The Empathy Belly or It’s OK to Play With Your Own Boobs

 

Sunshine is adding a fun new teaching aid to her childbirth curriculum. It’s called an empathy belly.

Dads, there’s a few things you should know.  First and foremost it has boobs.  The first thing I did, and the first thing you’ll do when you put it on, is grab your own boobs.

Second, it’s kinda heavy.  It’s designed to give you an idea of what your wife is going through and babies aren’t light.  There’s extra organs, a bag of water, feet kicking you in the kidneys.  It’s uncomfortable which is the point.

Third, and most importantly, you’ll probably only have to wear it for a few hours during a Lamaze class one night or, if you’re lucky, for a few minutes as other baby-daddies try it on.  When your wife purchases one is when you have to worry.  That indicates she’s  keeping track of how long she’s had to put up with what you’ve done to her and is thinking of making you wear it day for day after baby is born.

Empathy belly…google it.

Certified Doula*

(*not valid in the state of New York)

Being a doula does NOT require certification – rightfully so.  Because doulas don’t do anything that requires them to be certified.  Yet, as defined under this bill, literally anyone who happens to be in the room when a woman is having a baby can be defined as a doula.

At Sunshine’s birth there were six people in the room:

• My lovely wife,
• Me
• Our doula,
• A friend who was taking care of our 2 year-old,
• Another friend taking pictures,
• Our midwife.

Under this bill any one of them could be defined as a doula.  I know the bill states that it only seeks to define a “certified doula” and not define a scope of practice.  Presumably this is to help with reimbursement of fees which will somehow increase access to doula support by overcoming “income obstacles.”  That’s a very slippery slope.

First, government has historically proven to be terrible stewards of liberty and money.  It excels at removing your right to do something and then requiring you to pay a fee to get that right back.  Wanna go camping?  Pay a fee to the park ranger.  Wanna go to the state beach?  Pay a fee to park there.  Wanna carry a gun?  Who am I kidding…this is New York we’re talking about.

Are you a DONA certified birth doula?  Wanna be able to call yourself a certified doula on your website and pass out shiny business cards with CD(DONA) printed on them?  In NY you’ll need to submit proof you took a class and got certified…and pass a test…yes, even if your certification included an exam…and pay $40.  What happens if you’re DONA certified but you don’t submit an application with the state?  Is the hospital going to ask you to leave?

Second, with doula forums full of complaints about certification fees, recertification fees, fees to purchase certification packets, buying books, and paying a fee to submit your certification package, how does adding another layer of fees, exams, and applications increase access to doula support?  If anything, the very community this bill claims to be trying to help is going to to be damaged.  As becoming a certified doula becomes increasing difficult and costly  the pool of “certified doulas” will be reduced.  Especially in those communities that the bill claims needs the service the most.

Additionally, doulas don’t work for hospitals, or insurance companies, or the state.  The vast majority are hired privately by pregnant women who understand the value of continuous support.  Doulas work closely with the family to build a relationship which uniquely allows them to provide continuous emotional and physical support.  They often meet the woman when she goes into labor and doesn’t leave until a an hour or two after her baby is born.  This is a level of support that only doulas provide.

But requiring certification will alter that support.  If an OB or L&D nurse doesn’t like what the doula is doing, then you can probably guess what will happen.  It’s not unrealistic to imagine that a few complaints about a doula supporting the mother’s decisions that are contrary to the wishes of the attending physician is all that would be needed to yank your “certified doula” title.  Yet, unconditional support is exactly the role of a doula.  Most women who hire a doula do so because they acknowledge that they need the type of support their doctor, nurse, friend or mother-in-law is not able to provide.  I would argue that in a hospital setting is where doulas are needed most…but that’s exactly where a doula’s practice is going to be challenged.  Even more so if the threat of decertification is looming.

Also, this bill will certainly have an effect on the price a doula can charge for her services.  Certification, training, experience and customer reviews are sure to play no role when all doulas get the same (reduced) fee through state run healthcare.  You really think your client’s insurance is going to pay your full fee?  Think again.

Finally, and most importantly, DOULAS DON’T DO ANYTHING THAT REQUIRES THEM TO BE CERTIFIED!!!  Doulas do absolutely nothing clinical.  Well trained and certified doulas who practice in accordance with a strict code of ethics and standard of practice are not even allow to take a pregnant woman’s temperature.  Think about that.  If I’ve got a cold, my wife can take my temperature and give me some Tylenol to help reduce a fever.  But not a doula.  Certified Doulas can’t do vaginal exams, they can’t tell your doctor you don’t want your water broken, and they won’t talk you into an intervention because it’s 3:30 PM on a Friday and they have a tee-time at the club in 90 minutes.

This bill is classic government overreach disguised with a few lines of text about helping improve access.  If government really wants to help it should get out of the way.

The Plot Thickens!

Well, who could have see that coming?  It’s almost as if the Great Breastfeeding/Formula Feeding Battle of 2019 is nothing more than a she-said, she-said that will play out in court.  There’s always three sides to every story and I’m sure this one is no different.  So far all we know is what the media is reporting.

The Bluf

A new mom said she told her postpartum doula to not give her baby formula.  Then, new mom alleges that the doula gave her formula anyway.  So the mom sued the doula for a cool $10 gees.

The doula says, umm, no.  The doula alleges that the mom told the doula it was OK to supplement with formula and she’s got text messages to prove it.

WTFO?

That’s it.  That’s all we know.  There is a take-away, though, which is you can’t trust the media.  They can’t even get this woman’s title correct.  The Post headline says she’s a nurse, then the first word of the first paragraph calls her a “baby-nurse” and then the first word of the second paragraph her job title has morphed into doula.

Call or Raise?

Doula gets fired and sues the customer for the remaining $8,400 of the contract.  Customer counter sues for $10,000.  Either the doula is bluffing or she needs to see the $10k raise the customer several thousand dollars since her name has been dragged through the internet-mud and future customers are sure to see all the headlines and nasty remarks when they do a little bit of Google research before hiring the doula.

If there’s one thing we can all agree on it’s that this sucks for postpartum doulas and they should probably try and get ahead of this in the media.

$10 Grand for Baby Formula

The New Yorker has a piece about a new mother hired a postpartum doula and is now suing the doula for $10 G’s for giving her baby formula.  Romper has also weighed in and it sounds like the mom and doula didn’t necessarily see eye-to-eye on the care of the newborn.

The way I see it there’s a couple of WTF take-aways:

The media is doing an increasingly shitty job.

I’m guessing the majority of the six readers of DoulaBabyDaddy know the difference between postpartum doulas, nannies and nurses.  What exactly is keeping the media from doing a tiny sliver of research??  If they can’t even get titles and job descriptions correct then they shouldn’t be surprised that readers are losing confidence in news reporting at a record pace.

Who trained this “doula??”

If anything in these initial reports can be believed then I can almost guarantee that this doula is both under-trained and not certified.  Here’s how I know:

• The doula ridiculed the mother
• The doula disregarded the desires of the mom
• The doula placed her own sleep above the well being of the mom & baby

A trained and certified professional doula will have insurance to help offset the costs involved in a lawsuit.  But then a trained and certified doula practicing within a strong standard of practice and code of ethics probably wouldn’t get herself into a situation like this…

#FakeDoula

This stuff matters.

It was only a matter of time before the professional certified birth doula community was presented with a real-life example of the life and death importance of practicing in accordance with a standard of practice (SoP) and code of ethics.  Not just any SOP, but a widely accepted set of guidelines…something like the the standards adapted by the most widely recognized, oldest, most repeated doula certification organization in the whole wide world.  I’m talking about DONA.org’s SoP, of course.  This is important stuff; it matters to the professional birth doula community and if you’re a pregnant lady looking to hire a doula it should matter to you most of all.

Babies Lives Matter

I have a google alert set up for the keyword “Doula”.  If you’re not familiar with google alerts it basically crawls Al Gore’s internet and sends you a a daily email of the top search results for your chosen keyword.  Today’s google alert fucking sucks.

I’m sorry for the terrible language, but you know I’m an ex-sailor so it shouldn’t be too unexpected.  A baby died and, from the accounts so far, it’s because a doula practiced outside her scope.  I’m talking, of course, about the clown from Illinois.

Now, normally I try not to rush to judgement on such things.  But this is different because the doula in question has entered into a plea deal.  She got to pretend to be a doula and in return a baby is dead.  Her punishment?  A $300 fine, probably a few thousand more in court fees, and a court order to not do that again…for three years.  I’m gonna jump on the bandwagon here – she basically got a slap on the wrist.

I know that sounds kinda mean and judgmental but I don’t care.  I’m sure the “doula” didn’t set out to cause the death of a newborn, but that’s exactly what happened.  Certified doulas will tell you they’re not even allowed to take your temperature let alone tell your husband to run to the 24-hour pharmacy and buy a thermometer.  There’s a difference between certified and uncertified doulas, and if this case doesn’t convince you then nothing will.

That was a strong one!

That’s what she said!

When your wife starts going into labor everybody and their uncle are going to ask, “Have you been timing the contractions?  How far apart are they?”  Good news dads, this is a skill that you can master in just a few minutes making your role even more relevant.

There are a few ways to do this but the most common, tried-and-true method is to measure one complete cycle, which is from the start of one contraction to the start of another.  You also want to time how long the contraction lasts.

Playing with gadgets.

You can download a fancy contraction timer app, but the easiest way is to use the lap timer feature on your smart phone.  Start the timer when a contraction begins.  Hit the “lap” time when the contraction is over and then “stop” when the next contraction starts.  Your lap time will be how long the contraction lasts and the total time will be the time elapsed between contractions.

Do this four or five times to establish a baseline.

Daddy Tech Tip – Take a screen shot of the stopwatch so you don’t have to remember the times.  On the iPhone, push the home button and power button at the same time and the phone will save a snapshot of the screen in your camera roll.  When somebody wants to know what the contractions look like, simply navigate to your Photo app.  When you view the photo look at the top of the screen and it will show when the photo was taken (date and time.)  This is good to know information to be able to regurgitate to your healthcare provider.  I realize that not everyone has used a stopwatch but there’s hope…you can learn anything online nowadays!

If you don’t have a smart phone, for crying out loud, man, get one!  It’s 2018 and you’re having a baby…get with the program.

Then, when you’re asked, use your most professional and calm Daddy voice and say words to the effect of, “she’s been contracting for an hour.  They’re 5 minutes apart lasting around 60 seconds.”

Why is this so important?

The time between contractions are usually inversely related to the length of contractions, so as the contractions grow longer and more intense, the down-time between contractions gets shorter.  This is a good thing because the longer the contractions and the shorter the time between the contractions, the closer your lady is to having the baby and the closer you are to taking home your little bundle of joy so he can pee all over you.

These contractions are doing all sorts of stuff to her lady parts.  They’re making the cervix dilate and efface, and they’re changing the baby’s station.

It’s working…

It’s important to know what dilation, effacement and station are and how they’re measured.  If your wife was “checked” a few hours ago and she was at 5 cm and the nurse just checked her again a few minutes ago and she was still at 5 cm, but she’s been having contractions the whole time, then it’s time to ask some follow-up questions, like what’s the effacement and station?  Even though she’s still at 5 cm dilated she may have moved from 20% effaced and -2 station to 80% and 0.  This is great progress even though the dilation hasn’t changed.  It means her body is doing what its supposed and it doesn’t need any help (interventions.)

What the hell are you talking about you ask?  See my post on terminology.

And as always, I’m not a childbirth educator but I play one on Al Gore’s internet so be sure to invest in a quality childbirth class from a trained and certified educator.

Pregnant man gives birth…that’s a fact!

(Admit it, you read that with a female Scottish accent.)

 

I had a conversation recently with a birth professional I admire.  She used a phrase I’m familiar with but since I’m not a childbirth educator I don’t hear it very often so I wasn’t sure what she said at first.  I mean, I heard it before but I don’t hear it often enough so initially I was a little confused while I tried to figure out what she said.

The phrase was:

the birthing person.

It’s important to know that I understand the meaning of that term.  I’m aware that it’s meant to be an inclusive term to refer to a person who is giving birth regardless of gender.

But this is the Doula Baby Daddy blog, and as I said before, I make a few assumptions when talking about baby making.  One of those assumptions is that the pregnant person is a woman.

I think that’s a pretty safe bet considering the human race has a long history of women giving birth.  Also, the actual number of transgender men who have become pregnant is extremely small.  Just to be clear, I’m talking about men who were born female and then decided to become male but they still have all their female reproductive parts.  A lot of people are thinking it so I’m just gonna say it:

I don’t think that a transgender man, who was born a woman and has all the female reproductive parts already installed, who then gets pregnant and has a baby is that big of a deal.

Because in my mind, reproductively, he’s a woman, and it’s just not a big deal for someone with female reproductive organs to have a baby.  Maybe it’s just me but I don’t think so.

Take someone who was born a man and decides to become a woman and get her pregnant…now that would be a big deal!  We’re talking about all kinds of stuff that needs to happen.  Medically, did she get a uterus implanted or is it an ectopic pregnancy implanted somehow?  Ethically, would a doctor actually do that knowing the risks?  Morally, is this really something that we should be doing?

At this point if you’re of a certain mindset you’re probably getting a little perturbed.  “Who the hell is this guy to say whether or not a man can get pregnant.  There’s more than two genders.  Gender is fluid.  Yada, yada, yada.”

Frist, I’m a middle-aged, middle-class, cisgender, circumcised, “white privileged”, Christian, conservative male so my opinion is most likely going to differ from yours.  I can hear all three of my subscribers clicking the un-follow button.  However, that doesn’t mean my opinion doesn’t count.  I’m just trying to provide you with a little perspective.

Second, and this is the most important point:

Just because someone uses language that isn’t “inclusive” doesn’t mean that they’re being “exclusive.”

A few of you may disagree with me on this, but when I use the term woman to describe the birthing person it doesn’t mean I’m being exclusive.  Let me rephrase that just so it’s crystal clear – if I don’t use the term the birthing person it doesn’t mean I’m deliberately excluding transgender people.  I’m not using language that isn’t inclusive just to be an asshole.

The simple fact is that for all of human existence, including the last 4 decades I’ve been on this rock traveling around the sun with all of you, women were the ones having babies.  They just were.  Even today, the vast majority of birthing people are women.  A very, very, very small minority of the population is transgender (the most accepted figure seems to be 0.6%) and only a fraction of them are transgender men having babies.  So, it’s ok when someone uses the term woman to refer to a birthing person.  As long as they’re not doing it with full knowledge that the birthing person prefers to be called a man; then they’re doing it deliberately and you could argue they’re just being a jackass.

If you’re pregnant and I refer to you as a woman but you’re actually a transgender man, and you tell me that you prefer to be called a man, then I’m going to call you a man.  I may slip and say woman, and you may not like it, but you’re just going to have to come to grips with the fact that you’re the outlier and I just slipped up.  Oops.

Referring to a pregnant person as a man is just something most people are not used to doing.  But most transgender people are very sensible and they know that getting referred to as a woman when they identify as a man is not something most people do just to be nasty.  There are people who will still call you a woman because they just don’t agree with identity politics but that’s a completely difference topic.  We’re not talking about politics, we’re talking about human to human communication about having babies.

All of that being said, I do think it’s ridiculous for educators, doulas, midwives, nurses, doctors – basically anyone who interacts with pregnant women – to change their entire vocabulary just to satisfy the minute fraction of the population who may or may not be offended.  If a transgender person is offended, they’re going to let you know.

Judging from the main-stream media blasting away on every conceivable outlet 24 hours a day, social justice warriors have no problem letting you know when they’re offended, whether or not they’re transgender.

If It Ain’t Broke, Don’t Fix It

Yay Math!

I’m sitting outside Sunshine’s Lamaze class and her current topic inspired me to write a little.  So naturally I thought, “Hey! let’s do some math.”

Not those stoopid word problems like, “a train leaves Chicago at 50 miles per hour and a train leave New York at 60 miles per hour…where does everyone die a fiery death from the collision?”  The only people who use that type of math are train drivers and air traffic controllers.

I’m talking simple addition.  If you can count to eight then you can do this.  We’re going to add up your wife’s Bishop Score.

Bishop Score

The Bishop Score is used to determine if your lady is favorable for induction.  Induction means the doc wants to start labor instead of letting labor start by itself.  Ideally, you’d want your wife’s labor to start when it’s ready to start.

You’ve familiar with the saying “if it ain’t broke, don’t fix it.”  Well, that applies to making babies.  You’re in a better position to have less interventions and better outcomes if you don’t mess with it.  Just let labor start on it’s own.

But say you’re at the doctor’s office for a prenatal visit and your wife is 39 weeks pregnant.  Many doctors will start talking about things like induction.  This is your chance to look really smart by asking, “Hey doc, what’s her Bishop score?”

A couple of things may happen:

1. The doctor’s going to be taken by surprise.  He may be thinking “why is this guy asking me about the Bishop score?  Good for him, he’s done his homework.”  Then he’ll do a vaginal exam and tell you the Bishop Score.
2. The doctor’s going to be taken by surprise.  He may say, “we don’t really use the Bishop Score anymore,” or “that’s not a good indicator for when to start induction.”  In which case you raise the bullshit flag and show him all the references I’ve provided below.
3. You’re wife’s gonna be like, “damn, my man is hot!  Look at him getting involved and remembering stuff from our childbirth class!”  (You did take a class, right?)

The Bishop Score is determined by the results of the vaginal exam.  The doctor will be checking for five things:  Dilation, effacement, station, consistency, and position.  Then he’ll use the following chart to add up the different measurements and give you a score:

 

Here’s how it works…

Doctor does vaginal exam and says to your wife, “Your 5cm dilated, 50% effaced, baby’s still a little high (we’ll call that -2 station.)”  If I’ve lost you already, go back for a quick refresher on definitions.

Notice the doc didn’t give you a value for station, consistency, or position?  That’s because he doesn’t know how smart you are.  So you ask and you’re told -2 station, medium and anterior.

Look at the chart and find the dilation at the top, then move down the column until you find 5cm.  Now look at the blue number on the left and you’ll get a score of 3.  Not bad.  Now do that for the rest of the measurements, add them all together, and you’ll come up with a score of 8.

There’s a couple different schools of thought in regards to what score you want before you start induction, but the popular opinion is that a score of 8 or better means you have a good chance of having a vaginal birth if you’re induced.

Getting induced with a Bishop Score of 6 or less means the cervix isn’t “ripe” and you’re likely to NOT have a vaginal birth – meaning a surgical cesarean delivery.  You can find an online calculator here and some good descriptions of the different measurements being taken.

The Doctors Should Know This Stuff

Most lady part doctors (“OB’s”) are fellows of ACOG – The American College of Obstetricians and Gynecologists.  ACOG has a FAQ page all about induction.  There’s been some recent guidance from the college that even if your wife’s water breaks, you should be supported in your decision to let labor start on it’s own.

If you’re wife’s goal is an un-medicated, vaginal delivery, or in doulababydaddy phraseology a “natural birth,” then you should bookmark those pages linked above.  Induction rates in ‘Merica are high – over 40% in 2013, which means you doctor, at some point, it most likely going to suggest either induction or augmentation.  When he does, there’s nothing wrong with being armed with ACOG’s guidance and use your BRAIN.

 

In Which a Doula Forum Lurker Spews About Communicating Online

I think I’m pretty well tuned in to the doula community.  I wouldn’t say that I have my finger on the pulse of the labor support world but I’m confident that I know what you ladies are up to most of the time.

I dig writing about the haps in your world as seen through the eyes of a middle-aged, middle-class, white, circumcised, cisgender male who’s had a couple of rum & cokes and has been married to a doula for a long time.  I read a lot of what you all have to say and for the most part it’s predictable.  It usually goes something like this:

Somebody posts a question.

A handful of ladies post polite, cordial responses that address the question.

Then, inevitably someone replies:

a.) “you all don’t know what you’re talking about”, or

b.) “that’s not in a doula’s scope of practice”, or

c.) “that’s offensive…I’m telling (insert name of admin tagged)”, or

d.) some variant of cultural appropriation/transgender issue/racial inequality/Trump is a Nazi, or

e.  all of the above.

Luckily, a recent post only got a little heated before the warring parties had enough and went back to their white wine and reading 50 Shades of Gray.  The short volley did not snowball into a full fledged chick fight but it did highlight the fact that online communities are TERRIBLE for having conversations that deal with real life.

On this particular group, a question was posed about diarrhea:

As you know, recommending a medication is way outside of a doula’s scope of practice.  Well, a certified doula that is, because an un-certified doula can practice however she likes.

The conversation started out with a handful of ladies offering friendly advice.  There was a few comments regarding scope of practice but nothing too inflammatory, but then a full-fledged #bombcyclone dropped.  Needless to say, it was kinda yucky, but I’m not going to arm-chair quarterback the whole thing.

My point is communicating with someone through a blog, or a Facebook group, or 140 characters is not the way to have an honest and civil discussion.  If you feel so strongly about something that you feel the need to ignite a category five flame war then maybe you should consider asking the other person out for a drink and discuss it like grown men and women.  How does the lady-phrase go, “put your big girl panties on?”

 

It’s None of Your Business

There’s been been a disturbance in the Doula Force. Can you feel it?

I’ve noticed that there’s a small contingent of Doulas that can be pretty outspoken.  Just like any squeaky wheel, they can be persistent and relentless.  Dare I say annoying and rude?  Ok, I’ll say it – annoying and rude.  (I’m not one to back down from a dare, especially when I’m daring myself.)

Recently, Sunshine got a message from a fellow doula who was “curious about your classes and why you’re offering them for free.”  Now you can read a lot into that question but the truth is it’s none of your business.

My wonderful wife is a much better person than me because my answer would have been, “who the hell do you think you are?  You don’t honestly expect to get a straight-forward answer by sending me a message out of nowhere and questioning my business practices, do you?”  Sunshine was much more level headed and inquired as to what the other doula wanted to know about her classes.

Now, before we get to far into the weeds, let me bring you up to speeed.  My wife has a successful business which allows her wonderful giving heart to be a huge blessing to the families in our community who would otherwise not be able to afford quality childbirth education.  But she’s also not a push-over.

Just because she gives back (a lot) doesn’t mean she feels the need to answer questions from birth workers who are not like minded and feel that she’s just “taking food off of her kid’s plate” by offering free services.

No shit, those words actually fell out of someone’s brain, ran down her arm, and came out her fingers which pounded out a nasty message on a keyboard on a computer hooked up to Al Gore’s internet in some far away land and was sent to my wonderful, giving wife.

It’s very telling that a white “privileged” birth worker can’t operate a profitable small business nor can she use those profits and help low-income families (many of color) without stating her full intentions lest she’s the recipient of a barrage of negative comments – often from other white women.

Are you stepping in what I’m laying down?  The hypocrisy is amazing.  It’s almost as if there’s no rules anymore.

The “fellow doula” admitted that she didn’t want to know about the classes per se, she actually wanted to know how it was “profitable” for Sunshine to offer free classes.  She continued by asking if Sunshine was doing it simply for networking or if she was giving back to the community.  If it was the latter then the fellow doula wholeheartedly agreed and even said Sunshine was an amazing woman for doing so.

But what about the implication of was she doing it for networking?  So what if she was doing it just to network with pregnant women and their care providers?  What if she was doing it to advertise for her collective or her retail business?

Which brings me back to the point of my rant, which I acknowledge is all over the place:

It’s none of your business.

You have every right to question someone about their business practices.  You have every right to insist that they charge a certain amount.  You have every right to chastise someone for what you perceive to be inappropriate or insulting.  Just don’t be surprised when the answer is, “It’s none of your business.”

By the way, Sunshine graciously invited the “fellow doula” to coffee one day if she wanted to talk doula business.  I sincerely hope she does, because first impressions are pretty important.