 How to make the hospital feel more homey No matter what your birth preferences may be, whether you want an unmedicated birth or you know you’ll opt for an epidural, feeling as calm and unstressed as possible during labor is usually a part of everyone's birth plan. It’s one reason why some people opt to birth at home, where they feel most comfortable and are surrounded by familiar sights, sounds, and smells. This sense of comfort contributes to the production of oxytocin, also known as the “love hormone.” Oxytocin is a crucial part of labor, responsible for uterine contractions, labor progress, attachment to baby, and even breastfeeding. When you are feeling stressed or fearful, oxytocin production is inhibited, and labor can slow or stall. As a doula, I help my clients with relaxation, comfort, and helping their partners support them better (being near your partner, hugging and even kissing in labor can really get the oxytocin flowing!)  Get close to your partner in labor! In a hospital setting, creating that at-home state of relaxation and comfort can sometimes be a challenge. First there is the ride to the hospital— I don’t know of anyone who likes laboring in the car! When you arrive at the hospital, you spend some time in triage before being admitted to your own room. It can take a while for you to settle in and get back into a labor rhythm, which is why it’s not uncommon for contractions to slow or space out a little when you get to the hospital. But when you take steps to a bring bit of home into your hospital birth space, getting back into that at-home state of comfort becomes much easier.  It’s all about the senses Whether we realize it or not, what we see, hear, smell, feel, and even taste can affect our ability to relax. When we bring items from home that appeal to our five senses, we associate what we are experiencing to the comfort of home, even in a hospital setting. Sight Hospital lights can be very bright, or give off an unappealing florescent glow. It can be helpful to close the curtains in your labor room, or to turn off or dim the lights to create a “cavelike” space where you can burrow down and work through labor. You can bring in soft lighting like battery-operated candles, or you can hang up strings of twinkle lights around the room for a more personal touch. Think about the mood that restaurant lighting creates— dim lighting promotes feelings of closeness (hello, oxytocin!) while bright, harsh lighting can be jarring and unnerving.  There may be times when brighter lighting is best. Sometimes in labor the mood becomes stagnant, or tired, and so do the contractions— opening the curtains and letting sunshine in can bring in a needed burst of energy to move around and get labor going again. Sound Even if everyone in the room is silent, the sounds of the external fetal monitor, your blood pressure cuff, or even the air conditioning can cause an unwelcome distraction. Think about what sounds make you feel relaxed at home and bring those sounds with you to the hospital. You can bring in a sound machine, your Hypnobirthing soundtrack, or a playlist of your favorite music downloaded to your phone. Bring earbuds if you want to totally zone out. I recommend that my clients add both relaxing music and upbeat music to their playlists. Sometimes some dance-inspiring tunes are a good way to lift the spirits and get my clients moving in labor. Touch Sense of touch can be very sensitive in labor. Hospital pillows, while functional, are thin and don’t have the highest thread count. Bring your own pillow from home, or your own pillowcase. Consider bringing your own blankets, too (if you are afraid of special items getting dirty, you can save them for postpartum recovery.)  Bring your own clothes to labor in, if you don’t want to put on a hospital gown. Bring your well-worn stuffed animal from childhood, or a lovey you plan to give your baby (these things can serve as a visual focal point as well!) Bring your favorite lotion or massage oil, your favorite chapstick, your favorite pair of socks or fuzzy slippers. Bring your own birth ball to bounce on, that is the perfect size for you and feels familiar. Bring your own cup or water bottle to drink out of. Bring the things you are used to at home that bring you comfort! Smell You know how certain smells can take you down memory lane, remind you of something, or instantly relax or repulse you? The same thing happens in labor, only that sensation can be intensified. Sometimes, scents that usually relax you can become too much in labor, so instead of bringing in a scented plug-in or a diffuser, consider dabbing the scent on cotton balls in a plastic baggie. That way, if the scent becomes too much, you can easily remove it from the labor room. If you bring essential oils with you, make sure you know what possible effects they can have on your labor. Be very careful with oils that you put on your body as well, as some can be dangerous for newborns or can interfere with breastfeeding. Consider food smells, especially if your partner or family members are going to be eating around you. That pepperoni pizza smell that usually makes your mouth water may be too strong of an odor for you in labor. Suggest that visitors eat outside of your hospital room so that food smells don’t linger.  Be cognizant of bad breath, especially for longer labors or labor that lasts throughout the night. I always carry breath mints or chewing gum in my doula bag and offer some to my client’s partner— no laboring person wants to smell stale breath in their face! Taste Bring your favorite snacks with you to the hospital. I recommend high-protein snacks that can be quickly munched on or that can be eaten with one hand. Sometimes something sweet like your favorite candy can be nice when you need a little energy boost. Aside from water, bring your favorite electrolyte drink or juice so you can keep hydrated, which is very important as you labor. I am a certified birth doula, postpartum doula and childbirth educator serving clients in Boise, Eagle, Meridian, Nampa, and the Greater Treasure Valley. Are you planning a hospital birth? Discover how the continuous support of a doula can help keep you calm and relaxed in labor. elevated birth
Copyright 2019  What is it about pregnancy that invites other to share their birth horror stories? You announce your pregnancy to your family and friends, and it begins: you are subjected to birth horror stories. Sometimes others recount stories that aren’t even theirs--- they may share with you a scary news article they just read, or a third-hand account of someone else's traumatic birth experience. What is it about pregnancy that makes others want to share negative news? When you announce an engagement, people don’t start telling you about their marriage problems. When you share the news about a work promotion, they don’t dump on you about their own workplace drama. But pregnancy seems to open an invitation to others to give you unsolicited advice and warnings. Negative comments from others can interfere with your ability to keep your own worries and anxiety at bay, or to simply enjoy your pregnancy. And when the negative stories are related to your personal birth choices or preferences, or used as a way to discourage you or shame you for those choices, the emotional impact can be great. Here’s how to deal with those birth horror stories: 1. Understand the motivations behind sharing them. There are several reasons why people overshare the negative aspects of birth. Often they just want to connect with you, and they feel that sharing the hard parts of pregnancy and birth is a way to do it. What they don’t realize (or remember) is that you’re still in it! You’re pregnant and haven’t given birth to this baby yet. Even if this isn’t your first birth, each pregnancy and labor are unique and you really don’t know how it will go until you actually give birth. Sometimes people haven’t yet processed their own birth trauma, and instead of speaking to someone who can help them work through it, they are dumping their negative feelings onto you. Perhaps their concern for your well being creates a need in them to tell you about what can go wrong, as if speaking it aloud is all that’s needed to keep you safe. Some people are talkers with no filter. They see that you’re pregnant, and they blurt out all of the pregnancy-related things they know, even if they are negative. They don’t think about the impact on you. And sometimes, people just think they know more than you, and know what’s best for you. But they aren’t you. This is your pregnancy, and your baby.  2. The story is incomplete. Someone can tell you something negative about their birth experience with all the gory details, but here's what you may not know:
You don’t have all the facts about someone’s birth story. What’s missing may explain what contributed to a negative outcome, or their negative feelings about their birth. I'll say it again: Every pregnancy and labor are unique. Even if you have the same care provider as someone else, birth at the same location, at the same time of year under the same full moon, your experience is uniquely your own. 3. Consider the source. There are aspects of birth that can be painful, uncomfortable, and difficult. Knowing what to expect during labor and during your postpartum recovery, learning about the warning signs so you know when to seek medical care or when to see a specialist-- these things are valuable and important to share. But there is a difference between education and fear-based story telling. Consider who is giving you the information-- what is their knowledge of birth, of perinatal research, the policies and practices of your care provider, or of your unique medical history? Very rarely does an event or experience have only negative aspects. Is the person sharing information with you not aware of or are they withholding the positive aspects of a situation? Your care provider, childbirth educator, doula, lactation consultant, or informed friend may be a more reliable source for information than someone recounting a horror story.  4. Challenging births can still be positive births. You can’t predict or control how your birth will play out. Birth, by nature, is unpredictable. That doesn’t mean it’s necessarily dangerous, or to be feared, or that things will go wrong. And it doesn’t mean that what happened to someone else will happen to you. The way someone else feels about their birth experience, will not have to be the way you feel about yours. Even if you face challenges that you didn’t anticipate or want, or if things veer off course from your birth plan, you can still feel positively about your birth. When you feel informed and supported throughout, when you feel like your birth team cares about you and respects your wishes, when you feel safe and loved, then you are likely to feel more positively about your birth experience. Inductions, Cesareans, very short or very long births, unintentionally unmedicated births, high intervention births, or any birth that didn’t go as desired— these can all still be positive births. Birth is in the eye of the beholder. ************************* Preparing yourself by taking a childbirth education class, knowing your options in labor, choosing a care provider who supports your goals, and surrounding yourself with a strong birth team-- these steps themselves can help to buffer you against others' birth horror stories. You can also just stop them before they start. Change the subject, find an excuse to hang up the phone, or tell your family and friends what you do and don't want to hear when you are pregnant. Surround yourself with what will help you approach your labor with confidence, calm, and joy-- start your positive birth experience now. I am a certified birth doula, postpartum doula, and childbirth educator serving clients in Boise, Meridian, Eagle, Nampa, and the Greater Treasure Valley. Learning about the birth process and having caring, knowledgeable support throughout pregnancy and labor can make or break your birth experience. elevated birth
Copyright 2019  Water immersion in labor has many benefits You can use water in labor, even if you don't plan on a having a water birth!Water is one of my favorite pain management tools in labor. Whether you give birth at home or in the hospital, at some point my clients end up in the tub or in the shower. Here’s why hydrotherapy can be a wonderful option in labor: You can relax! Even for those who aren’t pregnant, a nice, warm bath after a long day of work can make you feel more relaxed and calm. Immersion in water can lessen anxiety and promote relaxation. These same benefits apply when you are in labor. The calming effects of water can actually help with labor progression. When you are feeling relaxed and calm, your body releases endorphins, which promote the production of another hormone called oxytocin. Oxytocin plays an important role in labor, stimulating contractions. (Known as the "love hormone," oxytocin is also involved in attachment and breastfeeding). When the oxytocin is flowing, your labor can progress. Conversely, when you are feeling stressed and anxious, adrenaline is produced, which can interfere with oxytocin production. So taking a warm bath, combined with other relaxation tools such as music, meditation, dim lighting, massage, and self-hypnosis, can help your labor keep a nice, active pattern. Note: In early labor, taking a bath can slow down contractions. This is just fine-- early labor should be a time of rest, since it can take hours or even days to turn into active labor. If active labor is imminent, taking a bath won’t stop it!  It provides pain relief. Water is sometimes referred to as a “liquid epidural.” While water doesn’t take away all sense of pain (although some clients report that at times it comes pretty close), it definitely helps to make the pain of labor more manageable. The website Evidence Based Birth gives a review of the evidence behind water immersion as pain relief in labor. In a meta-analysis of several studies, it was reported that people who labored in water were less likely to use epidurals or spinal anesthesia for pain relief. Submerging your body in water isn’t always necessary. Standing in the shower, with the hot water pointed at the part of your body where you are feeling the most pain or discomfort, is also very effective for pain relief. You can move. While submerged in water, it may be easier to move your body into positions that may be more difficult or uncomfortable "on land," like hands and knees, or in a squat. Being in water can help take pressure off of areas of your body that ache. You may feel more buoyant and lighter, contributing to feelings of relaxation.  It’s accessible. If you are laboring at home, you can use your own bathtub or shower. (In early labor, I encourage my clients to take a bath and then try to sleep for a while, to reserve their energy for active labor.) At the birth center, there are tubs and sometimes showers for your use. And more and more hospitals are offering tubs to labor in (although most hospitals still don’t allow pushing or giving birth in the water). Fortunately for those in the Treasure Valley, both St. Lukes and St. Alphonsus offer labor tubs, either in each room or in a single-use shared space on the labor and floor. Some tubs sport jacuzzi-style vents for additional comfort. For low-risk pregnancies, you can labor in the tub at just about any time, including after your bag of waters has broken, or if you have been induced. When laboring in the hospital tub, the nurses can monitor you intermittently without you having to get out of the water; if you consent to cervical exams, these can often be done in the water as well. (Note that with narcotic pain medications and epidurals, you won’t be allowed to labor in the tub for safety reasons.) You can try it again. At some point, if my clients aren’t planning a water birth, they decide to get out of the tub, either to push out their baby or to continue laboring on land. At this point, I can help them maneuver out of the water and wrap them up in a nice, warm towel so we can try some other comfort measures. Sometimes, my clients decide to try the tub or shower again, and they easily can. With some pain medications, you can have only a certain number of doses, and your mobility may be decreased for a while. With hydrotherapy, you can return to the tub or shower at just about any time during labor. If you are worried about an accidental water birth, your doula and care providers can often get a sense of how close you may be to pushing based on your behavior and sensations you are reporting. We can recommend getting out of the tub to give you enough time to get to the place where you intend to birth your baby. I am a certified labor (birth) doula and postpartum doula serving clients in Boise, Meridian, Eagle, Nampa, and the Greater Treasure Valley. Do you have questions about using water in your upcoming birth? elevated birth
Copyright 2019  Curious about nitrous oxide as pain relief in labor? If you are pregnant, sooner or later you will think about how to manage the pain of labor. Some clients know they want to get an epidural, and others would prefer to either forego pain medication entirely, or see how they feel in labor and make a decision in the moment. Pain management and comfort measures are topics I discuss at length with my clients in our prenatal meetings. When clients want to avoid or delay pain medication, we talk about natural pain relief methods like counter pressure, hydrotherapy, heat therapy, and position changes. When clients are open to pain medications, but want to avoid or delay an epidural or narcotic medication, nitrous oxide can be a great option. Nitrous oxide has been used by laboring people in the United Kingdom, Australia and Canada for decades. The ACNM (American College of Nurse-Midwives) supported its use in a 2011 position statement, affirming nitrous oxide as a pain relief option that fits into the midwifery model of care. While nitrous oxide was once frequently used in United States, in the 1970’s its use declined as epidural analgesia surged in popularity. As of 2017, one report stated that nitrous oxide was available in only around 150 hospitals and 50 birth centers nationwide. Fortunately for those in the Treasure Valley, both major hospital systems, St. Lukes and St. Alphonsus, offer nitrous oxide, also known simply as “nitrous,” in their labor and delivery rooms. With all interventions, there are benefits and risks. Here’s what you need to know if you are considering using nitrous oxide in your upcoming birth: The Benefits of Nitrous Oxide in Labor
The Risks, or Downsides of Nitrous Oxide in Labor
I am a certified labor doula (birth doula) and postpartum doula serving clients in Boise, Eagle, Meridian, Nampa, and the Greater Treasure Valley. Are you considering using nitrous oxide in labor? Would you like more information about it? elevated birth
Copyright 2018  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:
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. elevated birth
Copyright 2018  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:
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! elevated birth
Copyright 2018  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? elevated birth
Copyright 2018  Photo by AZGAN MjESHTRI via Unsplash Today we're going to back to the basics! Doula 101 - The What and the WhyPreparing 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? elevated birth
Copyright 2018  "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! elevated birth
Copyright 2018  Image by Ryan Franco via Unsplash This is a two-part series. Look for the next part coming soon: What this Doula Wants You to Know About Postpartum What this Doula Wants You to Know About Birth1. The way you give birth matters. If the way you give birth matters to you, then it matters. Period. I don't have an agenda and I am not going to tell you what's the best way for you to have your baby. But I know that you may have an idea of what's best for you, and so what is important to you in your birth is what becomes important to me. 2. Who you choose as your care provider matters. If you have opinions on how you want to give birth, make sure your care provider is familiar with your choices, and supports them. Ask them early on in appointments how they will support your choices. Ask the why, the how, and the when. If you aren’t satisfied with their answers, you may want to look for a provider more aligned with your preferences. If you come to form your opinions on birth later in pregnancy, or you change your preferences, that's a common occurrence. It’s rarely “too late” to get a second opinion or find someone more suited to the kind of birth you want. There are a wide variety of providers here in the Treasure Valley and it's likely you can find someone who is supportive of your goals. 3. Your emotional health is as important as your physical health. Childbirth is a normal, natural event, but it’s not without its complications and risks. Your care provider, family, and friends may be focused on the physical health of you and your baby, but know that how you feel about your birth can also have a lasting impact on your overall well being. It may impact how you interact and care for your baby as well. You are likely to feel positively about your birth if you:
4. Your partner’s experience matters. When your partner is well supported, you will benefit. Your partner could be anxious about seeing you in pain, or could feel lost on how to best help you. They could be tired or hungry, and unable to attend to you in the way you need. When we work together in pregnancy, you are both prepared on what to expect. Pressure on your partner is relieved because you know that I will be there to fill in the gaps so that both of you can approach birth with confidence. 5. Your birth story is your own. What happened during your birth, how your baby was ultimately born, the choices you made during pregnancy and labor— these facts can’t explain the complexity of emotions, circumstances, history, physiology, and timing that became your birth story. You are not the same as everyone else who had an epidural, or Cesarean, or went unmedicated, or had a long labor, or gave birth at home. Your partner, doula, family member or care provider may have their own take on how the story went, and that’s okay, too. You can take in their perspectives, but only you know how you felt in the moment. Your experience is valid. 6. I believe in you. I believe in your body’s ability to birth your baby. I believe that you are strong, capable, and fierce. Even when you may not feel that way, when you are feeling vulnerable and scared, know that I believe in you. I really mean this. Birth has a way of wiping out all pretense, all the social barriers and pleasantries we use to protect ourselves in the world fall away. What remains is this raw, emotional state is strength and love and beauty. With every contraction I am witnessing your power. With every difficult decision, I see your concern and love for yourself and your baby. I am in awe of you. I am on your side. I am a certified labor doula and professional postpartum doula serving clients in Boise, Meridian, Eagle, Nampa, and the greater Treasure Valley. Let's talk about how I can best support you in your birth. elevated birth
Copyright 2018 |
Doula RaquelI'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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