The Dish on Doulas

As this past October dawned, I woke early on a Saturday, put on some presentable clothes, and drove an hour north to a farmers’ market – and I didn’t even need any produce.

I was researching an article on doulas for Rhode Island Moms. My initial idea was “An Interview with a Doula” to create a personal connection introducing how and what doulas offer. After discussions with three doulas I either knew personally or through a few degrees of separation, the article’s focus became more broad-based. When I saw that Doulas of Rhode Island (DORI) was hosting a Meet the Doulas event at Lippitt Park in conjunction with the farmers’ market, I knew I’d learn even more.

What is a doula?

Click to read more of my article on rhodeislandmoms.com

My trusty little notebook quickly became filled with the emotional and physical support these women provide to mothers everyday in hospitals and homes. I spoke to Emma setting up the table and welcoming guests. I spoke to Katherine, membership coordinator for the doula organization (who connected me with Paulette who gave me more info via phone). I met Ava, based in my neck of the woods and friends with a Warrior Mom doula I know. I met Emily, who had just relocated to Rhode Island and was getting the lay of the land for mamas here. I met Shay who translated her own birth experience into a way forward with future moms. Some of these women prepare mothers in the prenatal phase and see them through labor. Others support them during labor and at home postpartum. Some prepare nutritious foods and provide childcare while mom sleeps. Some do it all. All establish a solid and supportive foundation for moms to thrive.

While it wasn’t meant to be an article about mental health, that is often the lens through which I view issues. I asked several of the doulas what they do to support and assess mental health/illness in their clients. They obviously all watch for the signs and know when to call in help, but I was shocked by the surprisingly simple, yet profound, response Lily had. As a postpartum doula and overnight nanny, she emphasized the benefit of sleep, how even PMAD treatment programs and hospitals focus on mom getting adequate sleep.

How refreshing that if we ensure moms get what they need (ie sleep, nutritious food, companionship, informed decision making), mood disorders may not even arise!

And THAT is why doulas are a force to be employed, paid attention to, and celebrated.

I spent over two hours speaking to and circulating around the doulas of Rhode Island and their table. I told Emily that I could talk about maternal (mental) health all day. “Me too,” she said.

The article that went to press November 5, 2024 could not contain all the stories and wonderful women I met. The way I serve women and mothers is affected by them. I am thankful for their work and their sharing.

With a community like this, women and mothers cannot go wrong.

The doulas who shared their work and time with me. . .

Many thanks

Mental Health Month 2017, motherhood

On This Day

11 months, 2 weeks ago, I was trudging through the day-to-day like an elephant on two legs in an animated film. I was full with pregnancy, with baby, aches and pains, in bladder, daily chaos, and exhaustion. I was in some sort of suspended stasis; neither did I want to be pregnant any longer nor did I want the onslaught of labor and care of a newborn.

Thanks to the equally annoying, nostalgic, and awe-inspiring features of technological devices and their applications, I can see last week, this week, today in tidy little boxes of unasked-for updates. That me has tired eyes, a wan smile, the ruddy mask of pregnancy fingering its way across my face. Except for the dropped weight, that me hasn’t changed much in the last near year.

And yet, looking at that me, it seems like another life.

Looking at this other life in my arms, I feel like she’s just arrived and yet, that other, older me in the photos is saying she’s been here for eons.

For the growing she’s done, I’ve done. For the countless hours of lost sleep, the endless ribbon of days and nights spooled out and folded in and around each other.

It’s time to celebrate her first year of life, but she still feels brand new to me. How has this time elapsed without my say so? For all the holding and staring and loving, I couldn’t hold her trapped in time with my gaze.

But if I stay focused on her in this day, all the others, past and present, will fall away.

Living, Mental Health, parenting, Recovery, Survival

Not in Vain

Before my third child, I never dropped the JC.

I was no pure linguist, but I did not take the name of the Lord in vain.

In the months and years following her birth, it became a regular part of my vocabulary, satisfyingly venting my rage and frustration at things gone wrong. Stupid things. Teeth not being brushed. Butts not being wiped. Nothing that should unleash rage, but they were the proverbial straws.

I knew its use signaled a loss of center, of control.

Perhaps it was a desperate plea. But it came out sounding like a kid forced to say please and thank you. Totally inappropriate in tone and timbre.

Finally, one Lent, I decided to make a focused effort to stop saying it improperly. Keeping track of my missteps, I counted eight uses during those forty days. A significant reduction. I never did decide what would be an appropriate penance for each of those eight uses, but my non-JC oath habit stuck.

So here I am 32 weeks into pregnancy #4 and I’m being pelted with more stupid little straws.

My six year old has decided this is a fabulous time to assert her independence. Not in a dig-your-heels-in toddler sort of way, but in a snotty teenage you-can’t-make-me sort of way. Holding a stuffie I’d told her to put away at least three times, I stood over her as she sat on the bathroom floor fully dressed and not making any attempts to prepare for bed. I had to fight the urge to bean her over the head with it. After numerous non-oath reminders, I unleashed a torrent of reprimands peppered with choice words (though no JC – does that earn me some credit?).

Having to remove myself from the situation, I stalked in our bedroom, where my husband stood.

“This kid isn’t even born yet and I’m already swearing!”

He laughed. I think he appreciates seeing me get as frustrated as he does sometimes.

But his laughter also signaled to me that perhaps my reaction, while a bit overblown, was natural. I may be hyper-vigilant to signs of rage due to my postpartum experience last time, but that doesn’t mean that every freak-out is a bad sign. It could just be a bad day. Or a bad moment.

Just as uttering Jesus Christ in a proper context is not a bad thing, expressing anger or frustration in an appropriate way is not either. I need to watch the tone of my words and actions to see whether I’m struggling. It may not be a spiral, but a slight dip in the mood of the day.

I know many postpartum women – or anyone who’s suffered a mental health crisis – who see a bad day, a down period, a low point as a relapse. But even if it is, having been where we have and coming back from that place, we are equipped to do so faster, better, and with the proper supports.

We also are entitled to the same bad days our “normal” counterparts have all the time. Not every infraction is a sign of our condition, a harbinger of more to come.

Of course, all of this is easier said than done. Ironically, the organ we must rely on most strongly to convince us of our strength and resiliency is also the one most affected by our illness.

In that case, perhaps a call to the Lord would not be in vain.

anxiety, Identity, Mental Health, motherhood, parenting, Survival

Without Wee, Within

I am very much inside myself lately.

Thinking about what needs to get done,
Worrying about pain and exhaustion,
Waiting for my next chance to lie down

I weigh this alone time
for its relaxation
vs
opportunity to accomplish,
both sans wee ones

Motherhood has brought me to this state
and yet, it’s all in my head.

I struggle and strive to survive
for them
yet yearn for me

powercube.net

postpartum depression

If it’s Monday, it must be . . .

After my third pregnancy, it felt like I saw every specialist under the sun. Midwife, general practitioner, physical therapist, behavioral therapist, chiropractor, podiatrist. It took a lot of work to put me back together physically and mentally.

My schedule hasn’t changed much this time around, except I’m starting my visits prenatally rather than post. And I haven’t hit everyone on the laundry list yet – which is probably a good thing, given I’m already having continuity of care issues.

Today I saw my general practitioner.

It was to be a followup after my visit to a psychiatrist. Shortly before my pregnancy, I’d started with this GP. When discussing my mental health history and current condition, she suggested I get a specific diagnosis from a psychiatrist since what initially presented as postpartum depression was persisting. I’d been continuing care with a LICSW I’d been seeing. Thanks to hospital systems and network nightmares, I’d need to go through 12 CBT sessions at his facility before even seeing the psychiatrist – even though that’s what I’d been doing for years with my own therapist. Already spooked by the red tape and thought of strong psychotropic drugs, I put it all on hold once I found out I was pregnant. I couldn’t start on new meds anyway and didn’t need any additional stress.

Through the guidance of my LICSW and midwife, I decided the benefits of continuing my low dose of meds were greater than the risk of harm during pregnancy. That’s not to say the decision was made lightly. I cut out mostly everything questionable when pregnant. I’d always felt guilt for taking meds in the first place. But after weighing all my options – and a few bad days of trying to wean – the meds stayed.

Now, my GP didn’t know any of this.

When I tried to verify my protocol and discuss my midwife’s suggestion to possibly wean toward the end of pregnancy so the baby would not suffer any possible ill effects of the drug as a newborn, she wondered whether she would’ve advised taking meds at all had she found out earlier in my pregnancy. She said that’s why she wanted the input of the psychiatrist, especially now with a pregnancy, to know exactly with what we were dealing.

Now, this GP is solid. She did not shy away from discussing different prescription therapies. She wanted me to see the psychiatrist to get to the origin point at the bottom of my pit. She is candid, empathetic. Today, however, I felt the doubt and guilt over taking meds during pregnancy try to push up. The doubt that I’m not getting the best possible prenatal care cropped up when she suggested I see an OB in my group rather than only a midwife; her reasoning being that should my situation become critical I would need someone to assess and intervene immediately.

She is following due process. She is looking out for the best interests of me and my baby. She is talented, trained, and professional.

And yet there are gaps in her knowledge of perinatal mood disorders and their treatment.

My midwife, fully aware there is no definitive research saying meds are 100% risk-free during pregnancy, also knows the research that an anxious and/or depressed mother can also have ill-effects on a developing fetus.

My LICSW knows the mental anguish I put myself through in making this decision and that I can’t hang without the meds.

All three are looking out for the best interests of me and my baby. All three are experts in their fields. And yet, at times, all three have told me something different.

Where is the continuity of care in the perinatal period? Yes, the knowledge base is growing. Yes, awareness is spreading. Yes, some practitioners are training themselves to be experts in this ever-growing area. But there isn’t enough widespread know-how. There are gaps in which women can and will fall through.

I haven’t met any of the OBs in the group I visit, but seeing one doesn’t guarantee me swift and effective intervention in the postpartum period. Not taking meds doesn’t guarantee a perfectly formed baby. Taking meds doesn’t even preclude mood disorders.

There is always some mystery involved in making and growing a baby. Insert mood disorders and mental health issues and the lines are blurred even further. Unfortunately, it still falls primarily to the mother to advocate for her own health amidst all the conflicting care.

Though still haunted by the postpartum experience in my previous pregnancy, I feel that I can advocate for myself this time. Knowing the danger signs, the markers, the despair, I feel equipped to request and access care as soon as it’s needed. I know who to ask and how to get it. However, that doesn’t mean that all of my helpers will be on the same page. One perinatal hand may very well have no idea what the others are doing – just as I don’t know which specialist I’m seeing unless I know which day it is.

hands

postpartum depression, Recovery, Uncategorized

Growing

Baby #1: I was excited. I was in awe. I read all the baby updates in all the manuals on the assigned week. I brought my legal pad of questions to each appointment. I was petrified of labor. I cried the hollowest cries while my husband slept beside me on the couch cradling our baby. Who would now console me?

Baby #2: I was excited. I was exhausted. I worried about my first baby with a new baby. I began to look forward to those late night/early morning feedings for the quality one-on-one time they provided. I was so fiercely devoted to protecting baby’s soft little skull and sacred nap time from boisterous big sister, I screamed a lot.

Baby #3: I was blindsided. I was in shock. I was overwhelmed, agitated, obsessive, irritable. I still hadn’t come to terms with the idea of a new baby even as I lay on the delivery bed. I loved her so fiercely I was afraid someone would take her from me. I flipped out at hair elastics stretched over finials of dining chairs. I swore, I flew off the handle, I hid in the bathroom. I cried, begged for it all to be over.

Baby #4: I was surprised. I thought I was done having babies. I have moments almost daily where I think, ‘we’re doing this again?’ and yet, I’m strangely at peace. I still get irritable. I hurt from the physical toll of four pregnancies. I put myself to bed before my children sometimes. I see a therapist. I take meds. I go to acupuncture. I do yoga. I pray the rosary.

But I’m okay.

When I look back at the timeline of my pregnancies, I can see the mounting mental anguish I couldn’t at the time. What could’ve been the ‘baby blues’ with #1, escalated into moderate mood dysfunction with #2, and plunged me into the deepest despair of postpartum depression and anxiety with #3. It still irritates me that something that was probably underlying all the time was manageable for me until I kept adding layer upon layer. However, I am not superwoman.

I am a woman, a mother armed to the teeth with resources and self-knowledge. Fighting, clawing out of that hole after #3, I will never let all that hard work be in vain. I will see the signs early on; I will know which preemptive strikes to take; I will make self-care measures so that I hopefully won’t even need the interventions.

I do not feel strong as a victor shining brightly; but stronger in my resilience, in my survival, my steely will to not succumb.

There is life after postpartum depression. It is different. It’s not easier – but somehow it’s clearer. The unrealistic mist of life as we thought we knew it dissipates. The real, the ugly, the harsh – and the beautiful – are etched crystalline. We see it all – and appreciate the beauty that much more.

To the life, growing inside all of us

Humor, motherhood, Uncategorized

Ode to Maternity Clothes

Thank you, maternity clothes, for making me feel less attractive than I already am

I realize the orb-like appendage extending from my midsection leaves you with lofty goals to attain; still, you fall grievously short of your endgame

With fabrics somewhere between highly viscous jet fuel and canvas starched to within an inch of its life

With shoe-string thin ties that either knot in one’s back or threaten to dip in the toilet in an already awkward dance

With handkerchief hems that add volume to our thighs, yet leave our sausage-like backside showing

Thank you

Thank you for pricing anything that looks remotely like real clothing out of range of anyone in her right mind – for three months of wear

Thank you to your merchandising gurus who decided to place your displays next to the plus size wear

Thank you for providing an infinite amount of baby-doll tops to go with three proffered pairs of pants

And to your partner in crime: the fitting room mirror

Thank you for showing me the parts of myself that I hadn’t realized has gotten so hairy under that belly

Thank you for accentuating just how wide my side view now is

Thank you for sallow skin, double chin, and purple circles under the eyes

Maternity clothes, you suck – only slightly more than trying you on

‘Portrait of an Unknown Lady’ by Marcus Gheeraerts II

Humor, Uncategorized

DJ Khalid Pregnancy Redux

All I do is eat, eat, eat no matter what

Got nausea on my mind,

man, I’ve had enough

When I walk into the bathroom

the toilet lid goes up –

and I stay there

Baby Center blog

and I stay there

Up chuck, up chuck, up chuck

make me say, what the *$@%

These flippin’ hormones

Living, motherhood, parenting

Blowing Up Eggs All Over the Place

Egg and cheese on a bagel.

from districtgourmet.com

This has been one of my comfort foods since I learned how to make one at my first job, schlepping bagels at a local shop. Ironically, I didn’t particularly like the job (people get really cranky if you mess up their cup of joe or bagel proclivities), yet this sandwich remains unscathed by any negative associations. Its positive connotations could come from the fact that it gave me a niche in my kitchen at home. No one could slice, butter, peel back melted cheese from the two waiting bagel halves to insert the egg like I could. Or it could just be the crunchy shell encasing the squishy gluten sandwiching the ooey gooey cheese melded with the fluffy egg.

The only drawback to this soul-satisfying ritual is exploding the egg in the microwave.

We used to have the perfectly shaped Tupperware container, molding the egg into a precise bagel-sized perimeter. If the lid was fitted on slightly askew, the steam would escape, the egg would cook, and you’d be good to go. However, close the gap too much, the steam could not escape; too little, egg splatters would escape. Such a quandry. Sometimes even with that perfect Tupperware and certainly with the smaller glass dish I’ve replaced it with, the steam blasts the lid clear off and sprays egg schrapnel all over the inside of the microwave.

Such was the case this morning.

As my crisp toast gently warmed my swiss cheese by osmosis, I cleaned the inside of the microwave. I gathered the flaccid little bits of egg that hung forlornly in my fingertips – because have you ever tried to wipe a bit of egg? – all while wishing I was already sinking my teeth into its tender gooiness.

And I thought, as my microwave approached its cleanest state in months, I’ve been blowing up eggs all over the place lately. In every sense of the word. See, the only reason I’ve reinitiated this comfort food ritual as a second breakfast in true hobbit fashion as of late is because of the fertilized egg growing inside me. I’ve returned to the prenatal craving of carbs and all things yellow/beige. I get two-thirds of the way through this delicious carb/protein fest and lament that it cannot last forever. I truly think I’d make another sandwich right away if I didn’t mean cleaning the microwave again.

The build up of steam and fire power inside that little Tupperware and the resultant shock of the pop as the lid flies loose is not unlike the advent of this pregnancy. It makes our life a little bit messier than it was already with three children. But I have the feeling it’ll be clean and smooth when all is said and done. There will be ooey gooey comfort and warm feelings way down inside. It will be as satisfying as finally sinking my teeth into that crispy yet soft soul food sandwich.

An explosion can change all matter involved. It can forever alter the blast site. It can also clear the way for new and wonderful things.

postpartum depression

Help Yourself

“If you do become depressed there are several things you can do to help yourself and make the illness as short-lived as possible.”*

I read this in a book preparing women for pregnancy and childbirth. It is meant well. It introduces a section on self-care and avoiding or alleviating depression (including medical help), which goes on to dispel the myth of the ‘perfect mother’, but the tone of this statement rankled me.

Self-advocacy, expectation, and positive outlook do play an important role in mental health, but they only go so far.

If a woman is clinically depressed, no amount of happy thoughts will pull her out. No amount of pampering will soothe her. Strong and mighty though she may be, bent but not broken, she still needs more. Some sort of medical and/or therapeutic intervention.

Statements like this perpetuate the feeling of failure that women suffering from mental illness already feel. That there is something they failed to do, some step they missed or didn’t push hard enough to save themselves. To embrace life and joy. And the idea that they’ve prolonged their misery by not making it as ‘short-lived as possible’ – argh!

Maybe I’m just cranky because it didn’t work for me. I know I’m reading this not as an objective observer or researcher, but as a severely chipped shoulder. But a lot of the literature I’ve found reads like it’s written by someone who’s too objective, like someone who views depression as a clear-cut, easily addressed condition.

Like someone who’s never been there.

* from I’m Pregnant by Lesley Regan, MD; no disrespect to the author, this post represents my own subjective opinion on the topic.

Chopping Potatoes

and other metaphors for motherhood

Tag Archives: pregnancy