The thoughts of a doula...
The thoughts of a doula...
I get asked a lot what I do. Many times the job of a doula gets confused with a midwife, but they are very different jobs. Some people may think of a doula and picture someone leading them into a pool of dolphins or blocking the door from doctors coming in to perform interventions. Neither is the truth.
A birth doula is a professional labor coach. As a birth coach I meet with my clients prior to their birth, get to know them and their wishes, and help them find evidence based information. I have the chance to spend hours with them before their birth so I know what they want, what they don't want, and how I can help them through the process.
In my many years as a doula, I have held the hands of laboring women as they experience the most profound pain and intense experience imaginable. I have seen the awe-struck look in their eyes as they feel their baby moving down and the amazing moment when new parents see their baby for the first time. I have wiped brows, moped throw-up, had blood, amniotic fluid, and more on me, and still serve the women who call upon me. I have squeezed hips to reduce sacral pain for 15 hour straight- yes- fifteen hours! I have been privileged to watch a dad as he discovers the best way for him to help his wife. I have helped explain to a woman why her new baby is being resuscitated. I have sat for hours with a woman whose baby did not make it. I have helped Dads not pass out or even throw up! In summary- I have been.
I have been able to just be in the room and find how I may support each new family in their journey. I am often asked in interviews what is my "thing" that I do for every birth. Simply put, I immerse myself in the experience, knowing that I can not guarantee an outcome, but do my best to give the best support. Sometimes that involves using the rebozo- an ancient tool to help women through labor. Sometimes differing positions, breathing techniques, aromatherapy, water immersion, or other techniques work.
What doulas don't do, is in any way act like the primary care giver. We do not do cervival exams, listen to baby's heartrate, administer medications, or operate any medical equipment. Although we are often said to advocate for women, we do not speak on their behalf. The job of the birth doula is to help make sure families have the information they need to make decisions for themselves. The doula may ask questions to make sure our client understands all their choices. In the end we support the decisions of our clients. No matter what the choices my clients make; whether medicated or natural, home birth or hospital birth, I will support their wishes.
The formal studies done on doula support is overwhelming in support of using doulas for every birth. In addition to that, the feedback from women who have had a supported birth from a doula tell the importance as well. The couples I have supported have felt that the support of a doula helped them feel closer during the birthing process. Dads have been able to focus on how they can best love on the laboring mom, while knowing a professional is always there to guide them through the process.
Think of a doula as a tour guide. Yes, you can go on vacation without a guide, and you may have an amazing time and see all kinds of things. If, on the other hand, you have a guide, you may see hidden places, find secret short cuts, and find amazing new adventures you never knew existed. People have babies every day without a doula. The doula can help show you those special ways to possibly shorten labor, feel more comfortable, and take the stress of being the only support off of the partner. This is turn can help the couple have a much better experience. The labor coach also acts as an interpreter, helping you understand the medical language and processes involved in birth.
A certified labor doula knows how to best help you decide when to go to your place of birth. She knows how to help with back labor. Your doula can help with understanding what is "normal" in birth, and what is outside the realm of average. The labor coach knows how best to get a hospital gown off quickly when a woman is hot, or where to get the emesis bags when she feels sick. A birth doula knows the signs of transition, when you may need to get in the shower for comfort, and the best way to keep washcloths cold for you.
Whether you are choosing to give birth in a hospital, in a birth center, or at home a doula can and will be an integral part of your birth. Come explore how you can grow closer to your partner while being fully supported for the birth of your baby.
Here we are..... coming up upon the end of the school year. Since we homeschool, our school year looks different than most people's, and yet we still wrap up this time of the year just like most public schools. It is during this time that some individual subjects are being finished, and for others- the end is in site. Everyone is getting impatient to be done and start a well-deserved break. Many times each day I find myself wanting to tell my boys, "You only have 3 lessons left in this subject, why don't you just do them all and be done?" To be honest, I have said that- not that they have taken me up on that though! LOL!
You see, although it is tempting to hurry things along with school, what would it really accomplish? Rushing through learning just to be done does not mean that the material is truly learned and understood. It takes time and patience to allow information to be permanently placed into anyone's brain. So, why do I feel the need to rush? It doesn't improve my children's education, nor does it make them feel any less stress. It actually can hinder their progress in the long run, and can teach them to just rush through something to be done.
It's always amazing how we seem to do the same thing with birth. We wait so many long months patiently for our little one to be born in their own time. In fact, the average gestation of an infant is similar to the length of a traditional school year! But what happens at the end of that time? We get impatient. We decide that they can be rushed out, and try to start things along. Care providers also add to the notion that we can certainly help mother nature along, and have no consequences from it. But there are, aren't there?
Induction of labor has been known to have several adverse risks including rise in c-section rate, pre-mature birth, low heart rate in baby, infection, umbilical cord problems, uterine rupture, and bleeding after delivery (http://www.mayoclinic.org/tests-procedures/labor-induction/basics/risks/prc-20019032). Sometimes just waiting a few extra days can reduce the chances of these risks occurring. Inducing labor for comfort level of mother or care provider, scheduling concerns, or because of pressure from family and friends can carry a high risk to both the mother and baby.
In a recent ACOG (American Congress of Obstetrics and Gynecology) meeting, the idea that every woman should be medically induced at 39 weeks came up. The idea is, that there are no risks, and only benefits to inducing EVERY woman once she has completed 39 weeks of pregnancy. Their studies show a decrease in larger babies which leads to shoulder dystocia, and a decrease in fetal demise. That all sounds great! Except one thing. In order to have the best outcomes they must have accurate dating on the pregnancy. Ultrasounds are used to achieve this dating, but can be off by at least a week in early pregnancy, and off by up to 21 days in late pregnancy according to the findings of ACOG themselves in October 2014 (http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Method-for-Estimating-Due-Date). That means, even when early ultrasounds occur, a 39 week pregnancy could contain a 38 week baby, which leads to higher complications to both mother and baby.
Babies need a minimum of 39 weeks to develop many things according to the March of Dimes (http://www.marchofdimes.org/pregnancy/why-at-least-39-weeks-is-best-for-your-baby.aspx)
More risks associated to the baby in delivering too early include: (https://www.acog.org/-/media/For-Patients/faq181.pdf)
Risks to mother in induction include: (http://www.dona.org/resources/CIMS%20Fact%20Sheet-%20Problems%20and%20Hazards%20of%20Induction%20of%20Labor.pdf)
According to ACOG in March of 2013 "Infants born at 37 to 38 weeks also have a higher mortality rate than those born later." (http://www.acog.org/About-ACOG/News-Room/News-Releases/2013/Early-Deliveries-Without-Medical-Indications) This means if the dating is not done right, or they are off by a week or more, your baby has a higher chance of not surviving. They even recommend women decline these inductions if offered by their care provider.
The thought that all babies will be healthier if delivered at 39 weeks just doesn't hold up when you see what ACOG themselves has published. I encourage all families to do research and make informed decisions based on evidence and clear research rather than on what one person tells you. Here is a well written review of the ACOG Summit outlining each point made in the session. http://www.modernalternativepregnancy.com/2016/05/16/mandatory-induction-39-weeks-acog-gone-far/
It wasn't that long ago in history that doctors would be comfortable waiting until baby made their own way into the world. Then it became- don't go past 42 weeks, and now many dr.s will not "allow" a patient to pass 41 weeks. With the new thought of 39 weeks and you are out, what is next? It won't be long before every woman will either need to have an out-of-hospital birth, or be scheduled for a c-section at 36 weeks. Seem like a stretch? I bet 20 years ago the thought that inducing every woman at 39 weeks looked just like that!
My last post discussed my cat- and his love for sinks, but how he approached them at first very cautiously. From this derived my understanding on how some parents approach birth centers and out-of-hospital births in general. Today we are going to take a look at some reasons why more and more parents are choosing birth centers now. One of the main reasons is- comfort! No joke, they are so comfortable to be in!
When you compare the atmosphere of a birth center and a hospital, you find definite differences. When I delivered my first child in a hospital, I had a room that was only big enough for the bed, the monitor, and the IV pole, with 2 small chairs by the door. The baby warmer was kept in the bathroom, and the chairs were taken out while I was pushing to make way for the warmer. When I was walking around the halls, I had several medical staff members freak out that I was too far from the Labor and Delivery area and told me to go back to my room. That was not how I had envisioned my birth to be like. This is one reason more and more families are choosing out-of-hospital births.
From the freedom to move, to eat, and to birth where you want, to the ability to be in full control over your medical care, birth centers provide expectant parents a level of comfort and care not found in traditional hospitals. Those who choose birth centers are usually looking for more involvement in their own health care. They want to birth the way they live life- to wear the clothes they want to wear, to do what they want to do, and have the freedom to express themselves in an atmosphere that will not only allow it, but encourage it as well. Let's take a look at some of the main comforts you may enjoy in your local birth center.
I have an amazing birth center located near me, NOVA Natural Birth Center. If you are located in Northern Virginia, DC metro area, I urge you to come check this amazing place out. As you enter the front door, you will find yourself in a spacious, peaceful room filled with comfortable furniture and calming videos playing on the large screen t.v. Throughout the entire birth center you will also find the sweetest pictures of squishy little babies which will make anyone want another little one. Already have little ones? Great! There is a wonderful play room for your little ones to find all kids of toys while they wait with you for your appointment. That's right- other children and family members are allowed and encouraged to be a part of your appointments, as the birth of a baby is the birth of a new family member. It should be a family event!
You are not confined to your bed, or even your room during your stay. If you would like you may walk around the center, lounge on the large couches in the reception area, visit the kitchen, or if the weather is nice- go for a nice stroll along the tree lined path in the back. The midwifery model of care stresses that the more comfortable you are and able to move around and nourish yourself, the easier it will be for your baby to be born. Oh- did you notice I said visit the kitchen? Yes! You should feel free to bring whatever you would like to eat during your birth. No restrictions on eating food as long as you feel like eating. Your body is doing a lot of work, and you need to fuel it, especially after the birth as well. During your labor your partner/family/friends may store food in the refrigerator, heat it up in the microwave, and eat whatever they and you would like.
Every effort has been made to make the birth center comfortable for you and the rest of your support team. Don't feel like going anywhere for your birth? Great! You may choose to have your prenatal care done at the birth center, and have one of the midwives come to your house for a home birth. You can't get much more comfortable than in your own home. Your labor and birth will not only be in the most comfortable places of your choosing, but with the utmost safety as well. In my next blog, I will address the safety of choosing a birth center or home birth with the midwifery model of care.
We just got this cute little all black, stripped kitten. Yes- he can be all black and have stripes! What a sweet kitty! He is a super good snuggler, totally playful, and exceptionally curious. His favorite activities include licking the touch screen on my laptop, walking on computer keys, and batting at things on the computer screen. Makes working awesome for my husband and myself. But, one thing that he really has an obsession with is, the sink.
Ever since he got little little yellow/orange eyes on the dripping water in the sink he has been truly fascinated! He comes running in whenever anyone is in the bathroom, just to go sit and stare at the water. He will sit and stare forever it seems! Then, he will stick one paw in. Then, go in a little further. Then, before you know it he is standing all the way in the sink, drinking the water at the drain while the water is flowing on his head. It's the funniest thing! It remind me of what many couples do when they consider a birth center birth.
"What? How does that even make sense?" You ask. Well, let me explain. Like my kitty and the sink, many moms and dads-to-be find themselves curious about birth centers and home births when they find out they are expecting. Some come to it because they have family or friends who chose an out-of-hospital birth, and others are curious since they do not feel the hospital is the best place for them. So they go "sniffing around" for other options. Many parents find themselves reading about other options first, just curious about what these options are, but not yet ready to take the plunge- just like my kitty peeking up on top of the counter. Then they may decide to go to open houses at birth centers, meet the midwives, and see if they see themselves there, just like my kitty leaping up on top of the counter and circling the bowl. After that, some may choose to give it a try, and see what appointments are like with a midwife, and ask even more questions- like my kitty sticking his little paw in the stream of water, ever ready to pull it back if it isn't favorable. And then, once couples find the location meets their needs, they are all in- readying for their birth, taking all the classes at the center, and enjoying all the benefits that come from a birth center experience- just like my kitty who sits in the sink while the water runs all over him as he happily laps up water.
Yes, many people do go to birth centers cautiously, but more and more are deciding that the birth center is the right fit for them. While still in the minority, the number of people choosing to have an out-of-hospital birth is increasing due to many personal factors. For some, they feel birth is natural, and therefore they do not need the high intervention rates that hospitals provide. For others, they may have other people in the family or friends who chose and out of hospital birth which ended very positively and they would like to also have that experience. Still others may have had a very negative experience in a hospital, and do not want to spend of the best days of their lives in one if they can help it.
Whatever the reason, birth centers provide many parents the safe out-of-hospital birth they are looking for. In the next few posts, I am going to be looking at one of the local birth centers near me in the Northern Virginia/DC metro area. You may discover that the setting and feel is just what you are looking for and start your cautious journey to discovering your birth location.
Or..... You could be just like my dog and a sprinkler and happily jump right in!
It's finally here! After a long 10 years after the last movie, the latest movie in the series has been released. Sitting here watching the previous movies in order of story line with my children, we are preparing for our time to see the latest movie. Considering the first movie ever made came out when I was a 1 year old, it has been a part of my life as long as I can remember. The waiting is exciting, and nerve wracking as we hope nobody spoils the movie for us. We hope the movie holds up to the hype, and it is just as amazing as the previous movies.
But what if it isn't? What if we see it, and are disappointed? What if we build the event up so high in our mind that no movie could ever live up to it? We run that risk when we anticipate such an event. What would we do it that happens? What does this all have to do with your birth?
Just like a long awaited movie, the arrival of a baby is filled with anticipation, excitement, and nerves. We build up the big day in our minds, and picture what will happen and exactly how it will be at that moment when we meet our new baby. But what if it isn't how we pictured? What if the birth doesn't go as planned? What if the process isn't as smooth as we imagined? What if the baby isn't exactly how we pictured? What then?
Even if things don't go as planned you can still have an amazing experience. Try to go into your birth without any pre-conceived ideas of how things will go, or how your baby will look/act. We all get that perfect picture in our heads, which can lead to disappointment if things don't go perfectly. When we place the process so highly in our minds that it can direct our feelings about our birth, we may never be truly satisfied. If you plan for a natural birth and end up with an induction, or hope for a home birth and have a c-section, it may be truly disappointing and lead to bad feelings about your birth. In the same way, if we do get the natural birth or home birth that is planned, we may still come away feeling the event was less than perfect if we built it up so high in our minds. Accept that whatever will happen is how your birth will go. We can not always control exactly how the process will occur, and if we try to picture it and plan it out, we risk letting ourselves down. Bring an open mind to your experience. That is the best thing you can pack to prepare for your birth.
I will take my open mind to the movie when our family does finally see Star Wars: The Force Awakens. Hopefully, we will not be let down, but also pleasantly surprised with the whole experience.
Thanksgiving is behind us and Christmas is right around the corner. Everywhere I look, anticipation of the upcoming holidays is around us. In every child's eyes you will see impatience and awe as they await the day when they will finally get to open up the packages under the tree and see what they have received. Every year it is the same thing, we must wait until the right time to see what magical item we have received.
Unfortunately, this time of year does not always allow for patience for babies to come at the right time.
Due to care-givers not wanting to miss out on their own family celebrations, families wanting the new little one home for the holiday, or simply because of the additional tax break involved with delivering prior to Jan. 1st, more and more babies are being induced for non-medical reasons (See info here). Bringing baby home a few days to a couple weeks early may not seem like a big deal, however according to the March of Dimes, inducing for non-medical reasons has led to a large uptick of late-preterm births which can cause more medical concerns for the baby. In addition, induction of labor can make a much more difficult labor for the mother and for the baby (see here).
If you are considering an induction, or your care-provider is bringing the topic up, make sure you know all your options. Ask lots of questions including:
Is this induction medically necessary?
What are the risks to me and my baby during the induction? (there are always risks)
What are the risks to me and my baby if we choose to not be induced yet?
What are the alternatives to being induced?
What medications/methods will be implemented to induce me, and what are the risks?
What alternatives methods are there, and what are the risks with each one?
By asking questions you will be more prepared for your induction if it is truly medically necessary, or you will be more informed to be able to comfortably decline an unnecessary induction. Also, do some research on what your care provider is telling you as the medical reason for induction. Find out about your Bishop Score here, adequate amniotic fluid levels here, baby size estimations here, and safety of late-preterm delivery of babies here.
Just as we must constantly remind children that they need to wait until Christmas day to open their presents, the best thing we can do for our babies and for mothers, is to wait until baby is ready to be born. The waiting can sometimes be frustrating, but the end result of having a healthy mother and baby is well worth the small wait.
So I finally got my site up and running after months of wanting to change it. Launching something for your business is a lot like giving birth. It can take time, a lot of planning, and it can even hurt sometimes. But in the end you look at what you have accomplished and you feel pride. I try to extend this to each and every one of my clients. No matter if their labor goes smoothly and exactly as planned, or nothing goes right, you should feel pride in what you have accomplished. Just look down at that precious little face, those 10 little fingers, and 10 little yummy toes, and know that YOUR body made that. YOUR body fed that. YOUR body kept it safe, and now YOUR body will love that little one forever. Birth is an amazing transformative process that leaves an impact on our lives forever. No- this little site of mine in no way compares to my children, but in a way, it left an impact on me. I can see it- and say to myself "Look what I did!".