 Photo Credit: Katie Emslie via Unsplash It goes without saying that having a baby changes your life. And it’s hard. From the nausea that sets in in early pregnancy, to the aches and pains and insomnia in the last trimester, the toll on your body is great. Add in waking up every few hours to feed your newborn, healing from birth, learning to breastfeed, and a number of postpartum challenges, and you may wonder why we choose to go through any of it. Until you hold you baby close and sniff their soft, sweet head. Or catch those fleeting dream smiles. Or get that first taste of back-and-forth interaction with your baby. The hard stuff is the price we pay for experiencing the overwhelming love and joy of being a parent. In recent years, society has acknowledged the challenges of motherhood. We see photos of celebrities in those ugly-wonderful mesh panties they give you postpartum. We support breastfeeding in public and also understand that breastfeeding isn’t always easy, or preferred, or for everyone. We accept that it’s okay to feel “touched-out.” We are learning to embrace our postpartum bodies. We talk more openly about postpartum depression and anxiety.  Photo Credit: Janko Ferlic via Unsplash This is all good, and necessary. We acknowledge that parenthood, and especially motherhood, involves some sacrifice, physical discomfort, and lack of sleep. This camaraderie gives us permission to release the unrealistic ideal that parenthood should be easy, or pretty, or that we’re the only ones who find it hard. It’s hard but we do it because that’s what the baby needs. The baby needs to grow, stretching out the uterus, and compressing our other organs up into the ribcage. The baby needs us to respond to his cries for hunger several times at night so he can eat and thrive. The baby needs to be born so we labor, and push our bodies to their limits, or undergo major surgery to bring the baby into the terrestrial world. There are things we want to give our kids, like toys, and activities, and quality childcare, and education— so we purchase less of what we might want to give the baby what he or she needs. All of this giving is normal, and instinctual, and a part of being a parent. But there is a piece missing. There are other things the baby needs—and they are actually the things we need.  Photo Credit: Alexandre Croussette via Unsplash As mothers, we overwhelmingly put the needs of our family before our own. And while it comes from a place of love, and from us accepting the “hard stuff,” it isn’t necessarily necessary. Ignoring our own needs can backfire on us. Denying what you need isn’t necessarily what your baby needs. Your baby also needs:
You’ve probably heard the phrase, “Put on your own oxygen mask first.” This is derived from airline safety instructions; parents flying with kids are instructed in an emergency to put on their own oxygen masks before they put on their kids’ masks. Otherwise they might pass out before they can put on anyone’s mask, and then nobody wins. It’s easy to understand the importance of taking care of yourself first, but it can be hard to do. Or easy to point to something simple like getting your hair done occasionally and say that that’s enough. Daily self care is much more difficult. Asking for help can feel impossible to do. Budgeting to see a chiropractor in pregnancy, or a pelvic floor therapist after birth, or hiring a postpartum doula, or a babysitter so you can get some alone time, is completely off the radar for many.  Photo Credit: Luis Quintero via Unsplash But if there is a shift in thought, in both you and your partner, that what you need as a person, is what your baby also needs in a mother— then maybe self care will turn into a family need. Your self care will be just as necessary as diapers, or a carseat, or daycare, or anything else the baby may need. And so it will be planned for and budgeted for. Self care isn’t just okay, it’s necessary. Your care is necessary. Pregnancy and parenthood will always be hard, and exhausting, and challenging at times. But by prioritizing your own needs, you are preventing it from being even harder. I am a certified labor (birth) doula and postpartum doula serving clients in Boise, Meridian, Eagle, Nampa, and the Greater Treasure Valley. Self-care can come in the form of a doula, whether that be during your birth or after your baby is born. elevated birth
Copyright 2019  Congratulations! Time for a doula? You pee on a stick and see two lines. Congratulations, you're pregnant! After telling your partner, and maybe some close family and friends (or maybe you want to tell everyone you know), there are a number of things you begin to do. You Google “pregnancy due date calculator” and figure out your estimated due date. You call your doctor or midwife’s office to schedule your first appointment. You start to look for a doula. What? In the first trimester?! It’s not as crazy an idea as you may think.  Here's why you may want to hire a doula in your first trimester: 1. The doula you want may not be available later in your pregnancy. There is no “right” time to book your doula; it’s a very personal decision. Sometimes you don’t even learn what a doula is or how one can help you in birth until later in your pregnancy. But if you know you are interested in doula support, you may want to start your search earlier rather than later. If you find a doula you really connect with and want to support you, communicating with her before she is booked for your birth month or before she makes vacation plans can ensure that she is available for your estimated due date. Note that birth work has its ebbs and flows; some months I find myself fully booked with births and other months I have no births booked at all. So even if you are approaching your estimated due date and still want to hire a doula, you will likely find one available for your birth. It just may not be the one you thought you would hire. 2. A doula can help you find the right care provider. Many people automatically contact the doctor or midwife they see for their yearly pap smear and begin prenatal care with that provider. Sometimes it becomes clear that your current care provider’s philosophy about birth doesn’t quite align with your own. Or you may decide that the hospital or facility where they catch babies doesn’t offer the amenities or experience you want for your birth. Your doula is familiar with a wide variety of care providers in your area. Want to switch from an OB/GYN to a home birth midwife? Your doula can give you a list of options to investigate. Know you want a hospital birth but aren’t sure which doctor to choose? Or you find out later in pregnancy that you need to transfer care from a midwife to a physician? Your doula can offer care provider suggestions who may be a good fit for your birth preferences and your personality. She can also outline the features and limitations of the different hospitals in your area, to help you narrow down your decision.  3. Your doula works for you the moment you hire her. Early pregnancy is fraught with its own unique challenges: morning sickness (that really should be called all-day or any-time-of-day sickness), constipation, feeling bloated, exhaustion, and food aversions to name a few. Your doula can suggest helpful things to try, alternative practitioners who may be of help, or she might suggest that you speak to your care provider if the issue is medical in nature. Your doula can sympathize with you, listen to your concerns with compassion and understanding, and reassure you that what you are experiencing is normal. Sometimes you just need to vent a little, or get some outside perspective; your doula is there to provide that emotional support. 4. The more established your relationship, the better your doula may be able to help you. When my clients hire me closer to their estimated due dates, we may have time for only one prenatal visit before their birth. When clients hire me earlier in pregnancy, we have time to have two spaced-out, comprehensive visits. Not only am I learning about their birth preferences and helping them sort through their options for labor, but I’m also getting to know my clients. I learn how they interact with each other, and identify their chief concerns and wishes. I get to know their sense of humor, what makes them unique, what motivates them, and how they show concern for their partner. All of this experience and interaction informs how I serve them in labor. And because I get to know them better, I may suggest certain things in labor over others. My support in labor is more tailored to their individual needs. Getting to know my clients helps me help them, and having more time to do this is a great advantage. ******************** Trigger warning: Miscarriage Sometimes in early pregnancy, there is a loss. According to ACOG (The American College of Obstetricians and Gynecologists), early pregnancy loss occurs in about 10% of known pregnancies. Approximately 80% of miscarriages occur in the first trimester. Some clients would prefer to wait until the second trimester, when the chance of miscarriage decreases significantly, or even later, until they begin to think about hiring a doula. This is a valid, understandable choice. The choice to hire a doula in early pregnancy or wait until later on is highly personal and totally up to the expecting couple.  If you do hire your doula in early pregnancy and experience a loss, you can turn to your doula for resources on what to expect and how to cope. The vast majority of doulas will refund to you your deposit, even if your deposit is non-refundable (you can ask your doula before hiring her what is her policy on refunds due to loss). She can offer you support and information on any medical procedures you can expect. She can direct you to resources in your area or refer you to a specially trained bereavement doula who can better support you through this difficult time. *************** Your doula can give you much more than labor support. She is there for you throughout your pregnancy, helping you navigate your way through a time of great change, uncertainty, and ultimately, of great joy. I am a certified labor (birth) doula and postpartum doula serving clients in Boise, Eagle, Meridian, Nampa, and the Greater Treasure Valley. Are you newly pregnant and interested in doula support now? elevated birth
Copyright 2019  Finding a caregiver who respects your parenting choices is key Whether you are looking at a return to work after maternity leave, or just need a sitter for an occasional date night, leaving your baby in someone else’s care for the first time can seem like a daunting task. Will they be safe? Will they get the same level of attention as they get from you? What if they don’t take a bottle? Will they cry? Will you cry? Here are five things to consider when finding a caregiver for your baby: 1. Determine the type of care you need and want. You will have different expectations of an occasional babysitter than that of a full time caregiver. It may not matter that an occasional sitter has a little trouble putting your child to sleep at his usual time, because his routine isn’t greatly affected by one late nap. However, you may want a regular caregiver to follow the same routine as you do at home. Depending on your budget, your child’s needs, and your personal preferences, you may be looking at the following types of care:
2. Get referrals and check references. When looking for care, ask your friends, family members, and neighbors for referrals. No matter what kind of care you are looking for, if you can get a referral from a family who has had personal experience with a caregiver, you may have more peace of mind about leaving your child with them. If you can’t get personal referrals, you can get referrals from local parenting groups, or you can view ratings on child care sites like care.com. You can use a child care agency; they screen their caregivers in advance, conduct background checks, and may require them to have a minimal level of experience or training. When you find potential caregivers, ask for references from families with whom they have worked in the past. If they can’t or won’t offer references, this can be a sign that they are inexperienced or have had negative experiences you may want to avoid. 3. You make the decisions. You have the right to choose a caregiver who will respect your parenting choices, including how and when to feed your baby, how to respond to crying and other cues, how their sleep is structured (or unstructured), how often they are held, how they comforted, how they are disciplined, and more. Look for child care providers who will work with you to accommodate your preferences. Sometimes they may have limitations due to the number of children they care for. Know which areas are the most important to you, and find a care provider who can meet your needs in those areas. When your care provider is a family member, your parenting choices should be respected. A family member who ignores your instructions may not be the best person to watch your child, even though they may be more emotionally attached to your baby than a professional caregiver. Also consider an out-of-home caregiver’s policies on dropping in to see your child. If a facility limits your ability to visit your child, or requires advance notice, this may be a red flag that they will present a different picture to you of the care your child is receiving when you are not around.  4. Ease into a schedule. If you have the flexibility, consider leaving your baby for small increments of time with their caregiver, and build up to a regular schedule over a period of weeks or months. This period of transition will help both you and your baby get used to being apart. A slower approach can also apply to occasional or part-time care. Have your sitter watch your child in your home while you are there before you leave your baby alone with them for the first time. The sitter can become familiar with your home and the baby’s routines, the baby won’t consider the sitter a stranger, and you will get a sense of how the sitter will care for your baby when you are gone. If you are breastfeeding, easing back into work may help you maintain your breastfeeding relationship while you pump to build up a supply. It may also give a baby who is reluctant to take a bottle time to adjust to a new method of feeding.  5. Consider alternatives. Sometimes, the needs and priorities of your family change after your baby is born. When pregnant, you may have had a plan to return to work after six weeks but now that your baby is here, you feel you need an extended maternity leave. Or maybe you planned on hiring a nanny, but you found an in-home daycare that seems like a better fit. Some families re-evaluate their need for a two-income household, and one parent decides to stay home to care for the baby full time. Or one parent transitions to work from home for a time, to be more available to help with child care. If you find yourself re-thinking your child care needs, there are many options available to parents these days. Start a discussion with your employer about what flexible options may be available to you. Examine your family budget to see if one or both parents can stay home with the baby, or work from home for a while. See if a family member is available to help out on a regular basis. Make the choices that are right for you new family, even if those choices are different than what you thought they would be when you were pregnant! I am a certified labor doula (birth doula) and postpartum doula serving clients in Boise, Eagle, Meridian, Nampa, and the greater Treasure Valley. Planning for birth and postpartum can be just as stressful as choosing child care. Find out how a doula can help you as you bring your new baby into the world. elevated birth
Copyright 2018  Photo by Picsea via Unsplash  At some point in just about every baby shower, the mother-to-be opens her gifts as the attendees ooh and aah over adorable outfits, the latest innovations in baby gear, and preciously impractical baby shoes. There are diaper cakes, and Costco-size boxes of diapers and wipes; those who have already had babies remark that even all of those diapers will last just a few weeks. There are generously-loaded gift cards, and practical items like nipple cream and wash cloths. Occasionally there is a present for the pregnant person as well, like a gift certificate for a pedicure or a prenatal massage. What isn’t gifted very often, however, is what very well may be needed the most: support. Not hugs and encouragement, although these things are wonderful to give. The support I’m referring to is the in-the-trenches, middle-of-the-night, time-intensive, utilitarian, hands-on support that anyone needs when going through a major life transition.
Often a family member or friend can do a couple of these things once or twice. Sometimes these needs can be met consistently by one person. But all too often, new parents are left on their own to figure it all out. What if they didn’t have to? What if in addition to the dozens of outfits the baby may wear just once, each person attending the baby shower committed to bring a home-cooked meal to cover the first month after the birth? Or to go grocery shopping once a week? Or what if they each contributed toward a postpartum doula fund? What if someone who was able to contribute a larger amount purchased a couple night’s worth of sleep in addition to the fancy new stroller? Or what if a few friends pitched in to cover a portion of birth doula costs, so the expecting couple are able to labor and birth their baby feeling supported, emotionally safe, and confident? Perhaps then the sleepless nights and disorganized house wouldn’t feel so overwhelming? That in-the-trenches support that is so needed, and that a doula is trained to provide, cannot be wrapped in beautiful paper. It can’t be seen, or always understood, even by the expecting couple themselves. But it can be felt, and it is always needed. Whether it’s given by a professional like a birth or postpartum doula, or a family member or friend with the heart of a doula, the support that keeps new parents fed, rested, and feeling secure is always needed, as long as it’s given in a way that respects their autonomy and preferences. * * * * * * * * * * * * Many of us did not have this kind of support when we had our babies. And we survived, right? Well, some of us barely did. Some of us had a really, really, hard time. And is surviving the standard for new parents who are nurturing and growing a tiny human being? Shouldn’t those we love who are in that position thrive in their new role instead of just survive? Expecting parents: Ask for the boring gift of support. Be specific in what you need. Don’t be afraid to ask for help. Gift givers: Go ahead and buy the newborn tutu. But also be boring. Get in the trenches, and if you cannot, give the gift of someone who can, like a doula.  I am a certified labor (birth) doula and professional postpartum doula serving Boise, Eagle, Meridian, Nampa, and the greater Treasure Valley. Did you know that you can add Elevated Birth doula services to your baby registry? We now offer gift certificates in any denomination ($50 minimum order). elevated birth
Copyright 2018  What will you choose to "see" in labor?  Visualization is a proven tool commonly used by professional athletes, corporate leaders, speakers, and marathon runners that is free, effective, and powerful. It can also be used by anyone birthing a baby, in any setting, in any position, for any type of birth. It's one form of childbirth preparation you can do just about anywhere. Visualizing a specific action has been shown to activate nervous system responses that are similar to actually performing that action, impacting your heart rate, blood pressure, and hormones. Visualization can help you stay calm and focused in a challenging situation; it can reduce physical symptoms of stress and anxiety and promote feelings of relaxation. Consider this tool a “mental rehearsal” for your birth. You can visualize the entire process, from imagining yourself feeling the earliest labor signs, to arriving at your birth place, to pushing out your baby and bringing her to your chest. Or, you can focus on just one thing, like your cervix opening up or your baby descending. Whatever you choose to visualize, keep the following tips in mind: Practice throughout your pregnancy. You won’t get the benefits of visualization from trying it out once or twice. Make the time to practice your visualization often throughout your pregnancy, so when you are actually in labor, it is familiar to you and easy to go back to when you need it. Get creative. Some people find it helpful to imagine their actual uterus pushing baby down with each contraction, or to imagine their baby’s head pressing against their actual cervix, thin and ripe. Others prefer to imagine something more abstract or metaphorical, like a flower opening, or waves crashing. Some may find an image of themselves passing through a barrier representative of “moving through” contractions, and in turn they become an active participant in their labor rather than a passive onlooker. And some choose to visualize something completely unrelated, like their favorite vacation spot, or some other peaceful location. Personalize your visualization so that it works for you. Break it down into steps. Whatever you choose to visualize, break it down into small steps. For instance, if imagining a flower opening, you might visualize each petal of the flower slowly unfolding until you can see the center. If imagining ocean waves, visualize the wave building far from shore, gathering momentum until it crests and then falls against the rocks; see the ocean spray, the bubbling foam, maybe even sand crabs scurrying around as the water is pulled back into the sea. If your visualization can be broken down so it lasts roughly 60-90 seconds— the approximate length of a labor contraction— you will find yourself with a tool you can use to manage each surge. Write it down. Write down the steps of your visualization to help break it down, and to get a clearer picture in your mind’s eye of what you will “see.” Pay attention to detail; incorporate your other senses, imagining what you might smell or hear if you were actually at the ocean, or in a field, or even in your place of birth.  Incorporate affirmations. Think about how you want to feel as you visualize, and tie this into any birth affirmations you may utilize in labor. You might think of your affirmation, or even speak it aloud, as you work through your visualizations. As author and speaker Dr. Wayne Dyer says about the power of affirmations,“I use the inner mantra I am, seeing myself as already having arrived at what I’ve placed in my mind.” During your labor, you might think or say aloud, “I am strong,” “I am open,” “I am calm,” or any number of phrases, while you are actively using your visualization.  You can use visualizations to distract yourself from any pain or discomfort you may experience, even outside of labor. Afraid of needles and about to have blood drawn? Consenting to a cervical check or having your membranes swept? In the OR having your baby by Cesearean? Having an IUD placed? Go to your visualization to distract your mind from your physical discomfort, and bring you back to a more peaceful state. I am a certified labor doula and professional postpartum doula serving Boise, Eagle, Meridian, Nampa, and the greater Treasure Valley. As a doula, I can remind my clients of their visualizations and affirmations and help them have a supportive, positive birth experience. 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  What to do when you're "overdue" I’m a big planner. When my husband and I went to Europe years ago, before we had kids, I researched for weeks to find the perfect hotels and activities within our budget, the trains that would take us from town to town, and how much money we would need for food per city, per meal, all laid out in a tidy spreadsheet that automatically adjusted based on that day’s exchange rate. Fast forward a few years later when we were expecting our first child: I knew that the baby could come as early as 37 weeks, and still be considered “at term,” and so I was prepared for his arrival at 37 weeks. All the baby gear was purchased, the newborn clothes were washed, the diaper changing station was stocked. Months before, we had taken all the classes— childbirth education, breastfeeding education, new parent preparation, and we had our doula booked. I was ready to have this baby. Over a month later, I was still pregnant. What I was NOT ready for, was the waiting. After a positive pregnancy test, one of the first things we learn is our estimated due date. One of the things we tend to ignore is the estimated part. Due dates are not an exact science. The website Evidenced Based Birth gives a whole explanation of how due dates came to be, but in a nutshell, determining your estimated due date based on the first day of your last menstrual period was a technique created in the 1744 in the Netherlands, refined in 1812 in Germany, and then revised again in America in the 1900’s. This method doesn’t take into account the fact that not every woman has a 28-day menstrual cycle, that ovulation can occur earlier or later in a cycle, or that implantation time can vary. Even if you’re aware that going past your estimated due date is normal, it can still be frustrating to be “overdue.” You might be feeling uncomfortable, as your baby is nearly his or her full size and pressing on both your ribs and your bladder at the same time. You might not be getting much sleep, as you wake up several times a night to pee, or you just can’t find a comfortable position to lay in. It can be especially frustrating when your family and friends view your estimated due date as an expiration date, and bombard you with texts and phone calls. When’s the baby coming? You haven’t given birth yet?! When are you getting induced? You look ready to explode!!! These comments and inquiries are NOT helpful. So if you find yourself pregnant at 40+ weeks, here is what to do when you are "overdue:" 1. Assume that you will go to 42 weeks. The mind is a powerful tool. Neuroscientist Robb Rutledge studies human happiness and developed a complex equation to predict happiness in a given situation. According to this New York Times article on his work, “How happy you are depends in large part on your expectations.” So if you expect your pregnancy to go past your estimated due date, you are less likely to be upset or frustrated when the bun in your oven needs a little more time to bake. And if your labor begins near or before your estimated due date, you may be pleasantly surprised. 2. Tell your family and friends that your due date is actually two weeks later. Granted, this is an extreme measure. And if you’ve already announced your estimated due date to your family, to your co-workers, and on social media, it may be ineffective. Just know that there are other ways to share your good news in early pregnancy. You can announce that you are expecting a baby “in October,” or “late fall,” as previous generations once did. If this isn’t your first rodeo, and you experienced the barrage of inquiries with your first baby, then fudging that due date might not sound like a crazy idea after all. 3. Indulge. See all the movies you won’t be able to go see when your baby is here. Take all the naps. Go out to a fancy restaurant, or any restaurant that doesn’t have a kids menu. Get your nails done. Get a massage. Catch up on that show on Netflix you’ve been meaning to watch. Do whatever you want to do, while you have the time and energy to do it. It may be a while before you are in charge of your schedule again, so take charge of it while you can. 4. Take time to savor these last few days with your older kid(s). Taking care of other kids can be exhausting when you are pregnant. You just want to lie down for a few minutes, but they are suddenly resisting naps. They may seem more clingy or needy, and you wonder how on earth you will take care of both a toddler and a newborn?? Flip the script. Your little kid will be a big brother or sister in just a few days or weeks. You won’t have as much time to color together, or get on the floor and play with blocks, or take a walk to the park. Hold their little hands, which will seem huge after your new baby is born. Listen to their stories and field their incredible questions. Allow yourself to enjoy your older kid(s) in this moment, because everyone’s life is going to get a little shaken up when the new baby arrives. 5. Devote some time to postpartum planning. We focus so much on pregnancy, the baby shower, decorating the nursery, and the birth, and tend to neglect preparing for the postpartum period. We often think, “It will all work out” and “We’ll manage” without realizing that a little bit of planning can make a world of difference in how we feel after baby is here. While binge watching A Baby Story, you can:
6. Check in with your doula. Your doula can be a great source of informational and emotional support when you find yourself past your due date. If your care provider is bringing up induction as a possibility, your doula can help prepare you for the process, or let you know about possible options or alternatives that you can discuss with your care provider. She will let you know that you are supported, and that she is there if you have questions or need reassurance. 7. Practice mindfulness. Mindfulness is a skill that can be honed with practice. To be present in the moment, able to acknowledge and accept your feelings—good and bad— without judgment, you free yourself from allowing your emotions to control you. Being mindful can positively affect the way you live your life in general, but in the world of birth and parenthood, its effects are significant. In labor, you can use mindfulness to accept the pain and discomfort you are feeling, and then let it go. This can help immensely with labor progress, with how you react to unexpected challenges, and how you end up feeling about your birth experience. As a parent, you can practice mindfulness while you figure out breastfeeding, when you have to wake up in the middle of the night to attend to your baby, or when your toddler throws a tantrum in the grocery store. So during pregnancy, as you wait for labor to commence, be mindful of what you are feeling. If you are tired, achy, sick of the constant text messages, fearful, or just ready to have this baby, acknowledge what you feel. Accept it, and let it go. Consider it preparation for your new life as a parent. 8. Find the good. What’s good about being “overdue?” Maybe you realize you do get some extra time with your partner as “just the two of us.” Maybe you get to attend that one last social event you weren’t sure you could make. Maybe your best friend from out-of-state will get to be there for the birth, after all. Maybe you know that when labor does start, you will be so thrilled you will welcome contractions instead of fearing them! Find the good in your situation and embrace the wait. I am a certified labor doula and professional postpartum doula serving clients in Boise, Eagle, Meridian, Nampa, and the greater Treasure Valley. Line up your doula now, so that if you go "overdue," you have the support you need! 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 |
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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