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The "Should's" of Pregnancy

5/30/2018

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Boise Doula support
In pregnancy and postpartum, you are faced with so many "should's"
I am an avid podcast listener. One of my favorites is a podcast called “Death, Sex & Money.” In one episode, host Anna Sale interviews actress Ellen Burstyn. Ellen shares that now that she is in her eighties, living alone, she has finally allowed herself “Shouldless Days,” days where she does only what she wants to do and nothing she should do. She turns away from the inner critic who faults her for not doing what she should, and instead listens to what she truly wants and needs.

I often think about Ellen Burtstyn’s "Shouldless Days" and think to myself, "Is it easier to do this when you’re in your eighties, without the responsibility of little mouths to feed and hands to hold? Is it easier to do this as a financially successful famous actress, living alone in a lofty New York apartment?"

And my answer is, "Of course!"

But that doesn’t mean that we need let the “should’s” dictate everything in life. By choosing to not act from a “should” mentality in every instance, you allow room for self-compassion, a turn to joy, and you prioritize self care.

Just stopping to question the “should” helps you to decide what to keep and what to let go. Sometimes you agree with the “should.” It aligns with your core values. You begin to edit out the unnecessary, the harmful, the confusion, and the waste that does not serve you and your family.

There are many opportunities to practice this in pregnancy and postpartum. You are faced with so many “should’s.” With a new tiny human to prepare for and care for, the stakes seem even higher on figuring out what you should do.

Should I birth in the hospital?
Should I find out my baby’s sex?
Should I get genetic testing?
Should I get an epidural?
Should my mother-in-law get to be in the room when I give birth?
Should we circumcise our son?
Should we host visitors after the baby is born?
Should I be able to keep the house clean?
Should we co-sleep?
Should I introduce a bottle?
Should I go back to work?
Should my baby be sleeping through the night by now?
Should I be back to my pre-baby weight?

To be truthful, the “should’s” never end. Whether you are expecting a baby, have a newborn, a toddler, or a teenager, there will always be someone (maybe yourself), telling you what you should do in any given situation.

Before you automatically oblige, pause. Are you also listening to the voice of self-compassion? Are you taking care of your own needs, as well those of your baby and family? Are you making room for joy? Do you need help? Do you need more information? Is there another way? What does your intuition tell you? 

Amidst leaking breasts, a non-stop nursing baby, a clingy toddler, and a pile of laundry, if you can’t swing a Shouldless Day, try a shouldless pause. A breath. A chance to let go of what doesn’t serve you. A turn to what brings you joy, even a trace.

Maybe it's advocating for yourself in labor. Maybe it's saying "no" to a visitor. Maybe it's ordering pizza that night so you can sleep a little bit longer with your baby. Maybe it's asking someone else to bring the meal. 

Question the "should's." Listen to what answers follow.
I am a certified labor doula and professional postpartum doula serving clients in Boise, Eagle, Meridian, Nampa, and the greater Treasure Valley.
​What "should's" are you facing in pregnancy? How can I help?
Let's Talk!
elevated birth
Copyright 2018
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What's a Doula, Why a Doula?

5/22/2018

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Why a doula for birth or postpartum
Photo by AZGAN MjESHTRI via Unsplash
Today we're going to back to the basics!

Doula 101 - The What and the Why

Preparing for a new baby can be an overwhelming task— there are numerous baby gear items to acquire, frequent care provider visits, increasing demands on your body as your baby grows and your body changes, classes to take, postpartum work arrangements to be made . . . . it’s no wonder that many people postpone thinking about how they will approach labor and birth until later into their pregnancy.

Sometimes it’s during a childbirth education class, or when you feel your baby’s rigorous kicks, or you can no longer see your toes underneath your growing belly, that you start to think, “This baby’s really going to come out soon!” You might panic, as you think about all the books you wanted to read, or that birth plan you need to write. And how in the world will your partner know what to do when you are in labor?!

Step in your doula. But what’s a doula? A doula is your continuous support during labor and birth, a knowledgeable birth guide who works for you, giving you the information, encouragement, and hands-on help you need to give birth in a way that feels right to you. She works with you and your partner in pregnancy, educating you about your options, and answering whatever questions you may have along the way. She knows all about birth. She helps your partner effectively help you by making suggestions on how to support you in labor. Your doula helps you both feel confident and prepared for birth, instead of fearful or anxious.

But isn’t that what your doctor or midwife is for? Or your nurses? Actually, no. Your doctor and midwife, and the hospital nursing staff, are primarily focused on the physical health and safety of you and your baby during labor. They are monitoring your blood pressure, checking fetal heart rates, administering medications, and watching for signs outside of a normal birth pattern. In a hospital setting, you may not even see your doctor or midwife until you have already starting pushing.

The nursing staff you may see more often, as they are the front line of patient care, but they usually have several other patients to care for besides you. They don’t have the time or the resources to continuously stay by your side, helping you breathe, or massaging you, or suggesting position changes. If you are in labor during a shift change, the nurse whose care you have been under will leave, and a new person will take their place.

That leaves just your partner and maybe another family member or friend to offer the continuous support that can make or break a birth experience. And although members of your support team may have given birth before, they aren’t necessarily familiar with birth in general, or the specific needs of your birth. They may not know what to suggest if certain challenges arise during labor. They may not have the information you need to make a decision about the course of your care.

Doulas bring a calming presence, knowledge about the birth process, and personalized care to your birth space. They attend all types of birth, from unmedicated home births, to Cesarean births, to inductions, and everything in between. Doulas get to know their clients during pregnancy, and support them in whatever decisions they make for themselves. They follow up postpartum, checking in on their clients’ well being, helping with breastfeeding, and referring them to additional resources they may need.

There are Postpartum Doulas, who work with families in their home, helping them adjust to life with a new baby. They help with newborn care, household organization, light housekeeping and cooking, and they help take care of baby so the new parents can get what every new parent needs— more sleep!

The Treasure Valley is a great place to have a baby, and one of the reasons is that there is a doula for everyone, in all price ranges, offering a different mix of services that work for your situation. When you have the right support, your birth and postpartum experiences are more likely to be positive, benefiting you, your partner, and your baby.
I am a certified labor doula and professional postpartum doula serving clients in Boise, Eagle, Meridian, Nampa and the greater Treasure Valley. Do you have questions about how a doula can help you have a more positive birth experience?
Contact Me
elevated birth
​Copyright 2018
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Pretty Powerful

5/16/2018

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After birth photo
Doula support birth photo
Apparently I was partial to blue sports bras in labor
Maybe it was a friend or family member, maybe it was you— that snapshot taken right after baby was born, mom’s long hair flowing over her breast, cheeks pink, eyes bright, lashes tinted with mascara. A gorgeous photo of a mother with her new baby. 

Sometimes the look is staged a bit, sometimes a mother’s natural beauty is shining through. Whether makeup is on your list of what to pack to the hospital, or you just can’t take a bad picture, I don’t fault anyone for taking a gorgeous photo on one of the most momentous days of their lives.

I just know that that person isn’t me. And it might not be you, either. 

Labor is hard work. It’s often compared to a marathon, but it’s way more intense than a marathon. Marathons take place during the day; the previous night you’ve eaten a solid meal, and you go to bed early to rest up for the strenuous activity ahead. You don’t always get that luxury in labor. It can creep up on you after a long day on your feet, in the middle of the night and last well into the next day— or for several days. You can’t just take a break and walk for a while in labor. You can’t quit, walk on over to the nearest pub, and try again next race. You are in it, fully committed, until you reach the ultimate finish line— the birth of your baby.

So it’s not a surprise that not everyone can pull off the perfectly coifed after-birth look. Nor does everyone want to. 

I’m not particularly adept at beauty routines. I didn’t start wearing makeup until late into my twenties. Most days my hair air-dries into frizzy waves, n’er a blow dryer in sight, unless it’s below freezing outside. So, after my 18-hour and 12-hour labors, after nights without sleep, face puffy and dotted with wonderful pregnancy-induced melasma, my after-birth pics aren’t very pretty.

But when I look at them, I see power. I see joy. I see a woman who, despite feeling afraid and vulnerable and more exhausted than I had ever been before, persevered and freakin’ birthed a baby. I am proud of myself when I look at those pictures. I am glad I have them— ALL of them, even the ones that few will ever see— because they show what I did, what I endured, what I rocked.

They aren’t necessarily pretty, but they are pretty powerful.
I am a certified labor doula and profesional postpartum doula serving clients in Boise, Meridian, Eagle, Nampa, and the greater Treasure Valley.
How can I help
you feel powerful during your birth?
Learn About Birth Support Services
elevated birth
Copyright 2018
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"Give Me All the Drugs!"

5/8/2018

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Picture
"Give me all the drugs!"

This is a humorous way some people inform others that they don’t want an unmedicated birth. You or someone you know may have used those exact same words during your pregnancy. As a doula, I’ve heard it from clients, too.


There is a misconception that people hire doulas only for unmedicated births. While I definitely have had clients who value “natural” labor, and give birth without pain medication or other medical interventions, I also serve clients who know ahead of time that they will get an epidural, or will utilize some other form of pain medication.

Why would you want a doula if you know you will opt for drugs in birth?


1. You want to wait as long as possible before opting for drugs. Some clients want to see how far they can get without pain medication, for a variety of reasons. Some are concerned about the side effects of certain medications, or the interventions required with their use, like continuous fetal monitoring, I.V. fluids, catheterization, etc. Some have concerns about slowing down labor, or taking medication too soon and being left with fewer options for pain relief later on. Others want pain medication as an option, but are okay with using it only if needed.

Until the client decides to utilize medication, they may need help with natural pain management, coping with contractions, and emotional support. As a doula, I can offer suggestions and provide whatever support is needed to get my clients to the point at which they feel they are ready to accept pain medication.



2. You want more information about the pain medication available to you. During pregnancy, we discuss your goals and intentions regarding pain management, and your options at your particular place of birth. You may know that nitrous oxide is offered at St. Alphonsus and St. Lukes hospitals, but you may not know how administration of the nitrous actually works. You may consider a narcotic for pain relief, but want to know the potential side effects before deciding. You may want an epidural, but be unaware of what positions you are likely to push in after getting one.

There are risks and benefits to every intervention, and knowing these before you are in labor can help you determine which medications you want to prioritize, and which you want to avoid. You can learn some of this information during a childbirth education class, or by doing your own reading, but having an in-depth discussion about your options with your doula brings the conversation to a more personal level. We discuss what support you may need for various pain relief options, and what you can expect to follow. The information is tailored to your individual needs, your personality, and your specific goals and values.


3. Sometimes medications don’t work as you expect.  You may have heard stories of an epidural “not working,” or working only on one side. You may experience an unpleasant side effect from a certain medication, like nausea and vomiting, loss of sensation, or severe itchiness. A doula’s calm, comforting support and encouragement can help to get you through unexpected pain or discomfort. I have utilized coached breathing, visualization, light massage, and other techniques to get clients through a difficult episode. When things take an unexpected turn, being able to turn to your doula for reassurance is sometimes all a laboring client needs.


4. Some births involve medication from the start.  You may need or opt for an induction or Cesarean birth, or you have a high-risk pregnancy that requires medicalized care. Just these circumstances alone can bring up fear and anxiety that a doula can help you work through. Even when a birth doesn’t go as planned, there are often options that may be available to you that you hadn’t considered or known about. For instance, there are different ways to induce labor-- pharmacological, mechanical, or low-tech options like trying an in-office membrane sweep. Your doula can inform you of these options, so you can discuss them with your doctor or midwife and see if they can be incorporated into your birth.


5. Continuous care is continuous care.  No matter how you choose to birth, or how your birth unfolds, having continuous support can make all the difference in how you feel about your birth.

It’s not always feasible to rely solely on your partner to provide this support; they may not feel knowledgable enough to support you, they may be nervous and require their own support, or they may need periodic breaks to best serve you in labor. It isn’t common or the norm for your doctor or midwife, or even your nurses, to be able to be with you at all times during labor. And often the on-call staff can be strangers, whom you’ve just met.

As your doula, I am a familiar face. During our prenatal visits, we've gotten to know each other. I am at your side, as long as you need, to help you get through whatever your labor brings. After the baby is here, I can help with breastfeeding, check on you at home postpartum, and serve as a resource for questions and referrals. As a postpartum doula, I can provide in-home care to make the transition to life with your new baby easier. The continuity that doula care provides is reassuring, convenient, and maximizes the chances of a positive birth experience.
I am a certified labor doula and professional postpartum doula serving clients in Boise, Eagle, Meridian, Nampa, and the greater Treasure Valley.
Are you planning on utilizing pain medications in your labor? Do you want to know more about what options are available at your birth place?  Let's talk!
Contact Me
elevated birth
​Copyright 2018
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Guest Blog Post: 5 Tips Before Your Newborn Lifestyle Session

5/3/2018

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Newborn Photography Boise
Courtesy Natalie Koziuk Photography
Picture
Today, I hand over my blog to talented Treasure Valley lifestyle photographer Natalie Koziuk. Natalie offers full-service photography, specializing in creating a fun, relaxed, low-stress photography experience with a stylish, high-end result. 
My clients receive 50% off a maternity or newborn session with Natalie ($200 value). For a short time, she is offering my clients a fantastic discounted package for maternity,  birth, and newborn photography. Contact me for details!

Check out Natalie's work at 
http://nkoziukphotography.com​. And check out the details on our collaborative Mother's Day Giveaway at the end of this post!

Boise Newborn Photographer - 5 Tips Before Your Newborn Lifestyle Session

​I get a lot of questions about newborn lifestyle photography and what to expect. Let's do a quick refresher on what lifestyle photography is and why I'm completely obsessed with it. 

Let's set the scene. You just brought home your new baby and instantly that little human starts growing (oh, so much faster than we'd like to admit)! What will you want to remember when that little human is all grown? Perhaps those tiny fingers wrapped around yours or how easy their head fit into dad's palms? Possibly the way you and dad looked at him completely in love and thankful that he's finally here? Here's the thing, life as you know it is complete now. The moments and details are what I capture and what you'll love years and years from now. 

Props, beanbags, and wraps oh my!
No need for posing and waiting hours for me to wrap, swaddle, and pose baby on a beanbag. I'll capture your family doing what it does best, being real, raw, and you. Lifestyle photography captures those authentic moments that can’t be planned or staged.

Let's talk wardrobe
Mom, start with what you feel comfortable in first. Either a dress, or something light, comfortable and casual. Light neutrals photograph beautifully, but I don't discourage darker colors mixed in. You’ll want to avoid bright colors like apple red or orange so they don't reflect onto that sweet newborn's face.

Pairing simple basics with textured overlays, such as a robe or a slouchy open sweater are always encouraged. From there you can coordinate the rest of the family.
Newborn Photography Boise Treasure Valley
Courtesy Natalie Koziuk Photography
A sleepy baby
I can't tell you how often I arrive and baby is up and ready to party.  Feeding baby right before your session gives us a good chance we’ll have a sleepy newborn right from the start. If not, no need to stress. More often than not, I'll catch those eyes closed at some point. Bottom line...Whether your baby is awake or asleep during your session, remember that those moments caught on camera happen organically.

Natural light
Keep an eye out in your house where and what time your rooms have the most light. I typically photograph in three areas-- the living room, your master, and the nursery. I ask that you send me photos of your rooms before the session if I don't come to visit you beforehand. Depending on your home, usually around 10am-2pm we get the best light. 

If you only have one room that works, that's great! I’m happily surprised with the sessions I’ve had with only one window to work with. 
Treasure Valley Newborn Photography
Courtesy Natalie Koziuk Photography
Siblings
Usually we'll start with the whole family if big brother or sister is happy and ready to go. If they're not excited yet, I’ll start with baby and we’ll add them in later. Photographers have quite a few tricks to keep things moving right along. Many times, they're so excited about their new role that they'll want to hold and kiss all over their new best friend. If they really don’t want to be involved, I still try my best to get them in the frame. Nine out of 10 times they'll change their mind. ;)
Newborn Photography Boise
Courtesy Natalie Koziuk Photography
Timing is everything 
I always advise parents to contact me in their second trimester to guarantee their session. I leave a healthy gap in my calendar open from before you're due to two weeks after you're due so we don’t miss the sweet spot. I’m in and out within an hour (sometimes 90 minutes) so you can get back to your newborn life as soon as possible. 
Are you excited yet?!  If it’s time to schedule your newborn session let's chat soon. Email me at hello@nkoziukphotography.com or call 208.794.7916 to ask questions or to check availability.
Mother's Day Giveaway
Don't Miss Out!!!
Natalie and I have teamed up to offer a Mother's Day Giveaway! One lucky winner will receive a photo session with Natalie, and a birth planning session and postpartum doula support with me. Visit Elevated Birth on Facebook or Elevated Birth on Instagram for details on how to enter. We will pick a winner on May 10, 2018 so enter now!
elevated birth
Copyright 2018
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What this Doula Wants You to Know - Part II

5/2/2018

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Treasure Valley Postpartum Doula Support
Image by Oleg Sergeichik via Unsplash
This is a two-part series. Look for the first part in my previous post:
What this Doula Wants You to Know About Birth

What this Doula Wants You to Know About Postpartum

1. The postpartum period is underestimated. Many people focus on the birth of their baby, choosing a care provider, a birth place, and making a birth plan. These are important endeavors, and require adequate research and planning. Yet often little consideration is given to the specifics of how life will function after the baby is here. Researching options for baby gear, registering for diapers and essentials, and choosing a pediatrician is only part of what you need to decide. Just as you need to determine who will take care of your house, older children, pets, work commitments, etc. before and during your birth, these needs will continue and perhaps be more difficult to meet when your baby is earthside. Factor in the need for physical healing, dramatic hormonal changes, and caring for your baby-- all with limited sleep-- you may realize that you need much more help than you planned for. Making a postpartum plan during pregnancy can help prepare you, your partner, and extended support system to meet the needs of the entire household after the birth.

2. Your body may take longer to heal than six weeks. There is a popular meme circulating on social media that pictures a paper dinner plate. That dinner plate represents the size of the wound in your uterus where your placenta was attached. I admit, as the mother of two kids and a trained doula, I had never considered the size of the wound inside my body after birth. It's a powerful visual. If that wound was on the outside of your body, no one-- including yourself-- would expect you to do much for several weeks after birth.
Postpartum Healing Placenta Wound
If your birth was physically difficult, you had tearing that required stitches, complications, a high-intervention birth, or a Cesarean birth, your body may take even longer to heal. In the immediate postpartum you may experience vaginal soreness, pain while urinating, difficulty pooping, heavy bleeding, contractions as your uterus shrinks back down to its pre-pregnancy size, sore breasts from learning to breastfeed, irritation or pain from your Cesearan incision site, swelling, profuse sweating,  and a host of other physical discomforts. 

Your care provider may "clear you" at six or eight weeks, but your body may need more time. You may not be ready for intercourse, work, chores, or outings. You may need more periods of rest, even if you feel physically better. You may need additional treatment, like physical therapy. 
Accept that your body went through a LOT, and allow yourself the time and grace to heal.

3. Be proactive with lactation support. If you choose to breastfeed, know that it can be difficult to get started. Taking a breastfeeding class in pregnancy is a good idea, but it may still confusing to implement what you learned when baby is actually at your breast. Add in hormonal changes, a baby that needs to eat, and conflicting advice from those trying to help you, and you have a recipe for anxiety and unnecessary stress. Seek out the support of a postpartum doula or lactation specialist early in the postpartum period to get you off to a good start. Any issues outside of normal may be more easily identified and addressed. If needed, referral to an IBCLC (International Board Certified Lactation Consultant) can be made. 

Two IBCLC's in the Treasure Valley I refer clients to are Melanie Henstrom at Baby Bonds and Lynnelle King at Family Seasons, LLC.


4. Pelvic floor therapy is a no-brainer.  Pregnancy and childbirth do a number on our pelvic floor muscles. Complications include urinary and fecal incontinence, uterine prolapse, pubic symphysis pain, diastasic recti, and more. In France, postpartum pelvic floor therapy is standard care. In the United States, it is not, and unresolved injury can be left untreated, causing years of pain, discomfort, and embarrassment. Check out my blog post all about the pelvic floor.

Seeing a pelvic floor specialist in pregnancy can set you up for easier care after your baby is born, or even prevent issues postpartum. In the Treasure Valley, pelvic floor therapy is now even easier to obtain, with the launch of Treasure Valley Pelvic Health, a mobile pelvic therapy provider who will come to you. Your first visit is 20% off in the month of May.


5. Your emotional and mental health needs as just as much attention as your physical health. Postpartum mood and anxiety disorders (PMAD) affect 15-20% of women. These include postpartum depression, postpartum anxiety, postpartum panic disorder, postpartum obsessive-compulsive disorder (OCD), and rarely, postpartum psychosis.  Educating yourself, your partner, and close family and friends in pregnancy about the signs of these disorders can help to identify them and get treatment as soon as possible.

​Even just noticing that you feel "off," and "not yourself," can be enough proof to seek out an evaluation from your care provider. Don't discount (or let others discount) the effects of a traumatic or disappointing birth experience on your emotional health, either.

Resources to begin to seek out help include Postpartum Support International (PSI) at www.postpartum.net, your care provider, or local mental health professionals with experience in treating PMAD's. You can find a recommended list of providers on my Parent Resources page.

Even if you don't suffer from a PMAD, you may feel overly tired, stressed out, emotional, sad,  disappointed, discouraged, or down at times. A healthy and committed support system that allows you to rest, heal, eat well, and focus on little more than you and your new baby can maximize your chances for a positive postpartum transition. Postpartum doulas can play an important role for those without a strong support system, or those who want or need extra support as they transition to life with a newborn.

By planning for the postpartum period, building a robust support system, and taking advantage of local resources, you can start off on your new parenting journey from a place of confidence and strength. Everyone benefits from a healthy mother or birthing parent-- your baby, your partner, and you especially.

I am a certified labor doula and professional postpartum doula serving clients in Boise, Meridian, Eagle, Nampa, and the greater Treasure Valley. How can I help you plan for your postpartum?
Learn About Postpartum Doula Services
elevated birth
Copyright 2018
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    Doula Raquel

    I've worked in the forest, in the lab, and in an office cubicle. My favorite and most passionate work has been alongside clients as they reach inside to find their innermost strength, and give birth to their babies. Each birth is an honor to witness.

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