59-Abrianna Canady-Birth Doula Perspective-Ryze Birth

In this episode, Abrianna speaks on what it's like to support clients in the hospital while still working full-time as an ER nurse. She also touches on the importance of preparation for birth and how strength training, with a professional coach, can help you meet your goals. 

Disclaimer: This podcast is intended for educational purposes only with no intention of giving or replacing any medical advice. I, Kiona Nessenbaum, am not a licensed medical professional. All advice that is given on the podcast is from the personal experience of the storytellers. All medical or health-related questions should be directed to your licensed provider. 

Resources:

• Abrianna Canady- Ryze Birth
• Birth Fit: strength & conditioning training for the motherhood journey
• The Business of Being Born Film
• Spiritual Midwifery by Ina May Gaskin

Definitions:

• Artificial Rupture of Membranes (AROM) 
• Strength Training Personal Record (PR)

Transcript

Kiona: 0:08

Welcome to Birth As We Know It, a podcast that is dedicated to recognizing the many different ways that birth unfolds. I am your host, Kiona Nessenbaum. I have experienced birth as a doula, a student midwife, a birth assistant, and as a mother of three amazing children of my own. After attending over 140 births, I've realized that each birth experience is truly unique, so make sure you subscribe and join me as we are guided through many different birth experiences through the lens of the storyteller. Please be aware that some of these stories can be triggering to hear, so feel free to pause, take a breath, and come back and listen whenever you're ready. With that said, let's prep ourselves to dive deep and get detailed about what really happens in the birth space. As a reminder, this podcast is intended for educational purposes only, and has no intention of giving or replacing any medical advice. All advice that is given on the podcast is from the personal experiences of the storytellers. All medical or health related questions should be directed to your licensed provider. Before we dive into the episode today, I wanted to remind you that we have an amazing Facebook group for the birthdays of, you know, what podcast listeners. This is a space where we can have conversation about the podcast as well. Let's just ask questions and be able to relate to one another. So join in on the fun by going to birth. As we know it, podcast.com forward slash Facebook. And I have one small favor to ask as you're listening to this podcast episode and you come across a moment when you learn something new. Please share it with a friend. That way we can get this podcast into the ears of more individuals who would love this content. All right friends. Let's dive into the episode. hello everybody. And welcome back to the Birth As We Know It podcast. Today, I am excited to have on Abrianna Canady, and she is the owner of Ryze Birth, where she offers birth doula services, postpartum doula services, as well as strength training during the pre and postnatal time. So Abrianna, thank you so much for coming on today.

Abrianna: 2:38

Thanks for having me.

Kiona: 2:40

Yeah, absolutely. So I'm super excited to dive into what it is that you do and how you support your clients and how you find your clients, who your target clientele is. But before we do that, I would love for you to tell us a little bit about where you're located, where you practice and how you practice.

Abrianna: 2:58

Yeah, so I am right outside of Boston in Brighton, Massachusetts. I work Full time as a travel nurse, so I'm in and out of all the hospitals around the area. I guess how I practice? I've been told, it's hard, I'm, just like fully getting my feet into the birth doula world. So I have been told by prior clients that I blend kind of the evidence based medicine and the more intuitive or spiritual aspects together. I guess that's how I practice.

Kiona: 3:37

Yeah, no, I think that's awesome. I really love how, You support your clients in hospital settings as well because you work in that setting. So how do you think you working as an RN in multiple hospitals as a travel nurse impacts the way in which you support clients when they're birthing in a hospital?

Abrianna: 3:57

That's a great question. I work in the emergency room, I've been doing that since 2018, so I've just seen how differently hospitals operate, and how a lot of things that patients are kind of, Pressured into agreeing to isn't always the one way to do things. a different hospital in the same city can handle things completely differently. Many times I've heard, patients say, well, this doctor at this place said this, and this doctor at this place said this. And those opinions, people don't realize that medicine is a practice, right? There is no right way. so that has been really eyeopening for me, to realize that, You could go to four different doctors and get four different opinions.

Kiona: 4:46

Oh, yeah, absolutely, and I think that's really important to mention because it brings back the human aspect of providers, how everybody has their own input, everybody has their own lived experiences that they're bringing into the decisions that they're making with each patient and especially in an ER setting, right? Like, ER doctors and nurses and providers, you all see. the emergencies. You all see when decisions have to be made really quickly. so that actually brings me to the question of, have you ever had to be around a birth in the ER?

Abrianna: 5:22

Yeah. Yeah, and it's, It's funny. I never had a birth in the ER until I became a doula. And then after I became a doula, they just, like, came. I had a young woman give birth in the back of her car, and she came in afterwards, and, The baby was latching, vital signs were perfect. Baby was pink, warm, dry, awake, no bleeding, there was, like, nothing. And even in that moment, at this point I had seen a couple births, but I was, like, watching the other nurses just panic. complete panic, like, separating mom and baby, because we had to make sure that the baby and mom are healthy. If you look at them, right, look at mom. She looks completely fine. And then, OB came down, and they ended up starting her on Pitocin, and it's just, like, all of these things, happen that, in that moment, and I'm not a provider. I'm just a nurse. But I was like, this is like the chaos that doesn't need to happen with a normal vaginal birth. so that was, that was kind of interesting to see. That was very interesting.

Kiona: 6:34

Yeah, first thing I want to say is you said you were just a nurse, flip that, flip that around because nurses do so much and yes, providers also do a lot, but I will say based off my experience of speaking with nurses and watching nurses in the labor and delivery ward, nurses are the ones that do the work and the providers are there at the very last minute. They also do work, but they're there at the end, you know, and you're running around doing all these things. And so. I just want to say you're not just a nurse. Okay.

Abrianna: 7:05

Yeah, yeah,

Kiona: 7:07

but I think it's also super interesting how you say that you didn't get any births in the OR until you became a doula. I find that so interesting because you know how Like when you get a new car and you're so in love with your new car and then all of a sudden you see that car everywhere. It just reminds me of that, of how you're like in the space and then it kind of just follows you, you know?

Abrianna: 7:34

oh totally,

Kiona: 7:35

I feel like that's one of the reasons why once you become a birth worker, you can't really get away from it is because you've been bit by the bug and it's around you all the time. And then you start noticing all of the pregnant people walking down the street and you're like, I wonder what they're going to do with their birth or how they're feeling and all of that stuff. So, yeah. so I am super curious because before we dive into some like potential experiences that were impactful or challenging. I would love to talk about what got you into birthwork. what inspired you to get into this space?

Abrianna: 8:11

Man, I mean, it's, I feel like it's been a long time coming, and I've been honestly avoiding it, which is so funny, you know, as a little girl, always playing with dolls, pretty normal, One of my aunts got pregnant as a teenager, and I was chasing her around with saltines and ginger ale. and then I remember when my mom had twins, And I would just, like, wake them up, just to, like, look at them, you know, and just, like sit with them. And then in college, I kind of got wrapped up into, the feminism, like, I don't need anyone, strong women, that's all I need. And then I was also taking my OB course. so I kind of really, it was easy, like that was the best grade that I had gotten in college. I didn't study. one of my friends was like, you're like pretty good at this, and I was like, no, never. I don't want any part of that. And I had some really impactful, preceptors and teachers, who really made me take a hard look at what, the medical system is doing. there was some extra credit stuff that I was like, you know, even though I didn't need it, I was like, yeah, I'll do the, I'll watch this and I'll do it. And, through Those extra assignments. I realized whoa, medicine is not this perfect Thing that I thought it was, you know, there's a lot of like nuance here But I pushed that away and I said I'm gonna work in the ER That's what I'm gonna do and then I realized probably two years in Around the height of, all the COVID stuff, I just realized, like, whoa, I am seeing, a lot of, death here. This is, this is not good, You know, so I went through the whole, what is the purpose, all this, and I realized that I needed, like, another, full circle. So I started looking into birth. I came across a strength and conditioning coach, Lindsay Matthews. She operates BirthFit. I got BirthFit certified, didn't know about a doula, and then I met a lot of women there who were talking about birth work, and I was like, whoa, there's a need here. Like people need to know what the hospital can give and what it can't give, because people come into the hospital and just don't even understand what's offered. It's such a big mystery, like nobody really knows, the doctor doesn't have time to answer your questions, so how are you supposed to get this information? Uh, so I just realized, This, yeah, that's kind of how I came into it, I guess.

Kiona: 10:43

Yeah. Oh my gosh. Yeah. I feel like that is such a journey to get to where you are because you were fighting against it in the beginning and you're like, heck no, I'm not going to go here. And then you end up here anyway. That last point you just mentioned is super important. How a lot of people just come into the hospital and I would say a lot of the time. Just expect to be able to get all of their questions answered or expect that the doctor and providers will know everything to do in your individual situation. And yes, providers are trained and of course hospital is one of the first places that come to mind, if not the first place that comes to mind when you find out you're pregnant. I know it was for me personally when I was young and pregnant at 19. I was like, okay, what hospital am I going to, and I feel like that's the mindset for a lot of people. So there's also those people who are scared of the hospital and still go to the hospital. So have you experienced seeing or supporting anybody with that kind of mentality of being fearful of what may happen in the hospital?

Abrianna: 11:51

Yes, honestly, I think my clients, now that I'm starting to, because in the beginning I was a little bit nervous to tell the truth about my experience as a nurse, because, in nursing school, there was a lot of, you're a hero, you're, you know, you're, you're saving the world, these patients need you, blah, blah, blah, which sometimes is true. And sometimes I think that, that sense of authority over another person is, misplaced. I don't think that I'm going to save the world. I don't think that, I don't think that I always know best, you know, I think most of the time everyone knows what's best for themselves. so I think now that I'm speaking a bit more clearly about my experience as a nurse and my experience in the hospital, I am getting more of those clients who are more fearful, of the hospital, which if you want to go into the hospital and you know that what they're offering is exactly what you want, you want all of the interventions or you're just fine with it. It doesn't bother you. That's fine. go for it. Go full force. If you know that you don't need a doula, don't have a doula. But I don't think that The majority of people know what they're agreeing to when they step into the system without some education.

Kiona: 13:20

Hmm.

Abrianna: 13:21

Those are the clients that are kind of finding me now are the people who understand that they don't really know how the hospital system works and they have goals and outcomes that they would like to achieve, but they don't know really how to make that happen.

Kiona: 13:36

Right. Yeah, I understand that for sure. especially with knowing that you have a nurse background, I feel like that puts a little bit of a safety film or shield around their birth because you are in the system on a regular basis with your full time job, and then you're aware of the jargon that's being talked about and said. You're use to longer shifts, so you, you know, however long their birth ends up being. I could definitely see some safety in that and some comfort in that from clients that are birthing in hospital. Have you ever been hired by someone who doesn't want to birth in the hospital, like in an out of hospital setting, like home birth or birth center birth?

Abrianna: 14:17

yes, I've done one home birth, ended up being a transfer, but it was, yeah, started, home birth, and then, now I just started, so Massachusetts just started, covering MassHealth clients for doulas, which is, it's a good start, So I have a couple clients who are Mass Health clients who would prefer to give birth at home, but the CPMs aren't covered, under Mass Health. Home birth isn't covered. so they are very fearful about, being in the hospital. so that has been interesting.

Kiona: 14:53

Yeah. Yeah, I can definitely see where there's a little bit of a loophole that would have to be jumped through for that. And, just trying to also get their coverage while still getting the birth that they desire, or at least try to get the birth that they desire. I think it's really cool that Massachusetts did start, covering that through the, you said Mass, Insurance? Mass Health, yeah. So I'm assuming that's similar to like, DSHS, which is State Insurance.

Abrianna: 15:20

Yes. Yep.

Kiona: 15:22

Okay,

Abrianna: 15:22

It is cool. I do think, personally, just my own beliefs. Because money is just like an energy exchange, so I think the best situation is if that energy exchange is just through the mother and the doula. so I am not super, I'm not thrilled about being paid, by another party, but, It was in the best interest, honestly, of my business, and in the best interest of, being raised by a single mom. I do think that there is obviously a need for doulas, it does just bother me that there's another hand, in that relationship between me and the moms, you know, because then there's some gray area of what if the mother calls me super late and then she gives birth at home, uh, you know, like those things do happen and it's like I don't know, I guess it just puts a little bit of a strain on the relationship, but it is what it is, we're going to make it work.

Kiona: 16:18

Yeah, I see that stress and unfortunate fact that there is a third party involved. You know, because hiring a doula is a very intimate decision to make. and being with a doula and inviting a doula into your space is a very intimate relationship that you're developing. And then for the financial aspect of, will I get paid if I actually attend this person's birth? Or how much will I get paid? what parts are they micromanaging? Or needing me to chart or upload in an invoice or something. Like, how do you actually get all of that to them? You know, so I understand that for sure. but on the flip side, I also understand the need for everybody to have access to a doula as an option. And there are a lot of doulas up here in the Pacific Northwest that do take state insurance because we are in the process of having a campaign called Doulas for All, where doulas are considered part of the birth team and get reimbursement for supporting clients. and I believe that we in the Pacific Northwest are also trying to get it covered for home birth and midwives. but it's a work in progress for sure but yes, so, Tell me a little bit more about your program. So you said that you got certified through birth fit. Tell me more about that. And is that what led you to become the strength trainer for pre and postnatal clients?

Abrianna: 17:49

So, BirthFit really introduced me to the idea, that strength training was not only okay, during Pregnancy but also that we live extremely sedentary lives. I wouldn't ever say that, like, strain training is necessary, but I do think that, it's a good practice, to see where your mind goes when your heart rate goes above 120, you know, if you don't know where your mind is going to go when you're in that physical state, I think it's very hard to practice. You know, you can do the ice in your hands and you can do all of these meditations, but like until your body gets into that state, how do you know? You know, because, and I've had, I've had a couple of clients who are like, well, I was a college athlete, blah, blah. Well now you have a baby in your body that you're responsible for. And that changes everything. BirthFit really opened the door, there's so much research out there showing the mother's heart rate should be 140 beats per minute. It's not true. It's from nowhere. Somebody just decided it. Some doctors I've heard will say, don't lift anything above 20 pounds. Well, what if the mom was lifting 245 pounds? And then what if a mom hasn't deadlifted at all? Why should those two people do the same thing? It doesn't make any sense. You know, for a mother who was squatting 250 pounds to go to body weight? It makes no sense to do that. so BirthFit really kind of opened my eyes to seeing, you know, there are women who in their second trimester will hit a PR, not meaning to, right? Pregnancy and birth is not the time to, Really, my own opinion is I don't think it's the time to, really try to test your limits but accidentally after, you know, you've gotten extra blood, people will hit a PR. And they feel good.

Kiona: 19:56

PR is personal record, correct?

Abrianna: 19:58

Yes. Yeah.

Kiona: 19:59

Okay. Yeah. just for some of the listeners. So, uh, a PR is a personal record, and I am so intrigued here because what you just said makes total sense. having that umbrella of every single pregnant person on the planet shouldn't lift more than 20 pounds. you shouldn't pick up your toddler, you shouldn't do this, you shouldn't do that. It's necessary for some, absolutely 100%. There are some risks, you know, incompetent cervix, or you're on bed rest, or, I really hate that term, by the way, incompetent cervix, hate it. but, you know, There are health issues that you have throughout your pregnancy that require you to not do these things because of, the risk of potentially going into early labor or causing damage or harm or something, right? Now, on the flip side of that, there are people that have been strength training for years and then they're pregnant and then they're told, don't lift this much. But if that person, Decides, hey, I want to keep working out. They have to run it by their provider, of course. But there's also that question of, is it still safe for me to do these things? Is it still safe for me to work out? Most of the time, the answer will be, yeah, just listen to your body. And so, in order to do that, you just gotta, Listen to your body. But in that process, having someone that has experience with supporting people in strength training while they're pregnant and even postpartum during their recovery time is awesome to have, Like if you have those questions, if you have that hesitancy and you want a personal trainer that knows what to do and what kind of limitations to push you at is important because. There's that experience. So, yeah.

Abrianna: 21:44

totally. Well, and you know, like I said there, I will just say that doctors, honestly don't get all of this information. You know, they they, they air. I mean most of them, I can't say everyone, but they will err on the side of liability. So, I've realized that, like I said before, you could ask four different doctors, four different opinions. so if your doctor says don't lift a certain, an arbitrary number that's coming from nowhere, I would probably go find another doctor. You know, and if you need that approval from your doctor, go find another one because they all have their own opinions. And that's a good indicator that you're probably not going to align somewhere else, anyways, if that's how they view, if they think that, pregnancy is a pathology and that you shouldn't lift, you know, you should just lay in bed upright and not move at all, you're probably not aligned anyways.

Kiona: 22:49

Yeah. Yeah, I agree with that. To a certain extent, of course, like I said before, with like, when there are issues and things like that. Like, when bed rest is required and stuff like that. But, I get that with the general, low risk pregnancy. And, I feel like that's the really hard part about The training, and not even necessarily blaming the providers or nurses, but the training that you all receive, in how medicalized birth is and how it's looked to be this sickness or something that needs to have treatment or be healed or fixed, right? Instead of going and learning more about the physiological aspects of birth and how the body works. And I'm not saying that doesn't happen. I've never been trained in a medical setting like that. I've been trained in out of hospital birth and things. So My training was focused on the physiological aspects of birth, but I've heard many, many times that in hospital providers and nurses aren't as much because you guys are trained on so much. You guys have such a wide, a wide net that you have to cast to be able to do all the things.

Abrianna: 23:55

Well and I think, in medicine, especially in emergency medicine, I joke, I joked with some of my friends, I was like, they prefer to keep us, Dumb, you know, in emergency medicine. And that makes total sense, right? Like in an emergency, you shouldn't be contemplating like all of these little nuances. You really just need to act on the big rocks. are they bleeding? Are they breathing? is their heart beating? Like those things are what's gonna save somebody's life. So in emergency medicine, that makes total sense that they would just want us focused on the task. But pregnancy is not an emergency. birth is not. an emergency in most cases, right? So the best providers that I know are ones who can tell the difference between an emergency and a normal process. And it's not easy, I'm not saying that this is an easy, it's obviously more simple for doctors to order every single test regardless if it's necessary or not. But then we open up a can of worms that causes stress, which we know has an effect on the baby, and we know has an effect on the mother. So we're opening up these cans of worms and doing all this extra testing for what? It's not, it hasn't been shown to benefit the mother. It hasn't been shown to benefit the child. So why are we doing all these extra things? You know, but like we talked about earlier, each provider has their own lens. That they're seeing you through, in the emergency room, you bet I am getting everyone undressed, everyone has a gown on, everyone, you know? And I'm not my doula self, when I'm in the emergency room, because I don't know if your chest pain is just gas pain, I don't know if your chest pain is a true, heart attack, I don't know, so, to make myself feel safe, I get everyone undressed, but birth and pregnancy is just, it's not the same thing.

Kiona: 25:56

Yeah, so tell me more about what goes through your mind when you have to transition from one place to another.

Abrianna: 26:04

That, so I'm trying to get myself into a little bit of a ritual, because it is It is hard. I've been trying to do a shower before, even just like meeting with clients, because who I am in the emergency room, I hope I'm recognizable. I hope people, would say, oh yeah, that makes sense that she would say that or that, you know, but they are different. And that's why when I go into, a labor room, I don't expect the nurses to, I just understand their role in that room. Their role is very different, than what my role as a doula is. It's not a, it's not a competition, we just have different roles, and I've heard so many stories of, tension between nurses and doulas, and I don't think it has to be there, but as a nurse, we're trained, you've gotta, you've gotta act confident, you've gotta have control of the room, and I think that, like, ego mindset has got to go if we're gonna have good relationships, and better outcomes for, for clients.

Kiona: 27:09

Yeah, I agree. and I agree with the fact that there are many, many stories that are told where there is tension in the room between the doula and the nurse. And I feel like there's multiple reasons for this, right? I had previously interviewed an RN who was a labor and delivery nurse and she said she loves doulas when they're prepared for hospital birth. I was like, okay, tell me more about what that means because doulas are prepared for birth and they are also prepared for hospital birth and out of hospital birth, but it was so awesome to hear from that perspective of, as a nurse, she liked having doulas that were prepared for hospital birth because she felt like some doulas came in ready to fight and use their client's birth as, an advocacy moment of, like, fighting the system. And in some cases, as a birth doula, I can see why she feels that way because, as a nurse in a labor and delivery ward, that is likely, if not truly, The first time you've ever met that client. It's the first time you've ever talked to them, communicated with them. You're getting to know them through their charts and their records and potentially through a birth preference form that they provide you. And as a doula, I don't know if this is what you do. Do you meet with your clients prenatally?

Abrianna: 28:32

Yeah.

Kiona: 28:33

Yeah, so being able to have that opportunity to meet with one of your patients or clients prenatally makes a huge difference than meeting them when they're in labor, right? Because you get to know their preferences, you get to know what it is that they want. And so I am curious with you being a ER nurse, when you step into the space of a labor and delivery room with your client, What is the shift in energy that you feel from the nurse once they find out you're a nurse versus air quotes here, just a doula.

Abrianna: 29:04

Just a doula. Yeah. Yeah. I think, honestly, it's dependent on each of the nurses. If they take it, defensively, if they feel like they're on offense now, I will say a lot of times and this is my own subjective like view, so I could be totally misinterpreting, what happens, but a lot of times when I have a patient who is a nurse, I almost feel a little bit tense, you know, it's like, oh gosh, like, ugh, if I mess this up, they're going to know, you know. so I do get that from the labor anD delivery nurses. but I think that my approach is always, to put the client first. so I have conversations with my clients in advance. there's a birth worker lawyer that I was listening to, And she was saying that really the client needs to announce, once you get into the birth room, the birth doula's role, which I think is super helpful. Do you do that with your clients?

Kiona: 30:08

Have them announce, what my role is?

Abrianna: 30:10

Yeah, yeah, she was saying that it can be helpful.

Kiona: 30:14

Not necessarily, or at least not intentionally, because sometimes it just comes up casually. I am the type of person that is very, conversational anyway, so when I'm in the birth space, I go in and I say, Hi, I'm the birth doula. I'm here, part of the team, and I kind of put myself in the forefront, not to like claim territory or anything like that, but to say, Hey, we're a team. Let me know if there's any way I can help you. You can lean on me if you need my help, you know, which has been super helpful because there are clients that need to be flipped and I know that they need to be flipped, but the nurse is busy and I had gotten. the okay of like, yeah, if your client wants to be flipped, go ahead and flip them, you know? Not that I wouldn't necessarily anyway, like, I don't need approval from the nurse to flip them, but it's more of just being on the same page and not, air quotes, messing with their patient in their territory, you know what I mean?

Abrianna: 31:09

But that's, that is so hard for me because as a nurse, I've had to come to terms with the fact that, like, I don't own you. You know, I've had several patients who I'm, like, I just straight up tell them, I'm like, you were in a car accident. I don't think that it's safe for you to be up and walking. because they've chosen that they want to walk to the bathroom. I don't think that it's safe. These are the risks. But like, at the end of the day, like you're an adult. you make your own decisions. And I just think it's sticky, because I don't think clients need to ask for approval, I just don't think that that's necessary, but I get what you're saying, and, like, trying to create a team, approach. It's just, it's always for me, the focus is on what is my client, what is their goal here? What are they willing to compromise on? What are they not willing to compromise on? And that's what I'm going to do. You know, if they don't want to ask the nurse for permission to move, then that's your choice. will there be, will the nurse get upset? Maybe. If you want to deal with that kind of tension, that's up to you. That's not up to me.**Ad for"What Was That Like" Podcast: Whatwasthatlike.com** so, the way the lawyer was talking about it, it was just like, because, When I'm in an emergency, in the emergency room as a nurse, I do want to know who is in this room right now. Why are you here? for my own safety, it's probably selfish, I don't need to know why everybody is there. but I do think that having the client themselves, recognize and acknowledge, like, why I'm having this person specifically here. for some people, it's going to be just for comfort measures. For other people, they want me there to advocate for them. But that's a conversation that I have with them. Like, why do you want me there? And I need you to tell that to the medical team, so they're not confused. And we are, like you said, all on the same page.

Kiona: 34:25

I get that, and I agree, and I feel like, It is very easy for it to get sticky,

Abrianna: 34:31

Yeah.

Kiona: 34:31

because as a birth doula, you know, every doula practices slightly differently, right? There are some that will verbally advocate for their client to the doctors because that is what is discussed prior and what they agree on and how they want their doula to show up for them. Which could lead to some of the nurses being like, Oh, these doulas are trying to fight the system. Like, why are they making decisions for them and doing all of this? But it's just hard because every single individual that is present in that space has a role or should, right? So whether that's the partner that's there as well as a birth doula, who knows that doula can be there to support their partner. To help them get through the moments and help them be reassured that everything that's happening the way that it's happening is normal and okay, and to get that, like, jargon translated into, you know, common conversation and, things like that. So, I do really like the announcement aspect of that. And I feel like it does happen in different ways, but it is something that's good to kind of have just in the forefront, even on the birth preferences form or birth plan. I call it birth preferences because I feel like, you know, I've mentioned it multiple times in this podcast, but birth plans never go as planned. So it's more of preferences about what you want and how we can get there, but also the alternative routes that we can take.

Abrianna: 35:52

Totally. Yeah. I like to call it birth philosophy, makes me feel, because then it's like, things can ebb and flow, but you can always, like, make decisions based on your philosophy,

Kiona: 36:04

Mm hmm. I like that. Nice. Yeah, so, I want to go back to birth fit really quick. So, tell me what it looks like when you're supporting someone who wasn't super active before pregnancy, but they want to make sure that they're strong and ready for birth. How do you support that person?

Abrianna: 36:28

I wish that there was, like, this magical, this is exactly what you do, but it really is the same as, if you weren't pregnant, right? I wouldn't, I wouldn't start you from day one deadlifting, barbell if you've never seen a barbell. So that doesn't change. It's really meeting the person where they are and understanding that there is another person involved. But there isn't like a magical formula.

Kiona: 36:58

Yeah, that makes sense. So it's basically you're meeting people where they're at regardless of when they come to you and how they come to you.

Abrianna: 37:04

Yeah.

Kiona: 37:05

Okay. Yeah. And so if there was a person that came to you and they were super fit and doing CrossFit before they found out they were pregnant, you're going to be like, all right, what do you feel comfortable doing?

Abrianna: 37:15

Right. Well, and what is the intention? Because sometimes people like that, people who are more intense, who are geared towards CrossFit, sometimes their intention is that they are worried they may lose themselves, right? And that's something that we have to explore. okay. Like, why are you training twice a day? While you're six months pregnant. What is that? Is that truly what is going to prepare you for this birth? You know, so that's where I take things

Kiona: 37:46

So it sounds like it can also be pretty therapeutic for people coming in.

Abrianna: 37:52

Yeah, there are some people who, like me, strength training is meditation. Right? You have to be connected to your body when you're in the bottom of a squat and you have 300 pounds on your back. You can't be anywhere else or you're going to get crushed. so I think it is preparation for life, for birth, and I know that there are people out there who feel the same way, but they've been told they can't strength train. They've been told that, you know, this is wrong. You're gonna hurt your baby, and it's, it's noise. That's just noise.

Kiona: 38:25

Yeah, I can feel that. And I understand that 100 percent about like how working out in general, whether you're strength training, going on a long distance run, or even just like doing, I don't know, gymnastics and flipping all over the place or whatever, like your mind has to be in what it is that you're doing. So that is great practice for preparing for birth because you're dealing with your internal dialogue of like, Oh my God, this is hard. Can I do this? Can I lift these? Can I get out of this squat when I have 300 pounds on my back? First off, kudos to anybody that can do that because this mama right here cannot.

Abrianna: 39:01

well, we all start somewhere, right? We all start somewhere.

Kiona: 39:04

Yeah, I'm like, uh, empty barbell on my back, okay? That's

Abrianna: 39:08

That's great. Yeah, that's great.

Kiona: 39:10

so yes, let's go ahead and take this conversation in the direction of birth experiences that you've had as a doula. So from the doula perspective, tell me about one birth that you attended that was a really challenging birth for you and why it was challenging.

Abrianna: 39:29

One that was challenging for me was actually, at the hospital that I used to work for. it was difficult because, the nurses came in very friendly, but it felt very on edge. they weren't sure, and this was before I decided to start announcing why someone has a birth doula. I think that coming in with a birth doula, sometimes, for whatever reason, I think it makes nurses feel like, why do they need protection from me? You know, what, what am I doing? And I don't think that that's the case. I think, people have birth doulas for a million different reasons, but that was the sense that I got, and my client, and I we talked about her birth. There was nothing like that mentioned, it was just something that I noticed. But I would never want that tension, to affect my client's birth. I had offered to help the nurse. I was like, Oh, she had a sterile glove on. I was like, Oh, do you want me to grab the ultrasound jelly for you? And she was like, no, don't touch it. You know? And it's just like, Oh man, like, I'm, you know, I'm so sorry. I'm just trying to help. but that birth was very difficult just because I saw, how they were kind of like guiding my client into what they wanted, without considering her. she had said that she didn't want Pitocin, after the birth, and they started her on a Pitocin drip, and one of the nurses said, oh, do you still want to, not get the ending dose of Pitocin or whatever they do, and the midwife said, well, she's already got the drip, so I think that's kind of mute. And I was like. These choices are just, being ripped from her. so that was hard for me, because I would prefer that nobody knows that I'm a nurse just because I think it makes it uncomfortable, but my clients want to tell them, I think it makes them feel better, so that's fine, it doesn't matter. but that, territorial thing, I was like, oh, this is, like, palpable. I know it's not all going to be like rainbows and sunshine and we're dealing with humans, but that was hard for me, because my aim as a birth doula, I try to look at results and outcomes. I look at what my client wants, what do they want, did we achieve it? that's the only way that I can really, say did I do, and I mean, you know, whatever. You can say, oh, you made me feel so good. You made me feel so empowered and special, but like, did we get the goals that you went into this birth? Because I think a lot of times doulas, I mean, I don't know all doulas. I'm just making a generalization, but a lot of times doulas will get their client's wishes and what they want for their birth, and then after the birth, they didn't get anything. They didn't have anything. And then the client is like, well, at least I had a healthy, happy baby. And it's like yeah, but what is the purpose of a doula if we're not improving the outcomes and not getting you the goals that you want? So that birth was very hard because, My client didn't get the outcomes that she wanted, she had a healthy baby, it was beautiful, absolutely beautiful, but I took some time and just like where was I not showing up, for this client and how did I not create, like you said, create an atmosphere where it felt like a team. Because that's ultimately what happened, was there was no team dynamic. How could I have shown up as a better teammate and what did I say, what did I do, that made the nurses not feel like I was trying to help. That was a hard one for me.

Kiona: 43:03

Yeah. So as I listen to you sharing this experience, it makes me think of a few things. The first thing is. I also did that once where someone had a sterile glove on and I was like, Oh, do you want me to grab the gel? Also got a similar response. But, there was also another experience that I had where I was supporting a client at a birth center and the student midwife was there and there was one, lead midwife that was present, and she was out of the room at the time, and the baby came really fast, and baby came out, but the student midwife was like, uh, what's going on? Like, she knew what to do, but the client was having a minor hemorrhage, and she was alone. I was a student midwife at the time, and I was like, Okay, I know I'm not supposed to be touching all of this medical stuff, but do you want me to draw a pit for you? Do you want me to give you the mesoprostol? I can help you because your hands are obviously occupied. And I can also go get the midwife, which I did, but she was like, yes, can I have pit right now? And then can you please go call the midwife? And I was like, yes, cool. I can do that. Now, the challenging part of that is I was in the doula role. Right? And I had to step in and put my student midwife hat on to keep my client safe, but then I stepped right back out as soon as I was able. but that's tricky when you have multiple hats that you've worn in a space before.

Abrianna: 44:29

totally. And that's, yeah, that's the biggest thing for me, I think, is just realizing, it's beautiful that I get to put together the nursing and the doula, but it is tricky in the hospital setting, so just getting really clear with my clients, and having them really say verbally, why they wanted me there, what I'm doing there, I think that puts everyone at ease.

Kiona: 44:54

yeah, I agree with that. There are also some times when I have felt the tension. You can literally cut it with a knife in the room. one way that as a doula, I've tried to navigate that situation is speaking directly to my client when I see that the nurse is about to do something or doing something that they may not have wanted. Because if someone puts up an IV drip and the client isn't aware or they're sleeping or something and then they still put it on, that's unconsensual. That is, you are not getting consent for that. And even though it's like, policy or protocol or something that you normally do and it's something that's not on my client's preference list, then at that point, I either turn to the partner and say, Hey, do you want to wake up your partner and ask them if this is something they want? I'll say, Hey, remind me, is Pit. Something that you wanted? And I'm talking directly to the client and the nurse sometimes gets all huffy and puffy because they don't get to do what they want. But that's one way that I navigate it because I have to be in the mindset, which is something that I'm actually hearing that you're experiencing is shifting the mindset of being with your client and not a literal part of the hospital team at that point, you know? So. In moments like that, I have to remind myself, I am hired by my client, not this hospital. So I am going to try my best to ensure that this client is getting what they need. So I make announcements to the room or, I will hear the nurse, talking to the provider with my client there about like a potential AROM, which is like artificial rupture of membranes. And I will then say, Hey, so and so. Remember when we talked about AROM prenatally? How do you feel about that now? Let's have a conversation and that pulls the client into the conversation that the hospital birth team is having. And I feel like that's a way to navigate that, but it's challenging and there is tension sometimes

Abrianna: 46:53

Well, and for me it's been hard just because, you totally see the conversations that are happening, out of earshot, and you see kind of how things are starting to progress, but it's so frustrating to me because those conversations assume That the providers know what is best for the mother without discussing with the mother. So that is I think that's where doulas, like yourself, really shine, right, birth is consuming for the parents, as it should be. this is a huge experience, but it's like just having someone in the room who can sit back and see the bigger picture, I think is, is super powerful for the parents that decide to, to go that route. So, that's awesome.

Kiona: 47:38

Yeah, I agree with you and I think it's awesome too

Abrianna: 47:43

pat myself on the back

Kiona: 47:44

yeah, pat pat. but so we definitely can't end this interview on kind of such a tense and downer energy. So let's talk about a birth experience that you had that was impactful in a positive way for you as a birth doula. And I do want to touch on your postpartum doula services too, and like what that looks like, but let's focus on birth right now and talk about an impactful birth that you've had as a doula.

Abrianna: 48:12

This is probably the most impactful, There was a woman who had given birth to four children, and had one cesarean, and then she ended up having twins, and her doctor was telling her, because of the cesarean, you can't give birth to the twins vaginally, blah, blah, blah, and this was at a big, well known hospital. And, without any prompting, she told the doctor, I'm actually going to give birth vaginally. I will bring my own kiddie pool and give birth in the parking lot, if you want to come and see. eventually he agreed. To let her trial, a, vaginal birth. And she did it successfully. Healthy babies. and it's, I understand that doctors have, comfort levels. I get it. But, I also understand that our comfort levels are challenged. that is what it is. It's called a practice for a reason, right? There's just no way around it. birth is inherently dangerous. So is driving a car. So is going outside and not getting struck by lightning. so if we can, like, recognize that and accept and take responsibility for the risks that we're taking, but then do what we feel is true, I think that's the most important thing. Find whatever knowledge you need to find, but then tune into yourself and like what is true for you. so that was, that was very impactful for me.

Kiona: 49:45

I think it's super awesome that she stood her ground prenatally and was like, Hey, I'm going to do this regardless. but also, It's risky to do something like that to a provider, because that can then create tension that comes into the birth space that makes it to where the provider needs to be defensive in the space while you try to do your thing. and depending on where she was in her pregnancy when she made that statement, if that's how you feel with your provider, you're not aligning with your provider. So Potentially make a shift there. but there are people that don't have the option or opportunity to make that shift. And so standing your ground and advocating for yourself in your birth space is absolutely necessary. which is where a birth doula comes in handy.

Abrianna: 50:27

Yeah, she was definitely a firecracker, you know, so, I think that when you see truth, you know truth, understand by saying these strong statements that you may make friends or enemies, but I think each woman truly does know what is true and what is right for her. So, I'm not here to stand in the way of that. I think there maybe are better ways to go about communicating, but, Yeah, I'm ultimately here to support women in whatever they choose.

Kiona: 50:58

I hear you and I think that that is something that is totally worth talking about and bringing up and everybody has different ways of communicating. Everybody has different lived experiences. So that doctor could have been like, heck no, you're pregnant with twins. Like I'm not doing that

Abrianna: 51:13

Yeah. That was a big gamble.

Kiona: 51:15

But, maybe they got a really good experience out of it. And they're like, you did do it. You proved me wrong. Thank you so much. You know? so pros and cons, awesomeness and scariness all coexisting in the same space.

Abrianna: 51:29

Yeah. Totally.

Kiona: 51:31

let's go ahead and touch on a little bit what your postpartum services look like and how you offer those to your clients.

Abrianna: 51:38

so, postpartum, I Offer, 30 hour packages, typically I try to sit with the client, figure out what their goals for their postpartum are, if it's, I don't want to feel frazzled, I just want to connect with my baby, I really want breastfeeding to go well, then those goals are how I, choose my services and how I focus our, postpartum visits. I would love nothing more than to see a mom like taking a nap, peacefully knowing that her infant is well cared for, but sometimes that's not the goal for the parent. and that's okay.

Kiona: 52:16

Yeah, I love that. And I just really feel that you're meeting people where they are and with what they need, which is super awesome. I'm curious, how does your strength training coincide with what you offer as a birth doula and postpartum doula? Do you have any packages that include everything or do you keep them pretty separate?

Abrianna: 52:37

Really, it just depends. I do combine them, sometimes even, to the dismay of some of my clients. We get into a little bit of the, the movement, while I'm there as a postpartum. It just happens, you know, I was moving here and this felt a little bit funny and, I'm curious and I'm like, can we just see, like, where your diastasis is? can we see how you're breathing? because I know it's so important. so sometimes it just comes on accident and that's okay.

Kiona: 53:07

Yeah, it kind of goes back to taking off and on your hats and like where where it lands. but yeah, that's super awesome. So Abriana, I really, really, truly appreciate you coming on and talking about your experiences and the things that you're offering. One question that I want to ask you before we dive into our final closing questions is, what is your connection to the term burnout, and how do you feel about it?

Abrianna: 53:33

Ooh. yeah. It's hard because I think that when burnout happens, you've lost your purpose for doing what you do, your reasoning, you can't rationalize it for yourself anymore. It's hard because, as a nurse, I've definitely experienced times where, I'm not sure, cause I think we get into this because we want to make a difference. We want to be helpful to other people. and when you don't feel like you're being helpful, that's, that's hard. For me. I think that being really honest with myself because when I experience burnout, it's usually because I don't feel like I'm being helpful. So usually for me, I need to look into all of the past experience. Where did I not feel like I was being helpful? Where could I have done better? and that usually cures the burnout, so to speak, is like, how can I do better as a nurse, as a doula.

Kiona: 54:29

Yeah, so that actually is a perfect segue to my next question, which is, what do you do for yourself when you are feeling like you're on the brink of burnout? you say you look back at your past experiences and ask yourself, where was I not helpful? But what do you physically do for yourself to like, physically get yourself and mentally get yourself back into the space of comfort?

Abrianna: 54:50

Yeah, it's, it's funny because whenever I have those, periods of feeling like I'm not, being useful, which is my ultimate, goal, it's usually because I haven't been eating the food that I feel best eating. It's because I haven't been taking walks. it's because I haven't been taking time. I have a very busy mind. I've got like a hundred, you know, I'm a nurse. I'm a personal trainer. I just have a lot of different things that I'm doing and I love it. but I do require some silent, quiet time. No phone, nothing. so when I feel like I'm completely drained, it's usually because I haven't been filling my own cup.

Kiona: 55:31

Yeah, so I imagine in those moments, you might put your phone down, potentially go on a walk, potentially do some strength training yourself to really have that focused mindset. So those are all things that sound awesome and just kind of grounding yourself again.

Abrianna: 55:48

Yeah. Totally.

Kiona: 55:49

Yeah. So, Abrianna I am going to go ahead and dive into the three final closing questions for our interview. The first question I want to ask you is, what is one piece of advice that you would give to someone who is wanting to either get trained as a doula or get trained as a birth fit coach?

Abrianna: 56:08

I think the, first thing to start is get clear as to who you are. because I think a lot of times what can happen is you want to be, A doula for everyone, and you want to be a strength trainer for everyone, and that totally washes away, what you have to offer. so I think get really clear on who you are, who you can serve, where your skills are, and then just barrel down.

Kiona: 56:36

Yeah, I think that's great advice because, it's finding your niche in the space that you want to be in. When you think of being a birth doula, what kind of clients do you imagine or see yourself serving? If you want to be a birth fit coach or trainer, imagine the kind of clients you want to see yourself supporting and serving. Like, if you're going to be a birth fit trainer, are you going to only look for clients that are already fit and want to continue their strength training process? Or are you going to look for clients that want to maintain like their minimum efforts of just moving and don't want pregnancy to weigh them down? what does that look like? So yeah, I think that's awesome. Great piece of advice there. My next question is, what is one word that you would use to describe your profession in the doula space, and then one word you would use to describe your profession in the birth strength training space

Abrianna: 57:31

This is tough. I think for the birth doula space, honest is how I would describe it, and then for the strength training, I feel like honest is like the, that's, that's the word. just because in training So many people go to the gym, go to the gym, go to the gym, don't see any results, because they're not putting in honest work They're not being truthful. And then other people will go in and damage their health. And it's because they're not being honest. so I guess, is that, does one, one for both work?

Kiona: 58:08

Absolutely, yeah. I just wanted to give you the opportunity to use two different words if you felt like it was needed, but I definitely can see how honest can be the word for both spaces. So yeah. the final question I have for you is what is one resource that I can share with my listeners on your behalf?

Abrianna: 58:28

There is so much info, out there. I just keep finding myself rereading, and she has, she has her flaws, I don't think she's perfect. but I keep rereading some sections of Ina May Gaskins, Spiritual midwifery, and I think that the way that she writes that, just really, if your provider isn't talking to you or acknowledging your power, like she does pretty well, I think. I think. You should just maybe think about, what kind of providers you're looking for. Because she really, truly does believe in women, and their abilities. So I think that that is probably my best resource.

Kiona: 59:12

That is actually a really good resource. Ina May has a good set of books that she refers to, but I do agree that they're, you know, nobody's perfect. There are pros and cons to each, author, each resource, But it is a good resource and just like any other resource that's ever given, take what you can from it, right? The entire thing may not speak to you, but take what you can and be open to learning from different angles and views and things like that. So yeah.

Abrianna: 59:43

Totally.

Kiona: 59:43

Yeah. So, Abrianna, thank you so much for coming on the podcast today. I truly appreciate it. And I had a really awesome, fun conversation with you today.

Abrianna: 59:51

Yeah, thank you. Thank you so much. It was a pleasure.

Kiona: 59:55

Yeah, absolutely. Okay. During this interview with Abrianna. I really enjoyed hearing more about what it's like to be a birth doula when your full time job is to be a nurse. I was also super intrigued to learn more about what it was like for her to be a strength trainer for pregnant people. I personally think that sounds super cool and incredibly beneficial. Abrianna thanks again for sharing your perspective with us. And as for you listening, if you are still here, that means you enjoyed it too. And guess what? You can text me exactly what you think by following the link in the top of the description. It's a new feature that I'm trying out because my host is offering it. So if you want to give me any direct feedback, that is an amazing way to go. If you want to leave a review, you can do that as well on apple podcasts. And if you want to support the show, you can go to birthasweknowitpodcast.com/support and become a patron, that is what makes it possible for me to keep producing this podcast. Tune into our next episode to hear Meg Chappell, share her journey through loss and IVF, leading her to parenthood. All right friends. This is your host, Kiona Nessenbaum. And I will talk to you again soon. Bye for now.