 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  What is it about pregnancy that invites other to share their birth horror stories? You announce your pregnancy to your family and friends, and it begins: you are subjected to birth horror stories. Sometimes others recount stories that aren’t even theirs--- they may share with you a scary news article they just read, or a third-hand account of someone else's traumatic birth experience. What is it about pregnancy that makes others want to share negative news? When you announce an engagement, people don’t start telling you about their marriage problems. When you share the news about a work promotion, they don’t dump on you about their own workplace drama. But pregnancy seems to open an invitation to others to give you unsolicited advice and warnings. Negative comments from others can interfere with your ability to keep your own worries and anxiety at bay, or to simply enjoy your pregnancy. And when the negative stories are related to your personal birth choices or preferences, or used as a way to discourage you or shame you for those choices, the emotional impact can be great. Here’s how to deal with those birth horror stories: 1. Understand the motivations behind sharing them. There are several reasons why people overshare the negative aspects of birth. Often they just want to connect with you, and they feel that sharing the hard parts of pregnancy and birth is a way to do it. What they don’t realize (or remember) is that you’re still in it! You’re pregnant and haven’t given birth to this baby yet. Even if this isn’t your first birth, each pregnancy and labor are unique and you really don’t know how it will go until you actually give birth. Sometimes people haven’t yet processed their own birth trauma, and instead of speaking to someone who can help them work through it, they are dumping their negative feelings onto you. Perhaps their concern for your well being creates a need in them to tell you about what can go wrong, as if speaking it aloud is all that’s needed to keep you safe. Some people are talkers with no filter. They see that you’re pregnant, and they blurt out all of the pregnancy-related things they know, even if they are negative. They don’t think about the impact on you. And sometimes, people just think they know more than you, and know what’s best for you. But they aren’t you. This is your pregnancy, and your baby.  2. The story is incomplete. Someone can tell you something negative about their birth experience with all the gory details, but here's what you may not know:
You don’t have all the facts about someone’s birth story. What’s missing may explain what contributed to a negative outcome, or their negative feelings about their birth. I'll say it again: Every pregnancy and labor are unique. Even if you have the same care provider as someone else, birth at the same location, at the same time of year under the same full moon, your experience is uniquely your own. 3. Consider the source. There are aspects of birth that can be painful, uncomfortable, and difficult. Knowing what to expect during labor and during your postpartum recovery, learning about the warning signs so you know when to seek medical care or when to see a specialist-- these things are valuable and important to share. But there is a difference between education and fear-based story telling. Consider who is giving you the information-- what is their knowledge of birth, of perinatal research, the policies and practices of your care provider, or of your unique medical history? Very rarely does an event or experience have only negative aspects. Is the person sharing information with you not aware of or are they withholding the positive aspects of a situation? Your care provider, childbirth educator, doula, lactation consultant, or informed friend may be a more reliable source for information than someone recounting a horror story.  4. Challenging births can still be positive births. You can’t predict or control how your birth will play out. Birth, by nature, is unpredictable. That doesn’t mean it’s necessarily dangerous, or to be feared, or that things will go wrong. And it doesn’t mean that what happened to someone else will happen to you. The way someone else feels about their birth experience, will not have to be the way you feel about yours. Even if you face challenges that you didn’t anticipate or want, or if things veer off course from your birth plan, you can still feel positively about your birth. When you feel informed and supported throughout, when you feel like your birth team cares about you and respects your wishes, when you feel safe and loved, then you are likely to feel more positively about your birth experience. Inductions, Cesareans, very short or very long births, unintentionally unmedicated births, high intervention births, or any birth that didn’t go as desired— these can all still be positive births. Birth is in the eye of the beholder. ************************* Preparing yourself by taking a childbirth education class, knowing your options in labor, choosing a care provider who supports your goals, and surrounding yourself with a strong birth team-- these steps themselves can help to buffer you against others' birth horror stories. You can also just stop them before they start. Change the subject, find an excuse to hang up the phone, or tell your family and friends what you do and don't want to hear when you are pregnant. Surround yourself with what will help you approach your labor with confidence, calm, and joy-- start your positive birth experience now. I am a certified birth doula, postpartum doula, and childbirth educator serving clients in Boise, Meridian, Eagle, Nampa, and the Greater Treasure Valley. Learning about the birth process and having caring, knowledgeable support throughout pregnancy and labor can make or break your birth experience. elevated birth
Copyright 2019  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  Curious about nitrous oxide as pain relief in labor? If you are pregnant, sooner or later you will think about how to manage the pain of labor. Some clients know they want to get an epidural, and others would prefer to either forego pain medication entirely, or see how they feel in labor and make a decision in the moment. Pain management and comfort measures are topics I discuss at length with my clients in our prenatal meetings. When clients want to avoid or delay pain medication, we talk about natural pain relief methods like counter pressure, hydrotherapy, heat therapy, and position changes. When clients are open to pain medications, but want to avoid or delay an epidural or narcotic medication, nitrous oxide can be a great option. Nitrous oxide has been used by laboring people in the United Kingdom, Australia and Canada for decades. The ACNM (American College of Nurse-Midwives) supported its use in a 2011 position statement, affirming nitrous oxide as a pain relief option that fits into the midwifery model of care. While nitrous oxide was once frequently used in United States, in the 1970’s its use declined as epidural analgesia surged in popularity. As of 2017, one report stated that nitrous oxide was available in only around 150 hospitals and 50 birth centers nationwide. Fortunately for those in the Treasure Valley, both major hospital systems, St. Lukes and St. Alphonsus, offer nitrous oxide, also known simply as “nitrous,” in their labor and delivery rooms. With all interventions, there are benefits and risks. Here’s what you need to know if you are considering using nitrous oxide in your upcoming birth: The Benefits of Nitrous Oxide in Labor
The Risks, or Downsides of Nitrous Oxide in Labor
I am a certified labor doula (birth doula) and postpartum doula serving clients in Boise, Eagle, Meridian, Nampa, and the Greater Treasure Valley. Are you considering using nitrous oxide in labor? Would you like more information about it? elevated birth
Copyright 2018  Modify your plans, minimize your stress It’s the holiday season, and that means interaction with family members you may see just a few times a year. Even if you have wonderful relationships with your extended family, if you are pregnant around the holidays, conversations can get difficult when talk turns to your plans for birth. Everyone seems to have an opinion to share about what you should or shouldn't do, or they offer a prediction of how your birth will go. Here are five tips to navigate the holidays while pregnant: 1. Modify your holiday plans. Modify your plans, and minimize your stress. If you usually host a family gathering, ask someone else to host this year. Plan on bringing in prepared foods instead of cooking, or make the dinner a potluck event. Can you limit family time this year? Use your pregnancy to your advantage. Perhaps you stay for just a few hours at your sister’s house instead of the whole day. Or take a nap while everyone else is watching football. If you are nearing your estimated due date, your care provider may actually warn against you traveling more than a couple of hours from your home. That means you can avoid a prolonged visit with family altogether, if that is your preference. 2. Prepare for difficult conversations. Chances are, your family members are excited about the new addition to their own extended family. But instead of only sharing in your excitement, they may also feel the need to share their opinions. Conversation will inevitably turn to your pregnancy, and will likely consist of three topics:
If you are making choices for your birth that are different from those your family members have made for themselves, be prepared for push back. You might hear things like, “Just you wait! You have no idea!” or “You’ll change your mind!” If your choices are vastly different, you may even hear things like “You are putting your baby’s life in danger!” or “You are being selfish.” With pregnancy hormones at play, and if you yourself are still navigating your birth options, these conversations can get heated, emotional, and very difficult. If you anticipate these conversations in advance, you can avoid feeling blindsided. You might tell your family before the event (or have your partner tell their family) that you don’t want to have these conversations at all. Or, you may choose to be more selective or vague in your answers to probing family members.  Expect difficult conversations about your pregnancy 3. Practice disengaging. Sometimes these difficult conversations can’t be avoided. Maybe your relatives already know your plans for birth and they are using this holiday gathering as one more instance to voice their disapproval. In these situations, don’t try to defend your choices, or try to convince your family members to accept them. Instead, answer their questions or comments with a neutral phrase, like, “Hmmmmm” or “Huh!” Or you can make them feel heard and say, “You know, that gives me something to think about.” Sometimes, you may feel the need to stop the conversation entirely. You can say, “Thank you for your concern. I don’t want to talk about this anymore.” Or redirect the conversation to another topic: “Okay. Hey, congrats on your promotion. How do you like your new job?”  Do whatever you can to relax during the holidays 4. Make time for self care. Taking care of yourself is always important, but especially so during the busy holiday season. Book a prenatal massage, take a long bath, make time to exercise, or plan a night out with your partner. Enjoy the time you have now that is all yours. Whatever brings you relaxation and calm increases your oxytocin levels. Oxytocin is the "love hormone" that plays a role in labor, attachment, bonding, and breastfeeding. Taking deep breaths, centering your mind, and finding ways to relax amidst the tension around you is also excellent practice for managing labor. 5. Create your own holiday traditions. With a baby on the way, your life will be changing in just a few short weeks or months. Whether this is your first baby, or you are adding a sibling, take the time to reassess what you and your partner want for your growing family. What traditions will you adopt? What will you let go? What is important? What’s not? These answers look different for everyone. They may not fit into what your extended family has chosen. But when you take the time to pause and think about what you want for your own family, the stress and furor that accompanies this time of year lessens-- which makes for a better holiday season, and a better pregnancy. I am a certified labor doula and professional postpartum doula serving clients in Boise, Eagle, Meridian, Nampa and the greater Treasure Valley. This holiday season, ask for doula support! Elevated Birth gift certificates are available in any denomination and can easily be added to your baby registry. elevated birth
Copyright 2018  These gorgeous photos are courtesy of Natalie Koziuk Photography. Clients of Elevated Birth get discounts on sessions with Natalie! New Baby? Pregnant? Trying? |
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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