Oh, where do I begin?! With such a big life change as a first-time parent, my
husband and I felt a little intimidated by the whole experience of labor and delivery. Not because we didn't feel emotionally prepared with one another, but mostly because we didn't have your traditional additional support of family to back us. I think for most women, we want to feel like we have our tribe of other strong women to coach us through such an unknown time. All of the questions from what does it feel like, how will we feel before, after, breastfeeding so on and so on. The questions and emotions are endless. I like to think of myself as in tune with my body and soul -- both the good and bad qualities I possess. And knowing that I am a planner by nature and I open myself to having support when I dont know what Im doing, both my husband and I decided that a Doula would be a great asset to our birthing journey. As I went through what felt like hundreds of profiles, dead end leads, and a few interviews I definitely did my due diligence of finding the perfect fit. I came across Tiffany Wilson through Doulamatch.net and immediately felt connected to her for a multitude of reasons. Timing was a bit limited for both of our schedules when I first reached out and Tiffany did whatever she could from the beginning to make herself available. She was at a midwifery conference in Arizona when I really wanted to meet her so we did an informal Google Chat to get the basics before moving forward with a formal in person meeting. Tiffany blew us away with her professionalism, holistic and business approach and overall knowledge of the birthing process. Things little, “Miss. Prepared,” me didnt even think about. I was already sold on having Doula support and she sealed the deal. From there, we decided to hire Tiffany and I didn't look back for a second. She answered questions from the moment we hired her. From weird little things at the end of my pregnancy to literally holding me while I cried in the delivery room. I had a 48+ hour labor and Tiffany advised me along the whole way. Things definitely didnt go to plan for me and my baby in one single way that I had envisioned. Having Tiffany there was even more instrumental -- guiding me to make some tough decisions that I really didn’t expect to happen (Ie an unplanned C-Section). She knew exactly what would be best for me but didnt push a single thing, and rather made sure I was informed to make the right decision for myself and baby. After 4 hours of pushing, Tiffany coaching and all of us delirious at 1am, I was wheeled into the OR for a C-Section, where they would not let Tiffany in (despite me requesting her be there). So she graciously waited until I was in recovery and visited us in the wee hours of the morning with a smile on her face. She's one of the things I remember clearly seeing and feeling relieved and calm with her after it was all said and done. She let me breathe and take it all in. Overall, Tiffany showcased a loving demeanor, a realistic approach on the process, patience, an abundance of techniques/tools and most importantly love for humanity as a whole. She is one of those lucky people in life who finds what they love to do for a living and succeed on many fronts. Her job is not easy. It's an emotional roller coaster with almost complete strangers, but at the end of it, she is an angel in your life who you will be forever grateful for. Thank you, Tiffany for giving us the best birthing experience we could have asked for. I highly recommend her and her services to anyone looking for Doula or Midwifery services.
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One of the significant benefits of having a doula at your birth works out great- not necessarily for you. Doulas reduce the amount of interventions that are implemented at births, overall, and increase resiliency and satisfaction with the birth experience. Who sees the benefit of this savings? Your insurance company! Doulas have been working for years to be recognized by the insurance companies as a service worth paying for. The presence of a doula reduces the need for pain medication, allows laboring clients to go into the hospital later in labor, reducing the need for labor augmentation, and provide breastfeeding support during the recovery period, and so much more. It seems like a no-brainer that insurance would provide reimbursement for our services, and make it more accessible to families. Reimbursement is spotty at best, but worth attempting. Parents can go through the process and find that they are fully reimbursed, partially reimbursed, or not reimbursed at all, and there’s no formula for us to know in advance what will happen. First, know if your insurance company has provided reimbursement in the past. These companies have been known to reimburse for doula services at some level. It would be best for you to check with your insurance company, find out of they have reimbursed for doula care in the past and if not, how you might approach attempting it. The list below was gathered by www.hellosunshineOK.com.
Second, it’s best if your doula is certified, and has a National Provider Identifier, and you will need the CPT code to write on your reimbursement request. There is now a CPT code for both birth doula (99499), and postpartum doula services (99501 and/or 99502), respectively. Third, it helps to have some personal statement about the benefits (to the insurance company) that having a doula brought to your birth. Did you have a vaginal birth? Perhaps having a doula helped you avoid a costly cesarean! Think about what will move the insurance company (hint… $$$), and speak to that. If your birth was complicated and by all rights, expensive, think about the benefits that doulas bring to births in general. Insurance companies want to save money and one client won’t be as impactful as how a service might a) benefit most clients, and b) save money at the same time. Got all that? Certified doula with an NPI, the appropriate CPT codes for your paperwork, and the appropriate forms, and you have a chance of having some of your doula fees reimbursed by your insurance company. We’ve made it easy with the Puget Sound Doulas Reimbursement Packet, the tools you’ll need to request reimbursement. Even if you think there’s no chance, the more requests insurance companies receive, the more likely they might approve it in the future. Best of luck! This post adapted from: Taproot Birth Partners Check out their awesome "how to seek reimbursement" instructions here:
We are so pleased with our birth experience and Tiffany's role in helping us achieve our somewhat hazy goal of an unmedicated birth. Meeting her for the prenatal appointment, we felt instantly at ease with her non-judgmental approach since we were uncertain which path we would purse until labor started. (Although we found her through community referrals, it turns out she is also very well known and respected in our midwives' office and at the hospital where we delivered, which says a lot.)
Our labor was somewhat unusual for a first time birth in that we did not have early labor so we arrived at the hospital already in the very active stages, and Tiffany was there shortly after we arrived and did not leave until well after our son's birth 12 or 13 hours later. She provided invaluable support during the labor and delivery for both me and my husband, always encouraging and supportive of my choices and suggesting multiple options to keep things moving. Her training as a midwife was paramount to the process going as smoothly as it did and I can't say enough how happy we are with the decision to have her there. Although hiring a doula is not an inexpensive venture, I can think of no better way to spend the money in preparation for the arrival of my little one. "Too often women who say they care about the details of their baby's birth day are accused of wanting an 'experience', as if it is selfish to care about how their baby is born, how they feel or how they are treated. But, as the saying goes, 'when a baby is born, so is a mother'. If a mother feels broken, dispirited, depressed or traumatized, how will this affect her baby? Is this healthy? The following sentence is crucial: When a woman gives birth, a healthy baby is absolutely completely and utterly the most important thing. Got that? OK – do not adjust your wig, there’s more… It is not ALL that matters. Two things – just to repeat: a healthy baby is the most important thing, AND it is not all that matters. Women matter too." My story: I was told by two different perinatologists at two different mfm clinics here in Seattle that I should have Charlie by Csec. I saw a neonatologist who agreed with the perinatologist, but helped us make a plan should we choose to birth out of hospital. I spoke to several midwives and found an amazing midwife who believed in choices, and supported us in our decision to birth at home. In addition to all the specialists we spoke to we also read. We looked at the research studies and asked questions of the doctors and the midwives. We talked about ALL the possible scenarios and outcomes. Then we waited for awhile and talked about it some more. It was exhausting but I don't think I have ever felt so well informed about any decision I have EVER made, which is as it should be. I often found myself defending my choice to give birth at home; that ultimately all that should matter is the health of my baby. I agree, the health of my baby was important, and to me, her health included the way she came into the world. Choice. Informed consent. Providers who listen. A healthy baby is not all that matters. Please share this article posted below: You’ve just given birth. You had a tough time and you’re not sure how you feel – but your body hurts and there are some memories floating around that you’d rather forget. As you hold your newborn and greet the stream of well-wishers, there’s one phrase you’re almost certain to hear: “All that matters is a healthy baby.” This phrase is repeated so often it has almost become a cliché. New mothers hear it over and over, usually the moment they begin to open up and say that having their baby was difficult or even traumatic. Sometimes they even find they are saying it themselves: “Giving birth was awful, but at least I got my healthy baby, that’s all that matters.” And this is wrong. Because a healthy baby is not ALL that matters. This article might push your buttons so before we go on I want to ask you to stay calm, grab a cuppa and keep your wig on. I need to be very very clear, because I know from experience that talking about this issue can cause an outcry. So please listen carefully. The following sentence is crucial: When a woman gives birth, a healthy baby is absolutely completely and utterly the most important thing. Got that? OK – do not adjust your wig, there’s more… It is not ALL that matters. Two things – just to repeat: a healthy baby is the most important thing, AND it is not all that matters. Women matter too. When we tell women that a healthy baby is all that matters we often silence them. We say, or at least we very strongly imply, that their feelings do not matter, and that even though the birth may have left them feeling hurt, shocked or even violated, they should not complain because their baby is healthy and this is the only important thing. Not only do we turn a blind eye to the woman’s feelings, but by gaily proclaiming everyone ‘healthy’ we also ignore the complex relationship between mother and baby, and the impact of the birth experience on the future mental and physical health of both of them. Too often women who say they care about the details of their baby’s birth day are accused of wanting an ‘experience’, as if it is selfish to care about how their baby is born, how they feel or how they are treated. But, as the saying goes, ‘when a baby is born, so is a mother’. If a mother feels broken, dispirited, depressed or traumatised, how will this affect her baby? Is this healthy? A good birth doesn’t have to be a hippy dippy ‘natural’ birth, all candles, knitting midwives and placenta smoothies. Many women who have hospital births that don’t go the way they planned and end in interventions such as caesareans, report feeling positive about what happened. This is because how a woman is spoken to and treated as she has her baby is much much more important than the actual mode of delivery. Women need to feel that they have been consulted, respected and given the information they need to make free choices in the best interest of themselves and their child. This allows them to begin motherhood feeling strong, capable and mentally healthy – surely the best way to be when you are about to be given another human being’s fragile developing psychology to hold tenderly in the palm of your hand? Birth matters. To be respected, to be treated with dignity, to be in control of what happens to our bodies. To really feel the power of bringing a new life into the world – no matter whether in theatre or at home in a birth pool – why is it so wrong for women to want this? Some women ask for a ‘woman-centred’ caesarean. This means a caesarean in which things are done differently, only slightly, but different nevertheless. Doctors keep their voices low. Music of choice can be played. The screen is lowered for the woman to watch the birth, if she so wishes. Wires usually attached to her chest are instead put on her back, so that baby can be placed immediately on her for skin-to-skin contact. The atmosphere is kept reverent, respectful. Why?! Because birth, no matter how it happens, is important. It is a huge event in a woman’s life that she will remember in great detail for the rest of her life. We don’t have much ‘spirituality’ these days, but even for the most cynical of us, the moment when a new human being takes their first breath is a special and significant one. And yes, being there and being a part of it, is an ‘experience’. Some reading this might feel this is nonsense. They don’t want a spiritual experience, or a rite of passage, or essential oils or a statue of a goddess. They don’t want the curtain lowered so they can see either, they just want the baby out safe and sound, and that’s fine too. Women are many and varied; birth can be many and varied too and should, ideally, be just as each woman wants it. What we do know is that many women DO care about what happens to them when they have their baby, but that they find it hard to talk about these feelings in a culture which persistently tells them that they really shouldn’t, and that what goes on in the delivery room is always acceptable as long as all everyone survives. Taken to the extreme, this idea that the woman does not matter as long as the baby is healthy can create an environment in which her autonomy over her own body is completely lost. If there is even a very small risk to the baby, what is justifiable? Recently, we have seen more and more reports of enforced caesareans, putting me in mind of the story – hilarious and awful both at once - of Dr Donal O’Sullivan, who famously declared on Irish radio in 1996 that if a woman wanted a home birth, her husband ought to put a bridle on her and ‘drive’ her to hospital like cattle. Extreme, perhaps, but if we continue to repeat that a healthy baby is all that matters, we open the doors for all manner of undignified or even abusive treatment to happen to women in the quest for absolute safety. We reduce a woman to being a mere ‘vessel’ for her child, and we quickly silence anyone who wishes to protest against any aspect of their care that they didn’t feel comfortable with. A healthy baby is the most important thing, and it is not all that matters. Respect, consent, choice, dignity – all that matters too. - Milli Hill Milli Hill is a freelance writer and the founder of the Positive Birth Movement. Find her on twitter @millihill or Instagram @milli.hill "Of all of the choices we made throughout my pregnancy, having Tiffany be our doula was the very best. We wavered about having a doula because I knew I wanted an epidural and we weren't sure whether we needed the extra support and whether a doula would be supportive of our choices. However a bad experience in L&D at 27 weeks + and knowing my OB would likely be on vacation during my birth left me anxious. We met with Tiffany and I immediately felt better. She was incredibly empathetic and made clear that her priority was supporting our choices. We figured that even if I had an uneventful birth, the peace of mind alone was worth it.
Well, my labor ended up being more eventful than I had anticipated. The doctor I had the bad experience with was on call, we had a nurse who didn't regulary work at our hospital, and my heart rate was quite high. However, I knew everything would be okay when Tiffany arrived. She and my husband were amazing helping me through the first part of my labor, advocated for me to labor in the tub, and helping me decide when to get the epidural. Later, I ended up needing extra testing and I couldn't always follow what the doctor and nurse were discussing. Tiffany always took the time to explain what was happening and why. After delivery, my heart rate got even higher and there was a flurry of people. Tiffany stayed to make sure I was okay and her calm presence reassured me. Given the circumstances, my birth could have easily been a bad experience, but thanks in large part to Tiffany, it wasn't. Her emotional support was pivotal. Women always remember how they felt during birth and I felt supported, safe, and cared for thanks to Tiffany. We can't thank her enough for making the most important day of our lives such a positive experience." -HA 6/22/2017 A new testimonial for Tiffany: " Although hiring a doula is not an inexpensive venture, I can think of no better way to spend the money in preparation for the arrival of my little one"Read Now"We are so pleased with our birth experience and Tiffany’s role in helping us achieve our somewhat hazy goal of an unmedicated birth.
Meeting her for the prenatal appointment, we felt instantly at ease with her non-judgmental approach since we were uncertain which path we would purse until labor started. (Although we found her through community referrals, it turns out she is also very well known and respected in our midwives’ office and at the hospital where we delivered, which says a lot.) Our labor was somewhat unusual for a first time birth in that we did not have early labor so we arrived at the hospital already in the very active stages, andTiffany was there shortly after we arrived and did not leave until well after our son’s birth 12 or 13 hours later. She provided invaluable support during the labor and delivery for both me and my husband, always encouraging of where I was at and suggesting multiple options to keep things moving. Her training as a midwife was paramount to the process going as smoothly as it did and I can’t say enough how happy we are with the decision to have her there. Although hiring a doula is not an inexpensive venture, I can think of no better way to spend the money in preparation for the arrival of my little one." -JJ "What is an estimated due date, and how is it determined? What are the risks of going past your due date? Does induction increase the risk of C-section? At which point do the benefits of being electively induced outweigh the risks? Do women’s goals and preferences for their births matter?" - Rebecca Dekker, PhD, RN, APRN
Check out this Evidence Bases Birth article on "The Evidence on Due Dates": evidencebasedbirth.com/evidence-on-inducing-labor-for-going-past-your-due-date/ 3/28/2017 Guest Blog: The Sun Will Continue Shining After the Rain. A story of coming full circle after loss.Read Now"This photo was taken one year ago on this day. It was the end of our Ocean Shores getaway where we celebrated the news that I was pregnant. My heart really was so full, and I thought this fortune was perfect given the circumstances. There was so much to look forward to and smile about. I don't think either of us had ever been so giddy before. Our drive home was spent talking about what the gender might be, names we loved, school districts, and all the things we had previously only been able to discuss in our dreams. Our entire world came crashing down on us that night we came home, when we discovered I was at the beginning of a miscarriage. The end of our blissful, celebratory getaway led us into the darkest week of our whole lives. These next 7 days were filled with more emotional and physical pain than I still have ever felt today. My life was spent solely between the bedroom and bathroom. We were so heartbroken, angry, confused, and ashamed. I was in the deepest black hole of sadness I had ever experienced and I had no foreseeable hope in getting out of it. Miscarriage is a sore subject. It's not something most women talk about or admit to, and there is definitely a strong stigma attached to it. If I've learned anything, it's that women are stronger because of it, and they should feel empowered by what they have overcome. I hope this touches anyone out there who has gone through such hardship, and that you realize you aren't alone in your feelings and experiences. There are more of us out there than you'd think. Share your strength with the world. It is the people who have been through the most, that have the most to give. Time can help heal trauma and tragedy, but I believe it's important that we don't forget to acknowledge the hurdles that we have overcome, regardless of the specific situation. We don't have to live in the past or dwell on the pain, but instead, recognize who we are today because of it and respect all that time has done for us, and how it has made us grow. One year ago on this day I would have never guessed I'd be where I am now, or that I would ever have the courage to speak out about it. Well, here we are, in the final week of what has been the most beautiful and rewarding pregnancy journey, awaiting the day we get to meet our son. I am too happy to be ashamed of the past. Is it irony that our due date falls on this very week? Coincidence? Fate? The universe has found a way of teaching me that strength and perseverance can truly transform your darkest moments into the happiest ones if you allow yourself to grow through them. As I type this, I can feel our baby kicking and rolling all around in my belly. I think he's trying to tell me he's ready to meet us, and that from now on, this week, every year, will be replaced with the happiest memories. Most importantly, he is our living, beating, squirming proof that the sun will continue shining after the rain. We cannot wait to meet you, baby Waldron!" - CW I've known Carly now for 5 years. I've watched her grow her family in fur babies, get engaged, married, experience loss, and carry a pregnancy full term. I am so excited to meet this little one earthside and see this all come full circle. Carly, I thank you for your friendship, and most importantly your trust throughout all of your story. Love, Your Midwife Tiffany Guys, I did it! I completed Midwifery School!
You might be asking yourself, "So what does that mean for Puget Sound Doulas? Will you be going straight into midwifery? Will you work with repeat clients? What about the partnership?" My midwifery practice with Cindi Thompson www.SeattleMidwives.com has continued to grow since 2014. At this point, the practice is not big enough to fully support two midwives, so I will continue to do doula work through Puget Sound Doulas throughout 2017. But guess what? SO many past doula clients are following me to the practice and now using Seattle Midwives as their maternity care provider! With the hope and positive thoughts put towards growth for the midwifery practice, Jen and I have decided to end our partnership 5/31/17. Jen will be entering into a new partnership with another doula, and I will continue taking clients as a solo doula through Puget Sound Doulas. (I'll let Jen make her big announcement when her new practice is up and running). This past year has been such an amazing growth opportunity for both of us as individuals, as friends, as parents, and as partners in business. We knew this time was going to come eventually, when we originally decided to partner together, well here we are! Wish us luck and continued growth! Love, Tiffany |
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