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.
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?
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?
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.
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!
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?
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?
"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!
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 Birth
1. 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.
Whether you grew up here or are a recent transplant, if you are expecting a baby in the Treasure Valley, you've picked a great place to procreate. Here's a list of reasons why:
1. Midwives Abound
Choosing a midwife as the primary care provider in pregnancy is a choice more and more people are making for their low-risk pregnancies. Midwives view birth as a normal life event, and tend to minimize interventions. Their care is more holistic, incorporating factors like nutrition and the social and psychological health of their patients alongside physical care. Midwives attend home births, births at freestanding birth centers, and in some hospitals.
In Idaho, all midwives are licensed by the state. They can be Certified Nurse Midwives (CNM), registered nurses with graduate education in midwifery, or Certified Professional Midwives (CPM), who are trained through a formal education program or through an apprenticeship. CPM's must pass a national certification exam. In the Treasure Valley, both types of midwives can be found practicing in a variety of venues. There are independent, traveling midwives who primarily focus on home births. There are those who see patients at birth centers, and either attend births there or at patients' homes. And within both major hospitals systems in the Valley, St. Luke's and St. Alphonsus, there are teams of Certified Nurse Midwives (CNM's) who work alongside obstetricians in the labor and delivery wards.
Midwifery and/or home birth is illegal in several states. In other states, poorly-defined or restrictive laws discourage midwives from practicing for fear of prosecution. Even in states where midwifery is legal and regulated, midwives are few in number, or not an option in local hospitals. The abundance of midwives in the Treasure Valley, and the variety of venues and patients they service, is impressive for a population of just under 700,000.
2. A Choice in Birth Centers
The Treasure Valley has four freestanding birth centers. FOUR! To put this number into perspective, the South Bay region of Los Angeles, which has roughly the same population as the Treasure Valley, has ZERO freestanding birth centers. You would have to travel in LA traffic for at least 30 minutes (double that in rush hour traffic) to get to the nearest birth center.
Not in the Treasure Valley! From Nampa to Meridian to Boise, you can opt for that middle ground between home birth and hospital birth and have plenty of options to choose from:
3. The Valley's Hospitals are Growing and Innovating
Maternity services are offered at several locations in the Valley. Family-centered care and patient choice is a focus at the major hospitals.
St. Luke's offers maternity care in Downtown Boise, Meridian, and Nampa. The Nampa hospital is brand new, and offers specially designed family suites, with large labor tubs, refrigerators, and plenty of room for family. Especially innovative is the fact that several of these suites are NICU (Neonatal Intensive Care Unit) rooms, the first of their kind in the Northwest.
St. Alphonsus offers maternity care in Boise and Nampa. The Boise campus boasts a level III NICU, the highest level of neonatal care in Idaho. Its Nampa hospital is also brand new, growing to meet the demands of the Valley's expanding population.
In Caldwell, West Valley Medical Center offers family suites with king sized beds. There is no minimum age for visitors, so younger members of the family can get the opportunity to meet and bond with new babies before they get home. West Valley opened a brand new NICU last fall as well.
4. A Doula for Everyone
The community of doulas in the Valley is growing and thriving. As more people discover doulas, and the important role they play in supporting birth, there has been an increase in their demand. Different doulas service different segments of the population; depending on your specific needs, you can find a doula that aligns with your personality, values, and budget.
Doula associations and partnerships foster cooperation within the doula community, and strengthen and elevate the profession. I am a proud member of the following local doula organizations:
4. Finding your People
When illness reaches your family, whether you reach for the elderberry syrup or the Sudafed, there is a group for you. The Treasure Valley offers many different online forums and in-person meet-up groups to help you navigate the world of pregnancy and parenting in a way that speaks to you.
New to the area is Building Villages https://www.buildingvillages.org, an organization focused on early childhood development and parent support. Their pilot program for parents of newborns is launching next month. Meeting in Meridian or Boise, the Newborn Groups will meet for 10 weeks and will focus on the practicalities of raising a newborn and parent self-care, and will provide its participants with an opportunity to meet other new parents and build community. For more information, visit https://www.buildingvillages.org/newborn-groups/
5. Just Look Around You
In so many parts of the country, kids just don't play outside anymore. In the Treasure Valley, it's hard NOT to get outside. From the river, to the foothills, to the plentiful parks, this is an easy place to expose your baby to sunshine and fresh air. Getting out in nature is good for your own health and wellness, too.
Birth (and life) is better here!
I am a certified labor doula (birth doula) and postpartum doula serving clients in Boise, Eagle, Meridian, Nampa, and the greater Treasure Valley.
How can I help you have a better birth? Let's talk!
Chances are, you haven't worn most of the clothes in your closet for months. And you won't for a while, even after baby has arrived. You've accepted this fact; your body is miraculously and beautifully growing another human, after all.
For those interested in maintaining their style throughout pregnancy, there are downright gorgeous maternity clothes available at all price points today. Late into pregnancy, usually comfort wins out over fashion. You may wear the same maternity pants day after day because nothing else fits just right. There is no right or wrong in what to wear during pregnancy.
Yet, many mothers-to-be agonize over one fashion choice: what to wear during labor?
I hear this question posed often. I get it-- when I was preparing to give birth to my first born almost eleven years ago, I wondered the same thing. I wanted to wear something functional, (and not knowing what birth would look like, what constituted functional wasn't clear), I wanted the option to cover private areas I normally didn't show to the public, I wanted to be comfortable, and of course, I wanted to look nice.
Consider these factors when choosing your laboring outfit(s):
Stage/Phase of Labor
Let's get one fact out of the way up front: When you are pushing out your baby, you won't be wearing anything from the waist down, except maybe socks. So be prepared to be naked at showtime.
Below-the-waist (or total) nakedness may feel like the best choice before it's time to push, as well. If you choose to hop in the shower, labor on the toilet, or if your clothes get soiled from bloody show or some other fluid, pragmatism may win out; being naked may just be easier for you to do the work at hand. Often people lose any sense of modesty they thought they had before labor, and just decide to be naked.
Most people start off wearing clothes, however. In early labor, you can wear just about anything. It's wise to wear stretchy clothes that allow you to squat, lunge, get on hands and knees, and get into any position you may want. When things start getting more intense, you may want to get into the tub or shower; if going naked at this point doesn't appeal to you, a bathing suit or sports bra works well.
If you find yourself using the toilet often (a great way to labor and a good sign you are well-hydrated), or if your bloody show is increasing (another sign of labor progress), you may opt to wear a skirt or swimsuit cover-up, like this:
This gives you freedom of movement, unrestricted access from the waist down, but covers your chest and provides some warmth. (Plus, it looks really cool).
When pushing, baby's arrival is eminent. You already know that you will be naked from the waist down. If you are planning to breastfeed, easy access to the breasts is essential at this time. You may find yourself comfortable with your breasts fully exposed at this point, or maybe you prefer a sports bra or pretty bathing suit top or bra, like this:
Even if you aren't planning to breastfeed, easy access to your chest ensures that you and baby get much-needed skin-on-skin time, which sparks a fresh wave of the hormone oxytocin. Oxytocin kept your labor going with contractions, and now, this so-called "love hormone" will help you bond to your new baby, and facilitate breastmilk production. You can always place a blanket over baby, to help keep him warm and to give yourself more privacy.
Place of Birth
If you are giving birth at home, surrounded by people with whom you are comfortable, you may not worry too much about being naked, or what to wear.
If you are in a hospital, where the staff will be virtual strangers, keeping covered as much as possible might make you feel more comfortable. Hospital nursing gowns are free, and readily accessible. You can wear two (one in the back and one in front) to offer maximum coverage. If one gets wet or stained, there are plenty of other gowns available to replace it. They leave much to be desired aesthetically, but function may trump style when you are actually working through labor.
With some advanced planning, you can order custom maternity gowns, from retailers such as: https://www.gownies.com and www.annieandisabel.com; there are also many versions sold on Etsy. The downside to these is that you may pay a high price for an item of clothing you may wear just once.
Losing or Damaging Your Outfit
Depending on the nature of your birth, your outfit of choice may suffer some casualties. A number of bodily fluids may stain or damage the fabric, or require you to take it off for the rest of your labor. Certain medical interventions, like IV's, epidurals, internal fetal monitors, catheters, etc. may necessitate the nursing staff to cut off your clothing.
Whether or not you are willing to lose your outfit may influence if or when you wear it. If you haven't spent much money on it, its loss may not matter to you. Or you may decide to save that expensive silk robe for after the baby is born.
How You Want to Feel During Labor
Clothes do impact the way we feel, even in labor. The scent and feel of your favorite t-shirt, the breeze of a satin bell-sleeved robe brushing against your skin, the dependable support of a sturdy bra, the strength you get from a favorite color-- whatever is pleasing to you at any point in time in labor, is valid and valuable.
Your environment, your support team, your mood, and even what you wear (or don't wear) matters, because what serves you, serves your labor. What impacts you, impacts your birth experience. You matter, and so what matters to you, matters, too.
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.