I met Mandi at a Waldorf playgroup in Ames, Iowa. I was feeling so lonely and isolated there that I looked for like-minded people with kids about Frank’s age, and found her. There she was, at the first playgroup meeting, with a 2 week old baby who was birthed unassisted (because the midwife didn’t get there on time). Amazing! I immediately had tons of questions for her, and thought I’d share the answers with you here.
Joanna Steven: Do you remember when you first started thinking of becoming a doula? What made you want to help women give birth?
Mandi Hillman: When I was pregnant with my 1st in 2007 I was SHOCKED at how many folks – even those who had never experienced birth – spoke to me extremely negatively about planning to have an unmedicated birth. I was rarely told things along the lines of “good for you… go for it… of course you can, etc.”
Instead it was far more often that I was told things like, “why bother… don’t be a hero… it’s not worth it, etc.” It made me very sad that I had to keep my plans to myself to try and buffer all the negativity. Then, I was even more surprised at people’s reaction when I accomplished my goal – with a 10.6 ounce baby no less. They silenced me again with their negativity. I was told I had a “high pain tolerance” or that I “just didn’t remember.”
I could not believe that more women didn’t want to hear how I did it and simply hear something positive about birth. This is when I really thought about becoming a doula for the first time, a few months after my first child was born. I wanted to be one more voice speaking positively about birth to women. I wanted to tell women that they were capable, and strong, and amazing and that YES you can do it! I wanted to help women during their births because birth is such an unparalleled, life-changing, transforming experience. I wanted to help women (and families) during their birth experiences because these experiences matter – and the memories last a lifetime. I wanted to be a part of making that transition and transformation as positive and beautiful (and confident) as it can be. Because going into to parenting confidently is good for moms and babies.
Joanna Steven: How is a doula beneficial to the birthing mother? Are there specific situations where you think a doula would be especially helpful?
Mandi Hillman: Studies have shown that doulas reduce requests for medical interventions like epidural, cesarean, episiotomy, and the use of Pitocin. Having a doula present has also been shown to reduce the length of labor. Women who have doulas report more positively about their birth experiences and, report more success with breastfeeding, and also have fewer signs of postpartum depression.
I think most significantly that doulas bring a certain presence to birth that encourages women to trust their intuition and to birth with confidence rather than fear. I often say to my clients, when I am first interviewing with them, that there is something very powerful and calming about having another women who has experienced birth in the room with you. There is this knowing between women – an unspoken trust. Certainly this is in no way to suggest that husbands and partners are not extremely valuable to be present during birth, but even a man who has attended several births still does not know in that same way a woman can know. There is something sacred about birth – something sacred that only another woman can know. In my opinion, it is this positive – carnal-like – presence, which a doula brings to birth that truly makes the difference.
I think a doula can help in any situation, but I specifically think if a woman experiences anxiety going into her birth, a doula can be an essential ally. As well, when there is an identifiable situation where there is a lack of support – whether that means physically or emotionally – a doula can really be a tremendous asset. There is a popular quote among doulas that “the birthing woman’s partner is her right hand and her doula is her left hand.” One thing I like to tell my clients is that I am as much there [at a birth] for the laboring woman as I am for the partner. What I mean by this is that one of my jobs is to help facilitate the partners involvement in the birth and promote a positive experience for both. Keeping the partner calm and happy (as well as informed and confident) is an essential and necessary part of my job as a doula.
Joanna Steven: Despite having a doula and a midwife, I was stuck with “failure to progress”. I suspect it was caused by the stressful hospital environment, and hope to give birth in a birth center next time. What do you recommend women do when they are not progressing “normally”? Are there natural ways to help speed up dilation and avoid Pitocin?
Mandi Hillman: “Failure to progress” is such an awful medicalized-model-of-care label that places blame on the woman for not following some arbitrarily set schedule. I am so sorry you experienced such a negative label, especially during a time when you were already vulnerable – like all laboring women are to varying degrees. I guess my short answer is yes, absolutely I agree that the stress of the hospital environment could have played a role. Receiving that label or any negative and blameful (“failure”) label could alone cause a woman’s labor to stop or stall.
To answer the rest of your question I would start by questioning what is “normal” and why should it be of concern to you individually when you are in labor. What is normal for one is not normal for another. I have attended many births and no two are ever alike. Sure, there are similarities, but I never cease to be amazed and surprised by how different women labor. I also like to explore physiological explanations for why a woman may stall or slow labor around 6-8cm. I often wonder if it is the bodies way of preparing for the final “push” (literally) that is about to come. Perhaps the body knows the woman needs to store up some energy (i.e., rest) in order to accomplish the final goal of expelling the baby.
When I am with a woman – who is being allowed to labor in a manner that is normal for her – and she appears that she is slowing during her labor or stalling, I leave her alone. It is my philosophy that if a woman’s body is telling her she needs to rest at any point in labor I, of all people, should certainly not question this and try and intervene. Let her be, let her be, let her be. It seems to all come down to trust. As a doula I trust nature – I trust women’s bodies. As a doula I try and support my clients to trust nature and their bodies as well. If a woman wants to try and speed labor some of the most common doula “tricks” are movement, nipple stimulation, and to explore any psychological (e.g., fears) concerns the mother may be experiencing. Many doulas like to keep their clients moving to a new position about every 20-40 minutes. Nipple stimulation can help release prolactin and oxcitocin, both of which can encourage contractions.
I personally never underestimate the power of influence one’s own mind can have on the body and work with my clients a great deal in this area both before, during, and after the birth. And my final go-to in these situations (“failure to progress”) is to ask about vitals. Is mom or baby showing any distress that needs to be considered when making a decision to intervene (with pitocin, etc.)? If mom and baby are both okay, I say leave her alone!
Joanna Steven: Are there specific exercises or healthy habits you recommend during pregnancy to help make labor easier?
Mandi Hillman: Exercise balls are great for helping to maintain core strength during pregnancy and even strengthen the pelvic floor. They are also great to use during labor and can help build strength after the birth as well. Drinking lots of water – always (before, during, and after birth). Squats are another good on for preparation for birth and also during labor. Many woman enjoy yoga and find various poses very helpful to relieve the pains of pregnancy as well as to ease labor. When it comes to healthy eating simply put – eat the rainbow! Healthy moms grow healthy babies and have healthy labors.
Joanna Steven: Thank you Mandi for this beautiful interview!
“I think it’s fitting to call myself a Jill-of-all-trades, as I often find myself filling many roles and juggling many different “jobs” in the process. For all practical purposes, I am the owner of Serendipity Family studios, which as you may notice is a bit of a business-of-all-trades.
As for my “professional” experiences: I have a Masters degree in psychological counseling and have worked as a professional in the field of mental health for several years. I earned a PhD from Iowa State University in the spring of 2011 in Human Development and Family Studies. My dissertation project was a feminist critique of modern maternity care experiences in the U.S.. I am a certified doula through DONA, International and certified childbirth educator through ICEA.”