A Doula for Dieula – Reflections from Haiti

Hello!

Rachel Lamb here, MBC Birth Assistant and Clinic Nurse, writing from beautiful Haiti. I have the pleasure to be back at Heartline Maternity Center in Port-au-Prince for a couple of weeks, and I wanted to share a sweet story with you all and let you peek into the life here (pictures shared with permission, always.)

Last week a woman named Dieula was in labor at the maternity center. In Haiti it is very rare for men to be involved in childbirth. It is different from the births at the Minnesota Birth Center in that regard. The women will choose one friend or family member to come with them in labor, usually a female. Often that support person stays out of the room, or will come in for part of labor and then go out at time of birth. This specific mama had an amazing younger sister along. This sister did all the things a doula would do: she offered counter pressure on her back, walked with her, swayed with her, walked the stairs and lifted her legs when Dieula was too tired, went on food runs, offered water, updated family members, and on and on. This sister seemed like someone who’s had much experience assisting with childbirth. I asked her if she’s helped many other women and she said she hadn’t but had only seen others in labor. She also has not had children of her own yet.

The relationship she shared with her sister was incredible and so sweet to watch. I explained that in English we would call her a doula- someone who provides comfort and assistance to the mom in labor. I told her she is a doula for Dieula: a needed gift of love and courage in the midst of difficulty.

The labor ended in an emergency – a stubborn stuck baby shoulder – that required quick thinking and acting on the part of the medical staff. It was scary at moments but this young doula stayed calm and by her sister’s side. All ended well for this mom and baby, which proved even more so how needed this little birth center is in Haiti. If she had delivered at home, like so many Haitian moms do, it would not have been a happy ending.

A few days later, after recuperating in the postpartum room and establishing breastfeeding, we were able to drive Dieula and her baby girl home. The sister doula met us on the road and walked with us to their house where she welcomed mom and baby. We will see them again at Heartline every Tuesday for the next six months, where Dieula will gain knowledge from and enjoy community with other new moms.

Another mom and baby safely home.

Another mom and baby kept together.

Another mom and baby who are part of the changing childbirth statistics in Haiti.

Rachel Lamb is an MBC Clinic Nurse and Birth Assistant with a heart for Haiti. Follow Heartline on Facebook here.

Not Your Mom’s NFP

From Toni Weschler’s book Taking Charge of Your Fertility to the myriad of smartphone fertility apps like Kindara and Glow, it’s evident that women today are taking a much more purposeful look at how they monitor their reproductive health. As a fertility awareness and natural family planning practitioner, it’s my privilege to work with women and couples who are “charting” their cycle using a fertility awareness-based method of family planning (FABM) to naturally monitor their fertility and plan for their families. Here are five ways I’ve found FABMs to empower women:

Photo by Brooke Lark on Unsplash

Charting is an accurate identifier of our fertile and infertile times. Really and truly.

Quite often in my instruction with fertility awareness clients, I ask them how their friends have reacted to them taking a fertility awareness course. For a few they acknowledge that their friends and family have been overwhelmingly supportive. But for many, they find that their friends and family just can’t get past the erroneous presumption that NFP is “just the rhythm method in disguise” and that unintended pregnancy is just around the corner.

But that simply isn’t the case for today’s NFP. Specific to the Creighton Model (which I teach here at MBC and use personally), assuming perfect use of the method there is a 99% effectiveness rate in avoiding a pregnancy. Taking into account user error or perhaps an error in instruction, the avoidance rate still stays high at 97%.

While I can’t speak for all methods of FABM, and specifically can’t speak for simply charting on an app where there is little to no guidance from a trained practitioner, I can say that the Creighton Model, and others like it, have a very high rate of avoiding a pregnancy, and all the more so, a very high rate of achieving a pregnancy when the couple is ready to do so.

According to Creighton’s research, 76% of couples will achieve in the very first cycle of practicing what we call “fertility-focused intercourse”, and 98% by the 6th cycle. This means that if a couple hasn’t achieved by the 6th cycle, there is very good reason to seek out the support of a provider trained in interpreting charts so that the appropriate testing and treatment can be performed. It breaks my heart when a couple comes to me after having been told by a conventional provider to “try for a year” to “see how it goes”. If a woman is consistently and accurately charting, practicing fertility-focused intercourse and hasn’t conceived by the 6th month mark, there is likely an underlying condition that needs to be assessed in either the man or the woman.

Photo by Guilherme Stecanella on Unsplash

We really begin to know our bodies.

Once a woman starts to feel comfortable with her observational routine and with charting (which I find is usually by the 3rd cycle) she starts to notice key patterns: Her period usually lasts X days. Her mucus cycle usually lasts X days. Her post-Peak (post-ovulatory) phase is commonly about X days. Charting helps her to know what her “normal” is, and also be aware of how diet, exercise, sleep, stress and other environmental influences affect her cycle. It wasn’t until several years into charting that I happened to shift to an anti-inflammatory diet (primarily no grains or sugars). I noticed that my period pain became virtually non-existent (this blew my mind), and my period itself became healthier and less prolonged. I loved that these health gains were something tangible I could see on my chart, which was a pretty great motivator for keeping with the healthier diet. And, I didn’t have to worry about the side effects that can sometimes come with using hormonal contraceptives to manage my period.

Photo by Ana Tavares on Unsplash

We become experts in identifying patterns that are outside the norm.


It happens time and time again: I meet a client who describes her cycles as “normal”, but after charting we start noticing inconsistencies: Limited cervical mucus (which could make it difficult to conceive). An unusually short post-Peak phase (which could indicate low progesterone or a greater risk of miscarriage). A period that doesn’t really bear the markers of a healthy period (which could also indicate abnormal hormone levels). As I tell all my clients, I am not a medical provider, so my job is not to diagnose. But it
is my job to help women to understand the patterns in their cycle and to feel empowered to ask questions when they observe something that is outside their range of normal. Charting with a reliable FABM is one of the best ways to monitor and maintain good reproductive health.

Photo by Timo Stern on Unsplash

Charting promotes participation from the woman and the man.


One of my favorite aspects of working with a new client is working with a husband/partner. While the woman observes, I often encourage the man to chart. No one person is responsible for the great gift of fertility but rather it’s the couple working together, communicating, sharing their intentions, and thoughtfully considering next steps that makes fertility awareness empowering not only for the woman, but for the man as well.

Photo by Dakota Corbin on Unsplash

Charting reminds us that our bodies are worth our time.


How in the world is this empowering, you ask? Well, I know for myself that when I take time to chart I’m telling myself a few important things: My body is valuable. My body is a gift. My body is a-maze-ing. And just like getting in a good run, setting aside time for peaceful prayer/meditation, or
scheduling my annual well-woman exam, when I’m  charting I know I’m doing a good thing for my body. Achieving or avoiding a pregnancy aside, charting my fertility reminds me that my body is worth my time.

Women around the world have embraced fertility awareness. I’ve had the honor of working with single women, engaged women, newly married women, and women 5, 10, or even 15 years into their marriage. For each of them, the practice looks a bit different. And as with pregnancy, birth, and parenthood, each of them encounters both joys and challenges along the way. But for each of them, they discover the gift of reading the signs of their body. And that, I think, is empowering.

Karen Schultz is MBC’s Administrative Manager, as well as a birth and postpartum doula and Creighton Model FertilityCare Practitioner. When she’s not extolling the beauty of fertility, birth, and breastfeeding, she enjoys puttering around her newly bought home and finding places of solitude on any lakeshore she can find. To learn more about the Creighton Model of Fertility Awareness and Natural Family Planning at MBC visit www.tcnfp.org.

References:
– Pope Paul VI Institute. Pregnancy Avoidance Rates. Findings published in the Journal of Reproductive Medicine, 1998.
– Pope Paul VI Institute. Pregnancy Achievement Rates. Findings published in the Journal of Reproductive Medicine, 1992.

Not Your Mom’s IUD

Photo by Guilherme Stecanella on Unsplash

Finding the right family planning option may feel overwhelming. It seems there are SO many options. MBC Certified Nurse Midwife Jessica Bohren explains some of the most popular options right now are Long-Acting Reversible Contraception (LARC) like the IUDs Mirena or Paragard. There’s very little user error because they can be put in place for years without having to think about them. There are also fewer side effects than other forms of birth control like the Pill. There are many myths surrounding these forms of birth control, especially IUDs, but their safety and reliability is scientifically proven! Jessica suggests making an appointment at the Minnesota Birth Center to discuss any preconceptions you may have about different forms of birth control and decide what will work best for you.


Call MBC to make an appointment to discuss your family planning options (including the option to use inhaled nitrous oxide for IUD insertion) at (612) 545-5311 for our Minneapolis location or (651) 689-3988 for our St. Paul location!