Sunday, November 20, 2011

I am officially an Abortion Doula!

The following is a post about my experience with the training for the Bay Area Doula Project, a brand new volunteer organization that is building up a solid crew of abortion doulas to offer support for pregnant people throughout their abortion experiences.  Trigger warning for talk of abortion, trauma, rape.

I've only been home for a couple hours from a two day weekend training workshop, so I feel that it's bit premature to write this post.  I am going to be dissecting my thoughts and emotions for days and weeks to come, but I do want to write a bit about my experience while the feelings are fresh in my mind.

I walked into the training session at the beautiful Zen Center in San Francisco and was greeted by a kaleidoscope of people of various races, ages, and gender identification.  I was nervous, because I'd only recently within the past few months become acquainted with the idea of an abortion doula, and I had plenty of reservations about whether I'm strong enough.  I still do, I'm not going to lie.  However, I felt an instant rapport with all of the people in the room.  All of us were there seeking knowledge, seeking strength, and wanting to know everything we could about how to help people navigate the challenging choice of abortion.

The training was multifaceted.  We discussed the actual medical details of a variety of procedures, going into first and second trimester abortions and the information that no one really talks about.  We talked about the types of anesthesia, the patient's experience, the surgical instruments used, the actual processes of removing the products of conception, all the blunt details about what is really going on during the procedure and what it could look like.  No one in the room was completely comfortable with these details, you could tell from the squirming and the questions.  However, we all knew that the abortion doula knowing what actually happens is beneficial to the patient and also beneficial to us so that we are not confronted with unexpected imagery once we are in the clinics.  No one could say it was an easy conversation, but it was an important one.

I learned about the real stories behind abortion. We talked about the difficult scenarios that may arise, such as parents who have chosen to terminate a pregnancy because the fetus has a disability such as Down syndrome.  We also talked about the complicated aspects of fetal anomalies -- in which highly desired pregnancies are terminated because the fetus has a disorder or disfigurement that is incompatible with life. We talked about the struggle some women have in their first trimester finding an abortion provider (due to financial or other restrictions) and how more-complicated second trimester abortions occur because of this lack of access.  We talked about teen pregnancy and how supporting those teenagers might be done differently.  We talked about cases of abuse, rape, and trauma and about how to navigate those situations. These are the stories that define us.

We talked for hours about the emotional aspect of abortion, which is an immense layer of complexity to navigate.  We learned about what kind of conversation we can expect, what kind of difficult questions we will have to answer and uncomfortable statements we will endure.  We challenged our own morals and our own values and took the conversation to deep places, but did so together in a way that made us all feel empowered by the end.  We learned about what the experience can feel like emotionally for the patient who has chosen abortion.

We learned quite a bit about self care, and how we can best support ourselves so that we can continue doing this challenging work despite emotional stress.  We meditated, we did yoga, we practiced staring into each other's eyes and holding the space.  We learned about loving ourselves and becoming a community of trained abortion doulas.  We were one.

We were so fortunate to have Lauren and Kathleen from the New York Doula Project to come train us.  The NY Doula Project started this all out, this entire beautiful and radical full spectrum idea to support those who have chosen abortion as their pregnancy outcome.  I feel like our Bay Area chapter will be following in their footsteps, learning from them and from each other.  One amazing aspect of this training was that it was totally trans inclusive.  We made sure to refer not to 'women' but to 'people'.  Not just women become pregnant, and it was fantastic that we adopted that language from the day 1 of training.

So that's it.  I'm now able to begin my abortion doula work and I am equipped with the internal strength and the practical knowledge that I need to support pregnant people.  I know it will be a challenge and I know it will be emotional and at times I may want to break down and cry.  However, I feel more strongly pro-abortion now than I ever have.  Hearing these true stories and knowing that both the pro-choice and anti-choice world have a 'spin' on the conversations in the media regarding abortion makes me want to write my own stories.  There is powerful work to be done out there.  Hard work.  Work that needs to be done, and I am so happy that there is a wonderfully revolutionary volunteer group right here in the Bay Area.

Monday, October 17, 2011

My First Birth Experience

As part of my training with Childbirth International, I am required to help support two women through labor and write up reports on my experience.  I could have just waited until I start my orientation and training with the SFGH doulas, but I have been eager to get started and start attending births.  A few weeks ago I sent a mass email to many local Bay Area doulas explaining my situation and asking if I could shadow anyone.  I figured it was a steep request, since shadowing as a doula requires having the mother comfortable with someone she might not have met before being present during one of the most special moments of her life.

On Friday morning, a local doula called me and told me that she had a client who had just gone into labor and was completely open to me coming to watch.  I was ecstatic, but had to complete my day at my fulltime job.  I told her that I would give her a call when I got off work and that if the mom was still laboring I would come on by.  I called her back at 6pm and she told me to come on over.  The mom was planning to labor in a hospital, but wanted to progress as far as possible at home.  This was her first baby, and she was expecting a girl.

I went to the laboring mother's apartment, where she was relaxing in a warm bath.  She was having contractions that were around 6-7 minutes apart, and she was coping well.  She breathed through them and didn't seem to be in too much discomfort.  My doula mentor had me feel the mom's belly, pointing out that the baby seemed to be posterior (facing forward instead of toward the mom's back) which was why we could make out hands and feet (pointy parts).  They tried all sorts of positioning to try to get the baby to flip around, but she was stubborn.  After several hours, the contractions weren't coming any closer or getting any stronger.  The mom decided to go to sleep for the night, so I went home and was on-call all night.

The next morning, I got a call around 10am telling me that the mom had gone to the hospital.  I headed there and her cervix was 4cm dilated.  While the doctor was checking her the first time, he ended up breaking her water.  The contractions came closer together, around 3-4 minutes all day long and growing in intensity. We walked the halls of the hospital, took a shower, spent a lot of time positioning and moving around, sat on the birth ball, used relaxing music, and tried everything we could to get her labor to progress.  5 hours after her water broke, she was still only at 5cm.   We waited another hour or two, and then the mom decided that she needed an epidural as she was exhausted.  An IV was started to give her fluids, and then an epidural was placed.  While watching, I started to feel lightheaded and left the room for around 5 minutes, which I was really disappointed about.  Mom was given fluid for about an hour to get her blood pressure up, then she was started on Pitocin to encourage the contractions to continue.

Mom managed to sleep for 3-4 hours and got the much needed rest that she needed.  She began pushing around 2:00am, and pushed for a couple of hours before the baby started to get distressed.  The doctor ended up having to use the vacuum to get baby out as soon as possible, and a healthy and happy baby girl was born at around 6:00am.

I was absolutely blown away by how quickly the baby latched.  She came out wanting to feed and ended up getting such a fantastic latch and nursed for almost a full hour after birth.  The hospital was very accommodating to mom's requests, such as delaying cord clamping and allowing the weighing of the baby to happen about an hour after birth so that they could bond.  I almost was very difficult to hold back the joyous emotions.

I have such an enormous respect for the laboring mother at this point.  It was a massive challenge and Mom had many things that she felt were "going wrong", but she was so strong and ended up having a great delivery with no episiotomy.  Though it wasn't a natural birth, the whole experience with the doula was very empowering and beautiful and perfect.   After watching this doula spend 48 hours straight with her client, helping her and supporting her every step along the way....I am now even more convinced of the need for doulas to be a standard part of care during labor.  I was overwhelmed with respect for the whole family.

I know that this needs to be a major part of my life.  I was terrified for much of it, but I also know that it will get easier the more birth experiences I am a part of.


So....I attended a birth!

I owe you all a huge update to explain all about it.  But let's just say it was empowering, exhausting, beautiful, and amazing. More details coming!

Thursday, October 13, 2011

Meeting the SFGH Doulas, an awesome experience

Last night, I had my first meeting with the San Francisco General Hospital volunteer doula program.  It was inspiring.  It was transformational, powerful, and intense.  And we didn't even interact with mothers. Just talking to people who share your same values about women and pregnancy is fascinating.

I found out a lot more about the program, and about what I can expect going forward. It is going to be everything that I had ever hoped for.  The room was filled with a variety of women from different walks of life, each one unique and passionate about what we're all here to do.  We started out the meeting by choosing one word that describes us, one word that explains why we are (or will be) a great doula.  My word was "acceptance", because I strongly believe in accepting whatever choice a mother is making for herself.  That is going to affect all of my volunteer doula work, and so I think it's a very big part of what makes me a great doula-to-be.  Everyone had great words to describe themselves, and it was obvious why everyone was there.

We talked about the SF General, and what makes it unique from other hospitals. To start, it has one of the most diverse patient population of any hospital.  It is over 50% Mexican, with people from all over the country coming due to the exemplary service it provides.  It is a public hospital, and sees the majority of the city's low income population, meaning that the people who come there are often desperate for care.  We will be supporting women who have suffered through domestic violence, torture, drug addictions, homelessness, incarceration, and more.  It is also the only level 1 trauma center in all of San Francisco and northern San Mateo County, so it has a high volume of patients at all times.  It's a baby-friendly hospital, one of the only ones around.  And it has a unique midwifery program that has existed for over 30 years.

The San Francisco General Hospital is also one of the only hospitals left in the West Coast (and maybe the country) who still provides late-term abortions.  These cases are all run by an ethics committee and are not taken lightly.  They are offered in the case of fetuses that have conditions that are incompatible with life.  As a rule, SF General will perform late-term abortions up to 6 months of age.  As a result, many of these women will be going through the birth process to terminate their pregnancies. Many of them have come from all over the country, with little or no support systems.  Some of them come up with heavy burdens and large amounts of judgement from their family, friends, and even their regular medical providers.  These women need doulas, badly.  They will be going through induction, and contractions,and will be delivering a dead fetus.  If that isn't an intense moment for all involved, I don't know what is.

As volunteer doulas, I found out that we will also be able to go to the neonatal nursery and hold babies if we do not have any women to give labor support to.  Many of the babies in the nursery are drug addicted or waiting on their foster parents to pick them up. We can also go into the waiting room and talk with prenatal patients about our doula program, or about breastfeeding.  It sounds fascinating.

I also talked to the woman who is part of the organizing team of the Bay Area Doula Project, which offers abortion doula support to women in various abortion clinics in addition to the SF General Hospital.  I am so eager to get started with that particular program, because it's completely aligned with what my vision of being a radical full-spectrum doula.

This isn't going to be an easy volunteer position.  For 12 hours a month (occasionally overnight) at a minimum, I will be helping women who truly need assistance.  They might be emotionally battered, physically hurt, have disabilities, non-English speaking, have no support, homeless, poor, underprivileged.  It's going to be intense and emotional, and I do wonder if I have the strength to give them the support they need. I seriously hope so, because this program is truly unique and I really want it to be a part of my life.  I'm hoping to get into the next orientation in November so that I can start as soon as possible.

Saturday, October 8, 2011

Last natural birth center closes in San Francisco

This is sad news.

On Aug. 5, the Sage Femme Midwifery Service and  Community Childbearing Institute -- Sage Femme for short -- closed with little fanfare or press attention. The clinic on Capp Street, where 100 babies were delivered a year, was run into the ground financially after it saw an increase in Medi-Cal patients and a decrease in insurance payments. 
This leaves San Francisco with exactly zero natural birth facilities.  There are a couple on the East Bay and the Peninsula, and several in the South Bay, and there are homebirth midwives who practice out of San Francisco proper.  However, the loss of Sage Femme means that there are no longer any birth centers where a woman can go to have her child in a natural non-hospital environment.

There is currently a donation drive in place to keep Sage Femme open.

Halfway through doula training!

An update on my doula training!

The Childbirth International (CBI) training for birth doulas involves three separate "modules": Communication, Physiology, and Doula Skills.  I have completed the Communications section and found it to be quite interesting.  I liked how it focused on the variety of cultures and beliefs that our clients might have, and teaches us how to be effective listeners.  It also talked about grief and talking to mothers after they have lost a baby through miscarriage or stillbirth, which was a difficult but very essential topic to read.

I'm about halfway through the section about Physiology.  This module has been fascinating.  I've learned about the physiology of pregnancy and labor, the changes that women and babies go through in the weeks after birth, proper nutrition for pregnant and breastfeeding mothers, illnesses and diseases that affect both mothers and babies, and much more.  It has been a ton of information, but I am truly impressed at the depth of information that CBI provides.  I was worried that the content would be too light and that I would regret not going to an in-person DONA doula training.  I think I made the right choice here -- while I might be missing out on the in-person face-to-face interaction with new doulas in my area, I think having this wealth of information in an easily accessible digital format will be a fantastic resource.  I'm really satisfied with the course.

I still have a big paper to write for the Communications module, which has to be about a major emotional event in my life since I have never had a baby of my own.  I also will have a big test after the Physiology module, and then the Birth Doula Skills module will be a long and meaty section with its own final test.  

On the volunteer front, I've talked to the San Francisco General Hospital and passed my phone screen.  Next week I am going to a meeting with all the other volunteer doulas, and then I'm going to be doing an orientation in November.  I will also need to get a Tuberculosis test and some other health and background screening to comply with the hospital rules.  This is all moving quickly and I'm so excited to start providing birth support as a volunteer doula in such a great hospital.

Tuesday, October 4, 2011

Doulas and Crisis Pregnancy Centers do not mix

Crisis Pregnancy Centers are non-profit facilities run by religious pro-life volunteers that position themselves as a medical facility offering support to pregnant women. They advertise that they offer support for women choosing abortion, adoption, and keeping their baby. Instead, they use abortion imagery, incorrect facts and statistics, sonograms, and coercion tactics to convince pregnant women to keep their babies. 

They lie to women. They assume that women are not strong and able enough to make their own choices about pregnancy.  They use false advertising and scare tactics to manipulate women into using their services.  They often name themselves something similar to a nearby abortion clinic to trick women. They try to fool women into thinking they're not pregnant so that they become too far along to legally abort. They discourage women from using some forms of birth control. They lie about the medical qualifications that they have. They disguise the outside of their buildings to look like abortion clinics. 

You absolutely cannot support one of these clinics by offering doula services to them.

A doula is a "woman who serves" by the Greek definition.  They believe in a woman's power to choose the best decisions for herself.  By using evidence-based medicine, they educate pregnant mothers about all of their options, trusting their ability to choose. They become a pregnant women's close support structure, someone that the woman can lean on and trust. 

As a doula, we are trained not to make medical suggestions and advice. We are trained to put our own religious and moral beliefs aside, and support a mother through any choice she may make. We are here to serve HER. She becomes our world

A doula would not manipulate a woman into making a choice. A doula would not coerce someone using scare tactics and misinformation. A doula would never attempt to influence a woman's choice with her own personal religious or political beliefs. A doula wouldn't deceive the woman she is working for and with, and wouldn't support an organization that does this regardless of their personal views.

You do not have to be pro-choice to see how crisis pregnancy centers are unethical, wrong, and are not at all aligned with our mission as doulas.