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  • Home
  • About
    • The Doula
    • Her Philosophy
    • Testimonials
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    • Q&A
  • Services
    • Birth Doula
    • Virtual Doula
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How To Find the Perfect Doula For You!

11/6/2018

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While woman-to-woman maternity support has been around ever since women have been having babies (well, technically, Eve was on her own), doulas are relatively new. In fact, the first US professional organization for doulas (DONA, or Doulas of North America; now called DONA International) only started in 1992. This leaves many women wondering, "If I have a labor support partner and a nurse during labor, do I really need doula?" The answer: Maybe.

The point of having a doula is to provide encouragement and support to new moms throughout pregnancy and birth; postpartum doulas even help with breastfeeding, housework, and cooking. Her role is to promote healing and bonding with the new baby — basically, whatever you need! Sounds nice, right?
Research seems to think so, too. Studies indicate that when doulas are involved in the labor process, women have fewer C-sections and report greater satisfaction with their birth experiences.

Doulas understand labor and birth from both the physiologic and emotional angles, and they know how hospitals work. They're gifted at helping women overcome really challenging contractions and labor transitions. They understand medical language and routine procedures, but they also know how to help mothers work around interventions that don't fall into their birth plans. And when those plans need to change quickly, the really great doulas know how to shift gears and continue providing top-notch support.

Sadly, there are also some challenging doulas. A few have strict personal agendas and confrontational approaches. They start arguments with medical staff over minor issues like taking mom's blood pressure. There are even doulas who have told their clients that under no circumstances would they allow them to have an epidural or C-section.

Plus, reimbursement from insurance providers is unusual. What happens to women who can't afford doulas? They receive support from their labor nurses, midwife or doctor, their partners and the people they've chosen to provide labor support. For many women, that's all they need and they report feeling well cared for.

Side note: There are doulas that are getting started in their career and can offer free services in order to get certified or more experience.

Still, more often than not, doulas are a real asset to the birth experience. Here's how to find the perfect one for you:
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1.) Check their credentials.
While DONA International offers certification programs, certifications aren't required to work as a doula. But a certification shows that your doula has passed a test that demonstrates her knowledge and competency. Before deciding on a doula, ask her where she studied, and if she received a certification.
2.) Ask for references.
See whom she has worked with in the past, and actually call them.
3.) Search wisely
Visit doulamatch.net to instantly find doulas, along with their availability, education, certifications, and testimonials. Also check out: BirthTube's Doula Directory and the DONA Doula Directory.
4.) Interview potential doulas — in person!
You're going to be spending a whole lot of time with this person, so you need to make sure your goals are the same, and that your personalities are compatible. If you don't fall in love with the doula you interview, find one that fits your desires and needs.

Have some fun and take the Birth Quiz to get a FREE Labor Cheat Sheet!

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7 Birth Factors That Stall Labor

8/24/2018

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I'm going to address the elephant in the room...labor is challenging! When you're in it, you wish that life would stop. You wish that you blinked, and in the next moment, you would open your eyes and find yourself lounging on a beach with an umbrella drink.

Although that kind of wishing is nice and can distract you from your current situation, it's not going to effective get that baby to be born. So here are 7 things you can watch for to get labor progressing naturally, safely and effectively.

1.) Full bladder
Now I know in regular circumstance, if you gotta go, you go, right? In labor, many things are happening in the body that we tend to ignore basic instincts, like peeing. Having a doula or a partner remind you to empty your bladder often is an understated factor. Urinating tells your body that you are making room for baby. There is nothing like a full balloon-like bladder that will get in the way of baby descending into the birth canal.

So make many trips to the bathroom. Better yet, stay in there and enjoy all the amenities a bathroom has to offer for laboring! Amenities like:
  • Tub
  • Shower
  • Squatting forward on the toilet
  • Turning off the lights and making it a den for your animal brain
  • Finding peace and quiet from the nurses who are constantly bombarding you with questions, pokes, and adjustments.

It's a glorious place to labor my darlings!!!

2.) Medications
Normally I don't vouch for labor-inducing medication but at times, they can be helpful and indeed save lives. Pitocin can help increase contractions to assist the uterus in pushing that baby down. However, once you begin medications, your risk of having more induction measures increases drastically. And you are destined to be on bedrest of the remainder of your labor and delivery. So take heed there. 

3.) Immobility
If you're sitting in a bed, hoping your baby will pop out, chances are you either have had an epidural or you're not in labor (deepest sympathies to my lovely 36-42 Weekers). In any other case, you should be moving around to urge your baby to come down his or her comfy womb space.

If you've had an epidural, you can have nurses, your doula, or partner adjust your positioning every 20 minutes so that movement is still present for labor to do its thing. We call this movement in bed  the Rotisserie Chicken! If you're in bed, this is IMPORTANT, not only to keep labor from digressing, but also to move the medicine around in your body. If you lay on one side for too long, the medicine will travel to that side of the body.
 
4.) Ineffective contractions
How can a contraction be ineffective you say?
O’Driscoll et al believed that primigravida uterine action[ineffective contractions] is ‘‘often insufficient to overcome the soft-tissue resistance in a woman having her first vaginal delivery.’’ The treatment for this is artificial oxytocin drip, or Pitocin, due to what medical practitioners call "Failure to Progress". Typically when I encounter a situation like this, I encourage mom to find ways to release her own oxytocin (see infographic). Oxytocin is influenced by, and influences feelings and behaviour. It is a hormone cocktail that enables mother and baby to form a bond and attachment. Since Pitocin only affects the uterus and does not cross the blood brain barrier, only oxytocin produced in the brain creates these psychological/emotional effects.

5.) Unfavorable presentation or position of baby
Nobody knows how your baby will react in labor and delivery. Just as all of our fingerprints are never identical, neither are laboring bodies. Fun fact: even the way a uterus contracts is different from woman to woman! How fascinating!

Let me give you the rundown on baby positions. Occiput anterior (OA) is when baby is face-down, spine facing your belly. This is the optimal fetal position. Occiput transverse (OT) is when baby is sideways inside your womb and can be the cause of a slow and more painful labor. Occiput posterior (OP) is when baby is face-down, spine facing your spine, which is the leading cause of back labor.
 
To help prevent pain, decrease pain or to help encourage your baby into a better position for delivery, you can use a variety of positions, including:
  • Hands and Knees
  • Lunges
  • Pelvic Rocking

​In addition to moving the baby, specific comfort measures can include:
  • Counter pressure
  • Massage
  • Rice Socks (heat packs)
  • Cold packs
  • Bathtub or shower (water)
  • Movement (swaying, dancing, being on a birth ball)
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6.) Dehydration and lack of nourishment
Never would I deny a marathon runner a drink of water midway through their run. Nor would I ever deny a laboring woman water and nourishment. In hospitals, they want to minimize consumption in the case that surgery is needed. It is also to lessen any chance of messes like throwing up. But a popsicle and honey sticks can be just what mama needs to get her through those last few stages of labor.

7.) Exhaustion or stress
Labor can be fast and furious or long and arduous. At times when labor hours have been trying, it is best to allow mom to rest if at all possible, keeping her comfortable and relaxed. There is always a time for movement but also for resting, letting the body truly relax into this journey.

Stress can play evil tricks on labor. First, it slows down oxytocin because fight or flight mode is turned on. For first-time moms, labor in and of itself can be such a stressful event for the body, mind, and spirit. For tips, see the above #4 section about releasing oxytocin to foster positive psychological/emotional outcomes.


Well, there you have it! I hope this was helpful for you! Let me know in the comments what you found insightful, helpful, and exciting. If you have any questions, please email us!

As always, keep your love in motion!

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Pre- and Early Labor Signals

7/20/2018

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  • Initiation of labor, progression and signals of labor
Parents face two common challenges during late pregnancy.
1) Impatience to end the pregnancy due to discomfort, fatigue and eagerness to hold their baby
2) The possibility of a long, discouraging pre-labor phase.

These challenges make parents more accepting of induction or vulnerable to the belief that there is something wrong. Parents need to understand that labor normally begins only when all of the following occur:
• The fetus is ready to thrive outside the uterus (breathing, suckling, maintaining body temperature, and more).
• The placenta has reached the point where it can no longer sustain the pregnancy.
• The uterus is ready to contract, open and expel the baby.
• The mother is ready to nourish and nurture her baby.

If parents understand that fetal maturity is essential in initiating the chain of events leading to labor, they may be more patient with the discomforts of late pregnancy, and less willing or anxious to induce labor without a medical reason.

Natural induction methods are a viable options to assist and allow for the above criteria to be met and for labor to commence. However, they are not meant to coax the baby out but rather to encourage the process along. I will blog about natural induction methods coming up but for now, please see one delicious way by checking out my Labor Cookies Recipe.

The ways to progress to a vaginal birth
Progress before and during labor and birth occurs in many ways, not simply cervical dilation and descent, which is what most people focus on. Labor unfolds gradually, which begin weeks before labor and involve the cervix. The cervix moves forward, ripens, effaces and then dilates. When parents understand that a long pre- or early labor is accomplishing necessary progress – preparing the cervix to dilate – they are less likely to become anxious or discouraged that nothing seems to be happening. The other steps involve the fetus: the fetal head repositions during labor by flexing, rotating, and moulding to fit into the pelvis; and lastly, the fetus descends and is born.

Possible signs of labor
  • Nesting urge
  • Soft bowel movements
  • Abdominal cramping
  • Backache that causes restlessness
These may or may not continue to the clearer signs of labor and may be associated with early cervical changes.

Pre-labor signs
The most important of these is the first one:
  • Continuing ‘non-progressing’ contractions (that is, over time, the pattern remains the same; they do not become longer, stronger or closer together)
  • Possible leaking of fluid from the vagina
  • Possible ‘show’ – bloody mucus discharge from the vagina
With these signs, the cervix is probably not dilating significantly, but is likely to be ripening and effacing.

​Positive signs of labor
The most important of these is the first one:
  • Continuing, progressing contractions, i.e. contractions that become longer, stronger, and closer together (or at least two of those signs). These progressing contractions cause cervical dilation, which is the clinical definition of labor.
  • Spontaneous rupture of the membranes (SRM), especially with a gush of fluid. This happens before or at the onset of labor in about 8% of women at term. It most often happens late in labor. SRM is only a positive sign of labor in conjunction with continuing progressing contractions.

Positive Notes
Staying positive amidst pre- and early labor is important in the process of delivering your baby. Women progress in many different ways and your journey is your own pathway to forge for you and your baby. The hard work put into the process is well worth it. Just knowing the signs above can and will help in understanding when it is a good time to bring in your birth team, call your midwife, go to the hospital (or stay at home), and move forward in a positive and healthy manner.

Stayed tuned for more progression through labor and delivery, as well as some natural induction methods!
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    Author's Philosophy


    I am a doula. I love labor, I love birth! But most of all, I love witnessing the beautiful transformation of women becoming mothers. My job is to facilitate that transition easily and with JOY!!

    ​My greatest goal is to ensure that you and your family feel safe and secure with me by your side, ushering you into a brand new heroic journey that is motherhood. It is my highest honor to serve women in one of the most splendid moments of their lives!

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