The Birth Team #139

Dr. Anne Rainville:

Hopefully that is the direction that will continue in the future is more collaboration between providers who truly have the best interest of the patient at heart and that we can realize that we can work together rather than thinking that's only one way to do it.

Leah Deragon:

The birth kind of begins as the baby's crowning. That really the birthing process is those days, weeks and months initially after the baby arrives to the family and that that was the process that we wanted families to have more support for. That entire process, not just the number of hours that meant the labor.

Jodi Phinney:

Having some additional support I think is so valuable so that you can look across to a partner and say with your eyes or with a thumbs up that this is exactly the sound that you want to hear or this is really hard, but she's doing this and we're going to keep moving forward and just encouragement for something that's unknown is really valuable.

Dr. Lisa Belisle:

This is Dr. Lisa Belisle and you are listening to the Dr. Lisa Radio Hour and podcast show number 139, the Birth Team, airing for the first time on Sunday, May 11, 2014, which also happens to be Mother's Day. Birth is arguably the most important of all life events. The way in which we come into the world and bring our children into the world has a far reaching impact. Today we speak with individuals who are thinking about birth in new and interesting ways. Listen in on our conversations with Portland OBGYN, Dr. Ann Rainville and Doulas, Jodi Finney and Leah Daragon of Birth Roots and hear about the evolution of this process and how young Maine families are bringing life into our state. Thank you for being with us on Mother's Day. I always enjoy having people in the

Dr. Lisa Belisle:

studio with me who were part of

Dr. Lisa Belisle:

my teaching experience, my learning experience as a Resident and medical student at Maine Medical center here in Portland.

Dr. Lisa Belisle:

Today I have with me one of

Dr. Lisa Belisle:

these individuals, Dr. Ann Rainville, who is an obstetrician gynecologist. She has been practicing in the Portland area for over 22 years and is very experienced in taking care of normal and complicated pregnancies. She is also a skilled surgeon and. And trained in acupuncture.

Dr. Lisa Belisle:

Thanks so much for coming in today.

Dr. Anne Rainville:

Oh, you're very welcome.

Dr. Lisa Belisle:

I remember well the deliveries that I did under your watch and with you, and

Dr. Lisa Belisle:

it was a very good experience

Dr. Lisa Belisle:

as a family medicine resident. When I came in, there was a broad variety of approaches that the OB GYNs would take. And yours was always very calm and happy despite the late hour. And your patients enjoyed having you as a physician. And I think that that's a huge part of delivering babies and caring for women.

Dr. Anne Rainville:

Absolutely. I mean, I think that it's been amazing to me the difference that it can make to have a very personal connection with the person you're taking care of in labor and delivery. There's a lot of intangibles there in terms of someone really feeling comfortable with you as a provider, feeling. Feeling that you are working together to be able to have this beautiful baby. It's really, for me, the most rewarding thing I get out of my professional career is being able to deliver patients that I know well, because it really adds a special dimension to the delivery.

Dr. Lisa Belisle:

Tell me why you decided to become an obstetrician gynecologist.

Dr. Anne Rainville:

Well, I had absolutely no idea that I was. It was not even on my radar. When I went to medical school. I thought I was going to be a. At the time, I said, you know, general practitioner. And of course, I'm still very interested in all aspects of medicine. But when I did my medical school training and I did obstetrics, it was my first delivery. I was just. I. I loved surgery. When I did my surgery rotation, I found that I was really sort of technically, it seemed like something that I was sort of. I gravitated towards, but I didn't feel that it was a good fit for me until I did ob GYN and I saw my first delivery. It was I to myself. I said, why would anybody want to do anything else? But obviously, a lot of people don't feel that way. But it's never. What we say in obstetrics is that you don't choose obstetrics, it chooses you. And it's absolutely true. You don't really have a choice.

Dr. Lisa Belisle:

Did you know you wanted to be a doctor from early on, yes, I

Dr. Anne Rainville:

remember 8 years old. I have no idea why I wanted to be a doctor, but I just was always interested in anything that had anything to do with medicine. And it's interesting because there's no one in my family that was in medicine, but I just was interested in it and from a very early age decided that that's what I wanted to do.

Dr. Lisa Belisle:

Why did you choose Maine?

Dr. Anne Rainville:

Well, I'm from Maine. I grew up in Maine. I actually was born in Kittery and for the first eight years of my life lived in New Hampshire, in Portsmouth, very close. And then we moved to Bangor and I grew up in Bangor and just I love Maine and wanted to come back.

Dr. Lisa Belisle:

So you've been sort of everywhere in the corridor between Kittery and two hours, three hours north.

Dr. Anne Rainville:

Well, I did my medical school training in Vermont, University of Vermont. So I was in Burlington for four years. And then when I finished my medical school training, I said I wanted to go someplace different for residency. I wanted to branch out, see what it was like to live in a city. So that's why I went to Washington DC And I loved Washington dc. It was very fun for four years to live there. But it was very clear to me after six months that I was not an inner city person and I needed to be back in Maine. So that was my goal.

Dr. Lisa Belisle:

What have you noticed over the last

Dr. Lisa Belisle:

22 years practicing medicine here in Portland? How have things changed for you as a doctor and for medicine in general in general?

Dr. Anne Rainville:

Well, there's actually been quite a change that I've noticed specifically in OB gyn. There was a big change from when I first started practicing. There are a lot of, lot of relatively small to medium size private OB GYN groups that were practicing independently but would cover each other. And that has really changed, morphed over the 20 years that I've been in practice to really being mostly two large, very large groups and only a couple of other smaller groups. And the independent solo OBGYN practitioner is a bit of a dinosaur. There really are only two of us that are still doing obstetrics and are solo practitioner. We happen to cover each other, which is fortunate for both of us. But there's been a big change from that sort of small group to the larger group. So that's one big change. There has, but obstetrics in general has changed in a very positive direction in terms of looking at obstetrics in a more sort of wellness perspective, in terms of looking at labor as being a normal process and trying to do less intervention and Trying to encourage the low risk sort of non interventional labors a lot more than we ever did. So it's interesting, although the group seemed to be getting bigger and one would think a little bit less personal in terms of. Because you may not see the person that you've been seeing in the office, in reality, it's actually becoming a lot more personal in the hospital with a lot more hands on, with the nursing, a lot more encouragement of more natural processes of labor, but allowing people, if they want, what's available to have it. But it seems like there's this nice push to kind of look at things a little bit more in a non interventional way. So that is a very good positive direction.

Dr. Lisa Belisle:

Why do you think that's happening?

Dr. Anne Rainville:

I think that, to be quite honest, I think it's the increase in women in obgyn. I mean, OBGYN is pretty much a primarily female dominant profession. And I think that with that, with a lot of physicians who have also had children and are looking at things in a little bit of a different way in terms of what they experience in their labor, what they would like for their patients, that there's been a little bit more incorporation of other types of obstetrical practices, such as midwifery practices. Looking at that more objectively in terms of what do midwives do very, very well, what is good about what they do? How can we incorporate that into general, into modern obstetrics so that we can all work together to allow women to have the best, safest and most rewarding experience for having a child. So I think that it's sort of, you know, the infusion of people who have actually been through it, also the open mindedness to look at other ways of doing things and to actually look at it objectively and then to incorporate it, it's very, very positive that what's happened between the main body, you know, the American Congress of Obstetrics and Gynecology, which is kind of the ruling body of obgy and the midwife administration, has been now coming together and looking more at a collaborative practice between doctors and midwives. And hopefully that is the direction that will continue in the future, is more collaboration between providers who truly have the best interest of the patient at heart. And that we can realize that we can work together rather than going at it from, you know, thinking that's only one way to do it. So it's really, it's very encouraging to me to see that there seems to be that, that direction.

Dr. Lisa Belisle:

You have children?

Dr. Anne Rainville:

I do, I have two.

Dr. Lisa Belisle:

How old are your kids?

Dr. Anne Rainville:

My oldest is almost 24 and my youngest is almost. He's 20. Yep.

Dr. Lisa Belisle:

So have you noticed a difference between your own deliveries and the deliveries you're now doing with women?

Dr. Anne Rainville:

Absolutely. Absolutely. When I had my daughter 24 years ago, I had to be induced. And the way that I was induced was a little bit more intense than the way that we do inductions at this time. And also I was given an episiotomy and we don't do those anymore. And so it was very. I mean, I did get an epidural. I have no qualms about having that epidural. I needed it, but it so a lot of it is the same, but there was but the obstetrical sort of more sort of interventional obstetrics was a little bit different than what we do now.

Dr. Lisa Belisle:

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Dr. Lisa Belisle:

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Dr. Lisa Belisle:

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Dr. Lisa Belisle:

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Dr. Lisa Belisle:

When I was doing deliveries and granted this was a while ago, what I observed was the more support a patient was given, the more time a patient was given, the more, I don't know, calming presence the patient had available,

Dr. Lisa Belisle:

the fewer interventions there were in general.

Dr. Lisa Belisle:

I mean, now of course there's always babies, that there are emergencies that happen and things that go on and you can't really prevent those. But in general, if you can have more of the human touch and more of that presence, you're better off. But that for a while was not a direction we were heading in.

Dr. Anne Rainville:

You're absolutely right. And I think that that is another change that has happened in obstetrics is the realization that we need to be more patient, you know, and that, you know, there are numerous studies that are coming out now about waiting longer, that if we just wait longer, if we are just a little bit more, you know, more patient with it, that people can deliver vaginally and can deliver safely. And I totally agree with you. I think that the more contact that somebody has when they're going through, I mean, labor is a very difficult process, you know, it's a very difficult process and, and having somebody with you that is Supporting you and is calming and letting you know this is normal. You know, don't worry about it. You know, we're not going to do anything, you know, interventional at this point. We can just keep going with it. You know that this is normal and reassuring all the time. It does. It helps people to need less intervention because then they help, then they allow their body to take over. And sometimes I feel like my biggest job is just staying out of the way and allowing it just to happen.

Dr. Lisa Belisle:

It also seems that, as with many things in medicine, I mean, we're starting to recognize the importance of what we

Dr. Lisa Belisle:

call the patient centered medical home, which

Dr. Lisa Belisle:

is really a team approach to caring for a primary care patient. It seems as though this team is something that has become important in birth as well. I mean, my best friends when I was delivering babies for that brief period of time were people who were experienced labor and delivery delivery nurses and midwives and doulas. And it really was a group of

Dr. Lisa Belisle:

people who all had the same goal in mind.

Dr. Lisa Belisle:

And it sounds like this is actually even more the case now.

Dr. Anne Rainville:

I think so. And I think that that's something that really I stress to the residents that I teach is that it's a team and that they need to use the resources that they have. And the best resource that they have to help them take care of their pat is the experienced labor and delivery nurse. And I think that sometimes when, you know, when you're a medical student and then you get in to be a resident, you think that, oh, I have to take care of everything and I have to have all my ducks in a row, and you forget that you need to use your resources. And it is definitely a team. And everybody has a part, and everybody who's there who's supporting that woman in labor has a job, and it's an important job. You know, whether it's, you know, the sister who is there to get the face cloth, the cold face cloth and put it on her forehead, that is an important job. And everybody who's there is important. And I think that that's very. Like I said, that's really important to me. To stress that to the residents that are coming up is, you know, oftentimes I've talked to them and I said, you know, what's going on with the patient? They're trying to. I said, what is the nurse? What does the nurse think? And they're like, well, wait a minute. I said, you know, that is your number one resource to help you is the nurse. She knows. Is she the person in Labor. What are their contractions? Like? You know, that's. Use everyone in the team to take care of that patient.

Dr. Lisa Belisle:

Another group of individuals that we didn't have as much exposure to when I was a resident was the.

Dr. Lisa Belisle:

Was the. Were the doulas.

Dr. Anne Rainville:

The doulas, yeah.

Dr. Lisa Belisle:

And that has really. The one.

Dr. Lisa Belisle:

The patients that had doulas, it seemed

Dr. Lisa Belisle:

as though they were just sort of a very comforting and competent extended family for these patients. And I'm really happy to know that there are more and more women and men who are becoming doulas and supporting women who are laboring.

Dr. Anne Rainville:

Yeah, I think that it's. I think it's sometimes very difficult for the. The primary support person that, you know, the significant other, you know, to be the only one to support someone in labor when they've never seen it before. They don't. You know, they. You know, they're so torn between their own excitement, you know, what's going on with the person that they. That they love. They're in pain, you know, what did they want, you know, that it's. It's just. I think sometimes it's a little bit too much to put on somebody who, you know, has never been in that position before. And so I think that. That sometimes that's where the doula really helps a lot, to have another person to be able to help, not just the person in labor, but the other partner to kind of be able to, you know, get through this journey in the best way possible. And I think, you know, I worked with many doulas. I, you know, anybody who is there in the room to help the patient, I am willing to work with, and I am happy that they're there. And I think that, you know, really, if there are more people that are there to support somebody, the better.

Dr. Lisa Belisle:

It used to be that doctors were the source of information for patients, and we had the ability to provide some, I guess, calm and perspective. And now a lot of information comes from other sources. And sometimes information can be scary. It can be helpful, it can be normalizing, but it can also be scary. So is there a way that you, as a doctor, are able to work with the information that's out there and work with the people who have this information and really make it a positive thing?

Dr. Anne Rainville:

Well, I try to. I run up against this all the time because, you know, every day in the office, when I see patients, you know, somebody brings something up, you know, that they saw something online, you know, that. Or their. Their friend or their mother or someone told them something. And I think that The. The important thing is to first. To validate. What's that? Yes, I understand, you know, where you got that information. And, and to say that, you know, there may be some truth to whatever it may be, that they're very concerned about that. But then I try to bring it back down, bring them back down to kind of to earth, to base, to say, okay, but what does that really mean for you? You know, and, you know, what is your situation? How is that different from this scary thing that you. That you heard about? And even if that scary thing happens, you know, I know we know how to deal with that. You know, you're going to be in a safe place. You're going to be with people who know how to deal with things such as that. And I think that it really. I think that that's the way to deal with it, rather than just say, oh, don't worry about it, because then they're still worrying about it, you know, and I think that you need to kind of just explain, you know, yes, I know about those things, but that's why it doesn't pertain to you. Or if it does, you know, we can deal with it.

Dr. Lisa Belisle:

You've been practicing quite a while now.

Dr. Anne Rainville:

Yeah.

Dr. Lisa Belisle:

Some of the first babies you've delivered, they are in their twenties having their own babies, I bet.

Dr. Anne Rainville:

Yep.

Dr. Lisa Belisle:

What keeps you passionate? What keeps you excited? What keeps you interested in being a doctor, being an obstetrician, gynecologist?

Dr. Anne Rainville:

Well, I guess one time I said, you know, I keep doing deliveries because I haven't done it perfectly yet. So I guess that that's one thing, but it's because it is changing. And the way that I practice obstetrics now is very different than the way I practiced 20 years ago. And it's that freshness, you know, trying to find the way to do it better. That's what keeps me going. And also it's my patients, you know, that interpersonal connection.

Jodi Phinney:

And.

Dr. Anne Rainville:

And like I told you, I did a delivery this morning. It's of someone that is close to me, and, you know, that's a wonderful thing. I mean, not many people can do that. It's pretty special.

Dr. Lisa Belisle:

And we have to let you go because I know you have another person laboring right now, and we don't want her to deliver before you're finished talking to us. How do people find out about your practice, Dr. Rainville?

Dr. Anne Rainville:

Well, I do have a website, and it's called womenswellnesscare.com or they can just look me up on the web as annRainville. MD. It'll just link right to my site. But I'm in practice in Portland, Maine on Ocean Avenue and we have lots of services to offer, not just OBGYN as well.

Dr. Lisa Belisle:

I like the fact that you also do acupuncture. As someone who does acupuncture and knows how important that is to have in my toolbox, I really appreciate that that's one of the things you have in your toolbox. So I'm impressed.

Dr. Anne Rainville:

All right.

Dr. Lisa Belisle:

I haven't seen you in a little while. I really appreciate your being one of my early teachers as a medical student and a resident. It meant a lot to me. Then it means a lot to me that you've come in today and having this conversation with me. It just is. It's great to know that there are doctors out in the world who are doing the good work that you're doing on a daily basis. And I know that your patients love you and I appreciate your being here.

Dr. Anne Rainville:

Well, thank you very much.

Dr. Lisa Belisle:

As a physician and small business owner,

Dr. Lisa Belisle:

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Dr. Lisa Belisle:

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[Unidentified voice]:

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Dr. Lisa Belisle:

it's Mother's Day and as a mother of three and a woman that gave birth.

Leah Deragon:

Wow.

Dr. Lisa Belisle:

It seems like a long time ago now.

Dr. Lisa Belisle:

I guess the longest.

Dr. Lisa Belisle:

My youngest is 13.

Dr. Lisa Belisle:

I know how important birth is and the process of going through birth is

Dr. Lisa Belisle:

something that can be made easier in some ways by people who are known as doulas. Today we are fortunate to have with us Leah Daragon and Jodi Finney.

Dr. Lisa Belisle:

Leah Daragon is a Doula certified childbirth educator and co founder of Birth Roots Perinatal Resource center in Portland where she facilitates semiannual doula trainings and childbirth classes. Leah has a five year old son and a one year old daughter. Thanks for coming in.

Dr. Anne Rainville:

Thanks.

Dr. Lisa Belisle:

And we also have Jodi Finney. She is a full time birth and postpartum doula. She has worked with moms of all ages in both high and low risk pregnancies, medicated and unmedicated. She also works at Birthroots where she is the office manager and facilitates the welcoming pregnancy class. Well, welcome to you, Jodi.

Jodi Phinney:

Thank you.

Leah Deragon:

Thanks for having us.

Dr. Lisa Belisle:

Why did you call it birthroots?

Leah Deragon:

Emily, Marie and I as the co founders were actually this is our 10 year anniversary. So 10 years ago we were both doulas, primarily birth doulas, attending families through their last weeks of their pregnancy with them for their birth and with them for the initial hours and a couple of weeks after they gave birth. And we realized that while this was an incredible service that some families were able to access, we wanted to provide that same model of non clinical care in a much broader context. And we realized that the experience of birth is not just did the baby make it to the other side of the pelvis and is everyone doing okay physically? But that there's a whole emotional component that the birth sets the tone or the stage for the layers of parenting that come after that. And so it was a rooting process of in much the way a tree has a root system. We have a quote up in our space at Birth Roots called the deeper the roots, the higher the reach. And we really believed in that vision or that metaphor that if the experience not just of the hours of labor and the first day after the baby was born, but the entire pregnancy and the entire first year of life was well supported, that the family would take root in a really different way, that there would be less anxiety, less adrenaline, more oxytocin, and that by being rooted in a community, specifically among other families who were also going through this very raw, vulnerable time in their lives rather than feel isolated and like they were maybe feeling like they were crazy or the only one, or why is this so hard? If they were rooted in a community of other parents who were exploring ways to Parent who were exploring, exploring how it could be less hard, not just giving birth, but I think at birth roots, and I would think most doulas would agree that the birth kind of begins as the baby's crowning. That really the birthing process is those days, weeks and months initially after the baby arrives to the family. And that that was the process that we wanted to have. We wanted families to have more support for that entire process, not just the number of hours that meant the labor.

Dr. Lisa Belisle:

So birth roots, you said, is 10

Leah Deragon:

years old, 10 years old this year

Dr. Lisa Belisle:

and you have a five year old son and a one year old daughter,

Leah Deragon:

which means I was doing this work before I was a parent.

Dr. Lisa Belisle:

Right.

Leah Deragon:

So why I think a lot of women feel a calling to midwifery or childbirth or what it means to hold space for the process of motherhood, of going from being an individual who only worries about the needs of an individual, to what does it mean to become a mother when you're called to midwifery? You think, well, let me get started. A lot of women get started with a doula training or being a doula as a vision of themselves as a midwife, literally or figuratively. And, and this is how we got started and we saw it was sort of a vision of what could be for families.

Dr. Lisa Belisle:

Jodi, you said that doulas are that

Dr. Lisa Belisle:

missing link for emotional support between doctors and the partner who may not have as much experience. This is an interesting idea that you know that there, that we have sort of, we have the need for multiple layers of support in birth.

Jodi Phinney:

I think the way I said it was that we kind of make up a chair and that the birthing mom and their partner are two legs. The birthing partner knows that individual who's birthing very well. And then you add in a doula and you've got someone who knows birth well and individuals has an idea of how people interact and can read facial expressions and really gel that room together. And then you have the doctors or the midwives who provide that back to the seat, who are there for support and are really overseeing the whole process, but are kind of in and out. And so having some additional support I think is so valuable. So that you can look across to a partner and say with your eyes or with a thumbs up that this is exactly the sound that you want to hear, or this is really hard, but she's doing this and we're going to keep moving forward. And just encouragement for something that's unknown is really valuable.

Dr. Lisa Belisle:

That is an important point is that there's a lot of unknown associated with this. We get to see what is on television. We get to see those births. Maybe we go through one birth of our own, and we know what that was like, or we watch a sister give birth. But every birth, even for an individual woman, is so different.

Jodi Phinney:

I was just talking to a woman yesterday who is on her seventh birth and is thinking about becoming a doula. And I talked to her about how even seven, she didn't see a lot of repetition, that each one had its very unique properties and timing.

Dr. Lisa Belisle:

So tell me about sort of the history of doulas. I know that there weren't. When I was at the Maine Medical center, doulas were just starting to have more of a presence there. When I was delivering babies there and at Mercy when I was in my training in family medicine, I think they

Dr. Lisa Belisle:

have a significant presence, especially in Portland,

Dr. Lisa Belisle:

but also really throughout the state now, and it's growing. I was more familiar with nurse midwives. What's the difference between a midwife and a doula? And why are doulas so. I guess so important in conjunction.

Jodi Phinney:

I think when birthing wasn't in the hospital, we used to see a lot of doulas that probably weren't called doulas. They were called friends, they were called sisters, they were called aunts, grandmothers. People who were around for you while you were laboring, who were making you food or making sure that other kids were taken care of or walking the dog, or, you know, bringing a warm washcloth or a cold washcloth, cloth, whatever. Whatever the situation needed. And then as birth came into hospitals, so they were attending. They were attending people. And it could have been your husband or your partner as well then. And then birth came into hospitals, and, you know, society changed. And so, oh, well, you're gonna go off and other people will help you take care of that, and you'll come back and you'll have a baby. And so we lost that. That family, that community piece of birthing, which was so integral to having it happen in a way that felt right to women. Not necessarily familiar, but there was encouragement to keep going and stay the path. And so I think bringing that back, bringing people back into the birthing scene and having some support is good. It could be a parent, it could be sister, it could be an aunt. But what's important is it's somebody who has familiarity with birth. And unfortunately, when birth came to hospitals, a lot of us lost that. So we didn't. We weren't there when our sisters gave birth or we weren't there with our when our brothers wives were giving birth or, you know, even, you know, an aunt or uncle, something like that. So I think familiarity with birth is important and having somebody who has that one step of way. So you're invested, but the emotional investment you can keep a clear head around, that kind of support is valuable.

Dr. Lisa Belisle:

The goal of the Dr. Lisa Radio

Dr. Lisa Belisle:

Hour is to help make connections between the health of the individual and the health of the community. The goal of Ted Carter Inspired Landscapes is to deepen our appreciation for the natural world. Here to speak with us today is Ted Carter.

[Unidentified voice]:

I am always amazed at how much the land speaks to us if we just stop and pay attention. I will very often place gazing rocks, which I call gazing rocks because it's a big huge slab of stone that I place in the landscape where you can lie on your back and look at the stars or you can reflect and dream about things and places you want to go to. But I often go to these places. They're called power places. My shaman that I worked with in the desert for many years talked to me about power places. And I go out there and leave the drafting table, go out to this special spot that I've created, lie on my back, and instantly almost fall into a dream state. And there's something called creative visualization, which I think a lot of people know about. And I'll just sort of turn that design slowly in my mind and look and see the design from different angles and sort of create it in a very sort of dreamlike state. And then I return back to the drafting table refreshed and ready to design. And time and time again, it's never failed me that this is how some of my most creative designs take shape. I'm Ted Carter, and if you'd like to contact me, I can be reached@tedcarterdesign.com

Dr. Lisa Belisle:

the Dr. Lisa Radio Hour and podcast understands the importance of the health of the body, mind and spirit.

Dr. Lisa Belisle:

Here to talk about the health of

Dr. Lisa Belisle:

the body is Travis Boyer of Premier Sports, a division of Black Bear Medical.

[Unidentified voice]:

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Dr. Lisa Belisle:

Jodi, you teach a well, I guess you facilitate a welcoming pregnancy class I do so well.

Dr. Lisa Belisle:

I have two questions.

Dr. Lisa Belisle:

First, I wanted to know why the word facilitate is so important. Because you both, before we got on air, talked about the word facilitate. And then I also want to know what does it mean to welcome pregnancy.

Jodi Phinney:

So we choose facilitate over time Teach because we are there as a guardian of your time and encouraging you to learn information and hear information from different people and different sources and pick and choose what's going to work well for you. And so from the very beginning we try to encourage you to make choices that will change your family in ways that you you may not have grown up, your friends may not have gone through their pregnancies or parenting with and pick what's right for your family. So we facilitate you getting information, having conversations, mulling it over, speaking it out loud in an effort to kind of grow that role of parenting. Moving it forward. The welcoming pregnancy class is it fills a gap that we see between when you recognize in the bathroom that you're pregnant or at the doctor's office and you kind of can get those first doctor's appointments or midwifery appointments. So there are weeks and months in the middle that you're kind of out there googling and googling and googling. And our encouragement is to step away from the computer and to come to a place where you can meet other families who are in the same time frame as you are, wondering some of the same questions, having already found answers that worked for them, having found nothing that worked for them yet, and everyone coming together so that they can start gelling as a new community. And that's what we do. Month after month we gel new groups of people who who then move forward as we call Them flocks and grow. And there are flocks that are five years old now. And people stay together and they count on each other. And so those very first few weeks where you come to a welcoming pregnancy group and you get some of your questions talked about, and you start finding out why people are choosing their provider, why they aren't choosing a provider, and you figure out who, what provider might work for you, and you're encouraged to try another one. You know, whatever works. You get questions talked about, what is a doula? You get questions like, what should I purchase? What should I not purchase? How should I tell my family? When should I tell my family? All of those kinds of things are talked about so that you can start making decisions that right for your family.

Dr. Lisa Belisle:

That's a good point, because I remember even my last child, the one who's now 13, thinking, I learned I was pregnant. She was. We always call her. She's our surprise. She's one of. We have two surprise children, the first and the last. But anyway, so then I was like, just left there with this surprise, surprise third child. Didn't have a doctor's appointment until, I don't know, eight weeks or 10 weeks or whatever it was. And there was so much time that kind of elapsed with me doing exactly as you said, looking online, and even as a doctor just kind of tuning in to what symptoms I should be feeling. And you're probably right that I would have been better served to kind of reach out and actually have these conversations with people around me.

Jodi Phinney:

Well, it's so unique when you get to talk to someone who's going through it or has just reached over their first trimester and is finally not feeling poorly anymore. And hearing experiences of people who are in the throes of it is very different than hearing how it was for your sister two years ago or how it was for your mother 30 years ago. So there's real value in having that community.

Leah Deragon:

For me, facilitation is so important because it's not so much of a teacher telling other people how to achieve a certain outcome as it is a couple of things are happening. I always encourage new families to get really good at two, listen to other people, lots of other people, and then listen to yourself and make sure you're doing both of those. If you're only listening to yourself, you might get down a wrong path. But if you're only listening to other people, you're not sort of developing your own internal muscle or strength that you'll need over and over again as a parent. There's so much that happens throughout the pregnancy and the labor that is all just in preparation for the parenting that you'll be doing so, taking that opportunity as it's presented to you, to develop that internal strength, that internal knowing of what is right for you or maybe won't work for you, even though it did work for your friend. So listening equally to other people and to yourself, but also a concept that's part of facilitation, is encouraging what is known as crowdsourcing. Though generally crowdsourcing is done online. We do more of face to face crowdsourcing where someone says, I'm struggling with a sleep issue, or I'm struggling with a fussy colic or, yeah, or pregnancy issue. And rather than the quote, unquote teacher saying, well, here's the solution to that problem, what the facilitator does is says, is anybody else struggling with that? Well, what have you tried? And so then the topic now comes up and we hear from eight or ten different people what they tried, what their doctor told them, what somebody else's best friend told them. And so now on the table, table, we have 12 ideas. And everyone gets to take from the 12 ideas on the table what sounds right to them because they have insider knowledge of why one idea might or might not work for their body, their baby, their partner, their family circumstance. So it's more accurate.

Jodi Phinney:

I think what that grows is an ability to count on the people around you and your community and a respect for the pluralism that birthright really works hard to create in that you might have done it one way and she might have done it another way. And he said that we should only do it this way. And this is what works for me, because I heard all of those things and I heard it from people who are doing the same thing that I am. And I trust right now.

Leah Deragon:

I mean, the way the things, the trends versus the standard of care versus. I mean, I had children four years apart, and what was recommended to me even four years later, I mean, you're a different person. The culture at large is different. Those circumstances change by the year. And so being in a room full of people who are currently facing what you're facing under the same set of circumstances is so valuable as opposed to reading it in a book, googling it, or hearing it from maybe a pediatrician or a care provider who, you know, their children are 25. And so not that, you know, they don't have lots of valuable things to contribute, but it might be what you needed to hear is that the mother sitting next to you who also has a six week old baby feels this way and so do you. So there's actually maybe not a clinical problem. There's just, oh, this is hard. And just like labor was hard, we can find our way through the hard part.

Jodi Phinney:

That's okay.

Dr. Lisa Belisle:

So there is a bit of.

Dr. Lisa Belisle:

There's a normalizing effect. Normalizing?

Leah Deragon:

Yeah, there's normalizing that what I'm experiencing is perfectly normal because 10 other moms in the room are feeling it or wow, 10 other moms in the room aren't experiencing what I'm experiencing. Maybe I should talk to my doctor about this. I think that's just as important as

Dr. Lisa Belisle:

a doctor who no longer delivers babies, but at one time very much enjoyed doing that. One of the things that I encountered a lot was a family that had worked so hard to create a birth plan and we had created such a great relationship and you know, they were looking forward to their baby and they'd done all their reading and they had done their breathing and they had gone to the right classes and everything was all laid out. And then things just didn't turn out the way that they had hoped. Sometimes they needed a C section or sometimes they wanted to breastfeed and they couldn't breastfeed. And sometimes it was so devastating for them and they would judge themselves so harshly for that, or they'd feel this great disappointment that I've somehow failed my birthday. Is this something that you can help women with?

Leah Deragon:

I think that's one of the primary roles of both the doula in her non clinical role in attention, as well as an organization like Birthroots, which I think of as an organizational doula, because there's a phenomenon out there where if a birth goes very much not the way a mom had planned, a common thing that gets said to a mom is, well, at least you have a healthy baby. Which completely invalidates her own well being, her own process, her own needs in the process of becoming a mother. As though mothers have no needs. They just live to make sure they have healthy children. And we always say when you have a relaxed mom, you have a relaxed baby. When you have a stressed mom, you have, you know, that sort of. So I think that the. Sorry, guys. Okay. The natural word is. Is something that women can torture themselves with. And I think that staying present for what is again, the labor, the pregnancy, the labor, the birth, the postpartum and parenting. Parenting isn't always what you set out, you know, the course you set out yourself. And if you have multiple children, you Find out, wow, this one child is really amenable to my ideas of myself as a parent, and this other child has no interest in the style of parenting that I want to parent. And I think that if people can get that while they're either pregnant, giving birth, or in the first year, they're miles ahead for what's coming. So set in the context of the supportive doula support or community support, it's easier to wrap your. Start wrapping your head around where utmost flexibility is important. You can do everything right sometimes in life in parentheses parenting and birth, and still be asked to be even more flexible than you thought you were gonna have to be. So I think doulas encourage ideas that maybe a family hadn't thought of, and it increases the likelihood that they'll get the birth they're hoping to have. But then doulas are there for a grieving process of, wow, we have a healthy baby. But I'm kind of bummed that I didn't get to birth in the water or it was either so fast that it was nothing like I imagined, or it was so long that I'm exhausted. And my first few days of meeting my child, I just was too exhausted to enjoy it. I think to discount the process that a woman or a family needs to make sense of their experience or play with the narrative of what happened and create a narrative that makes them feel strong and make sense to them as opposed to leaves them feeling incapable is extremely important. And I don't think that is falls under the job description of an obstetrician to help people work with their narrative about what happened.

Dr. Lisa Belisle:

Well, I'd like to. I think some obstetricians are very good about that and some. It's just not what they, it's not their experience. And I think you're, you're. You've hit on something that. It could also just be that if you're an obstetrician and you have 10 minutes to, to see a patient, there's some time involved in this.

Leah Deragon:

Right. I think all of the doctors I've ever encountered have a huge heart and that's why they're there. But a lot of what either a doula or an organization like Birthroots can do is fill in some gaps that have been created by the economic system we have or whatever. We don't live in an entirely pro family, pro mother, pro well being situation. And so trying to fill in those gaps with human beings such as doulas or other parents can make a huge difference in people's stress. Levels, and I think that's the bottom line is stress levels.

Jodi Phinney:

I think that's absolutely true. I was at a birth yesterday morning where I was working with a nurse at Mainmed that I know I've worked with before, although it's been a few months. And I said, do you want to come in here? You know, they come in to nursing because they have a love and especially labor and delivery of that process. And she was busy charting some information, and I encouraged her to, you know, move closer. And she's like, no, it's so great you're here, because I need to get this done. And so there's a real. There's a real lack and need and appreciation for everyone's job, especially when there's more support for everyone. So. So you never know who you'll be supporting. We often joke that you should have doulas for everything. You should have a dog doulas. House buying.

Leah Deragon:

Doula, right?

Jodi Phinney:

A dog doula.

Leah Deragon:

Birthday party. Doula, right.

[Unidentified voice]:

Yeah.

Dr. Lisa Belisle:

I'm actually kind of sad that my youngest is 13 and I'm pretty much done because I'm so. It's so exciting to hear what you now are offering in the Portland area and around the state. It's so exciting to know that this is the way that women and families and children are being supported, because I do think this is what we need. We need to focus on the family until you actually have somebody there who says, this is important and let's facilitate this process.

Leah Deragon:

Let's slow it down. My goodness, people. I think parents are under an outrageous amount of stress to get an undoable amount of work done in an undoable amount of time. And then they wonder, why can't I keep up? Why am I so exhausted? And I think the wiser women of the community, women who've experienced this and sort of gone through a hard time, come out on the other side and have perspective on what that time is about, are able to say, okay, let's start with slowing things down. I think doulas slow things down as part of their. What they're there to do is, wow, you just had a baby. Rather than, let's rush on to the next thing that's gonna happen. Let's take a breath here and, oh, wow, life has changed. How are you different than you were an hour ago or yesterday? And it makes an incredible. It alters the trajectory of the health of the family. For someone to say, let's pause for a minute.

Dr. Lisa Belisle:

I love what you're doing, and I know that we could fill an entire hour, probably multiple hours. Because I think that you're so on with where I believe that we all need to be thinking about healthcare and families. But I will encourage people to find out more about Birth Roots by going

Dr. Lisa Belisle:

to your website, which is www.our o

Leah Deragon:

u r birth b I r t hroots R-O-O-T s.org o r g or

Jodi Phinney:

birthroots.org which we have just purchased.

Dr. Lisa Belisle:

Very good. And people can also go back and listen to the show that we did with Emily Murray. I'm just, I'm thinking she was one of our very early shows. It was so important to us, even back at that point, that we had a show on it right away. So people would like to hear more

Dr. Lisa Belisle:

from Emily and her sister Alison.

Dr. Lisa Belisle:

Alison, yes. This is a family from Yarmouth I used to babysit from for. So it's kind of funny that everything just kind of keeps coming in circles in Maine. But anyway, go to the birthroots website to find out more about Leah Daragon and also Jodi Frank Finney. And Jodi, do you have a website yourself?

Jodi Phinney:

I do.

Leah Deragon:

We do a lot with Facebook. We find people. You can find birthroots on Facebook. Jodi Finney, A doula on Facebook.

Jodi Phinney:

A doula for me.

Leah Deragon:

A doula for me.

Jodi Phinney:

A doula for me.

Leah Deragon:

And we're just so thankful that you've given voice to this because so much of elevating what's happening is bringing into the cultural discourse of how are we all doing here. So thanks for.

Jodi Phinney:

I think it's also worthy to note that doulas do charge for their services, but it is not by any means a requirement to have a doula who charges that you can find a doula who wants to barter with you, who wants to do a payment plan, who is just starting out. I have a very good friend who only does pro bono work like they're. They're a doulas for everyone, regardless of how much they charge or you want to pay. And I think meeting someone who resonates with you is the most important piece first and then to figure out the financial piece second. You can definitely start. We train nearly 30 doulas a year throughout New England. They come from throughout New England to Portland. And so we have access to a great pool of people who have had six months of. Of experience, three months of experience, four years of experience, ten years of experience.

Dr. Lisa Belisle:

We've been speaking with Leah Daragon, the

Dr. Lisa Belisle:

founding director of Birth Roots Perinatal Resource center in Portland, and private doula Jodi Finney, who also works with Birth Roots. Thank you so much for all the work that you do and for this generation of healthy families that you're promoting and for coming in and talking to us today.

Jodi Phinney:

You're very welcome.

Dr. Lisa Belisle:

Thank you. You have been listening to the Dr. Lisa Radio Hour and podcast show number 139, the Birth Team. Our guests have included Jodi Finney, Leah Daragon and Dr. Ann Rainville. For more information on our guests and extended interviews, visit drlisabelisle.com the Dr. Lisa Radio Hour and Podcast is downloadable for free on itunes. For a preview of each week's show, sign up for our e. Newsletter and like our Dr. Lisa Facebook page. Follow me on Twitter and on Instagram. As Bountiful One. We love to hear from you, so please let us know what you think at the Dr. Lisa Radio Hour. We welcome your suggestions for future shows. Also let our sponsors know that you have heard about them here. We are privileged that they enable us to bring the Dr. Lisa Radio Hour

Dr. Lisa Belisle:

to you each week.

Dr. Lisa Belisle:

This is Dr. Lisa Belisle. I hope that you have enjoyed our Birth Team show. Thank you for allowing me to be a part of your day on Mother's Day. May you have a bountiful life.