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Who Gets to Be at Your Birth?

7/31/2018

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Boise doulas, birth doula Boise
Build a better birth team and have a better birth experience

Who will be invited to your birth?

This question can be a loaded one for expecting couples. The amount of stress and anxiety around who should be at your birth can be overwhelming.

Can you relate to any of the following scenarios?

You’re not sure if you want your mother in the room, but she’s your mother, so shouldn’t she be there? And if she’s going to see her grandchild’s birth, it’s only fair that your mother-in-law should be there, too, right? 

You really want one sister to be with you but your other sister will be loud and obnoxious while you’re trying to concentrate on labor. But how do you explain that you want just your one sister in the room?

You don’t want anyone in the room except your care provider, your partner, and your doula. And both sides of the family are making you feel guilty. What should you do?


Here are some things to consider to help you make a decision on who will be invited to your birth space:

1. Identify the most important person in the room. The person having the baby, the one whose usually-clothed body parts will be exposed, who is experiencing one of the most physically and emotionally challenging events of their lives, is the ultimate decision maker. Some couples will negotiate who will be allowed to visit during or after labor, and the partner’s need for emotional support can definitely be a part of that discussion. But if the laboring person has a strong desire to include or limit a particular person’s presence, it’s important for that to be respected.

In birth, it’s imperative for the laboring person to feel safe and supported. The hormones involved in labor are directly affected by whether or not this is the case. When it’s not, it can impede labor progression. An unhealthy emotional state can have physical implications for both the pregnant person and the baby.

We want oxytocin to flow in labor— this “love” hormone has a hand in contracting the uterus, breastfeeding, and in creating attachment with baby, and its production is supported when the person in labor feels safe and supported.

Also keep in mind that some survivors of trauma, or those with severe anxiety, are managing more than just their contractions when they are in labor. Creating a birth space that puts their emotional and physical safety at the forefront is necessary for their own well being.

2. Build your birth team mindfully. Approach the decision from a standpoint of value instead of a “should.” A “should” comes from an external pressure or rule. Someone who brings value to your birth space is a true part of your birth team. 

Your care provider and assistants bring their medical expertise to ensure you and your baby are physically healthy. Your doula brings knowledge about birth, comfort measures, and continuous care, to ensure you are emotionally and physically supported in alignment with your goals and values.

Think about the other people you and your partner are considering allowing into your birth space. What function will they serve? Will they bring joy, humor, welcome distraction, a shared bond? Or will their presence bring anxiety, discomfort, intrusion, negative energy, or doubt about your personal choices?

Anyone who is making you feel guilty for not including them in your birth is not acting like a teammate; they are not adding value. They are imposing their “shoulds” on you. As I recently wrote in my blog The Should’s of Pregnancy, make sure you are acting on your own core values, and not someone else’s. 

3. Know the why’s. When you have information, you can make informed decisions. Once you know that labor can be impeded by an unsafe or uncomfortable environment, because of the hormones at play, you can make a decision about keeping out people who make you feel unsafe or uncomfortable.

If initiating breastfeeding is important to you, and you know that it can be a challenge to learn how to latch your new baby, you may limit visitors for a few hours after birth so you can get uninterrupted practice.

If you know that you the wound inside your body after birth is roughly the size of a dinner plate, and you want to focus on resting after birth, then you may opt to limit the number of visitors you receive at home.


4. Consider timing. Sometimes, you welcome or can tolerate one person’s presence in early labor but you don’t necessarily want them there while you are pushing. Or, you may feel there are several people who would bring you positivity throughout your labor, but having them all there at once would be too distracting.

It’s okay to require flexibility from those you may want to include in your birth. It’s okay to impose rules, and it’s okay for you to change your mind at any time during labor. 

5. Practice setting boundaries now. Everyone has an opinion when it comes to pregnancy and parenting. Whether you are making decisions on breastfeeding, bottle feeding, medical decisions for your baby, bath products, types of diapers, who can hold baby, who can watch baby, who can visit you postpartum and when, where baby sleeps, etc. you will no doubt come across somebody close to you with a differing opinion. Sometimes those people can be outright disrespectful of your choices. 

Who you allow into your birth space can be a new parent’s first act of boundary setting, and it can be uncomfortable. But after your baby is here, there will be many more opportunities where setting boundaries is necessary, for the well being of you and your new family. Why not practice now, and take steps to ensure you have a more positive birth experience?


Even when you set boundaries, not everyone will respect your decisions. So here are some tips to fend off unwelcome visitors during labor, or when you are home after the birth:
  • Don’t post on social media that you are in labor or headed to the hospital/birth center
  • Be selective about who you tell about being in labor
  • Tell others to not post on social media anything about your labor or photos of your baby, without your permission
  • Post a sign on the door to your room asking visitors to check in at the front desk before entering (and have the front desk show them the door to the waiting room)
  • Designate a person on your birth team to be the uninvited-person “wrangler,” who will tell people to leave or where to go so you don’t have to. They can also be the person to communicate on your behalf about visiting hours or length of stay
  • Tell people ahead of time that they need to call or text before visiting
  • Put a sign on your front door asking those bringing food to please leave their meal in the cooler on your porch

​
You are entitled to a birth environment that will allow you to feel loved, supported, and safe, and to include or exclude anyone who doesn't contribute to that environment. Think about how you want to feel in labor, what you need to recover postpartum, and surround yourself with those who will help make that happen.
I am a certified labor doula and professional postpartum doula serving Boise, Eagle, Meridian, Nampa and the greater Treasure Valley.
Have you thought about who will bring value to your birth team? If that includes a doula, let's talk about how I can help you feel safe and supported as you birth your baby.
Let's Talk!
elevated birth
​Copyright 2018
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Childbirth Prep Done Your Way

7/23/2018

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Childbirth preparation Boise doula
Your version of childbirth prep might not look like someone else's!
“The aim of education is the knowledge, not of facts, but of values.”
William S. Burroughs
I encourage my clients to take childbirth education classes as they prepare for the birth of their baby. The more you know about the physiology of birth, and what you can expect at each stage of labor, the less fear there is surrounding it. 

Where you have your baby can also affect what what you experience— the procedures, care routines, people you will interact with, and what decisions you may have to make, can vary depending on whether you give birth at home, at a birth center, or even at different hospitals.

The amount of information you learn can be overwhelming. In the prenatal meetings with my clients, we sift through this information to find out what pertains to them specifically, based on their goals and how they want to feel during labor and birth. I help them identify what limitations may be present, and how to best work around them. I get to know my clients and their values, and what techniques, both physical and emotional, that will work best for them.

This is where childbirth preparation goes beyond childbirth education. 

Preparation for your birth is unique to you. Sometimes, it’s unconventional and maybe even a little strange. I’ll use my own experience as an example: When preparing for the birth of my daughter, I watched every episode I could find of a show on A&E called “I Survived.” The show profiled people from all walks of life who had endured horrible events, like attempted murder, natural disasters, near-death experiences, and trauma, and how they survived those experiences. Their outlook on life was usually gratitude, and a newfound strength. My mindset was that if these people could survive those horrific events, and still have a positive attitude, then I could make it through labor! 

That might not be the best form of prep for everyone, and that’s kind of the point. What preparation for birth looks like for me, will likely look totally different for you!

Here are ways others have prepared for their births:
  • Kim saw a homeopath and chiropractor throughout her pregnancy. She  turned a quote she read in a book into her mantra, “Your body was designed to do this.” She used that mantra during labor and has even used it in the years since when doing difficult, physical things.
  • Susie valued research, and knowing the variables that can occur during labor. She watched TLC’s “A Baby Story” even while trying to get pregnant, and then throughout her pregnancy, to get a sense for the many different scenarios she might encounter when giving birth. She also made sure to tour her hospital so she could see exactly where she would check in, labor, and where she would recover postpartum. She says, “Whenever I felt a kick, or Braxton-Hicks contractions, or the real thing, I could imagine myself in that hospital, doing my breathing, or sitting on the Swiss ball, and getting ready to meet my baby!  As a visual learner, that picture in my head was very important.”
  • Regina, an athlete, tapped back into the mental preparation techniques she would use when she was a professional swimmer by, “visualizing success, a smooth birth process, and birthing in a calm environment." She kept active, doing a lot of walking and squats, especially during the last month of pregnancy. She downloaded a meditation playlist to stay calm and focused during labor, and printed out motivational banners with encouraging phrases to hang in her birth space.
  • Spring valued humor and practicality in preparing for birth. She read the Girlfriend’s Guide to Pregnancy to get the kind of information a best friend would give, in a format that was more light-hearted, and even irreverent. 

What have you used to get through a physically or emotionally challenging time? Laughter? Visualization? Music? The deep breathing you learn in yoga or meditation? Do you value knowing the hard facts?

You can tap into your own experiences, your own strengths, in labor. Use what has worked for you, or what speaks to you, to prepare in a way that is as unique as you are.
I am a certified labor (birth) doula and postpartum doula serving Boise, Eagle, Meridian, Nampa, and the greater Treasure Valley. 
How can I help you have a more positive birth experience, that is focused on
you and your unique needs?
Let's Talk!
elevated birth
​Copyright 2018
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Planning for the Unplanned Cesarean

7/9/2018

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Doula in Boise, Meridian, Eagle, Idaho
Planning for your Best "Worst Case"
Most people give birth vaginally, and the majority of birth plans focus on wishes and goals for a vaginal birth. Some desire very strongly to avoid a Cesarean birth, choosing to exhaust all other options before deciding that surgical birth is their best option.

But roughly 1/3 of the time nationally (and 18.1% of the time in Idaho according to cesareanrates.org), whether due to a medical emergency, complication, or other circumstance, people find themselves giving birth in the operating room. 


The circumstances of your pregnancy and labor, how prepared you are for the procedure, who is there to support you during the surgery, and how your wishes are respected during your Cesarean birth, are all things that can affect your birth experience. Even when the unplanned happens, you can still have a positive birth!

So even if a Cesarean birth is your "worst case" option, it can be helpful to plan for it anyway. Here are some things to consider, and ways a doula can help you plan for the unplanned:


1. If you are familiar with the steps of the procedure, you won’t be caught off guard. Policies and procedures can vary by hospital and care provider. Will you be alone at any point? How many support people can accompany you? Is it commonplace to have your arms strapped down? What medications will you receive? What will it feel like, sound like, smell like? Will you be able to see and touch your baby right away, or even initiate breastfeeding in the OR? What can you expect after the surgery?
​
Your doula can help prepare you for what to expect, and help you formulate questions for your care provider. Some policies and procedures are negotiable, and having a discussion with your care provider ahead of time can make for a more positive experience. She can also help you create a Cesarean birth plan to accompany your standard birth plan. 


2. You may have more options than you think. Some of what happens during a Cesarean birth is dependent on the reason for it. If it’s a true medical emergency, you may not have as many options as if you had an “urgent” or even planned Cesarean.

In a true emergency, you are likely to be put under general anesthesia and the baby born within minutes. This is a small percentage of Cesareans. Usually there is a lot more time, and more variability in the experience. You may have a choice in:
  • What type of anesthetic is used. If you already have an epidural in place, that will be your anesthesia for the surgery. If not, a spinal block is usually administered. There are pros and cons to each, which you can discuss with your doula and care provider.
  • What other medications are administered pre-surgery and post-surgery. Familiarize yourself with what sedatives, antibiotics, and pain relievers you may receive. 
  • How you will be supported during the procedure. Your partner is usually allowed into the OR, but may not be allowed back in if they accompany the baby to the nursery or NICU. What other support people can join you? Will your doula be allowed to accompany you? Can you play your own music, or bring in personal comfort items? 
  • Your preferences. Will you be restrained? Will you be able to see and touch your baby or breastfeed? Will you be able to see the baby being born if desired? Can you delay cord clamping? Will your uterus be repaired inside or outside your body? What kind of sutures will you receive? 
  • Your recovery. Who will be with you in recovery? When will you see your baby, given there are no medical complications? When can you begin to breastfeed? When can you go home?

3. Your postpartum needs may be different.  Do you have a support system at home that can also accommodate your needs after a Cesarean birth? Will you need extra help moving around, breastfeeding, someone to make you meals, someone to help out with the baby? Your doula can be a great resource to plan for what additional support you may need, as well as provide referrals to specialists. You can opt to hire the support of a trained professional in your home, like a postpartum doula.

4. Your emotional needs may be different. This is where a doula can really help to listen, provide a supportive presence, validate your experience, and if needed, help you find additional resources so that your emotional recovery is treated as importantly as your physical recovery. 


Planning for a Cesarean birth when you desire a vaginal birth isn’t thinking negatively, or setting yourself up for one. It’s preparation for one outcome, out of many. It’s the first aid kit in your backpack as you hike up the mountain. It’s a mental exercise.
​
And it’s something you can do with a supportive, knowledgable, compassionate person on your side, looking out for you no matter what happens or how you give birth— your doula.
I am a certified labor (birth) doula and professional postpartum doula serving Boise, Eagle, Meridian, Nampa, and the greater Treasure Valley. 
Feel confident and prepared no matter how you give birth. Let's talk about how I can help!
Contact Me
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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