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!

I know far too well the feeling of helplessness at the end of pregnancy. You feel like a beached whale, a ticking time bomb, and people are constantly asking you if the baby has arrived...

The following are easy and gentle measures to urge baby to send your body the proper hormones to begin labor. Keep in mind that these are GENTLE METHODS and are not intended to be used without consulting a doctor or midwife.

Self-help Techniques

• Walking 20 minutes per day: Let gravity do the work!
• Try Curb Walking (stepping one foot up on the curb and keeping the other foot on the street, walk up and down like this down one block, turn around and walk the other way with the other foot going up on the curb).
• Supported Squats: open a door, hold onto both door knobs a sit your bottom down as low as is comfortable to get back up into a standing position. Aim for about 50 squats per day.
• Any weekly exercises or positions from Spinning Babies are extremely helpful in getting baby engaged and in the optimal fetal position (OFP). Check it out!
• Intercourse AND orgasm: Let someone else do the work! His big "O" contains the same hormonal cocktail as what you would typically receive in a medical induction (called Prostaglandin or the medical Cervidil/Cytotec).
• Nipple stimulation: Surprisingly, this is a wonderful way to increase oxytocin, the love hormone that gets labor going! You can self-stimulate or use a breast pump.
• Stairs: This is a wonderful way to create asymmetry in the pelvis to encourage baby to engage. Going up and down sideways can replace curb walking on bad weather days.
• Castor oil: Drinking this does not taste good, but can help upset the stomach enough to induce contractions. I would recommend all other induction measures before this!
• Chiropractic/Acupressure/Acupuncture/Massage: By aligning your meridians and balancing your body, it may be enough to nudge that baby out! PLUS, self-care induces relaxation, a labor starter! I recommend seeing Cecily Yousaf (Greenwood Village), Jennifer Ulman (Parker), or Crystal Jancovic (Lakewood) for acupuncture sessions. Give them a call.
  • Grab your FREE Foot Massage for Labor HERE!! It's seriously a marriage saver!
• Labor cookies: See my first blog post!
• RELAX...no, seriously! Sometimes the anticipation of labor can be the exact reason why you're NOT going into labor. A stressed mindset sends fear hormones into your system, telling your body that it's not ready to have a baby yet. So, here is my prescription:
  • Do this every day leading up to labor: Take a soothing walking meditation, go home and dim the lights, eat some food, take a bubble bath, watch a funny show, do a 10-minute breath exercise, and get as much rest as possible.
  • If you're still feeling stressed, reach out to a trusted person and/or your Doula!!

Complementary Medicine Methods

• Herbal tea and tinctures: Red raspberry tea
• Homeopathic remedies: Putting a couple capsules of Evening Primrose oil up your hoohah will soften the cervix and allow it to ripen. It worked for me! Other remedies are: Pulsatilla 200C, Caullophyllum 200C and Cimicifuga 200C.
• Foods: Dates, pineapple, spicy food...many moms swear by these!

Medical Non-drug Methods of Induction

• Balloon dilator (Cooks catheter) or Dilapan (Dilation rods): They can help if you are already in the hospital and labor is not active.
• Stripping (or sweeping) the membranes: This is uncomfortable but can help ease things along before you are in labor.
• Artificial rupture of membranes (AROM): Possibilities of cord prolapse (not common) with this method, but it can definitely get labor moving along.

To be completely honest: acupuncture and sex are truly the ONLY tried and true methods that actually move the marker from a natural standpoint, but EVERYBODY IS DIFFERENT.

Do you know of any other methods not mentioned here? Would love to hear from you!

While you're waiting for that new baby bundle, snag yourself a FREE Labor Cheat Sheet so you and partner have an easy reference for anything that could arise in labor!

Here's to keeping your LOVE IN MOTION!!

• 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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Throughout pregnancy, women experience many different changes, aches, and discomforts. A most common symptom is tired feet. A lot of pressure is put on the legs and feet as baby gets heavier. Not only does the baby attribute to more weight gain but so does the maternal physiology and metabolism: water, amniotic fluid and blood accretion, uterine and placental growth, and breast and fat mass. This is enough to convince anyone that a woman's feet are substantially underrated and undernourished.

The feet are the foundations of the body. They have reflex points for every organ. Modalities like reflexology can stimulate and balance the body. In the case of pregnancy, the body is going through a lot of changes so a foot massage can be highly beneficial in staying grounded and balanced throughout the process of growing a baby.

Benefits include: Increased blood flow, energy, and rejuvenation, reduced swelling, released tension and an overall happier mama!

The following is a SAFE foot massage that can be used all throughout pregnancy and for labor. It is good practice for the partner to have a supporting role in labor. And for all you single mamas out there, you can do this to yourself sitting in a cross-legged position.

**One caution: there is an acupressure point between the inner *ankle bone and the Achilles tendon, which, when stimulated, may produce labor contractions. This should only be stimulated when a pregnant woman is in labor.**

You may use essential oils with a carrier oil like coconut oil if that is preferred. Be sure to mix the oils together on your hands before massaging the foot. Safe essential oils for pregnant women are: Lavender, Lemon, Orange, Peppermint, Ylang Ylang, Sandalwood, Ginger, Geranium, and Bergamot.

Foot Massage for Labor

First, position the foot so that it is supported for the woman's relaxation and for you to work comfortably. 

1) Using the palm of both hands, use firm strokes to massage from the toes to the feet, all the way up to the calf, and lighter strokes to massage back down the calf to the feet and toes. Repeat at least 3x up and down.

2) Gently squeeze (not twist) the entire foot with both hands like you're squeezing water out of a sponge at least 5x. Count to 5 between each squeeze for blood flow to return. Just like a sponge when you squeeze out the water, you wait for the water to soak back into the sponge.

3) With your fingers on top of the foot, use your thumb to press into the spot just under the ball of the foot. Hold for about 10 seconds and let it go. Repeat this about 5x in the same way as the sponge technique.

4) Use your thumbs to make small circles on the bottom of the foot.

5) Use your knuckles to massage the instep/arch of the foot.

6) Use your fingertips to make small circles around the ankle bone* and top of the foot.

7) Use your fingertips or thumbs to stroke from the top of the ankle down between each toe.

8) Gently pull or wiggle each toe.

9) Use your thumb and side of your index finger to press down gently on the top of each toe and release, like you would when you click open a retractable pen.

10) Squeeze the top of the foot with both hands at least 3x.

11) Squeeze the bottom of the foot with both hands at least 3x.

12) Make a Hand-Foot sandwich: With your fingers pointing towards the ankle, use both hands to firmly "sandwich" the foot. Hold firmly to a count of five, then lighten the pressure and pull hands away slowly. Repeat at least 3x.

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Ladies and Gents, let me know your thoughts and how I can help!

Did you try it?

Ladies, did you love it?

Partners, was your mama happy with your foot work? What can you do to make it more enjoyable?