World Breastfeeding Week 2015: Breastfeeding & Work

Happy World Breastfeeding Week! August 1- 7 is dedicated to promoting international breastfeeding. Organized by the World Alliance for Breastfeeding Action (WABA), World Breastfeeding Week began in 1991 as “one unique unifying social mobilisation event that can build solidarity and action” according to the event’s original website. The theme this year is Breastfeeding and Work: Let’s Make It Work.

The stated objectives of World Breastfeeding Week 2015 are:

Galvanise multi-dimensional support from all sectors to enable women everywhere to work and breastfeed.
Promote actions by employers to become Family/Parent/Baby and Mother-Friendly, and to actively facilitate and support employed women to continue breastfeeding.
Inform people about the latest in global Maternity Protection entitlements, and raise awareness of the need to strengthen related national legislation and implementation.
Strengthen, facilitate and showcase supportive practices that enable women working in the information section to breastfeed.
Engage with target groups e.g. Trade Unions, Workers Rights Organisations, Women’s groups and Youth groups, to protect the breastfeeding rights of women in the workplace.

WABA states there are three key elements that determine success for women who work and breastfeed: time, space/proximity and support.

world breastfeeding week logoTime refers to adequate paid maternity leave to establish and support breastfeeding, paid breaks or reduction of work hours for breastfeeding and flexible hours to allow for more time with their babies or to pump.

Space/proximity addresses keeping mothers and babies physically close to one another to facilitate adequate nursing, a safe location for breastfeeding or pumping and a work environment that is clean and without harmful chemicals.

Support includes information about laws and benefits related to pregnancy and breastfeeding, positive attitudes by employers and co-workers regarding not only breastfeeding, but pregnancy and motherhood as well and elimination of employment discrimination around maternity and breastfeeding.

For US based doulas, below are some resources related to the laws that affect employed nursing mothers:

The US Department of Labor published a blog in 2013 in honor of National Breastfeeding Month called, “Know Your Rights: Breastfeeding in the Workplace” that states that the “Fair Labor Standards Act requires breaks for mothers to express breast milk during the workday” for up to a year after birth and specifies the requirements for the space. There is an entire section of the Department of Labor’s website dedicated to nursing mothers: http://www.dol.gov/whd/nursingmothers/.Nursing-Mothers-Employee-Rights-Card

To find laws by state that affect pregnant and nursing women, consult this handy and searchable map.

How you can get involved in World Breastfeeding Week:

Social media is a powerful communication tool and there are several ways to use social media to support the goals of World Breastfeeding Week:

• Change your profile picture or simply share the World Breastfeeding Week Logo (available in the Action Folder in in various size, colors and languages).
• Use these hashtags (individually or in combination): #WBW2015 #breastfeeding #MaternityProtection #WomenandWork in your posts about breastfeeding.
• Share the World Health Organization’s Infographic about their 2025 breastfeeding goal.
• Share information on breastfeeding laws and rights in your country and state/province via social media. Use the #KnowYourRights and #breastfeeding hashtags.
• Follow WABA on Twitter and/or Facebook to be part of the conversation and get great content to share.

Beyond social media, you can:
• Write a post about breastfeeding and work for your own blog. You can use the resources and images suggested above for social media or tell your own story.
• Write a Letter to the Editor of your local newspaper about breastfeeding and work.

After World Breastfeeding Week:
• Continue the conversation about the importance of time, space/proximity and support to successful breastfeeding while working. This can be person-to-person in your community, in your prenatal meetings with clients or via social media.
• Educate clients on their rights and the laws that affect them as related to breastfeeding and work.

We’d love to hear how you are participating in World Breastfeeding Week!

— Adrianne Gordon, CD(DONA), MBA

Top 10 Reasons to Attend the Virtual Conference

Recently, The DONA Doula Chronicles shared some ways to stay up-to-date on research and information for doulas. One of the absolute best ways to get the latest information in pregnancy, birth, breastfeeding and the postpartum period is DONA International’s Annual Conference. This year it will be a virtual event with sessions available beginning August 7th. It’s not too late to register! Not sure if you should attend? We bring you:

The Top Ten Reasons to Attend the 2015 Virtual Conference

1) You can attend in your pajamas. The Virtual Conference is the ultimate come as you are experience!

2) Get doula focused education from leading researchers and practitioners in the birth community. DONA International conferences are created specifically to support the unique role that doulas play in the birth and postpartum experience. Topics and speakers are selected that provide valuable information and resources for labor support and postpartum support professionals.

3) This is a great introduction to online training for those who are new to this learning format. The conference website is easy to use and there is no software to download.

4) No worrying about missing a birth to attend a training with this online conference. The sessions will be waiting for you on the conference website when you return from supporting that new family.

5) Rewatch sessions again and again for three months. Because all of the conference sessions are recorded, the ideas and insights can be paused while you take notes or reviewed to make sure you don’t miss a thing.

6) You can say Penny Simkin, Walker Kaarra, Amy Gilliland and other birth experts were in your living room (no cleaning required).

7) Attend all of the sessions and you’ll have more than the required continuing education contact hours for recertification.

8) The Virtual Conference is the most cost effective way to access this level of training. No travel or hotel expenses, but the same evidence based information you’ve come to expect from DONA International.

9) If you miss this one, you’ll have to wait a whole year for the next DONA International conference!

10) No choosing between sessions offered at the same time. The most difficult part of attending an in-person DONA International conference is deciding which concurrent sessions to attend! With the virtual conference you can attend all the sessions you are interested in, on your own time and at your own pace.

We received great feedback from the 2013 virtual conference and are excited to offer this experience again this year. As always, DONA International members receive a discounted registration for the Annual Conference. Registration will remain open until November 7th but there’s no time like the present for expanding your knowledge and skills!

Delayed Cord Clamping – Evidence & Resources for Doulas

The clamping and cutting of the cord is “one of the oldest interventions in the birth process” according to the American College of Nurse-Midwives Position Statement on Delayed Umbilical Cord Clamping. Early cord clamping was thought to prevent maternal postpartum hemorrhage and it was this idea that helped the practice gain acceptance as a standard of care in the 1960s. While research has since shown that early cord clamping does not reduce postpartum hemorrhage, there is still debate within the maternity care community about the optimal time to clamp the umbilical cord. While delayed cord clamping is discussed in most childbirth classes and often appears on the birth plans of families interested in a low intervention birth, it may be that families, doulas and care providers are not using the term to mean the same thing or all have the same understanding of what the evidence does and does not say about the practice.

First, let’s define “delayed cord clamping.” Just as we found with postpartum depression, this is a phrase that is commonly used in the maternity community but is not as clearly defined as one might think. The World Health Organization (WHO) considers cord clamping to be delayed when the cord is clamped “more than one minute after birth or when cord pulsation has ceased.” The American College of Obstetricians and Gynecologists (ACOG) has not issued a specific definition of delayed cord clamping. Their most recent document on the subject, an Opinion from the Committee on Obstetric Practice issued in December 2012 references 30 – 60 seconds after birth. The American College of Nurse-Midwives (ACNM) recommends delaying cord clamping for two to five minutes after birth depending on certain circumstances in their May 2014 Position Statement. If you are confused at this point, you are not alone. This lack of consistency across maternity care organizations about how to define delayed cord clamping is likely part of why there is still little consistency in how this practice is carried out despite growing evidence that waiting to clamp the cord has benefits for babies that last for months or even years.

Benefits of Delayed Cord Clamping
We know that the umbilical cord is a baby’s lifeline before birth. Once the baby takes her or his first breath does the umbilical cord still have a function? The short answer is yes, but only for a brief period of time. The cord, as we know, connects baby to placenta. The baby’s blood circulates through its body and through the umbilical cord to the placenta and back again receiving oxygen and nutrients from the mother. A full term baby may have as much as one third of its blood in the placenta when labor begins. During labor and birth, the placenta transfuses most of the blood back to the baby, but not all. The cord continues to pulse after birth to continue this process and, if left undisturbed, can transfuse enough blood to supply the baby with iron for around three months. A 2013 Cochrane Database Review of research on delayed cord clamping found that infants whose cords were clamped one minute or later after birth had higher iron levels when measured at two to six months of age. ACOG’s Committee Opinion on the subject states that the extra iron received after birth from the placenta “may help prevent iron deficiency during the first year of life.” Iron is very important for normal cognitive and social development in infants and deficiencies can lead to long-term consequences.

There are particular benefits of delayed cord clamping for preterm babies. ACOG recommends waiting 30 – 60 seconds after birth in these cases due to a nearly 50% reduction in the incidence of intraventricular hemorrhage or bleeding within the brain, a life threatening condition. Preterm infants also benefit from reduced need for blood transfusions and improved circulation when cord clamping is delayed by at least 30 seconds.

In a study published earlier this year in JAMA Pediatrics, researchers found that benefits to delayed cord clamping extend into early childhood. A Swedish study found that four-year-olds whose cords were clamped three minutes after birth had higher fine motor and social skills than those whose cords were clamped less than 10 seconds after birth. This is one of the few studies of full-term infants on the impacts of delayed cord clamping.

Risks to Delayed Cord Clamping
Research indicates no difference in immediate birth outcomes between babies whose cords are clamped early versus delayed including APGAR scores and respiratory distress. In their 2012 Committee Opinion (i.e. prior to the 2013 Cochrane Review), ACOG mentions several concerns (their term) regarding the universal adoption of delayed cord clamping including: risk of polycythemia in the baby, or too many red blood cells, particularly when other risk factors for the condition such as maternal diabetes, severe intrauterine growth restriction and high altitude are also present, the impact on timely resuscitation efforts for infants in respiratory distress, and that the practice may be technically difficult. ACOG notes that maternal hemorrhage due to delayed cord clamping remains a “theoretical concern” because of the volume of blood that continues to flow through the uterus at birth.

Recommendations for Delayed Cord Clamping
WHO (2014) – Not earlier than one minute after birth.
ACOG (2012) – No recommendation. Evidence supports waiting 30 – 60 seconds in preterm infants. Evidence is insufficient to support delayed cord clamping in term infants.
ACNM (2014) – Delayed cord clamping as the standard of care for term and preterm infants in all birth settings. Their Position Statement specifies time length in certain circumstances:
• Five minutes for term infants placed skin-to-skin
• Two minutes for term infants placed at or below the birth canal
• 30 – 60 seconds in preterm newborns

With a range between 30 seconds and five minutes it’s easy to see how there can be confusion about what is meant by “delayed” clamping of the cord. As doulas, our role is to share information with our clients and encourage them to discuss issues that matter to them with their care providers. Sharing up-to-date evidence on the risks and benefits of a care practice so that families can make informed decisions is an essential role of doulas.

Resources
ACNM Position Statement: Delayed Umbilical Cord Clamping http://www.midwife.org/ACNM/files/ACNMLibraryData/UPLOADFILENAME/000000000290/Delayed-Umbilical-Cord-Clamping-May-2014.pdf

World Health Organization, “Optimal timing of cord clamping for the prevention of iron deficiency anaemia in infants” http://www.who.int/elena/titles/cord_clamping/en/

ACOG Committee Opinion, “Timing of Umbilical Cord Clamping After Birth”: http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Timing-of-Umbilical-Cord-Clamping-After-Birth

Cochrane Database Review: “Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes” http://www.ncbi.nlm.nih.gov/pubmed/23843134

Science & Sensibility post on the 2013 Cochrane Review: http://www.scienceandsensibility.org/new-cochrane-review-further-substantiates-early-cord-clamping-is-not-beneficial/

JAMA Pediatrics, “Effect of Delayed Cord Clamping on Neurodevelopment at 4 Year of Age”: http://archpedi.jamanetwork.com/article.aspx?articleid=2296145

Certification Matters: CDs and PCDs Get Higher Fees & More Clients

By Kim James, ICCE, LCCE, BDT(DONA)

Kim JamesAbout the Author: Kim James has run a successful birth doula business for 15 years in Seattle, Washington. Kim’s roles in the birth community include: DONA-approved birth doula trainer at the Simkin Center for Allied Birth Vocations, childbirth and parent educator at Parent Trust for Washington Children, DONA International Washington SPAR (State Representative) and Lamaze International membership committee member. Kim is also the owner and operator of DoulaMatch.net.


From the doula availability database, DoulaMatch.net, we have solid evidence that DONA International certified doulas consistently earn a higher fee and receive more referrals than non-certified doulas and doulas certified through other organizations.

From January 1 through May 31, 2015, 2,627 active doulas in the database received at least two or more referrals.

Doula_Match_#1DONA International certified doulas commanded a 25% higher fee than non-certified doulas and a 7% higher fee than doulas certified through other organizations. DONA International certified doulas also received twice as many monthly referrals.

What’s more interesting is to look at how DONA International certified doulas compare to other doulas with the same amount of experience.

Doula_Match_#2

At all levels of experience, certified doulas, and DONA International certified doulas in particular, earn higher fees and attract more clients.
For new doulas, achieving a meaningful certification means you are more attractive to potential clients. When you don’t have a lot of clients under your belt, having a recognized certification demonstrates to potential clients that you have the skills necessary to be an effective doula. With certification, doulas achieve a major professional milestone that provides an edge over doulas with the same amount of experience who are not certified or are certified through lesser-known organizations.

For established doulas, experience is the great equalizer and decreases the fee and referral gaps. However, achieving and maintaining certification demonstrates your professional commitment and validates your higher fee, even when your practice is established and thriving.

Families who use a database to reach out to doulas are probably looking for mid-priced doulas with moderate experience. When faced with a lot of choices, whether or not a doula is certified seems to matter. For doulas with moderate experience of two to seven years, 59% of all referrals went to certified doulas. Of those certified doulas, 56% were certified by DONA International.

Whether you’re just starting out or firmly established, achieving and maintaining certification is a solid business decision that benefits not just families and our profession, but you as a doula business owner.

Keeping Up With News, Research & Trends in Birth and Postpartum

There seems to be more information every day, but we certainly don’t seem to have more time to take it all in! Here are a few tips on how to stay up-to-date on information and articles related to birth and the postpartum period.

Google Alerts

Google_alert_exampleYou don’t have to search the web daily to find the latest research or news articles. Search engine giant Google offers a free service that sends an email when new information on a particular topic appears on the Internet. This can be a great way to keep up with news or information in your local area or follow a subject you are very passionate about such as VBACs, pregnancy nutrition, etc. Go to http://www.google.com/alerts and type in the topic you want to receive updates on. You can choose to receive alerts on everything from the web or only news or blogs. Google also lets you set how often you want to receive emails. It’s possible to edit an alert once you’ve set it in case you aren’t getting the kind of information you want or feel you are getting too many messages. Target your alerts using quotes such as “postpartum doula” to be notified only of items that use that phrase exactly. A minus sign in an alert such as “research birth –control” can help filter out certain sub-topics that you don’t need. You can learn more about Google Alerts on their help page.

The DONA Doula Chronicles

TDDC_in_your_inboxWe try to do a good bit of the legwork for you by offering summaries of reports and protocol changes soon after they happen. We also collate several pieces of research or a collection of resources on a specific topic such as Cesarean Resources for Doulas and New Research on Premature Birth.

Tip: You don’t have to remember to check back here to get the latest posts; you can sign-up to receive posts via email to get research and resources right in your inbox.

International Doula

This quarterly print publication from DONA International covers topics in more depth than a blog or news article. Every issue includes media reviews and information specifically for doulas and the unique role we have in providing support during the childbearing year. Editions are printed in March, June, September, and December. DONA members can access back issues of the ID via the online Member Center. This is a great reference library! Issues are available back to 2011 in the Member Center.

Past_covers_ID

Not currently a DONA International member? Here’s a free back issue of the International Doula to see the type and range of content included.

Trusted Resources

Part of our scope of practice as doulas is informational support. Birth doulas provide clients with “assistance in acquiring the knowledge necessary to make informed decisions about [their] care” according to the DONA International Scope of Practice.  For postpartum doulas, the Scope of Practice says, “the doula offers evidence-based information.” Clearly, our role is to serve as a conduit for families to reputable information so that they can make informed decisions for their family. Determining what information is reputable, or even evidence based, can be a real challenge. To help, we’ve compiled a short list of websites that are well known in the birth community to provide evidence based information both for doulas and for the families we serve.

Childbirth Connection is a nearly 100 year old organization that recently joined forces with the National Partnership for Women & Families. Their website offers evidence-based information for families in clear, approachable language covering topics such as choosing a care provider, induction and cesareans. Pregnancy resource recommendations and information on labor support are also available. Childbirth Connection is likely a name familiar to many doulas from the Listening to Mothers surveys and the Hormonal Physiology of Childbirth report.

Lamaze’s Science & Sensibility blog provides in-depth coverage on research related to pregnancy, birth, and the postpartum period for childbirth educators, doulas and care providers. Giving Birth With Confidence,another Lamaze offering geared toward families, can be a good source of evidence-based information to share with clients. Their “Your Pregnancy Week by Week” emails are informative yet positive, which can go far to help reduce fear or anxiety in expectant moms.

The stated mission of International Cesarean Awareness Network (ICAN)  is “to improve maternal-child health by preventing unnecessary cesareans through education, providing support for cesarean recovery, and promoting Vaginal Birth After Cesarean (VBAC).” Their website offers supportive and evidence based information for pregnant and parenting families through articles and blog posts. ICAN chapters can be an excellent source of support for families and an important resource for doulas.

Rebecca Dekker’s Evidence Based Birth is exactly as the name suggests – articles on birth related topics that are rooted in research. While the material here is steeped in studies and scholarly articles, the information is presented in a very approachable way. Handouts, newsletters, and even classes are also available from Evidence Based Birth that are appropriate for both doulas and families.

How else do you stay up to date? Do you have favorite resources we missed? We’d love to hear from you!

— Adrianne Gordon, CD(DONA), MBA

Networking for Doulas

About the Author:  Wendy Scharp is the owner of Doula Love, a thriving doula agency and classroom in Portland, Oregon. She is a DONA approved birth doula trainer and ICEA childbirth educator trainer. She has been a doula and childbirth educator for over 10 years.

Builgroup-work-454882_1280ding a solid referral network for a service-based business can be an extremely rewarding and beneficial process, if done correctly. Making connections with other professionals is one of the most important parts of growing a successful and thriving business. However, if networking is done in a self-serving manner, and is focused only on what an individual business can gain, it can isolate and even reflect poorly on one’s business.

There are three pillars that create a solid foundation for a professional network:

  1. Finding the right people to connect with
  2. Making the connection
  3. Supporting each others’ businesses through referrals

These may seem very simple and straightforward, but people frequently make detrimental mistakes.

1. Find the Right People

First, finding other professionals to connect with can be an exciting but time consuming task. Taking the time to hone in on the professionals you would like to meet with and make connections with is extremely important. If you are not selective, you can not only waste your precious time, but also make connections that could reflect poorly on your business.

When you begin to search for other professionals, the first thing to do is make a list of the services that are the highest priority for you to connect with. For example, a doula may be most interested in connecting with a childbirth educator, lactation consultant and chiropractor specializing in prenatal and postpartum care. Once your list is made, talk to the professionals that you already know personally and ask them who they have as part of their referral network. Then reach out to past clients and find out which local practitioners and organizations they know and love. Search and read reviews on Yelp, Angie’s List and Facebook. Attend, and possibly join, a few local networking groups.

2. Making the Connection

Now that you have a healthy list of professionals that you are interested in connecting with, you can move on to the next step – making the connection. This is where many new professionals drop the ball. Far too frequently, professionals reach out with an email that reads something like, “Hi my name is Sally Smith and I own Belly Blossom Photography which specializes in pregnancy and birth photography. Can I please be on your resources list and send you some business cards to share with your clients? Thanks, Sally.” Many may read this and think that it seems like a legitimate request. However, the email makes several critical errors that may deter another professional from connecting with you. Were I to receive such an email, I would immediately notice that this person is asking me to take time out of my busy day and add her to my resource list, yet fails to offer me anything in return. Second, she is not providing me enough detail about her business and why I should trust that she is a good photographer. Finally, she is not offering me the opportunity to meet her and see if she is someone I would be interested in referring my clients to. I value my clients too much to simply refer them to a company or a service provider that I don’t have a real connection with or have any information about. If I did send a client to her, and she provided unacceptable service, that would reflect poorly on my company.

While making the connection with other professionals, it is important to communicate in a genuine and productive way. There are a few key pieces of information to include in your email when reaching out to another professional. phone-381282_1280When sending out your first email or making a phone call, you want to clearly inform the other professional of several things. Let them know why you have chosen them to connect with and how you learned about them. Explain to them why you value the services they offer in the community. Tell them who you are and what services you offer. Give a small bit of background about your journey to servicing the community. Help them understand why you think your businesses complement each other. Express that you would enjoy an opportunity to have tea or coffee to learn more about them and the services they offer. Finally, always thank them for taking the time to read your email or take your call.

By using these simple tips, you are helping the other professional to feel respected and valued. You are also giving them a reason to get excited to meet you and learn about your services. Professional relationships work better when there is some reciprocity. In a final step in making connections, make sure to keep track of who you have attempted to connect with and whether they respond to you or not.

Once the initial connection is made and you are setting up your meeting, there are a few things to keep in mind. Plan to meet in a location that is convenient for both of you. Make sure it is a place that is not too busy or so loud that you cannot hear each other. I suggest a small local coffee shop. Ask the person to bring some of their business cards/promotional materials to this meeting. And, of course, do not forget to bring yours. An extremely important part of building a solid network is connecting with people whose company you enjoy and that you feel will care for your clients with the same level of care that you provide. For example, if you meet a chiropractor that you do not hit it off with or find to be smug, you are less likely to refer clients to them. You are not going to like everyone you meet and not everyone you meet is going to like you. Remember that this is normal. Finding the right connections will serve all involved much more satisfactorily in the long run. Trust and connection will take time to build, so make sure you are willing to invest your time in this process. I love to be able to say to my clients “Sally over at Belly Blossom photography is wonderful, and I know she will take great care of you.”

3. Supporting Each Other Through Referrals

Now that you have built your network and feel confident with the providers/services you have connected with, the next step is to share referral information with your clients and the community. Knowing more about the different types of providers/services in your referral network will help you to more effectively share their information. For example, once you know what a craniosacral therapist does, you will feel more confident recommending craniosacral therapy to clients who struggle with breastfeeding problems, infant digestion and sleep issues. It helps to memorize a few key points on the benefits of services offered, the location and qualifications of each practitioner/organization that you refer to. You can make your referrals even more personal by adding a sentence about the provider’s personality or approach. You can tell your clients that, “Sally has a wonderfully calming presence and takes great candid photographs of your family’s precious moments.”

To begin sharing the services of your new professional network, you can implement various methods. One popular option is creating a resource list on your website. Resources screen shotAnother method is having a resource wall with pamphlets and business cards, if you have a location to do so. If you run a parent support group, having a speaker come every few weeks to give a presentation on a topic that is relevant to your clients can also help to promote your network while supporting your clients at the same time. Social media can also be a great way to share your referral network with the community. By liking, sharing, hash-tagging and linking to members of your referral network, you can boost the reach of your business and the business of the practitioner/organization.

The Value of Networking for Doulas

Networking with other professionals has been one of the greatest joys of my practice. Finding new ways to foster collaboration, respect and mutually positive relationships has been a satisfying way to benefit myself and my community. We can only personally benefit when we build up those around us. I recently helped a massage therapist find a space to rent at the office of an acupuncturist that I send clients to regularly. I also had the opportunity to teach a “What to Expect in the Postpartum” class with a local naturopathic physician. Additionally, I was invited to present on the topic of “optimal fetal positioning” in a prenatal yoga instructor training. All of these opportunities came out of me taking the time to connect with other professionals in my related field and community.

Throughout the network-building process, it is important to keep in mind that networking does not necessarily translate directly to client referral. Networking often occurs in unexpected ways; it can help you brand your business and make you a respected and well connected member of your business community. It can serve you in a myriad ways throughout the life of your business. As you move forward in your practice, make sure you have a way of asking your clients how they found you and the services you offer. This can be done by verbally asking or collecting information through a contact form on your website. Tracking where referrals come from is a very powerful tool of business.

thank-you-490607_1280Finally, after you have seen the results of your networking pay off, make sure to acknowledge the referral. Send the referring professional a handwritten thank you card for sending you the client. Always remember that networking can be a time consuming task with little immediate return. However, the long term benefits of a broad and strong referral network will make you glad you invested in the future of your business.

Paternal Postpartum Depression

donainternational:

As we think about dads this month, in particular how we as doulas can support fathers during the childbearing year, we wanted to re-share important information about paternal postpartum depression. If you have any additional articles or resources on this topics, please share in the comments.

Originally posted on The DONA Doula Chronicles:

paternal postpartum depressionDid you catch the first word in the title? Yes, that’s paternal, as in dads. We don’t often see the words paternal and postpartum together, and you may not have heard the term “paternal postpartum depression” before at all. Postpartum depression is a topic that we associate with new mothers. In fact, the very definition is depression in a woman after she has given birth. But what about new fathers? Feelings of irritability, guilt, anxiety, isolation and sadness, loss of energy or changes in appetite are not yet as widely recognized as cause for concern in a man after the addition of a baby to the family as they are for the new mother. Yet paternal postpartum depression is a very real issue and “is currently underscreened, underdiagnosed, and undertreated” according to a 2012 article in the Journal of PediatricHealth Care aimed at helping care providers recognize and treat…

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Early birds get Annual Conference discounts!

DONA International’s 21st Annual Conference will take place August 7 and 8 from the comfort and convenience of your very own home. As a virtual conference on-demand viewing of conference sessions will be available until November 7, 2015. With less time away from busy doula practices and our families and without the financial investment of travel, a virtual conference is a great way to gain world-class training to expand knowledge and sharpen skills. Early bird registration rates end June 30th so don’t delay! This year’s conference has an incredible speaker line-up including:

speaker_captureFifteen sessions are available for DONA International contact hours for recertification. Session topics include: ways to attract clients, the pelvis and birth positions, hospital based doula programs, supporting women who choose hypnosis for childbirth, language sensitivity, vaginal birth after cesarean, and woman-centered or baby-centered doula support.

For the full list of sessions and speakers, visit the virtual conference site.

Register now to take advantage of early bird pricing!

Happy learning!

— Adrianne Gordon, CD(DONA), MBA

Dads & Doulas: Myths & Resources

dad hands

Happy Father’s Day! In the United States, we celebrate dads this Sunday and so it seems like a great time to discuss how doulas support fathers before, during, and after the birth of a baby and share resources for new and expectant fathers.

There was a time when expectant fathers were portrayed as anxious, floor-pacing, cigar-smoking men who were tolerated in hospital corridors until the long-awaited moment when a nurse or doctor would announce they were the proud father of a daughter or a son. Today’s expectant fathers, loved ones and families are different.

This is the opening text to the DONA International topic sheet, “Dads, Partners and Doulas: Key Players on Mother’s Labor Support Team” and illustrates how much things have changed about the role of fathers in childbirth. Today’s dads are (thankfully!) active participants in pregnancy, childbirth and parenting. Doulas sometimes encounter questions or even resistance because the dad-to-be, or even the mom-to-be, are concerned that a doula will somehow replace or diminish the father’s role in labor and the postpartum period.

Penny Simkin, one of DONA International’s founders, shares three myths about doulas and partners in a widely circulated article addressing concerns about the doula/partner relationship. Her full article can be found here: http://health.ucsd.edu/specialties/obgyn/maternity/facilities/doula/Documents/simkin.pdf

# 1 – Role redundancy. There may be concerns that the roles of the doula and partner are so similar that only one is needed. The doula’s role is unique because she is not going through a personal transition like the father is; she is there simply to provide support to the mother AND father. The doula’s training and experience allows her to bring a wider perspective to the birth or postpartum period, tips and tools for coping with labor, recovery, newborn needs and breastfeeding in addition to information to help the couple make decisions. A doula cannot provide the same level of emotional support and connection a partner can, just as the partner cannot bring the same objectivity a doula can, including partners with extensive training and experience in birth or breastfeeding. Fathers are sometimes the ones initiating the conversation about hiring a doula! Doulas may find that some fathers, while they want very much to be involved and supportive of their partner during birth and the postpartum period, feel a great deal of pressure to remember everything from childbirth or breastfeeding class. Doulas bring a fountain of knowledge with them to the birth and postpartum period and this knowledge is available to both parents.

#2 – Doulas displace partners. Having a third person involved may raise concerns that doulas will come between the parents. Doulas are, in reality, a support person for fathers as well, ensuring that the partner’s physical and emotional needs are also met. Just as doulas see to the comfort, hydration, nutrition, and calm of laboring and new mothers, they also see to these needs for fathers. When doulas and partners work together, they are a very powerful support system combining knowledge of birth, labor, breastfeeding and newborns, with intimate understanding of this particular mother and her needs, desires, communication styles, and emotional responses. The doula’s training and knowledge are available to fathers and are shared via suggestions, examples, or referrals allowing the partner to be a greater participant in providing support and decision making.

#3 – Doulas bring agendas. This is a typical concern of families who are planning for the birth of their baby. Parents, understandably, want to craft their own plan for their labor, birth, and early parenting. Education on the role of the doula, to provide objective support for the couple’s wishes, can go a long way to dispelling this myth. A father may be concerned that he will have to be in the role of peacekeeper between his partner and the doula to ensure that what the couple wants remains paramount. For fathers who are already feeling anxious about being able to meet their partner’s needs, this concern may be exacerbated. Doulas can help dads feel more confident in supporting their partner since the doula is likely to be more familiar with the medical system and the process and typical behaviors expected during labor and postpartum by mothers and babies alike.

While a doula’s primary focus is the mother, supporting and partnering with fathers is key to serving the entire family’s needs. Understanding his needs and perspective allows the doula to expand her skills and impact on her clients. Below are a few resources that may be helpful to doulas supporting expectant and new fathers. These resources may also be useful to share with dads you are supporting as well. Please note that inclusion here does not suggest an endorsement or relationship with DONA International. Consider doing additional research to identify resources in your local community, books, videos or classes.

Resources:

Fathers To Be International

University of Michigan Health System – Fathering Resources

Fathers’ Forum

National Fatherhood Initiative 

— Adrianne Gordon, CD(DONA), MBA

Watch your mailbox for the June 2015 Issue of International Doula

Editor’s Note: Susan Troy, Editor of International Doula, DONA International’s beautiful, informative and inspirational quarterly magazine for doulas, shares this preview of the upcoming edition. — AG

We’re excited to feature Sherry Payne of Uzazi Village on the cover of our next issue of the International Doula. Her presentation at the 2014 Annual Conference in Kansas City was so well received that we wanted to make sure all of our members had the opportunity to learn more about her work. Here’s a small snippet:

“Though the willingness may be there, the opportunity to support women of color is often deficient. The training to support them in a culturally congruent manner is nearly always deficient, if not completely absent. It is important to understand a client’s cultural context when providing such personal care. Without that knowledge the care is inconsistent and incomplete and may even be detrimental.”

 In addition to the insight and inspiration of Sherry’s work, you’ll also find articles about closing the sale, the recent study by Sarah Buckley and a more in depth introduction to our Advisory Council. The Spring 2015 issue also includes book reviews, Ask Penny and essays from our members. We hope you find information and inspiration for your practice.

Keep an eye out for the Spring issue of DONA International’s magazine in your mailboxes in the coming weeks! Remember, you can always check your membership status and update your mailing address via the online Member Center. If you need help logging in, instructions are available here.

The International Doula is just one of the many benefits of joining DONA International. We welcome doulas, childbirth educators, maternity care providers and anyone supporting the role of doulas in birth and the postpartum period to become a member.