Fertility Doula

What does a fertility doula do?

fertility_journey_doula

Full spectrum doulas are becoming more common in Toronto - as are folks looking for doula care beyond birth and postpartum. We thought we’d take a moment to explore fertility doula care - one of the full spectrum services we provide.

What is a fertility doula?

A fertility doula is someone who supports people in their journey to become pregnant, regardless of what that journey looks like. Whether going the fertility clinic route, at home monitoring and insemination, or a mixture of the two - a fertility doula provides you with support best suited to your needs and wants.

This can look many different ways: in person or phone check-ins to process procedures, emotions, and information. It can also include unlimited text support, attending clinic appointments alongside you, providing you with resources and referrals to complementary health care modalities, helping you in formulating a fertility plan. Depending on the doula, they may also offer mindfulness session as well as fertility yoga.

If you’d like to learn more check out this guest blog post from one of Corina’s former fertility clients where they talk about the care they received during their IVF journey.

How DO YOU BOOK A FERTILITY DOULA?

At Spectrum Doula Collective you can book fertility support hourly or you can purchase a package. Check out our prices here.

Who hires a fertility doula?

Anyone who needs and wants one! At Spectrum Doula Collective we have worked with the whole spectrum of families (including single parents as well as queer and straight couples) who were trying to conceive. 

Want to learn more? Drop us a line and in the meantime, enjoy these 5 grounding fertility practices.

xo,

The Spectrum Team

Finding my support through IVF

I never thought I'd have to go through IVF. I suppose not many people do - but work gets busy, life gets busy, and having a baby remains a nebulous possibility. Until it doesn't.

At age 39, after several years of trying (naturally) and IUI (intra-uterine insemination) attempts, I finally relented and agreed to try IVF. I wasn't sure what to expect and my husband knew even less. We went through several clinics and we felt lost in the sea of people trying to have a baby, with doctors and nurses always too busy to answer all of our questions and to hold our hands through the process. 

And so I did what I do best - research! Throughout that research though, I still felt like I wanted support, not just information. That's how I came across Spectrum Doula Collective. I knew about birth doulas but I didn't know about doula fertility support! My doula, Corina, has been invaluable throughout the whole process.

Corina's help was crucial on two occasions that many of you may not even think of as traditionally associated with a doula. First, she accompanied me to my hysterosalpingogram (HSG) test, which I was convinced - based on Google searching - would be one of the most terrifying experiences on earth. I had postponed this visit for over a year and if it hadn't been for Corina I would have never moved forward in my fertility journey.

Corina squeezes my feet in encouragement

Corina squeezes my feet in encouragement

But she was there for me and she did a great job of explaining the science behind the procedure and all possible outcomes and, most importantly, comforting me when I was scared. As a result, the entire experience was positive and our bond grew from it.

It was thus no surprise that she was the person of choice to accompany me to the fertility clinic for an egg retrieval operation. I wasn't nearly as scared going into it because I knew I would be with someone who not only cared, but was also cool-headed and knowledgeable as to how to best handle me before, during, and after the procedure.

My husband and friends also care, but they aren't as great on the other two counts (needle-phobia, anyone?) and the least thing I needed on that day was worrying about someone ELSE's experience.

The procedure wasn't easy but Corina's presence made a huge difference. She made me relax, she made me laugh, and above all she made me feel safe. The picture is an 'after' shot in which she is squeezing my feet in encouragement. About an hour later we were at laughing at the outrageous, 'under sedation influence' topics we had covered while I was on the operating table. I felt relieved and hopeful.

I still do - and I am wholeheartedly (and bravely) navigating the rest of my fertility journey with Corina (and my loved ones by my side). 

Written by Spectrum Doula Collective Client

 

At Spectrum Doula Collective we work with the whole spectrum of families (including single, LGBTQIA+, and polyamorous folks) who are trying to conceive. We will attend important appointments at the fertility clinic for uncomfortable tests, such as the egg retrieval process, hysterosalpingogram (fallopian tube test), and insemination/in vitro fertilization. Our goal is to instill confidence and provide emotional and physical support for clients who are trying to conceive, or hope to be a parent later on.

When it's a period.

Trying to conceive is not an easy process, but that moment you get your period and you know, you know that for sure you are not pregnant is devastating. We are grateful to a client of ours who has shared how challenging trying to conceive has been for her, and just how difficult it is when it ends with a period. 

 

I never imagined that I would struggle with fertility. I suppose no one ever does. But somehow we are surprised whether we get pregnant quickly, or when we don't get pregnant at all. I've known people who planned for at least six months of trying before a positive pregnancy and then when that positive pregnancy happened right away they were actually disappointed and wished they had more time. On the other hand, I also have friends who have waited until all their ducks are perfectly in a row, and then when it doesn't happen right away it's heartbreaking. 

Back about 6 years ago, when the idea of kids was a little seedling, I had travelled to Chicago for the weekend with my married friends to catch a Cubs game. Like one does at a baseball game, in one of the oldest ball parks in the world, is to indulge in the park's delicacies - hot dogs and beer. We were of course disappointed to find the hot dog we had been given had been boiled, soggy, and limp, but nothing a little ketchup can't fix. 

After the game, my friend started to feel ill, so ill she spent the rest of the evening in the washroom, followed by the next two mornings, and our whole drive back to Toronto not feeling herself. Her husband and I could only assume it was the not so delicate hot dog, we clearly just had stomachs of steel. Turns out she was pregnant. That bad ballpark hotdog was her little man - we couldn't believe it - and well neither could she. 

The significance of this story is that I think about it often. Now that I'm trying to conceive, I seem to mistake my indigestion for a positive pregnancy on the regular... it can't be that chicken I ate!? It's been two years of trying, and it's tough. I always seem to waver between hopefulness and hopelessness. Every twinge I feel I wonder... could it be?? 

There are so many aspects that can be unpacked when trying to conceive, the monitoring, the fertility clinic, the fertility drugs, the constant stream of well intentioned but unsolicited advice. But it's that very real and very brief moment when you know you've got to pick yourself up, dust yourself off, and find what little hope you have for another month of monitoring, tracking, and trying, is the one moment I struggle most with. That moment your body tells you another month has passed, another failed attempt. That moment you get your period. 

It feels weird to look back at those decades of relief (sometimes glee) when you get your period, and then just like that you dread it, and not just because of the bloating, and cramping, but because it simply magnifies the sadness, the sadness of another month gone and your dream of having a family a little more crushed. But then again, I can't help but feel hopeful as I near my expected period date, wondering if the bloating, or tiredness I feel is a sign of a positive pregnancy. And then it arrives, as if shedding the aftermath of a battle that's just happened in my uterus. And I feel a loss, a great loss. I had dreamed, hoped and imagined that I would soon begin a new life with babe in tow. But instead I have to clean up the blood and move on. A lost opportunity, and my life in suspension waiting for another month, another attempt, and potentially another loss.

Written by Spectrum Doula Collective Client

 

At Spectrum Doula Collective we work with families who are trying to conceive, we will attend important appointments at the fertility clinic for uncomfortable tests, such as the egg retrieval process, hysterosalipingogram (fallopian tube test), and insemination/in vitro fertilization. Our goal is to be emotional and physical support for our clients who are trying to conceive, or hope to be a parent later on.

 

 

 

Beyond the Bio: Meet Megan . . .

* Since writing this blog post, Megan had a wonderful little baby (not so little anymore) and is taking some time off to be with him! We wish her all the best and we are loving Sacha’s cuddles!

When Megan started work as a doula, she felt that there was a gap in the Toronto birth community. And so Spectrum Doula Collective was born. Megan hopes that no matter how or when you choose to grow your family that Spectrum Doula Collective can be a safe space to find support. Pretty cool, hey? We think Megan is pretty cool too . . .

What drew you to doula work?

After a career break and travelling for a couple of years I came back to Toronto with a new perspective and was keen to work in an inclusive, and progressive environment where I would feel like I'm making a positive impact. When I returned from my travels my very pregnant friend was telling me about her doula, and with my previous work in maternal and LGBTQ health, a light bulb went off. A week later I signed up for the Birthing From Within Doula and Mentor Training, and the rest is history.

If you weren't a doula what would your alternate dream job be?

If I weren't in birth work, I would love to be working with penguins (I'm being very serious! I went to the Antarctic a couple years back and was in awe), OR I've often day dreamed about owning a Bed & Breakfast on Vancouver Island while bee keeping and making honey (pipe dreams?).

What did you want to be when you were in elementary school?

There were so many things I wanted to be, but it ranged between being an artist, a doctor, a firefighter, to an architect. I had no idea what any of the above entailed but they all sounded good at the time.

If you could go anywhere in the world where would you go?

This is such a hard question for me, I've been to so many countries that I would love to go back to (Norway, Mongolia and Nepal to name a few) and many more I would like to visit! I have never been to New Zealand though and it's top on my list!

What would the perfect off-call day look like for you?

Because off-call days are so rare, I usually like to spend them doing something away from my phone. I imagine paddle boarding on Toronto island with a good friend or two followed by a picnic in the summer would be lovely, or brunch followed by Body Blitz with some friends in the winter would be perfection!

Favourite vice (or two) that you have no guilt about?

Please don't judge me. I am a sucker for Survivor and the Bachelor/Bachelorette (I promise I won't bring either up unless you ask me first). I love playing bad pop music while I'm driving. And I love chocolate, and cake, and cookies, and sour cream glazed timbits. . . and well anything sweet.

 

Name One Thing . . .

. . . you learned the hard way about birth early in your career:

My first client hired me late in her third trimester and the day she confirmed, she found out she was 4 cm dilated and 60% effaced. I thought she was going to go in to labour that night. After a week of anticipation, and not much sleep she finally called with contractions. I had no idea that someone could be 4 cm dilated walking around the city like nothing is happening for a whole week!

. . . you look back on in your life that makes you feel proud:

I cycled across Canada the summer of 2014. When I started in Vancouver, my cousin asked 'what the heck are you doing??' I said, "I don't know, but I'm here and have to make my way back home". I had told myself that at anytime, I can hop on a bus or a plane if I don't want to finish. But I biked every inch, solo, and self supported from Vancouver to Halifax. Whenever I'm struggling or think something isn't possible I say to myself "Megan! You biked across Canada, you can surely do this".

. . . that usually surprises people about you:

That I use to play Rugby. I actually started the girls rugby team at my high school eons ago, and played Varsity at the University of Waterloo. Even when I was playing rugby people were surprised to find out. It's like they imagined me in the 'end' zone picking daisies or something? (To be fair there were some days where I would have preferred picking daisies).

. . . that's always in your fridge or pantry:

Almond milk, cheese, and hummus.

 

What's your favourite . . .

Colour

Green

Animal

Elephant

Season

Spring

Toronto Cafe

Boxcar Social Riverdale

Birth Book

Labyrinth of Birth by Pam England

 

Cycle Monitoring: What to Expect

Image courtesy of Functions of Cells and Human Body (www.fblt.cz/en/)

Image courtesy of Functions of Cells and Human Body (www.fblt.cz/en/)

When trying to conceive sometimes we find ourselves needing a little extra assistance. When deciding to get additional help from a fertility doctor, you can feel both relieved for potential answers and solutions, but also overwhelmed by trying to decipher what the hitch might be. Furthermore, with the multiple monthly visits and simply trying to reconcile that conception has moved from the bedroom to a clinic can be a process.

Cycle monitoring may be the only thing you need the clinic for, or it may be a part of further assistance that you require from the clinic, whatever the reason, if you've reached out to a fertility doctor you will likely be cycle monitored.

So what can you expect from cycle monitoring...?

Cycle monitoring allows your fertility doctor to find out exactly when you're ovulating to know when the best time to inseminate or have sex would be, and to increase the chances of a pregnancy. However, because everyone's cycle is different, it is hard to anticipate how often you'll need to visit the clinic, or when ovulation will occur.

When menstruation starts, so does your cycle monitoring schedule. You will need to visit the clinic on day two, three or four of your cycle, so your fertility doctor can review your blood work, how many follicles you have, and if one follicle is beginning to mature. At this visit your doctor will let you know when they would like to have you return which is usually somewhere between day 6 and 12 depending on the length of your cycle. After which, you will be asked to come back every two to three days until you get closer to ovulation, where you will then need to return on a daily basis until ovulation.

Each day that you're asked to visit the clinic, you'll need to get blood work done to monitor your hormone levels, have a trans-vaginal ultrasound to monitor your maturing follicle(s), and to meet with your fertility doctor to let you know when is best for you to return to be cycle monitored again.

Now what should you expect from your follicles?

During that first visit, or around day 2 - 5 of your cycle, your fertility doctor will be counting your ovarian reserve and is looking for between 6 - 10 follicles that will range between 2 - 10 mm in diameter. You should expect your follicle to grow 1 - 2 mm a day in size and when your dominant follicle reaches 20 - 24 mm, in combination with good hormone levels, this will indicate to your doctor that ovulation can happen with ease.

Lastly, what can you expect emotionally?

Cycle monitoring demands a lot more emotionally than physically, in particular when your follicle(s) are getting close to maturing and your fertility doctor would like you to return daily to keep an eye on that dominant follicle. Each clinic demands a different time commitment, some clinics schedule you in 15 min time slots, so you can be in and out (although you might end up with a time slot that doesn't work great in your schedule), while other clinics have you drop in between 7am and 9:30 am, so depending on how busy the clinic is you could be there for a couple of hours! Regardless of this the anticipation (or sometimes boredom) can be taxing. As you likely know, stress is not a friend of fertility. So what can you do:

  • Pack a Cycle Monitoring 'Survival Kit' including: if you're at a clinic that doesn't schedule visits, think about packing snacks, a good book, your computer to do work (this can decrease the stress of being away from work and keep you occupied), and your phone loaded with your favourite podcasts, audio books, or an audio meditation series.
  • If it's safe to do so, let your employer know, there will be times that you'll be late for work, and if your employer knows they'll likely be more flexible and accommodating with your schedule, which can help lower stress around time commitment.
  • It's so easy for us to want to keep conception on the down low to avoid unwanted questions and unsolicited advice. It is, however, worth letting in a close circle of friends that you can reach out to during those times you may be feeling overwhelmed or exhausted by the constant monitoring.
  • If you have a partner, a supportive friend, or a fertility doula, ask them to come with you if you need a little extra support or company on a particular day.
  • Often fertility clinics offer support groups for individuals or couples that are struggling with their fertility or need some assistance to get pregnant. They're not for everyone, but before you discount support groups, it is definitely worth inquiring if your clinic offers a support group.
  • Think about recruiting fertility practitioners outside of the fertility clinic such as a Naturopath, or acupuncturist, they are equipped with trade secrets that can help support and enhance the fertility treatments you're already receiving.

How cycle monitoring ends depends on what additional fertility assistance you require, whether it be simply help with timing, IUI or IVF.

I’m grateful that I’m getting help. But there are so many other things that I would rather do than be cycle monitored. It takes a bit of time to adjust being ‘on-call’ to your follicles.
— Client on Cycle Monitoring