Doula Discourse with Brooke & Rebecca


Portland based Doulas, Rebecca Durlin Smith and Brooke Noli, chat with Dr. Stafford about the amazing work they do supporting families through birth experiences. Their agency, Birth First Doulas, can match families with an experienced doula team that will provide continuity of care through the entire birth experience.


Learn everything you need to know about Birth First Doulas on their website:


www.birthfirstdoulas.com


Topics discussed in this episode:


•What is a doula

•Dr. Stafford’s experience with Brooke as her doula for the birth of her second child

•Ring of fire

•How a doula supports the entire process

•The value of the agency model

•Common concerns when hiring a doula

•How a doula works with other providers


Listen, read, watch! You can listen right here, or with a podcast app of your choice. You can also read the complete transcript below, or scroll to the bottom of this post for the video.


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Dr. Michelle: Hi, this is Dr. Michelle Stafford here again with Mixed Dentition, and today my special guests are Brooke and Rebecca of Birth First Doulas. Welcome ladies.


Brooke: Thanks.


Rebecca: Thank you.


Dr. Michelle: Thank you for being here today. So, I think the first thing we should start with is what is a doula exactly?


Rebecca: Well, you know there's different definitions. You can look on Webster's dictionary and get one that says something along the lines of, "A doula is a Greek word for servant." That's one definition.


Rebecca: And the modern rendition these days is we are professional birth, pregnancy and postpartum support, and our goal is to help people have the most positive experience they can through that whole journey.


Dr. Michelle: Wonderful. I like that, because it is a journey. Pregnancy until post birth, and having a doula on your side can help with that journey. I met Brooke in 2014, early 2014 with my second child [Elleden 00:01:01] . I wanted to have a VBAC, which is a vaginal birth after a cesarean, which I had with my first child, and I knew that I would need somebody on my team to really provide the best guidance and try to give me the best experience.


Dr. Michelle: And when people ask me about my birth, it always includes my doula, and how she guided the experience and also reassured me through what I now know is the ring of fire, when I thought I was going to die. And what I specifically remember is you holding my shoulders and telling me I wasn't going to die, and I was like, "Are you sure?" And I didn't.


Brooke: I was right.


Dr. Michelle: And I survived. And so, I had the birth that I wanted and I happened to be in a hospital setting, but I didn't want any medications until that moment. At that moment I did, but it was too late.


Brooke: Too late, and it goes too fast anyway.


Dr. Michelle: And I survived the whole thing without medications. And I credit you a lot and feel like when I describe you, I describe you as a magician that helps with the whole entire process. So, thank you once again for making that birth experience survivable and amazing.


Brooke: All that? I mean, that's thank you. It's a total pleasure to have been of service to you. It's why we do the work. And it's just so... It seems magical, but there's really very little magic to it, in that people have good experiences when they feel well supported. It is really as simple as that. The magic is just that you felt cared for, listened to and there were a few labor tricks that help people in the moment, and that's what we offer.


Brooke: But it feels magical in that moment because medical providers aren't taking care of those parts, and you're a whole person. You're not just a medical body. So, the doula is taking care of the whole person. We're thinking about your psychology, we're thinking about your emotions, what they mean by... You as a couple and your whole family, and holding that stuff creates the magic even though it's not magic at all. So, yeah.


Dr. Michelle: Well, I felt well supported, and my definition of a doula would be someone who supports you fully, just as you described through the entire process. Because when you're in a medical setting, if you're not with somebody who knows you well and can provide that support, then it can be more challenging, I think. So, yeah.


Brooke: Yeah. We're bridging that gap for people, especially having hospital births where they really want that continuity of care and that intimacy in their actual care, but they can't really achieve that in the hospital because everyone's just on call, and they don't know who it's going to be, and everyone needs to focus on their medical specialty.


Brooke: But the doula just gets to focus on you and your goals, and your hopes for your birth and gets to know you. So, it's one of the great things about the work. Is that we get to bridge that gap for people and they get to feel that support.


Dr. Michelle: Yeah. That's really great. So, I know you provide care before the actual birth as well as postpartum. Do you want to describe that a little bit to our listeners?


Brooke: Yeah, it's a package. So, when you hire a doula, you get a whole package. There's two prenatal appointments where we talk about all your hopes and goals, and your birth preferences and let you know what to expect at the hospital and what to expect from the birth process, and just make sure you have the information that you want. It's also a chance for us to learn about you and what specific things you want, because everybody wants different things.


Brooke: And then, the second prenatal appointment is usually more focused on what's going to happen day of. We practice some positions and talk about what to bring to the hospital, just that, the very practical parts of it all.


Brooke: And then, we're on call for people starting at 37 weeks, and we'll be available throughout that whole time to answer questions as you near your due date and have all the late pregnancy stuff. And you wonder if your water broke, and was that a mucus plug and what's going on, and is this baby ever going to come.


Brooke: And anyway, helping people understand that process and what's... Normalizing things goes a long way for people. And then, when you go into labor, we're there for the support, the hands on support. We give partners breaks and whisper in their ear what's going to help most and what kind of positions to get in, and when to go to the hospital.


Brooke: And at the hospital, we help them navigate the hospital system, talk with providers, figure out what their choices are, hold their shoulders during the ring of fire, try and show them they're not going to die, all that stuff.


Brooke: And then, after the birth there is the postpartum visit at home. And that's the package, which is the two prenatal appointments, the birth and a postpartum visit at home to do follow-up about the birth story, answer questions, newborn care stuff. Again, what's normal, what's not. They're having breastfeeding challenges, making sure people have resources. Yeah. What am I leaving out? What am I forgetting?


Rebecca: I mean, that's a lot of it. Another piece, because every family is looking for something different with their support, they can come into play. It's just how we're on call informationally and emotionally throughout from whenever people hire us and really up until six weeks postpartum. Because in between prenatal visits with their practitioner, there can be questions or things that come up with their health that are... It's not just a...


Rebecca: Labor and delivery is the only floor of the hospital where people are going, they don't necessarily have a problem. So, it's not just about how will this unfold physically, but how do the mental and emotional aspects come into play? So, some people will ask, "Well, but my partner is going to be my intimate person. Are you going to take that person's place?" Or, "My mom's going to be in the room. Are you going to step in front of our connection?"


Rebecca: And it's the opposite, is that we're spending time prenatally, even in between our visits [inaudible 00:07:24] as a unit, so that we know not only what you care about, but what sensitivities are around including partner and other family dynamics. So, we can help bolster everybody up. And on the big day, we're ready to help everybody be their best selves.


Rebecca: So, the last thing we want is to be the shining light. We're one of the shining lights. There's many beautiful moments and it's an honor to be one of them in the room.


Dr. Michelle: That's really great. Really great. And so, we talked about a hospital birth. What other birthing places do you guys support?


Rebecca: We'll go anywhere people are having their babies. It's just the majority of people give birth in the hospital these days. Oregon has doubled the rate of out-of-hospital birth as the rest of the country at 2%, versus the rest at 1%.


Rebecca: So, I mean, there are... We'll go anywhere that there's an accredited provider who's handling the medical care. We'll handle all the rest of the support aspects. So yeah, we love working at the birth centers and with home birth midwives, and wherever people decide to have their babies.


Dr. Michelle: It's wonderful. And now, explain a little how you two work together to provide services to families.


Rebecca: Well, there's two specific ways. One, Brooke and I work in a doula partnership. So, we serve our clients together. So, when people hire us, they hire us as a team. And we also own an agency. Birth First Doulas is our group, and we have three teams. So, two other doula teams who work the same way that we do, serving their clients together.


Rebecca: And then, we have a few individual doulas who handle everything from the prenatal through the birth experience on their own. That's how we both started out as. Solo doulas, is what we call those individual doulas. And then, over time saw the joys of having a partner and being each other's work wives through getting to support families and bring our two brains together.


Rebecca: So, the agency, when people come to Birth First they can hire whomever off of the team that's a fit. So, they can hire us, they can hire another team, but they're hiring the agency as a whole and we get to take care of all of the back end specifics of people pay us, and the doulas who are on the team get to just focus on the craft.


Rebecca: It's like here in this office. I would expect many doctors and dentists' offices, people who want to come to work. You [inaudible 00:10:01] their schedule and then focused on being amazing providers. That's what we're hoping that we can allow our doulas to do, is just to focus on the client care and not have to worry about, did this check come in? And, what do we do when something needs to be followed up on on the financial side? We handle all of that.


Dr. Michelle: That's great.


Rebecca: Another goal that we have with Birth First is to just provide a level of mentorship to the doulas who are on our team, because everybody starts out at this career with a lot of passion and those who have hearts stay in the game, but there are a ton of barriers to continuing. Having to run an entire business on top of providing the support. Just the on-call life alone is a lot to get used to it.


Dr. Michelle: Yeah, that's tough.


Rebecca: Yeah, it's not for...


Brooke: Babies don't come from 8:00 to 5:00 all the time.


Rebecca: No, they don't. It would be so boring if they did.


Dr. Michelle: You think?


Rebecca: Yeah, it's just part of the variability, is that we're there and we're there for the whole thing. For as long as birth takes, we're there. And so, running a business on top of all of that is just-


Brooke: More than some doulas want to do. We also have doulas at all different levels of experience to meet different budgets. And so, depending on what your goals are... And then, there's just personality. We also have a lot of different doulas, so that... Every family is looking for something different.


Brooke: And so, some people are drawn to what we offer and some people are drawn to what some of our other doulas are offering, and they all have different skillsets and offerings, and personalities. So, it's so much about... We all offer a similar service, but it's so much about the fit in the end. So, part of our goal is to help you find the doula that's the best fit for you and your family.


Dr. Michelle: That's very great. I imagine it's really wonderful working as a team as well, because you can bounce off new ideas and like you said, a mentorship. So, you can learn from one another. I know for myself, working with several different dentists, I get to share cases or share ideas and talk about it. But also just emotional too. I would think as a doula perhaps some emotional support would be important.


Brooke: Absolutely. We're a community. We're about to have our retreat together. We're all so excited. Yeah, we rely on each other for all sorts of things. But part of it is for community and yeah, cross pollinating and learning together. It's a really valuable part of it.


Dr. Michelle: That's wonderful. And where can our listeners find you?


Rebecca: We have a website, www.birthfirstdoulas.com. It has the contact form. When people are interested in services, they can write in and it reaches Brooke and I, and we write back. People sometimes know exactly because they've already looked at the bio. It's like, "I know I want a doula who's one of these two. Are they available?"


Rebecca: And we help with all that matchmaking to help people find that right fit. And sometimes people just have questions about, "Is birth doula care right for me?" And we're happy to answer all of that. We also serve as a resource space, so stay tuned for some new additions of... We have, for example, a postpartum offering of a nurturing circle with some of our postpartum doula colleagues.


Rebecca: So, we have different collaborations that are all in the works. And so, there'll just be more and more ripples of things offered to our clients you can find on the website over time. Yeah.


Dr. Michelle: That's wonderful.


Rebecca: And we have all the social media things that people have.


Dr. Michelle: Yes. For Birth First Doulas?


Rebecca: Yes.


Dr. Michelle: Wonderful. Is there anything else you ladies would like to add?


Rebecca: I think that things that often come up when people say... Because sometimes one partner is very much on board with the investment, the time that you spend with a doula, the money and also just the sharing of the intimacy. And so, sometimes we'll get asked, "Well, we took these classes together. That was six weeks of our time. And we're reading these books. What value will you add to this experience? Is it really worth it?"


Rebecca: And one of my favorite ways that... When a past client shared their experience. I used to teach this really long class. It's the most rigorous childbirth ed class. It's part of how I became a doula as a prenatal yoga teacher, and then making me a Bradley method childbirth instructor. So, my job was to spend three months teaching basically partners how to become mini-doulas.


Rebecca: It was for your partner. It used to be called husband-coached childbirth when it was created back in the thirties. And so, yeah, it was a thing that was designed for partners to be front and center. And so, they most often were coming in saying, "I'm going to be the person. We don't need another person," but after three months came away saying, "I'm the person who's supposed to be responsible for all of that? I mean, I've never been through this myself before. Maybe I have, but maybe it wasn't exactly the experience either of us wanted. And how could we make it something a little different?"


Rebecca: So, when one of the couples ended up hiring me as their doula, they said, "You know, on the date of, it was like having the local tour guide. Yes, we'd read the book for the island that we were going to visit and we knew what hike we were going to take, and where we were going to stop and eat on the way.


Rebecca: But when we got to that hike and the river was high and the path was muddy, you were there to help us find the... and navigate the other ways and feel good about all of those choices, even though it didn't look exactly because you just can't plan exactly. You just have what falls in front of you and you navigate through that river."


Rebecca: I was like, "I need to tell every human that that's exactly what we do." Because even if the question is just, "When do we leave to go to our birth place?" That is a decision point that is hard for almost every family. So, our ideal is for people to feel like they did this together, no matter what. That whatever hand you were dealt, that you get to play the cards as best as you can, and that you feel like you were both held through the experience. Both partners were held, so that at the end of the day you can feel like, "Yeah. That was something we did, yet another thing together. And we're even further bonded and ready for this next chapter to open." All of that.


Dr. Michelle: That's wonderful. That is a wonderful analogy too.


Brooke: It's a good one.


Dr. Michelle: Because I know personally, we took classes together, my husband and I, and felt ready-ish. I don't know if you ever feel real ready, but then, when the moment came it's like everything I learned fell out of my brain, and I know it was very overwhelming for my husband as well. And just having a doula present was the calming energy and focus, and our guide for the whole thing that we needed. So, that's a great analogy. Thank you for sharing it.


Rebecca: Sure.


Brooke: I think another thing that comes up in people's minds is they're wondering... They both want somewhat an advocate who doesn't work for the hospital that just works for them, but they're simultaneously concerned, "Is it going to be okay with my providers? Is this going to threaten providers? Will they all get along?" That kind of thing.


Brooke: And at least our doulas, I can say with a hundred percent assurance that we just think of ourselves as a team member with everyone in the room. So, we have really good relationships with providers and that's... because that's good for our clients.


Brooke: So, it is like this balance of making sure our clients have the autonomy they want and need, in terms of decision making, making sure they have all the information they need to make the decisions, and inviting that open communication with providers to be happening. And so, it's never a tense feeling that happens in the room, I would say, between at least our doulas and providers. It's much more about opening that and creating a better feeling all around.


Dr. Michelle: Yeah. That's great. Like a team that's working together.


Brooke: A team that's working together.


Dr. Michelle: Yeah, offer the mum... [crosstalk 00:18:01]


Brooke: And at least here in Portland providers are very used to doulas at this point. So, it's not... They don't think it's weird to have a doula.


Dr. Michelle: That's good. That's wonderful. Well, thank you ladies. I appreciate you both and what you do for families. I think you're both amazing and awesome.


Brooke: No, thanks for all you're doing for kids and families.


Dr. Michelle: And Birth First Doulas, we will... at our website and make sure everyone can find you as well. And thank you for joining me on the podcast today.


Brooke: Thanks for having us.


Rebecca: Thank you.


Dr. Michelle: And to all of our listeners, thanks for joining us today. And remember, fill the world with smiles!



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