Tag Archives: how to show up for first time moms

Choosing a Midwife for your Prenatal Care

Hey fam!

For folks who are in the process of choosing a midwife for their prenatal care, I’ve compiled a list of questions to consider during your interview. These questions were inspired by a list created by doula and birth photographer Paulina Splechta  I edited and organized them based on my years of professional experience in this field. I hope you find this as helpful as my families have over the years.

Prenatal/Postpartum Care:

  1. *What is the cost of care and what is included? How does it work with my insurance covering your midwifery services and how often are clients reimbursed the full fee by their insurance? Do you offer payment plans or discounts for early payment in full? What “extra” or surprise costs might we encounter while in your care? What is your refund policy if we decide to switch care providers?
  2. What is your preferred method of communication (phone, email, text)?
  3. *What are your prenatal visits like? How long are they? Where do they take place? How often are they scheduled?
  4. Do you offer or suggest taking childbirth preparation (CBE) courses?
  5. My partner has concerns about home birth. How have you dealt with this in the past?
  6. *When do you consider yourself “on-call” for me? When can I expect you to join me in labor? What do you do if two families are in labor at the same time? Will you ever leave a labor?
  7. *How do you proceed in the event of pre-term labor or a medically necessary induction?
  8. *What are your policies or recommendations regarding urine dips, basic blood tests and labs, genetic testing, routine ultrasounds and growth scans, gestational diabetes testing, group beta strep (GBS) testing, iron levels testing? Are there any you don’t recommend declining? Can you draw blood or will we need to use an outside lab?
  9. *Do you continue to see clients with Gestational Diabetes, or do you refer them to an obstetrics practice?
  10. *What is your philosophy on weight gain, nutrition, prenatal supplements, and exercise? We will receive counseling or education on those topics?
  11. Do you facilitate water birth? Does a tub rental come as part of my package? Do you have a recommendation for where to rent or buy your favorite pool? Are you comfortable delivering in my bathtub?
  12. *How long will you and/or your support team stay with couple and baby after the birth? What kind of postpartum care do you offer? Do you work with postpartum doulas? How many postpartum visits are offered under your care and on what days do these visits occur? What changes if I transfer and deliver in a hospital? Does your visit include care for the baby? Will you be available for well-woman visits?
  13. *What are the pros and cons of vitamin K shot and eye ointment for the baby? Can you administer Vitamin K and Erythromycin if we want? Can you administer the PKU test or will we need to see our pediatrician? Will you administer Rhogam if needed? Can you provide us with a hearing screening, and if not, where do you recommend clients go?
  14. Is breastfeeding support offered? Do you have local IBCLCs that you recommend?

Birth Experience:

  1. *How long have you been practicing midwifery? How many births have you attended? Why did you become a midwife? What is your training/education/certification?
  2. *Do you have experience working with clients like me?
  3. Do you have references that would be willing to discuss their experiences with your work and care?
  4. *Are there any induction methods that you are comfortable using (stretch and sweep, foley bulb, castor oil, black and blue cohosh, breaking waters) and when might you suggest them?
  5. What is your experience with herbs, homeopathy, and alternative medicine as pregnancy and labor support?
  6. *Can you resuscitate an infant?  Are you NRP certified? 
  7. *Which hospital(s) are you approved for working in case of an emergency?
  8. *Do you have experience with postpartum hemorrhage, shoulder dystocia, breech baby or cord prolapse?
  9. *Do you deliver breech? Do you deliver all kinds of breech? Do you have training and experience in this kind of delivery? If not, do you have a midwife you would refer me to if the baby had not turned?  Do you have experience with turning babies?
  10. *What do you do in the case of a nuchal cord? Or if the baby changes into a breech position during labor and it is too late to be transferred to the hospital?

Birth Team:

  1. *Who comes with you to the birth?  If that person is another midwife, how does their experience compare to yours?  If that person is NOT another midwife, what qualifies them as a birth attendant?
  2. When can I meet your back up midwife and back up OBGYN? 
  3. *Are you and your team neonatal resuscitation (NRP) certified? Have you ever had to resuscitate a baby? Are you and your team CPR certified? Have you ever had to resuscitate a birthing person? How recently have you recertified?

Birth Procedures:

  1. How many vaginal checks do you do, during pregnancy, during labor; should I get them, how necessary are they, what are the benefits/downsides and when do I need to have them done? 
  2. *What equipment do you bring with you to a birth? What kinds of medications (Pitocin Cytotec, Methergine) or tools (birth stool, Rebozo) do you have access to in case of an emergency? Are you legally allowed to carry Pitocin (for rare post-birth hemorrhaging)? Do you?
  3. What methods of pain management do you recommend?
  4. *At what point during my labor will you come to my home? When should I call you?
  5. *How does it work if I am GBS positive – how often do you administer antibiotics during labor and do you do specific procedures with the baby after birth?
  6. Under what circumstances, if any, do you perform episiotomies?
  7. How long do you usually leave the cord intact? How long are you comfortable waiting for a placenta?

Hospital Transfers:

  1. What kind of medical situations during pregnancy would require me to be transferred into the care of an OBGYN?
  2. To what gestation are you comfortable waiting? What is your standard protocol for clients going over 40 weeks before you transfer my care to an OBGYN? How many minimum weeks pregnant must I be to be able to have a home birth (36 weeks? 37 weeks? 38 weeks?)
  3. If my water breaks before labor (contractions) even begins, how long can I labor at home for before you are required to transfer me to the hospital?
  4. What is your protocol for non-emergency transfers to the hospital? For emergency transfers? (Once this is answered, look to the following questions for things that were not covered in the Midwife’s answer that you may want clarification)
  5. Under what circumstances would you transfer to the hospital? In the event of a transfer, (whether or not you have any privileges at the medical facility or know the doctor who I was transferred to) will you stay with me and support me through my entire birth and for the first couple of hours once the baby is born?
  6. What constitutes a non-emergent transfer vs. emergent transfer? Where do I go in the event of a non-emergent transfer vs. emergent transfer?
  7. What things would make me “high risk” and necessitate transfer of care either during pregnancy or labor?
  8. What is your hospital transfer rate?
  9. If I change my mind about home birth during labor and ASK to be taken to the hospital, how will you respond? 
  10. How bad would a perineum tear need to be for you to feel it required a hospital transfer? 
  11. What would it look like to transfer a baby to the hospital if needed after birth? What would it look like to transfer a birthing person to the hospital after birth?

Self Reflection:

  1. How did you feel as the midwife spoke?
  2. How did the things they said make you feel? 
  3. Did they let you feel heard and not rushed?
  4. Did their personality help you to feel connected and instantly safe and supported?
  5. Take note of what feelings may rise from your instincts.

Thank you! Luna Doula’s Year in Review

Hey Fam,

Today is my BIRTHDAAAY!! I thought what better way than to start off my day celebrating with you all. My amazing community! So please accept this month’s newsletter as a love letter of gratitude to all of you for your support, trust, and encouragement. I wanted to share how you all have impacted the work that I have done with Luna Doula this year, and some lessons learned that I will be taking with me into the new year.

This year, I was able to support 25 families, spanning birth, postpartum, end of life/grief support, and abortion support. Many of my families came by word of mouth from current Luna Doula families, friends, and colleagues, but some found me through internet searches for Black Doulas in the DMV area. How amazing! Through some generous donations over the last two years, I established the Mbusa Fund which enables me to provide discounted and pro bono support to families in need that cannot financially meet my sliding scale prices. Although I raised my prices this last quarter, I’ve worked hard to maintain accessibility with my sliding scale pricing. This year with the help of the Mbusa Fund, I provided two weeks of discounted overnight postpartum care for a family, pro bono abortion support for two families, and pro bono end-of-life consulting for another grieving family. We faced the overturn of Roe v. Wade which significantly impacted abortion support in addition to the quality of care during pregnancy loss and life-threatening situations for pregnant folks. With the help of thousands of educators, activists, and policymakers, I found myself engaging in resource coordination and educating folks on ways to navigate the changing laws and how to find the life saving support despite restrictive policies. Let’s keep our foot on their necks to ensure equal and just reproductive rights for all.

This year, I ventured into some fun and exciting projects, attended trainings to enhance my work, and was featured on some pretty dope media outlets. I was cast and performed in two plays this year. Both plays, Fences and King Hedley II, were written by acclaimed Black playwright the late August Wilson. What a fun and empowering experience. Thank you to my Doula families, friends, and family who came to see me perform and support the local community theatres in Bowie, MD and Alexandria, VA.

I expanded my birthing knowledge and attended the Spinning Babies training with my doula sistahs Brittany Martin and Leah Hairston. I also attended a two day grief symposium and learned more about how to offer grief support in creative, culturally affirming, and expansive ways. I also learned more about Haitian Postpartum traditions and care from midwife Barbara Verneus, which I was able to put to use with one of my postpartum families who requested a traditional Haitian Bain (postpartum herbal bath). As some of you know, I launched this Newsletter series in March, with the help of my Virtual Assistant Lisa Trinidad. This has been one of the most challenging yet rewarding ventures for me. Each and every one of you who have emailed, texted, and commented to share stories and continue conversations started in my newsletters, have been the fuel to keep me going. I hope you know how impactful you have been.

I had the distinct honor of being interviewed and featured in the Black Doula Project’s documentary about the importance of Black Doulas and how families have benefitted from the work of Black doulas. My work was also discussed in the Angry African Podcast featuring guest doula Leah Hairston. This episode also mentioned some dope local doulas Vanessa Hanible and Zaynab Aden, so I was in really great company.

The major lesson I learned this year is how to actually incorporate the rest that is so needed for this work to be sustainable and consistent. I took an intentional break from births these last three months, and focused on rest, postpartum support, and planning for next year. I’ve learned my limits and I’m enjoying establishing healthy boundaries to maintain them! For me, rest looked like more quality time with my parents, my siblings, and my niece. I’ve been able to make plans with friends, hike more, attend Black ass events, sleep, graduate to a new level of psychotherapy, learn some cool things about myself, incorporate more moving meditation into my weekly routine, and sleep. Did I mention sleep? Haha. Next year I am booked until May for births, with some flexibility to take on an extra birth each month. I am hoping to acquire some more educational materials for my prenatal education work, like Black and Brown infant dolls and a flexible life-sized pelvis with accompanying reproductive organs and surrounding organs/muscles. I’m also hoping to expand the reach of my End-of-Life consulting and grief support.

Mostly though I’m looking forward to keeping in touch with my Luna Doula families, helping new families, continued growth, and community partnerships. I learn so much from all of you. I thank you for your trust in my work, your sweet family updates, grateful for sharing in your joys and challenges, and bearing witness to the love you have ever so present in your lives. Wishing you all a lovely Holiday season, and a gentle, restful, and joyous New Year!

With love and gratitude,

Doula Jo

How We Show Up

Hey Fam!

How do we build that village and foster relationships that carry us through the hills and valleys of life? Our concept of community and showing up for each other has shifted in recent decades. We’re either too overwhelmed with our own lives, uncomfortable with other people’s discomfort, lack adequate boundaries, or just unaware of social norms that prevent us from genuinely being there. I’ve seen the ways that individuals and families are left feeling isolated and even abandoned by the people they thought would be their biggest support. A part of that though, is knowing how to ask for what we need. That takes vulnerability and courage. So, let’s get into it, shall we?

Best place to start is to ask. If you don’t know *how* to be there for someone, just ask. That opens the door for the person in need, to really think about what would work for them. “How can I best support you in this moment?” or “What would be the most helpful way to support you?”. I know, I know, it sounds a bit corny. But hey, if you can’t be a lil corny and cheesy (mmm corn and cheese!) with those you care about, then what’s the point? Sometimes the person in need doesn’t know what would be helpful. So be ready to make a suggestion or two, careful not to overwhelm them with options. “I’m making some goat and roti for dinner, can I bring you a plate?”, “I’m heading to the grocery store, can I pick anything up for you?”. If after offering, they decline your help, then let them know that you are ready and willing, free of judgement when they are ready to reach out. If they cross your mind randomly, reach out and let them know. Let a few weeks pass and then check in again about ways that you can support. Ultimately people want to know that they haven’t been forgotten after a life changing event has passed. They want to know that someone is keeping them in mind, and that they have at least one or a few people who they can call on when their head is above water and they have a clearer idea of what kind of support they need. But of course, if they’ve asked for some time to themselves, give em time. That, too, is a gift.

Now, as a recovering people pleaser (anxious attachments unite!), I cannot stress how important it is to establish healthy boundaries as the giver AND receiver. “No” or “not right now” is a complete answer. If someone is overstepping your boundaries and smothering you with offers to help, it may take a bit more energy to let them know your limits, but it is okay to ask for some space before they reach out again. I like the good ol’ compliment sandwich approach. “You have been so gracious in your offer to help. I am feeling overwhelmed at this time. I hold you in my heart and look forward to reaching out to you in a few weeks.” If you absolutely do not have the capacity to be the support that someone needs, you can express your love for them, regret that you cannot show up in the way that they need, but that you can offer whatever is within your capacity. It really is all about communication and having some initially uncomfortable conversations, but ultimately honest and heartfelt conversations.

Let’s get into some specific examples from my line of work. We do not handle death well as a society. It’s uncomfortable, it’s scary, and it brings up some hard emotions. When someone you know is grieving (whether that’s the loss of an elder or the loss of a baby), what’s most important to keep in mind is that eventually the calls stop, the sympathy cards peter out, the casseroles stop coming. One of the most compassionate things you can do, is check in a few weeks/months after the death. If this person is really close to you, take note of the death anniversary and try to reach out, take on an errand, or do something nice for them around that time. Say the deceased loved one’s name, and share a fond memory you have of them or a way that they may have impacted your own life. Find out if there are any cultural grief practices that would be meaningful to them (repast, sitting Shiva, military commemoration, etc). Also significant to note that someone can be grieving a loss other than a death (divorce, unemployment, friendship, physical ability).

As someone prepares to give birth, they may want some help getting the home set up and ready for baby. You can offer to wash baby’s clothes, fold, and organize them. You can offer to wash and sanitize baby bottles/pump parts. Perhaps, with their input, you can help to start a meal train for them so that they have prepared meals for the week leading up to the birth, and for the few weeks postpartum. Could they use a light housecleaning or a deep clean? You can offer it yourself or offer to pay for a service. Gift them a birth/postpartum doula (wink wink)! During postpartum, you can offer to do all of these things as well; the laundry, dishes, meals, cleaning, etc. Don’t just come over and fawn over baby. Ask and genuinely listen to how the birthing person and their partner are doing and coping. If there are other children in the home, can you babysit or take them for a day or more to help lighten the parenting load. Parents with a newborn need adult time too, so feel free to talk about things other than the children.

In general for anyone going through a life transition or celebrating something, a greeting card, a gift card, a meal, and offering your time and skills in any capacity, go a long way. Establish and maintain those boundaries so that you can show up as your full, best selves. And if folks haven’t stepped up in the way that you expected, ask if they have the capacity to help and then, if so, ask for what you need. Looking forward to hearing your feedback, as always. This is such a dope community!


Doula Jo

This Newsletter was inspired by a book I read last year, of the same title,

“How We Show Up” by Mia Birdsong. Brilliant read!