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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
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​Copyright 2019
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Water Isn't Just for Water Birth!

1/10/2019

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natural birth Boise
Water immersion in labor has many benefits

You can use water in labor, even if you don't plan on a having a water birth!

Water is one of my favorite pain management tools in labor. Whether you give birth at home or in the hospital, at some point my clients end up in the tub or in the shower.

Here’s why hydrotherapy can be a wonderful option in labor:

You can relax!
​
Even for those who aren’t pregnant, a nice, warm bath after a long day of work can make you feel more relaxed and calm. Immersion in water can lessen anxiety and promote relaxation. These same benefits apply when you are in labor.

The calming effects of water can actually help with labor progression. When you are feeling relaxed and calm, your body releases endorphins, which promote the production of another hormone called oxytocin. Oxytocin plays an important role in labor, stimulating contractions. (Known as the "love hormone," oxytocin is also involved in attachment and breastfeeding).

When the oxytocin is flowing, your labor can progress. Conversely, when you are feeling stressed and anxious, adrenaline is produced, which can interfere with oxytocin production. So taking a warm bath, combined with other relaxation tools such as music, meditation, dim lighting, massage, and self-hypnosis, can help your labor keep a nice, active pattern.

Note: In early labor, taking a bath can slow down contractions. This is just fine-- early labor should be a time of rest, since it can take hours or even days to turn into active labor. If active labor is imminent, taking a bath won’t stop it!
boise natural birth
It provides pain relief.
Water is sometimes referred to as a “liquid epidural.” While water doesn’t take away all sense of pain (although some clients report that at times it comes pretty close), it definitely helps to make the pain of labor more manageable.

The website Evidence Based Birth gives a review of the evidence behind water immersion as pain relief in labor. In a meta-analysis of several studies, it was reported that people who labored in water were less likely to use epidurals or spinal anesthesia for pain relief.

Submerging your body in water isn’t always necessary. Standing in the shower, with the hot water pointed at the part of your body where you are feeling the most pain or discomfort, is also very effective for pain relief. 

​

You can move.
While submerged in water, it may be easier to move your body into positions that may be more difficult or uncomfortable "on land," like hands and knees, or in a squat. Being in water can help take pressure off of areas of your body that ache. You may feel more buoyant and lighter, contributing to feelings of relaxation.
water birth Boise
It’s accessible.
If you are laboring at home, you can use your own bathtub or shower. (In early labor, I encourage my clients to take a bath and then try to sleep for a while, to reserve their energy for active labor.)

At the birth center, there are tubs and sometimes showers for your use. And more and more hospitals are offering tubs to labor in (although most hospitals still don’t allow pushing or giving birth in the water).


Fortunately for those in the Treasure Valley, both St. Lukes and St. Alphonsus offer labor tubs, either in each room or in a single-use shared space on the labor and floor. Some tubs sport jacuzzi-style vents for additional comfort.

For low-risk pregnancies, you can labor in the tub at just about any time, including after your bag of waters has broken, or if you have been induced. When laboring in the hospital tub, the nurses can monitor you intermittently without you having to get out of the water; if you consent to cervical exams, these can often be done in the water as well. (Note that with narcotic pain medications and epidurals, you won’t be allowed to labor in the tub for safety reasons.)



​You can try it again.
At some point, if my clients aren’t planning a water birth, they decide to get out of the tub, either to push out their baby or to continue laboring on land. At this point, I can help them maneuver out of the water and wrap them up in a nice, warm towel so we can try some other comfort measures.

Sometimes, my clients decide to try the tub or shower again, and they easily can.

With some pain medications, you can have only a certain number of doses, and your mobility may be decreased for a while. With hydrotherapy, you can return to the tub or shower at just about any time during labor.

If you are worried about an accidental water birth, your doula and care providers can often get a sense of how close you may be to pushing based on your behavior and sensations you are reporting. We can recommend getting out of the tub to give you enough time to get to the place where you intend to birth your baby.
I am a certified labor (birth) doula and postpartum doula serving clients in Boise, Meridian, Eagle, Nampa, and the Greater Treasure Valley.
​Do you have questions about using water in your upcoming birth?
Learn About Birth Support
elevated birth

​Copyright 2019
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What You Need to Know About Nitrous Oxide in Labor

12/12/2018

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nitrous oxide for labor
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

  • It doesn’t affect the normal progress of labor. Often with an epidural, pitocin (artificial oxytocin) is used to compensate for reduced uterine contractions. Nitrous doesn't interfere with the normal course of labor.  It can also be used at any stage, from early labor to the pushing stage.
  • Your movement is not restricted. Although you may have to remain close to the nitrous tanks to utilize the gas, you can labor in any position: standing, squatting, bouncing on a birth ball, on all fours, etc. While you can lie in bed while using nitrous, you aren't limited to the bed as you would be if you were administered an epidural.​
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  • You are in control. You administer the nitrous oxide yourself by holding your own mask; when you don’t want it anymore, you remove the mask. With other pain medications, like narcotics and with the epidural, if you have a negative reaction you may have to wait until the medication runs its course through your system, or you may not have the option to discontinue its use until after your baby is born.
  • Its effects are immediate. As soon as you breathe in the gas (which is actually a 50/50 mixture of nitrous oxide and oxygen), you begin to feel its analgesic (pain relieving) effects. As soon as you remove the mask, the gas dissipates quickly and its analgesic effects stop almost immediately.
  • It may help you breathe more efficiently. Often people tense up during contractions, and they forget to take the deep breaths which help them more effectively manage their pain. Because you have to take deep breaths into the nitrous mask to get its full effects, you may be better able to regulate your breathing, ensuring you get enough oxygen and helping you to remain calm.
  • It does not affect infant alertness at birth or interfere with breastfeeding. Pain medications like narcotics and the epidural can cause your baby to be “sleepy” at birth, which can delay the initiation of breastfeeding, or result in lower Apgar scores. These effects are not seen with the use of nitrous oxide.​
boise doulas
  • No drop in blood pressure, so no need for an IV. Epidurals cause a decrease in blood pressure. An IV is required when you get an epidural to help keep blood pressure stable.
  • No catheterization is required. When you get an epidural, a catheter is inserted into your urethra to catch urine. There is no such need when using nitrous.
  • No risk of maternal fever. When you get an epidural you are more likely to experience hyperthermia, or a rise in body temperature. Sometimes this manifests as a clinical fever, which can pose risks to the baby.
  • Continuous fetal monitoring is not required. When you get an epidural or narcotic medication, you will be continuously monitored for signs of fetal distress. (With narcotic medication you can usually revert to intermittent monitoring after a time). While this monitoring is usually external, sometimes internal fetal monitoring becomes necessary. No additional monitoring is required when using nitrous.​

The Risks, or Downsides of Nitrous Oxide in Labor

  • Nausea or vomiting. Some people don’t tolerate the gas well, and find that it makes them feel nauseous. If this occurs, you can discontinue its use and move on to another method of pain management. Know that nausea and vomiting are common symptoms in active labor, whether or not you utilize any pain medication.
  • Dizziness. Some people experience an uncomfortable dizziness or lightheadedness. You may choose to stop using the nitrous, and this feeling should go away.​
labor support boise
  • Nitrous oxide doesn’t completely eliminate pain. My clients who have used nitrous explain that they can still feel their contractions, but they feel more relaxed when managing them.
  • You must hold the mask yourself. The laboring person is required to hold the nitrous mask to their own face as a safety measure. If you become too dizzy or faint, the hand holding the mask will naturally fall away from your face, and the nitrous will dissipate. Some people find holding the mask cumbersome or tiring.
  • Long term effects on fetuses and newborns are unknown. While the use of nitrous oxide has been shown to have no effect on newborn alertness, the long term effects of exposure are unstudied. One study showed neurological dysfunction in rodents when given at high doses, and there have been some concerns about harmful reproductive effects from prolonged exposure in heath care workers.
  • Certain populations may have negative side effects. Those with Vitamin B12 deficiency, the MTHFR gene mutation, acute asthma or lung disease, or bowel obstruction are at risk for harmful side effects from using nitrous oxide. Consult your care provider if you fall into one of these at-risk groups.
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?

Let's Talk!
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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Guest Blog Post: 5 Tips Before Your Newborn Lifestyle Session

5/3/2018

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Newborn Photography Boise
Courtesy Natalie Koziuk Photography
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Today, I hand over my blog to talented Treasure Valley lifestyle photographer Natalie Koziuk. Natalie offers full-service photography, specializing in creating a fun, relaxed, low-stress photography experience with a stylish, high-end result. 
My clients receive 50% off a maternity or newborn session with Natalie ($200 value). For a short time, she is offering my clients a fantastic discounted package for maternity,  birth, and newborn photography. Contact me for details!

Check out Natalie's work at 
http://nkoziukphotography.com​. And check out the details on our collaborative Mother's Day Giveaway at the end of this post!

Boise Newborn Photographer - 5 Tips Before Your Newborn Lifestyle Session

​I get a lot of questions about newborn lifestyle photography and what to expect. Let's do a quick refresher on what lifestyle photography is and why I'm completely obsessed with it. 

Let's set the scene. You just brought home your new baby and instantly that little human starts growing (oh, so much faster than we'd like to admit)! What will you want to remember when that little human is all grown? Perhaps those tiny fingers wrapped around yours or how easy their head fit into dad's palms? Possibly the way you and dad looked at him completely in love and thankful that he's finally here? Here's the thing, life as you know it is complete now. The moments and details are what I capture and what you'll love years and years from now. 

Props, beanbags, and wraps oh my!
No need for posing and waiting hours for me to wrap, swaddle, and pose baby on a beanbag. I'll capture your family doing what it does best, being real, raw, and you. Lifestyle photography captures those authentic moments that can’t be planned or staged.

Let's talk wardrobe
Mom, start with what you feel comfortable in first. Either a dress, or something light, comfortable and casual. Light neutrals photograph beautifully, but I don't discourage darker colors mixed in. You’ll want to avoid bright colors like apple red or orange so they don't reflect onto that sweet newborn's face.

Pairing simple basics with textured overlays, such as a robe or a slouchy open sweater are always encouraged. From there you can coordinate the rest of the family.
Newborn Photography Boise Treasure Valley
Courtesy Natalie Koziuk Photography
A sleepy baby
I can't tell you how often I arrive and baby is up and ready to party.  Feeding baby right before your session gives us a good chance we’ll have a sleepy newborn right from the start. If not, no need to stress. More often than not, I'll catch those eyes closed at some point. Bottom line...Whether your baby is awake or asleep during your session, remember that those moments caught on camera happen organically.

Natural light
Keep an eye out in your house where and what time your rooms have the most light. I typically photograph in three areas-- the living room, your master, and the nursery. I ask that you send me photos of your rooms before the session if I don't come to visit you beforehand. Depending on your home, usually around 10am-2pm we get the best light. 

If you only have one room that works, that's great! I’m happily surprised with the sessions I’ve had with only one window to work with. 
Treasure Valley Newborn Photography
Courtesy Natalie Koziuk Photography
Siblings
Usually we'll start with the whole family if big brother or sister is happy and ready to go. If they're not excited yet, I’ll start with baby and we’ll add them in later. Photographers have quite a few tricks to keep things moving right along. Many times, they're so excited about their new role that they'll want to hold and kiss all over their new best friend. If they really don’t want to be involved, I still try my best to get them in the frame. Nine out of 10 times they'll change their mind. ;)
Newborn Photography Boise
Courtesy Natalie Koziuk Photography
Timing is everything 
I always advise parents to contact me in their second trimester to guarantee their session. I leave a healthy gap in my calendar open from before you're due to two weeks after you're due so we don’t miss the sweet spot. I’m in and out within an hour (sometimes 90 minutes) so you can get back to your newborn life as soon as possible. 
Are you excited yet?!  If it’s time to schedule your newborn session let's chat soon. Email me at hello@nkoziukphotography.com or call 208.794.7916 to ask questions or to check availability.
Mother's Day Giveaway
Don't Miss Out!!!
Natalie and I have teamed up to offer a Mother's Day Giveaway! One lucky winner will receive a photo session with Natalie, and a birth planning session and postpartum doula support with me. Visit Elevated Birth on Facebook or Elevated Birth on Instagram for details on how to enter. We will pick a winner on May 10, 2018 so enter now!
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Copyright 2018
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Birth is Better Here!

2/22/2018

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Boise birth doula
What a gorgeous place to birth a baby!
Whether you grew up here or are a recent transplant, if you are expecting a baby in the Treasure Valley, you've picked a great place to procreate. Here's a list of reasons why:

1. Midwives Abound
​ Choosing a midwife as the primary care provider in pregnancy is a choice more and more people are making for their low-risk pregnancies. Midwives view birth as a normal life event, and tend to minimize interventions. Their care is more holistic, incorporating factors like nutrition and the social and psychological health of their patients alongside physical care. Midwives attend home births, births at freestanding birth centers, and in some hospitals.

In Idaho, all midwives are licensed by the state. They can be Certified Nurse Midwives (CNM), registered nurses with graduate education in midwifery, or Certified Professional Midwives (CPM), who are trained through a formal education program or through an apprenticeship. CPM's must pass a national certification exam. In the Treasure Valley, both types of midwives can be found practicing in a variety of venues. There are independent, traveling midwives who primarily focus on home births. There are those who see patients at birth centers, and either attend births there or at patients' homes. And within both major hospitals systems in the Valley, St. Luke's and St. Alphonsus, there are teams of Certified Nurse Midwives (CNM's) who work alongside obstetricians in the labor and delivery wards.

Midwifery and/or home birth is illegal in several states. In other states, poorly-defined or restrictive laws discourage midwives from practicing for fear of prosecution. Even in states where midwifery is legal and regulated, midwives are few in number, or not an option in local hospitals. The abundance of midwives in the Treasure Valley, and the variety of venues and patients they service, is impressive for a population of just under 700,000.
​
2. A Choice in Birth Centers
The Treasure Valley has four freestanding birth centers. FOUR! To put this number into perspective, the South Bay region of Los Angeles, which has roughly the same population as the Treasure Valley, has ZERO freestanding birth centers. You would have to travel in LA traffic for at least 30 minutes (double that in rush hour traffic) to get to the nearest birth center.

Not in the Treasure Valley! From Nampa to Meridian to Boise, you can opt for that middle ground between home birth and hospital birth and have plenty of options to choose from:
Boise
  • Mercy Birth Center http://www.mercybirthcenter.com
  • Treasure Valley Midwives https://treasurevalleymidwives.com
Eagle
  • Boise River Birth Center & Women's Health https://www.boisebirthcenter.com​
Meridian
  • New Beginnings Birth Center http://www.newbeginningsbirthcenter.com

3. The Valley's Hospitals are Growing and Innovating
Maternity services are offered at several locations in the Valley. Family-centered care and patient choice is a focus at the major hospitals.

St. Luke's offers maternity care in Downtown Boise, Meridian, and Nampa. The Nampa hospital is brand new, and offers specially designed family suites, with large labor tubs, refrigerators, and plenty of room for family. Especially innovative is the fact that several of these suites are NICU (Neonatal Intensive Care Unit) rooms, the first of their kind in the Northwest.

St. Alphonsus offers maternity care in Boise and Nampa. The Boise campus boasts a level III NICU, the highest level of neonatal care in Idaho. Its Nampa hospital is also brand new, growing to meet the demands of the Valley's expanding population.

In Caldwell, West Valley Medical Center offers family suites with king sized beds. There is no minimum age for visitors, so younger members of the family can get the opportunity to meet and bond with new babies before they get home. West Valley opened a brand new NICU last fall as well.

4. A Doula for Everyone
The community of doulas in the Valley is growing and thriving. As more people discover doulas, and the important role they play in supporting birth, there has been an increase in their demand. Different doulas service different segments of the population; depending on your specific needs, you can find a doula that aligns with your personality, values, and budget.

Doula associations and partnerships foster cooperation within the doula community, and strengthen and elevate the profession. I am a proud member of the following local doula organizations:
  • Treasure Valley Doulas http://www.treasurevalleydoulas.com
  • Idaho Doula Associates https://www.idahodoulas.com​

4. Finding your People
When illness reaches your family, whether you reach for the elderberry syrup or the Sudafed, there is a group for you. The Treasure Valley offers many different online forums and in-person meet-up groups to help you navigate the world of pregnancy and parenting in a way that speaks to you.

New to the area is Building Villages ​https://www.buildingvillages.org, an organization focused on early childhood development and parent support. Their pilot program for parents of newborns is launching next month. Meeting in Meridian or Boise, the Newborn Groups will meet for 10 weeks and will focus on the practicalities of raising a newborn and parent self-care, and will provide its participants with an opportunity to meet other new parents and build community. For more information, visit https://www.buildingvillages.org/newborn-groups/

5. Just Look Around You
In so many parts of the country, kids just don't play outside anymore. In the Treasure Valley, it's hard NOT to get outside. From the river, to the foothills, to the plentiful parks, this is an easy place to expose your baby to sunshine and fresh air. Getting out in nature is good for your own health and wellness, too.

Birth (and life) is better here!
I am a certified labor doula (birth doula) and postpartum doula serving clients in Boise, Eagle, Meridian, Nampa, and the greater Treasure Valley. 
​How can I help you have a better birth? Let's talk!
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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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"Five stars aren't enough - Raquel is incredible! She made sure that I was informed and comfortable with all of the decisions made both before and during labor. She's an excellent resource for information, and she respected every decision that I made along the way . . . I am so grateful that she was there for me through labor and delivery (and my husband is too!). If we have another baby, she'll be my number one choice of doula." - Alex H.

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