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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.

Doula to Doula : Talking Sleep with Parents

For the past several months, I’ve had the really wonderful opportunity of teaching Infant Sleep Basics for Doulas with Cornerstone Doula Training. Though I wasn’t trained by Cornerstone apart from their Nutrition for Midwives course, I’ve worked with many doulas trained by them and have been so impressed. I knew I had big shoes to fill in being taken on as one of their instructors — especially on a topic as loaded as sleep training.

Well, so far it’s been awesome and I’ve been so thrilled to be apart of so many doulas’ expanding knowledge. One doula-in-training reached out to me recently about a particular struggle and the back and forth exchange was deeply resonate with what I hear from many other doulas and parents in my sleep training practice that I asked her if I could share it. Luckily, she said “yes” and so here it is! I hope this sheds come insight into the common struggles of new parents and their in-home care takers in navigating the tricky territory of sleep support.

J : I run into a situation frequently where a baby 1-6 months will SCREAM and fuss as soon as you take them into a sleeping area, or they know it’s going to be time for a nap. Which has resulted in parents holding them for naps etc. Is there any way around this? These babies also only sleep one 20-45 minute cycle at MOST. And maybe even just 1/2 naps for a 12 hour day. 

I would appreciate any insight you have! Thank you!! 

Me : Easiest solution - have them sleep wherever. Stick a basket in the living room. Who cares? They are responding to some other stress than the room itself since they have no object permanence anyhow. But anyway, infants can just sleep wherever.  Or they can start staying in the room with baby longer with a hand on baby’s chest. Check out Kim West’s Sleep Mommy Shuffle. 

If they insist on baby being in another room :

Is the baby swaddled? - They will transfer better if so and will sleep more soundly if they are not put down till at least a few minutes into the deep sleep phase. 

What sort of space are they sleeping in-basket, crib, etc? - Trying to transfer baby into many sleep spaces can be challenging since they are often quite deep (triggering a baby’s reflexes to stir), too large (messing up baby’s vertigo and causing them to feel alone and thus “unsafe,” which will impact deep sleep), they may need to be closer to a human body for the sake of developing their biorhythms and there is really no need for an infant to sleep in a separate space since they can’t sleep well on their own and don’t have object permanence to cause a “bad habit.”

Are the parents generally anxious or stressed around sleep rituals in a way that might cause overstimulation in the baby? - often this becomes a vicious cycle where parents and care takers feel pressure about sleep and then start routines with anxiety which these primal little blobs soak up like sponges, causing more stress and crying, and ever onward till someone caves. They can either accept the need to hold/carry baby for some naps (which is certainly an ok thing to do  if it works for their life) or accept that it will take some adjustment if they are not thriving. Adjustment can be gentle or difficult so it’s a balancing game that will be different for each family. I’ve worked with many families who thought it was near impossible to get babe into their own sleep space without using harsher methods, but time (TIME TIME TIME) and observation and gentle care for everyone involved (and for me at least, Glenn Harrold in my earbuds) did the trick 99% of the time. 

Do the parents do a lot of “development” activities in between naps? - you can help them see that those aren’t really necessary and can overstimulate baby and make it harder to get them settled for sleep. Two articles to look into on this: Leave Those Kids Alone from the Atlantic and this one.

My advice to you and family is to keep tuning into baby over reaching for quick fixes or giving up. Both lead to more confusion and suffering most of the time. 

Hang in there, this is normal. You’ll develop your rhythm and approach to all this as you hang with more babes and families and see the possible pitfalls and solutions. 

J : I think the root of the question is really just WHAT is normal? 

I know some babies who have slept through the night at 6 weeks without crying and others just never want to be put down. 

I feel like in our culture people feel it is abnormal for babies to want to be held and co-sleep. Do you have any resources that are nice and REALISTIC about what you can actually expect from a baby?  And what do healthy sleep "habits" actually look like? I totally understand if you cannot answer these questions! I am happy to read articles or books or listen to podcasts, it just seems everyone is either so far on the left or far on the right when it comes to what a baby sleep should actually look like and who qualifies as a "baby". 

Me : So pretty much everything is normal. That’s what crushes parents. There are going to be LOADS of circumstances where you try everything under the sun and nothing seems to help. We are a culture obsessed with diagnosing and “solving” things, but that doesn’t totally jive with the primal blob nature of infancy. 

Over time you will feel desperate in some way and it will lead to a cool trick or some deeper understanding that helps you better communicate these things to parents. If you fight the urge to make promises, rely on crappy information, or feel that your role is to give definitive answers to things that aren’t actually “problems,” you and the folks you serve will be better off. It’s hard when word of mouth and testimonials are such a big part of our business, but you have to keep in mind that you’re teaching parents to be parents, not acting as a contractor mending a collapsed wall. Our help is more subtle and nuanced and can take time to be appreciated or understood — even within ourselves. 

Instead of furthering the bullshit idea that there are “right” and “wrong” ways to sleep/hold/feed/rest/care/bond/teach/parent, keep pushing the notion of filtering and thriving : Filter through information + Pick things that help your family thrive (regardless of the other book sitting next to the one you picked that says the opposite thing than what you’re doing). HARD and EASY are relative. 

This isn’t the same as doing nothing. Making shifts and observing then adjusting when folks aren’t thriving is a great thing. You being there to normalize that, give options, validate choices, and take some of the physical load off implementation is priceless. 

This all sounds floofy, trust me, I’m a legal researcher who pushes evidence constantly, but the truth is no matter how deep you dig into trying to find a solid answer with newborns, they exist on some other plane not quite here on earth, talking to faeries as my Irish grandmothers would say, and so logic doesn’t always prove solid. And almost always, the answer is be gentle with them, be gentle with yourself, be firm in your ideas of what is necessary to thrive, and give it time. 


I hope that helped give some insight into my process of postpartum and sleep consultation work and gives some validation to the struggles you might be facing as a doula or new parent. You’re not alone in not being able to feel confident in navigating what is “normal” right from the go.

Books are currently open for all consultation services, including sleep training. I have two sleep classes scheduled at Mini Mint Studios in Santa Cruz next month — May 9th from 1-3 for parents and May 13th 4-7 for doulas and midwives. You can register for both on my Contact page.

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.