Ep 5: From Being in the System to Serving in It: Keena Armstrong’s Journey

Episode Title: Episode 5: From Being in the System to Serving in It — Keena Armstrong’s Journey as a Parent-Educator, Therapist & Doula

Host: Melissa Harley, B.A., AdvCD/BDT(DONA), CLC, LCCE, FACCE
Guest: Keena Armstrong, M.S., Counselor, Doulas, LMHC

In this powerful and heartfelt episode of the CCDS Doula Collaboration Podcast, host Melissa Harley sits down with Keena Armstrong, LMHC, a licensed mental health counselor, parent-educator, birth doula, and postpartum doula, to explore her full-circle story—from growing up in the foster care system to becoming a compassionate, community-based provider serving families within it.
Keena shares how her lived experiences shaped her life’s mission to support others through birth, mental health challenges, and family transitions. With authenticity and clarity, she reflects on her own struggles with postpartum anxiety, her journey to licensure, and her vision for wraparound support for birth and foster parents alike.
This episode is a moving testament to the impact of healing-centered care and the importance of bringing lived experience into professional service. It will leave birth workers and mental health providers alike inspired, informed, and reminded of the deep value in showing up with heart.

How Keena’s childhood in foster care informs her work todayThe role of doulas and therapists in postpartum mental healthHow Keena balances advocacy, parenting, and community careHer vision for a Fourth Trimester Recovery Space and what comes next

💬 “I want people to normalize and understand that some things that come with becoming and being a parent are normal. Being touched out and overstimulated—that’s normal.” — Keena Armstrong
💬 “You’re being a doula to those foster parents, right? How neat is that?” — Melissa Harley
💬 “It felt amazing… My goal and my vision board said I’d be licensed by the end of the year. And it happened.” — Keena Armstrong
💬 “Support isn’t linear—it’s circular. And I move through those roles and hats seamlessly.” — Keena Armstrong

📌 Perinatal Mental Health Certification (PMHC) – Offered through PSI, MIMH, and other training organizations- https://postpartum.net/professionals/certification/
📌 Edinburgh Postnatal Depression Scale (EPDS-US) – Screening tool for postpartum mental health – https://epds-us.vcu.edu
📌 Healthy Start Programs- community support, some with doula programs
📌 Postpartum Support International (PSI) – ⁠www.postpartum.net⁠

About the guest: Keena Armstrong is a Licensed Mental Health Counselor (LMHC) in Florida and a trained birth doula since August 2019. Currently pursuing her Perinatal Mental Health Certification (PMHC), Keena brings a deep passion for social work, child welfare, and advocacy into every aspect of her work. As a proud mother and devoted partner, she is driven by a commitment to nurture, uplift, and empower those in need. Keena’s mission is to help change the world by promoting mental wellness, supporting families, and being a strong voice for the vulnerable.

🎙About the host: Melissa has been a dedicated birth professional for over two decades as a birth doula and childbirth educator. A DONA-approved trainer since 2010, she has trained over 1,300 doulas worldwide, blending evidence-based practices with insights from her extensive leadership experience. She served on the DONA Board of Directors for seven years, (DONA International President – 2020), contributing to strategic planning, education, and advocacy initiatives. Currently, she coordinates DONA’s conferences and webinars, fostering ongoing professional growth in the perinatal community. Based in Florida, Melissa remains an active doula trainer, childbirth educator, & lactation counselor. To connect with Melissa, visit ⁠www.capitalcitydoulaservices.com⁠📩 Have a topic suggestion or want to be a guest? Contact Melissa at: ⁠⁠www.capitalcitydoulaservices.com🎧 If you enjoyed this episode, please subscribe and leave a review!

Ep 4: Mothers, Daughters, and Birth: Sarah Yastrab on Orthodox Jewish Birth

*Audio Only Episode*

Host: Melissa Harley, B.A., AdvCD/BDT(DONA), CLC, LCCE, FACCE
Guest: Sarah Yastrab, Birth Doula

In this insightful episode of the CCDS Doula Collaboration Podcast, host Melissa Harley welcomes birth professional Sarah Yastrab for a conversation rooted in faith, family, and the depth of doula work. Sarah shares the meaningful experience of supporting her daughter through labor and birth—an intergenerational moment filled with emotion, purpose, and presence.

Drawing from her lived experience within the Orthodox Jewish community, Sarah invites listeners into a thoughtful discussion about how doulas can respectfully support families navigating sacred and long-standing cultural practices. Together, she and Melissa reflect on the importance of cultural humility, emotional awareness, and creating safe spaces for all families.

This episode includes content that may be sensitive for some listeners, including the impact of antisemitism and discussions of Orthodox Jewish birth traditions. At CCDS, we are committed to honoring diverse perspectives, holding space for growth, and embracing the complexity that comes with truly client-centered care.

About the Guest:
Sarah Yastrab is a birth doula based in Woodmere, New York. Her journey into birth work began when her daughter asked Sarah to support her through a successful VBAC (Vaginal Birth After Cesarean). This personal connection inspired Sarah to pursue formal doula training with Melissa.
A mother of four children, Sarah brings decades of personal experience with pregnancy and motherhood to her practice. Having spent many years immersed in maternal support within her community, she combines professional training with lived experience to guide families through their birthing journeys. Sarah currently serves expectant parents throughout Long Island, offering compassionate and informed support during one of life’s most transformative experiences.

What You’ll Learn in This Episode:
✔️ How personal identity and professional experience intersect in birth work
✔️ Why it’s vital to honor religious and cultural traditions in doula support
✔️ The importance of learning directly from communities we wish to support

Quotes from the Episode:
💬 “My family is a family of Holocaust survivors. We’re only 80 years since the Holocaust and there’s no greater expression of joy. There’s no greater expression of hope. There’s no greater expression of faith and trust in a better future than having a baby.” – Sarah Yastrab
💬 “You’re a soul and they’re a soul and you’re just two souls in a room and just connect on that level. Everything else can exist outside, but when you’re together, you’re there for a reason.”– Sarah Yastrab
💬  “It does go back to what you said in the beginning, which was respect, and I do believe that there is the right doula for the right clients.” – Melissa Harley

Resources Mentioned in the Episode:
📌 Orthodox Jewish Culture Resources – Encouraging understanding and solidarity
📌 Intergenerational Birth Experiences – Reflections on supporting family through labor

About the Host:
Melissa Harley, B.A., AdvCD/BDT(DONA), CLC, LCCE, FACCE is an experienced doula trainer, childbirth educator, lactation counselor, and maternal health advocate. A doula since 2003, she has trained over 1,000 doulas and mentored countless professionals across the perinatal field. Melissa served as the President of DONA International in 2020 and is the founder of ⁠Capital City Doula Services⁠ and host of the CCDS Doula Collaboration Podcast, which amplifies the voices and stories of doulas, educators, and birth professionals around the globe.

🎙 Host: Melissa Harley, B.A., AdvCD/BDT(DONA), CLC, LCCE, FACCE

📩 Want to be a guest or share your feedback? Reach out at https://capitalcitydoulaservices.com.

🎧 Subscribe to the CCDS Doula Collaboration Podcast wherever you listen, and don’t forget to leave a review to help others find the show!

Ep 3:My First Doula Baby is Having a Baby: Abigayle Braudaway on Becoming a Mother

Host: Melissa Harley, B.A., AdvCD/BDT(DONA), CLC, LCCE, FACCE
Guest: Abigayle Braudaway

In this heartwarming episode of the CCDS Doula Collaboration Podcast, host Melissa Harley welcomes a very special guest—her niece, Abigayle Braudaway—who also happens to be the first baby Melissa ever supported as a doula! Now, 23 years later, Abbey is expecting a baby of her own, bringing the journey full circle in a deeply meaningful way.
Melissa and Abbey discuss what it’s like to grow up surrounded by birth work, how Abbey’s perspective on pregnancy and birth has been shaped by her upbringing, and the emotions surrounding her transition into motherhood. Abbey also shares her thoughts on birth planning, fears about infertility, and the affirmations she’s using to embrace this journey with confidence.

Join us for a conversation filled with love, nostalgia, and the excitement of a new generation coming into the world.

In this episode:
✔ How growing up with doulas in the family shaped Abbey’s perspective on birth
✔ Abbey’s journey to conception and her thoughts on overcoming infertility fears
✔ Her vision for birth, including natural birth preferences and provider choices

Standout Quotes:
💬 “I was worried about infertility before we even started trying. I was already seeing doctors, doing tests, and preparing for the worst. And then, on my birthday of all days, I took a test, and it was positive. It felt like a sign from God.” – Abigayle Braudaway
💬 “Doulas are always teaching about birth confidence, and I just keep telling myself: My body was designed for this.” – Abigayle Braudaway
💬 “Pregnancy is 40-plus weeks for a reason—it’s not just about growing the baby, it’s about growing into the role of being a parent.” – Melissa Harley

Resources Discussed:
📌 Affirmations for Pregnancy & Birth – The power of positive thinking and self-affirmation in preparing for labor
📌 The Breast Crawl – How newborns instinctively find the breast when placed skin-to-skin after birth
📌 Finding a Birth Provider Who Supports Your Vision – Questions to ask OBs and midwives to ensure a good fit
📌 Home Birth & Midwifery Care – The importance of risk assessment and transfer plans for out-of-hospital birth

About the guest: Abigayle “Abbey” Braudaway is a dedicated medical assistant specializing in dermatology who currently resides in North Alabama with her husband, Uriah. The newlyweds are excitedly awaiting the arrival of their first child in September 2025.
Deeply family-oriented, Abbey treasures relationships with her loved ones above all else. She finds joy in creating meaningful memories and quality experiences with family members.
When not serving patients in dermatology, Abbey focuses on nurturing the connections that matter most to her and embracing each moment of her journey into parenthood. Abbey was also the FIRST doula baby for podcast host and doula, Melissa Harley, known as “Aunt Melissa” to Abbey.

🎙About the host: Melissa has been a dedicated birth professional for over two decades as a birth doula and childbirth educator. A DONA-approved trainer since 2010, she has trained over 1,200 doulas worldwide, blending evidence-based practices with insights from her extensive leadership experience. She served on the DONA Board of Directors for seven years, (DONA International President – 2020), contributing to strategic planning, education, and advocacy initiatives. Currently, she coordinates DONA’s conferences and webinars, fostering ongoing professional growth in the perinatal community. Based in Florida, Melissa remains an active doula trainer, childbirth educator, & lactation counselor. To connect with Melissa, visit ⁠www.capitalcitydoulaservices.com⁠

📩 Have a topic suggestion or want to be a guest? Contact Melissa at: ⁠⁠www.capitalcitydoulaservices.com

🎧 If you enjoyed this episode, please subscribe and leave a review!

Ep2: From Doula to Patient: Danielle Sollars on Holding Space for Self & Others Through Cancer

Episode Title: From Doula to Patient: Danielle Sollars on Holding Space for Self & Others Through Cancer Treatment

Host: Melissa Harley, BA, AdvCD/BDT(DONA), CLC, LCCE, FACCE
Guest: Danielle Sollars, RN, CD(DONA)

In this meaningful episode of the CCDS Doula Collaboration Podcast, host Melissa Harley sits down with Danielle Sollars, an experienced doula and labor nurse, to discuss an unexpected twist in her journey—being diagnosed with breast cancer while actively supporting birthing families. Danielle shares how she navigated the emotional and physical challenges of her diagnosis while continuing to provide doula care, how her experience changed her perspective on advocacy and self-care, and the ways her clients, backup doulas, and medical team rallied around her in support.

Melissa and Danielle discuss the parallels between birth and healing, the importance of surrender, resilience, and support systems, and how doulas can hold space for others while also receiving care themselves. Danielle also shares how this journey has influenced her work as a doula, her insights on boundary-setting, and her plans for growing her birth practice in a new city.

✔ How Danielle balanced her doula work while undergoing cancer treatment
✔ The unexpected ways her clients supported her during this time
✔ The parallels between birth work and facing a health crisis
✔ The importance of boundaries, self-care, and receiving support as a doula
✔ How Danielle’s experience has reshaped her birth work and advocacy

Quotes from the Episode:
💬 “It was almost like my clients were doulaing me right back. The love and support I received was incredible.” – Danielle Sollars
💬 “I kept relating everything back to birth—facing the unknown, surrendering, taking it one step at a time. It all felt so familiar in a different way.” – Danielle Sollars
💬 “Doulas are so often the ones holding space for others. But this was a powerful reminder that we also need to let people hold space for us.” – Melissa Harley
💬 “Sometimes we overthink this doula thing. At its core, it’s about meeting people where they are, with love and support—and that’s exactly what your clients did for you.” – Melissa Harley

About Danielle:
Danielle is not just a birth doula, childbirth educator, and birth photographer, but a unique blend of these roles with over 2 decades of experience in the birth field. She is certified through DONA (Doulas of North America) and has supported over 100 births since becoming a full-time doula in 2018. Her diverse background includes working in ob/gyn offices, a birthing center, and as a labor and delivery nurse in a hospital for 5+ years. What sets her apart is not just her extensive experience, but also the calming presence she brings to the birth space.
🌐 Website: ⁠Birth Chattanooga – Labor with Danielle⁠
📸 Instagram: ⁠@labor_with_danielle⁠
💙 Facebook: ⁠Labor with Danielle⁠
Resources Mentioned
📌 ⁠Coloring pages for labor⁠ as a mindfulness tool
📌 The ⁠role of patient advocates⁠ in medical settings

0:01 Introduction and Background of Danielle Dollars
03:23 The Role of a Doula vs. Labor Nurse
05:45 Navigating Personal Challenges: Breast Cancer Diagnosis
08:11Continuing Doula Work During Treatment
10:39 Support from Clients and Community
13:12 Sharing the Journey on Social Media
15:49 Coping with Side Effects and Personal Growth
16:39 Emotional Transformation Through Hair Loss
17:50 The Importance of Support Systems
18:48 Advocacy in Medical Care
19:37 Using Experience to Help Others
20:20 Self-Care and Coping Mechanisms
22:20 Resilience and Surrender in Treatment
23:47 Boundaries and Self-Preservation
26:07 Finding Joy in Work During Hard Times
27:23 Future Aspirations in Doula Work
29:35 Prioritizing Self-Care as a Doula

About Your Host:
Melissa has been a dedicated birth professional for over two decades, supporting more than 1,000+ families as a birth doula and childbirth educator. A DONA-approved trainer since 2010, she has trained over 1,200 doulas worldwide, blending evidence-based practices with insights from her extensive leadership experience. She served on the DONA International Board of Directors for seven years, including as President in 2020, contributing to strategic planning, education, and advocacy initiatives. Currently, she coordinates DONA’s conferences and webinars, fostering ongoing professional growth in the perinatal community.
Based in Florida, Melissa remains an active doula trainer, childbirth educator, and lactation counselor, committed to excellence and the advancement of birth work.

📩 Have a topic suggestion or want to be a guest? Contact Melissa at: ⁠CCDS Podcast Guest Inquiry Form⁠

🎧 If you enjoyed this episode, please subscribe and leave a review!

Episode 1: Doula, Advocate, Changemaker: Talethia Edwards on Birth Work & Community Leadership

Episode Title: Doula, Advocate, Changemaker: Talethia Edwards on Birth Work & Community Leadership

Host: Melissa Harley, BA, AdvCD/BDT(DONA), CLC, LCCE, FACCE
Guest: Talethia Edwards – Doula, Advocate, Community Leader, and Author

In this inspiring episode of the CCDS Doula Collaboration Podcast, host Melissa Harley sits down with Talethia Edwards, a powerhouse in the birth and community advocacy space. Talethia shares her journey from becoming a doula to advocating for marginalized communities and working in urban planning. She discusses the deep intersections between birth work and community development, emphasizing the importance of doulas engaging in local advocacy. Talethia also shares about her reflective journal, Only Paper Understands, and how it can be a resource for doulas as they process experiences working with clients.
✔️ Talethia’s path to becoming a doula and how personal experience led her to advocacy
✔️ The role of doulas in community development and how birth work connects to broader social issues
✔️ The impact of Healthy Start doula programs in providing equitable access to doulas
✔️ The importance of reflective writing for doulas in processing birth experiences
✔️ Strategies for balancing a demanding career, personal life, and self-care
🗣 “We really doula in community. That support—emotional, psychological, and physical—is about getting individuals and communities to the next place safely.” – Talethia Edwards
🗣 “We don’t have a right to be in the birth space, so it is an honor to be invited. But it’s also a huge responsibility.” – Melissa Harley
📚 Only Paper Understands – Talethia Edwards’ reflective journal for personal growth ⁠(Amazon Link)⁠

🌐 Website: ⁠https://talethiaedwards.com/⁠
📷 Instagram: @TOEdwards
💼 LinkedIn: Talethia Edwards

About Talethia:
Talethia O. Edwards is a doula, author, community activist, wife, and mother of eight. Talethia became very passionate about family engagement and parental involvement by being hands-on with her own children who have a myriad of complexities that caused her to have to advocate and “fight” on their behalf.
Talethia realized that her voice was not only needed for her own family and children but for others who have yet to feel so empowered.
Talethia continues her commitment and advocacy through volunteerism and service through board work with agencies like Kids, Inc. of the Big Bend, Early Head Start, CACA Head Start, The PHI Center, Tallahassee Lenders Consortium, and committees like the Early Childhood Obesity Prevention (ECOP) task force, the Leon County school district advisory committee, and Title I advisory committee and more.
As her commitment and service list goes on, she is firmly committed to forwarding the work of parental engagement, advocacy, and empowerment because she believes in strong families and strong communities.

About Your Host:
Melissa has been a dedicated birth professional for over two decades, supporting more than 1,000+ families as a birth doula and childbirth educator. A DONA-approved trainer since 2010, she has trained over 1,200 doulas worldwide, blending evidence-based practices with insights from her extensive leadership experience. She served on the DONA International Board of Directors for seven years, including as President in 2020, contributing to strategic planning, education, and advocacy initiatives. Currently, she coordinates DONA’s conferences and webinars, fostering ongoing professional growth in the perinatal community.
Based in Florida, Melissa remains an active doula trainer, childbirth educator, and lactation counselor, committed to excellence and the advancement of birth work.
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The Birth of CCDS Doula Collaboration Podcast: Building a Stronger Doula Community

In this trailer episode, Melissa Harley, doula trainer and founder of Capital City Doula Services and the CCDS Doula Collaboration, introduces her vision for creating a thriving, connected community of doulas. This podcast will focus on building strong relationships, fostering collaboration, and supporting doulas in their personal and professional growth. Melissa will explore how coming together as a community enhances the work doulas do, creating opportunities for learning, sharing, and mutual support. Tune in to discover how CCDS Doula Collaboration will unite doulas in a shared mission to uplift one another and strengthen the birth work community. We’re so glad you’re here!

Want to be a podcast guest? Fill our out interest form here: https://capitalcitydoulaservices.com/ccdspodguest/

About the host:
Melissa has been a dedicated birth professional for over two decades, supporting more than 1,000 families as a labor doula and childbirth educator. A DONA-approved trainer since 2010, she has trained over 1,200 doulas worldwide, blending evidence-based practices with insights from her extensive leadership experience. She served on the DONA International Board for seven years, including as President in 2020, contributing to strategic planning, education, and advocacy initiatives. Currently, she coordinates DONA’s conferences and webinars, fostering ongoing professional growth in the birth community. Based in Tallahassee, Melissa remains an active doula trainer, childbirth educator, and lactation counselor, committed to excellence and the advancement of birth work.

Doula to Doula – Encouragement for Certification

Editors note: I became a DONA International certified doula in 2003, and since that time, have seen lots and lots of fellow doulas complete certification.  What strikes me about certified doulas, is that they have a real, stick-to-it attitude as they work through the process. It takes grit and commitment to complete each step, and at the end, a doula who’s DONA Certified can proudly proclaim- I DID IT!  Today’s blog in the Doula to Doula Series,  newly DONA certified doula Samantha King shares some tips for doulas pursuing certification. #DONAProud  – Melissa

By: Samantha King, CD(DONA)

You just received the call – you’re officially a DONA certified doula!

Before I dive deeper into that moment, let’s hit the rewind button and bring us back to the very beginning. What brought me to want to pursue birth work? Why DONA International?

For starters, the birth of my second son lit a spark in me that has grown by the day. I was lovingly guided and supported by not only my midwife and assistants but my doula as well. Though much time wasn’t spent with these women due to a fast labor, the impact they left will forever be remembered. The energy was divine; the care, top-notch. I walked away from that experience wanting to provide others what was given to me during one of the most monumental moments of my life.

As for DONA International being my organization of choice, it was a no-brainer. They’re the world’s first, largest and leading doula certifying organization, founded in 1992. In addition, five leading maternal-child health experts stand behind the name. One of the most notable being Penny Simkin, a leader in childbirth education and labor support since 1968. Amazing, right?


The certification process was a lengthy one for me, but I’ve known others to fly by the requirements with ease. After attending a DONA approved workshop (Step one!), I was able to land a couple of births.

Not long after, I became pregnant with my third son and knew it would soon be best for my family and I for me to put birth work on the back burner. Despite not being able to commit to births, I tried to stay on top of the behind-the-scenes work. For me, this meant working on that certification to-do list while my baby napped or when my husband occupied the littles after work. When you’re passionate about something, you find the time. 

I recently received that glorious call that all doulas, birth and postpartum, anticipate.

 

Despite the amount of time it took to check everything off and the moments where I felt discouraged (Hey, starting a business isn’t always the easiest – but it’s worth it!), I DID IT and would do it a million times over. There’s just no stopping you when you’re called to do something.

 

Here are a few tips if you also happen to find yourself drawn into this wildly, beautiful world of doula work. 

1. Draw up a plan – What’s your birth philosophy? Target market? Have you considered a business name or possibly joining one already in existence? What does your certification timeline look like for you and who can you lean on for support (community is everything!)?

2. Get organized – Purchase a binder, folder, etc to keep your certification documents in one place. All the certification requirements are listed in the beginning of the certification packet, and even better, there’s a handy checklist that’s provided at the end. When submitting your certification packet, organization is key. This not only makes it easy to keep track of everything, but it also makes it easy on the person reviewing your packet. Most importantly, keep copies of everything, just in case.

3. Be patient – You may have births lined up, but that doesn’t necessarily mean that you can count on them being your certification births. DONA requires that in order for a birth to qualify, your support must be continuous and given before or at the onset of active labor. As you know, birth is unpredictable (I’ve attended many fast births!) and client’s needs vary. You may not receive the call to assist until your client is well beyond the active phase of labor, but don’t fret, your presence is still much needed and the experience gained is invaluable.

4. Have fun & be gentle with yourself – While in the certification process, you’re really finding who you are as a doula and how you’d like to shape your business. Just like birth, having a plan in place is of great importance, but you must be flexible. Push through obstacles when they arise and shower yourself with grace along the way.

Lastly, always remember that you possess the skills to care for, guide, and support the families you meet along the way. You need no lavish doula bag to do your job well – hands, heart, and knowledge.

Now friends, get out there & make DONA proud!

Samantha King, CD(DONA) is a certified birth doula and bengkung belly wrap artist. She’s a proud wife and mother to three boys and has resided in the Florida Panhandle for nearly 9 years.

She’s passionate about all things birth and empowering women, which has led her to create her business, Blooming Within Birth Services.

 

Editors note: Samantha is one of our doulas who was impacted by Hurricane Michael in the Florida panhandle.  She submitted this piece before the storm, and I have been in communication with her since. While she and her family are safe, the entire area is devastated. If you are interested in helping with relief efforts for Hurricane Michael, please contact me at mharley@capitalcitydoulaservices, and I can put you in touch with people who are heading local relief efforts. Our prayers are with Samantha, and everyone on the Florida gulf coast…especially our doulas. 

 

Doula to Doula- Quick Tips for Attending a Longer Birth

Editors note: The CCDS Doula Collective blog was named by doulas who have trained with Capital City Doula Services to reflect the goal of the blog – to inspire readers with content and to highlight the doulas from the CCDS community.  I believe deeply in our ability to learn from one another, and today, new doula  Sharea Jenkins shares some things she’s learned in her first year as a doula.  – Melissa

By: Sharea Jenkins, pursuing certification with DONA International

Okay! You’ve gotten the call and your client is in labor, ready for your support.

Do I have everything? As a doula, that runs through my mind a few times before even leaving the house.

Labor is slow, but gradually progressing. Time flies as we go from one position to another, the tub, the peanut, walking, side lying, and nipple stimulation.

Sharea practicing counter pressure during her doula training. Also pictured, fellow doula Cimona Seagraves.

Back compressions and belly rubs.

Dad coming in and out.

Midwife reassuring and checking in.

Contractions slow down, everyone dozes off to sleep. Now, it’s just my client and me, both extremely tired; we’ve been up all night…

To say that at times we attend long births, is a TOTAL understatement. These experiences sometimes lead me to doubt,  to wonder.

Am I doing enough?  

Is my role valuable to this family?

Births are hard work and some are very challenging for moms and the team supporting herIn a recent longer birth I attended, I constantly darted back to my memory of everything I learned in my training with Melissa. The birthing scenarios, the information, the hands-on demonstrations; that learning along with going with the flow, helped get me through. So what did I learn from this experience as a doula?  Here are a few things I’d like to share.

FIVE tips for the doula

  1. Never underestimate the power of a good hoodie or cardigan! Yes, even in warmer months, moms get hot fast which leaves everyone else cold.  Also, hospitals are set on freezing! Lol.
  2. Don’t skimp on the snacks and water. Yes, pack more than one snack and a quick meal. You’ll need the energy when you take a break for a bite. Energy bars, pre-packaged oatmeal, noodles, sandwiches, and fruit are some things that are easy to pack. Try staying away from food that has strong odors. Moms are extra sensitive to smells during labor. Also packing a mint or gum just in case can be helpful. Bring a water bottle if you can. Water is essential not only to your client but to you as well, stay hydrated.
  3. Be the master of patience with others. There may be family and friends who are totally over the birthing experience and may express their thoughts. Remember mom is the focus and try to tune them out or involve them. Extra massaging and fanning, fixing a cool face cloth or a cool drink for mom or even helping in positioning can keep others engaged if they are open to helping.
  4. It’s okay to lay down and to take a break. I have rested right beside my clients so when she needed back compression it is easy to be right there. If you can’t lay down try to get the partner or family involved if possible, so you can close your eyes for a minute and recollect.
  5. Never ever forget your hands have all the love, care, and support that a mom needs. They are your best tools. The touch of your hands tells her “I am with you, I believe in you, Trust your body and you are not alone!”

There is no question that a moms body goes through tremendous work with any labor and delivery.

As doulas, our bodies do as well, with all the adrenaline rushing we might not feel the soreness and aches until the next day.

Some doulas have very busy lives to get to right after a labor, but aftercare is important for the doula. Take the time to rest, take vitamins, stretch (get a massage if possible) and love yourself.

There are lessons to learn from every experience but don’t be down if labor has been extremely long.  Taking care of ourselves makes it much easier to be there for the family and to be more prepared for whatever may arise during labor. What we do is not easy at times, but so worth it.

Sharea is originally from Connecticut but has been a Tallahassee resident for over 18 years. 32 years old, she is the owner of Supporting Hands Doula Care and is working towards becoming DONA certified. Sharea has a 12-year-old daughter and 10-year-old son, together they cook, exercise and enjoy the outdoors. Along with being an active doula, she volunteers at women’s centers and shelters in the Tallahassee area.

Mamas Want To Feed Their Babies

Seven thousand and thirty.7030. Seven ZERO THREE ZERO. 

That’s an important number.  The number of days my oldest child lived under my roof until he moved to his first college apartment just a few short weeks ago. Full disclosure, we are lucky to live in a city that has three great colleges, so he didn’t have to go far, he’s a 27-minute drive from home, to be exact.

But as you can imagine, this move has forced us to reflect back on the early days, months, and years of parenting.

As we were planning and packing and moving, my husband and I started to talk about what kinds of things our dear son would need in his first apartment. The essentials, clothes, bedding, towels, rugs, shower curtains, dishes, kitchenware, you name it, we collected it.

And then there was food. 

At first, my husband was thinking that we would give our son his budget, and he’d buy his own groceries from the start…but…

Mamas like to feed their babies. 

An early feeding session with our oldest, the one who made me a mama.

I shared with my partner of 20 years, that I had the desire to help our kiddo stock up before the big move (and give him the grocery money too).  I spent the evening cooking freezer-friendly meals and making a list. By the next day, I had a dining room full of groceries before lunch hour (bought by none other than dad, himself).

You see, daddies want to feed their babies too. 

Lunch date with our college-age son about two weeks after the big move.

It may seem like the idea of feeding a college-age student is way off from the idea of feeding an infant child, but at the end of the day, we want our offspring taken care of, no matter if they are a few hours old or senior citizens.

Did you see this news story for this year old mama who wanted to take care of her baby? She moved into the same retirement home as her 80-year-old son, so she could look after him. How heartwarming.

For many, it starts with pregnancy and birth…and it never goes away. For a lot of parents, especially in the early days, “taking care” of an infant is internally measured against the ability to successfully feed the baby. Time and time again, I see parents with feelings of accomplishment when their babies are well fed, and feelings of defeat when faced with feeding challenges. Mamas and daddies want to feed their babies.

Okay, so, what’s the connection here to our work as birth professionals?

Today, with great excitement, I want to discuss the recent accreditation of Tallahassee Memorial Hospital as a Baby-Friendly Hospital. What is the Baby-Friendly Hospital Initiative (BFHI), and what does it mean, you ask?

It means a lot, a whole lot.

According to the Baby-Friendly website, “The BFHI assists hospitals in giving mothers the information, confidence, and skills necessary to successfully initiate and continue breastfeeding their babies or safely feed with formula, and gives special recognition to hospitals that have done so.”

As a labor doula, childbirth educator, and lactation counselor, I have been working with birthing families in this facility since 2003, and in that time I have seen a major shift in the way that providers care for new families.

From moving away from the newborn nursery (separating moms and babies for hours at a time), towards routine skin to skin after birth and “rooming in” to keep moms and babies together, (a Lamaze Healthy Birth Practice); we’ve seen a BIG change in policy and practice!

In becoming baby-friendly, facilities must educate, promote, and adhere to the Ten Steps of Successful Breastfeeding, AND agree to the International Code of Marketing Substitutes to Breast-Milk.

The Ten Steps are endorsed and promoted by maternal and child health authorities in the United States, including, the AAP, AAFP, ACNM, ACOG, The CDC, The Surgeon General and more.  Adherence to the code of marketing is a big commitment, as it has a significant financial impact for hospitals.

Becoming baby-friendly is a commitment of time, resources, continuing education, and it’s an investment of MONEY. This investment will lead to more support to new families as they transition to parenthood.

Baby-Friendly hospitals support practices that are more, well, friendly {read: healthier} for babies.

The benefits of breastfeeding are well studied and documented.  We know it’s healthy, safe, and has the potential to save lives. Take for instance the almost 20% lower rate of childhood leukemia for the baby who’s breastfed for six months, or the lower rate of sudden unexpected infant death (SUIDS, formerly SIDS) for the breastfed baby.

At the end of the day, the BFHI supports breastfeeding as well as a more family-centered approach to the transition to parenthood, which will absolutely lead toward better health for moms and babies.  While breastfeeding support is a cornerstone of the BFHI, many other baby-friendly practices come along with it.

More skin to skin time, delayed cord separation,  and delayed newborn bath are a few we see being implemented as standard care. It’s a mind-shift, from the days of checklists and getting things done quickly after a newborn arrives, to understanding the importance of The Magical Hour after birth, and honoring the transition a baby and family make from living in utero to in the world around us.

Baby-friendly accreditation is another step in the right direction and shows that our hospital has made great strides to shift with the times, and ultimately support better and better care for families. 

The accreditation is something to be proud of, as it shows families and the birth community that the hospital is committed to healthy, safe, practices for new families.

Successful feeding is not only essential for a healthy baby, but for many, it makes a difference in the emotional health of the family.

I am grateful for those who made this shift happen. It means that we as a birthing community have an eye on the future, and in collaboration, we can make big changes for the betterment of maternal and infant health.

To the TMH lactation department, the nursing staff, the midwives, the doctors,  and admins and others, thank you for your part in making birth better for families in Tallahassee.

Bravo.

Kudos.

you are making a difference for families in our community.

Well Done, My Friends.

Thank you.

And to my own college-age child now living on your own, wanna come over for dinner?  

Always growing, ever learning, much loving,

Melissa Harley, AdvCD/BDT(DONA), CLC, LCCE, FACCE is an advanced certified birth doula, approved birth doula trainer, lactation counselor, and certified childbirth educator.  She is the owner of Capital City Doula Services (CCDS) and this blog.   While working as a doula led her to the childbirth profession, mentoring families and professionals is one of her greatest joys.  To contact Melissa, please visit our contact us page.

 

Lessons learned from April The Giraffe

April the Giraffe- Hooves

We have hooves! A quick shot of my tv as we were live-streaming the magnificent birth!

This past weekend, thousands and thousands of people watched April The Giraffe give birth at the Animal Adventure Park in New York.  After months of watching and waiting, many of us woke up on a beautiful Saturday morning with the news that active labor was confirmed and that hooves were visible.   In our household, of course, we had to live stream it up on the big screen; first when the live cam went up in Feb, and then as soon as we knew it was the big day- for real this time.

April Collage

 

Why were people so enamored with this majestic creature and her ability to birth her baby into this world you ask?  Maybe it was the uniqueness of the event or the ability to watch it live that drew us all in, similar to how many people watched a bald eagle nest earlier this year for the signs of a new baby bird emerging from its egg.  Or maybe it’s just the miracle of birth and the ability to watch it unfold in a way that we as a society don’t get to see very often.

But, what I want for people to take in was the very beautiful, very important lessons April The Giraffe demonstrated about birth.

As a Lamaze Certified Childbirth Educator, I am versed in what we call the 6 Healthy Birth Practices.   Basically, Lamaze has collected the research-based data and put out 6 recommendations for families to plan for when giving birth to promote the healthiest, most evidence-based birth possible.   These birth practices include:

  • Let Labor Begin On Its Own
  • Walk, move around and change positions throughout labor
  • Bring a loved one, friend or doula for continuous support
  • Avoid Interventions That Are Not Medically Necessary
  • Avoid giving birth on your back and follow your body’s urges to push
  • Keep mother and baby together – It’s best for mother, baby, and breastfeeding

As I watched April birth the lanky giraffe into her stall, I was struck by how many of the 6 birth practices are just mammalian nature.  The parallels with animal birth and human birth are a plenty, let’s take a deeper look.

Let Labor Begin On Its Own (HBP 1)

So, for many folks, waiting for April to birth was hard…and LLLLOOOOONNNNNGGGGG.  If you were anything like me, you watched a lot on day 1 and thought, “Oh, this is it.”  And then day two came and you thought “Oh thank goodness we got through the night and I didn’t miss it.”  And then day 3 came and you thought “TODAY! Is the day.”  And then, it was weeks which turned into months of waiting.  Your patience was tested to the max, and some days you may have given up hope and wondering if something was wrong or if the veterinarians should intervene in some way. But they didn’t.  They waited patiently for labor to begin on its own, and they encouraged us to do the same.

The end of pregnancy is hard for many women.  Sometimes it feels like you’ll be pregnant forever and ever and ever.  But, there are so many great physical and hormonal reasons(barring no medical complications) to wait for your sweet baby to say- “Hey mom, it’s time, let’s go!” The wait is worth it.  Check out this article from the March of Dimes about induction of labor and their campaign to wait until at least 39 weeks gestation.

Walk, move around and change positions throughout labor (HBP 2)

Did you notice how April The Giraffe walked and moved in the days preceding her labor and birth? I even noticed some swaying back and forth.  At one point my youngest child (teen #2) walked into the room and exclaimed, “I know what she needs to do, she needs to SQUAT.”  It was utterly amazing to watch this creature do exactly what she needed to do throughout the process to meet her very instinctual needs.  From walking to swaying to resting and sleeping, she was a fine example of patiently waiting and working with her body.

If you’ve been a part of my childbirth classes or Husband Rubs Back of Wife During Home Birthdoula trainings, you know that the cornerstone to much of what we teach about labor progression and comfort is movement and position changes for labor.  I like to say, the more you move, the less you hurt, the quicker the baby comes out. The process of labor is so smart that the body intuitively signals the mother to move in ways that are beneficial to both labor progress and for pain management. It’s such an amazement to me that some moms often begin swaying side to side instinctually in pregnancy, and then in labor, and then continue to sway to soothe a newborn.

Have you ever seen a woman in the checkout line at the grocery store swaying at the sound of a baby crying nearby?  Yup, it’s instinctual.

And the design of that instinct is paramount to helping the baby move deeper into the pelvis while also providing comfort for the mother.  Rhythmic movement is a coping strategy, and movement lessens pain!

Bring a loved one, friend or doula for continuous support (HBP 3)

Okay, so this one is near and dear to my heart (for obvious reasons).  How special sweet was it for us to watch April The Giraffe supported through the process by her companion, Oliver.  Did you notice her mate paying much attention to what was happening with her throughout the experience?  He was kept close by because giraffes are herd animals and the park experts knew that she needed support through the process. Because Oliver is a bit of a rambunctious boy, he couldn’t be IN with April most of the time, but he watched in the next stall and at times they would nuzzle or eat from the shared feeder. During the birth- he sure was pacing, just like a lot of dads out there.

In addition to her fellow giraffe, April had the park attendants on watch 24/7 for over two months, as well as regular check-ups from the park veterinarian. Her lead keeper, Alyssa would show her some love and support and you could tell that the two had a bond.  April was loved and supported throughout the process. In some ways, Alyssa, and all of the park attendants were her doulas.

Support in labor is important.  Really important.

Research shows that when women are attended by a professional labor support person such as a doula they experience:

  • 31% decrease in the use of Pitocin
  • 28% decrease in the risk of C-section
  • 12% increase in the likelihood of a spontaneous vaginal birth
  • 9% decrease in the use of any medications for pain relief
  • 14% decrease in the risk of newborns being admitted to a special care nursery
  • 34% decrease in the risk of being dissatisfied with the birth experience

The 2012 Cochrane review by Hodnett et al. concluded that continuous support during labour has clinically meaningful benefits for women and infants and no known harm. All women should have support throughout labour and birth.” 

In 2014 and 2017, ACOG (The American College of Obstetricians and Gynecologist) endorsed doula support stating evidence suggests that, in addition to regular nursing care, continuous one-to-one emotional support is associated with improved outcomes for women in labor.”

The bottom line- emotional support in labor matters, and is significantly meaningful to maternal physical, Emotional, and mental health.

Melissa and Sister

Melissa with her own sister, after the birth of her third child.

The founders of DONA International knew this all the way back in 1992 when they founded DONA International (then Doulas Of North America), the education and certification organization for training up the next generation of doulas. The basic tenants of the importance of labor support are now finally starting to get the recognition that they deserve!

Avoid Interventions That Are Not Medically Necessary (HBP 4)

I got a really big chuckle reading many comments across the web about the speed of April’s “labor.”  It seems that we’ve become a society of intervening in the natural process, sometimes just because it’s hard to wait.  The very smart professionals at the Animal Adventure Park were quick to keep us grounded in the natural process that was unfolding.  As a matter of fact, they said that they couldn’t actually confirm labor until they saw the hooves!  They held fast and waited, knowing that when the time was right, we’d know. And, boy did we know.  It was such a joy to watch the facebook live video from park owner Jordon Patch as he was racing to the barn as it was baby day!  Wasn’t he just like any excited dad!!  If you haven’t seen it yet- take a quick look.

Okay, so are all interventions bad?  In a word NO!  Interventions in labor can be life-saving for both mom and baby. 

Let’s say that out loud again.  Interventions in birth can be life-saving.

ACOG- Limit InterventionsWith that said, we know that in the United States, we have a tendency to overuse…well just about everything.  Recently, ACOG published an opinion piece with new recommendations for OB/GYNS and the public titled Approaches to Limit Intervention During Labor and Birth.  The piece listed many ways for practitioners to promote healthy birth and reduce interventions in healthy pregnancies including awaiting hospital admission, reducing amniotomy(artificially breaking the water), providing continuous one to one labor support, encouraging non-pharmacological pain management support and so much more. The recommendation piece which was endorsed by ACNM and AWHONN was a huge step forward in promoting healthy, safe, birth for low-risk childbirth.

Additionally, this Huffington Post piece from March 2017, highlighted the difference an hour can make in our overall cesarean rate- and it’s substantial.  Basically- more time, more patience, and only medical management when medically necessary is healthier for moms and babies.

Isn’t it great to see the data and evidence support what many people feel instinctually! Birth and the bodies ability to give birth is simply amazing.

Avoid giving birth on your back and follow your body’s urges to push (HBP 5)

Look how far that baby giraffe dropped to the ground!  WOW!

Look how far that baby giraffe dropped to the ground! WOW!

Wasn’t it completely fascinating how April the Giraffe gave birth while standing up…tall?  It’s estimated that the newborn giraffe falls six feet to the ground because of how tall the mother stands off the ground.  In perfect design, the fall enables the cord to sever and gives the new baby a little jolt to inspire breathing. For the sake of survival, in the wild, the newborn giraffe must be up and on its feet very quickly, so the fall to earth helps encourage the process along.

Using upright positions and following one’s body for pushing is one of the most passive things a laboring mother can do.  We have a celestial gift in the form of the gravitational pull that makes it all the more important for mothers to use upright positioning during birth.  Just like April The Giraffe, the human body knows exactly what to do and when to do it when it comes time for pushing, sometimes there’s just no stopping it.  The body will take over, and the uterus will do its job!  Using upright positions and working WITH the urges you feel will make the process more expedient, and less complicated. And, the squat gives you a significant amount of extra room for baby to pass through, so get upright and follow the bodies urges when the time comes!

Keep mother and baby together – It’s best for mother, baby and breastfeeding (HBP 6)

One thing I absolutely love about watching animals give birth is that almost always, mama mammals and baby mammals are NOT separated.  It just makes sense to keep moms and newborns of any kind together!  In keeping with this form, the Animal Adventure Park stated many times before the birth that the mother and baby would be together until the time of weaning.  This allows the young one to get nutrition and guidance from their mother.happy mother breast feeding her baby infant

Several years ago, when birth moved from home to hospital, we introduced the idea of the newborn nursery after birth.  The role of the nursery was to look after the newborn and to allow the mother to rest, and while well intentioned, research shows that keeping newborns with their mothers has many health benefits. I, myself remember that just 17 years ago after I held my little blanket wrapped burrito, he was taken to the newborn nursery for his bath and other newborn procedures and didn’t return back to me until FIVE HOURS LATER.

Skin to skin contact after birth has been proven over and over again to be optimal for healthy babies.  Additionally, Kangaroo Care has also been proven to benefit sick babies in the NICU.  There are many documented health benefits of keeping mom and baby close, and I’m thankful to say that many hospitals have changed their ways.  My local hospital Tallahassee Memorial Healthcare has begun to pursue Baby-Friendly Status, and the quest for this designation has affected many newborn routines(*hand clap* for TMH).  For instance, rather than giving newborns an immediate bath after birth, our hospital initiated a “Wait the first eight” policy, and after several successful months, that transformed into- wait until the next day!  Something so small makes such a big difference for the health of the baby as well as the transition for both mother and baby!

All in all, watching birth is magnificent. And watching April The Giraffe birth was inspiring and majestic.

While I watched her intuitively follow her instincts and birth her new calf into the world, I was reminded of the normal, natural process that birth can be, and struck how the six healthy birth practices support a birth similar to Aprils.  Prepared and supported but also with clinical care available as needed.  A hands-off approach until something showed that it needed to be different- which thankfully, it never did.

In birth, we sometimes say that the pendulum swings, and it seems that we as a society are swinging to more intuitive, hands off approach right now.  I’m seeing practitioners take a slower stance, and offering more and more communication with patients about their care.  It is encouraging.  Medical management of complications of pregnancy can be life-saving and can be beneficial to mothers and babies, and it seems that we may be re-learning how to use the tools and the expertise we have at our fingertips, only when necessary.

Change takes time; and while organizations such as Lamaze International, DONA International, ACNM, AWHONN, and ACOG often advocate for change based on best evidence, data shows that it takes a bit longer for those changes to reach regular practice.

Communication between patients, families, and health Care providers, is key to working together for the most healthy, safe, births possible.  

 

Always growing, ever learning, much loving,

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Melissa Harley, AdvCD/BDT(DONA), LCCE is an advanced certified birth doula, approved birth doula trainer, and certified childbirth educator.  She is the owner of Capital City Doula Services (CCDS) and this blog.   While working as a doula led her to the childbirth profession, mentoring families and professionals is one of her greatest joys.  To contact Melissa, please visit our contact us page.