 Photo Credit: Dave Clubb via Unsplash The benefits of breastfeeding, or providing breastmilk to your baby, are well known. Most of my clients intend to breastfeed for some length of time. What I try to impart in prenatal discussions with clients, however, is that intention is usually not enough to get off to a good start with breastfeeding. Maximizing the breastfeeding relationship also involves education, planning, and knowing where to turn if difficulties arise. 1. Take a prenatal breastfeeding class. There is so much more to breastfeeding than putting baby to the breast. While breastfeeding is a natural process, that doesn’t mean it is necessarily intuitive, easy, or without complications. A good prenatal breastfeeding class should cover most of these topics:
 While you may not retain or need all the information you learn in a prenatal breastfeeding class, you never know what important facts will be helpful as you learn to feed your baby. Misconceptions you may have had will be dispelled, enabling you to use the most accurate information to support your efforts. Plus, it will be much easier to find the time and energy to learn about breastfeeding before your baby is born, rather than while you are recovering from birth and learning to feed your baby, all with limited sleep. 2. Get hands-on help with latch. A good, deep latch is one of the most important factors in establishing a good breastmilk supply. When your baby suckles at the breast, it signals to your body to produce the hormone prolactin, which stimulates the production of breastmilk. Oxytocin is also released, triggering the let-down reflex which expels the breastmilk from the milk ducts. When the latch is shallow, or there is a problem with latching, this hormonal interplay is interfered with and over time, your milk supply and/or baby’s ability to transfer milk from the breast can be negatively affected. Most hospitals offer lactation support, sometimes immediately after birth and in postpartum recovery. Birth center and home birth midwives also help with breastfeeding and latch; during postpartum home visits, midwives assess baby’s weight gain and can make recommendations for additional lactation support if needed.  As a birth doula, I can help my clients with that initial breastfeeding right after baby is born, showing them the hallmarks of a good latch. Or, I can help them to facilitate baby latching on his or her own, either via a breast crawl or with a laid-back breastfeeding position. If there is separation from baby for a period of time, I can help them hand-express colostrum into a cup or syringe that can be given to their baby instead of formula, if that is their preference. And when I visit my clients at home, either at the follow-up postpartum visit or as a postpartum doula, we can continue to work on latch after their milk has come in, trying out different positions. If there are signs of a complication beyond my scope as a doula, I can refer them to a local lactation specialist for professional support and problem solving. Getting frequent, hands-on help with latch can ease anxiety and frustration in the birthing person, possibly avoid supply issues and injury to the nipples, ease pain or discomfort during nursing, and make the experience more enjoyable. 3. Turn to the experts for help. Breastfeeding problems and solutions can be complex and can involve several factors, including breast anatomy, baby’s anatomy, diet and nutrition, hormones, birth influences, emotional and cultural considerations, the need for supplementation, and more. Sometimes, people get advice or help from family members or friends, or even professionals, including lactation consultants, pediatricians, and family doctors, that aren’t based on the latest research. Or the advice doesn’t take into account all of the factors mentioned above that can make breastfeeding issues challenging. They may not be familiar with alternatives or breastfeeding best practices. And they might not have the availability or resources to provide the frequent, hands-on help that nursing people often need. When my clients need breastfeeding help beyond what I can provide, I refer them to the infant feeding experts: International Board Certified Lactation Consultants (IBCLC’s). The requirement to become an IBCLC includes extensive education, over 1,000 hours of clinical experience, and passing a rigorous exam. IBCLC’s know breastfeeding and can help you work through a myriad of problems, with solutions tailored to your individual needs and preferences. See my Parent Resources page for some local IBCLC’s I know and trust. 4. Support for breastfeeding goes beyond actual breastfeeding. Knowing how to support breastfeeding and actually having the support you need to breastfeed are two different things.  When you are recovering from birth and learning to care for your new baby, it becomes much more difficult to learn to breastfeed when you also have to worry about preparing meals, keeping your house in order, caring for older kids, entertaining visitors, or “bouncing back” to a preconceived notion of how your life should look. Anything that adds stress instead of reducing it can interfere with breastfeeding. Making a postpartum plan while you are pregnant, reframing in your mind for what the postpartum period should look like, and enlisting help wherever possible— whether that be from your partner, family and friends, outsourcing tasks, or a hiring a postpartum doula— are all ways to support breastfeeding.  5. Be gentle with yourself in your journey. Breastfeeding doesn’t always go as you plan. Sometimes you find that supplementation, or exclusively pumping, or formula feeding, or sourcing donor milk, or weaning, or some combination of these, is the best choice for you at any point in time. Know that what works for you now may not be what works for you down the road. Know that if you struggle now, that doesn’t mean you will be struggling later. Know that if you hit a snag, there are people in the community who can help. And know that your mental and physical health matters. There is no “right” time to wean, except when you and/or your child are ready. Be gentle with yourself and allow yourself the grace to find your own way. I am a certified birth doula, postpartum doula, and childbirth educator serving clients in Boise, Meridian, Eagle, Nampa, and the Greater Treasure Valley. What kind of breastfeeding help will you need when you have your new baby? elevated birth
Copyright 2019  Photo by henri meilhac on Unsplash I love doula work. I will wake up early on a Saturday morning to finish up a blog post. I will enthusiastically jump out of bed at 3:00am, sneaking into our bathroom so as not to wake up my husband, and help a client figure out if it’s time to head to the hospital. I will hold a client’s emesis bag, get her a cool cloth to wipe her face and jump right back into a hip squeeze. With a smile on my face. But there are some things I won’t do for my clients, and there are good reasons why. 1. Give medical advice. Doulas have a scope of practice; I did not go to medical school or midwifery school and it would be out of line for me to tell you to take a particular medication or supplement, or to ignore the instructions of your care provider. If you ask, I can give you information about medical issues or options, and then you can talk to your care provider about those if you wish.  You hired your doctor or midwife for a reason: to care for the health and safety of you and your baby. You hired me for a different reason: education, continuous labor support, comfort measures, help for your partner, etc. We each have a role, and it’s in your best interest that I stick to mine! Now, if you describe symptoms to me that can be signs of a more serious issue, I’m going to suggest that you talk to your care provider. But again, I’m not diagnosing or treating you. I’m leaving that up to your care provider. 2. Make decisions for you. There is something about being pregnant that makes you and your partner stop and examine what’s important to you. You have to make decisions about what life will look like after your baby is born, what you will change, what you will hold onto. This usually translates into setting up a space for your baby, acquiring gear and supplies, making plans for a temporary or permanent leave from work, taking classes, and thinking about how, where, and with whom you want to give birth. Research is often involved, and as you learn more about pregnancy and your birth options, certain things resonate with you, and you develop your preferences and values. Now, imagine if someone else decided those things for you. They arbitrarily picked your care provider; they told you which hospital you were going to give birth at, they told you which pain medications you would or would not receive and when. They told you that you had no control over what was done to your baby when he or she was born. How would you feel about your birth experience? Empowered? Confident? Positive? Likely not.  When you and your partner make decisions for yourselves, based on what you both value, you are in control of your life. If you aren’t sure about a decision you have to make, you can ask me for information about your options or alternatives, and I can help you figure out the benefits and risks. But the decision should be yours to make. And for me to support wholeheartedly. 3. Replace your partner. First of all, it’s impossible for me to do. Your partner is your primary support person in labor, and in life. They are irreplaceable. Second, I don’t want to replace them! They are an integral part of your birth experience. Their love and presence literally helps with labor progress. They are my clients, too, and we are all on the same team with the same goal in mind. What I can do, is give them a break when they need it. You are more likely to feel relaxed if your partner gets a chance to grab a bite to eat, take a nap, use the restroom, or leave for a few minutes to attend to other kids, or run interference with family members. What I will do, is help them help you more effectively. I will make suggestions on what they can physically do to provide you comfort during contractions. I will give them the space to support you the way only they know how, while I step in when needed. I will reassure them if things veer off course, and make them feel as safe and supported as you feel. Sometimes partners want a more hands-off role, and that’s okay, too. Whatever the two of you need to get through labor, I’m there to provide.  4. Mess with your mojo. Often in early active labor, but sometimes throughout labor and into transition, you are handling labor beautifully. You are in a groove; you need to focus on each contraction, you may be vocalizing or moaning, but your breath is steady, your body is relaxed, and you are doing just fine on your own. I will not interrupt this magic of yours. I may softly let you know I’m there, I may compliment you occasionally, but this is not my show, it’s yours. At some point in labor, it becomes apparent that you may benefit from some physical support, you may need suggestions for a position change, or nourishment, or a reminder to breathe and soften. You may need more vigorous encouragement, you may need your whole birth team to get you through to the next level. And I’m ready to step in exactly when you need it. I am certified birth doula, postpartum doula, and childbirth educator serving clients in Boise, Meridian, Eagle, Nampa and the Greater Treasure Valley. Interested in learning what a doula does (and doesn't do) for you in pregnancy and labor? elevated birth
Copyright 2019  How to make the hospital feel more homey No matter what your birth preferences may be, whether you want an unmedicated birth or you know you’ll opt for an epidural, feeling as calm and unstressed as possible during labor is usually a part of everyone's birth plan. It’s one reason why some people opt to birth at home, where they feel most comfortable and are surrounded by familiar sights, sounds, and smells. This sense of comfort contributes to the production of oxytocin, also known as the “love hormone.” Oxytocin is a crucial part of labor, responsible for uterine contractions, labor progress, attachment to baby, and even breastfeeding. When you are feeling stressed or fearful, oxytocin production is inhibited, and labor can slow or stall. As a doula, I help my clients with relaxation, comfort, and helping their partners support them better (being near your partner, hugging and even kissing in labor can really get the oxytocin flowing!)  Get close to your partner in labor! In a hospital setting, creating that at-home state of relaxation and comfort can sometimes be a challenge. First there is the ride to the hospital— I don’t know of anyone who likes laboring in the car! When you arrive at the hospital, you spend some time in triage before being admitted to your own room. It can take a while for you to settle in and get back into a labor rhythm, which is why it’s not uncommon for contractions to slow or space out a little when you get to the hospital. But when you take steps to a bring bit of home into your hospital birth space, getting back into that at-home state of comfort becomes much easier.  It’s all about the senses Whether we realize it or not, what we see, hear, smell, feel, and even taste can affect our ability to relax. When we bring items from home that appeal to our five senses, we associate what we are experiencing to the comfort of home, even in a hospital setting. Sight Hospital lights can be very bright, or give off an unappealing florescent glow. It can be helpful to close the curtains in your labor room, or to turn off or dim the lights to create a “cavelike” space where you can burrow down and work through labor. You can bring in soft lighting like battery-operated candles, or you can hang up strings of twinkle lights around the room for a more personal touch. Think about the mood that restaurant lighting creates— dim lighting promotes feelings of closeness (hello, oxytocin!) while bright, harsh lighting can be jarring and unnerving.  There may be times when brighter lighting is best. Sometimes in labor the mood becomes stagnant, or tired, and so do the contractions— opening the curtains and letting sunshine in can bring in a needed burst of energy to move around and get labor going again. Sound Even if everyone in the room is silent, the sounds of the external fetal monitor, your blood pressure cuff, or even the air conditioning can cause an unwelcome distraction. Think about what sounds make you feel relaxed at home and bring those sounds with you to the hospital. You can bring in a sound machine, your Hypnobirthing soundtrack, or a playlist of your favorite music downloaded to your phone. Bring earbuds if you want to totally zone out. I recommend that my clients add both relaxing music and upbeat music to their playlists. Sometimes some dance-inspiring tunes are a good way to lift the spirits and get my clients moving in labor. Touch Sense of touch can be very sensitive in labor. Hospital pillows, while functional, are thin and don’t have the highest thread count. Bring your own pillow from home, or your own pillowcase. Consider bringing your own blankets, too (if you are afraid of special items getting dirty, you can save them for postpartum recovery.)  Bring your own clothes to labor in, if you don’t want to put on a hospital gown. Bring your well-worn stuffed animal from childhood, or a lovey you plan to give your baby (these things can serve as a visual focal point as well!) Bring your favorite lotion or massage oil, your favorite chapstick, your favorite pair of socks or fuzzy slippers. Bring your own birth ball to bounce on, that is the perfect size for you and feels familiar. Bring your own cup or water bottle to drink out of. Bring the things you are used to at home that bring you comfort! Smell You know how certain smells can take you down memory lane, remind you of something, or instantly relax or repulse you? The same thing happens in labor, only that sensation can be intensified. Sometimes, scents that usually relax you can become too much in labor, so instead of bringing in a scented plug-in or a diffuser, consider dabbing the scent on cotton balls in a plastic baggie. That way, if the scent becomes too much, you can easily remove it from the labor room. If you bring essential oils with you, make sure you know what possible effects they can have on your labor. Be very careful with oils that you put on your body as well, as some can be dangerous for newborns or can interfere with breastfeeding. Consider food smells, especially if your partner or family members are going to be eating around you. That pepperoni pizza smell that usually makes your mouth water may be too strong of an odor for you in labor. Suggest that visitors eat outside of your hospital room so that food smells don’t linger.  Be cognizant of bad breath, especially for longer labors or labor that lasts throughout the night. I always carry breath mints or chewing gum in my doula bag and offer some to my client’s partner— no laboring person wants to smell stale breath in their face! Taste Bring your favorite snacks with you to the hospital. I recommend high-protein snacks that can be quickly munched on or that can be eaten with one hand. Sometimes something sweet like your favorite candy can be nice when you need a little energy boost. Aside from water, bring your favorite electrolyte drink or juice so you can keep hydrated, which is very important as you labor. I am a certified birth doula, postpartum doula and childbirth educator serving clients in Boise, Eagle, Meridian, Nampa, and the Greater Treasure Valley. Are you planning a hospital birth? Discover how the continuous support of a doula can help keep you calm and relaxed in labor. elevated birth
Copyright 2019  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 |
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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