Black Breastfeeding Week

Hey Fam,

We just wrapped up World Breastfeeding Week (Aug 1st-7th) and are on the cusp of celebrating the 10th anniversary of Black Breastfeeding Week (Aug 25th-31st). All bodies with nipples are able to lactate, and so you will find that I may switch to terms like chestfeeding and bodyfeeding to honor and support all lactating parents of all genders and body composition. 

Why do we need a Black Breastfeeding Week (oddly acronymed to BBW which has a whole other meaning these days… awkward). Well, journalist Kimberly Seals Allers, public health advocate Kiddada Green, and writer and activist Anayah Sangodele-Ayoka recognized the huge racial disparities when it came to bodyfeeding. There is a lack of diverse representation within the lactation field, lack of access to lactation resources and food sources for Black families, high rates of diet related diseases in Black infants, and disparaging cultural and generational myths about chestfeeding. All of these factors have a direct effect on Black maternal and infant health. So, they created BBW to educate the masses, encourage the training of more Black and POC lactation professionals, support disenfranchised communities with lactation resources, and advocate for more funding to address the Black mortality rate.

As a full spectrum doula and peer breastfeeding coach, I emphasize the importance of discussing lactation goals during the prenatal period. Best to start early so that the individual, couple, and family can have a plan to mitigate any barriers or complications during postpartum. Bodyfeeding is a challenging and rewarding journey that requires much support. It is emotionally, mentally, and physically taxing, BUT chestfeeding is so helpful for bonding and attachment, infant sleep, infant gut health, topical healing treatments, disease prevention for the parent, blood pressure regulation, and so much more. Give yourself grace, be patient with yourself and with baby.

A few tips: Have your baby assessed for any functional issues that may affect latching, such as a possible tongue tie/ lip tie. If you birth at a hospital, try and get that assessment done before you are discharged home. You can absolutely feed with an inverted nipple, and there are options for folks who have had breast augmentation or mastectomy. There are also options to induce lactation for adoptive or non-gestational parents. If you are currently breastfeeding and/or have plans to bodyfeed, I highly encourage you to have 1-2 support persons who are also receiving the same information and education as you regarding lactation tips and strategies. Your personal Titty Committee, if you will. Ask your doula or birth provider for a referral to a lactation counselor or International Board Certified Lactation Consultant (IBCLC) and have your support person(s) accompany you to your visits. If you plan to pump, have a lactation professional help fit you for the correct sized flange, be sure to properly wash all parts of the motorized breast pump, and try to replace the parts if they look loose or worn out after repeated use. If you lactate before giving birth, try and save as much of that liquid as you can in a small syringe and store in the freezer until needed. Don’t let anyone dictate to you how long you should breastfeed your child.

Breastfeeding is a challenging journey but with the right support, you can find ways to continue on or to allow yourself the grace to consider other options; whatever decision that brings you the most peace and comfort and provides the best care for your baby. What are you doing to contribute to and celebrate Black Breastfeeding Week?

Happy Lactating,

Luna Doula Jo

Doula Support Through Pregnancy Termination

Hey fam,

We’re talking about some heavy stuff today, but I hope you can dip your toe in these waters and wade in the deep for a little bit. Being a full spectrum doula is very important to the quality and diversity of services that I provide, now more than ever. I support the full range of family planning experiences and that includes abortion. Rare is the sensationalized image of abortion as a seedy procedure being done in a dark alley. Abortion is a lifesaving, medical procedure both physically and mentally. A lot of the public conversations hypothesize the right to abortion in cases of fetal viability, maternal mortality, or sexual assault. Abortion isn’t only justified in the most heinous of situations. It is a valid choice solely because someone wishes to no longer carry a pregnancy. Terminating a pregnancy should not carry shame.

So what role do I, your badass neighborhood doula, play in supporting someone through a procedure to terminate a pregnancy? I provide non-judgmental support at any point throughout the termination journey. As a licensed clinical social worker, one of my strongest skill sets is resource coordination. So as a doula, I tap into those skills and connect folks with a list of caring, attentive, and inclusive abortion providers and, if desired, a list of mental health providers in their area. I work hard to ensure that folks feel empowered, educated about their choices in termination methods, risks, benefits, side effects, and recovery expectations. I’m mindful about practicing within my scope, so together we create a plan for safety and support. I am also a traveling doula and offer virtual support. My presence at the institution during the procedure depends on the person’s support network, the institution’s policy, and the chosen method of termination. Sometimes folks work with me just for the planning process, others only want me to be present at the clinic, and some just want the aftercare support. Support at home includes (but is not limited to) physical and emotional support, light tidying up, meal prep, monitoring for changes in symptoms, continued education, and help with advocacy. My supportive services vary depending on their unique needs.

Folks who make the decision to move forward with abortion are deserving of empathy, guidance, care, and unwavering support. My sincerest hope after reading this is that whether or not you support someone’s choice to terminate a pregnancy, you know a caring professional who is trained and committed to making them feel safe, not judged, and cared for in their recovery.

With Gratitude, 

LunaDoula Jo

Advocate for an empowering C-section

Hey Fam! 

April is Cesarean Awareness Month. Seriously, there’s a nationally recognized holiday for every week and every month of the year. I thought it was a great opportunity to share some ways that you can prepare for and feel empowered when it comes to conversations and decisions regarding c-sections. Firstly, c-sections deserve awareness as a life saving birthing method/intervention that don’t necessarily have to be seen as an unfortunate end to a birthing experience. For some folks and for various medical/personal reasons, they have pre-scheduled c-sections. For others, yes, perhaps c-sections were not their preferred choice but due to circumstances during labor, beyond the parents’ control, baby was born via c-section. I also want to acknowledge the ways in which those in the birth community are working to change the language and stigmatization of the term c-sections. We’ve got Belly Birth, Surgical Birth, Abdominal Delivery, etc.

As a doula, I’m especially attuned to the ways in which I support parents through the possibility of a cesarean and how I support them afterwards. Most of my families know that we talk about all possible what-if scenarios and include preferences on the birth plan that detail ways to make a c-section inclusive, empowering, gentle, and just as sacred as any other method of birthing. And yes, doulas support folks who have pre-scheduled cesareans! The term “gentle c-section” is sort of a buzz phrase in the 

birth community nowadays and I even had a provider once tell my client and me point blank that they don’t do gentle c-sections. What?! Some cesarean prep points for your prenatal period would be to ask your provider about what their procedure is for c-sections and how they make the determination to move forward with a surgical birth. For the actual procedure, it’s important to think about establishing the right energy in the room so that you feel centered and connected to the process and to your baby’s birth. Do you prefer a certain type of music played in the OR, do you want your surgeon to narrate a play-by-play of what’s happening, how involved do you want your support person to be, would the medical team allow baby to birth through the incision on its own or do they pull baby out, and do you have certain cultural birthing traditions that are sacred to you?

I also recommend asking your provider questions about c-section postpartum healing and support. Some questions include, what is the recommended level of activity during the first few weeks, how to regain sensation at the incision site, recommendations for pelvic floor therapists, challenges with breastfeeding and bonding after a c-section, etc. The takeaway to all of this is to know that you have choices and rights for your birthing procedure AND you should absolutely be receiving guidance and support for postpartum recovery. Sending love to all Cesarean parents out there. I see you and I honor your experience. I welcome you to reach out to learn more about my customized birth and postpartum support for cesarean births and cesarean postpartum recovery.

With Gratitude, 

LunaDoula Jo

Endometriosis

Hey fam!

First let’s start with, what the heck is endometriosis. Endometriosis happens when tissue similar to the lining of the uterus grows outside of the uterus and on other areas in the body where it doesn’t belong.

Endometriosis growths may swell and bleed in the same way the lining inside of the uterus does every month — during one’s menstrual period. Ouch. This can cause swelling and incredible pain because the tissue grows 

and bleeds in an area where it cannot easily get out of your body. In addition to debilitating pain and bleeding in between menstrual cycles, endometriosis can also cause pain during intercourse, GI issues, and most commonly infertility. How? Well, patches of endometriosis block off or actually change the shape of the pelvis and reproductive organs. This can make it harder for the sperm to find the egg. Once fertilization occurs, the immune system, which normally helps defend the body against disease, attacks the embryo.

Because these are vague symptoms that present as other conditions, endometriosis is often misdiagnosed for many uterine carrying bodies. It occurs most often in folks ages 30-40 (but can definitely present earlier), whose menstrual cycle lasts longer than 7 days, and there is evidence that there is a genetic component.

Why is it important for you to know this? If you know and love someone who presents with some of these symptoms and/or who has a family history of Endo, share this information with them. A confirmed diagnosis could be the key to resolving years/decades of life altering symptoms. I also want to call in more empathy for menstruating folks who have such painful and long lasting cycles, that their life literally stops for weeks at a time. Hopefully with more research we can find a definitive cause and cure for Endometriosis.

With Gratitude, 

Doula Jo

Preeclampsia

Hey Fam!

Let’s chat about Preeclampsia, what it is, who’s at risk, treatment options, and how your doula can help support you after a diagnosis. Preeclampsia is a syndrome that is characterized by an increase in a pregnant person’s blood pressure and increased proteins in the urine. It can affect their brain, kidney, and liver functioning, and experts believe that complications with the placenta is one of the factors that causes preeclampsia. Problems with how well blood circulates in the placenta may lead to the irregular regulation of blood pressure in the pregnant person.

Studies show that Black and Indigenous women are more likely to develop preeclampsia during and after pregnancy. It’s also often under diagnosed and less monitored in Black and Indigenous people which can lead to serious birth complications. Some researchers claim obesity as a risk factor, and with how fatphobic our health care system is, I’m giving that a big ol’ side eye. Folks are always quick to put fat people in this unhealthy box and as we know, there are many healthy fat people. *Sashays off soapbox*. Other risk factors include:

  • Type 1 or type 2 diabetes before pregnancy
  • Gestational Diabetes
  • Kidney disease
  • Autoimmune disorders
  • Use of IVF
  • Pregnant with multiple babies (such as twins or triplets).

Depending on the severity of preeclampsia, some providers may recommend bed rest, BP meds, administering steroids to the fetus to speed up lung growth, and induction/c-section. Delivering the baby can help resolve preeclampsia but symptoms can continue even after birth, and some of them can be serious. What is often not discussed is the onset of Postpartum Preeclampsia which can affect birthing people immediately after birth or even days after baby is born. Some signs to look out for include severe headaches, blurry/distorted vision, edema/swelling in the extremities, and shortness of breath.

After a preeclampsia diagnosis, I typically check in with my clients on a more frequent basis. I recommend using a reliable blood pressure machine at home to monitor BP, and get a few pairs of compression socks to help with feet/leg swelling. At any sign of increased symptoms, I ask that clients reach out to their provider immediately and keep me posted. Because some of the recommended birth interventions can be invasive, we talk about advocacy, risks, and benefits. We have extensive conversations about birthing preferences and plan out what various emergency scenarios would look like for them. Even with a preeclampsia diagnosis, you can stay informed, have a say in your birthing experience, and be empowered in monitoring your prenatal and postpartum health.

 

With Gratitude,

Luna Doula Jo 

For more information and research about preeclampsia, please see the following sources.
https://www.nichd.nih.gov/newsroom/resources/spotlight/101812-preeclampsia
https://www.mayoclinic.org/diseases-conditions/preeclampsia/symptoms-causes/syc-20355745
https://www.cdc.gov/bloodpressure/pregnancy.htm

Disenfranchised Grief Part 3

Hey Fam,

Welcome back to the final installment of our disenfranchised grief series. In my previous two newsletters, I talked about a few examples of ambiguous loss and how isolating it can be to experience grief in a silo. I also talked about what informs our expectations of grief, how long we allow ourselves to grieve, and validating all kinds of loss. So, as you navigate a loss that is not often acknowledged by your community, it’s important to ask yourself, what is the story of grief that you know? What have you been told what it’s supposed to look like? What are the words that come to you? I think we don’t even realize how often we are carrying these external stories of grief. First step in working through disenfranchised grief is acknowledging the feelings and affirming that they are true and deserving of you expressing them fully and authentically. You have the power to decide what you want your grief to look like and what coping strategies help you move through it.

  • Loss of Support– support from significant figures/changes in relationships/friendships, etc.; this type of loss can show up at any point in the family planning journey, from fertility treatments to postpartum. The nature of friendships change, partners separate, family conflict happens. The grief of losing a relationship or a changed relationship in your life during one of the most important times in your life is a valid and heartbreaking loss. Allow yourself the grace and time to honor that feeling.
  • Adoption– Adoption is a beautiful, joyous gift, and it is important to discuss the ways in which grief & loss show up for all involved. One aspect of ambiguous loss is when something or someone is lost physically but still remains ever-present psychologically. So for example, birth parents experience this when they place their baby for adoption, are physically separated from them, and yet the memory of their existence and the experience of birthing them remains. Many people don’t understand that even though some birth parents choose adoption and are confident in that choice, there is still loss involved. Adoptees also experience something similar. Even if placed with the most loving of families, some wonder what life could have been like with their birth family, the psychological presence of their birth parent(s) remain. They experience loss of not knowing pertinent genetic or medical information and there can also be secondary loss of identity when adopted into families of a different culture, race, ethnicity. For adoptive parents, some choose to adopt because they have experienced the heartbreaking journey of infertility, which comes with its many layers of grief and loss. However after adopting, that loss is not often recognized or validated because of the benefits gained from adoption. Joy and pain can co-exist.
  • Traumatic Birth– While people acknowledge how difficult coping from a traumatic birthing experience is, most don’t often recognize that there is a real grief and mourning that occurs following such an experience. One is left with grieving the loss of autonomy and grieving the expectation of a certain labor outcome. Having a traumatic birthing experience comes with very nuanced layers of grief, guilt, shame, anxiety, fear, regret. Folks feel pressured or put pressure on themselves to put a time limit on their grieving period. I want to also acknowledge traumatic births that result in partial or full hysterectomies. The unexpected loss of reproductive organs is something that feels taboo to discuss and seek support for. There are many skilled psychotherapists who specialize in pregnancy related traumas and I encourage you to seek their supportive services. Don’t know where to start? Ask your PCP/OBGYN for recommendations.
  • Returning to work– grieving the loss of family bonding time, time spent with your baby, flexible schedule, and a routine that you worked really hard to create. Take things slow as you reintegrate back to work, create a transition plan with your employer/colleagues, and give yourself the grace to feel the myriad of emotions that come up for you, most importantly I encourage you to talk about it with trusted and supportive people in your life.

This is by no means a complete list of the ways that disenfranchised grief and ambiguous loss show up in the family planning journey. There is so much more to discuss, but hopefully after sharing this information, you can continue those conversations. Acknowledge the loss, validate the grief, give yourself time and permission, and seek support. Wishing you all a beautiful end to Pride Month and Black Music Appreciation Month.

With Love & Gratitude,

Doula Jo

For more information about the lived experiences of adoptees, check out Denise Defoe, LMSW and her book They Chose Me: An Adoption Story, Saara McEachnie’s article on Legacy and Adoption, and resources offered by The Barker Adoption Foundation.

Disenfranchised Grief Part 2

Hey Fam!

This is the second installment of our Disenfranchised Grief series, so let’s do a recap. I talked about how grief shows up when parents mourn their ease of pre-parenthood lifestyle, grief after a first trimester pregnancy loss, and the ambiguous loss experienced by the non gestational parent. Disenfranchised grief is so hard to recognize and validate, partly because we don’t allow ourselves to fully grieve major losses. We carry stories of what grief looks like, sometimes based on the grief that we’ve already experienced. If we have never been through grief, we base our perception on movies we’ve seen, books we’ve read, or from witnessing someone else going through grief.

We internalize so many messages from our culture about how long we are allowed to grieve. Think of the 2-5 day bereavement policies in our workplaces, which is in itself a message on how long we get to grieve. And even with those policies there are stipulations on what a legitimate loss is. Any loss other than the death of an immediate family member doesn’t qualify most of us for bereavement leave. And that is not realistic for most of us. So there are these implicit and explicit things that inform a story of what grief should look like. Below are a few more examples of how disenfranchised grief and ambiguous loss show up in the family planning journey.

  • Complications after birth– anything that causes one to be separated from baby and family: NICU stay, postpartum pre-eclampsia, postpartum hemorrhage, even difficulty with breastfeeding. That ambiguous loss of time, grieving the bonding experience, the expectations of returning home, and the expectations of the ease in feeding your baby.
  • Abortion– I want to acknowledge that terminating a pregnancy may bring relief, safety, and opportunity for some. However, there are folks who grieve the conscious decision to terminate a pregnancy, for many reasons. Because of the polarized and politicized conversations about abortion, many do not feel free to express their grief. There are few spaces where people can go to seek support for their grief after a pregnancy termination. Full spectrum doulas are an excellent source of support and can help to link you to resources in your community. Your medical provider may also have recommendations.
  • Difficult Pregnancy– celebrities make pregnancy look easy don’t they? This is, of course, not everyone’s experience. Some people just don’t enjoy their pregnancy. As a pregnant person, it is stigmatized to express regret or disdain for your pregnancy experience. Whether it’s hyperemesis gravidarum, persistent and debilitating swelling and joint pain, frequent monitoring and tests, feeling disconnected from one’s body, it’s okay to grieve the experience that you wanted or thought you’d have.
  • Gender Disappointment & Disability Diagnosis- I wasn’t sure about including these two experiences of disenfranchised grief because while one’s feelings are valid, these instances of grief and loss are rooted in ableism, sexism, and the chokehold that gender constructs have on us. I think talking about it provides us the opportunity to assess what we value as a society and why. And if you’re thinking “Pfffff eye roll!”, that’s exactly why I included it under disenfranchised grief. Now, when I talk about a disability diagnosis, I’m not talking about a life limiting or terminal diagnosis. I’m talking about a chronic condition that may affect the baby’s care, appearance, functioning, and quality of life. There’s an emotional suffering that happens when some parents learn that their baby has a disability. They feel grief for themselves, the loss of the parenting journey they expected, grief for their child, for their siblings, because of how hard life will be in this ableist and unaccommodating society. There’s not really a safe space to have these discussions and process these feelings. Some people have a deep expectation for their baby’s biological sex and go through a grieving period, thinking of all the future losses when they find out their baby’s sex is not what they wanted. The pressure we put on ourselves and our children based on their sex and gender expression is something to further investigate, and processing those feelings may help to release the deep sadness associated with the loss.

Our last newsletter in this series comes out in two weeks! And as always, I love hearing your feedback. I’m so glad that this resonates for so many of you.

With love,

Doula Jo

Disenfranchised Grief

Hey fam!

I want to talk with you about disenfranchised grief. Many of you know, as a doula AND hospice social worker, I work with families who welcome new life into this world as well as families who are preparing to say to goodbye to their loved ones. What a gift this work has been. I’m in the unique position to witness some common threads in the areas of birth and death. Grief and loss show up in many ways. Joy and peace also show up in death work, but that’s another story that I’d love to share with you for another day.

What is grief? Grief is a natural response to loss. It can make you feel confused, forgetful, anxious, angry, profoundly sad, and scared. It can also have physical symptoms. Grief asks a lot of us; it can be beautiful and transformative and is a healthy part of our life cycle. We grieve throughout our lifetimes for many things.

Disenfranchised grief is the experience of loss that is not often recognized or validated by society at large. One feels isolated, shamed, and undeserving of grieving these kinds of losses. Below is a list of some of the most common ways disenfranchised grief shows up in the family planning, pregnancy, birth, and postpartum journey. Because there’s so much to say about this experience, I’m actually splitting this up into a three-part series. Would you like to submit a question? I’d be sure to answer it in the upcoming newsletters.

  • Exclusion of Non-gestational Parent– often times, the experiences of loss, grief, and postpartum adjustment for the non-gestational parent are invalidated, minimized, or ignored.
  • First Trimester Pregnancy Loss– because folks are advised to wait (typically 3 months) to share news of their pregnancy, if a loss happens before that time period, individuals and couples are left to grieve in silence. If others do know of the loss, it’s unclear how to proceed.
  • Loss of Support– support from significant figures/changes in relationships/friendships, etc.; this type of disenfranchised grief can show up at any point on the family planning journey, from fertility treatments to postpartum.
  • Difficult Pregnancy– celebrities make pregnancy look easy don’t they? This is, of course, not everyone’s experience. Some people just don’t enjoy their pregnancy. As a pregnant person, it is stigmatized to express regret or disdain for your pregnancy experience.
  • Traumatic Birth– While people acknowledge how difficult coping from a traumatic birthing experience is, most don’t often recognize that there is a real grief and mourning that occurs following such an experience. One is left with grieving the loss of autonomy and grieving the expectation of a certain labor outcome.
  • Ease of lifestyle– As a parent, it is absolutely ok to mourn the ease and freedom of your pre-parent life. You are human. There is a loss of identity, in trying to find and acclimate to a new identity.

Stay tuned as we continue this conversation on how to deal/cope with each of the disenfranchise grief mentioned above. I hope you feel seen. Feel free to share with others in your community.

The Importance of Doula’s

Every family deserves to feel empowered in their choices to birth. Everyone deserves the respect and care in their choice to terminate a pregnancy. Every person deserves to feel supported in growing their family via adoption and surrogacy. It takes a village and birthing folks and their families deserve rest, support, education, as they care for themselves and their baby or as they recover from pregnancy loss. As a full spectrum doula, these four tenets and core beliefs are what brought me to this work. Why are doulas necessary? Because we work with and for you, not for your medical providers, not for your medical institutions, YOU.

For so long, medical care has been more transactional than collaborative. And so we have generations of people who know very little about their bodies, their choices/rights, and the power that they have in coordinating their care.

My work is unique in that I bring my mental health background as a Clinical Social worker, my specialty with end of life, grief, and bereavement hospice work, and the indigenous herbal knowledge from my Haitian heritage. So not only do I provide the physical, emotional, and educational support to your experience, but I bring a whole knowledge base to help with your mental and physical health and healing. I’ve had the privilege of helping families all across the country, sometimes the same families multiple times and it’s exciting and different every time. Feel free to share with a friend who you think may benefit from my services.