Volume 1, Issue 5
I hope everyone is enjoying the beginning of fall. This is my favorite season, apple picking, warm apple cider donuts, the leaves changing and warm days and cool nights.
This month we have added a little over 120 doulas to the ProDoula family. Welcome home!
The Share The Vision 2016 conference is right around the corner and we are in the final stages of getting everything perfect for you to have an awesome conference. I cannot wait to see you and share with you all the exciting things we have planned. By now you should have received your conference information packet, and we hope you had as much fun opening them as we did making them!
Remember to send me your web page questionnaires so we can add you to the ProDoula Website – this is one of the many perks of being a ProDoula member. Also, if you have moved and have a new address, please don’t forget to let us know.
Remember we are always here for you at the Home Office and would love if you’d give us a call if you have any questions, concerns, need help or would just like to say hi.
Flight 1549 might not ring a bell to you, but for Captain Chelsey Sullenberger and the 155 passengers that survived the crashing of Flight 1549 into the Hudson in 2009, it was quite memorable.
Before 2009 Twitter wasn’t one of the go-to sources for breaking news and streaming information like it is today. After the Flight 1549 tweets, Twitter evolved in a major way.
Check out Sully and the Twittersphere to read more about how this event plays a role in social media history.
Relaxation is essential to physiologic birth. Designed with the laboring woman in mind this two-CD set is set to a tempo of 80 beats per minute to mimic a resting heart rate. Clients and doula alike rave about the calming effect this set has on laboring individuals and toddlers alike!
Consider this set a practical and business essential!
Head on over to our shop to purchase your copy today!View this Product
By: Angela Horn – Owner of Tucson Doulas
It’s no great mystery that there is a lot of fear surrounding the use of Cytotec/misoprostol in the birth community. However, I’m often puzzled by assertions and claims made by doulas or birth advocates when it comes to the use of this drug in obstetrics.
There is a lot of outdated information and complete lack of basic understanding as to not only the use of this drug but the use of drugs as off-label.
Most of the bad outcomes with Cytotec/misoprostol in years past were a result of the lack of evidence-based information that existed at that time to establish dosage and safety guidelines. There were also bad outcomes that were a result of using Cytotec/misoprostol in women with previous cesarean surgeries, which we later learned increased the risk of uterine rupture.
There is also a terrible lack of understanding of the off-label use of drugs for other conditions/situations outside of their approved use among many doulas and birth advocates.
Off-label use happens frequently in medicine. Babies with certain heart conditions are given Viagra to support their cardiac systems. Magnesium Sulfate, when used to try and halt premature labor and/or treat preeclampsia is also and example of off-label use.
Off-label use in and of itself is NOT bad. But all too often I see “Cytotec is not approved for labor induction, it’s being used OFF-LABEL” as some kind of justification as to why it shouldn’t be used. If that’s the case, then magnesium sulfate is off the table now too.
Then there’s the pesky issue of those that fail to understand the black box warning about the use of Cytotec during pregnancy. Again we see a terrible lack of understanding in what this warning means.
The current warning against use in pregnancy is stated as such:
WARNINGS. Cytotec should not be taken by pregnant women to reduce the risk of
ulcers induced by non-steroidal anti-inflammatory drugs (NSAIDs).
Spoken plainly, don’t take this drug to treat ulcers resulting from the use of anti-inflammatory drugs during pregnancy. If you do, it can cause you to have a miscarriage or go into labor before term. Which is why this drug has been used for years to treat incomplete miscarriage, to prepare the cervix before surgery that requires instruments to be inserted into the uterus via the cervix, and yes, induce abortion.
The licensing of a drug is not proof of its effectiveness for the purpose for which it’s being used. There are countless drugs who have proven efficacy for a certain use that are in fact, not licensed for that use. As previously mentioned, Viagra and magnesium sulfate, to name two.
There are now over 76 trials on the use and safety of misoprostol in obstetrics. These trials have established that oral misoprostol has comparable efficacy to oxytocin and results in lower cesarean rates. The use of misoprostol for cervical ripening also results in lower cesarean rates as compared to Cervidil.
The results of these combined trials support that low doses of misoprostol for induction of labor are safe, with oral misoprostol being the preferred method of administration*
As doulas and birth workers we need to be aware of our personal bias and it is essential that as birth professionals we have a clear and accurate understanding of how medications are used off-label.
Any drug can be abused misused. In my approach to discussing induction methods with clients, I suggest they do their own research. What is the reason for the induction? Is there a medical indication? What is the Bishop’s Score? What is the client’s personal risk threshold when it comes to the use of any induction medication and cesarean?
I use the answers to these questions to help the client formulate their own set of questions to take back to her care provider. Together they make the decision that is best for the client.
I have no desire to sway my client’s choices in any particular direction. This is not my decision to make and I am not the one who will have to live with the outcome. My personal opinion has no place in the discussion. I am there to provide information and unbiased, non-judgmental support.
At the end of the day. we as birth professionals need to be able to sit down and intelligently discuss the issues surrounding Cytotec. We benefit no one, least of all our clients when we run around like our hair is on fire at the mere mention of the possibility of its use.
Using arguments like “Have you read the package insert?” or “It’s not been approved for use in labor.” to argue against its use just make us look uneducated and unprofessional.
To learn more about the current, evidence-based recommendations for the use of misoprostol in obstetrics please visit www.misoprostol.org
*Citation: Alfirevic Z, Aflaifel N, Weeks A. Oral misoprostol for induction of labour. Cochrane Database of Systematic Reviews 2014, Issue 6. Art. No.: CD001338. DOI: 10.1002/14651858.CD001338.pub
Bethany Sawhill – Owner of Phoenix Family Birth
I am a statistic.
I was the teenage mother, the college dropout, the divorcee, the school teacher who quit within 7 years.
All my life, I’ve had people whispering in the wings: She won’t amount to anything.
One day, I had new people to listen to. And these people don’t whisper. They buzz, they speak, they even shout from the rooftops: You are enough.
These people are ProDoula.
A few years ago, I was facing major burnout in my teaching career. Physical fatigue that never ends, depression, feelings of failure, anger, resentment, utter lack of work-life balance. I was supposed to be living my dream as a teacher. Every day I went to work and greeted 36 eager little faces. Every day I came home with more burnout.
I needed to make a change. I decided to become a doula.
I certified with an online organization and got to work. Then the real world started up with its statistics again. Doulas can’t make a living. It’s not really a career. Most burnout within three years.
Wait – what?! Burnout? Three years??
Meanwhile, I was hanging out in ProDoula’s Facebook group, The Business of Being a Doula. It seemed harsh. It seemed tough. It seemed to go against the grain of everything I thought a doula was supposed to be. I stayed anyway.
Soon, I realized that what these conversations made, was an awful lot of sense. They were speaking to the harsh reality that is the landscape of doula work today. They were giving their colleagues tough love. They were going against the grain of everything that causes doula burnout. It was enlightening.
I knew I had to become a ProDoula.
Over the course of three days of labor and postpartum training, my role as a doula exploded. I learned hands-on skills that I never knew existed. I learned communication that was applicable to every area of my life.
I learned how to read words and tone, but also to uncover motive to meet a client where they are at in their current moment. I was able to take this knowledge and apply it to my relationships with my husband, my children, the clerk at the grocery store.
I learned how to structure my business for longevity, to create sustainability for my business and my family, and to become a part of a network of professionals outside the “doula community”.
I learned that non-judgmental is not just a word, but a lifestyle.
My ProDoula training gave me freedom from worrying about the “right” way and the ability to release all of my biases about pregnancy, birth, and parenting. It taught me that the status quo doesn’t have to define me. It gave me permission to wholly and fully embrace the real me and bring authenticity to my work as a doula. It instilled so much confidence that my dreams suddenly became a plan.
But training was only the beginning. I was ready to certify.
ProDoula’s certification process sets you on the road to greatness. It forces you to dig deep and uncover facts about birth, facts about your local birth culture and resources, and facts about who you are as a doula. It forces you to stretch outside your comfort zone. And in so doing, it forces you to see that you are a doula. You are a success story. You are enough.
Burnout isn’t on my radar anymore. I surpassed the three-year mark. I know that the work I do is important and valid. I am appreciated by clients and colleagues alike. I am making a living wage and providing for my family.
This time, I’m not just a statistic; I’m a success story. I am an entrepreneur, an agency owner, and a doula.
I am ProDoula.
No Child Wet Behind is growing!
Stay tuned for specific details in the October issue of the ProDoula newsletter.
What is the most embarrassing thing that’s happened at a training?
I don’t believe I’ve ever had anything embarrassing happen at a training, but on they way home from a cross country flight after a training I was trying to figure out how to sleep on the plane for my first ever red eye flight. I awoke to the passenger beside me staring and I realized I had to look absolutely ridiculous. Imagine me sitting upright with a blanket wrapped around my neck multiple times that was covering my head and face and my head leaning against a pillow. I must have looked like I couldn’t breathe under all of those blankets.
Share with us the moment you realized the importance of doula work.
I feel like this is constantly evolving for me. The more clients I work with the more I see the value in what we do and offer through non judgmental support. Most recently I’ve noticed this through work as a postpartum doula.
Share with us an epiphany you had at your own doula training.
This is exactly what I’m supposed to be doing with my life!
Mediterranean and Indian food
Do I have to pick just one? I own a lot of black, but I also love patterns that have multiple colors. See, I can’t pick!
Must have item when traveling to a training.
Other than my training materials, I would have to say this amazing water bottle that my daughter purchased for herself and that I take every chance I get because it’s so wonderful! Contigo for the win!
As a trainer you spend a lot of time on airplanes traveling from training to training. What is your favorite thing to do when sitting on a plane?
When I sit on a plane I always think I’m going to work, but I’m usually distracted. I end up watching movies if there is wifi and if not, I warm chat with my neighbor!
Daughter of Angela Horn – Owner of Tucson Doulas
How long has your mom been a doula?
My mom has been a doula since before I was born and I’m 12, so a long time.
What is the best part about your mom being a doula?
She helps people and she knows a lot about female bodies.
What are/were the downsides to your mom being a doula?
My mom can be gone at literally the worst times and no one knows when she’s coming home.
You may also try stirring in a spoonful of your favorite jam or nut butter to add an additional level of flavor!