Interviewing Doctors and Midwives: What should you ask? | Ruth Castillo Salty Mama Doula

Interviewing Doctors & Midwives: What should you ask?

Picking out a doctor or midwife for your pregnancy can be tough!  There are so many factors that we want to (and need to!) consider.  Does this Nurse-Midwife take your insurance? Does this OB have privileges at the hospital you liked?  A quick search will give you lists and interview forms – pages upon pages of questions such as

  • “How many years have you practiced?”,
  • “Are you board-certified?”, and,
  • “What’s your rate of inductions and cesareans?”.

While those are some great questions to ask, you might not get a good feel for the provider out of yes-or-no questions.  So I leave you with some questions that may not be on your typical checklist: Continue reading

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What Defines a birth? Cesarean birth and language choice | Ruth Castillo, Salty Mama Doula & Family Services

What defines a “birth”?

A closeup photograph of a dictionary entry for the word, "birth". | Ruth Castillo, Salty Mama Doula & Family Services

Birth: a : the emergence of a new individual from the body of its parent
b : the act or process of bringing forth young from the womb. 
Birth.” Merriam-Webster.com. Merriam-Webster, n.d. Web. 5 Apr. 2017.

Who decides what counts as a birth or not?

“Vaginal” and “natural” are often used synonymously to describe birth; instead of considering that “cesarean” would be the antonym, some people would rather use language that detaches “cesarean” completely from “birth”.  There are those who reject phrasing such as “cesarean birth” because it would normalize cesareans as a part of the birth landscape – as if 1 in 3 American births was not by cesarean.  Some people feel that since a surgeon intervened in delivering baby, that it was not “giving birth”.  Toxic thinking like this leaves some parents feeling detached from the experience of their child’s birth.

But cesareans are births.  The body still must open, and baby must come out.

So who decides what counts as a birth?

You do.

Ultimately, you define birth when you do it.  For you birth, may be a very active, all-hands-on-deck birth at home with two doulas, a photographer, a midwife and her assistants, and your family.  Birth might be a quiet affair with just you and your partner in a hospital.  Birth might even be a cesarean.

I most often use “cesarean birth” when I work with clients or speak of my own experience, but I also say cesarean, cesarean section, section, C-section, and surgical birth. Why? When I work with clients as their doula or childbirth educator, I use reflective language. Mirroring the phrasing and language my clients use gives them the power to define their experience. I want to validate that some of my clients give birth via cesarean, and that their journey and decisions are just as valid and valued.

Birth workers like myself, will always work towards encouraging healthy pregnancy and birth practices — practices that increase the overall health of all parents and infants.  When we work on a one-on-one level, we step back from philosophy and support each individual where they are.

I help people as they navigate pregnancy and birth, however that happens. I will always help them find the best practices to use for their health – physical and mental.  If my use of the phrase “cesarean birth” helps them to frame their experience of their child’s birth, then that is precisely what I plan to do.  Because language matters.

What does a doula look like? Blog header Ruth Castillo Salty Mama Doula San Antonio Texas

What Does a Doula Look Like?

What does a doula look like?

I honestly could not tell you.

Sorry. There is no one type of person who pursues doula work. Doulas provide support in many different situations and different people find themselves doing this work, so there’s no one doula “uniform”.

I can tell you what you can expect to see in your doula:

Continue reading

I Went to a Cuddlist and I Loved It

A couple of days ago, I told my partner that I needed more touch – I needed an intensive massage or something. He’s been working third shift for a few months now and we have had some trouble finding the balance to hang out, much less cuddle or be intimate. We have made a concerted effort to steal away for date nights, but it had been a few weeks. I needed nonsexual touch.

Enter an acquaintance of mine: just a day after this conversation with my husband, she posted on Facebook. She was completing training to be a Certified Cuddlist and needed someone for a taped session. I laughed about it for a hot second – who would want to go to a relative stranger’s home and pay to snuggle? Then I stopped and realized that was exactly what I needed. It’s hard to place the need for touch on Maslow’s Hierarchy of Needs, but I knew I was lacking it.

Why not seek out someone who had training in understanding that need?

So I messaged her to arrange the session.

It. Was. Perfect.

I drove up to the house where our session would take place. I was wearing my best attempt at “athleisure” – some comfortable capri leggings and my favorite concert tee. She uses her living room to facilitate group meetings, but that day the lights were dimmed and she had made a pallet for relaxing in the middle of the room. She asked that I wash my hands and told me where payments and tips would normally be left. She had some snacks and water available. We met on her couch in the cuddle space and went over guidelines for the session.

Certified Cuddlists have a code of conduct: all touch within a cuddle session is to be non-sexual and consensual. There is no genital touching. My Cuddlist let me know that she would let me guide the session. I asked her if could start with her hands running through my hair – I find scalp massage extremely relaxing. I asked her to do some of the touch techniques that I use to comfort my doula clients, like brushing down my shoulders and pressing at the base of my skull and forehead together.  When something felt great, I could encourage her to keep doing that motion; when I did not like the touch, I felt safe asking her to stop or modify.

Just like when I get a massage or a pedicure, the hour passed quickly, but I left feeling so light and good about myself.

Seeing a Cuddlist is not for everybody, but I definitely see the value in this service. I did not need a counseling session and I did not want a massage. I needed to connect with another human in a respectful environment that allowed me to prioritize my desires for a short time. I liken my experience to having a doula: in providing non-judgmental physical and emotional support, I may not be providing a service that others could not, but I am uniquely positioned to focus only on those needs for parent(s).

In San Antonio, Janet Treviño is our local Certified Cuddlist. You can find more about her and the groups and classes she facilitates, at her website www.janettrevino.com. You can find other Cuddlists at www.cuddlist.com.

The Grief of Cesareans

April is Cesarean Awareness Month.  People all over the internet are recognizing this month, reminding us that one in three first-time mothers in the United States will deliver via cesarean.

I had a cesarean birth with my daughter in 2011. It was not the birth I planned. I struggled to heal physically from that birth – extra swelling from the fluids, increased pain in my core, an infection at my incision. I still struggle sometimes with healing emotionally – grieving the loss of the birth experience I had planned, the impact on my obstetric future, the hurt of the days of separation between me and my newborn necessitated by the circumstances that led to that cesarean.

My story – my grief and triumph – is unique to me;  I will not pretend to speak for every other mother.  But I am able to speak as a supporter of people who have had cesareans – a daughter, a friend, a relative, a doula.  For those who are not sure about how to support their friend, family member or partner who had a cesarean, I want to offer you a two things to consider:

Firstly: Let them grieve. You should also let them celebrate and let them feel neutral. A person is entitled to their own feelings and perspectives. They also do not need your “permission” to feel certain ways. Telling another how to feel is not conducive to any sort of growth or momentum.

You may find that different, maybe even opposing, emotions come up for you when you are with others who are grieving a birth experience.  You can feel your own emotions… without imposing them on others.  This can be tough for some, but to be an effective supporter of people, one must learn to focus outside of their own experience and to be careful with how they direct their passions. You can advocate for reduction in cesareans, or the option of Vaginal Birth after Cesarean (VBAC) as a public health issue without negating the personal experience and perspective of a parent who did have a cesarean.

Secondly: If they are grieving their birth, you do not have to “fix” it. It can be incredibly uncomfortable to see someone grieve. It does not matter our relation to the person – some of us just have natures that drive us to want to make them happy. We want to “do something.”  But often the best “something” we can do is to just be present with our friends in pain. Be with that person, there in that moment. “Puddle sit”, if you will. You do not have to find the silver lining in the situation – “well, at least you didn’t tear up your yoni!” You do not have to educate them on what you think went wrong – “it was that cascade of interventions,” or, “your doctor was quick to cut you.” You don’t have to find anything nice to say – “Your scar is very tidy,” or, “at least you have a healthy baby.” All you have to do is be there and listen.

For some, having a cesarean birth is not something they need to grieve – they may even celebrate it.  That is okay.  For those that need to grieve the birth or an aspect of that process, that is just as valid.  Be there for them by giving them the space to grieve and lending them your ear.

First Foods: Is My Baby Ready?

Blog Title: First Foods - Is My Baby Ready? Header image designed by Ruth Castillo, adapted with photograph, "Mimi Feeding 2" by Phillippe Put (via Flickr)

Thanksgiving 2011 was pretty special. My daughter was just about 6 months and everyone was coming over to our house for dinner.  I was so excited to show off my new found Super Mom abilities by parenting a six-month-old and single-handedly preparing a complete turkey dinner for 10 people!  I have no recollection of how the meal went over, but I do remember that it was my daughter’s first meal.  We put her in her high chair, covered her in a cute bib and offered her a spoonful of sweet potato – roasted just for her!  I was pretty stoked.

Many parents get excited to offer their child their first mouthfuls of food, but how does a parent know when the time is right to start offering solids?

Many health organizations, like the American Academy of Pediatrics, have general recommendations suggesting waiting until around 6 months of age to introduce complementary foods.

Why? At birth, infants are not well-equipped to digest much more than breastmilk, much less deal with breaking down solids efficiently.  We cannot see when that magical switch turns on that says an infant’s gut is ready to start digesting more complex sources of nutrition, but around six months of age many infants show outward signs of being able to eat.

Many parents will report around five and six months that their baby is reaching for their cups and plates.  This interest with eating (or playing at eating at least) is one sign that baby is ready to try foods.  An observant parent will see these others signs when baby is ready for solids:

  • Loss of the “Tongue Thrust” reflex.  Newborn and very young infants will naturally push foreign objects forward with their tongue.  As their oral muscles mature, they’ll “lose” that reflex and have more control over their tongues and finally be able to work food from the front of their mouths to the sides to be chewed up and then to the back to be swallowed.
  • Baby is sitting up well on his own.  Your mother always told you to sit up when eating and infants are no different. Babies who do not have the trunk and neck control to sit up might not yet be ready to control his eating.  Let baby work on one milestone at a time and offer more tummy time and babywearing time to help them get to that point.
  • Development of the pincer grasp.  When baby is finally able to pick up small objects (like a tiny, smushy cube of ripe avocado) with his thumb and first fingers like a crab claw – instead of smashing them in his palm, Hulk style – he is ready to bring them to his mouth.

Many parents will find these developmental markers show up somewhere between five and eight months, but the most important take-away is to watch baby.  Baby will indicate that he might be ready to try new foods – and he will also tell you when he is done with lunch or snack.  Let your child be your guide.

Contact me today to learn about a “First Foods” consultation and other services.


Image: Phillippe Put, via Flickr.