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Breastfeeding: Get Off to a Good Start

8/1/2019

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boise breastfeeding
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:
  • The bodily mechanics of breastfeeding, including the hormones involved, breast anatomy, and how breastmilk is produced and transferred
  • The composition and benefits of breastmilk and breastfeeding
  • Your baby’s dietary needs, from birth through the first few weeks or months
  • Your baby’s hunger cues and feeding patterns
  • How to establish a good latch and why this is important
  • Different breastfeeding positions
  • Your dietary needs and postpartum support
  • How your partner can support and encourage breastfeeding
  • Hand expression and pumping and when to start, and breastmilk storage guidelines
  • Alternative ways to feed your baby
  • When and why to supplement with formula or donor breastmilk
  • Bottle feeding, including paced bottle feeding
  • Complications that can interfere with breastfeeding such as tongue tie, Cesarean birth, premature birth, nipple pain, clogged ducts and mastitis, thrush and supply issues
  • Local resources for breastfeeding support
breastfeeding class boise
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.
breastfeeding help boise
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.
boise postpartum doulas
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.

boise lactation support
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?
About Postpartum Doula Support
elevated birth

​Copyright 2019
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When Others Share Birth Horror Stories

4/18/2019

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treasure valley doula
What is it about pregnancy that invites other to share their birth horror stories?
You announce your pregnancy to your family and friends, and it begins: you are subjected to birth horror stories. Sometimes others recount stories that aren’t even theirs--- they may share with you a scary news article they just read, or a third-hand account of someone else's traumatic birth experience.

What is it about pregnancy that makes others want to share negative news? When you announce an engagement, people don’t start telling you about their marriage problems. When you share the news about a work promotion, they don’t dump on you about their own workplace drama. But pregnancy seems to open an invitation to others to give you unsolicited advice and warnings.

Negative comments from others can interfere with your ability to keep your own worries and anxiety at bay, or to simply enjoy your pregnancy. And when the negative stories are related to your personal birth choices or preferences, or used as a way to discourage you or shame you for those choices, the emotional impact can be great. 

Here’s how to deal with those birth horror stories:

1. Understand the motivations behind sharing them.
There are several reasons why people overshare the negative aspects of birth. Often they just want to connect with you, and they feel that sharing the hard parts of pregnancy and birth is a way to do it. What they don’t realize (or remember) is that you’re still in it! You’re pregnant and haven’t given birth to this baby yet. Even if this isn’t your first birth, each pregnancy and labor are unique and you really don’t know how it will go until you actually give birth.

Sometimes people haven’t yet processed their own birth trauma, and instead of speaking to someone who can help them work through it, they are dumping their negative feelings onto you. Perhaps their concern for your well being creates a need in them to tell you about what can go wrong, as if speaking it aloud is all that’s needed to keep you safe.

Some people are talkers with no filter. They see that you’re pregnant, and they blurt out all of the pregnancy-related things they know, even if they are negative. They don’t think about the impact on you.

And sometimes, people just think they know more than you, and know what’s best for you. But they aren’t you. This is your pregnancy, and your baby. ​
natural birth boise
2. The story is incomplete.
Someone can tell you something negative about their birth experience with all the gory details, but here's what you may not know:
  • How were they feeling physically? How did labor feel to them and how did they cope?
  • What kind of emotional support did they have? Were they scared, or did they feel disrespected or abandoned? 
  • How did their partner feel? How did their partner respond in labor?
  • What kind of preparation did they have for labor? Were they informed ahead of time about interventions, alternatives, and their benefits and risks?
  • Was their care provider or the on-call care provider a good fit for the type of birth they wanted? Were they supportive of their choices?
  • How did their labor match their expectations for their labor?
  • Were there complications or extenuating circumstances that affected their birth experience?
  • Did they plan for the postpartum period? Did they have the physical and emotional support they needed? Did they have enough help?

You don’t have all the facts about someone’s birth story. What’s missing may explain what contributed to a negative outcome, or their negative feelings about their birth.

I'll say it again: Every pregnancy and labor are unique. Even if you have the same care provider as someone else, birth at the same location, at the same time of year under the same full moon, your experience is uniquely your own.


3. Consider the source.
There are aspects of birth that can be painful, uncomfortable, and difficult. Knowing what to expect during labor and during your postpartum recovery, learning about the warning signs so you know when to seek medical care or when to see a specialist-- these things are valuable and important to share. But there is a difference between education and fear-based story telling. 

Consider who is giving you the information-- what is their knowledge of birth, of perinatal research, the policies and practices of your care provider, or of your unique medical history? 

Very rarely does an event or experience have only negative aspects. Is the person sharing information with you not aware of or are they withholding the positive aspects of a situation?  

Your care provider, childbirth educator, doula, lactation consultant, or informed friend may be a more reliable source for information than someone recounting a horror story.

boise c-section
4. Challenging births can still be positive births.
You can’t predict or control how your birth will play out. Birth, by nature, is unpredictable. That doesn’t mean it’s necessarily dangerous, or to be feared, or that things will go wrong. And it doesn’t mean that what happened to someone else will happen to you. The way someone else feels about their birth experience, will not have to be the way you feel about yours.

Even if you face challenges that you didn’t anticipate or want, or if things veer off course from your birth plan, you can still feel positively about your birth. When you feel informed and supported throughout, when you feel like your birth team cares about you and respects your wishes, when you feel safe and loved, then you are likely to feel more positively about your birth experience.

Inductions, Cesareans, very short or very long births, unintentionally unmedicated births, high intervention births, or any birth that didn’t go as desired— these can all still be positive births. Birth is in the eye of the beholder.

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Preparing yourself by taking a childbirth education class, knowing your options in labor, choosing a care provider who supports your goals, and surrounding yourself with a strong birth team-- these steps themselves can help to buffer you against others' birth horror stories.

You can also just stop them before they start. Change the subject, find an excuse to hang up the phone, or tell your family and friends what you do and don't want to hear when you are pregnant. Surround yourself with what will help you approach your labor with confidence, calm, and joy-- start your positive birth experience now.
I am a certified birth doula, postpartum doula, and childbirth educator serving clients in Boise, Meridian, Eagle, Nampa, and the Greater Treasure Valley. 
Learning about the birth process and having caring, knowledgeable support throughout pregnancy and labor can make or break your birth experience.

About Birth Doula Support
elevated birth

​Copyright 2019
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Your Baby Needs This, Too

2/14/2019

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doula in Boise Id
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.
postpartum depression boise
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.
boise postpartum doula
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:
  • A mother who isn’t physically suffering, whether that be during pregnancy or after the baby is born
  • A mother whose choices in birth are respected, even if others don’t understand or agree with them
  • A mother who is not afraid to voice her fears, sadness, or anxiety
  • A mother who gets time to heal
  • A mother who gets some time to herself
  • A mother who gets medical care when she needs it
  • A mother who gets mental health care when she needs it
  • A mother who gets social time
  • A mother whose needs are recognized and met

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.
boise obgyn
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.
About Birth Support
About Postpartum Support
elevated birth

Copyright 2019
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Why You Might Want to Hire a Doula in Early Pregnancy

1/29/2019

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doula in Boise Idaho
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.
boise pregnant
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.
boise obgyn
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.



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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.
miscarriage help boise
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.

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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?

Let's Connect!
elevated birth

​Copyright 2019
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5 Tips for Finding a Caregiver for your Baby

12/27/2018

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boise daycares
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:
  • A postpartum doula works in your home, caring for you and your entire family. While postpartum doulas typically don’t watch your children while you work or leave the home, they do help in caring for babies and older children while you are in the home so you can sleep, shower, exercise, or take some time for self-care. They are trained in all aspects of the postpartum period, from newborn care, to breastfeeding support, to help in spotting the signs of perinatal mood disorders. They support the entire family, and typically work with a family on a short term basis.
  • A mother’s helper does not usually have formal training, and works at your direction to care for your children while you are in the home. Mother’s helpers are usually employed on a part-time basis.
  • A babysitter is similar to a mother’s helper, only a babysitter usually watches your children while you are outside the home. Some babysitters have taken child care courses and some are CPR certified. They usually care for your children on an occasional or limited basis.
  • A nanny works in your home, caring only for your children while they are there. (Some parents nanny-share, where the nanny works part-time for their family and part-time for another family).  A nanny can be an independent contractor or a household employee. A nanny should follow all of your parenting preferences. They are not licensed by the state, but may have independent training or certification in CPR and basic first aid.​
boise nannies
  • An in-home day care is typically smaller than a day care facility, and may or may not be licensed by the state. When licensed, there are regulations regarding caregiver to child ratios. There may be only one caregiver on site, or there may be multiple caregivers depending on the number and ages of children. Each in-home day care varies on their policies regarding illness, vacation closures, and their ability to accommodate your preferences for feeding, sleep schedules, and parenting style. Your child will likely be exposed to children of various ages.
  • A day care center provides full time care in a facility outside of the home. The caregiver to child ratio is highest in this setting, as they care for more children. The facility will be licensed by the state; caregivers will be screened by the daycare operator. Depending on the facility’s capacity and policies, they may or may not be able to accommodate your preferences for individual attention, feeding, and sleep schedules. Your child will likely be exposed to other children her own age, as children are usually grouped by age.​
​
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.
daycares in boise
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.
boise postpartum doulas
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.
More About Doula Support
elevated birth

​Copyright 2018
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Embrace the Parenting Season You're In

11/1/2018

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boise doulas
These gorgeous photos are courtesy of Natalie Koziuk Photography. Clients of Elevated Birth get discounts on sessions with Natalie! 
Find Out More

New Baby? Pregnant? Trying?
​What's Your Season?

back to work new baby boise
Fall is in full swing here in the Treasure Valley. The hardwood trees are showing off their splendent colors like a proud peacock, while the evergreens are happy to provide an understated contrast to their brilliance. The air is crisp in the morning, but often mild enough in the afternoon to encourage bathing in the warm light of the sun. 

This is the season for pumpkins, and jewel tones, and scarves and boots. It’s also the season of extending the time between shaving my legs a little (okay, a lot!), and sleeping in as long as possible in the mornings because it’s dark outside, and then without fail, rushing on our way to school.

The seasons are a time of transition, of moving from one state of being to another. The same is true of the seasons of our lives, especially when we have children. When we transition from not pregnant to pregnant, from pregnant to raising a newborn, through toddlerhood, teething, returning to work, deciding to stay home, our relationship without kids and then with kids—these seasons look different because they are different.

We make different choices; we approach life differently than we did last season. We are, in many ways, different people.

And despite what social media presents, or what your friends are doing, or what your critical inner voice is telling you, it’s okay to just embrace the season you are in. Here’s how:

1. Identify your season.
After I had my first child, I gave away all of my high heels. I decided I was going to quit my corporate job to stay home with him, and since my Friday nights now looked exactly the same as my Tuesday mornings— in yoga pants and flats— they were just taking up space in my closet. Purging a small section of my closet felt like a big step toward embracing my new life.

What season are you in? Are you getting out as much as possible before your baby arrives? Are you hunkered down at home with eternally sick toddlers? Are you freezing breastmilk for an upcoming return to work? Are you trying to get pregnant?

When you recognize where you are, you can then:

2. Accept both the joys and the limitations.
I miss breastfeeding. It surprises me to say it now, because my daughter never took a bottle and wanted to nurse all the time, until she was almost two years old. Dinnertime was the hardest, because she always wanted to be on my lap nursing and I could never seem to finish a hot meal.

In that season, eating my dinner without a child attached to me wasn’t possible. But being able to comfort her in a way only I could, was. In that season, my dream to pursue doula work wasn’t possible for our family. But now that my kids are older and don’t need me in that way, I’m able to help other families as they begin their early parenting journeys.


Each season has its joys and limitations, even if you aren’t always able to see them until you’re out of it. So,

It’s okay to let the dog hair accumulate on the floor because nursing a newborn takes forever, and a shower was more important than spotless floors.

It’s okay that all you did today was hold your baby. That was all you needed to do. Everything else really could wait.

It’s okay that your body looks different than it did before. It’s a different body, an amazing one, that grew and birthed a human! And in three months, one year, or three years, it will be a different body again because you will be in a different season.

boise doulas
Photo credit: Natalie Koziuk Photography
3. Say no to what doesn’t fit into this season.
When you say no to one thing, you are often saying yes to something else. And vice versa. Only you and your partner can determine what does and doesn’t fit into this season.
  • If you say no to hosting visitors, maybe you are saying yes to getting enough rest and sleep.
  • If you say yes to a messy house, maybe you are saying no to added stress and physical strain.
  • If you say no to allowing a particular person into your birth space, maybe you are saying yes to establishing healthy boundaries.
  • If you say yes to giving your baby a bottle, maybe you are saying no to neglecting your own mental or physical health.
  • If you say no to returning to work right away, maybe you are saying yes to establishing breastfeeding.
  • If you say yes to the expense of outside help, maybe you are saying yes to more time to take care of yourself.

And so on. Embracing your season means making choices that align with what you want and need from this time.


And when the next season begins to unfold, take a deep breath and open your eyes to the beauty to be found at any time. Even in the biting cold of winter there is warmth in the nuzzle of a baby's soft cheek. At any time, this amazing, exhausting, incredible world of parenting has so much to embrace.
I am a certified labor doula (birth doula) and professional postpartum doula serving Boise, Eagle, Meridian, Nampa, and the Greater Treasure Valley. What season are you in?
Do you need support for an upcoming birth, or help with your new baby?
Let's Talk!

​elevated birth
Copyright 2018
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Five Facts About Newborns You May Not Know

9/20/2018

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Postpartum Doula Boise
He will teach you what you need to know
newborn Boise
One minute they are in your body, the next minute they aren’t. It’s pretty insane when you think about the moment of birth, when the baby who grew from a speck of cells inside of you, is now an individual, still very much dependent on you, but now distinctly their own--although tiny--person.

Experienced parents will tell you that babies are born with a particular personality, and that looking back, traces of that personality were evident as early as birth. Some strong-willed tots emerged from the womb with mighty wails from their freshly-initiated lungs, and more pensive kids met the world with a quiet awareness. It’s one of the greatest lessons I personally have learned as a parent— that there is so little about my children that I can control. They are who they were when they were born.


Still, newborn babies share many common characteristics. The various newborn reflexes that have been identified are the same in babies the world over. Many of these reflexes are designed as survival mechanisms, or to facilitate finding and latching onto the breast.

Newborn sleep cycles, those initial smiles and coos, the surprisingly tight grasp of a baby’s hand around your finger (or strand of hair— ouch!) We take classes during pregnancy and read books to prepare ourselves for life with a newborn, but often most of our learning comes from on-the-job training. They teach us how to be their parents.

And there are some things the books don’t tell you, or even if they did, you may have glossed over. So here are five newborn facts you may not know, that may help you as you meet and learn to care for your new baby:


1. Babies sometimes take a while to breathe.  When babies are born, it can take about ten seconds—sometimes longer— until they begin to breathe with their lungs. Because the umbilical cord is still attached to the placenta, which at this point, is still attached to your uterus, your baby continues to receive oxygen through the blood that is traveling from the placenta to your baby. As soon as the umbilical cord is cut, the placental oxygen supply is cut as well. (This is one reason why parents and care providers choose to delay clamping of the cord, so that baby receives as much blood from the placenta as possible.)

Babies can appear blue or purple in color for minutes after birth; once their bodies are fully oxygenated, they begin to “pink up.” Parts of their bodies, especially their extremities, can still appear bluish after birth, but this usually improves after their circulatory system begins to mature.



2. Babies benefit from the breast even before your milk comes in. Your breasts don’t begin to fill with milk until around 2-3 days after birth, sometimes even longer. However, babies benefit from latching onto the breast as soon as they are born, if possible, and then every few hours after that.

At birth (and sometimes during pregnancy), you produce colostrum, a concentrated form of early breastmilk that contains antibodies and nutrients. Even though it may not seem like they are getting much from the breast, colostrum is usually all your baby needs until your milk comes in. Plus, the very act of sucking at your breast puts in your baby’s “order” for milk later on. The more your baby latches on, the more your body gets signals to produce milk. So if you intend on breastfeeding for any length of time, have someone help you get a good latch going and get lots of nursing practice!



3. You may want to opt out of that first bath. Not yours— a nice, hot shower after labor can feel like heaven! I’m talking about your baby’s first bath. Many hospitals have changed their policies to delay bathing newborn babies for at least 24 hours, or not at all. Here are some reasons why you may want to wait to bathe your baby:
  • Some babies are born with vernix caseosa (known simply as “vernix"), a thick, white substance coating your baby’s body. Vernix has antibiotic properties, and along with colostrum, can help protect your baby’s vulnerable immune system. You can rub it in like lotion, or wipe off areas that may have been stained with baby poop. (Note: later-term babies tend to not have vernix at birth, and that’s perfectly normal!)
  • The stress hormones released by the bathing process can cause baby’s blood sugar levels to drop, which may have a negative impact on feeding.
  • The more time a baby spends with his parents, bonding and breastfeeding, the greater the rates of breastfeeding success. Oxytocin, the hormone responsible for contracting the uterus during labor, is also called the “love hormone,” because it plays a role in bonding with your baby, bonding with your partner, and breastfeeding. Delaying that bath keeps the oxytocin flowing.

4. Newborns are noisy. Your baby's cries can feel like the loudest sound on earth. But newborns are noisy when they sleep, too. They grunt and grimace, whimper and yelp. All while they are sound asleep. While it is important to respond to your baby's cries and offer immediate comfort, you may be unintentionally waking a baby who is actually asleep!

If your baby is due for a feeding soon, look for cues like rooting or sticking their hands in their mouths. These are more reliable sign of hunger than the noises you hear when they are actually asleep. If you co-sleep with your baby, you may find that you become more quickly familiar with the noises she makes, and begin to anticipate your baby's needs before she begins to cry.


5. Newborns learn with their hands. You may look back on photos of you as a baby, hands covered by cotton drawstring baby mittens, and assume that mittens are a must for your baby registry. This thought is confirmed when your baby’s dagger-like nails are already scratching up her cheeks with red marks just days after birth. Or maybe you feel she needs mittens to keep her hands warm.

However, baby development experts now advise to ditch the mittens. Babies learn by touch, and when their hands are covered by mittens, they miss out on valuable tactile learning time. Instead, use a baby nail file to shorten and smooth out their nails, and allow them to explore their new world through their sense of touch.

​So let those baby hands free!

baby registry boise
Let those baby hands free!
I am a certified labor(birth) doula and professional postpartum doula serving Boise, Eagle, Meridian, and the greater Treasure Valley. 
Need help preparing for birth or need help with your baby? Let's talk!
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The Boring Baby Shower Gift That is the Best Gift

8/30/2018

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Baby shower Boise
Photo by Picsea via Unsplash
Boise postpartum doula
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.
  • Who will prepare nutritious, diet-sensitive, warm meals on a regular basis? Or who will coordinate a team of friends and family to do so?
  • Who will take a crying baby to the mother at 2:00am to be fed, then change the baby and rock him to sleep so she can sleep just 30 minutes longer? And then do it again at 4:00am?
  • Who will tidy up the house and fold the laundry, then stop to help her latch the baby onto her breast?
  • Who will show the parents how to bathe their baby? Who will answer their many questions throughout the day, about sleep, and pumping, and pacifiers? Who will listen to their worries and assure them that they are doing a great job?
  • Who will walk the dogs and scoop the cat litter?
  • Who will sit with her as she pours out her heart because the birth didn’t happen like she hoped, or because she didn’t think it would be this exhausting?
  • Who will help organize the diaper bag and who will go with her and the baby to doctor visits?
  • Who will do all of these things more than once, for more than a couple of days, for several times a week?

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.

Boise baby shower
​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).
Find Out More
elevated birth
​Copyright 2018
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Visualize Your Positive Birth

8/20/2018

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Boise doulas
What will you choose to "see" in labor?
Visualize labor Boise
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.
Doulas in Boise
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.

Birth affirmations boise
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.

Find Out More
elevated birth
​Copyright 2018
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Who Gets to Be at Your Birth?

7/31/2018

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

Who will be invited to your birth?

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

Can you relate to any of the following scenarios?

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

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

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


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

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

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

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

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

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

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

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

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

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

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

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


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

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

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

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


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

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

    I've worked in the forest, in the lab, and in an office cubicle. My favorite and most passionate work has been alongside clients as they reach inside to find their innermost strength, and give birth to their babies. Each birth is an honor to witness.

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