As one of the first in her friend group to have a baby, Tamiya remembers moments from the early weeks with her son and the appreciation she felt for a friend who came over, took the baby, and told her to take a long shower. She learned about doulas shortly after, but didn’t think to train as one herself until three years later at a community meeting where community members requested doula services from the health department and advocated for the ways doulas can impact outcomes. She knew at that moment that she wanted to be a doula. She completed her training the following summer. 

Tamiya had always felt called to help others navigate pregnancy and the tender, early months of parenthood. By the time she got her formal training, she’d supported so many through these stages that the doula certification felt more like confirmation of the role she was already playing, than an entirely new one. 

Can you tell me a little bit about your background and why you decided to train as a doula?

In college I studied Family Science, with a focus on maternal and child health. I also got pregnant with my 7-year-old son, Kaiden, during my senior year of college, so everything I was passionate about learning, I was also experiencing.

It wasn’t until after I had my son, when all the visitors had come and gone and I found myself alone not knowing what to do with him or how to care for myself, that I started to think about how to help other mothers in similar situations. That’s when I found out about doulas. And so, in summer of 2018 I trained with DTI as a birth and postpartum doula.

Can you tell me a little more about what birth doulas and postpartum doulas do?

The Greek term for doula is “servant, or a woman who serves.” At first this definition rubbed me the wrong way. It sounded like doing meaningless work for another person, but as I dove deeper into the doula world, I realized it was the complete opposite. Doulas provide emotional and physical support, offer education, and advocate for the birthing person. A birth doula usually helps create birth plans, teach comfort measures, and discuss labor and delivery. Postpartum doulas provide after birth support for the birthing person by discussing the birth experience (especially if it was traumatic), helping with the transition into parenthood, and providing breastfeeding guidance, newborn care, and community resources. 

What do you think people misunderstand about doula work?

People often confuse doulas with midwives, and although the philosophies surrounding birth are very similar, doulas do not provide medical advice or support. But doulas and midwives do work very well together – their philosophies around birth (especially labor and delivery) are aligned. The hospital environment on the other hand wasn’t always welcoming to doulas, but I’ve definitely seen this change over the last few years as doula care has become more universal. There isn’t the same power struggle in hospitals that there used to be between hospital staff and doulas. 

I also think people have a perception that doula work is more fun than work, and it’s far from that. Holding space for others is a huge task to take on, and can be a really heavy load to carry. Lastly, with so many positive statistics surrounding doula care, there is added pressure on us, as if we are the ones deciding a birthing person’s experience.  

Who could benefit from working with a birth doula? When should they start looking for one?

Any and every birthing person, but I especially think women of color regardless of education or socioeconomic status, benefit from having a doula. With the horrifying statistics surrounding Black mothers and babies, on top of a history of people of color being dismissed in medical and healthcare settings, having a doula can really change the trajectory of one’s birth experience. And while it isn’t the responsibility of the doula to correct this, doulas have been known to save people of color’s lives. 

You can start looking for a doula as soon as you start to plan for a baby. Support may not start that early, but finding a doula can take some time and the more time you have, the better the chance you’ll have a strong connection with your doula. 

Who could benefit from working with a postpartum doula? If they hire a birth doula, should it be the same person?

Every birthing person could benefit from a postpartum doula. To have support through such a huge transition is so beneficial. A postpartum doula can identify signs and symptoms and encourage people to seek support. Postpartum doulas can help if families have older children. They can also simply hold space so the birthing person doesn’t feel alone. 

How should someone go about finding a doula that’s a good fit? Do you have any questions you’d recommend Ovia members ask?

Before getting to the point of thinking about what questions to ask your prospective doula, I would advise you to consider what you hope to gain from having a doula with you. This will help guide the questions you ask. Some people are birthing alone and are looking for support, some people are afraid of being mistreated and want an advocate, some people want to know how to manage pain. Once you figure out what you are looking for in a doula the questions to ask them will come naturally. 

There are multiple ways to find a doula. Some doula organizations have directories, some hospitals and OB offices have doulas who they can recommend. There are websites like DoulaMatch and facebook groups. I have even seen doula speed dating events!

Doulas are not one-size-fits all, so the earlier you start looking, the better chance you’ll have to build a relationship and connection with them. 

What do you do to help spark a connection with the client?

I try to include everyone who wants to be a part of the birth. A lot of misconceptions come from people thinking that the doula is replacing the partner. So including the partner in the process is essential. I give them the techniques to use (for example how to hip squeeze during a contraction) and I can give the family the language to speak for themselves. I’m not there to take over anyone’s role, but to support the family in the way that they choose to be supported. I also share my own experiences to show them that I’ve been where they are. 

How do doulas get support themselves? This is intense work – is there anything the Ovia community can do to support doulas?

This is very intense work, its emotional labor. Some doulas form collectives where debriefing from births is a standard practice. Others have individual mentors or talk with their own therapists as well. Doulas are pretty good at gaging the number of births we can take on and giving ourselves breaks to rest and rejuvenate.

Read more

• What you should know about doulas 
• Where can Black families go for breastfeeding support?

Cassandre is a marketing executive, mom of two, and a trained doula. We sat down to talk about discovering she had PCOS, opening the conversation around infertility, and helping other families through their family planning and birth experiences.  

Can you tell me a little bit about your family?

I come from a big family, on both my mom and dad’s sides. I’m one of five girls and grew up in a house in Brooklyn with about 20 family members — siblings, cousins, aunts, and uncles. I’ve always had a lot of kids around me (I don’t even know how many cousins I have)! 

I always knew I wanted kids. I used to say I wanted four — that was my magic number. My career was also important to me, but I knew I wanted a family. 

What role did your career play in your life? How did that influence your family plans?

Balancing family planning and my career was a challenge, but once I began dealing with infertility, starting a family became my top priority. I still worked — which probably made it harder because I was in a stressful job — but family planning was #1. The thought of not being able to have kids really scared me. 

Tell me a little more about your experience with infertility. 

I got married in my early 30s, and we waited four years to start having kids because we wanted to enjoy marriage and have fun. I recommend that to everyone, if you can!

Once we started, we tried for 6 or 7 months before my midwife recommended an infertility specialist. It took her a while to diagnose me with PCOS. I will never forget that day in the infertility specialist’s office when she told me, “You’re not going to be able to conceive naturally.” At that time, I didn’t know much about fertility treatments. I didn’t know anyone in my life who went through this because no one talked about it. I had no clue where to begin. 

No one in my family knew. Finally, my husband told me, “You have to tell your sisters.” So I finally told them and my parents. Eventually, I told everyone, in part because I wanted people to stop asking me when we were going to have kids. From that point on, whenever someone would ask me, “Hey, why don’t you have kids yet?” I would respond, “Because we’re having fertility problems.” That got them to stop asking. 

Starting IUI was emotional. I had to take shots every day. We had two cycles, the second one took, and we finally had our miracle baby!

Tell me about your pregnancy experience. 

Pregnancy was good, but it was emotional. If you go through infertility or miscarriage, when you finally do have a successful pregnancy, it’s hard to enjoy. I was so worried something would go wrong. I didn’t take any photos when I was pregnant for that reason. We moved recently and I found the one picture I took when I was pregnant. I was so happy to find it.

Once I had her, though, I said to myself, “Never again will I not share this story.” I tell everyone now. And I found the more I was honest with people about my experience with infertility and IUI, the more people reached out sharing they were dealing with the same issues. And it just continued. In my life so many people are dealing with infertility issues. All of a sudden, I became this unofficial, unlicensed infertility specialist! 

I wanted to know everything about PCOS and infertility — I dug all the way into the research, I bought books, I joined online communities — and I realized there is this whole world of people going through the same thing and no one is talking about it. Especially in the Black community. No one. 

Why do you think that is?

Black women seek medical treatment for infertility at much lower rates than their white counterparts. There is a stereotype that Black women are super fertile and have lots of kids. And culturally within the community, we do it to each other. You’ll hear Black folks say things like, “Oh she’s a fertile myrtle.” These stereotypes make it feel like we don’t have fertility problems, like we don’t do IUI. I had two friends who froze their eggs recently, and I was so proud of them. It’s an investment in their future, but there are barriers that need to be broken. 

I dealt with infertility in silence with no one. It was just me, my thoughts, and my little online communities. It was very isolating. I’m happy to see the conversation becoming more normalized now. 

Yes, it does feel like people are getting more comfortable having conversations about women’s health: periods, fertility, postpartum health, and menopause.

Yes. Education is a huge part of it, and so is listening to your body. Part of the reason I found out I had PCOS (even though it took my doctor forever to figure it out) is because I went through this period of 3-4 months where I was regularly exercising, eating well, and I lost no weight. I was breaking out (which I never do). I knew something was wrong. 

I got some regular bloodwork done at my doctor’s office. A few days later, she called me and told me that something was wrong with my hormone levels. She referred me to an endocrinologist (my fertility specialist), and that’s when we realized I had PCOS.

Moral of the story: listen to your body!

And your body changes! I had a baby 12 years ago and had all kinds of challenges, and then at 44, I got pregnant with no problems. We weren’t trying. I was done having kids. It’s so important to trust your body. Work together with your doctors, but you know your body. 

Yes, and when you’re used to ignoring pain or discomfort, that becomes your norm. 

When you’re used to needing to minimize how you’re feeling, you don’t think anything of it when you’re actually feeling pain. 

I wonder about the role that weathering plays in this fertility space too and how holding generational pain within the body might impact fertility. 

I think it absolutely does. Among unmarried couples, Black women are five times more likely to be the head of household than Black men. When you have the responsibility of providing and caring for your family, the added pressure of infertility adds another layer of stress. And stress is absolutely a huge factor in infertility. 

We tried to conceive when I was at my previous company, and it just was not happening. The moment I left and joined another company, I became pregnant. The exact same thing happened to two of my other coworkers. Stress is a major factor. 

Do you think your experience influenced your decision to become a doula?

It was a big part of it, but what really convinced me was when my sister-in-law was pregnant. Her doula was very late to the birth, she literally almost missed it. So I ended up naturally working as her doula. When I left, I started looking into doula work. I didn’t have a doula with my first, but the more I dug into it I realized I could do it and it connected with my story. Especially being about to help people through infertility — it’s such a soft spot for me. I did a training specialized program for infertility work during the pandemic. 

Tell me about the differences in your birth team for your first versus your second pregnancy. 

I’ve always gone to midwives. Because I had a midwife, I had a great birth experience. Midwives labor with you — that’s the difference between a midwife and an OB. 

And for your second pregnancy, you gave birth far from your home, right?

Yes. I live on Long Island now. It’s diverse and great, but I did not feel comfortable giving birth here. I got great OB recommendations, but there are no midwives near me. So I commuted all the way to Brooklyn for my midwife. I just made it happen. I was not going to sacrifice that part of my care. 

How has having a second baby later in your reproductive years impacted your birth and parenting experience? 

Because I’m a doula and I’ve attended so many births, with my second I felt like a complete expert in terms of what I want and didn’t want. 

Basically, you could have delivered the baby yourself…

If I could have, I would have! I knew I wanted to be induced. I had some fear about my age, but while it was unexpected, I had less fear the second time around than I had with my oldest. With my oldest, I didn’t have any information. Information is so critical. 

Now, I’m leaning on my first pregnancy, my work as a doula, and even working at Ovia. Working at Ovia while having kids is truly a blessing. I can’t count the number of times I’ve emailed an Ovia Health Coach (shoutout to Lisa and Lilly!) with a question about breastfeeding or something else. They are just amazing and have helped me so much. 

But overall, the beauty of having a baby at this age is the confidence, the education, knowing I can disagree with my midwife, knowing all my opinions; it’s been so much easier. 

Do you have any advice for someone going through a first pregnancy or feeling nervous about pregnancy for any reason? 

I’m a strong advocate for midwives, but the most important thing is to trust your body. You have to get to the place of trusting yourself and trusting your body. I was so nervous when I was pregnant with my first that my body was going to fail me. But you have to remember that your body is built for this. There may be some complications, but listen to and trust your body.

This article is part of Ovia’s Black Birth Experience series.

Read more

• Identify your advocate
• Advocate for your health by bringing a support person with you to appointments

Kami Wigginton is a sales executive. She’s also a mom to two girls, Simone and Sutton. Here, Kami shares her family building story — the unexpected twists, sibling dynamics, and her advice to other Black women and families navigating the healthcare system. 

Can you tell me a bit about your family planning journey? Did you always know you wanted to have kids?

I don’t know that “Mom” was always at the top of my priority list. Motherhood was a bit of a delayed experience because there were other things at the top of my goal list that I wanted to come first — like going off to college and starting my career. I wanted to do that before prioritizing starting a family. 

And so, for me, it was about it being the right time in life, but I didn’t know what that journey would look like — or whether it would be easy or hard. I had my first child at 31 and my second at 38 (to my surprise!). I was fortunate that both pregnancies happened naturally, but definitely not on my timeline.

Yes, for such a naturally forward-looking and career-oriented person, what was your reaction to that second pregnancy?

I am a very type A person, and I had everything planned out. We had actually just relocated from Kentucky down to Tennessee — and I had thrown away all the baby clothes. I thought it just wasn’t going to happen, and I had accepted that. Plus, the first pregnancy was hard on me, and the idea of a geriatric pregnancy alongside my career was intimidating. 

And so, we were planning on skipping the whole pregnancy phase and adopting a toddler. I set up an adoption appointment, but by the time it came around (and after six and a half years of trying), I was pregnant! God laughs at my plans! 

How did your second pregnancy compare to your first? 

As most moms know, no pregnancy is the same. But the second time I went in with my eyes wide open. And so I was prepared for it in many ways, but I wasn’t completely mentally ready to do it all over again. That said, once I got over the initial shock of the pregnancy, it was relatively easy. 

What was it like telling your daughter you are going to have another baby?

That was a good part. Simone was six at the time so she was in her baby doll stage. She welcomed it and we did all the sibling classes at the hospital. It was very cute. 

In a blog post you wrote for Ovia, you discuss feeling as though your care team wasn’t addressing your pain. You wrote: “And I kept wondering, ‘Is it me, or is it something else? Is it because I’m Black?’ Even having that thought is traumatic.” Can you tell me more about that?

Pregnancy is a unique experience where you get nine months to really know your physician, so it’s important that you build rapport and a relationship, and that you watch to see how they address your questions along the way. It’s also important that you’re not scared to switch providers if you’re feeling like it’s not a good fit. 

My primary OBs were great for both pregnancies. They respected me. But then on the day of (i.e. when things get real!) there are different players in the room. Advocating for yourself, having a voice in the room, raising your hand, it’s all okay. You have to ask the questions and listen to your body. My natural personality type and the fact that I work in the industry helped me feel informed and able to advocate for myself.

What’s your advice to someone who feels less comfortable pushing back or speaking up?

Partnership. Get someone in your family who is comfortable speaking up and who can pay attention to the signs. After all, you’re busy having a baby! A doula is a great option if you’re looking for someone who is supportive and an expert, especially if it’s your first or second time. 

And then identify your advocate. For me it was my doctor. She had me change hospitals to make sure I could deliver in the way she recommended. 

There are so many pros and cons to having babies earlier and later in your reproductive years. Can you tell me how age has played a role in your parenting, if at all?

Going into OB appointments and signing my date of birth (in the 70s) while everyone else is in the 90s or 2000s sometimes made me think, “Why are we doing this?” But the benefits are that you’re calmer and more experienced. With my second child, I felt more comfortable, had more financial stability, and just had more information about what to expect. 

The hard part is the energy now that they’re here – keeping up, staying active, and taking care of myself so that I’m here for the journey. But you’ve got to have grace with yourself.  I definitely think my older child got a different experience than my younger one is getting, but I’m not stressed about it; she has someone to play with! I’m always reminding my older daughter, “This is the little sister you prayed for! Go play with her!”

This article is part of Ovia’s Black Birth Experience series.

Read more

• What you should know about doulas 
• Advocate for your health by bringing a support person with you to appointments

Deanna Barnes works in Chicago in advertising technology sales and lives with her husband of twelve years and her three kids: Avery (age 8), Bennett (age 6), and Greyson (age 3).

We sat down to talk about her breastfeeding experience and how it changed with each baby. From setting breastfeeding goals early to pumping all across the country, this resourceful working mom knew from the start that she wanted to breastfeed each baby for 12 months. Here’s her story. 

Can you tell me a little bit about your breastfeeding journey?

I knew I wanted to breastfeed. I come from a Black mother who did not breastfeed – maybe it was her generation, but it wasn’t a focus. She knew she was going to formula-feed before she left the hospital. I breastfed all my children for a year, and as a working mom that definitely had its challenges. 

Two things to take away from breastfeeding:

1. Breastfeeding is not as intuitive as you would think. I needed help in the hospital with a lactation specialist. I needed help when I got home with a lactation specialist. It’s not intuitive. I can remember crying but pushing through.
   
2. Secondly, the first kid teaches you a lot. We really learned it all together. With my second and third, I had some great lactation specialists who said: “Every baby is a different dance partner,” and I just remembered that throughout the process whenever it got hard. 

Are there any moments that stand out when you think back on breastfeeding?

Those 3 a.m. quiet nights, nursing in a rocking chair while listening to a podcast. I remember just thinking, “This is really nice.” As many challenges as there were along the way, when it came time to end, I was very sad. 

There is no bond like the bond created when you’re breastfeeding. I knew I was going to miss that time together. That’s why I love the infant and newborn stage so much — you don’t get that back and it’s just the best time.

Was it challenging to care for other kids while also breastfeeding your second and third kids?

Oh yes. And don’t forget to throw a pandemic into the mix. When I had my first two, I was the working, parenting mom. I pumped in airplanes and Amtrak stations, in bathrooms and hotel gyms and cars. There was so much transporting of milk. I’ve had my milk dumped out by the TSA. There were many challenges. 

But when my third kid was born, I had to do all that and navigate a new job. I had a two-week orientation in New York with a three-month-old at home. So I pumped and used Milk Stork to ship all my milk back. It was a lot. I had alarms on my phone so I could pump at work, it required time management and planning. But if you’re a mom running a household, you’re used to all that planning. 

What specific issues did you face along the way?

Like I said earlier, it’s just not intuitive! I didn’t intuitively understand the latching part and it was so painful. But I had lactation specialists who taught me all kinds of different methods. That education aspect is important. We’re so vulnerable at that stage and open to everything. My biggest challenge was just knowing what to do, understanding supply and demand, etc. I feel so fortunate that I got that education because I know a lot of people don’t. 

Did you ever have a moment where you thought, I can’t make it to 12 months? 

Never. I had a freezer of milk. I feel very fortunate that I had enough supply. Every body is different, but I never had to supplement. I did everything possible so that I could make it to a year. And if there was a challenge, I always thought, “Ok how can I fix this?”

Do you have any messages for people who are preparing to breastfeed? Either for the first time or for another child. 

Every kid is a new dance partner! Remember that, so you don’t put so much pressure on yourself. You have the kid who falls asleep on the boob and the other one who drinks drinks drinks. And don’t succumb to the pressure. If you feel you’ve reached the end of your journey in three months, kudos! If it’s one day, that’s great. Three months is better than nothing. One day is better than nothing. 

It’s a lot to be a mom and take care of a little being. So do what works for you. In the end, the baby wants you happy and healthy and mentally stable first. Make the decisions you need to make to feel mentally stable and present. 

Read more

• Breastfeeding Bootcamp
• Breastfeeding how-tos

Midwives

The term “midwife” covers a range of different care providers, from certified nurse midwives, who are registered nurses (and usually possess a graduate degree like a Masters of Science in Nursing or a Doctorate of Nursing Practice) who have also completed special training specifically in midwifery, all the way to lay midwives, who enter practice directly following apprenticeship to an established midwife.

Midwives, regardless of their level of certification, share a common foundation: they are trained in women’s reproductive health. While obstetricians mainly concentrate on the delivery itself, midwives take a broader approach, focusing on the entire “birth year” of both the woman and her baby. This period encompasses labor and the first year of the baby’s life. Birth is a significant life event that impacts women in various ways — mentally, physically, and socially. Midwives play a vital role in educating women and their families on how to maintain wellness before and after childbirth. Essentially, midwives view pregnancies and births that do not involve serious risk factors as natural life events, rather than purely medical ones.

This doesn’t mean midwives don’t monitor pregnant women carefully for signs that could turn into medical complications. In fact, midwives who detect medical issues often have the ability and authority to treat them. They also often have established relationships and protocols for transferring the care of pregnant women with health conditions to obstetricians or for working alongside doctors. 

So why go to a midwife for care when it’s possible to end up under the care of an obstetrician anyway? Midwives provide continuity of care, both by attending all prenatal appointments and by staying with you throughout labor and early infant care. Women who feel strongly about natural birth or alternative birthing methods often feel more supported in that preference by midwives, too.

Beyond that, certified nurse midwives are medical professionals qualified to provide most prenatal monitoring and care and make recommendations for further care. In the U.S., depending on state regulations, many certified midwives can write prescriptions for medications, and outside of the U.S., certified midwives are often qualified to give all types of prenatal care and care during birth except for C-sections.

Doulas

Doulas are not medical professionals unless they have independent medical training in another area. Instead of providing medical care, doulas provide physical and emotional support before, during, and after labor. Doulas can share information about pregnancy, the process of birth, and newborn care with new parents, and help to make sure you know all your options as you’re going into labor.

Doulas can help new parents feel a sense of stability during labor, since they often arrive either before the midwife or before new parents are recommended to head towards the hospital. Doulas also generally stay with parents throughout labor, which can be especially valuable in a hospital setting, when shift changes may mean that your doula is the only face that stays constant throughout the process.

Labor nurses

Labor nurses are entirely different from midwives or doulas, though in some ways, their functions can overlap with both. In hospital settings, labor nurses can take on some of the monitoring that a midwife would do in a birth outside of a hospital setting. They can also provide some of the support and education before, during, and after the birth, such as what a doula might provide.

This overlap doesn’t mean that labor nurses are equivalent to either. Labor nurses don’t attend to each stage of birth in the way that either a doula or a midwife would. Unlike midwives, labor nurses do not generally deliver babies, and unlike doulas, though labor nurses may provide some emotional support and education, their jobs are not defined by that.

Also, unlike a midwife or a doula, labor nurses often have multiple patients at a time and may move from room to room during labor. Their shifts are independent of any individual woman’s labor and may change midway through or even multiple times, depending on the length of labor.

Different medical needs, availability, and new parents’ preferences mean that no labor team is exactly the same, but they are all teams—every member plays a part. Having a good idea of what each team member can provide is the best way to ensure that you’re making the best choices when you’re picking your team.

Sources

• Jessica Austin. “The Difference Between Midwife and Doula Explained.” BirthTakesaVillage. Birth Takes a Village, Dec 2011. Web.
• Yvonne Butler Tobah, MD. “Doula: Do you need a doula?” MayoClinic. Mayo Foundation for Medical Education and Research, Jan 15 2016. Web.
• “Differences between a Doula and a Midwife.” AllNursingSchools. All Star Directories, Inc., nd. Web.

OB/GYN

You’ve likely heard about OB/GYNs, but here’s the formal definition. An OB/GYN is a doctor whose specialty is obstetrics (the branch of medicine dedicated to childbirth and the care of women giving birth) and gynecology (the branch dedicated to the reproductive system).

Many women with low-risk pregnancies who plan to give birth in hospitals often choose OB/GYNs as their primary care providers during pregnancy, but when it comes time for delivery, they are safe in the hands of other providers like nurses or midwives. For women with high risk pregnancies, OB/GYNs are the recommended birth providers because they are the most well-equipped to deal with any complications and surgeries like C-sections.

If you’re considering giving birth at a birth center or other non-hospital setting and want an OB/GYN present, it’s important to note that OB/GYNs often serve as consultants at birth centers, but likely will not be present unless there are complications. Find out where your OB/GYN delivers as you create your birth plan.

Midwife

Midwives are healthcare providers who offer comprehensive care to childbearing women during pregnancy, labor, and birth. Midwives are also trained to serve as primary care providers Midwives can provide much of the same care that an OB/GYN can.

Women with low-risk pregnancies who work with midwives often experience fewer medical interventions, and may deliver babies in a variety of settings, including hospitals, birthing centers, and homes.

One of the biggest differences between a midwife and an OB-GYN is a difference in philosophy — midwives view pregnancy and birth as natural life events rather than major medical events. If this philosophy rings true for you and your pregnancy is low risk, a midwife could be a great fit.

Birth Doula

Birth doulas are labor coaches who help prepare you mentally and emotionally for delivery, and guide you through it. Doulas know about every facet of the labor process and can help you get a firm grasp on what will definitely happen, and what could.

Doulas can be useful for women who have had other pregnancies as well, because every pregnancy and delivery is different. It’s important to note that doulas are not doctors, and so may not be knowledgeable about a specific high-risk or complicated pregnancy. Postpartum doulas can also help you adjust to life with your new one and breastfeeding.

Birth Partner

Think of your birth partner as your right-hand. This person could be a partner, parent, sibling, or friend, as long as they are a person who supports you and you feel you can trust. Delivery is intense, and someone who helps you work through stress and discomfort is an ideal match for delivery day.

You get to decide who joins you for the birth journey, so spend a little time thinking about who can help you prepare for delivery and join you for the process.

Read more

• Building a birth plan
• Finding the delivery location that is right for you

Find your primary support person

Determine your primary support person. This person would be responsible for driving you home, making sure you are fed, and helping you with basic needs. This could be your partner, a close friend, a family member, or a postpartum doula — whoever they are, it’s important that you can rely on them. 

Make a clear, documented plan of your expectations for those first forty days with your support person. If it seems like too much for them to take on alone, bring on more than one person so they can work in shifts to support you and your baby. It’s important that whoever you choose is encouraging, nonjudgemental, and capable of supporting you holistically. 

Set up a food chain

Don’t be afraid to ask for what you need. Everyone is going to want to meet your little one, so ask them to bring basics when they visit. Request that family and friends drop off food so you don’t have to spend any energy thinking about what you are going to eat and preparing food. 

Make sure to clearly articulate your dietary needs ahead of time! Here’s one option for organizing meals: https://www.mealtrain.com. There are plenty of other resources with similar functionality. 

Arrange your appointments before delivery day

Book your postpartum wellness check ups before your little one arrives! Schedule your appointments now, and put them on the calendar so your primary support person can refresh your memory and help transport you to the appointments. Although, if something doesn’t feel right before your scheduled check-up, don’t hesitate to call your provider. 

Plan for the worst, but expect the best

Life can sometimes take some unexpected twists. It’s important to be as prepared as possible for the worst. Talk to your provider about your specific health conditions to get a better understanding of what could happen during labor and postpartum. Ask questions about what you can expect physically and emotionally during those first 40 days and what are common warning signs. Once you have a clearer picture of what to expect during labor, make a plan for each emergency scenario and clearly talk through it with your primary support person so they can advocate for your needs and wants.

The bottom line 

Create a postpartum plan now. It is important to start thinking about your first 40 days and beyond, so you can set expectations with your support network well in advance. Lean on your network to support you in communicating with your provider if something doesn’t feel right.

Read more

• Feeling more like you after giving birth
• The nitty gritty: Emotional stress after giving birth

How can doulas help?

Starting in pregnancy, doulas can support you by helping you learn more about labor and delivery, answering questions you have about the process, and helping make sure that you know all your options before the big day. Doulas can also support you throughout labor, helping you position your body to find more comfort, offering hands-on touch to provide relief and promote calm, and helping you communicate with your healthcare provider to ensure that you feel in control during the process.

And because, in many instances, you might not deliver your baby with the healthcare provider who has been seeing you throughout your pregnancy, a doula can serve as a great source of consistency and stability throughout your pregnancy journey. They can even provide you with support postpartum as your body recovers, as you learn to breastfeed (if you choose to) and care for an infant, and as you adjust to how this major transition reshapes your life. 

Another big way doulas offer support is by helping you to advocate for the kind of care you want and need. Self-advocacy when it comes to the medical care you’ll receive during this time is hugely important, especially if you experience a medical professional who is not really hearing you. Because you’ll have been working with your doula for sometime and they’ll really understand what you want and need — and because you’ll likely be very comfortable speaking with them honestly about your wants and needs — they can help back you up, communicate your needs, and make sure you’re heard.  

In addition, recent research shows that doulas can help lead to better health outcomes. Folks who work with doulas are less likely to experience complications that involve them or their baby, are less likely to have a baby with low birth weight, and have higher rates of breastfeeding.

Why it’s important to find one who gets you

Clearly working with a doula has some major benefits, but how can you choose one who’ll be best for you? It can be incredibly helpful to work with a doula who can provide you with personalized support — physically, emotionally, and educationally. Often finding a doula who works in your community — someone who you feel you can really connect with and speak with honestly — is the best choice.

How doulas can play a role in helping with birth equity

Health inequity in the United States has devastating consequences for Black women and families, who experience disproportionately worse maternal and infant health outcomes for a number of reasons — including limited access to care, dismissal of pain and other health concerns, and higher rates of underlying health conditions — racism and unconscious bias in the healthcare system are huge factors in each of these areas.

Doulas can play a role in improving  birth equity, which is “the assurance of the conditions of optimal births for all people, with a willingness to address racial and social inequities in a sustained effort.” There are, for example, doula groups run by and for Black women, so that those doulas can really understand what the people they are working with are going through, the challenges they may be facing, and can help support all of their unique needs. A personalized doula experience, where you really feel like your doula understands your unique needs and wishes, can greatly improve health outcomes. 

You deserve support

So if you’d like to work with a doula, try and seek one out in your community who you connect with and who understands where you’re coming from. A quick internet search may help you find independent doulas or doula groups in your area (DONA International, a leading doula certifying organization, has a database to search by location). You may also want to ask your healthcare provider if they have any recommendations. And it’s also worth noting that some healthcare offices and community clinics may even be able to help get you set up to work with doulas in your community, some of whom may be available to support you at no cost during pregnancy and postpartum.

Doulas can be expensive and inaccessible for some people to hire on their own, so even if free community doula services are not available through your healthcare office or clinic, many student doulas do offer free or discounted services. So if you’re interested in doula services, start your search today. You deserve to have the kind of support a doula can provide. 

Read more

• How to advocate for yourself as a patient to get the care you deserve
• Why bringing a support person with you to appointments can help you advocate for the best healthcare

Sources

• Kenneth J. Gruber, Susan H. Cupito, Christina F. Dobson. “Impact of Doulas on Healthy Birth Outcomes.” The Journal of Perinatal Education. 22(1): 49-58. Winter 2013. Retrieved August 31 2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3647727/.
• “Find a Doula.” DONA International. DONA International. Retrieved August 31 2020. https://www.dona.org/what-is-a-doula/find-a-doula/.
• “Obstetric Care Consensus: Safe Prevention of the Primary Cesarean Delivery.” The American College of Obstetricians and Gynecologists. The American College of Obstetricians and Gynecologists, 2016. Retrieved August 31 2020. https://www.acog.org/clinical/clinical-guidance/obstetric-care-consensus/articles/2014/03/safe-prevention-of-the-primary-cesarean-delivery.

As a queer Black person, it can be especially helpful to see a care team that shares your cultural background. Studies show that seeing Black providers typically leads to better health education and health outcomes for Black patients. Here are some tips to help you navigate the system and advocate for yourself.

Find a provider who gets you

First things first: it’s critical that you find a provider who really understands your position, whether or not they’re queer and Black themselves. Finding a provider that takes the time to correctly pronounce your name and use your pronouns, can go a long way in making you feel comfortable and taken care of.  If your provider is consistently misgendering you or mispronouncing your name, this can be a clear sign that they are not a good fit for you. 

Don’t be afraid to shop around for a provider that makes you feel comfortable. There’s no one-size-fits-all approach, and the OB/GYN your friend loves so much may still not be the right fit for you. Ovia Health’s coaching team can help you find in-network providers who fit your needs across specialities, location, queer-friendliness, racial and ethnic identity, and more. Once you have your list together, schedule a few appointments and be sure to ask each provider specific questions during your first visit about how you will work together towards your reproductive health goals. about finding the right provider. 

Consider alternative options

More and more people are choosing to work with a midwife for their ongoing reproductive care rather than a traditional OB/GYN. Midwives offer most services that OB/GYNs do and focus on taking a whole-health approach to patient care. They can address low-risk to normal-risk conditions, whether around sexual health, pregnancy and birth, or postpartum. They can help with things like STI counseling and testing, common concerns like yeast infections or UTIs, and fertility support. In fact, due to their holistic approach, many midwives focus on ensuring that you and your body are prepared to have the healthiest pregnancy possible if you are trying to conceive. The ability to prescribe medications can vary by state. 

If you already have a provider but aren’t satisfied with their care, or if your goals have changed (perhaps you’re now trying to get pregnant), consider switching providers for one that better fits your needs. Advocate for yourself and find the right fit for you.

Advocate for your needs

During every visit, you have the right to ask as many questions as you want to understand exactly what is going on with your body. Try keeping a list of the concerns that arise in between visits and bringing it to your next appointment (and be sure to talk to an Ovia Coach in the meantime!) Check out these helpful resources on talking to your provider. 

You have the right to be seen, heard, and get the care you need.

Sources

• “What is a Midwife and Why Might a Woman Want to See One?” Jessica Costa, CNM. Cleveland Clinic. Cleveland Clinic. December 12, 2018. https://my.clevelandclinic.org/podcasts/health-essentials/what-is-a-midwife-and-why-might-a-woman-want-to-see-one. 
• “Benefits of Using a Midwife.” Cleveland Clinic. Cleveland Clinic. https://my.clevelandclinic.org/departments/obgyn-womens-health/depts/obstetrics-family-maternity-center/midwife#benefits-tab.

1. Prepare for uncertainty 

While we can probably all agree that accepting “uncertainty as the only certainty” is easier said than done, most of us worry less about uncertainty when we feel prepared. Writing a birth plan helps channel any anxious energy into something productive. Use your sense of accomplishment from creating your rock-star birth plan to help you conquer your fear of childbirth.

2. A birth plan helps you get to know your provider better

Talking early (anytime after 25-30 weeks) and often about your childbirth and postpartum plan helps you confirm that you have chosen the right provider for you. The right provider for you is someone who listens to you and who you can trust. When you trust your provider (or provider team), you can feel more confident that they have your best interest at heart.

3. Choose who should attend the main event

Just as you need to know that your provider has your back, you want to make sure the right people are around you when contractions start for real. (Who knows, maybe you have always been waiting for the chance to be able to tell your MIL to take a hike?) A birth plan can be a tactful way to have these difficult conversations before you’re in labor. Nobody wants family drama in their delivery room!

4. Birth plan = partner’s prep

Even if your partner is an OB/GYN, that doesn’t mean they know exactly how to support you in the delivery room. Every birth partner needs to prepare, regardless of who they are. Researching, writing, and talking about a birth plan together can help ease your birth partner’s worries too. The last thing you want to be worrying about in labor is your partner worrying about you.

5. Let your knowledge help you reclaim your power

Learn about what is and isn’t normal during pregnancy, delivery, and postpartum. There is a reason why What to Expect When You’re Expecting was such a blockbuster success — expectant parents need information to prepare. So geek out all you want on crafting the mother-of-all birth plans — doing so will help you prepare for the main event. You’ll feel more confident, powerful, and in control because less will be new, unfamiliar, or unknown during your delivery and postpartum.

6. Establish open lines of communication

Many people who are afraid of childbirth worry that they will not have a voice in decision-making. When it comes to a good birth, over communication is the name of the game. Talking about your birth preferences early and often with as many people as possible will likely help reduce your anxiety. Think of your birth plan as your opportunity to tell your doctor and labor and delivery nurses what you do and don’t want to happen at your delivery. The more practice you get talking about complicated health information with healthcare providers, the more your self-confidence and power will grow. It is time to claim your seat at the table (or birthing stool in the delivery room as the case may be).

Worrying less during pregnancy is good for you and your baby. A June 2013 review in ​Obstetric Medicine​ also found that prenatal stress — like fears about childbirth — can have lasting physical consequences for both expecting parents and their babies, including low birth weight, premature delivery, and gestational diabetes. Writing your birth plan can help you meet uncertainty with acceptance, not anxiety. When your birth plan is flexible and comprehensive, both you and your birth team can turn to it as a good birth wishlist — a guide to what matters most to you as you enter the next chapter of your life as an expectant parent.

Read more

• Building a birth plan
• Finding an OB/GYN or midwife