Kelly Pedrozo is a DTI certified doula and part-owner of ATX Doulas located in Austin, Texas. She became a doula only three months post-birth of her first child. Today, she explains how her doula care helps women relax into what she calls "labor land" for a powerful birth experience. Tune in for lots of inspiring and informative bits about birth, labor, and doula care.
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Q: Who are you before labels, titles, or what Google would say?
A: I have two kids. I have a three-year-old and a five-year-old. I am from Austin. I kind of stayed in the same area, which is really fun. It's really fun to kind of be in the area that you grew up in, and I get to raise my kids here as well. I have a new dog we just added to the family. Her name is Luna, and it's been really wild with having a three-year-old and a five-year-old and learning how to navigate also having this puppy now—but it's really fun.
I married my high school sweetheart—and he is actually from Brazil, so he moved here when he was younger. He was eleven I think. So, we are raising our kids in a bilingual household, which is really fun. So, he speaks to them in Portuguese only, and I speak to them in English only. That's a little bit about me. I love nature. I love the outdoors. I love exploring historic places. One of my favorite things is to go to really old houses and learn about their architecture and history. Other than that, my life is kind of birth work right now, so it takes so much for that.
Q: Tell us about your experiences with birth with your two children.
A: So, my experiences are pretty intense. Pretty different from a lot of people. So, my first was a very intense birth. She was born at a birth center. I had this wonderful care from this group of midwives, and she ended up having a pretty hard labor. it was mostly due to her position. She had her hand up by her face. If any of your listeners have had a baby born up with the hand by the face, they know what I'm talking about. It's a pretty intense labor. A lot of back labor. It was really hard.
I didn't have a doula because I had midwives and thought, “Why do I need a doula if I have midwives?” Back then, I just didn't realize that midwives and doulas are not the same thing. They're not there to support you in the same ways. A lot of the things that midwives and doulas do intersect, but they're very different in the support they give.
So, she ended up having, at the very end of the birth, a mild shoulder dystocia. But she had a very intense and traumatic resuscitation. So, she ended up going to the hospital with my husband.Looking back, it was very hard. But I try to think of that as their special time together. I stayed behind at the birth center. My mom was there with me. So, my daughter went with my husband to the hospital and she was in the NICU for a while. She had some pretty scary health issues because sometimes that happens with the resuscitation. So, that was her birth—and that was sort of the catalyst for intense change in my life.
Fast forward to my son's birth, who's three now. I was a doula. I had recently quit my job to pursue birth work full time, then COVID happened. His conception story is really funny because I was at the longest birth I have ever been to. I think I was with this client for a total of 52 hours. Somehow, we conceived my son that week. No idea. So, that was the week that everything shut down with COVID. I was at this birth, came out of the hospital, and everything was shut down. Then a month later, I found out that I was pregnant. So I was pregnant through that whole time. It was actually a really wonderful way to just be in connection with other pregnant people. I think it helped me to get through that pregnancy and not feel so isolated—just feeling like I had a purpose. It was such a hard time for everybody.
So, he ended up being born at the hospital. I had an unmedicated birth with him at the hospital, which is a whole thing. It's very different to have an unmedicated birth at the hospital for me. When I know that epidural is right on the corner, it's hard for me not to want to “eat that epidural donut” is what I call it. So, I had a doula with him and I had a lot of support. It was an amazing birth, but definitely very different between giving birth at the birth center and then giving birth at the hospital. Also, being a doula and having all of that—I don't want to call it baggage, because I don't feel like that's what it is—but carrying all those stories with you when you give birth is very different.
Q: What was it like choosing your own doula as a doula?
A: I actually found my doula because I worked with her. So, she was a very close coworker for me. I co-own a doula collective called ATX doulas, and we work together as, we call it, a doula hive. So, we share all of our clients and work together and support each other in that way. So, she was one of the people I was very close to and worked with. She was really funny. Her name was Diana. She's from Brazil. So, it was this cool thing we had in common that my husband was from Brazil and, really, he needed the support of a doula, too. I think it's really helpful for partners to have the doula as well. So, it was kind of just this really great connection that we had.
I think the more births that I've seen, I have learned that we really cannot control what happens during birth. Birth is wild and it's intense and it's going to unfold in the way that it's going to unfold. It's this really big lesson in releasing that control, which can be really hard. I definitely struggled with it at times, but I think what's so beautiful about birth is that it's your baby's own birth story and it's how they come into this world. I believe that my children chose their births, and it's very special for me to know that that was the way that they wanted to come in. I don't have very much control over that, it’s just who they are as people. So, I think that's kind of how I reconciled all the stories that I carried and letting go of that in labor.
I don't think there's a specific way that anybody should give birth. I think if you want to get an epidural, get an epidural. If you want to go unmedicated, that's great. For me, what I like about going unmedicated is labor land—floating into labor land and turning off that thinking brain and not really being totally aware of what's going on around you and just kind of being in your body, while also sort of like floating in the cosmos of labor land. I think it's just a very cool experience.
So, through that labor with him, I held the power of all the other people that I had supported while pregnant with him. But, I also very much was able to just let go. It was just a really wonderful, beautiful experience.
Q: What made you want to choose the birth center for the first birth, especially given that you weren't a doula yet?
A: So I think for me, it started way before I was even thinking about being pregnant. The documentary “The Business of Being Born” was a really huge game changer, because I think it helped me to sort of understand that hospitals, as much as we need them and they're important, I think we also have to know they are often functioning from a place of liability. So, for me, I really did not want to be a liability, which, in the end, you are always going to be in some way a liability if somebody is attending your birth.
But, I also was very used to out-of-hospital birth because my mom had home births and my husband's mom had a home birth. So, for us, it was a little bit more natural in our household and talked about a lot more. Whereas, what I find with a lot of the clients I work with, they usually come from backgrounds where their parents had hospital births. So, to go outside of this box and think of having an out-of-hospital birth is a really huge jump for them. But, for me, it just wasn't as big of a jump just because it was something I grew up around.
I remember being at my mom's prenatal appointments as a little girl with the midwives and looking through the books. I remember climbing into bed with her after she had my sister and eating lasagna. It was just this really cool memory and experience. So, I never really thought twice about it. I have nothing against hospitals. Obviously, I had my son at a hospital. I think they are tools that you use when you need them, and if that's where you feel the safest to open up and give birth, then that is definitely where you should give birth. But, for me, I just felt the safest outside of the hospital.
Q: How does fetal ejection reflex happen? How often does it happen? Do you see that commonly? Do you have to be in a certain state?
A: So, with the fetal ejection reflex, a lot of times I think that we have this misconception that when we're ten centimeters, it's time to start pushing, right? That’s just not always the case. Sometimes, we're ten centimeters and we don't really have that urge to push yet. So, unmedicated, when you don't have an epidural and you're feeling the full force of the contractions, it's basically where you push without you even trying to. You don't have a choice. Your body is going to push this baby out. I've heard people describe it as throwing up backwards.
It's really cool to be with people who are giving birth. You will hear the change in their tone whenever they start to bear down. It's almost like that grunt and you hear it and you're like, “Okay, all right, we're gonna have this baby soon.” I think when we let birth unfold as it's going to unfold, most people will get the fetal ejection reflex. I actually never had it. I had two babies unmedicated, and I'm like, “Okay, third baby, I'm gonna wait until I have that reflex and then start pushing.” But, for me, by the time I'm ten centimeters, I don't want to be in labor anymore. I just don't feel it.
But, I think it's so good for our babies to sort of let us let them be the guide of us pushing them out, because it's really helpful for their lungs to have those pushes and have them slowly clear their lungs as they're being pushed out. Sometimes, I think when we go a little bit too intensely with pushing, that can kind of hinder that process as well. But, it also is so good for our bodies to wait to have that reflex, because it can help reduce the chances of severe tearing. It can also help reduce the chances of us pushing for a really long time, which, with a first baby, it's pretty normal to push for a while. But, if we try to wait until we're feeling—with an epidural, it would feel like you have a ton of pressure—almost like you have to poop and it's not going away. That is what I consider more of the equivalent to a fetal ejection reflex when your epidural is working.
I tend to see it with almost everybody who is unmedicated. If we let the birth unfold the way that it's meant to without intervention—somebody coming in and saying, “Okay, you’re ten centimeters, let's start pushing now”—it's sometimes good to labor down a little bit and let our contractions push that baby down and then let that fetal ejection reflex take over and let baby come out that way.
Q: I would love to hear you set the scene for how you guide your clients to labor?
A: So, getting to that place of what I call “labor land” where we are out of our thinking brain and we're in this much more primal state. In an ideal situation, we're going to have as little interruption as possible. That is just, honestly, not always possible, especially in a hospital birth situation. Many people need to give birth in the hospital and they may need to be induced. There are medical reasons for induction. So, I like to think of those Interventions as tools. Sometimes, we need those tools to have our baby.
But then, how do we also integrate that this is also a very primal process. We need to be able to let go in order to get to that space and to experience that part of labor where we can really be primal.I always tell people if you are giving birth at the hospital, we talk a lot about creating your labor cave. So, if we're going to be giving birth in the wild like cavemen, we're probably giving birth in a dark cave. So, let's try to recreate that environment in the hospital. It’s amazing how when you do that, the people who come into the room, their energy shifts too. It's like they have a different respect for the space when they come in. The lights are dim. Everybody in the room is using low tones. If you like essential oils, maybe you have essential oils going, I love music for changing the energy of a space. Even if you are so in labor you can't even hear the music anymore, it just creates that energy of the space that when other people like nurses and doctors walk in, they know this is what we're doing right now. They're not going to come in using loud voices.
I think also setting up that expectation before you give birth. Have it on your birth plan that these things are important to me. Even if you're planning to get an epidural, there's a period of time before you get an epidural where it's helpful to labor a little bit and it's helpful to let your body release and to not be in that thinking brain. So, doing those things, even if your plan is at some point I'm going to ask for an epidural—but especially if you're planning to try to go unmedicated all the way through, we really want to build that respect for your birthing space from the beginning.
Another thing too is if you're not being induced, try to labor at home for as long as you can. That's something I think doulas are really good at doing is laboring at home with you and helping you figure out when is a good time to go to the hospital. First babies, you can labor at home for a while. Second babies, you have to be a little bit more cautious because they do tend to come quite a bit faster. But, first, baby, we have a while that we can labor at home and we can utilize the comfort of your home space before going to the place that you're giving birth.
I can't stress enough how important it is to be able to really let go and labor. It is hard sometimes when we have those interventions like the poking and the fetal monitoring and the different things that happen that make it really hard to just completely let go. But I will say, with my second baby, I was attached to every single cord that you can imagine, and knowing that you have people on the outside of you advocating for you, like your partner, your doula, your nurse, those people, that you can let go and you don't have to be in control of what's going on outside—it makes it so much easier.
Q:t I would love your take on how and when you use the epidural tool and any facts you may have around it. And then, what happens if it fails?
A: It's such a huge bummer when that happens. One of the really few therapeutic ways to use an epidural is when you become exhausted. I think that sometimes exhaustion actually can hold our body back from progressing. That's because we're mammals, so our body is not going to labor if it's not safe to labor. Exhaustion is one of those things that would make sense that your body wouldn't feel safe to labor. So, it would make sense that your body would not progress as well and shut down.
I also sometimes see that with some people who have very tight pelvic floors, if that is the thing that's holding the labor back, sometimes the epidural will just kind of help loosen everything up and then they progress. So, those are situations where I think that the epidural is a really wonderful and therapeutic tool to get you through your labor. So, it's kind of one of those things when you're planning an unmedicated birth, there's also the side of it that maybe being open to an epidural is not the worst thing, because sometimes that is what we need to be able to give birth vaginally. So, if that is the intervention that you choose, it may set you up for less intervention down the line.
I think that's where doulas can come in really handy. We can sometimes see where this actually might be really helpful for you. So that is when I would say that it can be a really wonderful tool. I also think in situations where somebody has just really intense trauma around pain. I have a wonderful gift to be able to give birth with an epidural.
It's also important to remember that the epidural a lot of times isn't going to take away all of the pain. There's different levels of that. Sometimes people are going to feel a lot of intense pressure, but no pain. Sometimes it registers as more pain. So, there's different things that we can ask for in the hospital if that's going on. Sometimes, it's that the anesthesiologist needs to come back in and give a bolus of the epidural medication, and that can kind of help cover the pain a little bit more every once in a while. It's like the placement of the epidural just isn't right.
Something that I actually see quite a bit is the position of the baby kind of hinders the efficacy of the epidural. So, if the baby's in a really funky position and they're putting pressure on a nerve or a muscle that is making it a little bit more intense. Sometimes, what we can do is because you have that epidural, it allows us to do a lot more positional work that can help the baby move out of that position and decrease the pain. So, there's there's several reasons why people will feel more intensity with the epidural. There are things that we can do to try to lessen the intensity. Every once in a while, there's somebody that, for some reason, they're just not responsive to the anesthesia.
Q: Orgasmic birth. Is that a thing? Is that possible? Have you witnessed it? Experienced it? Do your clients ask you about it?
A: So, I totally believe that it's a possibility. I have not experienced an orgasmic birth. I also have not seen somebody experience an orgasmic birth. But, I think it probably comes to how we reframe the way we feel pain and intensity when we are giving birth. It probably just has a lot to do with how we reframe the way we feel that feeling of the contraction in our body.
So, with my first baby, I remember just battling through contractions for a long time and I was so tired. At some point, I came to this reconciliation with myself where I was like, “Okay, Kelly, if you keep battling these contractions in the way you are doing it, you're not going to make it. You have to change something here.” So, at some point, my body totally protected me and I completely let go.
I was in this labor land, a different brain space. The way I felt contractions when I was fully in that space was I would feel the contraction come, but I didn't feel the sensation of the contraction. I would actually see this light go through my mind, and I would see the wave of light just like a wave, and then it would come back down the other side. The really crazy and interesting thing about it was that whenever somebody would talk to me, it would pull me back over to earth, and then I would feel the intensity of contractions again.
So, it's like the ability to go so deep and so into yourself, I think can totally change the way that you perceive contractions. So, maybe that is, for some people, feeling pleasure during labor. I've just never experienced that. I would love to. That would be like a goal of mine with giving birth, but I haven't gotten to that point. I think it's because I've always had some level of distraction going on around me when I've given birth. I haven't been able to just be in that space. But, I've heard it being compared to unmedicated birth can be the most psychedelic trip of your life, and I totally think that that is so true.
Q: So you actually chose to become a doula when you were early postpartum?
A: Yeah, I can't say I recommend that. But, for me, I just felt like that was the direction that I needed to go in my life. I was actually working for an economic development association for a very long time before having my daughter. I always knew on some level that I would want to get involved in birth work, but just never really took the initiative to do that. I got comfortable where I was and then when my daughter was born, it was such a majorly transformative process for me. It was also obviously very traumatic. It wasn't just the birth that it was traumatic, but it was the postpartum.
I see this all the time too. It’s actually really traumatic when you have your baby and then you realize that your life completely changes and slows down, but everybody else around you is carrying on their merry way. It's like, “Wait, I need help. I need support. I'm different now.” Going back to work and trying to be the same person that I was before my daughter was born felt so suffocating to me that I was like,”I'm gonna have to make a pretty drastic intense light of change”. I’m really glad that I did.
At the time, it was actually pretty wild and probably, on paper, not the smartest decision. I gave up a lot financially to do that, but it was what I needed to do at the time. It's been a wonderful journey of getting here. Making it through postpartum while also attending births and supporting other people was really incredible. It was hard, but I wouldn't change it.
Q: So with ATX Doulas, how did you get involved with them? Have you always been with them? You guys have other services, so talk to us about that.
A: So we are a birth and postpartum doula collective. We've been around for over ten years. We're one of the oldest doula collectives in Austin, which is really cool.
I had been dabbling my foot in being an independent doula and I found what was hard about that was I had to be on call all the time. I didn't have the support of other people. You have to really go out and find your support. A lot of independent doulas do that. There's such a beautiful thing about independent doulas as well.
But, when I found ATX Doulas—this was before I became one of the owners—I was really just looking for a team to get to have through birth work. It's really cool because once you start learning from others as a doula, you learn so fast and you learn so much more. I think that's one of the beautiful things about being in a collective. It's also allowed me to be able to be a mom of two young children and have days off and be able to have somebody cover my shifts if my kids are sick or if I'm sick. It just makes it a lot more sustainable.
It's allowed me and other doulas on my team to stay in this profession much longer than the average burnout rate. So, the average burnout rate for a doula is about two and a half years. So, it's because it's very hard work. I've been a doula for over five years now. Many people on my team have as well. So, we've really carried each other through this space and it's just so wonderful to be able to process things with a team and also know that you have checks and balances with the information that you're giving people.
We have doulas all over Austin going to all of the hospitals and working with all the doctors. So, we really have a pretty wide footstep of the things that we're seeing. I always say that we have eyes everywhere, and it's true. So, we really like to be here for our community.
So if anybody calls, even if they're not using us as their doula and they have a question about “This is what I want for my birth, this is my provider, what would you recommend?” We want to be a community resource for that information. So, we were trying to build community for people that are giving birth and going through the birth and postpartum periods.
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This blog post was written based on kozēkozē Podcast Episode 376: Exploring "Labor Land" with Kelly Pedrozo.
If you’d like to listen to the conversation first-hand, tune in here.