Book report: The Doula Advantage

Gurevich, The Doula Advantage, 2003.

My score

9/10

Amazon link

The Doula Advantage

My review

Why this book wasn't recommended instead of The Doula Book, I don't know. This fabulous paperback introduces the idea of a labor companion, and spends a chapter discussing the importance of touch and support in labor, citing many of the same statistics. Unlike The Doula Book, however, The Doula Advantage refrains from getting all hippie on the reader. Instead, the book discusses the practical implications of having a doula: what a doula actually does for a woman; how a doula supports a woman who chooses to or must have pain medication; how a doula supports a woman with a c-section; what a doula does for a birth partner; and how to hire a doula, including examples of interview questions, how much doulas charge, and how to cut doula costs by bartering and hiring doulas in training (like me!).

The Doula Advantage goes on to talks about postpartum doulas and what they do, and how they differ from lactation consultants, babysitters or nannies, and maids. The purpose of a postpartum doula is, just as a birth doula, to support the new mother. The postpartum doula does whatever is necessary for the mother or around the house to make the mother calm, content, relaxed, and focused on her new task at hand: taking good care of her newborn. Sometimes the task is to help with lactation; sometimes, she must help with older siblings or hold the new baby while mom takes a long shower; sometimes the mother's stress level is proportionate with the mess in the house or the number of dishes in the sink. Then, the doula will pick up the house, clean the kitchen, and prepare a healthy meal.

Another type of doula discussed is the antepartum doula. Slowly gaining popularity and recognition, the antepartum doula serves the mother-to-be before the onset of labor (although such a doula may stay and support the mother during the birth). Women on bedrest or with particularly difficult pregnancies benefit from antepartum doula support, as do single mothers and teens. An antepartum doula will meet the emotional needs of the mother-to-be, coming over to talk, cook some meals, and help prepare for the baby. She may hold a one-on-one childbirth class with the new mom.

I am a big fan of Rachel Gurevich's book as a practical overview of the benefits of having a trained labor companion and how to obtain one. If I were to teach a childbirth class, I would put this book on the reading list... and recommend it to all my clients.

Four months: a retrospective

Around four months ago, my son was born.

When they put him on my belly, immediately after birth, I was stunned. Was this squirmy, hot, wet thing the same thing that was my pregnant belly? No, you read that right: pregnancy was my belly, not what was inside it; the baby, outside it, bawling, came seemingly from out of nowhere. Why was he so hot and wet? And why was he crying?

Now he's four months old, drooling, laughing, and putting everything in his mouth.

At first I thought that six weeks was my favorite age. He was so portable. I took him with me everywhere: to classes, to meetings, even to a conference. He would ride in my little pouch on the bus and the motion of the bus would put him to sleep. He had no opinions. He was happy being fed every two hours (every. two. hours.) and changed when he pooed (every. two. hours.) and so alert, looking around with his enormous eyes.

But now, at four months, when he giggles and coos when he sees his papa and opens wide when he sees his mama; when he gets excited when he sees boobies (I guess most men do); when he grunts to indicate bedtime --- I think this is my favorite age. It's delightful to sort out his preferences, to play, to interact. That's something we didn't have at six weeks.

He's a puzzle, and the pieces are still forming. But as they do, we can snap them into place. The landscape that is my son is growing, and it's an exciting time.

Movie review: The Business of Being Born

The Business of Being Born. Directed by Abbey Epstein

My score

8/10

The continuum: Theatre - Matinee - Rental - Discount rental - Library

I would watch this movie at a matinee.

Amazon link

The Business of Being Born

My review

Why does the United States have a higher maternal and infant mortality rate than other first-world (and even some third-world) countries? Why didn't the midwives move into the hospital when births did? Why has the home birth rate fallen from over 90% to less than 1% in just a hundred years?

Ricki Lake and her cohort answer these questions in several ways. First, like everything else, it's economics. C-section rates are around 30% because it's fast, clean, efficient. Induction and augmentation rates are high because it gets the beds filled and emptied faster. Doctors charge more than midwives. Second, it's the marketing. Not only does "midwife" have a bad connotation whereas "OB/Gyn" has a good one, but also the entertainment industry as a whole shows labor and childbirth as a grueling, terrifying, awful process. Movie stars opt out of natural birth and schedule c-sections. Third, it's the education. Women simply do not know what their options are, what the hospital procedures are at the location they choose to give birth, and many OBs have never attended a normal, natural birth before.

Now, we take this one step further.

Most women in the US miss out on the critical moment of mother-child bonding. That is, the flow of oxytocin, the love hormone --- the largest amount of oxytocin a mother ever experiences in her lifetime, that happens the moment after birth. Women miss out because oxytocin is formed as a response to the pain of labor and subsequent birth. With an epidural, pain is dulled; the bonding hormone does not flow in such great volume.

A monkey momma has no interest in her baby if the baby is delivered via c-section.

I'm not saying we as humans don't overcome this. We do. Oxytocin is also released when breastfeeding. And what human momma doesn't think her offspring is adorable? But breastfeeding rates drop for babies delivered with an epidural, and especially for c-sectioned babies. We can see how effective, on a benefits-to-baby scale, a particular birthing method or establishment is by studying how long, on average, a mother nurses her young.

If as many mothers birthed at home here in the US as in the Netherlands, for example, more babies would be breastfed for longer.

So, overall, a good movie, and informative. I would have liked more of a research element. I had to dock a point for the graphic c-section footage (ew!).