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Writing the Book on Birthing

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For Penny Bussell Stansfield — a doula, childbirth educator, and massage therapist — childbirth is a critical time for a woman and can affect the rest of her life. “Women do not forget their birth experiences,” she says. “A lot of women, even when their kids are in their 30s, will talk about their birth experiences and choke up. It’s really a roller coaster, and it’s an important part of who they are.”

A doula is a person who supports a woman emotionally and physically during childbirth. “Every birth is unique, and you learn something new,” she says. “Every woman is different. It’s always a mystery, a journey into the unknown.” A gift Stansfield has given to the parents in the 100-plus births she has supported is a write up of everything that happened during the birth. “I try to remember all the little details,” she says. Sometimes she jots a few words in a notebook she keeps in her doula bag, like the name of the nurse or silly things like the father getting stuck in the elevator.

One day, thinking about how fearful young women often are about giving birth, she realized that a collection of these birth stories could offer a realistic sense of the range of possibilities. So she selected 25 stories she had written that reflected a wide variety of experiences and contacted the couples for permission to use them. She changed all the identifying details. Through a friend she met with book packager Marie Galastro of MLG & Associates in Princeton (see story page 31) last summer. “I was very impressed by her expertise and knowledge,” says Stansfield, “and I realized it would be way better to work with a professional than do it all by myself.”

Stansfield will read from and talk about her book, “Labors of Love: A Doula’s Birth Stories” on Saturday, March 19, as part of Local and Independent Author Day at Princeton Public Library.

Reading “Labors of Love: A Doula’s Birth Stories” is like being a silent partner in the process of labor, privy to the emotional and physical challenges, the quick decisions made on the fly, and the joy of watching a mother hold her newborn child. These vignettes, averaging six or seven pages, are divided into several sections: births with no interventions, births with medical interventions, births by cesarean, twin births, births with siblings present, and at the end the birth story of Stansfield’s daughter Kate. The stories themselves also serve to educate interested readers about the process of childbirth, whether they experienced it themselves in the past, plan to do so in the future, or are just interested.

For Stansfield, a Belle Mead resident, each of her three childbirth experiences moved her closer to a career involving childbirth. Her first two births were in the hospital, each with its own challenges. Her daughter, Johanna, now 26, was a breach birth without a cesarian, and her son, Alastair, required an emergency cesarian due to the knot he managed to tie in his umbilical cord while in utero.

It was after Alastair’s birth that her passion for childbirth began. “I was fascinated by the process — the extraordinary effect that it has on your life as a couple and as a woman, how becoming a mother changes your perspective and can even change your intrinsic life values,” she says.

Both because she wanted to explore the process more deeply and, as the mother of a two-year-old and a baby, was looking for some kind of mental stimulation other than changing diapers, she trained with the National Childbirth Trust to become a certified childbirth educator.

When Stansfield was pregnant with her youngest, Kate, the family was living in a village of 120 people 20 miles outside of Strasbourg, France, where her husband Rob, a biochemist, was working. For Kate’s birth they left the house a little too late and didn’t quite make it to the hospital in sufficient time. “My husband was driving, and we were stuck in rush hour traffic in Strasbourg,” recalls Stansfield. “He managed to pull over, rushed around to my side, and by the time he opened the door, I was holding her in my arms. There was nothing to do but to drive on.

“It was in no way planned, but it was a very empowering experience,” says Stansfield. “I’ve read a lot of studies of the psychological impact of birth on the mother, and the studies show us that a positive, empowering birth experience can psychologically affect you positively for the rest of your life, whereas a traumatic, negative experience can also negatively impact you for the rest of your life.”

What is important, she adds, is not whether the birth is easy or difficult. “It’s whether or not you feel you are well supported and that you are in charge of the decision making — that you are the pivotal, key player in the team moving along this journey toward birth.”

Born in Devon, England, Stansfield was exposed early to the caring professions. Her father was an old-style, country family doctor, “the type who visited people in their homes,” says Stansfield. From him, she got “the personal touch.” As a doula Stansfield spends a lot of time “waiting by the phone,” and that’s a role that echoes her mother’s experience as the typical doctor’s wife. “When he was on call, there had to be somebody by the phone,” says Stansfield. “She was his unpaid assistant.”

Stansfield completed a four-year bachelor of arts honors degree in French at the University of Southampton. Then she moved to Grenoble, France, where, she says, “my passion was hiking, backpacking, skiing, and mountaineering.” She became a teacher of English as a foreign language in corporate settings and also served on and off as administrative assistant to the United Nations High Commissioner for Refugees.

She met and married her husband, also a Brit, in Grenoble, where he was doing a postdoctoral fellowship. In Strasbourg Stansfield taught childbirth classes to the English-speaking community, many of whom were postdocs from the United States, pregnant with their first babies. Her classes covered the stages of labor, coping strategies, and potential medical interventions. Her goal was to give the moms-to-be as much knowledge as possible to relieve some of the fear out of the experience. Having had a baby herself in France and being bilingual, she was also able to explain the French medical system and reimbursement procedures.

When Stansfield and her husband finally arrived to the hospital in Strasbourg with newborn in tow, her obstetrician said to her, “You couldn’t wait for me, right? Would you like to go home?” She had no intention of leaving. “I had a great pile of books to read and someone to take care of my other kids,” she says. “I stayed for the allotted four days.”

After six years in Strasbourg, Rob was offered the opportunity to transfer to Tucson. “We were ready for another adventure,” says Stansfield. “We love traveling and living in different places.” And with her children being 10, 8, and 3, she felt it was an okay time to move them.

Stansfield says she had always wanted to be midwife, but in Tucson, when she was thinking about her next career move, this route seemed closed. With a degree in French, she would have to complete seven years of education — not to mention umpteen prereqs for nursing school — to become a nurse and then a midwife. With young children, she did not see this as a real option.

Then one day during her children’s swimming lessons, she heard someone talking about a doula. “It very much fitted with my personality of being a caretaker and support person as opposed to a leader and an authority figure,” she says.

She immediately signed up for a 20-hour workshop (due to her childbirth education knowledge, she was able to skip part of the training), where she learned how to be a good, nonjudgmental listener, how to support women emotionally and physically during labor, how to work with the family, how to work with the hospital staff and not get in the way, and how to interact with professionals without stepping on anyone’s toes.

“Being a doula is not about what you do as much as about who you are,” says Stansfield. “You become a doula through experience, not by attending a workshop.”

So how does it work? First she meets with clients prenatally to establish a bond and create rapport, and then they meet to talk about their priorities for the birth. To get a feel for what is really important to her clients, she asks, “Other than a healthy mom and a healthy baby, what are your top three priorities? What really matters to you?” Answers might range from getting an epidural when the mother starts getting uncomfortable to avoiding a cesarian, not having any medical interventions, or being able to hold the baby as soon as it is born.

Then comes what Stansfield finds the toughest part of being a doula — being on call for the couple 24/7 in all the weeks when they could have the baby. Of course she works with a backup doula in case of an emergency, illness, or family event that she can’t miss.

One of the biggest challenges her clients face is being patient. “We are so used to things being under our control and happening pretty fast these days,” she says, “and when we watch media reports about a birth, they’re not in real time. They show you the highlights.” The result is people having the false impression that it’s all over in a few hours. But a normal birth process can last from a few contractions to a few days.

It can also be difficult, both for the doula and the mother, to maintain stamina. The doula’s calm, continuous support is important, because the nurses come and go, and when they’re present are busy with such things as charting and blood pressure checks. And the father is not only emotionally involved, but doesn’t have the experience to know what is normal — which can include really intense contractions and emotional extremes. So when the mother is shaking and crying and saying, “I can’t do that,” the father is overwhelmed and afraid his wife is going to die. At that point, Stansfield can put her hand on his shoulder, and say, “It’s okay; she’s doing great.”

Stansfield emphasizes how important it is to have someone there to offer that kind of encouragement. “Sadly in our system there isn’t anybody available on the medical staff to give that kind of reassurance,” she says. “The doula is there to fulfill an old tradition that is lost.”

Stansfield sees the target audience for her book as twofold: women of childbearing age and a few thousand student doulas. Two years after Stansfield became a doula she also became certified as a doula trainer and has trained 350 women.

As do most doulas, Stansfield works in a small group. She is co-owner of Hillsborough Massage Therapy with five others, two of whom are also doulas. She is also a certified massage therapist, having completed the 1,000-hour program through the Desert Institute of the Healing Arts, where she specialized in prenatal and postpartum massage.

She also works for Mama Mio, which offers a high-end, luxury brand of skin care, created specifically for pregnancy. For the company she travels to Ritz Carlton hotels around the country and teaches massage therapists to do pregnancy massages and to use Mama Mio products correctly.

Says Stansfield “For me, I would go to the births for nothing; I feel like I’m being paid for the on-call piece. As soon as a woman calls you, you have to drop everything and just go.”

Stansfield says both her husband and her children have been very supportive. “When my kids were younger, I would sometimes miss driving them to something, and they would have to give things up for me. They were so gracious about it and so excited that someone was having a baby and bringing new life into world the world.”

Independent and Local Author Day, Princeton Public Library, 65 Witherspoon Street. Saturday, March 19, 10 a.m. to 4 p.m. Three workshops for writers with speakers Don Lafferty talking about social media tools; John Calu and Dave Hart talking about making a transition from self-publishing to traditional publishing; and Chris Illuminati talking about self-promotion and blogging. Selected readings from 1 to 4 p.m. Featured authors with 10-minute readings include Lauren B. Davis, John Fleming, Chris Illuminati, Huck Fairman, and Kelly Rouba. Five-minute readings presented by Penny Bussell Stansfield, Ed Tseng, Todd Ritter, Linda Arntzenius, and Rob Antes. Free. 609-924-9529 or www.princetonlibrary.org.

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