The Lumineers playing...

A woman spiraling
a partner drawing
a woman in the shower
a cat watching
a doula holding
a fan blowing
a strong woman
a boy crying
a midwife whispering
a bird singing
a grandma helping
a boy in the rain
a lost cat
a push
a pant
a baby at home!

(Photo courtesy of dad Chad Smith. Extra love always to mum Carie. Love to midwives Gillian and Carolyn and Patti. Hugs to grandma Smith and big brother Bruce, the boy in the rain...and the cats. And kisses to bonny Alice.)

Cascade of interventions in first-time mothers with term births who experienced labour

Today, the report "Listening to Mothers III: Pregnancy and Birth" was released. I saw that the data suggested that the highest percentage of cesareans came from the induction group.

I looked at my own data from the past 12 months (N=30) for first-time mothers who experienced labour (so gone are the multip births, the scheduled cesareans for placenta previa, the premature births, etc.) Of the 87% of clients who did not have an induction, there were NO cesareans. Of the 13% of clients who had inductions, 100% of them had epidurals and 50% of those women had cesareans. Overall, of the 30 clients who fit the criteria (two were at home), the epidural rate was 40% and the overall cesarean rate was 13%. Interesting.

See my hand-drawn results below the pretty chart.

I will publish my complete stats for the past few years soon, and will tease out some more of the interesting results, including VBACs (I believe the past year's VBAC success rate was 100%), home birth stats, and more.

Enjoy!

"I see someone has been food shopping!"

“I see someone has been food shopping!”

One little sentence spoken by one little boy,

In an epic pose,

Hand on hip,

Peering into my fridge.

We just looked at each other

Eyes shining

And we laughed!

It was a simple statement.

At three years old, Finn knows that his Dagum (Grandad) and I (Deecy) keep quite an empty fridge. We tend to do European-style daily shopping for our meals - whatever we can carry home in baskets or on my bike. We eat very well. He was just genuinely surprised to see that we’d filled the fridge before he (and Jack, of course) arrived for a sleepover.

But, what if an adult had said that to me? Would those words have been interpreted as a comment on my (lack of) organizational skills? If I had just announced a pregnancy, or embarked on a postpartum weight loss challenge, think of the potential impact. My confidence would have been shaken. I might even remember the comment for a lifetime.

“Does she think I bought the wrong stuff? Is she going to critique me on my fruit purchases? Do I have too much dairy? Too much carbs? I shouldn’t be eating meat…or maybe I should? So glad she didn’t open the freezer! She just eats nuts and seeds.”

Yes, Finn’s innocent comment started me thinking about how much we read into what other people say to us, especially when we are pregnant. “What was she implying when she said that?” “Was he judging me?” The resulting guilt and loss of confidence can really shake us to the core.

I still remember the sleepless nights spent thinking about my weight gain (or lack thereof) and eating habits (or urges) during my pregnancies, just as clearly as if it was yesterday.

At 16 weeks in my first pregnancy, I had a nutritional consultation at our local health unit. I’d had to record my food intake for a week.  “Not enough cheese, I see,” said the nutritionist, shaking her head. “Not enough crackers. You’ll have to add more snacks throughout the day – cheese and crackers.” She looked me in the eye. I’m sure she would have been fine if I ate something different, but I spent the rest of my pregnancy scouting out different cheeses and something other than Carr’s water biscuits.

I had an obstetrician (for no particular reason). At 35 weeks, he said, “Let’s see if you’ve grown this week.” Yes, the italics were in his tone. All I could think was, “Didn’t I grow last week? What’s with the emphasis?” I went home and worried. At 38 weeks, I was sent for an ultrasound "for suspected IUGR"...growth RETARDATION???, and told to expect a baby under six pounds at birth, and told to eat more.

At 40 weeks, I stood on the scale so the nurse could weigh me. I had gained fifteen pounds in a week! “Oh, my!” said the nurse. “You’ve been eating some good meals this week!” I looked down, shocked, but then I started laughing. I was holding heavy shopping bags in each hand! It wasn’t until I was home that I felt the true absurdity of the situation. If I had been able to weigh myself (or even been given the right to NOT be weighed) like an autonomous healthy adult, I certainly wouldn’t be recalling this event 26 years later!

No one ever asked about our food habits. No one knew that we rode our bikes to Granville Island to buy our food, cooked wonderful meals, and grew our own summer vegetables.

Just to let you know…at birth, my daughter was a happy chunky 8.5 pounds…cheese or no cheese.

In contrast, during my second pregnancy, I was in charge of my chart. I wrote down my weight (if I liked) and checked my urine myself before each prenatal visit.  I was treated as an adult. I was trusted. We talked about nutrition, sharing recipes and ideas and laughing about the comedy of pregnancy. No judgment. No pronouncements. All the comments were positive. “Oh, what a bonny baby!” didn’t make me worry that I was eating the wrong food. It filled me with pride and confidence. I’d made a bonny baby! The experienced hands palpating my uterus belonged to Sheena Mavis. She described my “cavernous pelvis” so I could easily imagine birthing my baby (who, after a joyful labour, turned out to be a slippery 9.5 pounds).

What astonishes me is that my clients still describe similar critiques of their weight gain or food intake.  “It makes me feel like a child,” said one client recently. “I can’t even be trusted to weigh myself or eat properly. I have a CSA and my caregiver has no clue!” (We laughed together!) Don't think that one caregiver type or another make these comments - it's across the board. We all say these things. Thoughtless comments (without any implied meaning) can have such a negative impact.  Rather than expecting people to stop making these comments, we must become more informed and increase our confidence in our bodies.

We need to arm ourselves with the best evidence, so these comments won’t touch us. I love how the current BC Maternity Care Pathway comments on the practice of weighing a woman in pregnancy, “Some women may not wish to be weighed regularly. Since the evidence for any benefit is not strong, the woman’s preference should be a consideration.” It recommends that caregivers “advise women to refer to Healthy Pregnancy BC, a BC online resource for women related to healthy eating and healthy weight gain.” It expects that women can be trusted to educate themselves about healthy eating and weight regulation in pregnancy.

The UK NICE guidelines (which I love for its simplicity and clarity) lists “antenatal interventions not routinely recommended”, which include:

•            Repeated maternal weighing 
•       Iron or vitamin A supplements 
•       Ultrasound estimation of fetal size for suspected large-for-gestational age unborn babies 
•       Routine ultrasound scanning after 24 weeks 
•       Gestational diabetes screening using fasting plasma glucose, random blood glucose, glucose challenge test or urinalysis for glucose

      For more information, go to Eating Well, BMI Calculator, Healthy Eating, have fun walking to the Farm Markets, and, if you really need to enter a supermarket, make it as organic as you can, and cruise the outer rim of the store (where the unprocessed foods are), and keep your armour on when anyone says, "I see someone has been food shopping!"

The Garden and the Family

When I joined my husband's family, I found that I had to learn a new language...latin! All his sisters seemed to be avid gardeners and would chatter about moving the pieris japonica, or the joys of alchemilla mollis (I love showing children how the rain drops glisten on this plant, also known as Lady's Mantle). Three of us were pregnant at the same time, and we would dig and plant flowers and vegetables at the family cabin as our bellies grew, after our babies were born, and as our extended family expanded. Pregnancy strengthened our need to nurture the gardens.

As my love of birth grew, so did my bookshelves fill with gardening books that linked women's bodies and plants, from Herbal Healing for Women to Susun Weed's Wise Woman's Herbal, The Complete Book of Herbs, Plants of Coastal British Columbia (great on car trips!) and Michael Pollan's books, the first of which was my favourite, Second Nature.  I discovered that the Lady's Mantle that I loved has been used since medieval times as a medicinal herb, and rainwater collected in the leaves was used for its alleged magical powers. I never tested its use as a tea to reduce excessive period bleeding, but I like knowing that women in the past had used this plant for that purpose.

Crawling on hands and knees, digging and dividing in the perennial garden, helped me to turn my son from posterior to anterior.  Squatting and weeding between the vegetable rows helped prepare me for my daughter's birth. There's no sitting still when you have a growing garden! Sheila Kitzinger's daughter laboured in her garden and held trees as she pushed. My own clients have laboured on hillsides in the dark, in Queen Elizabeth Park by the flowers, leaning on trees, and squatting on the grass. Many birthing centres in warm climates encourage women to labour in gardens specifically landscaped for labour and birth. This "Birth in Nature" video shows a woman whose labour is entirely outdoors.

One Master Gardener, Donna Guillemin, opened my eyes to the "art" of gardening, and the world of Plant Spirit Medicine. While I would work in my garden, raising my children and attending births, she would (seemingly magically) help clients of mine to conceive, or cure their PUPPS, or relieve their anxiety. She would send them (or me) to Finlandia Pharmacy or Gaia Garden for tinctures and teas, if her own tinctures and teas weren't quite what was needed.

Fast forward to today - and we have two more helpers, Jack and Finn, in the garden. They have changed the soundscape of my mother's garden - windchimes, stellar's jays and shrieks of laughter are now heard over the sound of the sprinkler. They are also learning to ask if they're pulling out a weed or a plant, or if the berry they hold in their hands is a "bird berry" or a "people berry". We pull and squat and crawl in the dirt and work hard and play hard together. From age 3 to 89, our family work together in the garden, connecting to the earth and each other.

Do we garden safely? Pregnant or not, we try to remember to wear our gloves (or at least have a good soap and water wash at the end of a gardening session), and take precautions to avoid toxoplasmosis or chemicals, and avoid strains or sprains. But any potential risks of gardening during pregnancy (or postpartum or otherwise) are far outweighed by the positive emotional, physical and spiritual benefits (check out the Canadian Horticultural Therapy Association for more). 

Our gardens in Point Roberts, Tsawwassen, and Vancouver have nurtured four generations of our family. They have helped our babies turn into the perfect position, strengthened our legs for labour, watched us nurse our babies on the grass, calmed our minds when we've been anxious, and cleared our heads when the 21st century has been going too fast. Sure, we buy our vegetables most years (yes, we must connect more with the Urban Farmer)...but we try to buy local and ride our bikes or walk to the local farmers markets. This year's markets open this weekend!

So, if you're starting to grow a baby, try adding a garden to your family.  There you will find joy for a lifetime (and you might just be able to avoid a posterior labour, too!)

Doula Myths...and the Reality

Oh, those urban doula myths...they just keep circulating...

Myth #1: 
I'm always fully booked. 
The reality: I always have openings! I currently have 2 spaces available per month from August through the end of December 2013.  Many clients call as soon as they're pregnant, but, it's never too early nor too late to call. Sometimes, clients birth early (or move away), making room for a last-minute client. So, please email or phone me and we can have a good chat!

Myth #2:
I work with 7-10 clients per month. 
The reality: Eek! I'm a busy doula, but not because I work with that many clients.  I actually book an average of 4 clients per month (to a maximum 50 births a year). That way, I am able to attend 98% of my client's births each year, and rarely need a back-up doula. (In fact, my last missed birth was in September 2011, when I was in Europe.)


Why the myths might have started:
Myth #1: Yes, I am often fully booked within a month or two of a due date, so please call early.
Myth #2: Yes, there are some rare months when I might attend six births. Earlier this year, one baby was born at 32 weeks, one at 38, one at 40, and another at 42 weeks - all in a 6 day period. Then two more babies came the very next week. Nature has a wry sense of humour. My "4 births a month" concept can be just a dream at times.

Deeper into the reality:
So, with just four booked clients a month, I often do short "tea visits" before a client books me. Then I make two prenatal visits with each family in their home...and I might squeeze in an extra visit if a client would benefit from the extra care in the final anxious weeks.  I also allow lots of time for postpartum visits, and any extra breastfeeding help that might be needed. Yes, I often have to reschedule some visits so I can attend a birth...but that's the way birth works. It's random. It's unexpected. It's also amazing.

Going slow:
Because I walk, cycle, or car2go to client visits in a small catchment area, there's a natural slow pace to each day. Today, my first prenatal visit was at 9am, but I was able to chat with another postpartum client on the phone as I walked over (yes, the end of the phone call was spied by my client, as I stood on a blustery corner below her window).  Then I walked to Matchstick to warm up before my second "repeat client" visit, while answering new client emails. Later, I talked with some postpartum clients before popping over to see another family for their first prenatal visit. All told, I had three client visits today, and connected with another 11 clients.

Yours forever:
11 client chats in a day? That's right. I always tell my clients that "I'm yours forever", so I do spend time each day connecting with former clients, answering their questions, brainstorming, and talking about breastfeeding, parenting, sleep!, growth spurts, baby-led weaning, and more sleep! It keeps me current, connected. And I hope each client comes away feeling uplifted, confident that she can trust her instincts and her baby.

Slow and Simple Parenting:
I also spend as many days as I can (hopefully, 2-3 days a week) with "the boys", my twin three year old grandsons, to do field research for Slow and Simple parenting. (Okay...it's not just research!) And I am also in the early days of facilitating the Slow and Simple Parenting monthly sessions at Pacific Midwifery.

So, please don't hesitate - give me a call. If I don't pick up right away, I might just be slowly riding my bike to a client visit. Or I might be pulling two boys and their dinosaurs to the park in their big red wagon. Yes, I'm a busy doula. But be assured, I'll call you as soon as I pull over!

The Possible Effect of Yaletown Condo Living on Labour Length

Pssst. I think I have discovered a secret formula for birth. I know, I know, every labour is unique and distinct, and you just can't apply a formula to birth. But, this has worked so many times recently that it's blogworthy. Here's the secret:

1. Take one new condo with a view of the water (False Creek, especially).
2. Add one spacious and powerful shower.
3. Add one first-time labouring woman whose contractions have just dipped under the 5 minute mark.
4. Take one doula who says, "I will sit silently on the floor outside this door so you can labour undisturbed. I hope you will be able to stay in the shower for at least 45 minutes. I won't disturb you, but I will respond to you if you express a feeling or a need or ask me a question. But remember these words. Trust your body. Trust your baby. You are strong. You are spiraling your baby down, down and through. You are open, wide open."
5. Take one partner who says, "I will make sure everything is ready for you when you need to come out of the shower. I will put towels in the dryer for you, and place the clothes you will need on our bed. I will not disturb you. I will be here when you need me. I trust you, I trust our baby, and I trust your body."
6. Add filtered sunlight through a crack in the door.
7. Add liquids and food within easy reach.
8. Add the sounds of an iTunes playlist created by the woman, her partner, or loved ones.
9. Gradually, add the apparent dissolution of time and space.
10. Add one fast elevator and a short drive to the hospital (or the arrival of two midwives at home)...and the addition of a baby soon after with very little (okay...maybe a little) drama.

Okay...there's more to Step 10, but you get the idea.

I've just had such luck lately with condo labours, with unlimited showers, beautiful views of the water, no disturbance, a fast elevator ride, and a short drive to the hospital (if planned) with few stop lights. And, recently, one woman never made it out of the quiet dark space, and gave birth on her bathroom floor (yes, her midwife was there).

Am I just in the middle of a statistical blip that balances the challenging births of this past Fall, or am I onto something here?

I pulled the info from my database, and was truly surprised to discover the high percentage of women living in the tall condos around False Creek (think Yaletown, Crosstown, Fairview, Olympic Village, etc.) who have had relatively short labours requiring limited technology or assistance. Okay, I'm not just imagining things. But why are these labours going so well???

Perhaps, it's the women who live in condos in Vancouver? Okay...I'll give you that one.

Perhaps, it's the unlimited hot water.  I have had similar experiences with women who have laboured at home in tiny basement suites with flash hot water heaters. But, it's rare to have a flash heater in a single family dwelling in Vancouver.

Perhaps, it's the speedy elevators. One study linked a fast elevator ride with a reduction in cesareans (strangely, the working theory was the elevator ride to the OR somehow repositioned the baby, resulting in the cancellation of the surgery).

Perhaps, it's the ability of these women to remain undisturbed high up in a concrete condo. No one knocks unannounced if you live on the 23rd floor. There are no mail carriers tromping up your stairs. No garbage trucks barreling down the lane. No neighbours to worry about. We know that disturbance can slow down a labour (we've seen the effects of jackhammers in the hospital during renovations and a labour speeding up after the roofers go home for the day).

Perhaps, the answer is as simple as one word. Many women have said the word "spiraling" had a huge impact on their labour. "I saw myself as being calm, zen, quiet, in the middle of a storm, and the baby was spinning, spiraling down to earth. I released everything, and the baby starting pushing his way out!"  Aha! Ina May Gaskin's sphincter law in action.

Or it could be that one special song that her partner added to the playlist.

Or it could be his, "I trust you," that made all the difference.

So...I guess I have to retract my announcement of a secret formula. There are so many combinations of things that can add up to a smooth and short labour. Each labour takes as long as it needs. Each baby takes as long as it needs. Each woman takes as long as she needs. You aren't at a disadvantage if you don't live in a condo with unlimited hot water. There is a big world out there.  You can have lovely smooth labours in Dunbar and on The Drive, inside or outside, in birth pools or on dry land with slow dances and kisses and just one word. You can also have a challenging birth. That's just how it is sometimes.

I'm sorry that I took you on lighthearted ride to look at our universal need to make sense of birth.  I doubt there's a secret formula involving Vancouver condos. But, if you remove all the noise and chatter from the labour equation, you might just find one word, one concept, interwoven throughout...

That one secret word might just be...

undisturbed

(Although, in an alternate universe, I would dearly love to know the results of a randomized controlled trial on "The Effect of Living in Yaletown Condos on the Length of Labour in Primiparous Women".)

Slow and Simple Parenting - "What's going on in there? Life and sleep from baby's perspective"

How do you develop a rhythm of feeding, sleeping, and playing with your baby? How do you listen beyond your baby's cries to connect with her and understand her needs? How do you achieve balance between parenting and your other roles and relationships?

Slow and simple parenting, as an extension of the slow movement, aims to discover each family's pace, respect each family's needs, and nurture stronger connections within communities. These monthly sessions are designed to empower new and expectant parents with skills and knowledge to slow down and enjoy parenting. Slow and simple lessons of connected, conscious, and conscientious parenting will take you from pregnancy to beyond the teen years. Our discussions will weave together practical and philosophical approaches to:

• Breastfeeding
• Sleeping
• Baby wearing
• Diapering and elimination communication
• Physical and mental well-being
• Relationships
• And more...

The topic for our second evening is: "What's going on in there? Life and sleep from baby's perspective"
May 22, 2013, from 6:30-8:00pm

at Pacific Midwifery 1540 W 2nd Avenue, Vancouver

$20 per family

Email vancouverdoula@gmail.com to preregister

PREREGISTER NOW FOR MAY 22nd 

Jacquie Munro, founder of the "Slow Birth" movement, is an experienced doula and childbirth educator and is well-known for her individualized, intuitive approach to supporting families in the childbearing year and beyond. Since 1987, she has provided support at over one thousand births, at home and in hospital, and taught thousands of expectant parents. At home, Jacquie lives only a bike ride away from four generations of her family. You can usually find her at the park or beach, playing beside her twin grandsons who call her "Deecy".

Slow travel, Slow Birth, Slow Family

Venice, Liguria, the Tour de France, Provence and Catalonia are calling! I'll be cycling and hiking and loving the slow travel with my husband for 5 weeks at the beginning of summer.

I'm fully booked until we leave, but there's still plenty of space for new families with due dates from August 15th onwards.  I'm getting calls for due dates right up to December now, so please book me soon!  It's never too early to connect!

In addition to my doula care, I now offer monthly Slow and Simple Parenting evenings at Pacific Midwifery.  We are hoping to build a Slow Family community, combining expectant parents and new families (0-3 months). Please email for dates and to preregister.

There also seems to be a lot of interest in starting sessions for families with older babies and toddlers, the Slow and Simple Parenting way (Slow Movement meets Attachment Parenting meets RIE meets Nature Preschool meets Reggio Emilia concepts, with a dash of Waldorf!) So please get in touch and you can be in at the beginning!

- Jacquie Munro

A Lesson from the Fall

With maturity there comes
an
awareness

that there is darkness at birth

Walk with it. Respect it. Never forget it.

But do not make your choices
out of fear
of the darkness

Trust birth

Trust

birth

Slow and Simple Parenting

How do you develop a rhythm of feeding, sleeping, and playing with your baby? How do you listen beyond your baby's cries to connect with her and understand her needs? How do you achieve balance between parenting and your other roles and relationships?

Slow and simple parenting, as an extension of the slow movement, aims to discover each family's pace, respect each family's needs, and nurture stronger connections within communities. These monthly sessions are designed to empower new and expectant parents with skills and knowledge to slow down and enjoy parenting. Slow and simple lessons of connected, conscious, and conscientious parenting will take you from pregnancy to beyond the teen years. Our discussions will weave together practical and philosophical approaches to:

• Breastfeeding
• Sleeping
• Baby wearing
• Diapering and elimination communication
• Physical and mental well-being
• Relationships
• And more...

The topic for our second evening is: "What's going on in there? Life and sleep from baby's perspective"
May 22, 2013, from 6:30-8:00pm

at Pacific Midwifery 1540 W 2nd Avenue, Vancouver

$20 per family

Email vancouverdoula@gmail.com to preregister

PREREGISTER NOW FOR MAY 22nd 

Jacquie Munro, founder of the "Slow Birth" movement, is an experienced doula and childbirth educator and is well-known for her individualized, intuitive approach to supporting families in the childbearing year and beyond. Since 1987, she has provided support at over one thousand births, at home and in hospital, and taught thousands of expectant parents. At home, Jacquie lives only a bike ride away from four generations of her family. You can usually find her at the park or beach, playing beside her twin grandsons who call her "Deecy".

1000 Births

A baby called Wyn was born this week, and in that moment I reached 1000 births.

Wyn is connected to all those 1000 births through his mother, through me. Every birth, every woman, has left me with a lesson, a memory...something that has helped the next woman and baby. One touch of the hand connects us.

It's not a straight chain. It's a wonderful, tangled, messy linking of hands. But birth is wonderful and messy...so that's just about right.

Someone asked how I'm sure I've reached 1000 births. I've kept a record of every birth that I've attended, every family, and all their connections, right from the first birth I attended in 1987. At first, my notes were written in a coil binder. Blue cursive writing. Now, I have my complete database on my MacBook. It's organized, but not as much fun to read through as those early binders, stuffed with baby photos and years of Christmas cards showing taller and taller children.

But there's one part of the dry database that I love to study - the connections. Wyn's mother is connected to Evan's mother through me...and Kian's mother through work...on and on...interwoven connections, through three generations. I'm now a grandmother. My first clients' babies are grown up and are starting to have babies. I have attended the births of all the women in some families. I have learned so much from this community of 1000 women.

I love running into them on my rounds..."Hi Beth!" (on Granville Island, as I run to grab a car to head downtown to visit a week old baby and his mum)  "Hi Sarah!" (at Elysian Coffee while I meet someone new). Even after the babies are born, I try to keep those links strong. "Beth - I have another client who's interested in EC." or "Tara...I have a client who would dearly love to hear from you." then "Leigh...someone might be calling you." We are always making more connections.

After 1000 births (there's more than 1000 babies - think twins!), you'd think that the births would blur together. But, nope.  I have lightbulb memories of each and every woman who has given birth. It's never usually the moment of birth.  It's often the memory of a sound "shhhhhhh, ha ha ha, shhhhh"...or the memory of the smell of ylang ylang in the tub...or the glorious snapshot of how she threw a scarf around her neck as she grabbed the keys and ran out into the snow at 7 centimetres.  A thousand connected images stretching back 25 years. Each one, a lesson.

This past year has been strange. The most challenging births ever started to coming one by one as summer (and birth 1000) approached. Everything seemed to slow right down.  I was forced to take notice, be aware. I couldn't write about any of it. I just had to live it. It was like the birth gods knew I could handle new and unusual scenarios now. So they came.

One. at. a. time.

The births were messy and tangled and, in the end, in the end, the drama ended. The stitches have healed. Finn has a new heart. The preemies are home. The babies have safely left the NICU. They are all at home, in their mum's arms. But the emotions are still swirling.

So, I will leave the story-telling of these births for another time. Right now, I'm weaving one memory from each of these births into the memories of all the other 1000 births. Making connections and giving thanks. And I'm hoping that birth 1001 will be smooth...

- Jacquie Munro, Slow Birth, Vancouver Doula

**With so many thanks to the 1000 mums...and dads and babies and families and friends...who have held my hands and taught me for 25 years.
**In memory of Dr. Kerry Telford Morrissey and Debra Karby, who are woven into our hearts.
** Thanks to Adam and Ever, for the photo of their hands...

The challenge of slow birth

I spent today delivering the new Slow Birth doula cards to different practitioners' offices. One supportive physician read the words "slow birth", and laughed - "Some of our doctors won't like that...they're always talking about births that are progressing too slowly!" 


...slow...birth...


These words might prove challenging for some people. 


I am an example of Slow Birth. This is my 25th year as a doula, and I will attend my 1000th client's baby's birth this year. And I think maybe, just maybe, I'm starting to understand birth. It has been a slow gradual process. Each birth teaches me what I need to know for the next birth. Birth forces me to slow down, then stop, then really look at it. I feel like I'm just starting to fully appreciate the nuance of birth. 


It shakes me and demands my respect.


I have heard some people say that I know birth. I don't. None of us can truly know birth, because each birth is totally different.  But, I know this much - Birth takes its time. Birth is challenging in every way. Birth doesn't respond easily to control or what we want. Birth loves surprises.


...slow...birth...


So, think about it. Slow Birth is not about having a slow labour, or having a fast labour. Slow Birth is about honouring birth and surrendering to the rhythm of the body and the baby.


Slow Birth reminds me to take whatever time is needed to prepare each family for the early years of parenting. This takes time. Time on the phone. Time in person. Time texting back and forth. Time talking, laughing, crying. Every client requires a different approach. This is not a conveyor belt. It's not textbook. It is a creative process. It is bespoke. It is organic. It is slow.


As a Slow Birth doula, my job is to remain aware, to remain flexible, to read the body, to translate its messages, to listen to each woman and family, to remind each woman that she can trust her body, to help her draw on her life lessons, to help her build her own community. 


Slow Birth, as an extension of the slow movement, is my commitment to each doula client and her family to nurture stronger connections, and to discover each family's pace, each family's needs.  Slow Birth is about supporting the birth of each family with time and care. Ultimately, the aim is to help clients build their own connections within their community, slow down, and enjoy the first years of family life together. 


Whatever is needed...as long as it takes...that's what Slow Birth is about. 


- Jacquie Munro - Slow Birth, Vancouver Doula

On Surfing...and Facebook...

Googling during pregnancy can be a big bad scary activity.  For sanity's sake, I encourage clients to avoid general googling of pregnancy topics at this time.  I do, however, encourage clients to become informed about birth, breastfeeding and parenting. How can you filter all the information? My favourite books and research resources are linked on my site, so that's a great place to start.

But, another easy way to have a steady flow of current research and opinions and an overview of "best practice" is to "like" some of the great sites below on Facebook. And don't forget to bookmark the best birth and parenting websites that I have linked in the sidebar (for those burning questions at 4am!)

In no particular order, here are some recent articles/sites/videos that I recommend:

The Alpha Parent The Timeline of a Breastfed Baby
KellyMom (!!!) Sleeping Through the Night
Lakeshore Medical Breastfeeding Clinic (Dr Jen) Just One Bottle and Breastfed Newborn Weight Loss
TED Talks The Shocking Truth about your Health and What We Learn Before We're Born and The Linguistic Genius of Babies
NPR What's Behind A Temper Tantrum?
Mother-Baby Behavioral Sleep Lab Dr James McKenna
Infant Sleep as a Public Health Issue (10 parts) Dr Wendy Hall
Mothering Car Seats are for Cars

These are some great Facebook pages that you can "Like":
Power To Push (Best Birth Clinic)
Family Practice Maternity Service (BirthDocs)
Science & Sensibility

Enjoy the surf! More to come...

12 Times a Day...

I have a dilemma...after 24 years as a doula, I'm still trying to discover the best way to help pregnant women have a successful start to breastfeeding. 

Breastfeeding classes are great, La Leche League meetings are supportive, our talks over months of pregnancy provide continuity, the breastfeeding books are inspiring, kellymom.com and Dr. Jack Newman's videos are linked on my blog. But one client just nailed the problem on the head in a phone call tonight: "It feels like I'm putting the cart before the horse if I try to think about breastfeeding now! I'm trying to finish up at work! I feel like I'm not prepared to have the baby yet! I have to get the baby born! I can't think about breastfeeding now!" (Yes, I know, I'm paraphrasing, but the exclamation marks were certainly there.)

My clients say that everything flies out the window as soon as the baby is born.  In the first few days, despite my encouragement to each woman to feed her baby skin to skin, and to feed early and often (12 feeds per day gets you a gold star!), both sleep deprivation and the overwhelming nature of being a new parent can shatter prior learning and all self confidence. Add to that a stream of visitors, and you have a perfect storm. No wonder the breastfeeding relationship suffers or sputters to a halt.

So, what will work? Talk to each other. Find yourself a friend who will be your breastfeeding mentor. Put the cart before the horse. Start to build your breastfeeding community!

To start you on the right path, I've asked some of my clients to write down their words of wisdom after a year of breastfeeding. Many clients are ready and willing to offer their support and be your mentor. So, first up, let's hear from Abby!  

"When I gave birth to my daughter I, like every other new mom, was completely exhausted. I was (and still am) dedicated to breastfeeding my daughter so when the nurses in the hospital told me to breastfeed 8-12 times per day I made sure to feed her at least 8 times per day (sometimes 9) and I thought I was doing great! 3 weeks later she wasn't gaining enough weight and I was diagnosed with "low milk supply." I was devastated and I couldn't understand it -- I was doing everything right, wasn't I? 

After many visits with lactation consultants, many hours with my pump, and many breastfeeding articles later I had a realization: I should have been feeding my baby AT LEAST 12 TIMES A DAY, or even better every hour. You're going to be tired anyways, so buy a good breast feeding pillow, sit back, watch TV, snooze, avoid visitors, and feed your baby all day! You'll be surprised how relaxing it is. Your breasts need the stimulation from your baby and your baby's brain needs nutrition constantly. It took me months to learn all this so I hope that my experience can help other new moms learn this in minutes instead of months. My daughter is now 1, and I have met many women who were diagnosed with "low milk supply." Every time we went to a baby class there was at least 1 or 2 women who had the same problem as me. That just can't be right. We were made to feed our babies to it can't be possible that so many women "can't make enough milk." Many women may be able to make enough milk with minimal stimulation (i.e. 8 times a day), but a large minority of us cannot. So PLEASE FEED YOUR BABY AT LEAST 12 TIMES A DAY!" - Abby, mum to Ellie 

(One way to keep track of those 12 feeds per 24 hours, without relying on a clock, is to have two bowls by your breastfeeding "station".  One bowl is filled with 12 pennies.  Just move a penny over to the second bowl after a feed.  At the end of 12 hours, just look and see how many of the pennies have been moved to the second bowl. How are you doing? Will you be able to make 12 feeds in the day? No worries if you're a bit low on feeds. You can just pick it up. No need to write anything down. No need to look at the clock. No need to stress! It's just a great way to feel the rhythm of breastfeeding your baby in the first few weeks.)  

Slow Birth return!

Look who's back at Vancouver Doula ...and Slow Birth! My daughter, Sarah, is returning from her maternity leave to provide doula services to clients, as well as providing additional breastfeeding services. Welcome back!

"Born and raised in Vancouver and mentored by my doula mum, Jacquie, I have always been passionate about women's health. Since the age of 4, I have watched my mum care for hundreds of families -- slipping out in the night to attend births, coaching women through breastfeeding struggles, chatting with them over tea about the life changes a baby would bring.  

As an adult, I initially (and naively) resisted the calling to support childbearing women and pursued graduate studies at the University of British Columbia, studying women's sexuality and reproductive lives in early modern literature. This work naturally evolved into more contemporary studies of childbirth and in 2007, when I completed my Master's degree, I began working actively in doula care. In 2008, to better support mums postpartum, I gained my certificate in Breastfeeding Support for Health Care Professionals from Douglas College. 

I've pursued my other passion, academic research, in parallel with my doula and breastfeeding practice. I am currently on leave from doctoral studies, in which I explore informed choice in the childbearing year. Through my work with the Rural Maternity Care New Emerging Team at UBC, I have published qualitative (interview-based) research on midwifery in Canada, decision making for caesarean delivery, and sustainable rural maternity services. Slow birth and slow parenting are also a research passion, and I weave those philosophies into my doula and breastfeeding practice. 

Since the birth of my twin boys, Jack and Finn, in 2010, my desire to support new mothers has only intensified and I am excited to return to doula care with some new experiences under my belt, including both a home birth and a hospital delivery, and nursing twins into toddlerhood (we're still going at 19 months).  

I am honoured to be part of Jacquie's practice again and to support families through birth, breastfeeding, and beyond."  - Sarah Munro, BA (Hons), MA

I'm back and ready for babies!

I'm back from the land of scarves (Paris) and gelato (Italy), art, churches, sparkling seas and rolling hills...and so many babies!

We saw babies in Paris, Tuscany and the Cinque Terre being carried in slings, Ergo carriers, and wraps (so much easier on cobblestone streets than strollers!)...children singing while skipping home for lunch...restaurants welcoming children of all ages...children being greeted and twirled around by Nonnas and Mamas...and many playgrounds tucked into tiny squares.

Birth issues seemed to be everywhere...even on Medieval streets...

One street in Volterra, Italy, was decorated with branches covered in blue ribbons. At first I thought the branches were a local custom, announcing a home birth of a baby. But, it turns out that there has been a big fight to retain birth services in Volterra.  A pilot project allowing women to give birth locally had been scheduled to end in July.  So, why were the branches on this street in September? Had a woman given birth at home recently, against local recommendation? Or were the branches part of a protest against the removal of services? I'd love it if any Italian-speaking clients would read local news articles and let me know!

But, I learned that, no matter where I am, even when I'm on holiday, my thoughts do not stray far from the focus of my passion...birth, babies, mothers...

So, please don't hesitate to contact me by phone or email now... I'm home, rested and ready for babies again!

Nine Months of Babies (or...and so we embark on a slow travel journey...)

It's been 9 months of babies...35 women, 35 births...since I last wrote a blog post.  Three sets of sparkling twins, 2 out of 2 successful and life-changing VBACs, six joyful home births (one with only 16 recorded active labour contractions!), one surprise vaginal breech birth, a few fourth babies and many first babies, eight wonderful repeat clients, more than a few speedy car rides, and many sleepless hard-labouring nights... 

These babies and their mums teach me about strength, acceptance and love daily.

In between the births, and the client phone calls (both pregnancy and postpartum), and the visits to help with breastfeeding, I get to be gran to a pretty great pair of toddlers. You can find us most days (in between some long stroller walks) at Rosemary Brown Park and Kits Beach Park. Join us if you like diggers and soccer balls!

Very early in the morning (and late at night) I try to stay current by reading as much birth/child-related research as I can, but you can also find me reading Kellymom, First the Egg and Dr. Jen as well as Paris by Mouth, Joel Henriques and Apartment Therapy. It's all about balance, right?

Ah, balance...

To that end, we're off to Europe on our annual slow travel journey. So many clients have told me that they were married in Siena (or got engaged in the Cinque Terre...or conceived their baby in Florence), that we decided we just had to find out what the fuss was all about.  So, Italy awaits! Oh, and Paris, too...

This is my only chance to take a break during the year (mine is a 24/7 on-call life), so please understand that I won't be receiving calls until the end of September (the 28th should be fine). I still have room for a few more babies in November (why is November always a slow month?), and in February (and beyond!) 

Please don't hesitate to email me at Vancouver Doula, but expect a sloooow response until my return from la dolce vita.

- Jacquie Munro, Vancouver Doula

The Sweat Lodge

This Christmas Day, I offer you the gift of a story told by a new client:

I see that going into the sweat lodge in remote northern Ontario when I was 17 is something that I can use to propel me through birth. The experience was a powerful one then and now, as I face a long pregnancy and its culminating labour, the event is taking on new significance and its power is spinning in the expanding darkness of my womb.

I went into the sweat lodge to heal. I didn’t even know what parts of me needed healing. All I knew was that I was being offered a chance to experience something profound that might just change the course of my life. The sweat lodge itself was like a womb--dark inside but for the orange glow of rocks heated by fire until they took on their own light. The air was wet from water sprayed periodically on the burning rocks that would immediately vapourize and turn the tight dome into a small ocean that housed us all. There were perhaps ten girls and two men -- our first nations guides on this journey into the Sweat.

Once we had all gathered inside and been given instructions the animal skin flap of the sweat lodge was closed and we were cradled in primal darkness. I could feel the other girls breathing around me. I could feel the warmth of their bodies and their anxious energy. We didn’t know where we were journeying to or what sort of people we might be once we emerged from our process of rebirth. It was a moment very similar to what I have been experiencing in my state of early pregnancy, where very little has changed on the surface of things but I can feel strange ripples of energy coursing through my body and smell the electric smell of great change rolling in like a summer storm.

My memories of the Sweat are hazy. But images flash back to me like prophecies. I think there was a drum. The steady heartbeat of the world reminding us of our embodied state. The sweat has four stages each marked by one of the sacred herbs--sage, sweetgrass, cedar, and tobacco. At the end of each stage the lodge would be opened and we would have the choice to leave or to stay on for the next stage. We could decide that we had learned what we came to learn or that we needed to go deeper to reach whatever lesson was meant for us. Inside the sweat lodge I descended into the core of the earth to access the essence of myself. I imagine labour will be much like that--a spiralling downward into the most secret spaces of the soul where reserves of power you never imagined you had can be accessed and put to use.

I floated in the humid air of the sweat lodge as the ceremony commenced. It wasn’t long before I was soaked with the wet air and my own sweat that poured out of me like rain. My body slowly emptied itself of fluids and I’m sure that I became severely dehydrated. Stories poured out of us with the sweat. We told of our young lives’ greatest hurts, the things that were holding us back and torturing us. Tears began to mingle with the sweat. Girls cried out in pain or because they saw visions emerging from the blackness. Each time the flap was opened at the end of a stage some would leave, desperate for water, content that they had gleaned all they could, or simply exhausted physically and mentally.

I was becoming worn down myself. My body needed water and I was deeply aware of that. But I couldn’t bring myself to leave. I was sure that there was something at the end of all this that would be worth the suffering and somehow, amidst the agony of the Sweat I was able toembrace the experience as transformative. By the end of the Sweat I was deep within my own body and had become animalistic in my thoughts and movements. I was lying on the dirt floor of the lodge with my head in the lap of another girl. I was screaming a low animal scream that originated deep in my throat and resonated at my core. I clawed the ground like a dying creature letting the earth bury itself under my nails. I thought that I might die yet refused to leave until the flap was opened for the final time.

I find that my memories of the Sweat sound much like the experiences of labouring women who find intense beauty amidst pain, fear, and confusion. Labouring women connect to their animal selves just as I did in the suffocating final moments of the Sweat. And while I wasn’t comfortable or even fully conscious of the world around me I believed that I was safe. I believed that the guides wouldn’t let me come to harm, that the girls would hold me. This feeling of safety in the midst of chaos will be crucial to birth as well. I will need to feel that I am held in competent arms and that I will be told if there is real danger at hand. I think that if I can maintain a feeling of safety that I will be able to bear whatever pain or discomfort comes my way and hold on to the belief that bodily trial can be a gateway to spiritual truths.

When the sweat was finally over I lifted myself up off the earth and ate canned fruit that was being passed around. As liquid and sugar entered my body I felt deep relief and also a great sense of well being for having made it to the end. I drank water and water has never again tasted so pure and delicious. When I stepped out of the lodge I was given a moment that will forever be a part of my personal mythology. I emerged from the heat of that womb and into the cold fresh air of the northern summer night. The sky was spattered with stars and I walked carefully on unsteady legs to the edge of the lake where the water was black and silent. I let the air cool me and many of the girls swam in the midnight waves, coming fully alive after touching the edges of death. Time had lost all meaning. I have no sense of how long I stayed in the sweat lodge. It could have been minutes or hours. All I know is that I went in when the sun was still up and when I came out it was long past sunset.

I will hold on to the sweat lodge when I enter labour. I will let time lose meaning and surrender to the animal impulses of my body--letting it cry out when it needs to and growl deep in the throat and belly. I will let myself be cradled by my husband and the midwives, and doula who will attend me. I will remember that I am safe so that I can ride out the waves of birth without getting lost entirely. I see suddenly the the sweat lodge was a gift that I didn’t see the full value of at the time. It was a perfect preparation for birth given to me in days when I never expected to have a child. How strange that I can travel backwards now and see new aspects of the experience and new ways to apply it. I have already been both the mother and the child: The labouring woman clawing the earth in wild torment and the new baby crawling from the womb into the wide wide world under the slowly gyrating sky. May this experience give me strength and courage in the months to come and at the moment of birth.

"It doesn't get easier, it just gets different"

As part of my doula service, I provide two prenatal visits, attend my clients' births, then make a postpartum visit to debrief and hug, but that's only the tip of the iceberg.

I encourage my clients to call or email me frequently...for years (yes, I mean that). I'm often on the phone for a few hours each day, answering clients' questions, brainstorming, or providing support and encouragement. I encourage my clients to call me whenever a question arises during pregnancy or postpartum, which is SO much more helpful than asking them to store it up for visits. We're able to work through each concern in the moment.

Please don't be shy about calling! It makes everything smoother in the long run!

Recently, I checked in with a former client to see how things were going (three years after she gave birth to twins). "Any words of wisdom?" I asked.

"It doesn't get easier, it just gets different," she said.

I've been a mum for 27 years, and I've cared for over 900 families as a doula...but with those few words, she reminded me of the daily reality of mothering little ones.

Change comes in an ever widening circle. Change comes daily with a newborn, then weekly...then monthly...then yearly, as she grows. The physical and emotional challenges of raising children are dynamic. "Someone keeps moving the goal posts!" said one client. "Did they cover this prenatal class!? I can't remember anything anymore!"

Who knew that flexibility, creativity and spontaneity (along with a whole whack of family and community support) were the keys to successful parenting? In the beginning, we thought we just had to learn the basic rules of "How to Parent" and everything would be smooth sailing! Boy, were we wrong! It's all about rolling with the changes...

But you don't have to reinvent the wheel. You are not alone! Someone else is going through the same thing...right now...

So, give me a call. Whatever you're dealing with...I've probably chatted with another client about something similar, just yesterday. And maybe, you might just want to connect with her. Together, we can support each other through the daily changes and challenges of mothering.

For example...One day this week I was standing in the rain on Granville Street, discussing a woman's overabundant milk supply, then an hour later I received a call in the IGA about another baby gagging and spluttering on his mum's gushing breast milk.

Then, the next day, I was sitting in my parked car talking with another client about how to increase her low milk supply, just before receiving a call from a different client to ask about donor milk.

Various solutions, including the "Eats on Feets" Facebook group (community milk-sharing), the local Donor Milk Bank, and my favourite lactation consultant, popped into my mind. Personal connections were made...and they were off!

Yesterday, a mum called looking for some support dealing with the changes that happen around six weeks. She had found her rhythm a few weeks earlier. Feeds had been going well, sleep had become more predictable. Then...wham! the six week growth spurt had begun. Her baby had become more alert and started to sleep less. She was having to feed more to increase her milk supply. The goal posts had moved!

We talked...I made tea while we talked...and we talked some more...

I'd better call her again on Monday to check in, and encourage her to go to her local community mum's group.

Every time a client calls me with a mothering question, it increases my ability to support the next woman. Each woman teaches me something completely new. I encourage her to share her experiences at the local mum's group or La Leche League meeting. We each strengthen the chain of women helping women. We support each other through the daily changes.

I won't tell you what to do when you call. None of this parenting stuff is black and white. I'll just help you add to your mothering tool chest, share recent research, brainstorm.

But, above all, I'll just do my very best to listen.

I'll do my best to share the wisdom that I've learned from my years as a mum (oh, gosh...and now a grandma, too!) and as a doula, and learned from all my other clients.

Yes, there will be times when I won't have the experience to address your particular problem. But, at the very least, I'll know someone...maybe a professional...or maybe even another mum...who will be able to give you the tools to help yourself.

And then, I'll remind you that each day will be a mix of joy and tears and laughter. That's mothering. It's always changing, it's always challenging. It's never boring.

My client was right..."It doesn't get easier. It just gets different."

Jacquie Munro - Vancouver Doula

What have I been doing all this time?

Well, it's been 8 months! I think I must have been rather busy, to have left my blog for this long!

In addition to my doula work, "loving the grandsons" was added to my list of passions. With twins, there's a lot of room for family involvement, so we've all been chipping in daily to help our daughter and son-in-law and their brood. My memory of this past summer is long long walks by the seashore with my husband, carrying the boys in slings, allowing their parents a break at home...to sleep or eat, or just plain enjoy the peace and quiet.

It's been eight months filled with love and joy (we're not the sleepless ones).

Is there any downside? I tend to forget things more easily now, with so many things happening every day, but my iCal alerts keep me on task. So, clients...please call me before or after your prenatal visits for a chat if I haven't called you already. And when you call me, you might find that I whisper when I answer (sleeping babies!), and I might screen some prospective clients' calls if I'm rocking a tired boy while another stands holding my leg (I just can't reach my phone). Please accept my apologies in advance. BUT...the upside is that I now have a renewed and updated understanding of breastfeeding issues, sleep issues, introduction of solids, safety issues, attachment parenting...and a multitude of other topics. It's like I'm living a daily refresher course in how to support my clients through their pregnancies and postpartum experiences. You will benefit!

I'm now taking on fewer clients per month (4-5 at the most), so that I'm (hopefully) able to provide the best care to all. So, you'll need to call me early in pregnancy to book a spot. With this growing family, I'm learning to multitask all over again - and love it!

So, please don't hesitate to call or email! I'm here...just covered in babies from time to time....

Jacquie - Vancouver Doula

Dear Jacquie...

Dear Jacquie,

We've not met, but I just wanted to thank you for my daughter's birth. I live in Edinburgh, although I'm from Victoria, B.C, and I stumbled across your blog about a year ago. My son (who's now 2) was born in hospital: my flat wasn't big enough to fit a birth pool and 2 midwives, and I hoped I could have a water birth in hospital instead. In the end, I was induced due to blood pressure and got a very controlled, restricted labour: I was on my back, monitored, for the whole thing.

When I became pregnant last spring, your blog was the final inspiration I needed to plan a home birth. You and Ina May were my encouragement through 4 days of slow contractions. In the end, though, my beautiful daughter came racing into the world, one hand over her head, into an empty bathtub. (The midwife had arrived 17 minutes before and let the water out of the bath to check me over...never happened! The birthing pool was filled and waiting in the next room but into the empty bathtub she came.) I had a wonderful, wonderful birth with no one monitoring, examining, or worrying me and the difference in my two birth stories still amazes me.

I'm attaching a photo of me and Rosa with my midwife team, an hour after the birth (the one in blue was the midwife, the one in white was a student on her first week - I was her first birth!, and the one behind was the second midwife who arrived 20 minutes too late).

I have loved reading your blog, and I really can't thank you enough for the inspiration you gave me.

All the best,

R (Edinburgh)