What's in a form

I have gotten a few requests to share information about Doula Intake forms.
I don't know what other doula orgs do, but ALACE gives out a massive general form that is really really overwhelming (to me at least). In my doula practice, I whittled the form down to bare essentials with a lot of room for additional note-taking and found it worked great. I am happy to share a sample form with you. It is not formatted, but gives you the information to go create your own. I will post ore on other types of forms in the near future. I also welcome feedback on what is missing or needschanging in this form! Enjoy:

Creative Birth Doulas
Client Intake Form

ABOUT YOU:

CLIENT NAME DOB
OCCUPATION

PARTNER DOB
OCCUPATION

ADDRESS
CITY STATE ZIP CODE
HOME PHONE CELL/WORK PHONE
ALT PHONE ALT PHONE

RELATIONSHIP AND FAMILY INFORMATION:
HOW LONG HAVE YOU BEEN TOGETHER AND HOW DID YOU MEET?



FATHER OF BABY (if other than partner)

HOW MANY CHILDREN DO YOU HAVE? PLEASE LIST SIBLINGS NAMES AND AGES:


PETS?

OTHERS WHO LIVE IN HOUSEHOLD (names and relation to you, please)?


WHO REFERRED YOU TO OUR SERVICES?


ABOUT YOUR HEALTH CARE PROVIDERS:
PRIMARY CARE PROVIDER (ie, your doctor or midwife):
TYPE OF PRACTICE (Private, HMO, Group…): PHONE:
PLANNED PLACE OF BIRTH:
BACK UP HOSPITAL (if you are planning to give birth at home or a birth center):
If hospital/birth center:
HAVE YOU TAKEN A TOUR? REGISTERED?

BABY’S HEALTH CARE PROVIDER: PHONE:
HAVE/WILL YOU TAKE(N) CHILDBIRTH EDUCATION CLASSES?
IF SO, WITH WHOM? WHEN?
BREASTFEEDING CLASSES? WITH WHOM? WHEN?
OTHER PRENATAL CLASSES? (ie, yoga, infant cpr…)
OTHER HEALTH CARE PROVIDERS YOU SEE (ie, acupuncturist, naturopath, therapist, etc…)
FEELINGS/QUESTIONS/CONCERNS ABOUT THE CARE YOU ARE RECEIVING?


CLIENT’S HEALTH HISTORY:
HOW IS YOUR HEALTH?
ANY ALLERGIES?
WHAT IS YOUR DIET? (vegetarian? Special needs?)
VITAMINS/SUPPLEMENTS?
ROUTINE OR OTC MEDICATIONS?
DO YOU DRINK ALCOHOL? QUANTITY/FREQUENCY
DO YOU SMOKE? QUANTITY/FREQUENCY
PRESENT EXERCISE AND FREQUENCY
ARE YOU CURRENTLY RECEIVING CARE FOR ANY HEALTH ISSUES?
IF SO, FOR WHAT?
HOW IS YOUR MENTAL AND EMOTIONAL HEALTH?

OPTIONAL: DO YOU HAVE ANY HISTORY OF PERSONAL TRAUMA (ie, abuse, assault, or anything else you want to discuss as we prepare a safe space for your birth experience)?
ANYTHING ELSE YOU WANT TO SHARE ABOUT YOUR PHYSICAL AND/OR EMOTIONAL HEALTH AS RELATED TO YOUR PREGNANCY AND BIRTH?




FAMILY INFORMATION:
CLIENT, WHERE DOES YOUR FAMILY LIVE?
PARTNER (if applicable), WHERE DOES YOUR FAMILY LIVE?
PLEASE BRIEFLY DESCRIBE YOUR RELATIONSHIP WITH YOUR AND YOUR PARTNER’S FAMILIES:

PLANS FOR FAMILY TO BE INVOLVED WITH BIRTH OR POSTPARTUM PERIOD?
ANY RELEVANT INFORMATION YOU WOULD LIKE YOUR DOULA TO KNOW OR UNDERSTAND ABOUT FAMILY OR FRIENDS INVOLVED IN THE BIRTH PROCESS?

CURRENT PREGNANCY/CHILDBEARING HISTORY:
WAS THIS A PLANNED PREGNANCY?
HOW DO YOU FEEL ABOUT THIS PREGNANCY?
WHAT IS YOUR ESTIMATED DUE DATE (EDD)?
HAVE YOU BEEN PREGNANT BEFORE? HOW MANY TIMES?

HAVE YOU GIVEN BIRTH BEFORE? HOW MANY TIMES?
HOW MANY CHILDREN DO YOU CURRENTLY HAVE?
HAVE YOU BREASTFED BEFORE? IF SO, ANY SPECIAL CONCERNS FOR THIS
TIME?
HAVE YOU EVER HAD POSTPARTUM DEPRESSION? MOTHER/SISTERS?




CIRCLE ANY THAT APPLY FOR THIS PREGNANCY:
INDIGESTION FATIGUE/TIREDNESS MUSCLE CRAMPS
ANXIETY HEMORRHOIDS NAUSEA/VOMITING
CARPAL TUNNEL SYNDROME INCONTINENCE SHORTNESS OF BREATH
CONSTIPATION, DIARRHEA LACK OF SLEEP SWELLING

ANY MEDICAL COMPLICATIONS THIS PREGNANCY?





ABOUT YOUR BIRTH (feel free to use as much space as you need to answer questions):
MOTHER: WHAT IS YOUR VISION FOR THIS BIRTH? (PLEASE BE SPECIFIC):








PARTNER (if applicable):WHAT IS YOUR VISION FOR THIS BIRTH? (AGAIN, PLEASE BE SPECIFIC):







WHAT ARE YOUR EXPECTATIONS OF YOUR LABOR ASSISTANT/DOULA PROVIDER?






WHAT IS YOUR PLAN FOR COPING WITH THE INTENSITY OF LABOR? ANY SPECIAL IDEAS ABOUT WHAT YOU MIGHT LIKE FOR LABOR (ie, massage, aromatherapy, special snacks…) OR ARE THERE ANY SPECIAL POSITIONS OR TECHNIQUES YOU WOULD LIKE TO USE?






PLEASE BRIEFLY DESCRIBE YOUR PREGNANCY AND BIRTH HISTORY IN YOUR OWN WORDS (if applicable):




DO YOU HAVE ANY EMOTIONAL OR PHYSICAL ASPECTS OF PREPARATION FOR BIRTH YOU WOULD LIKE SPECIAL ATTENTION, INFORMATION, OR SUPPORT FOR?






DO YOU HAVE A BIRTH PLAN? REVIEWED WITH CAREGIVERS?
IF YOU HAVE A BIRTH PLAN, PLEASE MAKE SURE TO GET A COPY TO YOUR DOULA!


ANYTHING ELSE YOU WOULD LIKE YOUR DOULA TO BE AWARE OF TO PROVIDE THE BEST SUPPORT POSSIBLE DURING YOUR LABOR AND BIRTH?







THANK YOU!

Addressing our Culture of Fear

Thanks to the folks who posted comments recently. I LOVE and NEED feedback from all of you so that I can pull from your ideas and address relevant topics in the field. I would still love to hear what challenges that you are facing or what topics you want see discussed from a Creative Birth perspective, so don't hold back!

One of the last comments (Thanks Lyndsay) stated:

Something I have been thinking about these past 8.5 months is how fear corrupts a gentle birth. We cannot be present, loving of our bodies and our unborn babes if we are overcome with fear of the birth process and our bodies. Fear creates a negative chemical environment in our bodies for both mom and unborn babe...

I couldn't have said that better and I wanted to come back to that point to discuss a number of ways that fear corrupts our health and well-being and also that of our babies. Our culture is rife with messages that instill fear and anxiety into our hearts and minds. Women's bodies sell millions of products for companies capitalizing on the fact that sex sells. Women are told in one form or another to be thin, to be curvy, to be motherly and nurturing yet also sexy and seductive, that we need to buy "things" to be happy and whole, that our bodies are imperfect, that we are this, that...

Basically people will tell us anything if it will make them money.

In the book, Selling Anxiety, by Caryl Rivers (2007), Rivers points out that "The news media sell anxiety to women the way advertising sells insecurity about their faces, bodies and sex appeal...Today, not only is the news embedded with images created by advertisers to sell products, but, increasingly, the news itself is becoming infected with the values, attitudes, and requirements of infotainment" (2-3).

This is relevant because we need to first realize that our culture's fear and anxiety, particularly about women's bodies, is pervasive. It is everywhere- not just in ads anymore, but even in the nightly news reported as fact. It is SOLD to us! And, we buy it.

Bring this back to pregnancy and birth and what does this translate as?

A culture of childbearing women who have been sold fear for much of their lives. And when we become pregnant, those messages don't suddenly *POOF* and disappear. Instead, for many, they are the platform from which we begin our life as mothers.

Women are then brought into a medical culture that tends to look for what's wrong rather than discuss what's right and, voila, this is a recipe for keeping women scared of their bodies, their babies, pregnancy and birth. After all, companies (including medical companies) need to sell and pregnancy, birth, and motherhood are new opportunities to market toward.

I think some level of fear is completely normal and natural and healthy. After all, fear has developed evolutionarily as a protective mechanism and can still function as such. And, let's face it- birth is always an unknown. For those who have given birth before, you get the idea, but each birth is different and we have no conscious control over it, which is, yah, pretty scary.

But, it's what we do with our fear and our underlying belief structure that affects the context of fear. Imagine that same fear in a different context- say one of reassurance.

For example, a woman who is told

• her body is normal, healthy, and whole
• birth is a normal life event
• that all she has to do to have an optimally healthy pregnancy is eat well and take care of herself
• the baby is an active and wise participant in birth
• that she is beautiful and sexy at every stage
• that birth is also sexual
  
• that many women have fun, or even orgasm in labor
• that even if birth is hard and painful, her body will know exactly what to do and she can do it
• that she doesn't need to buy or have anything to be "ready" to be a mother
• that motherhood, like birth, is hard, but she can do it
• that "we," (as some collective of people) trust in her body...

Well, I think you get the idea that fear in this context can be acknowledged, but not validated as ultimate truth. Anxiety would be much easier to ultimately let go of if these were the pervasive messages we heard all our lives.

This is why doulas are important. Because a good doula will be sending these positive, affirming messages explicitly and by example and therefore, mitigating some of our cultures messages of fear and anxiety. This, though in no way replaces a women-positive culture, acts as a small but vital piece of creating a healthy environment for a woman's experience of fear in pregnancy, birth and postpartum. This is also what the midwifery model aims to hold as basic tenants of their philosophy and culture. If only the midwifery model was the norm around here!

I would love to write even more and expound upon my ideas further, but I will save this for what will be inevitably more conversations on the topic.

PLEASE SHARE~ I want to know your stories of your own fear in pregnancy, birth and postpartum. How did you deal with it? What were some ways you worked to affirm trust in your body and baby? Did you have someone to support you in this process? How did they help?

Why a Gentle Birth?

My partner Matt is a video-guy/video producer wonderman and together we are trying to enter a video contest for Birth Matters Virginia to be judged by some of the most recognized names in birth, like Sarah Buckley, MD, and video, Ricki Lake and Abby Epstein (makers of The Business of Being Born).

The basic premise of our video is to promote the idea of Gentle Birth. What is Gentle Birth? I thought I might organize some of my thoughts here.

The basic premise of Gentle Birth is to respect the mother and baby in the birth process. This respect translates many different ways. Here are some:

• Respecting the mother's birth choices
• Honoring the birthing mother's right to move, act, birth as she pleases in whatever way she pleases
• Access to food and drink in labor and birth.
• Trusting a women's body and its intuitive knowledge of how to give birth.
• Trusting and Respecting the baby and the baby's active role in the birth process.
• Little to no intervention unless medically necessary (as opposed to routine)
• Acknowledgment of the affects of drugs on mom and baby, and the benefits of being drug-free
  
• Access to non-pharmocological pain relief (ie- water, movement, making noise, massage, etc...)
• Mother-led pushing or "breathing down"
• Honoring an un-broken mother baby diad and keeping the baby and mother together in the postpartum with skin-to-skin contact and early breastfeeding.
  
• Honoring the baby as a sentient being who also has their own experience of birth and can feel a range of physical and emotional sensations.
  

These ideas are ideas that are part of the Midwifery Model of Care, a model based on the fact that pregnancy and birth are normal life experiences and not considered medical events unless there is a complication or situation that necessitates medical attention. Midwives practice in hospitals, birth centers and attend home births and some doctors practice in the midwifery model. But because hospitals are required to have protocol, it's often difficult to opt out of routine procedures and escape the medicalized views that those protocols enforce. I have attended many beautiful births at hospitals and I have also attended many beautiful births at birth centers and home.

I am a strong advocate for home birth for the reason that with the right Certified Professional Midwife (CPM), the basic tenants of the miwifery model are upheld in the prenatal, birth and postpartum care of women and their babies. Home birth is a wonderful setting to set the stage for a truly gentle birth because a woman is free to listen to her body, trust herself and her baby, birth in awareness without pain medicaion, and to have the space to freely bond with her baby postpartum. Recent studies have shown that for low-risk, healthy women and babies, home birth is as safe and associated with lower levels of intervention than hospital births.

I will post a link to our finished video when it's complete along with some more resources to support the idea of gentle birth. In the meantime, here are some websites with more information on the ideas discussed above:

www.gentlebirth.org
www.sarahjbuckley.com
www.mana.org
mothersnaturally.org

Please send me your comments and ideas about gentle birth and any other resources you might have to share about this topic!

Who I am, What This Is.

I am so glad to begin this blog as a guide to doulas who want their questions answered, who want tips, tricks, event information, and information about their profession. The field of labor support is getting ever more popular and I find that in the years I have been a doula, it's becoming more and more frequent that when people ask me what I do and I say

"I am a doula"or "I do labor support"

they nod and smile. I used to get crazy looks of uncertainty when the word doula parted from my lips. Or people thought I did labor/union organizing- no, no. This is definitely not union organizing!

My name is Gina Forbes and I am a co-founder of Creative Birth Doulas, a Boston-based doula collective offering a range of birth services to women and their families in the childbearing year. I was trained as a doula with ALACE in 2004 (now certified) and began my independent practice immediately. I was instantly enthralled with the work I was doing. It was an honor and privilege to step into the lives of each of my clients and walk with them on the intimate and special journey of welcoming new life into their family. I attended births all over Boston- at the major hospitals, the Cambridge Birth Center, and homebirths all over the place. I loved guiding women in their birth choices and supporting families. I loved, of course, seeing and meeting each new baby, but also witnessing the birth of new mothers and fathers as they transformed from men and women into parents. I didn't even mond the crazy hours and sleep-deprivation because I love birth!

Soon after being trained, I began meeting regularly with Sarafina Kennedy and Corina Pinkerton, two other ALACE doulas, for support and inspiration. We quickly identified our amazing chemistry together and named ourselves the Creative Birth Doulas (CBD). It felt right to call ourselves "creative" because we placed a great value in honoring differences in choice and perspective and felt particularly creative with the ways in which we could support a diversity of women to birth their babies. We also birthed myriad ideas in each others presences, creating new energy for us each to take to our work and our clients.

We enjoyed our blissed out years of work together. My doula work led me also to midwifery training and supported me through an apprenticeship and studying to become a CPM. I also worked at ALACE for several years as their Workshop Coordinator and more recently as Executive Director. But then something happened- I got creative in other ways. Yup, it was my turn to have a baby. To grossly summarize, I became pregnant in Feb 2008, went to Senegal with the African Birth Collective during my first trimester to attend births, came back and went to some more births in the Boston area until I was 5 month pregnant and then I stopped.

I stopped doing births for several reasons. One, I was tired. Two, I moved to Maine to be with my partner. Three, I don't know, but I felt a new era of birth work was before me. I just didn't want to be a new mom and be on-call. I started to feel something else was in my future and, sure enough, on November 6, 2008, I became a full-time mom to Chester Thomas and he has been my life and work since. Motherhood has wrapped her arms around me and taken me in. I am 100% a mothr all the time and, for me, that means birth work is on a temporary hiatus.

But, folks who know me know that I can't sit still for long. So, here I am.

The point of this blog is to use my years of experience as a doula and birth professional to be a resource and guide to other doulas. One could say I am a doula to the doulas- guiding, educating, and empowering you to get out there and offer the best labor support you can. I hope to provide tips, tricks, information, tools...all to make your job as a doula as easy as can be. I want to see how my guide can grow to also offer basic shopping for your doula tools and who knows what else. But, for now, this is my start.

Welcome to A Creative Birth Guide to Doula-ing.