses from a Facebook breastfeeding support community, this should come as no surprise.

Great bonding, a healthy baby and confidence as a mother topped the list of benefits. One respondent reminded me of the cost savings of breastfeeding, while others let me know that the confidence and sense of accomplishment they enjoyed extended beyond that of parenthood. Said one mom, “It was the best thing I ever did”!

Now for the bad news. Sadly, childbirth educators were found to be the least helpful. Not to say they were harmful, but 36% found them to be neither helpful nor unhelpful. Next came prenatal care providers, whom 12% of women found somewhat unhelpful or not at all helpful. The third least helpful group was workplace/coworkers. One in 10 women found their workplace to be not at all helpful! This may contribute to the fact that over 1/3 of respondents indicated difficulties with breastfeeding and work.

Nearly 60% of women experienced pain when breastfeeding, followed by cracked nipples (56%). Low milk supply and difficulties latching tied at 48%.

The advice moms gave formed a couple of distinct themes:

  • Find a support group: Overwhelmingly, moms who have breastfed want other moms to know that they should connect with others, ask for help when needed and not be afraid to seek professional support. As one mom said, “Find your momma tribe”!
  • Don’t give up: Many moms stated that if you can get through the first few weeks, it gets easier. All agreed that it was worth it in the long run.
  • Be flexible: 38% of respondents supplemented breastfeeding with formula. Said one mom who’s been there, “Don’t be too discouraged if you have to supplement with formula.”

Thanks to everyone who completed the survey! For more information on breastfeeding resources in the Muskegon area, check out the “resources” section of my website.