Blog

I'm Hysterical

My brain is a little fried from the news lately. It’s easy to get worked up and feel like there’s nothing we can do but scream. The word “hysterical” comes from the Greek word “hyster” or uterus. It translates into “wandering uterus.” In the days of Antigone, it was thought that women were empty save for a brain (generous) and a uterus. When they were being “hysterical,” it was because their uterus floated up to their brains and was causing mayhem. The cure for this was to tie a very tight rope around a woman’s waist in the hopes it would keep her stray womb at bay. Misogynist (also a Greek word), yes, but also sort of fantastical and cute compared to the resent assaults and misunderstandings about the internal machinations of womb-owning in our current medical and political bodies.

I rewatched the second season of Handmaid’s Tale, finishing up just before the news coming out of Alabama and Missouri a few days ago. When that show first premiered, half of the people I knew wanted me to watch it to get a doula’s take on it. It felt all to familiar, was my response. I watch women (and other pregnant folx) being told that they’re not good enough to take care of their own bodies or their babies constantly. The scene in the second season where June picks up Hannah from the hospital and is grilled about not being a “good mom” sounds like half of the concerns coming from the lips of the parents I work with in postpartum.

fuck these abortion bans

fuck these abortion bans

Pregnant people over the age of 35 are considered “geriatric” like their uteri are going to collapse in on their precious cargo just for having a fucking birthday. AJOG released research in 2011 outlining how 2/3 of OBGYN practice in the US is not based on high level evidence, but on doctor opinion. No shit. And it’s clear that those opinions can be racists, misogynist, and just downright wrong. So if the people supposedly in charge of understanding our changing bodies can be so brazen, can it be so shocking that 25 white men (and some particularly vitriolic women) who are convinced women are vessels and murderers don’t understand ectopic pregnancy? Or that you don’t need to cut into a uterus to remove 12 weeks of dividing cells?

We are an increasingly unscientific nation. I see that in how parents talk about research they come across (usually poorly digested in mommy blogs and the hellscape of Facebook) and feeling shamed into doing something against their intuition.

For those of us who work with folks in the childbearing year, the burden often falls on us to calm the storm, find and present valid information, and to fight diligently. And we do it as grossly unpaid and structurally unsupported persons in the shadows. Compassion fatigue is high. Burn out is fast and furious.

I’m reclaiming the word Hysterical.

And yeah, this is a shameless plug for the things I’m trying to do with Rosewood. My mission in birth work was always structural. It was always to support the people who support reproductive health and I’m finally carving out more than a marginal space in my life to do so. I want to do more to help doulas collectivize. I want to do more to help prepare birth workers with high level research. I want to help them make their businesses succeed so that they can be sages at 6 years, 9 years, 25 years of practice and not have to walk away from their passion after 2 years of begging to get paid for sleepless nights and combating structural injustices. I want to help birth workers get paid decent incomes so they can take on more volunteer and sliding scale work and serve those who need support most. I want other birth workers to feel that they can move into a position of policy and profit because they have done the groundwork and are ready to create larger platforms for others doing this essential care work.

I don’t have every answer to what’s going on politically. I shouldn’t and won’t be the voice that starts a revolution or changes the world. I had that vision of myself at some point when I was younger and working in non-profits and teaching myself international law in college. Then I was confronted with how much ego gets in the way of progress. Now, after a decade of being in birth work in many different communities, I see how being shamed into retreating too far away from ego, my fellow birth workers are setting themselves up to be taken advantage of (even if not maliciously) and why our profession stays in the margins. I believe that there can be individual triumphs, revolutions in our solo practices, and teamwork across our small communities to create incredible change for ourselves, the families in our care, those not wanting to create families who need our support and guidance, and on a much much bigger scale by showing up for ourselves and each other.

My place in this whole thing will be to help doulas set better expectations for themselves and their clients through their contracts and professional presentation. I will take my experiences of building sustainable non-profits to as many doula groups as I can in hopes that they can great organic, productive, and structurally sound collectives to protect and promote themselves and their colleagues. I will mirror these approaches in the workshops I give to parents and caregivers so they can understand and start to dismantle the influences that want to convince them their not good enough and connect with the passionate care providers who know that they are. I will do my best to listen more, allow my own biases to be dismantled, and to not shut up.

My goal for this year is to be in at least 10 different cities with these classes and consultations. I’m also writing a book on contract writing that focuses heavily on sustainable birth work and joining forces in our communities and country to make changes. If you would like to work with me, please reach out. This work can be exhausting and isolating and it’s not possible to do on your own.


Head on over to my Doula Trainings page to see what workshops I can bring to you. If you’d like me to come to your city this year, please fill out the form on my Contact page with details about you and your doula community and let’s get the ball rolling together. I offer a trade deal for anyone offering to host my workshops in their town. It’s a great way to collaborate, keep this momentum organic and unique to your particular area, and to connect with one another. Plus, you get to take my classes FOR FREE! Looking forward to working together.

Cesarean Awareness Month

cesarean awareness month

It’s #CesareanAwarenessMonth so I want to talk a bit about the discussion around cesarean rates and place of birth / chosen care providers.

I take some issue with this statement by Dr. Neel Shah (Director of the Harvard School for Public Health) in that if you’ve been attending births as long as I have, you can really start to understand why some hospitals have higher rates of surgical births than other.

There is a hospital in SF that is notorious for it’s induction and cesarean rates. The culture of the interactions between doctor and nurse, doctor and laboring person has at times been so hostile that many doulas refuse to take clients choosing to birth there. I am one of those doulas. I’ve seen too much there where I felt my clients were disrespected and put into unnecessarily risky situations, as well as overhearing some disturbing things while walking the halls among the doctors and nurses and no longer feel like my practice benefits from supporting pregnant folks seeking care at CPMC. I’ve lost a ton of potential working opportunities by sticking to my guns on this, believe me, but I felt my will to continue to do this work and the liability aspect of my practice suffer by attending births there. I never looked back.

I’m not the only one who has made this hard choice. The topic has come up with peers and it’s clearly a difficult one. Some doulas do very well in that hospital, they feel comfortable there, their clients are able to be treated well. Those doulas tend to have been working for a long time and are confident and outspoken in their normal lives, let alone in the birth space. I, however, don’t feel like it’s my role to have to fight every arbitrary decision being made for my clients around misused testing and labeling in pregnancy and the lightening speed toward interventions. At the end of the day, these folks chose where they are planning to give birth, chose their providers, and deserve bodily autonomy.

HOWEVER, despite not taking clients at this hospital, when folks email or call me for an interview and tell me they are planning to give birth at this hospital, I often spend some time talking about why I don’t take births there, rather than just funneling them along.

I can say the same things about pretty much every hospital and why the cesarean birth rate is too high (the tipping point is thought to be somewhere around 19% of all births), but there are definitely some practitioners and some hospitals where the outcome of a cesarean birth is much more likely. I feel like I owe it to my clients to be forthcoming about this.

Furthermore, I owe it to them to talk about the non-clinical reasons why most unnecessary cesareans occur, which start building LONG before the day of labor and have EVERYTHING to do with practitioners and where they get their care. If my client describes their visits with care providers with lots of, “well, they don’t ALLOW that,” or “I asked about X but they told me I had to do it anyway,” I don’t shy away from brining up that their care providers aren’t actually able to make them do or not do anything. Ultimately, my clients are in charge of their care and that of their fetus, so they should have the final say in refusing interventions, when they come into the hospital in labor, who is allowed in their room, what tests they may refuse, interventions they may refuse, firing nurses or doctors who make them feel uncomfortable and who’s decisions they don’t agree with, leaving the practice at any point in care, leaving the hospital if they don’t agree with the decisions being pushed on them, and what can and can’t happen to their baby after birth. Too often, doulas are the only gatekeepers to this important dialogue and unfortunately, we’re often the lowest rung on the ladder of care since we are non-clinical providers working with families often after they’ve gotten negative messaging from their clinical providers since conception.

Not all cesareans can or should be avoided, but there is a crisis in maternal care in this country and overuse of technology, interventions, and operations is a large part of the worsening picture. As doulas, we are obligated to speak up about the realities of why this happens. Too many doula trainings shy away from teaching newer doulas how to navigate these gray areas of scope. I do think it’s valid for us to stay within our physical scope of practice in terms of what we can do to help direct outcomes, but it is ABSOLUTELY our role to be forthcoming about systematic neglect of evidence and widespread abuse of role if we see it time and time again in certain places of care. More doulas need to be told this and we need to be more supportive of each other in navigating these tricky territories.

We are not magical talismans to ward off cesarean surgery if our clients are going to be told that their “high risk” from conception without good reasoning. It is not our job alone to protect our clients from unnecessary interventions — we guide them to the sources of empowerment, but they must ultimately empower themselves. And we must collectively empower one another to take the professionally risky move to speak up to our clients prenatally about the abuses we see. Remember that medical bullying often comes with a smile and a reminder that it’s the woman’s fault she’s high risk. We need to fight that language in our own practices and not shy away from telling the truth about certain places of birth.

Why Doulas Should Work with Contracts

I had the great privilege of being interviewed by Esther Gallagher for The Fourth Trimester Podcast on why it’s important to have a doula contract — both for the doula and for the client.

Framing this as an opportunity to use the contract to open dialogue, instead of it just being a boring or intimidating part of our profession, I brought up issues around setting expectations, strengthening our community and individual practices, and other fundamental components of our demanding practices.

These are some of the key issues I address in my contract writing workshops and individual contract edits for doulas, midwives, and nannies. I also cover things like :

  • Termination vs Cancellation

  • Deposits and fees

  • Scope of Practice and Practice Restrictions

  • Doula - to - Doula Paperwork and Partnership

My next workshop will be on January 17th from 4:30-7pm in Oakland. Sign up before Jan. 5th for an early bird discount! You can register on my Contact Page or contact me directly for more information. All types of in-home, independently contracted care providers are welcome to join us.

CONTRACT WRITING WORKSHOP FAQS (2).jpg

I highly encourage parents and providers to take a listen to this episode, as well as the other incredible interviews Esther and Sarah have conducted over the past year. Please consider subscribing to The Fourth Trimester Podcast on Patreon so they can keep this resource going!


Call Your Girlfriend -- I'm Doing Virtual Consults!

Here to tell you about my phone and video consultation services!

Okay okay okay, truth be told, I HATE talking on the phone. I don’t even like FaceTime chats except to see my baby nephew so this has been a stretch for me. BUT I loving it.

image via  Mere Street

image via Mere Street

I was asked to start doing phone consultations by a former client who is building a network of experts to reach Chinese families around the globe who are trying to find more holistic parenting resources. It started as short video workshops (that was challenging enough for me as a rambler) and merged into phone consultations for small groups of parents interested in holistic sleep education. That lead to phone consultations for doula contract writing, prenatal education with families outside my services areas, and more. It’s inspired me to keep going.


I’m going to start offering almost all of my services virtually from now on -- Well Woman Consultations, Pregnancy Consultations, Postpartum Prep Consultations, Sleep Support Consultations, and Doula Contract Writing Consultations and Classes.


Here’s what each might look like :

Well woman consultations :

After you reach out about wanting to work with me to find a more tailor-fit approach to your hormonal and reproductive health care, I’ll send you one of my whopping 10 page intake forms to fill out and send back to me. You can sign up for 1+ hour of support over the phone or video, we’ll pick a day and time, and that’ll be when we can go over your needs and wishes for care.


After we chat, I’ll do a bit of research and reach out to my network for good recommendations in your area and send you a detailed email with everything you need. If you want to keep working with me, we can do so in the same manner on and hour-to-hour basis or you can jump into one of my annual or 6-month packages for further support.

We’ll cover everything from nutrition to seeking a primary care provider to navigating tricky hormonal issues to birth control options, and more.

I’m very dedicated to working with young persons and their parents/guardians to help them navigate the transition from pediatric into reproductive/gynecological health care that’s supportive, inclusive, expansive, respectful of the enormity of these age transformations, and doesn’t scare them out of routine care. We can work as a team and have private sessions so everyone feels comfortable and connected in this process. Privacy, compassion, and empowerment are the keys here and I’d love to be a guide for you and/or your child in this process.


Pregnancy consultations :

These can work the same as my in-person package options where you can sign up for a 2 hour consult at any point in pregnancy or the full 10 month support package. After you let me know what might work best for you (and if you start with the 2 hours and want to jump into a larger package, that fee will just be transferred over), I’ll send you a detailed intake form so you can let me know about your pregnancy journey so far and fill me in on what I might be able to help you with going forward.

For some families, you’re just looking for extra information on a specific topic like choosing a care provider, GBS testing, nutrition, finding a doula, home or birth center birth vs hospital birth options, how to find and interpret high quality research and information, information on comfort measures in birth, or other singular topics.

Other families want to get the support they would traditionally get from an independent midwife (minus the clinical testing) that they aren’t able to access for any reason and want to have me fill in a lot of the huge gaps left in our maternal care system.

With ten years of experience supporting pregnant persons in all sorts of ways (childbirth educator, doula, midwifery student, infant care specialist, researcher, doula trainer) and in many different states, countries, and settings, I’m here for all of it! If you feel like my style is the best fit for you, or you feel like you’re not finding what you need in your area at this time, let me help you virtually!


Postpartum Consultations :

Feeling like you’re not getting the resources on what to expect once baby is home? Feeling like you’re getting a lot of conflicting information or information too focused on risk and fear and opinion? Wanting an infant and mama/birthing person healing crash course done on your own time and with your specific family’s needs in mind? Let’s set up a call or video to go over what you need to know. This also can be done as a one-time 2 hour session or as part of the broader packages.

Unlike traditional newborn basics or breastfeeding classes now widely offered, these consultations don’t follow a standard system. Instead, they are focused on the concerns you have individually and specific to what you feel you’re not getting. We can set these up before baby arrives (ideally) or up to 4 months after baby is here. This can be a truly awesome baby shower gift!

I offer discounts for group consultations, so if you have a few friends or a parent’s group of expectant/new folks due around your same time (minimum 4 participants), the price is dropped to $20 per participant per hour.


Sleep Consultations :

Wanting some basics in infant sleep expectations? Not sure you want to sleep train or what sleep training even entails? Wanting a holistic and personalized approach to discussing sleep difficulties without fear or judgement? Need a point person on standby for those crazy weeks of transitioning sleep schedules? That’s me!

Lack of sleep is one of the number one challenges parents face in the first few months with a new babe. There is no way to make this obstacle disappear -- it’s part of the process, sorry to tell you. However, so much of the sleep training information floating around is not routed in good science or good practice and often leaves families feeling more stressed and tired. This often leads to them either ditching their goals for compassionate sleep adjustment sooner than they’d like, or makes them feel like giving up even trying to get babe to sleep on their own. There is a middle path, friends!

For better or worse, this middle ground takes a lot of extra support, guidance, and respect for nuance. Rosewood consultations aim for realistic, quality information-driven, and non judgemental discussions around safe, healthy, and lengthier sleep options. This isn’t a promise of X hours or a leave your baby to scream bullet point plan, no-sir no-thanks.

There is an option to have a 2 hour basic rundown of common sleep issues and information you can access while still pregnant, or you can reach out to me once baby is here and you feel you need more advice, either as a 2 hour consult or as part of a larger package based on your needs. This can also be a group virtual class at the $20 per person per hour rate (for at least 4 registered participants).


Doula Contract Consultations :

Let’s face it, most doula trainings leave you totally in the dark about how to write a contract that really protects you or supports your individual practice.

With a one-on-one contract consultation and edit, we can work together to go over the basics of contract writing (I send you my full how-to booklet once you register), using your contract to set up healthy and cooperative expectations for yourself and your clients, how long to keep a contract, what goes in your contract vs on your website or handouts, myth-busting scary legal language and legal fears, and how this practice can evolve and grow and be a benefit to your wider doula community.

Individual virtual edits are 2 hours of prep on my end going over your material as-is, 2 hours of virtual meeting time, and 2 email follow ups built in with the option of adding more at a low hourly rate.

Virtual group classes can be done at an hourly rate of $100 per hour for any size group. I’ve loved talking to doula groups and collectives around the country about how to use this exercise together to create better contracts and support one another in this often difficult work.  


Want to bring me to your group or training organization in person? I’d love that! We can chatrates and options, so please reach out.

Rates for virtual consults are the same as in person consultations at this time and can be found on my Services and Doula pages. As always, sliding scale and some trades are options to keep this type of support accessible in many areas.

If you are part of a parent’s network or group and think I’d be a good fit for one of your gatherings, please reach out! I love discussing specific topics families want more information on like holistic sleep advice, environmental parenting, choosing a care provider, finding a doula, and more.

If you are a doula group and want me to speak (virtually or if possible in person) about one of my specific focus areas, LET’S CHAT! I do it all the time and love meeting and teaching doulas from all over.