Do Something

I began my doula work before I knew the word “doula.” As a childbirth educator in 1986, I attended my first birth with a couple from one of my childbirth classes and immediately knew that this was what I wanted to do with my life. As the mother, I felt that it would be an honor to nurture women and their partners at such a critical time. In 1987 I  read an article in Mothering magazine about Doula, Inc., of Rhode Island. As I read the description of a doula, I said to myself, “I am a doula.” It was a magical moment. I called the organization and spoke with Cindy who knew of a woman named Jane Arnold in Westchester County, New York (across the Hudson River from my New Jersey home) who was running a doula service called Mom Service, Inc. I soon had Jane’s brochure in-hand and called her. I was pleased to learn more about doulas, what they do, and how to run a doula service. Jane was hosting a picnic that weekend for her doulas and invited me and my children to attend. I will never forget driving across the Tappan Zee Bridge that warm sunny day and arriving to meet Jane and her children and her doulas, as we laid our blankets out and had a picnic in her yard. He warmth and passion embraced me. She shared her dream to become a nurse, then a midwife and to bring doulas and midwives together, with a passion to serve underserved women.  I remember thinking how will she do this and Do this and more she has!

Jane became my mentor. As the mother of four, running her own company, she helped me to begin MotherLove, Inc., and to learn and grow as a doula. In those early days, no one knew what a doula was, friends called us “granola and oatmeal women.” Hospitals and medical providers wouldn’t even return phone calls. On many days when I was ready to give up, Jane helped me regain the vision of a doula for every woman who wants one. She kept me focused on the work we had done and what lay ahead, reminding me that change is a long, slow process, but well worth the effort. Jane began nursing school soon after we met. I greatly admired her determination to achieve her goals. Her example kept me focused on mine: to bring doula care into mainstream medical care.

I grew interested in the role and history of doula care and maternity care around the world. I reached to anyone who knew how different cultures or countries cared for women around the time of birth. I talked with anyone who would listen about doulas and the importance of caring for women and children.

Jane completed nursing school and began practicing as a registered nurse at North Central Bronx Hospital in New York City. Although we had less time to speak on the telephone, she kept encouraging me to carry the doula torch. Jane went on to midwifery school through the Frontier School of Midwifery in Kentucky, and was soon a certified nurse-midwife (CNM) working at the Morris Heights birthing Center in the South Bronx.

One day in 1994, Jane called to say she had been awarded a grant from the Robin Hood Foundation the Aaron Diamond Foundation to begin a doula training program, to be called the Morris Heights doula Program, in the Bronx. To my delight, Jane invited me to participate.  She was bringing midwives and doula together for the very first community doula program. I will never forget the first day I drove to the Bronx, a community not far from my own geographically, yet so very different from my suburb. I felt excited, nervous about not knowing what to expect, and keen interest in how this ethnically diverse community would react.

The training was exhilarating. To hear women from many cultural backgrounds share their stories to share their visions and hopes for nurturing support for pregnant and birthing women justified the days I had spent learning and planning. I knew then that Jane and I were right: Women everywhere would embrace this concept. We would work hard to return caring, education, and nurturing to communities everywhere. The Morris Heights Doula Program reignited my passion and determination to bring doula care to all women who wanted it.

In 1992 I attended the first meeting of Doulas of North America (DONA) in Boston and found myself a member of its first board as chair of public relations. I was to work with Penny Simkin, Dr. Marshall Klaus, Dr. John Kennell, Phyllis Klaus, Annie Kennedy and many other wonderful people. My horizons continued to broaden and my views expanded.

In 1994 I was invited to speak at the White House to the Task Force on Health Care Reform about doula care. A few years before, I had been unable to get a local obstetrician to speak with me. Now Hillary Clinton wanted to know more about doulas and the role we could play in rebuilding our families and communities.

In 1995, as a board member of the Northern New Jersey Maternal Child Health Consortium, I had an opportunity to participate in the development of a grant proposal to provide doula care to women in treatment from substance abuse and alcohol addiction in Paterson, New Jersey. The Neighborhood Doula Project was founded with a grant from the Robert Wood Johnson Foundation of Princeton, New Jersey, and later Healthy Mothers, Healthy Babies of Paterson. Again Jane provided guidance and wisdom as we brought doula care to a community burdened with difficult issues. Unemployment is rampant. More than 30% of homes with children have only one parent. High rates of violence and child abuse and widespread distrustfulness cry out for emotional and spiritual nurturing. I trusted my heart that doula skills were needed here. One cold winter morning in Paterson after a month of training- five talented black women spoke passionately of the need to reduce the high rate of black infant mortality in their communities. They vowed to help raise the low rates of breastfeeding, to lower the incidence of postpartum depression, and to reduce ever-increasing rates of child abuse and neglect. They proclaimed their determination to assist teenage mothers, to help women stay off drugs while pregnant, and to prevent child abuse.  Hearing my words echoed in theirs, I felt fiercely proud of them.  If training and education no longer come automatically from one’s actual mother, sisters and friends, they can come from surrogate mothers… from doulas.

Directing the Neighborhood Doula Project enriched my life in ways I had never anticipated. I learned so much from the doulas and the women we served. Running this program reinforced my belief that caring for pregnant, birthing, and parenting women and their families is necessary if we are to provide the next generation with the love and family values we hear thrown around in political speeches.

In 1996, with a grant from the New York State Department of Health, Jane was hired by the Department of Obstetrics, Gynecology, and Reproductive Medicine at the State University of New York at Stony Brook to begin a midwifery practice there. As Director of Midwifery, and with the help of other key nursing personnel within Women and Children’s Hospital at Stony Brook, she prepared to bring doulas to the surrounding community. In 1998, Jane and I began to train doulas at Stony Brook.

Jane and I and the Midwifery Practice and School of Nursing at Stony Brook are honored that our work to return education, caring, nurturing, and high-quality medical care through midwives and doulas into communities was featured in “Indivisible,” a national documentary funded by the Pew Charitable Trusts. (www.indivisible.org)

Our journey has continued to include bringing Midwives and Doulas together in North Carolina and Botswana- Africa. We don’t know the next place we will be together,  yet,  Jane will always be in my heart as I pass along the warmth and wisdom she greeted me with years ago. I now train, speak, consult, and design doula programs for hospitals, medical providers, and doulas globally.

Doula programs are regularly being started in new communities around the world.  Jane and I continue working together to bring midwives, doulas and doula training to all women and all communities.

Wherever the doula heart and spirit live, the interrupted tradition of woman-to-woman, mother to mother care resumes and prevails.

I thank all the doulas and midwives who have joined us on this journey. They bring their dedication and love to grateful families every day.

Thank you Jane for starting me on a journey that continues to evolve. Looking back to that day on your lawn, I could not have imagined the many places around the world we have reconnected the circle of support of midwives and doulas. Thank you for sharing your vision and making it happen.

With love and gratitude,

Debra Pascali-Bonaro

 

Debra and Jane collaborated on Nurturing Beginnings, found on the DONA Post Partum Reading List- an updated, digital version of Nurturing Beginnings will be available later this year. If you’d like to receive announcements about this updated, electronic version of Nurturing Beginnings please sign up here.

I love when three powerful things happen all at once, showing a sign that we are shifting.  My mother always shared with me “the one constant in life is change.” Yet, sometimes it is hard for us to see or feel the change.  The landscape of maternity care in my state of NJ and in the U.S in general has been far from what I hoped for.  A day that can transform women, as Deepak Chopra said:

“Labor is an opportunity for women to learn about themselves and discover the strength and wisdom inherent in their bodies.”

Yet sadly a day that can be ecstatic, powerful, blissful or orgasmic is  turning traumatic for far too many women.

As I drove into NYC to attend the UN meeting on Respectful Care I listened in to the press conference for the release of the Listening to Mother’s III Survey.

It was sad to hear the data, but not surprising.  The last few years I have seen both women and providers so filled with fear of childbirth that they are using technology as false safety nets, not wanting to acknowledge all the risks we are putting our Mothers and Babies thru and the poor outcomes we have for a country that spends more on maternity care than any other country in the world.  “The United States spends $98 billion annually on hospitalization for pregnancy and childbirth, but the US maternal mortality rate has doubled in the past 25 years. The U.S. ranks 50th in the world for maternal mortality, meaning 49 countries were better at keeping new mothers alive.”  http://www.huffingtonpost.com/2012/08/24/maternal-mortality-rate-infographic_n_1827427.html

For all our interest in eating healthy and organic, many women turn their bodies and their babies over to medicine and allow many drugs and procedures to be given to them, some that we know are harmful or ineffective and many that we don’t know the short or long term consequence for MotherBaby  What happens when we disturb a healthy process and replace our natural hormones with drugs and surgery at alarming rates? We are only beginning to ask these questions.

Here is what I heard on the press conference of what women shared about their birth experiences that rang in my ears as I walked into the Respectful Care meeting:

• Few women used simple, low-risk, drug-free measures to ease labor pain, like taking hot showers or baths. Women who had taken childbirth education classes were more likely to try such measures.
• Many women report experiencing pressure from a care provider to have a cesarean, labor induction, or an epidural.
• Many women reported that they held back from asking questions because they were concerned about being perceived as difficult, they wanted maternity care that differed from what their health care provider wanted, or their provider seemed rushed.
• Most women who had an episiotomy, an incision in the skin around the vagina made during delivery, were not included in the decision to undergo the procedure.

There were some good findings: Women’s readiness for pregnancy appears to be improving. Hospital support for exclusive breastfeeding is improving, although women’s intentions to and experiences with exclusive breastfeeding appear to be declining.

The room was full, I quickly found a seat up front and just settled in as the presenters began to speak about Disrespect and Abuse, D & A and defined Respectful Care through the White Ribbon Alliances Universal Rights of the Childbearing Woman http://www.whiteribbonalliance.org/WRA/assets/File/Final_RMC_Charter.pdf

I wanted to call out and say we need to frame the LTM III survey results within this same human rights framework.  How have we silenced American women so that we accept institutional abuse and disrespect?  Thinking back to the survey, we cut women’s vaginas without their permission and this is acceptable?  If a woman were cut on the street she would know it’s abuse, but in a hospital it’s allowed?

It’s your body and your baby, you should be able to ask questions, to be respected, treated with dignity and fully involved in collaborative decision-making.  In addition, the proportion of women with a prior cesarean who reported a lack of access to VBAC grew to 56% in the current survey from 42% a decade earlier.  This is putting women at three times greater risk of dying in childbirth with major abdominal surgery. Yet, many women report experiencing pressure from a care provider to have a cesarean, labor induction, or an epidural.  Many women reported that they held back from asking questions because they were concerned about being perceived as difficult.  Would you buy a computer, cell phone, car from someone who is pressuring you and that you don’t feel comfortable asking question?

Yet, we trust our health and well-being to a maternity care system that is clearly broken giving us care that is not supported by the best research and women are made to feel as they are the ones that can’t speak up?

It’s time we speak out about abuse, speak out to have access to more effective, low cost comfort measures that are not available to many women such as tubs, balls, doulas that we know make a difference!

This is a human rights issue!

I am getting ready to fly to Malaysia to speak on the Respectful Care Panel at www.womendeliver.org with over 5000 global leaders and change makers coming together.

“Women Deliver 2013 will serve as a global platform for ensuring that the health and rights of girls and women remain top priorities now, and for decades to come.”

I will be sharing about the International MotherBaby Childbirth Initiative www.imbci.org that offers quality evidenced based care, within a human rights framework and a caring heart.  Honoring each woman’s right to choose where, how and with whom to safely give birth.

Please join me in one of these ways:

• Liking this post and sharing it with your friends.
• Share your birth story with us
• Were you offered access to the Lamaze Healthy Birth Practices that provide the safest birth we know based on the research? Share what you wished you had know or received.
• Visit http://www.whiteribbonalliance.org/index.cfm/the-issues/respectful-maternity-care/ and share their video Break the Silence.
• Support the US  Mother-Friendly Childbirth Initiative www.motherfriendly.org and the global version the International MotherBaby Childbirth Initiative www.imbci.org.
• Globally next week is World Respected Childbirth Week, http://www.smar.info in many countries there are events, education, films, discussion and a look at birth as a human rights issue. If there is an event in your community join it, if not, consider creating one.

We have the information and the knowledge to make a change, now we need you to Stand up and Deliver, Don’t take it lying down!

To explore more natural comfort measures for an Eco-Friendly childbirth look for my upcoming Talks & Webinars and find more tips in my Weekly Enews.

“The equality and empowerment of women and girls is truly the moral, economic and humanitarian issue of our time.”  – Marie Forleo

Marie’s quote was going thru my mind as I was pushing thru the pain in my morning yoga class at Eat Pray Doula in Nyuh Kuning, Bali. Gabby, our beautiful teacher, kept saying move thru the pain, go deeper, move, move move, breathe breathe breathe. Her words not only ring true to the physical stretching we were doing, but also emotionally and spiritually. As a woman, we all have our own pain, past grief, loss, and in many cases, trauma. We must first heal ourselves, and in doing that, we give ourself the gift of love and empowerment. As we push thru and past our pain we become healers, ready and able to serve other with our example, to share our love and compassion.

On International Women’s Day, my honoring and celebration starts personally within, and expands to how each one of us can help bring respect, dignity, and honor to every girl and woman.

You can make a difference. How often do you read something and think it is too much to take on. You don’t have the time or money? Someone else will do it?

International Women’s Day is a day that I urge you to take a stand! You can make a difference in many simple ways to help empower women and girls. You may already be doing this in your own family or community. If not, now is the time to begin. To begin with yourself. What do you need to do to feel your power- to “Awaken Your Inner Wisdom?”

The Face of Birth Documentary The women of our Eat Pray Doula Workshop will be part of the global screening of “The Face Of Birth”– see our recent blog post “The Issue of Homebirth in Australia” to learn more about this film about Birth as a Human Rights Issue and find your local screening. http://www.faceofbirth.com/

 

No Woman No Cry Another important film that will be screening on facebook today at 11am eastern time is from Every Mother Counts is “No Woman No Cry” This is a powerful documentary from Christy Turlington-Burns of the tragedy of maternal mortality around the world.

Half the Sky Have you read or seen the documentary Half the Sky: Turning Oppression into Opportunity for Women Worldwide ? This powerful book and film is on my must read for everyone! It looks at the tragedies of women enslaved in sex trade, dying from preventable causes in childbirth and more. While hard to read at times, I encourage you to open you eyes and heart to what is happening globally to women and girls. The co-writers and husband and wife team, Nicholas D. Kristof and Sheryl WuDunn, show us how in each case just one person made a difference and transformed a girls or woman’s life. You will cry, smile and move to action!

Video “Most AMAZING INSPIRATIONAL Transformation” by Sun Gazing While this video clip is not about women, it does show how our determination to push past our pain, past our beliefs can create miracles in our own life and touch other’s lives by our examples. Grab a tissue and watch.

IMBCI There are many organization that are dear to my heart that are working to improve the lives of MotherBaby in childbirth. Two I would like to share with you and encourage you to visit and support today are The International MotherBaby Childbirth Organization– a human rights framework around quality care with a heart for all pregnant and birthing women around the world. As Chairperson of IMBCI I know first hand the difference your donations will make!

Bumi Sehat Bali I am writing this from Bali where I am working with Katherine Bramhall and Ibu Robin Lim a CNN Hero as they raises awareness and money for Gentle Birth at Bumi Sehat Bali. Please give $1.00, just one dollar, or more… you will make a difference in the lives of women today. Bumi Sehat is the Global Birth Fair Spring Featured Organization. This month purchase a pair of adorable Bumi Baby Booties & all proceeds go to Bumi.

I am thinking of you today, celebrating every girl and women of the world. Join me in standing for every woman right to respect and dignity in life and in birth!

As www.womendeliver.org say – “Invest in Women- it pays!”.

Love and blessing,

Debra