Transcription of The Birth Team #139
Dr. Lisa: This is Dr. Lisa Belisle, and you are listening to the ‘Dr. Lisa Radio Hour and Podcast’ show number 139, ‘The Birth Team’, airing for the first time on Sunday, May 11th, 2014 which also happens to be Mother’s Day.
Birth is arguably the most important of all life events. The way in which we come into the world and bring our children into the word has a far reaching impact. Today, we speak with individuals who are thinking about birth in new and interesting ways. Listening on our conversations with Portland OBGYN, Dr. Anne Rainville and doulas, Jodi Phinney and Leah Deragon of Birth Roots and hear about the evolution of this process and how young Maine families are bringing life into our state. Thank you for being with us on Mother’s Day.
I always enjoy having people in the studio with me who were part of my teaching experience, my learning experience as a resident and medical student at Maine Medical Center here in Portland. Today, I have with me one of these individuals, Dr. Anne Rainville who is an obstetrician-gynecologist. She has been practicing in the Portland area for over 22 years and is very experienced in taking care of normal and complicated pregnancies. She’s also a skilled surgeon and trained in acupuncture. Thanks so much for coming in today.
Dr. Anne: You’re very welcome.
Dr. Lisa: I remember well the deliveries that I did under your watch and with you, and it was a very good experience. As a family medicine resident when I came in, there was a broad variety of approaches that the OBGYNs would take and yours was always very calm and happy despite the late hour, and your patients enjoyed having you as a physician. I think that that’s a huge part of delivering babies and caring for women.
Dr. Anne: Absolutely. I think that it’s been amazing to me the difference that it can make to have a very personal connection with the person you’re taking care of in labor and delivery. There’s a lot of intangibles there in terms of someone really feeling comfortable with you as a provider, feeling that you are working together to be able to have this beautiful baby.
It’s pretty … For me, the most rewarding thing I get out of my professional career is being able to deliver patients that I know well, because it adds a special dimension to the delivery.
Dr. Lisa: Tell me why you decided to become an obstetrician-gynecologist.
Dr. Anne: I had absolutely no idea that I was … It was not even on my radar when I went into medical school. I thought I was going to be a … at the time I said general practitioner, and of course, I’m still very interested in all aspects of medicine. When I I did my medical school training and I did obstetrics, it was my first delivery. I was just …
I loved surgery with my surgery rotation. I found that I was really sort of … Technically, it seemed like something that I was gravitated towards, but I didn’t feel that it was a good fit for me until I did OBGYN, and I saw my first delivery was … To myself, I said, “Why would anybody want to do anything else?” Obviously, a lot of people don’t feel that way, but it’s never …
What we say in obstetrics is that you don’t choose obstetrics, it chooses you, and it’s absolutely true. You don’t really have a choice.
Dr. Lisa: Did you know you wanted to be a doctor from early on?
Dr. Anne: Yes. I remember eight years old, I have no idea why I wanted to be a doctor, but I just was always interested in anything that had anything to do with medicine. It’s interesting because there’s no one in my family that was in medicine, but I just was interested in that, and from a very early age decided that that’s what I want to do.
Dr. Lisa: Why did you choose Maine?
Dr. Anne: I’m from Maine. I grew up in Maine. I actually was born in Kittery. For the first eight years of my life, I lived in New Hampshire in Portsmouth very close, and then we moved to Bangor. I grew up in Bangor and just I love Maine and wanted to come back.
Dr. Lisa: You’ve been everywhere in the corridor between Kittery and two hours, three hours north?
Dr. Anne: I did my medical school training in Vermont, University of Vermont so I was in Burlington for four years. Then, when I finished my medical school training, I said, “I wanted to go some place different for residency.” I wanted to branch out, see what it was like to live in a city.
That’s why I went to Washington D.C., and I love Washington D.C.. It was very fun for four years to live there. It was very clear to me after six months that I was not an inner city person and I needed to be back in Maine. That was my goal.
Dr. Lisa: What have you noticed over the last 22 years practicing medicine here in Portland? How have things changed for you as a doctor and for medicine in general?
Dr. Anne: In general? There’s actually been quite a change that I’ve noticed specifically in OBGYN, there was a big change from when I first started practicing. There are a lot of relatively small to medium size private OBGYN groups that were practicing independently but would cover each other.
That has really changed, morphed over the 20 years that I’ve been in practice to really being mostly too large, very large groups and only a couple of other smaller groups. The independent solo OBGYN practitioner is a bit of a dinosaur. There really are only two of us that are still doing obstetrics and are solo practitioner. We happen to cover each other which is fortunate for both of us.
There’s been a big change from that small group to the larger group, so that’s one big change. There has … but obstetrics in general has changed in a very positive direction, in terms of looking at obstetrics in a more wellness perspective in terms of looking at labor as being a normal process and trying to do less intervention and trying to encourage the low risk non-interventional labors a lot more than we ever did.
It’s interesting, although the group seemed to be getting bigger and one would think a little bit less personal in terms of … because you may not see the person that you’ve been seeing in the office. In reality, it’s actually becoming a lot more personal in the hospital with a lot more hands-on with the nursing, a lot more encouragement of more natural process of labor, but allowing people if they want what’s available to have it, but it seems like there’s this nice push to look at things a little bit more in a non-interventional way. That is a very good, a positive direction.
Dr. Lisa: Why do you think that’s happening?
Dr. Anne: I think that to be quite honest, I think it’s the increase in women in OBGYN. I mean, OBGYN is pretty much a primarily female dominant profession. I think that with that, with a lot of physicians who have also had children and are looking at things in a little bit of a different way in terms of what they experienced in their labor, what they would like for their patients that there’s been a little bit more incorporation of other types of obstetrical practices such as midwifery practices, looking at that more objectively in terms of what do midwives do very, very well, what is good about what they do, how can we incorporate that into general into modern obstetrics, so that we can all work together to allow women to have the best, safest and most rewarding experience for having a child.
I think that it’s the infusion of people who’ve actually been through it, also, the open-mindedness to look at other ways of doing things and to actually look at it objectively, and then to incorporate it. It’s very, very positive that what’s happened between the Maine body, the American Congress of Obstetricians and Gynecology which is the ruling body of OBGYN, and the Midwife Administration has been now coming together and looking more at a collaborative practice between doctors and midwives.
Hopefully, that is the direction that will continue in the future is more collaboration between providers who truly have the best interest of the patient at heart and that we can realize that we can work together rather than going at it from thinking that’s only way to do it. It’s very encouraging to me to see that there seems to be that direction.
Dr. Lisa: You have children?
Dr. Anne: I do. I have two.
Dr. Lisa: How old are your kids?
Dr. Anne: Yes. My oldest is almost 24, and my youngest is almost … he’s 20. Yes.
Dr. Lisa: Have you noticed a difference between your own deliveries and the deliveries you’re now doing with women?
Dr. Anne: Absolutely. Absolutely. When I had my daughter 24 years ago, I had to be induced. The way that I was induced was a little bit more intense than the way that we do inductions at this time. Also, I was given an episiotomy. We don’t do those anymore.
It was very … I mean, I do get an epidural. I needed it, but it … A lot of it is the same, but the obstetrical sort of more interventional obstetrics was a little bit different than what we do now.
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When I was doing deliveries and granted, this was a while ago, what I observed was the more support a patient was given, the more time a patient was given, the more calming presence a patient had available, the fewer interventions that were in general. I mean, of course is always babies that … there are emergencies that happen and things that go on and you can’t really prevent those.
In general, if you can have more of the human touch and more of that presence, you’re better off. That for a while was not a direction we were heading in.
Dr. Anne: You’re absolutely right. I think that that is another change that has happened in obstetrics is the realization that we need to be more patient, and that there are numerous studies that are coming out now about waiting longer, that if we just wait longer, if we are just a little bit more patient with it, that people can deliver vaginally and can deliver safely.
I totally agree with you. I think that the more contact that somebody has when they’re going through … I mean, labor is a very difficult process. You know it’s a very difficult process. Having somebody with you that is supporting you and is calming and letting you know, “This is normal. Don’t worry about it. We’re not going to do anything interventional at this point, we can just keep going with it that this is normal,” and reassuring all the time. It does. It helps people to need less intervention because then they allow their body to take over.
Sometimes, I feel like my biggest job is just staying out of the way and allowing it just to happen.
Dr. Lisa: It also seems that as with many things in medicine, we’re starting to recognize the importance of what we call ‘The Patient-Centered Medical Home’ which is really a team approach to caring for a primary care patient. It seems as though this team is something that has become important in birth as well.
I mean, my best friends when I was delivering babies for that brief period of time were people who are experienced labor and delivery nurses and midwives and doulas. It really was a group of people who all have the same goal in mind. It sounds like this is actually even more the case now.
Dr. Anne: I think so. I think that that’s something that really I stress to the residents that I teach is that, that it’s a team, and that they need to use the resources that they have. The best resource that they have to help them take care of their patient is the experience labor and delivery nurse. I think that sometimes when you’re a medical student and then you get in to be a resident, you just think that, “I have to take care of everything and I have to have all my ducks in a row”, and you forget that you need to use your resources, and it is definitely a team, and everybody has a part. Everybody who’s there, who’s supporting that woman in labor has a job and it’s an important job.
Whether it’s the sister who is there to get the face cloth, the cold face cloth and put it on her forehead, that is an important job. Everybody who’s there is important. I think that that’s very … like I said, that’s really important to me to stress that, the residents, they’re coming up. Oftentimes, I’ve talked to them and I said, “What’s going on with the patient?” I said, “What does the nurse think?”
They’re like, “Wait a minute.” I said, “You know, that is your number one resource to help you is the nurse. She knows.Is the person in labor? What are their contractions like?” That’s used … everyone in the team to take care of that patient.
Dr. Lisa: Another group of individuals that we didn’t have as much exposure to when I was a resident were the doulas.
Dr. Anne: The doulas, yes.
Dr. Lisa: That has really … The patients that had doulas, it seemed as though they were just a very comforting and competent extended family for these patients.
Dr. Anne: Yes.
Dr. Lisa: I’m really happy to know that there are more and more women and men who are becoming doulas and supporting women who are laboring.
Dr. Anne: Yes. I think it’s sometimes very difficult for the primary support person that the significant other to be the only one to support someone in labor when they’ve never seen it before. They’re so torn between their own excitement, what’s going on with the person that they love, they’re in pain, what did they want that … It’s just I think sometimes, it’s a little bit too much to put on somebody who has never been in that position before.
I think that sometimes, that’s where the doula really helps a lot to have another person to be able to help not just the person in labor, but the other partner to be able to get through this journey in the best way possible. I think I’ve worked with many doulas. Anybody who is there in the room to help the patient, I am willing to work with and I am happy that they’re there.
I think that really, if there are more people that are there to support somebody, the better.
Dr. Lisa: It used to be the doctors were the source of information for patients?
Dr. Anne: Yes.
Dr. Lisa: We have the ability to provide some, I guess calm and perspective, and now, a lot of information comes from other sources, and sometimes, information can be scary. It can be helpful, it can be normalizing, but it can also be scary. Is there a way that you as a doctor are able to work with the information that’s out there and work with the people who have this information, and really make it a positive thing.
Dr. Anne: I try to … I run it up against this all the time because every day in the office, when I see patients, somebody brings something up that they saw something online or their friend or their mother or someone told them something. I think that the important thing is to first to validate what’s that, “Yes, I understand where you got that information,” and to say that, “There may be some truth to whatever it may be that they are very concerned about that.”
Then, I try to bring it back down, bring them back down to earth, to base to say, “Okay, but what does that really mean for you?”, and “What is your situation? How was that different from this scary thing that you heard about?”, and even if that scary thing happens, we know how to deal with that.
You’re going to be in a safe place, you’re going to be with people who know how to deal with things such as that, and I think that it really … I think that that’s the way to deal with it, rather than just say, “Don’t worry about it,” because then, they’re still worrying about it. I think that you need to just explain, “Yes, I know about those things, but that’s why it doesn’t pertain to you, or if does, we can deal with it.”
Dr. Lisa: You’ve been practicing quite a while now.
Dr. Anne: Yes.
Dr. Lisa: Some of the first babies you’ve delivered, they are …
Dr. Anne: Yes. In their 20s, yes.
Dr. Lisa: … having their own babies like that.
Dr. Anne: Yes.
Dr. Lisa: What keeps you passionate? What keeps you excited? What keeps you interested on being a doctor and being an obstetrician-gynecologist?
Dr. Anne: I guess one time, I said, “I keep doing deliveries because I haven’t done it perfectly yet.” I guess that that’s one thing is … but it’s because it is changing. The way that I practiced obstetrics now is very different than the way I practiced 20 years ago. It’s that freshness, trying to find the way to do it better. That’s what keeps me going.
Also, it’s my patients that interpersonal connection and like I told you, I did a delivery this morning. It’s of someone that is close to me. That’s a wonderful thing. I mean, not many people can do that. It’s pretty special.
Dr. Lisa: We have to let you go because I know you have another person laboring right now.
Dr. Anne: Yes.
Dr. Lisa: We don’t want her to deliver before you’re finished talking to us.
Dr. Anne: [laughs]
Dr. Lisa: How do people find out about your practice, Dr. Rainville?
Dr. Anne: I do have a website. It’s called ‘Womenswellnesscare.com’, or they can just look me up on the web on as Anne Rainville MD.. That will just link right to my site and practice in Portland, Maine on Ocean Avenue. We have lots of services to offer not just OBGYN as well. Yes.
Dr. Lisa: Wow. I like the fact that you also do acupuncture. Someone who does acupuncture and knows how important that is to have them in my toolbox, I really appreciate that that’s one of the things you have in your toolbox. I’m impressed.
Dr. Anne: All right.
Dr. Lisa: I haven’t seen you in a little while.
Dr. Anne: I see, yes.
Dr. Lisa: I really appreciate you’re being one of my early teachers as a medical student and a resident. It meant a lot to me, and then it means a lot to me that you’ve come in today and having this conversation with me. It’s great to know that there are doctors out in the world who are doing the good work that you’re doing on a daily basis. I know that your patients love you and I appreciate your being here.
Dr. Anne: Thank you very much.
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Dr. Lisa: It’s Mother’s Day. As a mother of three and a woman that gave birth, it seems like a long time ago now. I guess the longest the … my youngest is 13. I know how important birth is and the process of going through birth is something that can be made easier in some ways by people who are known as doulas.
Today, we are fortunate to have with us Leah Deragon and Jodi Phinney. Leah Deragon is a doula certified childbirth educator and co-founder of ‘Birth Roots Perinatal Resource Center’ in Portland where she facilitates semi-annual doula trainings and childbirth classes.
Leah has a five-year old son and a one-year old daughter. Thanks for coming in.
Leah: Thanks.
Dr. Lisa: We also have Jodi Phinney. She is a full-time birth and postpartum doula. She has worked with moms of all ages in both high and low risk pregnancies medicated and unmedicated. She also works at Birth Roots where she is the office manager and facilitates the welcoming pregnancy class.
Welcome to you, Jodi.
Jodi: Thank you. Thanks for having us.
Dr. Lisa: Why did you call it ‘Birth Roots?”
Leah: Emily Murray and I as the co-founders were actually … This is our ten-year anniversary. Ten years ago, we were both doulas, primarily birth doulas, attending families through their last weeks of their pregnancy, with them for their birth and with them for the initial hours and a couple of weeks after they gave birth.
We realize that this was an incredible service that some families were able to access. We wanted to provide that same model of non-clinical care in a much broader context. We realized that the experience of birth is not just, “Did the baby make it to the other side of the pelvis, and is everyone doing okay physically?”, but that there’s a whole emotional component that the birth sets the tone or the stage for the layers of parenting that come after that. It was a rooting process of, in much the way a tree has a root system.
We have a quote up in our space at ‘Birth Roots’ called, “The deeper the roots, the higher the reach.” We really believed in that vision or that metaphor that if the experience not just of the hours of labor and the first day after the baby was born, but the entire pregnancy and the entire first year of life was well-supported, that the family would take root in a really different way, that there would be less anxiety, less adrenalin, more oxytocin and that by being rooted in a community specifically among other families who were also going through this very raw, vulnerable time in their lives, rather than feel isolated and like they were maybe feeling like they were crazy or the only one or, “Why is this so hard?”, if they are rooted in a community of other parents who are exploring ways to parent, who are exploring how it could be less hard not just giving birth, but I think at Birth Roots and I would think most doulas would agree that the birth begins as the baby’s crowning that really, the birthing process is those days, weeks and months initially after the baby arrives to the family.
That was the process that we wanted to have. We wanted families to have more support for that entire process, not just the number of hours that met the labor.
Dr. Lisa: Birth Roots you said is 10 years old?
Leah: Ten years old this year.
Dr. Lisa: You have a five-year old son and a one-year old daughter?
Leah: Which means I was doing this work before I was a parent.
Dr. Lisa: Right. Why?
Leah: I think a lot of women feel a calling to midwifery or child birth or what it means to hold space for the process of motherhood of going from being an individual who only worries about the needs of an individual to, “What does it mean to become a mother?” When you’re called to midwifery, you think, “Let me get started.” A lot of women get started with a doula training or being a doula as a vision of themselves as the midwife literally or figuratively. This is how we got started and it was a vision of what could be for families.
Dr. Lisa: Jodi, you said that doulas are that missing link for emotional support between doctors and the partner who may not have as much experience. This is an interesting idea that we have the need for multiple layers of support and birth.
Jodi: I think the way I said it was that we make up a chair, and that the birthing mom and their partner are two legs. The birthing partner knows that that individual who’s birthing very well, and then you add in a doula and you’ve got someone who knows birth well and individuals has an idea of how people interact and can read facial expressions and really gel that room together.
Then, you have the doctors or the midwives who provide that back to the seat, who are there for support and are really overseeing the whole process, but are kind of in and out. Having some additional support I think is so valuable so that you can look across to a partner and say with your eyes or with a thumbs up that, “This is exactly the sound that you want to hear,” or “This is really hard but she’s doing this, and we’re going to keep moving forward,” and just encouragement for something that’s unknown is really valuable.
Dr. Lisa: That is an important point is that there’s a lot of unknown associated with this. We get to see what is on television, we get to see those births, maybe we’d go through one birth of our own and we know what that was like or we watch a sister give birth. Every birth even for an individual woman is so different.
Jodi: I was just talking to a woman yesterday who is on her seventh birth, and is thinking about becoming a doula. I talked to her about how even seven, she didn’t see a lot of repetition, that each one has very unique properties and timing.
Dr. Lisa: Tell me about the history of doulas. I know that there weren’t … When I was at the Maine Medical Center, doulas were just starting to have more of a presence there when I was delivering babies there at Mercy when I was in my training in family medicine. I think they have a significant presence especially in Portland, but also really throughout the state now.
Jodi: Growing. Definitely growing.
Dr. Lisa: It’s growing. I was more familiar with nurse midwives. What’s the difference between a midwife and a doula, and what is the … why are doulas I guess so important in conjunction?
Jodi: I think when birthing wasn’t in the hospital, we used to see a lot of doulas that probably weren’t called doulas. They were called ‘Friends’, they were called ‘Sisters’, they were called ‘Aunts’, ‘Grandmothers’ … people who were around for you while you were laboring, who were making you food or making sure that other kids were taken care of or walking the dog, or bringing a warm washed cloth or a cold washed cloth, whatever the situation needed. Then, as birth came into hospitals …
They were attending. They’re attending people. It could have been your husband or your partner as well then. Then, birth came into hospitals and society changed, and so you’re going to go off and other people will help you take care of that, and you’ll come back and you’ll have a baby. We lost that family, that community piece of birthing which was so integral to having it happen in a way that felt right to women, not necessarily familiar, but there was encouragement to keep going and stay the path.
I think bringing that back, bringing people back into the birthing scene and having some support is good. It could be a parent, it could be a sister, it could be an aunt, but what’s important is that somebody who has familiarity with birth. Fortunately, when birth came to hospitals, a lot of us lost that, so we weren’t there when our sisters gave birth, and we weren’t there when our brother’s wives were giving birth or even an aunt or uncle, something like that.
I think familiarity with birth is important, and having somebody who has that one step away so you’re invested, but the emotional investment you can keep a clear head around. That kind of support is valuable.
Dr. Lisa: The goal of the ‘Dr. Lisa Radio Hour’ is to help make connections between the health of the individual and the health of the community. The goal of Ted Carter Inspired Landscapes is to deepen our appreciation for the natural world. Here to speak with us today is Ted Carter.
Ted: I am always amazed at how much the land speaks to us if we just stop and pay attention. I will very often place gazing rocks, which I call ‘Gazing rocks’ because it’s a big, huge lava stone that I place in the landscape where you can lie on your back and look at the stars, or you can reflect and dream about things and places you want to go to. I often go to these places. They’re called ‘Power places’. My Shaman that I work with in the desert for many years talked to me about power places.
I go out there and leave the drafting table, go out to the special spot that I’ve created, lie on my back and instantly almost fall into a dream state. There’s something called ‘Creative visualization’ which I think a lot of people know about. I’ll just turn that design slowly in my mind and look and see the design from different angles and create it in a very dream-like state, and then I would turn back to the drafting table refreshed and ready to design. Time and time again, it’s never failed me that this is how some of my most creative designs take shape.
I’m Ted Carter. If you’d like to contact me, I can be reached at ‘Tedcarterdesign.com’.
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Dr. Lisa: Jodie, you teach a … I guess you facilitate a welcoming pregnancy class.
Jodi: I do. Yes.
Dr. Lisa: I have two questions. First, I wanted to know why the word, ‘Facilitate’ is so important, because of you both, before you got on air talked about the word ‘Facilitate’. Then, I also want to know what does it mean to welcome pregnancy?
Jodi: We choose facilitate over teach because we are there as a guardian of your time and encouraging you to learn information and to hear information from different people and different sources, and pick and choose what’s going to work well for you. From the very beginning, we try to encourage you to make choices that will change your family and ways that you may not have grown up, your friends may not have gone through their pregnancies or parenting with, and pick what’s right for your family.
We facilitate you getting information but having conversations mulling it over, speaking it out loud in an effort to grow that role of parenting moving it forward. The welcoming pregnancy class is, it fills a gap that we see between when you recognize in the bathroom that you’re pregnant, and/or at the doctor’s office, and you can get those first doctor’s appointments or midwifery appointments.
There are weeks and months in the middle that you’re out there Googling and Googling and Googling. Our encouragement is to step away from the computer and to come to a place where you can meet other families who are in the same timeframe as you are, wondering some of the same questions having already found answers that worked for them, having and have found nothing that worked for them yet, and everyone coming together so that they can start gelling as a new community.
That’s what we do month after month. We gel new groups of people who then move forward as we call them ‘Flocks’ and grow. There are flocks that are five years old now, and people stay together and they count on each other. Those very first few weeks where you come to a welcoming pregnancy group and you get some of your questions talked about, and you start finding out why people are choosing their provider, why they aren’t choosing a provider, and you figure out what provider might work for you and you’re encouraged to try another one … whatever works.
You get questions talked about, “What is a doula?”, you get questions like “What should I purchase? What should I not purchase? How should I tell my family? When should I tell my family?” … All of those kinds of things are talked about so that you can start making decisions that are right for your family.
Dr. Lisa: That’s a good point because I remember even my last child, the one who’s now 13 thinking … and I learned I was pregnant. We always call her … She’s our surprise. She’s one of … We have two surprise children, the first and the last. Anyway, then I was like just left there with this surprise, surprise their child didn’t have a doctor’s appointment until … I don’t know, eight weeks or 10 weeks or whatever it was. There was so much time that elapsed with me doing exactly as you said, looking online and even as a doctor, just tuning into what symptoms I should be feeling and you’re probably right that I would have been better served to reach out and actually have these conversations with people around me.
Jodi: That’s so unique when you get to talk to someone who’s going through it or has just reached over their first trimester and is finally not feeling poorly anymore, and hearing experiences of people who are in the throws of it is very different than hearing how it was for your sister two years ago, or how it was for your mother 30 years ago. There’s real value in having that community.
Leah: For me, facilitation is so important because it’s not so much of a teacher telling other people how to achieve a certain outcome as it is, a couple of things are happening. I always encourage new families to get really good at two things, listen to other people, lots of other people, and then listen to yourself, and make sure you’re doing both of those.
If you’re only listening to yourself, you might get down a wrong path, but if you’re only listening to other people, you’re not developing your own internal muscle or strength that you’ll need over and over again as a parent. There’s so much that happens throughout the pregnancy and the labor that is all just in preparation for the parenting that you’ll be doing. Taking that opportunity as it’s presented to you to develop that internal strength, that internal knowing of what is right for you or maybe won’t work for you even though it did work for your friend.
Listening equally to other people and to yourself, but also a concept that’s part of facilitation is encouraging what is known as ‘Crowdsourcing’. Now, generally, crowdsourcing is done online. We do more a face to face crowdsourcing where someone says, “I am struggling with a sleep issue, or I’m struggling with a fuzzy memory or yes, or a pregnancy issue.
Rather than the “Teacher saying”, “Here’s the solution to that problem,” what the facilitator does is says, “Is anybody else struggling with that? What have you tried?” Then, the topic now comes up and we hear from eight or 10 different people what they tried, what their doctor told them, what somebody else’s best friend told them … Now on the table, we have 12 ideas, and everyone gets to take from the 12 ideas on the table what sounds right to them because they have insider knowledge of why one idea might or might not work for their body, their baby, their partner, their family’s circumstance, so it’s more accurate I think.
Jodi: What that grows is an ability to count on the people around you and your community, and a respect for the pluralism that Birth Roots really works hard to create and that you might have done it one way and she might have done it another way, and he said that we should only do it this way, and this is what works for me because I heard all of those things, and I heard it from people who are doing the same thing that I am, and I trust that.
Jodi: Right now. I mean, the things, the trends versus the standard of care versus … I mean, I had children four years apart and what was recommended to me even four years later … I mean, you’re a different person, the culture at large is different. Those circumstances change by the year, and so being in a room full of people who are currently facing what you’re facing under the same set of circumstances is so valuable as opposed to reading in a book, Googling it or hearing it from maybe a pediatrician or a care provider who their children are 25. They don’t have lots of valuable things to contribute.
It might be what you needed to hear is that the mother sitting next to you who also has a six-week old baby feels this way, and so do you. There’s actually maybe not a clinical problem, there’s just, “Oh, this is hard,” and just like labor was hard, we can find our way through the hard part.
Leah: That’s okay.
Dr. Lisa: There’re a normalizing effect?
Jodi: Normalizing, yes.
Leah: There’s normalizing that what I’m experiencing is perfectly normal, because of 10 other moms in a room are feeling it or 10 other moms in the room aren’t experiencing what I’m experiencing. Maybe I should talk to my doctor about this. I think that’s just as important.
Dr. Lisa: As a doctor who no longer delivers babies but at one time very much enjoyed doing that, one of the things that I encountered a lot was a family that had worked so hard to create a birth plan, and we had created such as great relationship and they were looking forward to their baby and they’ve done all their reading, and they had done their grieving and they had come to the right classes, and everything was all laid out. Then, things just didn’t turn out the way that they had hoped.
Sometimes, they needed a C-section, or sometimes, they wanted to breastfeed and they couldn’t breastfeed. Sometimes, it was so devastating for them and they would judge themselves so harshly for that and they feel this great disappointment that I’ve somehow failed my birth.
Is this something that you can help women with?
Leah: I think that’s one of the primary rules of both the doula in her non-clinical role and attention, as well as an organization like Birth Roots which I think of as an organizational doula, because there’s a phenomenon out there where if a birth goes very much not the way a mom had planned, a common thing that gets said to a mom is, “At least you had a healthy baby”, which completely invalidates her own well-being, her own process, her own needs in the process of becoming a mother as though mothers have no needs, they just live to make sure they have healthy children.
We always say when you have a relaxed mom, you have a relaxed baby. When you have a stressed mom, you have a … That’s sort of … I think that the … Sorry?
Jodi: That’s okay.
Leah: The natural word is something that women can torture themselves with. I think that staying present for what is again the pregnancy, the labor, the birth, the postpartum and parenting … Parenting isn’t always what you set out … the course you set out yourself. If you have multiple children, you find out, “Wow. This one child is really amenable to my ideas of myself as a parent, and this other child has no interest in the style of parenting that I want a parent.
I think that if people can get that while they’re either pregnant, giving birth or in the first year, they’re miles ahead for what’s coming. Set in the context of the support of a doula support or a community support. It’s easier to start wrapping your head around where at most flexibility is important. You can do everything right sometimes in life in parenting, in birth and still be asked to be even more flexible than you thought you were going to have to be.
I think doulas encourage ideas that maybe a family hadn’t thought of and it increases the likelihood that they’ll get the birth they’re hoping to have. Then, doulas are there for grieving process of, “Wow, we have a healthy baby, but I’m kind of bummed to that. I didn’t get to birth in the water or it was either so fast that it was nothing like I imagined it or so long that I’m exhausted in my first few days of meeting my child. I just was too exhausted to enjoy it.”
I think to discount the process that a woman or a family needs to make sense of their experience or play with the narrative of what happened and create a narrative that makes them feel strong and make sense to them as opposed to leaves them feeling incapable is extremely important. I don’t think that falls under the job description of an obstetrician to help people work with their narrative about what happened.
Dr. Lisa: I think some obstetricians are very good about that, and some, it’s just not what they … It’s not their experience. I think you’ve hit on something that it could also just be that if you’re an obstetrician and you have 10 minutes to see a patient, there has been some time involved in this.
Leah: Right. I think all the doctors I’ve ever encountered have huge heart and that’s why they’re there, but a lot of either a doula or an organization like Birth Roots can do is fill in some gaps that have been created by the economic system we have or whatever. We don’t live in an entirely pro-family, pro-mother, pro-well-being situation. Trying to fill in those gaps with human beings such as doulas or other parents can make a huge difference in people’s stress levels. I think that’s the bottom line is stress levels.
Jodi: I think that’s absolutely true. I was at a birth yesterday morning where I was working with a nurse and a med that I know, I’ve worked with before, although it’s been a few months. I said, “Do you want to come in here?” They come into nursing because they have a love and especially they bring delivery of that process. She was busy charging some information and I encouraged her to move closer. She’s like, “You know, it’s so great you’re here because I need to get this done.” There’s a real lack and need and appreciation for everyone’s job especially when there’s more support for everyone. You never know who you’ll be supporting.
We often joke that you should have doulas for everything.
Leah: House [bind 00:53:27] doulas …
Jodi: Should have a dog doula, house bind doula. Right? Get a dog doula.
Leah: Birthday party doula.
Jodi: Right.
Dr. Lisa: Yes. I’m actually sad that my youngest is 13 and I’m pretty much done, because it’s so exciting to hear what you now are offering in the Portland area and around the state. It’s so exciting to know that this is the way that women and families and children are being supported, because I do think this is what we need. We need to focus on the family until you actually have somebody there who says, “This is important and let’s facilitate those process.”
Leah: Let’s slow it down. My goodness, people … I think parents are under an outrageous amount of stress to get an undoable amount of work done in an undoable amount of time. Then, they wonder, “Why can’t I keep up? Why am I so exhausted?” I think the wiser women of the community, women who have experienced this and gone through a hard time, come out on the other side and have perspective on what that time is about are able to say, “Okay. Let’s start with slowing things down.”
I think doulas slow things down as part of their … What they’re there to do is, “Wow. You just had a baby,” rather than “Let’s rush onto the next thing that’s going to happen. Let’s take a breath here,” and “Oh, wow. Life has changed. How are you different than you were an hour ago or yesterday?” It makes an incredible … It alters the trajectory of the health of the family for someone to say, “Let’s pause for a minute.”
Dr. Lisa: I love what you’re doing and I know that we could fill an entire hour or probably multiple hours, because I think that you’re so on with where I believe that we all need to be thinking about healthcare and families. I will encourage people to find out more about Birth Roots by going to your website which is?
Leah: ‘Www.ourbirthroots.org’ or ‘Birthroots.org’ which we’ve just purchased.
Dr. Lisa: Very good. People are going to also go back and listen to the show that we did with Emily Murray.
Leah: Yes.
Dr. Lisa: She was … I’m thinking she was one of our very early shows. It was so important to us even back at that point that we had a show on it right away. People would like to hear more from Emily and her sister …
Leah: Yes, Allison.
Dr. Lisa: … Allison, yes. This is the family from Yarmouth I used to babysit for. It’s funny that everything just keeps coming in circles in Maine. Anyway, go to the Birth Roots website to find out more about Leah Deragon and also Jodi Phinney. Jodi, do you have a website yourself?
Leah: We do a lot with Facebook.
Jodi: We do a lot of Facebook.
Leah: We find people … You can find Birth Roots on Facebook, Jodi Phinney doula on Facebook.
Jodi: A doula for me.
Leah: A doula for me. A doula for me. We’re just so thankful that you’ve given voice to this because so much of elevating what’s happening is bringing into the cultural discourse of, “How are we all doing here?”, so thanks for …
Jodi: I think it’s also worthy to know that doulas do charge for their services, but it is not by any means a requirement to have a doula who charges. You can find a doula who wants to barter with you, who wants to do a payment plan, who is just starting out.
I have a very good friend who only does pro bono work. There are doulas for everyone regardless of how much they charge or you want to pay. I think meeting someone who resonates with you is the most important piece first, and then to figure out the financial piece, second.
You can definitely start … We train nearly 30 doulas a year throughout New England. They come from, throughout New England to Portland. We have access to a great pool or people who have had six months of experience, three months of experience, four years of experience, 10 years of experience.
Dr. Lisa: We’ve been speaking with Leah Deragon, the founder and director of Birth Roots Perinatal Resource Center in Portland and private doula, Jodi Phinney who also works with Birth Roots.
Thank you so much for all the work that you do and for this generation of healthy families that you’re promoting and for coming in and talking to us today.
Leah: Very welcome. Thank you.
Dr. Lisa: You have been listening to the ‘Dr. Lisa Radio Hour and Podcast’ show number 139, ‘The Birth Team’. Our guests have included Jodi Phinney, Leah Deragon and Dr. Anne Rainville.
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This is Dr. Lisa Belisle. I hope that you have enjoyed our ‘Birth Team’ show. Thank you for allowing me to be a part of your day on Mother’s Day. May you have a bountiful life.
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