Friday, August 28, 2015

5 Ways You Can be an Amazing Birth Partner

Dads and Moms who are about to witness their partner give birth often have many concerns.  As a childbirth educator, doula, and friend I have been asked by over a thousand partners:

"What is the best way for me to help?"

It doesn't matter where you come from or how advanced you are in your profession.  When you have never before witnessed birth and are about to step up to the task of supporting your beloved on a journey famous for its intensity and unpredictability, it is normal to feel reduced to the status of "rank amateur".

Here are five tips to build your confidence and help you support the birth of your child like a pro:

1) Get Educated

Take a prenatal class that is geared towards giving you skills to work together with your partner to effectively promote comfort and relaxation thoughout labour and the postpartum period.  Make sure your options and rights will be outlined in a way that is objective and evidence based, respecting whatever choices your partner and you are thinking about making for the birth and early days of parenting.

Chat with your prospective childbirth educator before choosing a class.  Active experience in the field of childbirth and mom/baby support as well as an established excellent reputation with the doctors, nurses, and midwives in your area means your educator will have valuable insider knowledge about your place of birth.  A good prenatal class will help you to feel inspired, confident, and empowered to support your partner no matter how birth unfolds!

2) Be Present

At the end of a birth, when Baby is safely in arms, the birthing mama will usually beam at her partner and say, "I couldn't have done it without you," leaving them surprised because they often don't feel like they were particularly useful in easing most of  the discomfort.  Remember this: it isn't about what you DO, it is about how you ARE.  Birth is hard work, and while you can't do it for her, birthing moms appreciate feeling like you're fully available to be leaned on for physical and emotional support.

Since the advent of smart phones and tablets, the opportunity for distraction is always available.  It is common to hear of partners frequently updating folks outside the birthing room as to what is going on inside of it.  Whenever possible, TURN OFF YOUR DEVICE! Birthing folks don't like feeling their partner was connected to everyone else but them.

Birth is hard.  You are needed. And you only get to have this baby once.  Generally the more present you are, the richer and more bonding the birth experience can be for the family.  Birthing moms report that what they appreciated most in labour was not the fancy massage techniques their partners used or how handy they were with a stop watch, but simply how THERE they were, tuning into and quietly meeting her needs.

3) Protect the Space

I repeat: birth is hard.  Amazing and thrilling, but challenging.  Though birthing mothers are the strongest people ever, they are also vulnerable to environmental factors that can impact the groovy hormonal flow which gets the job done.  Communication skills are hard for mamas to summon when in the throes of strong labour.

Protecting her space means being a strong but gentle buffer for environmental distractions.  Especially in a hospital birth, many questions have to be asked and things explained. If you are able, field the questions you can, especially if your partner is having a contraction.  If you feel that a staff member is not understanding your partner's needs because she is too absorbed in her labour process to articulate the way she normally does, participate in the communication.  Having good prenatal education under your belt and having a clear understanding of your partners' birth preferences will help you be effective with this task. Doing so in a friendly way is always best for everyone.

If there are family members/friends who show up to your place of birth uninvited or are contributing to the environment in a not so helpful way, lovingly and compassionately explain to them that they need to leave/stop calling the room and that you will give them news AFTER the baby arrives.  If their excitement is greater than their tact and you don't want to create drama, you may engage your nurse (who has your back) to play bad cop and enforce the hospital rules about too many people in the room/clogging up the waiting room.  You will find nurses are very skilled at doing this in a way that leaves everyone's feelings intact.

4) Stand up for Birthing Mom's Wishes

What goes on in a birthing woman's body is best known to the woman herself in partnership with her caregiver.  If a woman had certain plans or expectations about labour, it is possible these things may change as the experience unfolds. Your voice is important.  This is your kid too.  Your loving encouragement can help soothe the rough edges and get her through the hardest bits. You will discuss decisions together.  But in the end, the choices will be hers.  If she wants to birth naturally and you find yourself scared of the "fierce", breathe and trust so she knows you're okay.  If she wants pain relief when you knew she wanted a natural birth no matter what you try to bring comfort, I repeat: breathe and trust. Don't take it personally. Always make her feel like the rock star she is.  Unconditional support from you helps the changes in birth expectations be embraced as empowering, not defeating.  She will carry those feelings of support and empowerment into new motherhood, shaping the quality of her experience.

5) Take Care of YOU

There was a time partners were never allowed in the birthing room. Now there is an expectation upon them to not only be there, but to be the primary source of comfort, the one to figure out how to support birthing mama's self-advocacy, know all the questions to ask, understand the benefits and risks of interventions, at the same time as being an emotionally invested and desperately sleep deprived partner and parent.  That can leave birth partners very depleted at the time they most need to take care of their new little family.

Ensure you get rest during labour's down times, remember to eat and hydrate, take breaks so you can take little walks to compose yourself, tell yourself frequently that you are doing an AMAZING job, deal gracefully with the surprise appearance of bodily fluids, ask your primary healthcare providers for information when necessary so you can make choices together about clinical care, and know that sudden barf, odd sounds, and the striking of surprising poses are perfectly normal during labour.  If this sounds overwhelming, get some support.  It feels great to have some of that pressure off so all you need to do is bring the love. Whomever you choose as a support person, they will ideally uphold you as the indispensable and primary support person that you are.

Doula care is famous for how much it supports birthing mothers, reducing the risk of common medical interventions that may not necessary for her case, increasing maternal satisfaction, etc. The case for doulas.  But doulas are there for the partner too!

No matter what, I know you're going to come through.   You've got this.

I wish you the most wonderful birth imaginable, Precious Birth Partner.


Wednesday, August 12, 2015

My Baby is a Jerk!

You have the most amazing baby in the world.  You are SO in love with this bundle of joy.  Those eyelashes nestled fan-like, ever so delicately upon his face as he sleeps....those little hands...the thigh chub...utter perfection!  We know your gratitude knows no limits for this magnificent baby of yours.  And, let's face it:


One day on a postpartum visit after a particularly long birth the mother dealt with like a rock star, the dad took me aside.  He wanted to be out of earshot of his wife who at that particular moment was cooing animatedly at their little son as he spat sour milk up all over himself, as proud of him as if he had just ended world hunger.  

Looking cautiously over his shoulder Dad said, "Don't get me wrong.  We love this baby more than words can express.  But he cries a lot.  Like, a LOT.  We worked really hard to birth him. We feed him, we change him, we hold him, we make stupid faces at him, we talk to him in voices our friends would never let us live down if they heard. We are doing our best to make him happy. We adore him, but between you and me, I think he's kind of a jerk sometimes.  I'm terrible, right?"

I hugged this earnest new papa, so invested in his child's happiness, willing to wrestle a pride of lions if need be to protect his family. He was feeling so powerless about the reality that there were times he couldn't elicit smiles and contentment from Junior despite his valiant efforts, and so guilty that he couldn't help entertaining a negative thought about this precious new life entrusted to him.

"You're not terrible at all," I reassured him. "Most parents feel like this at times. Besides, it's true," I admitted, having been in the trenches of life with New Baby a few times myself.  "Babies CAN be jerks."  

I believe it is important for parents to be able to have the space to express the truth of their frustration once in a while amidst their sweet whispers of undying love.  Lectures from those who feel the need to snap people out of their emotional struggle by reminding them how grateful they should be for their babies can serve to create shame around these occasional feelings which, if you check in with most parents, you'll find are pretty normal.

Babies are born unprofessional at this life business.  They aren't interested in keeping decent hours. They frankly don't care that you're exhausted and sporting stitches in unspeakable places on their account.  They demand attention in excessively dramatic ways.  They are incontinent.  As soon as you remove one poop saturated garment to replace it with a fresh one, they explode tiny little geese.  They throw up without apology, and rarely let you get any work done.  It is a fine day when you can take a shower AND do a load of dishes.  

There will be times when for a moment we are caught up in taking it all just a little bit personally.  The sheer magnitude of new parent love can strip us down to emotional brass tacks, exposing the soft underbelly of vulnerability which lies just beneath the thin veneer of "I have my sh*t together."  We can find ourselves feeling irrational in moments of overwhelm, ashamed at our intruding  frustration when just moments before we knew with absolute certainty there was never a more holy being on Earth than our very own baby.  

There is no need to be so hard on ourselves.  It is normal and okay to wonder sometimes if our babies (and older children) are intentionally sabotaging our efforts to be great parents. 

If you whisper to me that you secretly think your baby might be a jerk, I'll meet you in that place with empathy.  Go ahead and let off a little steam.  Your baby will not be ruined or jinxed because your parental feelings aren't always pristine. Your gratitude lives within you intact even if you've momentarily misplaced it.  I also promise not to let you know that I'm barely surviving my third teenager. Because that is a whole other story.

MotherWit Doula Care

Saturday, June 13, 2015

Five Tips for Birthworkers Dealing with Challenging Client Choices

It happens to every one of us in our careers where we will feel challenged and triggered by some of the choices a client makes for themselves.  How can we continue to serve in the best way possible?

1) Receive
Sit with what your client is saying in a receptive way.  It is important you are not attached to having their choices resonate with what you would do in any given situation. Respond in a way that demonstrates you are receiving them.  The question "Could you tell me more about that?," invites your client to express their concerns and feelings, giving you an insight into their experience. Many clients will consider choices that feel radically different from the ones you feel are healthy and empowering.  Breathe, and listen.  Get out of your head, and drop down into your heart, that place from which the deepest listening space is held.  It is only by listening and giving space for their stories to unfold that you can begin to truly understand their needs, responding appropriately and effectively.  We have two ears and one mouth for a reason: listen at least twice as much as you speak.

2) Don't React...RESEARCH!
Imagine what might happen to the conversation if you met your client with a reaction to their potential choices with words such as, "But epidurals can lead to Cesareans or perineal tearing!", or "Formula feeding isn't good for your baby!", or "That is mutilation!"

 Doulas understand that fear can impact the birthing/postpartum experience.  We must be careful not to contribute to fear with our own reactions.  For one, it doesn't honour our clients.  For another, people tend to dig in their heels and stick to their guns in defensiveness if they feel attacked.  This shuts down the opportunity to have the good information you have to share received.

Once your client has talked out their decision making process with your support, you can, if they have felt safe enough in your presence to ask for more information, provide evidence based knowledge.  A clear understanding of the benefits and risks of any given choice can be helpful in supporting a client in a decision making process, but be careful how you give it.  Check in to see if you are being "persuasive" by emphasizing certain benefits or risks according to your own bias.  We criticize "the system" for doing this all the time, and must be mindful about  not participating in this game ourselves.  Direct clients to further resources (evidence based ones) so they can do their own research too. You can refresh your own knowledge as well on the subject, in case any new evidence has come to light you haven't yet heard.

3) Respect
It is not true that "if people just knew the right information they'd make "healthier" choices".  Health encompasses more than just the body.  Sometimes choices are made based upon what clients know is right for them mentally, emotionally, spiritually, and socially.  Only they can decide what is best for their and their family's well-being.  Your job is not to "make" them choose the things you think are "right".  It is simply and truly to inform and to support choice.

4) Reflect
If your client's choice irks you so much that you are challenged in your attempts to give them your respect, honouring the reign of their sovereignty over decision making, it is time to take a look at what is making you take this so personally.  Is it possible you identify yourself as successful only if you've "made" everyone feel empowered according to your own standards?  Are you identifying with and taking on the vulnerability of your client or their baby and want to "save" them, getting caught up in some counter-transference?  Is their decision striking a painful chord in your moral/emotional landscape?  Is your ego challenged by their not choosing what you've outlined? Do you feel "in competition" with their choices? Ask yourself these things gently and lovingly.

There are many examples of why it may be too hard for you to happily and effectively serve a client every once in a while. It happens!  You're human. Don't be too hard on yourself.  All people judge.  We can't help it.  Judgement doesn't make us "bad".  It is what we do with our judgment that demonstrates our character.

5) Renew or Release
If you witness your judgment, identify your triggers (you can talk to your mentor, a counselor, or a doula colleague about this), and find that after some reflection you are indeed able to support your clients' choices with respect even though it feels tough to you, carry on!  Renew your commitment to serve in an unbiased way.  If you cannot, that is okay too.  We all have areas within that are raw and unyielding.  We are all works in progress.  Every single one of us.

It is a gift to everyone to be able to own to yourself that you cannot serve these particular clients with the open heart they need to be met with.  In this case, release them from your care gently (you don't have to share with them it's because you aren't sympatico with their choices), with referrals to other doulas you trust, and wish them a most beautiful birth experience.  You have not failed, you have succeeded in ensuring someone has the best care possible.  That in and of itself is good doula-ing.

Wednesday, April 15, 2015

Don't Give Me My Baby: Reclaiming a Vital Moment

There is an old video from Brazil called "Birth in the Squatting Position".  This video, made in the 70's, got under my skin in a huge way and took my studies, explorations, and ruminations upon birth to a whole new level.

It is not the squatting aspect of the mothers delivering their babies that is so fascinating to me.  As a long time doula, I have witnessed many women squat to give birth. I squatted myself (for many hours) to birth my first child, who remained stubbornly face-up (babies normally emerge face-down).  What excited me and moved me to a whole new level of appreciation for the team effort between Birth Giver and Baby were the things we do NOT see in this video.

The birth giver and the baby are undisturbed in the second stage of labour.  However, they are in a clinical setting, which needs to be clear.  This is a medical birthing centre, not just women squatting willy nilly in the woods.  I actually LOVE this aspect.  It demonstrates the possibility that birth givers and babies can have their cake and eat it too, meaning they can be trusted to do their work together without unnecessary distraction AND have the clinical safety net the majority of families want for those times surprises happens.  When disruptions in the normal process are radically minimized, we will likely see an increase in uncomplicated births and a decrease in the births that require a need to get the birth/baby dyad out of a potentially iatrogenic pickle.

So let's look at what we don't see:

1) Nobody is telling the birth givers to lie on their backs.  The intro to the video states that many of the women this clinic supports are very active, and when they get the opportunity to chill out, they so by squatting.  They traditionally birth in the squatting position.  So these women are doing what comes naturally, or are at least being guided to do something that is more ergonomic than the medically preferred semi-reclining (or even lithotomy) position.

2) Nobody is coaching them.  Now granted, most of these are probably not first time birth givers.  Subsequent babies do tend to come out with much greater ease.  However, in my doula practice which consists mainly of people having subsequent babies, the surge of "rush" energy rises in the room like a tidal wave, people charge in, and many voices often help them to "remember how to push".  The squatting birth givers in this video have their need for quiet and concentration respected.   I have no doubt there are some loving murmers going on that we don't hear over the flute-y music, but I highly doubt the "push harder...NO..slow down...NO push more" during the crowning/expulsion phase is going on.

Some people give birth in near silence with great focus simply breathing their babies out, and others give a high pitched shriek, often referred to as the "perineal cry".  If things are moving along well, it is probably unnecessary to tell them to do other than they are doing.  I have seen many birthers told not to scream, directed to bear down and push through that pain even when it is clear Baby is emerging without a hitch.  I wonder if that final shriek often given at the end isn't a natural way for some of the powerful energy to be dispersed, like steam from a kettle, with the result minimizing the force with which Baby comes through, and perhaps reducing tearing.

3) The birth giver's genitals and the baby's emerging head are not touched.  
It is not unusual in a hospital to see a lot of perineal and vaginal manipulation throughout the pushing phase.  It is most certainly with the kind intention to help.  But what we know about stretching things out or fiddling as a default rather than just when there is evidence it is necessary, is that it brings extra blood flow to the area.  This means it can potentially make the area thicker.  For a perineum to slip as gently over the baby's emerging head as possible, a thinner quality of tissue is likely more acceptable (Thank you, Gloria Lemay).  I wonder, though these things are hard to know for sure, if we would have LESS tearing if there were LESS touching.

I have a feeling Baby is often not happy about having its tender, oh so squished little cranium touched while trying like a little trooper to crawl out of the smallest space they will ever be in.  They are working hard.  I imagine it could be very distracting for them.

4)   The baby is not delivered by anyone but the birth giver.
There are supportive hands available to prevent any bumpy landings, as well as to intervene quickly if necessary, and perhaps to provide a little positioning help if a baby has landed on their face.  But given that squatting brings birthing bottoms close to the surface the feet are grounded, a soft place for Baby to land seems to be what's most needed.  Babies do tend to come out, even if there is nobody to "catch" them.

5) Nobody interferes with the birth givers' instincts.
In a lovely effort to get them participating with the delivery of their babies, many birth givers are encouraged to "touch their baby's heads" or to "reach down and take their babies".  This is actually a sweet gesture that many people who birth in a highly clinical setting with monitors, strangers, prescribed positions, etc. appreciate.  I used to encourage this too....until I realized as I observed (which I get to do, not having to worry about anyone's clinical safety) that most people appeared shocked and pulled out of the deep space they were in to follow my direction.

There are deep resources and motherwit within that rich inner wold of the birth giver.  Brain waves shift.  Hormones flow.  There is a primordial blueprint.  The shrieking (if there is shrieking), or thrown back head, closed eyes and perhaps the clinging tightly to someone or something are not generally signs of terror and disassociation.  Rather, they are usually signs that the birth giver is tapping into and riding a massive flow of power.

In this video, we see the women left to their own motherwit, bringing forth life without the external world assuming to know better and exerting pressure upon the experience.

6) and this is my favourite thing of all....nobody hands the birth givers their babies!

The "Birth in the Squatting Position" video suggests, as well as other studies that have observed what humans tend to do on  a primal level when left to birth undisturbed, that placing Baby directly upon the chest or abdomen is NOT "natural".  It is done in the name of "immediate skin to skin" if the hospital wants to appear progressive or simply because the bottom of the hospital birthing bed is removed, so right after birth there is nowhere else for the baby to safely go.

This is a very accepted part of our birth culture.

If you observe, though, which I have, as well as having experienced this myself, there is something that happens when someone claims their own baby.

What generally happens, is that the birth giver goes to a peak level of human experience.  As has the baby.  They are off in realms that are not akin to our normal, every day brain waves.  This is a consciousness that cannot quite be described.  If they are left undisturbed, they will stay in that space for a little while.  I have a belief that in this space, subtle "information" is being downloaded.  Genes are being activated.   Ancestral memories are being evoked. Neural pathways are being forged.  Something is being shaped. It seems like there might be some really important stuff going on that we should probably think twice about messing with.

Watch the women in this video.  They take a few deep breaths, slowly coming back to themselves a little.  When they are ready, they look kind of sideways at their babies.  With one hand first (likely their dominant hand), they touch and stroke one side of the baby (who is to say this type of touching is not part of some kind of important human activating system), and then with the other hand they stroke the other side of the baby.  Within a minute or so, these women are not handed their babies to them, they CLAIM THEM, and when they have emerged from wherever it is they went, they emerge with their babies, stepping into their identities as new parents.

When I teach prenatal classes, I let parents know that likely, unless they say otherwise, their babies will be put immediately onto their abdomens or chests.  Most of them will likely love it and grasp enthusiastically for their babies.  And some will feel shocked.  Why?  Because they are being pulled prematurely from that important place.  If birth givers are not told about this, they sometimes feel guilty, as if they are lacking in parental instinct.  They are "supposed" to want their babies plopped onto their chests by an external source.  I tell them they are simply demonstrating normal mammalian behaviour.  It is perfectly fine for them to wait until they are ready to claim their babies on their own terms (if possible), having the baby supported at their thigh, or perhaps handed over to the partner for a few moments.

A dream of mine is to see these few precious moments before Birth Giver claims Baby restored to human birth.  I want to see it as understood, honoured, and protected as the important concept of skin to skin has been.  I am excited to explore the impact this could potentially have upon humanity as a whole.  So mote it be.


Saturday, April 11, 2015

7 Steps to Owning Your Hospital Birth

You're about to give birth in a hospital.  Perhaps you're a bit nervous about how you will be treated, or about what kinds of things the health care providers are going to do with your body while you are in the throes of labour.

As a doula, I attend birth in every setting: from home births, to births in free standing centres run by midwives, to births in hospitals with family doctors or obstetricians.  A beautiful birth experience can be had anywhere.  In a hospital, however, there can be a seemingly endless sea of unfamiliar people tending to you.  Many only know your name by looking at your chart.  Fewer have time to get to know what you truly want or don't want for your birth.  This is where your need to use your  voice to stand up for your wishes (whenever possible) becomes important.

These are some tips to help you feel like you have some influence within a situation like childbirth, which can be so very unpredictable.

1)  Know Who Delivers

This is not about knowing the person who will deliver your baby when it is time.  In many hospitals, you will have no control over this, and likely, this person will be a stranger.  What it means is knowing who the power of birth giving belongs to.

A prevailing attitude among birth givers in our highly technocratic birth culture is: "Women have been having babies forever, so I'm sure it will be fine.  I trust my doctor to get my baby out."

There is a dangerous discrepancy in this statement. There is the intuition to" trust my body", but then the responsibility left entirely in the doctor's hands to "get my baby out".

Though it is acceptable to say that doctors and midwives deliver babies, if we look more closely at the truth of that, if all is going well, all they really need to do is "catch" or "receive" your baby as you give birth.  Most health care providers admit that in a normal birth, aside from a little vigilance, encouragement, and a few reasonably simple safety measures, it is you who does all the work.

After the blood, sweat, and tears of birthing a baby, the glory of delivery belongs to YOU!  Nobody can have your baby but you. Step into and deliciously own YOUR power and agency in bringing forth life.

2) Don't Leave it to Chance

The "whatever happens, happens" attitude towards childbirth does have its benefits in some ways.  It is important to be flexible when it comes to giving birth. You can certainly have a goal. Relaxation, a trust in your birthing magnificence, and positivity lend beautifully to the crafting and realization of your birth vision. Sometimes, though, your little passenger within calls some of the shots regardless of your hopes. Finding the balance between your expectations vs the reality of your birth's unfolding will leave you ready for unpredictability.

Leaving it all up to your hospital care providers and luck, however, can set you up to feel quite discombobulated if you're not prepared for certain things. You don't want things to be a shock on the big day,  like the reality of the sensations of labour, or the fact that anesthetists (if you want an epidural) aren't always available when you call them. You also don't want to miss opportunities to feel more comfortable, and should know that in many places you CAN eat if you're hungry and NOT lie on the bed if you're not happy there. Just because you're led to do something, doesn't mean you have to do it if you don't like it. Ultimately, if you don't know your options, you don't really have any.

It is so important as a pregnant person to take the time to explore how you would feel most powerful and satisfied giving birth.  It doesn't really matter how, as long as you feel GOOD about it! Envision yourself giving birth. What might you like or not like? What makes you feel better when you are stressed out and in pain?  What are your values about giving birth? Do you want to/will your health allow your birth to unfold as normally and naturally as possible, or do you feel like/know pain relief or a Cesarean birth would be an important option for you? So many things to think about!

How do you begin to look at these options?

3) Educate Yourself

Nothing beats good childbirth education which focuses on your empowerment. A prenatal class that spends ample time describing the sensations of labour and how you and your partner (if you have a partner attending your birth) can cope with the experience is an excellent idea. This is important even if you plan on having an epidural early on. Why?  Because it is not feasible to expect you can co-opt all your sensations to be relieved by drugs as soon as you want that to happen. Not because you shouldn't want that if that is your comfort zone, but because in a busy hospital, things don't always go that way. Many birth givers have to wait much longer than they wanted for their pain relief, some having their babies come before the pain relief got there. Sometimes they receive a desired epidural, only to have it not work as well as they'd hoped. So having a few solid coping skills under your belt can ensure you are able to navigate the sensations of birth no matter how things happen. This can reduce the incidence of shock and birth trauma.

A good childbirth education series should not push any kind of agenda, but be open and inclusive to all your potential choices, informing you of the important things to expect, and how to speak up for yourself.

4) Know Your Rights

Hospital birth givers have rights. Often, you can find these rights published. This is what we have here in Quebec:
Women's Rights in Pregnancy and Delivery in Quebec

Here are some examples:

a) You have the right to eat and drink as you please in labour.
b) You have the right to be informed of the benefits and risks of all medications and procedures
c) You have the right to informed consent and informed refusal.
d) You have the right to labour and deliver in any position that suits you.

Research the rights in your area!
In the US check out this book "The Rights of Patients" by George J Annas (thanks Jessica Turon!)

5) Use your BRAIN

When making decisions about your care, keep the following in your mind so you can make the best decisions for yourself.  It is important BEFORE you give birth to have an idea of what you want or don't want so self-advocacy is easier, but if you are presented with something you're not sure about, use the following questions as a guide:

B-What are the BENEFITS of the medication/procedure being offered?

R-What are the RISKS?

A-Are there any ALTERNATIVES to what you're being offered medically? (example: having a snack and going for a walk up and down stairs to try to move labour along instead of labour augmenting medication...or maybe, you'd just like to have a nap and not have your birth clock monitored)

I-What does your INTUITION say? Your motherwit, meaning your innate, practical intelligence and common sense can be more active than you imagine in labour. What does your gut tell you?

N-NOW? Health care providers are usually open to giving your body a chance to do its thing normally, so don't be afraid to ask. Also, the word NO is allowed to be said! Even if you choose something the caregivers aren't fond of, if this is your conviction, you have the right to say NO. "I do not consent." is a phrase that holds a lot of power.

Parents often worry that a doctor or nurse will walk out of the room and abandon them if they make unpopular choices, but this is not the case.  They can be challenged at times by your wanting to labour or push in different positions or refuse an episiotomy, or whatever it is you feel strongly about, it is true.  But hey are not allowed to abandon you and leave you without care.  Practicing in pregnancy how to deal calmly and effectively with other people's reactions to your choices can give you confidence. Most often, you will find your caregivers on your side and will be very happy for you if you have the birth experience you were hoping for.

6) Get Your Partner on Board

As many birth givers realize when the heat of labour is on, all of the above gets very difficult to implement because the brain goes from think-y to primal. Even just talking, never mind intellectual discernment, becomes challenging as the waves of contractions sweep you off into the hormone- hazed mind trip that is Active Labour.

Ensuring your support person knows your wishes allows them to do some advocating for you.  Nobody can ultimately speak for you in labour, however, they can relay the wishes you communicated to them prenatally, "Pat was wanting a hep lock for the Step B treatment instead of the whole IV setup," for example, while you're busy having a minute power snooze between massive contractions. Your partner is generally your strongest ally. Especially if they are one of the child's parents, they have a say!

Many people create Birth Plans or Birth Preference Sheets to articulate their desires in labour. This can be helpful IF you have the type of hospital in which caregivers have the time to read them.  Many don't.  Personally, I have never seen a birth plan make the difference between a good birth and not.  Birth Preference Sheets or Birth Plans are more effective as prenatal tools to help you explore your options and clarify your values than something to actually bring to the hospital.  They don't "protect" you from anything. Only using your voice gives you the best shot at that.

7) Hire a Doula

"If a doula were a drug, it would be unethical not to use it." -John H. Kennell, MD

While a doula cannot and will not assume to speak FOR you in labour, they will respect and uphold your sovereignty as a birth giver. They have spent  a fair bit of time with you prenatally, getting to know your hopes and fears, gathering ideas of how to tailor their support techniques to suit your own individual style. They also know what your partner needs to feel safe and supported as they witness you traversing rough and unknown terrain.

If your doula knows, for example, that you expressed a strong desire prenatally to push your baby out in the hands and knees position, and when the time comes you find the nurse turning you onto your back and putting your feet on the pedals, your doula will probably gently ask you, "Are you comfortable like this?  Is this how you want to deliver?"

Your doula will not jump in and say to the nurse, "Hey, don't put my client on her back!"  Why?  This will create tension in the room in a big way, which is the last thing you need.  Your doula will not say, "Let's get on your hands and knees.  That's how you wanted to be, so let's get you off your back now."  Why?  Because you might have changed your mind.  There is a possibility you are actually super comfy the way the nurse is positioning you and find you want to be this way after all.  Your doula will not assume.

A question like, "Are you comfortable this way?" gently nudges your hormone besotted mind to remember what you valued prenatally. It is okay if that value has changed, but the doula wants to make sure things are going how you want.  The question allows you to say, "Yes, I'm good like this." or "No, Nurse, this is not what I want."  This is the subtle, elegant way doulas serve as supporters of your self-advocacy, leading you to use your own voice whenever possible.

While experienced doulas are experts in informing, comforting, and supporting a birth giver and their partner/s, they don't generally claim to offer expert advice.  Why?  Because their job is to shine a light on your personal power and have you claim your own expertise as the one who makes, carries, births, and parents this baby/ies.  Your doula supports your work to step into this power that is already yours, and celebrates you as you own your birth.

Have a strong and wonderful birth!

Lesley Everest
MotherWit Doula Care

Tuesday, March 24, 2015

What it Means to be a Doula. Happy World Doula Week!

I want to take this opportunity to wish all the doulas on the planet a Happy World Doula Week!

When I began this work over 21 years ago, I was a pioneer in my town, forging connections and laying foundations.  When I look at the thriving doula communities we have now, knowing there are countless families who have experienced more satisfying births because of the work we doulas do, I am so very proud of us all.

When I grab the Metro home in the early morning after an all night birth, I still look at all the people going to their nine to five jobs and just want to hug them so they can get get a hit of all the yummy, oxytocin laden vibes I've just been exposed to.  How healing to be allowed to bathe in that energy for a while!   I want to thank the Powers That Be for this life....for this path...for this opportunity to serve in such a humble, intimate, yet glorious way!

As I continue to grow and settle into this work, I continue to hold the space for surprise.  This keeps me humble.  Whenever I think I might just have figured this birth thing out, Birth changes to show me it prefers to be an unsolved Mystery.  Every single birth reveals to me a new layer, a subtle nuance of learning.  Nothing has taught me more about life than attending Birth (and Death).

While being a doula is an ancient role, it is a reasonably new profession. Like many newer professions, kinks are still being worked out.  Do we strive for national standardization?  How do we find ways to make our crazy on-call work sustainable for ourselves and our families physically, emotionally, and financially?  How do we finally demonstrate to wary medical communities that we are not to be feared and mistrusted, but valued... as we value them?  What does certification really mean?  How do we honour each approach to this work while ensuring we provide the best service to our clients?  There is much to explore.  And I am excited about that!

Having the honour and privilege of training doulas around the country, I get to witness them grow into the work and forge their own communities in their unique, beautiful ways.  My heart soars, because I know the future of doula work is in good hands.  I know we will figure it out.  I know our profession will grow, be more accessible to all families who want our services, and more sustainable to those who want to make this work a career.  I know doula work will thrive.

How do I know?  Because so very many magnificent doula hearts continue to love fiercely, and continue to have hope for a world in which new life can unfurl (whenever possible) in the sweetness of honour of birth's a way that quivers with the power of miracle.  When beautiful hearts come together with love as the intention, mountains are moved.  As Hazrat Inayant Khan said, "With love, even the rocks will open."  And so it is.

I want to shout out to all my doula colleagues, doula sisters, doula students, and the primary health care providers who care for our clients.  Thank you.  With hands clasped to my heart and head bowed, I thank you.

Most of all, I want to thank the families who have invited me to bear witness to and support your births.  I carry you all in my hearts, and am indelibly changed and honed by your precious work. I have grown because of you.  I have found healing because of you.  I know who I am because of you.

Saturday, October 11, 2014

Postpartum Pressure

The season is upon us at MotherWit to embark upon our yearly postpartum doula training events.

I love autumn and winter for these trainings, because it gets us into the energy of hunkering down, lying fallow, resting up, and gathering power.  Every new parent needs this sacred time after birth to hibernate a little, and to process the lessons Birth has taught them. After their temporary withdrawal from every day life into the cocoon of the Baby Moon, they can unfurl like flowers in the spring, refreshed, renewed, vibrant, and confident in their new roles.

In "Westernized" societies, new mothers and fathers often eschew the more traditional approaches to postpartum healing, which include about a 40 day period of deep rest, within which the birther (and hopefully their partner/s as well) are fed, massaged and nurtured by older and wiser family members/friends/doulas, as well as kept skin to skin with Baby/ies for the vast majority of the time.

As a doula for over two decades, I do bear witness to the profound benefits to fully stepping into the Baby Moon period with the intention our ancestors supported. Parents seem to emerge from this potentially sweet and intense time having learned about how to tend to their particular baby/ies with a sense of calmness.  There seem to be less aches and pains.  They tend to have a greater sense of trust in their maternal/paternal decisions.  They seem less disturbed by the unpredictable ebb and flow of Baby/ie's needs.

Sadly, despite the tremendous benefits of taking advantage of the Baby Moon the way Nature seems to have intended, families often feel an incredible amount of pressure to do the opposite.  Much of this is fostered by the need to return to work soon after birth.  The work of sinking into the exploration of parenthood, rather than the frantic "let's figure it all out now, and FAST", is not at all honoured by our driven society which places higher value upon the power of "do".

New parents are often quite susceptible to this pressure.  They often feel that in order to be successful as parents, the house should look like it on the page of a magazine.  The parent who birthed should be losing the physical evidence of childbirth (soft tummy, extra padding, sleepiness, baby fog) as soon as humanly possible.  Money should be made, meals should be great, date nights arranged, schedules enforced, etc.  I get exhausted even thinking about it.

In my guidance of postpartum parents, we take a moment to honour their fears that the choice, if they are able, to sink deliciously into their Baby Moon is not always looked upon favourably.  There is often the fear that the very busy can be judgemental of those who do not appear to be very busy.

But let's look a little more closely at that. It is true media and community support a certain standard of postpartum "achievement" which can be rife with a sense of competition. We often applaud the person who may, for example, be in full hair, makeup, and heels bopping about town with a two day old (instead of offering her a chair and suggesting someone drive her home).  We ooh and ahh over the fact she barely looks like she just walked out of the delivery room.. We have to ask ourselves why we personally ascribe to this.

I have been there.  Often I still AM there. I have felt immense pressure to buy into the myth that the archetype of SuperMom/Dad is correct, and that to do otherwise denotes my failure as a "thriving" parent.  But what I finally asked myself was this: what if I unhook myself from that insane belief system, and realize that the one who exerts the greatest pressure upon me is ME?  It is easy to blame media, but what is my part in this? What is the worst that will happen if I take a few weeks after birth giving to simply hang out skin to skin with my baby lying down most of the time, reading, chilling, or taking short walks when I feel like it?  What happens if I make no apologies for my soft tummy, for holding court in bed without a shirt on when people visit, not getting up to make them coffee? What if I allow my older kids to watch movies without worrying about their development for a while, and let them go visit relatives for a few days at a time?  What if I say "YES" to offers to tidy up the obviously grungy kitchen and to hang diapers outside on the line to dry?  What if I commit to being present for all the crazy feelings and thoughts the postpartum period reveals without drowning them in "busy"?  What if I tell people right the heck off for encouraging me to smile because I have a healthy baby if I'm having a day that blows?  What if I trust the direction I want to take in how I gather information to parent instead of having it preached to me unsolicited?

I had the incredible privilege to think of asking myself these questions, it is true.  There are some new parents who are alone and without resources or community and must take care of all the kids and the household, finances, and errands on their own, sometimes in terrible situations.  But let us never refer to the Baby Moon as a luxury only for those who can afford it.  This dishonours its necessity for all human beings who have just had babies. We must also include in this people who have birthed and do not have their babies.  A period of healing and grieving  loss is necessary for them.  Parents who have new babies but who have not given birth also need time to adjust and get to know their child/ren.  Instead of "luxury", let us think of the Baby Moon more as an important healing option for those who want/need it,  What if there were a way we could work together to provide support to anyone who has just birthed/ received a child so they may get some hits of Baby Moon, even if it is only for a couple of hours at a time.? What if we invested in providing this support to our newly birthed citizens and their parents?  What would we look like as a society if this were considered of universal importance?

You know what happened when I took the plunge and chose to take my Baby Moon?  The sky did not fall.  In fact, I felt more thoroughly integrated, rested, and healed than I ever had with my first three children.  I felt more connected to my needs.  At one point I went for a walk, and went farther than my body wanted to go.  I tuned into the deep calling my body gave me to get back to my nest a little late, and really felt how beat I was after ignoring myself. When we give the time and space for Body to teach us, we absorb its lessons more readily. I learned many things during that exquisite Baby Moon, lessons which inspired me to encourage others to try taking their own Baby Moons, in whatever capacity they could, if they expressed the longing to do so.

Now I have the honour of training postpartum doulas, who are the keepers of the Baby Moon.  Even if parents do not want to take up this tradition in its entirety, the postpartum doula brings in an infusion of energy, a voice of support, and a whisper of encouragement to trust one's motherwit in the storm of postpartum recovery in a way that speaks to their unique needs.  Postpartum doulas listen, anticipate needs, gather information about what will bring the most energy to flagging parents (processing a hard birth, sleep, some tidying, baby tending lessons, feeding support,resource giving), and get the job done. We do this so the family has what they need to do their most important postpartum work, which is to bond with their new arrival/s, in whatever way they feel is best for them.  Sometimes a family who did not have a Baby Moon and is feeling the repercussions many months later seek out help, We can also offer them nurturing support to recreate that sacred space, if only for a few hours at a time.

Many families wouldn't give birth without a doula.  With the prevalence of postpartum depression, anxiety, burnout, and confusion, families are realizing the deep need to carve out a nest during their postpartum periods, relying on doulas to support them in this goal.  If this role speaks to your heart, join us!

Our next MotherWit Holistic Postpartum Doula Trainings are in Montreal (November  6th to 9th) and Toronto (November 13th to 16th).  If you are interested in an information/application package, email us at


Monday, October 6, 2014

Birth and Beyond Conference Memories

I am just settling back home after an amazing, nourishing, and crazy conference experience.

What I feel was the most important aspect of the feeling of supportive community the Vesta Parenting ladies (Birth and Beyond Conference organizers Shawn DeVree and Melanie Taylor) fostered, was the emphatic focus upon the person rather than their title.  All we had on our identity tags were our names.  Nobody knew if you were a doctor, IBCLC, midwife, nurse, doula, student, vendor, or conference presenter by virtue of your tag.  People took time to get to know each other, and people were seen for their smiles and the brightness in their eyes, their titles only discovered as the conversations unfolded.  I so appreciated this.  It actually helped me to heal a couple of prejudices.  I admit to a bit of concern at anything that speaks of sleep consultation for babies.  Yet I forged amazing relationships to beautiful souls without knowing in advance what they did, learning about their sleep work within the context of their compassion and beauty. Had I potentially shut down my mind a little to them (as I may have had their name tags announced what they did...sad to say, but in all honesty possibly true), that would have been a terrible shame.  I learned stuff about ways to support the real need for maternal sleep while supporting the needs of the night waking baby that I may have missed with bias clogging up my ears.

End of day wrap up!
From Left Dr. Jack Newman, Ina May Gaskin, Attie Sandink,Robbie Davis-Floyd,Nancy Wainer,
Gena Kerby, Adriana Lozada, Lisa Marie Thibodeau, Lesley Everest, Melissa Krawecki, Carol Peat

I have been a doula for over two decades, and have experienced most of the conference speakers before, but I've never hung out at length with them.  So that was fun. It meant a lot to me to pick some pretty amazing brains and express my gratitude for all they do to support families and babies.  This  conference was about being together in community as birth and breastfeeding workers/supporters/researchers rather than being among a hierarchy of professionals.  Everyone kind of hung out together and shared a lot of lively conversations.   Making deep connections with many people, sharing many passionate discussions, and holding space (and being held) throughout emotional process was as rich to me as sharing my work with the people who showed up to come hear me speak.

I loved every minute of The Healer Within workshop I gave, and appreciated the willingness the attendees showed for such a deep level of participation.  I felt like the talks I gave were well received given the lively conversation and questions.  I so appreciate those who reached out to tell me they enjoyed themselves.

Most of all, I want to give an enthusiastic round of applause to the organizers, their supporters, and those of us who were graciously drawn into their inner sanctum.  Ya'll know who you are.. You embraced me with open arms, fed me, checked in on me, plied me with drinks, invited me to hang with you, hugged me, let me hug you, shared stories, rubbed my feet, let me rub your feet,  and were fully your beautiful, raunchy, awesome, open, badass selves.   I couldn't have possibly loved you more. Butterflies.

Tuesday, May 20, 2014

Random Doula Tip #2: Get to Know Who Your Clients Are

I spend a lot of quality time with my clients prenatally.  I find this kind of careful attention pays off in the birthing room.  It is important for me to know who they are.

I find there can sometimes be attachment to certain "methods" of labour support.  Some doulas love Hypnobirthing, some love Bradley's, some love the Bonapace Method.  And that is great!  All of these methods contain wisdom and value.  However, and it is very important to keep this in mind: one method does not address the needs of all people.

In my doula training, a good chunk of our time is dedicated to the art of conducting prenatal meetings for birth preparation.  What do you talk about, and when?  How to you bring in the great coping skills you have learned along the way to impart to your clients?  The best way?  Listen!

Along with the important discussion topics, such as health history and talking about choices in childbirth regarding hospital routines and interventions, I like to ask: "How do you deal with stress and pain in your every day life?"  Discovering how someone copes with these things can give you decent insight into how they may like to deal with contractions.

For example if a woman replies, "If I stub my toe I like to jump around, swear really loudly, and then get a hug," this might give you the clue that your client may potentially process the sensations of labour in a kinesthetic (moving around and holding tight to people) and auditory (making noise) way.  If you wanted to explore her visual processing capacities, ask her if it would ever occur to her to visualize riding the wave of pain, or whathaveyou.  If she looks at you sideways, you realize she may not be much into imaging.  There is nothing to make a mother feel inadequate in learning coping skills if her natural faculties don't resonate with them.  Some women upon stubbing their toe will go silent, breathe deeply, and stare at a space in front of them.  USE this information to tailor personal, meaningful coping skills with them.  Many women HATE counting breaths, others need someone to speak to them gently through each contraction, and others would labour smack you if you opened your mouth made a sound.  While things can flow flexibly in labour, and as a doula it behooves you have many coping tricks up your sleeve to help your clients prepare for and cope with labour if they wish, knowing who they are can give you amazing insights into where to start.

What are some other questions?  I like to ask, "How do you envision your labour?"  or, "what concerns you most about your birthing experience?"  Exploring hopes and fears are important ways to discover what your clients' deep, internal resources are, and how you can activate their motherwit when the going gets tough.  Is it the pain she's afraid of, or is it a fear of the loss of control?  Do her expectations seem realistic given her chosen place of birth?  Is your expecting her partner to be super hands on and whisper sweet nothings in her ear appropriate when that is simply not the nature of their relationship?  Be so so sensitive to what THEY say, not to what you think they SHOULD do.  If they don't seem into what you're suggesting, move to something else.  There will always be one coping technique somewhere that will make a mom say, "Oh, yes, I think I like that one!"  Sure, sometimes women end up needing things they'd never expected, so be prepared, but having attended births for a long time, I believe they usually turn to the things they enjoy.  And those things they enjoy are usually things that are akin to how they naturally process the world around and within them. Why would she want to spend time "hoo hoo-ing" and "ha ha-ing," and looking at her partner count off with his/her fingers when everything in her longs to chant, "OOOOOOOOOPen" while keeping her mind on a still point?  Or vice versa? It is all good.

The greatest satisfaction in my work comes about when my clients are holding their babies happily and they tell me they felt deeply heard, and deeply honoured for their unique expressions.  Feeling understood and validated leads to emotional safety, and this safety is the cornerstone of doula work.

Sunday, May 11, 2014

Random Doula Tip #1: TALK to Your Labouring Clients

Happy Mother's Day, Sweet Mamas!  I haven't blogged in a long while, and have missed it.  So I thought every now and then I'd throw out some random doula tips that have helped me along the way, just to throw y'all a bone.  Please know that these are my personal opinions and stories and in no way are meant to tell you what you should do if what you are doing in your practice is already working for you.  I certainly don't have all the answers.  Keeping in mind that Birth is a great Mystery which shifts every time you get cocky enough to think there is a formula, and that every vessel Birth moves through will express the energy uniquely teaching you something every time you witness it, my musings are simply ideas and shared from my heart to yours.  This will in no way replace your own knowledge and experience.


"Well, duh, Lesley," I hear you all saying.  Hear me out for a sec.  I'm not suggesting I think doulas are busting out their best mime gestures to communicate or playing  rousing games of charades.  What I am suggesting is that you need to rely on your client's voice as much (or more) than you do her words.

Just to segue in to the meat and potatoes (or tofu and yams if you prefer) of this tip, let me share that my last "real" job was as a pastry selling, coffee making counter-girl at a restaurant called La Tulipe Noire in 1991.  After having a baby and beginning my La Leche League journey, I did my doula training in Boston with what was then Informed Home Birth/Informed Birth and Parenting (IHB/IBP), became ALACE, and is now ToLabor.  Then I hung out my "doula" shingle, and have been going strong ever since, having a few more babies, gathering many more skills along the way, and teaching lots of students to "do the doula".

All this is to say that I did not begin my career in "the communication age".  We did not have a home computer with Internet until  about 1999, like many people. So there was no information on line at your finger tips (Effective Care in Pregnancy and Childbirth by Chalmers and Enkins was the doula bible at the time), nor emailing clients to schedule. I had no cell phone.  If I was on call, I would have to check my phone messages from a PAY PHONE every hour or so.  These were the days you had to keep pockets full of change to use them.  Soon I got a pager, but I discovered that when I went on the Metro, I would not receive a page, so I had to check in via public phone every time I travelled around the city.

Now that I have revealed my dinosaur status and you can envision me rocking on my porch and shaking my head at you crazy kids and your electronic gadgets, you can imagine that it still amazes me that we can communicate by text.  Doulas receive intimate communications via invisible connections.  When I stared out, photos were still captured on film, so when I receive images of mucous plugs or poopy diapers within seconds of the image being taken, I still get little jolts of, "Wow, I never imagined this would be a possibility back when I started out!"  It is wonderful stuff.

And, we have to be careful.  Hence the name of my random doula tip.

You see, when we rely on text communication, especially when our birthing client is in labour, we miss the subtle cues the voice can reveal.  I emphasize this even more with women having subsequent babies, as their psychology can be different.  People having contractions for the first time are generally keeners. Everyone is different, which is why I say "generally", before people bombard me with how this was not their personal experience.  It wasn't mine second birth was way harder and way longer than my first. So, "generally", meaning not ALL people, but enough overall to take notice and make preparations for the possibilities thereof.  Not having experienced contractions before, and not really knowing what to expect in terms of intensity, first time contraction-ers often go to their place of birth (or call in their support) early on in the process.  Ladies birthing again tend to be much more laid back.  They have done this before, and their experience has usually told them that it is intense for a fair amount of time before a baby comes. They know that just 'cuz it hurts, doesn't mean the baby is coming. They often don't want to jump the gun. And while this is wonderful, there is often a very predictable state of denial which settles over the subsequent birther.  I see this again and again, enough that I put forth this random doula tip: TALK TO YOUR LABOURING CLIENT.

The last few births I attended, for example, were of mamas having second or third babies.  Texts revealed that contractions were far apart, that the contractions felt strong. But no no, it wasn't REAL labour, it was more that they were probably just feeling scared by the fact that the veil of partial amnesia about the reality of sensation of childbirth had lifted and were smacking themselves in the head a little bit for deciding this might be a good idea to do again.  It was all fine, just being a little wimpy, no worries, go off and do your thing and I'll call you when I think I need to go to the place of birth/call the midwife.  Doulas, this might be denial.  It is not intentional, it is not anything weird.  It just very often is a reality.  Enough that I feel it worthy to mention to newer doulas.  You veterans know exactly what I'm talking about.  After my long and hard second birth, having already been to nearly 100 births as a doula and being an experienced mama, lo and behold when I went into labour with my third, I did the very same thing.  I did not realize I was in REAL labour until ten minutes before the baby arrived.  Accidentally unassisted.  So even if your client is a birthworker herself, pay attention.  I have doula-ed doctors who themselves catch babies for a living, and they can fall into this trap too.

The last birth I attended, had I not actually called the mother to check in and relied only on her texts, she would have very possibly birthed in her car.  And I can't imagine that being very fun. The texts said that contractions were about every ten minutes, lasting maybe thirty seconds.  If you take that information at face value, as a doula you're thinking, "Oh, that's gonna go on all day, and we are just beginning," and perhaps not be on alert. Given that I don't find timing contractions very helpful when it comes to figuring if labour may be progressing, and given she told me the contractions were feeling like they were kicking her butt, I knew texts were not going to serve our purpose. I had to hear her voice to satisfy me. So we chatted on the phone, old school.  Her voice revealed right away that oxytocin and endorphins were flowing (far away and sleepy sounding between contractions), that contractions were way longer than she thought (she was only counting the peaks as worthy of notice, cuz you're often more badass the next time 'round and aren't fussed by every sensation), and were actually quite close together (she had only been counting the BIG ones, and as we doulas know about some active labours is that often Nature gives you a "butt kicker" contraction, followed by a little "cool down" contraction).  Well, those "cool down" contractions COUNT!  They do stuff.  But since they are not not as challenging, they are often reported more as just "twinges" between the "real" things.

If this had been a person experiencing contractions for the first time, it wouldn't have felt as urgent to me, but because it wasn't, and because my job is to lay out information as best I can so clients can decide what to do, I did have to let her know that while I certainly couldn't know for sure, I felt perhaps labour was more advanced than she thought.  Given a reasonably long car ride, taking that into account would be prudent.  Let's just say it was a good thing we talked.

And in my experience, though I realize other people's experience may be different, this happens SUPER frequently.  Experience has taught me (and I am a believer that it is all academic until you've actually witnessed it a few times and grounded the knowledge empirically), to be on the ball with moms who have previous experience with contractions, and to let your mouth and ears do the communicating instead of your thumbs.

Happy Sunday, and Happy Mother's Day!